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Many clinical trials leverage real-world data. Typically, these data are manually abstracted from electronic health records (EHRs) and entered into electronic case report forms (CRFs), a time and labor-intensive process that is also error-prone and may miss information. Automated transfer of data from EHRs to eCRFs has the potential to reduce data abstraction and entry burden as well as improve data quality and safety.
Methods:
We conducted a test of automated EHR-to-CRF data transfer for 40 participants in a clinical trial of hospitalized COVID-19 patients. We determined which coordinator-entered data could be automated from the EHR (coverage), and the frequency with which the values from the automated EHR feed and values entered by study personnel for the actual study matched exactly (concordance).
Results:
The automated EHR feed populated 10,081/11,952 (84%) coordinator-completed values. For fields where both the automation and study personnel provided data, the values matched exactly 89% of the time. Highest concordance was for daily lab results (94%), which also required the most personnel resources (30 minutes per participant). In a detailed analysis of 196 instances where personnel and automation entered values differed, both a study coordinator and a data analyst agreed that 152 (78%) instances were a result of data entry error.
Conclusions:
An automated EHR feed has the potential to significantly decrease study personnel effort while improving the accuracy of CRF data.
Traditionally, primate cognition research has been conducted by independent teams on small populations of a few species. Such limited variation and small sample sizes pose problems that prevent us from reconstructing the evolutionary history of primate cognition. In this chapter, we discuss how large-scale collaboration, a research model successfully implemented in other fields, makes it possible to obtain the large and diverse datasets needed to conduct robust comparative analysis of primate cognitive abilities. We discuss the advantages and challenges of large-scale collaborations and argue for the need for more open science practices in the field. We describe these collaborative projects in psychology and primatology and introduce ManyPrimates as the first, successful collaboration that has established an infrastructure for large-scale, inclusive research in primate cognition. Considering examples of large-scale collaborations both in primatology and psychology, we conclude that this type of research model is feasible and has the potential to address otherwise unattainable questions in primate cognition.
Given the very recent investment in research on organic rabbit production, many knowledge gaps remain. Simulation models based on data from experiments and farms may help generate general principles for organic rabbit production. Our goals were to (i) develop a model to simulate intake regulation and growth of rabbits raised on pastures, (ii) validate this model under a diversity of conditions and (iii) conduct a simulation experiment to predict the potential to decrease the supply of complete feed by increasing the grazing area per rabbit. The model developed (PASTRAB) simulates organic rabbit fattening on pastures in four main submodels that represent dynamics of (i) herbage standing biomass, fill and feed values; (ii) intake of herbage, complementary feed (i.e. complete pellets, cereal–legume grain mixtures) and hay as regulated by herbage allowance, fill and feed values of feedstuffs and rabbit physiological parameters; (iii) conversion of rabbit intake into live weight gain; and (iv) rabbit mortality. The model also calculates gross margin per rabbit sold. Model accuracy was assessed by considering the fit between observed and predicted herbage intake, which was low, with a relative root mean square error (rRMSE) of 51% and 66% on grass-based and legume-based pastures, respectively. However, the standard deviations of observed herbage intake were similar to the root mean square error of predicted herbage intake, indicating that it would have been difficult to improve model calibration. The fit between observed and predicted rabbit live weight was acceptable, with an rRMSE of 11% and 10% for grass-based and legume-based pastures, respectively. Simulated scenarios showed that a decrease in complementary feed combined with an increase in the grazing area per rabbit had little impact on average daily growth and gross margin per rabbit but increased herbage use efficiency. With 90 g of complementary feed per day and grazing of 0.4 m²/rabbit per day, herbage use efficiency was 22%, with average daily growth of 21.6 g/day and gross margin of 18.80 €/rabbit. With no complementary feed and grazing of 1.2 m²/rabbit per day, average daily growth decreased (19.2 g/day), but herbage use efficiency reached 100% and gross margin reached 19.20 €/rabbit. We used PASTRAB in participatory workshops with farmers so that the latter could explore adaptations to their current practices. Overall, farmers considered the model predictions realistic, and some of them decided to adapt some of their management practices immediately after the workshops.
Hunter-gatherers collected and used various woody species depending on the landscape, availability of plant communities, and sociocultural considerations. With extensive paleo-wetlands and groundwater-fed oases, the Atacama Desert was interspersed with riparian woodlands that provided vital resources (fuel, water, and game) at the end of the Pleistocene in areas such as the Pampa del Tamarugal (PdT) basin. We use anthracological analyses to determine the fuel management strategies of hunter-gatherer societies in this hyperarid environment and explore whether the “Principle of Least Effort” applies. First, we present the combustion qualities and characteristics of woody taxa from the Atacama and analyze possible exploitation strategies. Second, we use anthracological analyses from Quebrada Maní 12 (QM12), a late Pleistocene archaeological site (dated from 12,750 to 11,530 cal B.P.) located in the PdT basin, to show the prevalence of two woody species that were either freshly collected or gathered (very likely on purpose) from subfossil wood. Our results suggest that fuel selection strategies were based on prior knowledge of the qualities of these woody taxa and how they burned. Thus we conclude that fuel management was part of a number of social and economic decisions that allowed for effective colonization of this region. Furthermore, we stress the need for caution when using charcoal to exclusively date archaeological sites located in desert environments.
With aging, most cognitive functions decline, especially processes concerning memorizing, attention, concentration, organizing, planning and problem solving. Neuropsychology can make an important contribution in early and differential diagnostics. The borderline between normal and pathological cognitive aging is especially important in this respect. The neuropsychologist gains insight in medical, biological, psychological and social factors of the aging person. Has the profile of complaints and deficits a normal background or is a pathological process taking place? It is important to people who are unnecessarily worried about possible dementia.
Neuropsychological assessment also provides information about a patient's disturbed and undisturbed cognitive functions, their personality and their way of coping with problems in every day's life. This is of major importance, because it provides information and possibilities for biological or psychological interventions. Because of the complexity of problems that may occur, it is necessary that the neuropsychologist is experienced and works in a multidisciplinary team in which neurological and psychiatric expertise is present.
The purpose of this study is the time domain modeling of a piano. We aim at explaining the vibratory and acoustical behavior of the piano, by taking into account the main elements that contribute to sound production. The soundboard is modeled as a bidimensional thick, orthotropic, heterogeneous, frequency dependent damped plate, using Reissner Mindlin equations. The vibroacoustics equations allow the soundboard to radiate into the surrounding air, in which we wish to compute the complete acoustical field around the perfectly rigid rim. The soundboard is also coupled to the strings at the bridge, where they form a slight angle from the horizontal plane. Each string is modeled by a one dimensional damped system of equations, taking into account not only the transversal waves excited by the hammer, but also the stiffness thanks to shear waves, as well as the longitudinal waves arising from geometric nonlinearities. The hammer is given an initial velocity that projects it towards a choir of strings, before being repelled. The interacting force is a nonlinear function of the hammer compression. The final piano model is a coupled system of partial differential equations, each of them exhibiting specific difficulties (nonlinear nature of the string system of equations, frequency dependent damping of the soundboard, great number of unknowns required for the acoustic propagation), in addition to couplings’ inherent difficulties.
The paramyxean parasite Marteilia refringens infects several bivalve species including European flat oysters Ostrea edulis and Mediterranean mussels Mytilus galloprovincialis. Sequence polymorphism allowed definition of three parasite types ‘M’, ‘O’ and ‘C’ preferably detected in oysters, mussels and cockles respectively. Transmission of the infection from infected bivalves to copepods Paracartia grani could be experimentally achieved but assays from copepods to bivalves failed. In order to contribute to the elucidation of the M. refringens life cycle, the dynamics of the infection was investigated in O. edulis, M. galloprovincialis and zooplankton over one year in Diana lagoon, Corsica (France). Flat oysters appeared non-infected while mussels were infected part of the year, showing highest prevalence in summertime. The parasite was detected by PCR in zooplankton particularly after the peak of prevalence in mussels. Several zooplanktonic groups including copepods, Cladocera, Appendicularia, Chaetognatha and Polychaeta appeared PCR positive. However, only the copepod species Paracartia latisetosa showed positive signal by in situ hybridization. Small parasite cells were observed in gonadal tissues of female copepods demonstrating for the first time that a copepod species other than P. grani can be infected with M. refringens. Molecular characterization of the parasite infecting mussels and zooplankton allowed the distinguishing of three Marteilia types in the lagoon.
Although clam populations in France are known to be infected with protozoans of the genus Perkinsus, no molecular characterization was previously performed on these parasites. Considering that several members of this genus have been associated with mortalities of molluscs worldwide, a study was undertaken in order to characterize these parasites in France. For that purpose, clams, Ruditapes philippinarum and R. decussatus, collected from different production areas and found to be infected with Perkinsus sp. in thioglycolate culture medium, were selected for PCR-RFLP tests and sequencing. Perkinsus olseni was detected in all the investigated areas and results also suggested the presence of P. chesapeaki in Leucate, a lagoon on the Mediterranean coast and in Bonne Anse in Charente Maritime, on the Atlantic coast. Clonal cultures from both detected species were produced in order to describe and compare in vitro stages. Differences in size between both Perkinsus spp. were noticed especially for schizonts and zoosporangia. Lastly, in situ hybridization tests allowed confirmation of the presence of both species in the same R. decussatus population and even in same clams. This is the first detection of P. chesapeaki in Ruditapes species and outside North America, which questions its introduction into Europe.
This work concerns multiple-scattering problems for time-harmonic equations in a reference generic media. We consider scatterers that can be sources, obstacles or compact perturbations of the reference media. Our aim is to restrict the computational domain to small compact domains containing the scatterers. We use Robin-to-Robin (RtR) operators (in the most general case) to express boundary conditions for the interior problem. We show that one can always factorize the RtR map using only operators defined using single-scatterer problems. This factorization is based on a decomposition of the diffracted field, on the whole domain where it is defined. Assuming that there exists a good method for solving single-scatterer problems, it then gives a convenient way to compute RtR maps for a random number of scatterers.
In France, haemorrhagic fever with renal syndrome (HFRS) is endemic along the Belgian border. However, this rodent-borne zoonosis caused by the Puumala virus has recently spread south to the Franche-Comté region. We investigated the space–time distribution of HFRS and evaluated the influence of environmental factors that drive the hantavirus reservoir abundance and/or the disease transmission in this area. A scan test clearly indicated space–time clustering, highlighting a single-year (2005) epidemic in the southern part of the region, preceded by a heat-wave 2 years earlier. A Bayesian regression approach showed an association between a variable reflecting biomass (normalized difference vegetation index) and HFRS incidence. The reasons why HFRS cases recently emerged remain largely unknown, and climate parameters alone do not reliably predict outbreaks. Concerted efforts that combine reservoir monitoring, surveillance, and investigation of human cases are warranted to better understand the epidemiological patterns of HFRS in this area.
Depending on the extent of evolutionary divergence among parent taxa, hybrids may suffer from a breakdown of co-adapted genes or may conversely exhibit vigour due to the heterosis effect, which confers advantages to increased genetic diversity. That last mechanism could explain the success of hybrids when hybridization zones are large and long lasting, such as in the water frog hybridization complex. In this hybridogenetic system, hybrid individuals exhibit full heterozygosity that makes it possible to investigate in situ the impact of hybridization. We have compared parasite intensity between hybrid Rana esculenta and parental R. lessonae individuals at the tadpole stage in two populations inhabiting contrasted habitats. We estimated intensity of Gyrinicola sp. (Nematoda) in the gut, Echinostome metacercariae in the kidneys and Haplometra cylindracea in the body cavity (both species belong to Trematoda). Despite high sampling effort, no variation in parasite intensity was detected between taxa, except a possible higher tolerance to H. cylindracea in hybrid tadpoles. The low effect of hybridization suggests efficient gene co-adaptation between the two genomes that could result from hemiclonal selection. Variation in infection intensity among ponds could support the Red Queen hypothesis.
We studied 7 patients with nosocomial Legionnaires' disease to determine the relationship between isolates of Legionella pneumophila recovered from potable water and those recovered from patients. Potable water was cultured from all rooms in which patients had stayed prior to the diagnosis of Legionnaires' disease. The 38 isolates of L. pneumophila (31 environmental, 7 patient) were resolved into 9 distinct patterns by pulse-field gel electrophoresis (PFGE), 3 by plasmid content and 2 each with monoclonal antibodies and conventional agarose gel electrophoresis of small fragments of DNA.
Using PFGE it was determined that 4 of the 7 patients were infected with L. pneumophila identical to an isolate recovered from the potable water supply in one of the rooms each had occupied prior to the diagnosis of Legionnaires' disease. Patients had resided in a mean of 3·57 rooms before a diagnosis of nosocomial Legionnaires' disease. We conclude that in the setting of contaminated potable water and nosocomial Legionnaires' disease water from all the rooms which the patient has occupied prior to this diagnosis should be cultured. PFGE of large DNA fragments discriminated best among the isolates of L. pneumophila.
In a setting where potable water is contaminated with Legionella pneumophila serogroup 1, we performed two case control studies. The first case control study consisted of 17 cases of nosocomial Legionnaires' disease (LD) and 33 control (the patients who were admitted to the ward where the case was admitted immediately before and after the case) subjects. Cases had a higher mortality rate 65% vs 12% (P < 0.004); were more likely to have received assisted ventilation (P < 0.00001); to have nasogastric tubes (P < 0.0004) and to be receiving corticosteroids or other immunosuppressive therapy (P < 0.0001). Based on the results of this study, sterile water was used to flush nasogastric tubes and to dilute nasogastric feeds. Only 3 cases of nosocomial LD occurred during the next year compared with 12 the previous year (P < 0.0001). Nine cases subsequently occurred and formed the basis for the second case-control study. Eighteen control subjects were those patients admitted to the same unit where the case developed LD, immediately before and after the case. The mortality rate for the cases was 89% vs 6% for controls (P < 0.00003). The only other significant difference was that cases were more likely to be receiving corticosteroids or other immunosuppressive therapy 89% vs 39% ( < 0.01). We hypothesized that microaspiration of contaminated potable water by immunocompromised patients was a risk factor for nosocomial Legionnaires' disease. From 17 March 1989 onwards such patients were given only sterile potable water. Only two cases of nosocomial LD occurred from June 1989 to September 1990 and both occurred on units where the sterile water policy was not in effect. We conclude that aspiration of contaminated potable water is a possible route for acquisition of nosocomial LD in our hospital and that provision of sterile potable water to high risk patients (those who are receiving corticosteroids or other immunosuppressive drugs; organ transplant recipients or hospitalized in an intensive care unit) should be mandatory.
The able review of my paper on the Geological Age of the Earth which appears in the March number of this Magazine (p. 124), from the pen of the Rev. O. Fisher, raises again questions of such wide interest that some further remarks, referring principally to the criticism of the distinguished writer of the review, and also to criticisms which I have received from others and which are probably in the minds of many who have considered the matter, may not be out of place.
From time to time I have received from correspondents suggestions that the method of determining the geological age of the Earth by the rate of solvent denudation of sodium might be open to considerable error if the allowance made in my paper (Trans. R.D.S., ser. ii, vol. vii), for sodium chloride carried from the sea by winds and washed from the atmosphere by rain, was seriously at fault. These suggestions arise from incomplete study of the quantities involved. Had more space been given in my paper to this question, the hasty criticisms I have had to contend with, doubtless, would be less often advanced. The whole matter is capable of the simplest arithmetical statement, and the limit of error arising from this source easily defined. Recently one gentleman has written at considerable length on the matter in the pages of the Chemical News. I have replied to Mr. Ackroyd in that journal. But the definition of the limit of error referred to, and the consideration of some other points raised in the discussion, are more in place in a geological than in a chemical journal. I would therefore seek for space in the Geological Magazine wherein to repeat in part what I have said in the Chemical News, adding some matters more especially suited to geological readers.
In the Geological Magazine for August I gave the major limit to the period of time we can assign to the geological age of the Earth by the solvent-denudation method, when it is assumed that all the chlorine of rivers is derived directly from the ocean, and that all such chlorine (falling, as assumed, in rain) carries its full complement of sodium from the ocean. The major limit with these assumptions is 141 million years. A second estimate is given on the more moderate assumption that one-third the amount of chlorine in rivers is derived from the sea and brings with it its full equivalent of sodium; this affords 105 millions of years as the age. Finally, there is the original estimate based on a 10 per cent. deduction from the chlorine of rivers as rain-borne, affording 96 millions of years.
In vitro tests have been developed for the diagnosis of tuberculosis (TB) infection. The objective was to analyse latent TB infection in drug and alcohol abusers through two interferon-γ techniques. One hundred and thirty-nine patients were admitted between February 2006 and May 2007. Mean age was 39·8 years [31% HIV positive]. The enzyme immunoassay (EIA) and enzyme-linked immunospot (ELISPOT) interferon-γ assays were positive in 34% of patients with an agreement of 83% (κ=0·63). Tuberculin skin test (TST) was positive in 29% of patients and the agreement of TST with EIA and ELISPOT interferon-γ assays was 85% (κ=0·62) and 83% (κ=0·57), respectively. Almost 50% of patients with history of TB had a positive in vitro test. In conclusion, we observed a high prevalence of latent TB and good agreement between the new in vitro tests that otherwise may continue to be positive long after developing TB disease.
Infrared absorbance and visible/near-IR excited plasmon resonances are investigated in gold-black, a porous nano-structured conducting film. Polymer infusion (for hardening) generally reduced absorbance in the long wave IR but has little effect at THz wavelengths. The characteristic length scales of the structured films vary considerably as a function of deposition parameters, but the absorbance is found to be only weakly correlated with these distributions. Initial investigations of gold-black by photoelectron emission microscopy (PEEM) reveal plasmon resonances, which have potential to enhance the efficiency of thin film solar cells. For films with different characteristic length scales, the plasmon resonances appear in structures with similar length scales.