Tecan (Switzerland)

Capillary electrophoresis (CE) often provides superior separation of macromolecules such as monoclonal antibodies (mAbs), a major biopharmaceutical class, compared with liquid chromatography. However, electropherograms frequently exhibit complex baselines and peak shapes that are not reliably handled by integration algorithms designed for chromatographic data, and manual integration is often required. Many concepts have been proposed to improve peak integration, ranging from incremental algorithmic refinements and signal-to-noise (S/N)-based approaches to artificial intelligence (AI)-driven strategies, but objective performance comparisons are not possible without shared reference data sets and agreed peak limits. To address this gap, we initiated a multinational collaboration involving industrial and academic laboratories to create a comprehensive reference data set for CE peak integration. A total of 227 challenging and practically relevant electropherograms were collected from diverse applications, converted to a standardized format, and independently integrated by multiple experts. Using dedicated software tools and a structured consensus process, mutually accepted reference integration limits were established for each data set. These reference electropherograms, together with the underlying integration rules, are now made available to the scientific community. Analysis of the reference data set identified general principles for reliable peak integration, including the importance of standardized zoom levels and consistent handling of small peaks near the noise level. The data set provides a common foundation for benchmarking commercial chromatography data systems (CDS) and for developing and validating new algorithmic and AI-based integration methods. We expect this work to speed up the development of practical, automated integration strategies for CE and that these core concepts can be applied to other separation techniques.

Die thorakale Sonographie ist von breitem Nutzen bei der Diagnostik und Therapie pleuraler, pulmonaler und anderweitiger thorakaler Erkrankungen. Da immer mehr Ultraschallgeräte in der Hausarztpraxis im Einsatz sind, sind Grundkenntnisse in der thorakalen Sonographie essentiell. Die thorakale Sonographie erlaubt in Echtzeit eine rasche Analyse thorakaler Pathologien. Neben der Diagnose von Pleuraergüssen können auch Zwerchfellfunktionsstörungen, pulmonale Konsolidationen, Tumore, Empyeme, Abszesse, Rippenfrakturen und thorakale Lymphadenopathien ohne Strahlenbelastung nachgewiesen und weiter spezifiziert werden. Zudem macht die Thoraxsonographie thorakale Interventionen sicherer (insb. Pleuraergusspunktionen) und kann postinterventionelle Röntgenuntersuchungen vermeiden. Thoracic sonography is widely beneficial in the diagnosis and treatment of pleural, pulmonary, and other thoracic diseases. With an increasing number of ultrasound devices being used in general practitioner offices, basic knowledge in thoracic sonography is essential. Thoracic sonography allows for a fast real-time analysis of thoracic pathologies. In addition to diagnosing pleural effusions, it can also identify diaphragmatic dysfunction, pulmonary consolidations, tumors, empyema, abscesses, rib fractures, and thoracic lymphadenopathies without radiation exposure and further specification. Moreover, thoracic sonography makes thoracic interventions safer (especially pleural effusion punctures) and can avoid post-interventional X-ray examinations. **Peer reviewers:** Prof. Dr. Robert Thurnheer, Kantonsspital Münsterlingen, Münsterlingen, Schweiz Dr. Rudolf Horn, Center da sandà Val Müstair, Sta. Maria, Schweiz Artikel erhalten am 8. Januar, 2024. Artikel veröffentlicht am 15. April, 2024.

Obesity is a debilitating disease of global proportions that necessitates refined, concept-driven therapeutic approaches. Policy makers, the public and even health care professionals, but also individuals with obesity harbour many misconceptions regarding this disease, which leads to prejudice, negative attitudes, stigmatization, discrimination, self-blame, and failure to provide and finance adequate medical care. Decades of intensive, successful scientific research on obesity have only had a very limited effect on this predicament. We propose a science-based, easy-to-understand conceptual model that synthesizes the complex pathogenesis of obesity including biological, psychological, social, economic and environmental aspects with the aim to explain and communicate better the nature of obesity and currently available therapeutic modalities. According to our integrative 'Behavioral Balance Model', 'top-down cognitive control' strategies are implemented (often with limited success) to counterbalance the increased 'bottom-up drive' to gain weight, which is triggered by biological, psycho-social and environmental mechanisms in people with obesity. Besides offering a deeper understanding of obesity, the model also highlights why there is a strong need for multimodal therapeutic approaches that may not only increase top-down control but also reduce a pathologically increased bottom-up drive.

Abstract BACKGROUND: The quality transparency of medical care in Switzerland is underdeveloped in comparison to the range of healthcare services and utilisation of care. In order to strengthen the focus on quality, the Health Insurance Act (KVG) was revised and the Federal Quality Commission (EQK) was established. In the summer of 2021, the Swiss Society for General Internal Medicine (SGAIM) published six quality indicators for the inpatient sector, which support national efforts. The aim of these indicators is to facilitate a structured quality improvement process in internal medicine. There are currently no reference or comparative values for the SGAIM quality indicators. The present implementation study examines the practicability of the quality indicators recommended by the SGAIM in a hospital. It examines which quality indicators are helpful and supports the quality improvement cycle intended by the SGAIM. METHODS: Using the QUALIFY assessment tool for quality indicators, the SGAIM indicators are structurally evaluated using the example of Hospital Männedorf (Canton of Zurich). Within this framework, a retrospective data analysis of the years 2020 and 2021 was carried out with 5,376 internal medicine patients, internal medicine assistants and management physicians (32 in 2020; 34 in 2021) as well as the CIRS reporting circle of internal medicine. RESULTS: The examination of the methodological quality criteria for practicability according to the QUALIFY assessment instrument showed that many of the methodological quality criteria are fulfilled. However, the comprehensibility and interpretability for patients and the public are only given to a limited extent. The results of the SGAIM quality indicators in Hospital Männedorf were calculated according to the recommended evaluation intervals and were as such: A provisional discharge report within 24 hours was sent to the follow-up institution for an average of 23.7% of discharges. A new prescription of benzodiazepines in patients with an age of ≥65 years occurred in an average of 17.2% of patients per month. The fall history was collected from 100% of the patients. The monthly proportion of patients with transfusions with an Hb value of >8g/dl was 17.9% on average. The proportion of CIRS cases per patient averaged 1.3%. Hepatitis B vaccination protection was available to 100% of the staff in the medical service of internal medicine. Reference and comparative values for the classification of these results do not yet exist. CONCLUSIONS: The quality indicators recommended by the SGAIM for the transmission of provisional discharge reports, new prescriptions for benzodiazepines and transfusions with Hb values >8 g/dl proved helpful. Development potential was shown for the following quality indicators: CIRS case processing, biography of falls in the last 12 months and hepatitis B vaccination protection. In the sense of national quality development in accordance with the KVG, it is desirable that the specialist society further develops its quality indicators and contributes them to the national quality efforts, which are coordinated by the EQK.

The amendment to the collective agreement is intended to significantly improve the working conditions of physicians and includes longer-term duty scheduling, work on amaximum of two weekends per month, less overtime. Smaller hospitals often have problems implementing these requirements and have to make compromises. At least the overtime is now better paid-overall, an improvement in working conditions can only be achieved by increasing the number of staff, then better and more intensive training is also possible.

Nachdem im vorangegangenen Kapitel die methodischen Grundlagen der Untersuchung aufgezeigt worden sind, gilt es im Folgenden, die Vorgehensweise bei der Durchfuhrung der empirischen Untersuchung genauer darzulegen. Dazu werden in Abschnitt 4.1 mit der Wahl des Kooperationspartners zunachst die wichtigsten Informationen uber das Untersuchungsumfeld herausgearbeitet. Im Anschluss daran wird die Erhebung der fur die beiden Studien der Untersuchung benotigten Daten sowie deren Gutebeurteilung anhand der in Kapitel 3 vorgestellten Methodik detailliert erlautert.