We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Clinical trials often struggle to recruit enough participants, with only 10% of eligible patients enrolling. This is concerning for conditions like stroke, where timely decision-making is crucial. Frontline clinicians typically screen patients manually, but this approach can be overwhelming and lead to many eligible patients being overlooked.
Methods:
To address the problem of efficient and inclusive screening for trials, we developed a matching algorithm using imaging and clinical variables gathered as part of the AcT trial (NCT03889249) to automatically screen patients by matching these variables with the trials’ inclusion and exclusion criteria using rule-based logic. We then used the algorithm to identify patients who could have been enrolled in six trials: EASI-TOC (NCT04261478), CATIS-ICAD (NCT04142125), CONVINCE (NCT02898610), TEMPO-2 (NCT02398656), ESCAPE-MEVO (NCT05151172), and ENDOLOW (NCT04167527). To evaluate our algorithm, we compared our findings to the number of enrollments achieved without using a matching algorithm. The algorithm’s performance was validated by comparing results with ground truth from a manual review of two clinicians. The algorithm’s ability to reduce screening time was assessed by comparing it with the average time used by study clinicians.
Results:
The algorithm identified more potentially eligible study candidates than the number of participants enrolled. It also showed over 90% sensitivity and specificity for all trials, and reducing screening time by over 100-fold.
Conclusions:
Automated matching algorithms can help clinicians quickly identify eligible patients and reduce resources needed for enrolment. Additionally, the algorithm can be modified for use in other trials and diseases.
Background: After a transient ischemic attack (TIA) or minor stroke, the long-term risk of subsequent stroke is uncertain. Methods: Electronic databases were searched for observational studies reporting subsequent stroke during a minimum follow-up of 1 year in patients with TIA or minor stroke. Unpublished data on number of stroke events and exact person-time at risk contributed by all patients during discrete time intervals of follow-up were requested from the authors of included studies. This information was used to calculate the incidence of stroke in individual studies, and results across studies were pooled using random-effects meta-analysis. Results: Fifteen independent cohorts involving 129794 patients were included in the analysis. The pooled incidence rate of subsequent stroke per 100 person-years was 6.4 events in the first year and 2.0 events in the second through tenth years, with cumulative incidences of 14% at 5 years and 21% at 10 years. Based on 10 studies with information available on fatal stroke, the pooled case fatality rate of subsequent stroke was 9.5% (95% CI, 5.9 – 13.8). Conclusions: One in five patients is expected to experience a subsequent stroke within 10 years after a TIA or minor stroke, with every tenth patient expected to die from their subsequent stroke.
Fasciola jacksoni is a significant contributor to the health and mortality of Asian elephants, particularly those in Sri Lanka. Despite the impact of fascioliasis on elephant populations, it is a neglected veterinary disease with limited taxonomic understanding. Molecular characterization and phylogenetic analysis of F. jacksoni were carried out to evaluate its suggested basal position in the Fasciolidae. Adult worms were collected during post-mortem of elephants, and eggs were collected from living elephants in National parks across Sri Lanka. Using the mitochondrial genes nicotinamide dehydrogenase subunit 1 (nad1) and cytochrome oxidase subunit 1 (cox1), and a partial 28S ribosomal DNA (28S rDNA), DNA sequences were generated from the F. jacksoni adult and egg material. Maximum likelihood (ML) phylogenetic analyses did not resolve F. jacksoni to be basal to the Fasciolidae. Furthermore, the ML analyses showed that the genus Fasciola was not monophyletic and that F. jacksoni was a sister species to the deer liver fluke Fascioloides magna. A clear framework is required to determine the taxonomic status of F. jacksoni and this current study provides the first detailed application of molecular techniques from multiple hosts across Sri Lanka with the production of reference DNA sequences for this important parasite.
We have mapped the nearby face-on spiral galaxy M 33 in the 1.1 mm dust continuum using AzTEC on Atacama Submillimeter Telescope Experiment (ASTE). The preliminary results are presented here. The observed dust has a characteristic temperature of ~ 21 K in the central kpc, radially declining down to ~ 13 K at the edge of the star forming disk. We compare the dust temperatures with KS band flux and star formation tracers. Our results imply that cold dust heating may be driven by long-lived stars even nearby star forming regions.
A series of laboratory experiments was carried out to examine the interaction between stratification and turbulence at an inversion layer, with the objective of gaining insight into certain wave–turbulence encounters in the atmosphere. A three-layer stratified fluid system, consisting of a (thick) strongly stratified inversion layer, sandwiched between an upper turbulent layer and a lower non-turbulent weakly stratified layer, was employed. Oscillating-grid-induced shear-free turbulence was used in the upper layer. During the experiments, a fourth (interfacial) layer developed in the region between the inversion and the turbulent layer, and most of the wave–turbulence interactions were confined to this layer. Detailed measurements of the vertical velocity structure, internal-wave parameters and mixing characteristics were made in the stratified layers and, whenever possible, the results were compared to available theoretical predictions.
A series of laboratory experiments was performed to investigate the overall mixing characteristics of oscillatory stratified flow past an isolated topography. The experiments were conducted by oscillating a right-circular cylinder in an otherwise quiescent linearly stratified fluid contained in a rectangular basin. The mixing was largely confined to the turbulent ‘core’ region around the cylinder. This mixed fluid was then injected into the fluid interior of the basin by numerous intrusive tongues. These intrusions were accompanied by return currents of unmixed stratified fluid into the turbulent core. The overall effect of this mixing process was to increase the potential energy of the fluid in the basin. An expression is derived to relate the rate of change of potential energy of the system to the basin-averaged buoyancy flux. This formula was then used to calculate the mean buoyancy flux from measurements of the rate of change of potential energy of the fluid system. Basin-averaged diapycnal eddy diffusivities for the experiments were evaluated and the results were found to be in good agreement with the predictions of a heuristic model based on the energetics of the mixing. Observations on the spreading of intrusions and the evolution of the density field are also presented.
X-ray absorption and glancing angle reflectivity measurements in the energy range of the Nitrogen K-edge and Gallium M2,3 edges are reported. Linear muffin-tin orbital band-structure and spectral function calculations are used to interpret the data. Polarization effects are evidenced for the N-K-edge spectra by comparing X-ray reflectivity in s- and p-polarized light.
A Description of “World Orthography”, which is now the official manner of writing a number of languages of Africa, is to be found in the booklet Practical Orthography of African Languages published by the International Institute of African Languages and Cultures. The system is a phonetic one and is in most respects the same as the International Phonetic Alphabet, the chief exceptions being that j and y are used with their English values, vowel length is indicated by doubling the letter, and capital letters are provided for the use of those who consider them necessary. J. R. Firth has shown how World Orthography may be applied to Burmese and to several Indian languages, and it is the object of this article to show how it might be applied to Sinhalese.
In the following text an attempt has been made to represent as accurately as possible the speech of Mr. H. Perera, a form of speech which we believe to be fairly typical of that of the educated Sinhalese of Colombo. The form of speech here recorded is that used in familiar conversation and will be found to differ greatly from the literary or semi-literary language of the ordinary textbook
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.