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This article discusses the implementation of a safety bundle for operative vaginal birth (OVB) and its impact on birth outcomes. The bundle includes routine intrapartum ultrasound, a structured time-out, and a procedural checklist. A retrospective cohort study was conducted, comparing births where the bundle was and was not used. The study found that the use of the bundle was associated with fewer neonates delivered in an unexpected position and a trend towards reduced neonatal morbidity. The authors conclude that the use of a safety bundle for OVB may improve perinatal outcomes. [Extracted from the article]

Singleton arc consistency is an important type of local consistency which has been recently shown to solve all constraint satisfaction problems (CSPs) over constraint languages of bounded width. We aim to characterise all classes of CSPs defined by a forbidden pattern that are solved by singleton arc consistency and closed under removing constraints. We identify five new patterns whose absence ensures solvability by singleton arc consistency, four of which are provably maximal and three of which generalise 2-SAT. Combined with simple counter-examples for other patterns, we make significant progress towards a complete classification.

The main objective of this project about mobile team service extension to the socio-educational home of the whole Vaud canton targets to decompartmentalize the socio-educational and youth-psychiatry domains. 64 patient were assessed during this pilot phase (after one-year functioning). In addition, a satisfaction survey was done either at the end of the follow up or at the end of the pilot phase of the project (31.12.2012). This experience was very positive as highlighted by the vast majority of the person involved in the socio-educational and youth-psychiatric domains taking care of youth. A desire of extension of mobile team service to other institutional structure or other situations was expressed.

Purpose: High variability has been observed in the estimation of the glomerular filtration rate (GFR) in older patients, according to the formula used and no single formula has been recommended to date. The aim of this study was to quantify the precision and accuracy of the GFR estimated by means of three formulas and the measurement of cystatin C., Methods: This prospective study was conducted in an acute care geriatric unit. Participants were patients, aged 70 years and over, having a possible 24-hour urine collection. The GFR was estimated using the Cockroft-Gault (CG), the Modification of Diet in Renal Disease (MDRD), and the Creatinine Clearance (Cl-Cr) formulas. The serum level of cystatin C was also measured., Results: Eighty-one patients were included in the study. CG formula underestimated the GFR by a mean difference of 8.65 ml/min, compared with MDRD formula. Cl-Cr underestimated the GFR by a mean difference of 7.56 ml/min, compared with CG formula, and by a mean difference of 16.79 ml/min, compared with the MDRD formula. The degree of discrepancy between CG and Cl-Cr estimates, and between Cl-Cr and MDRD estimates decreased as the estimated GFR approached normal values. MDRD best matched the measurement of cystatin C, followed by CG and Cl-Cr (Kappa coefficient=0.43, 0.22 and 0.16, respectively)., Conclusion: Our study confirms the high variability of GFR in older patients and particularly in those with abnormal renal function, depending on the formula used. Serum cystatine C level and MDRD formula appear to be the most concordant estimates of GFR in this population.