Comparison of Automated Strategies for Surveillance of Nosocomial Bacteremia

Objective. Surveillance of nosocomial bloodstream infection (BSI) is recommended, but time-consuming. We explored strategies for automated surveillance. Methods. Cohort study. We prospectively processed microbiological and administrative patient data with computerized algorithms to identify contaminated blood cultures, community-acquired BSI, and hospital-acquired BSI and used algorithms to classify the latter on the basis of whether it was a catheter-associated infection. We compared the automatic classification with an assessment (71% prospective) of clinical data. Setting. An 850-bed university hospital. Participants. All adult patients admitted to general surgery, internal medicine, a medical intensive care unit, or a surgical intensive care unit over 3 years. Results. The results of the automated surveillance were 95% concordant with those of classical surveillance based on the assessment of clinical data in distinguishing contamination, community-acquired BSI, and hospital-acquired BSI in a random sample of 100 cases of bacteremia. The two methods were 74% concordant in classifying 351 consecutive episodes of nosocomial BSI with respect to whether the BSI was catheter-associated. Prolonged episodes of BSI, mostly fungemia, that were counted multiple times and incorrect classification of BSI clinically imputable to catheter infection accounted for 81% of the misclassifications in automated surveillance. By counting episodes of fungemia only once per hospital stay and by considering all cases of coagulase-negative staphylococcal BSI to be catheter-related, we improved concordance with clinical assessment to 82%. With these adjustments, automated surveillance for detection of catheter-related BSI had a sensitivity of 78% and a specificity of 93%; for detection of other types of nosocomial BSI, the sensitivity was 98% and the specificity was 69%. Conclusion. Automated strategies are convenient alternatives to manual surveillance of nosocomial BS

Understanding and Measuring Inequality in Higher Education

This paper highlights that the choice of the indicator is not without important consequences vis-à-vis the monitoring of equity in higher education for the post-2015 UNESCO agenda. Both cross-country and over time comparisons will be impacted. We defend the idea that current proposals at political (the targets) and technical (the indicator proposed to monitor the targets) levels would deserve to be improved. The current set of indicators should be more aligned with the concept highlighted in the targets (access) and odds ratios and the concentration index have our preference for monitoring equity (IEO) in higher education. Gross enrolment ratios are not a good measure of access to tertiary education and should probably be switched with the gross intake ratio into tertiary education or the maximum age specific enrolment rate for the tertiary school age population. In addition, the transition rate between upper-secondary education and tertiary education should be added to enable conditional analysis. Odds ratios are more consistent than simple ratios which have been disqualified in current sociological research and the concentration index has been highlighted, in particular in the field of health but also in education, as being particularly fit to provide an estimation of wealth-related inequalities. In addition to being more coherent both indicators are simple conceptually and easy to calculate with existing data. Finally, a number of data challenges remain for the monitoring to be comprehensive and effective. In particular, it is not possible yet to tackle the issue of differentiation hence preventing to draw a full picture of inequality of opportunities in access to higher education, especially in developed countries

TULIP 4

Tulip is an information visualization framework dedicated to the analysis and visualization of relational data. Based on more than 15 years of research and development, Tulip is built on a suite of tools and techniques , that can be used to address a large variety of domain-specific problems. With Tulip, we aim to provide Python and/or C++ developers a complete library, supporting the design of interactive information visualization applications for relational data, that can be customized to address a wide range of visualization problems. In its current iteration, Tulip enables the development of algorithms, visual encodings, interaction techniques, data models, and domain-specific visualizations. This development pipeline makes the framework efficient for creating research prototypes as well as developing end-user applications. The recent addition of a complete Python programming layer wraps up Tulip as an ideal tool for fast prototyping and treatment automation, allowing to focus on problem solving, and as a great system for teaching purposes at all education levels

On the Production of Semantic and Textured 3D Meshes of Large scale Urban Environments from Mobile Mapping Images and LiDAR scans

International audienceDans cet article nous présentons un cadre entièrement au-tomatique pour la reconstruction d'un maillage, sa textu-ration et sa sémantisation à large échelle à partir de scans LiDAR et d'images orientées de scènes urbaines collectés par une plateforme de cartographie mobile terrestre. Tout d'abord, les points et les images georéferencés sont dé-coupés temporellement pour assurer une cohèrence entre la geométrie (les points) et la photométrie (les images). Ensuite, une reconstruction de surface 3D simple et ra-pide basée sur la topologie d'acquisition du capteur est effectuée sur chaque segment après un rééchantillonnage du nuage de points obtenu à partir des balayages LiDAR. L'algorithme de [31] est par la suite adapté pour texturer la surface reconstruite avec les images acquises simultané-ment assurant une texture de haute qualité et un ajustement photométrique global. Enfin, en se basant sur le schéma de texturation, une sémantisation par texel est appliquée sur le modèle final. Mots Clef scène urbaine, cartographie mobile, LiDAR, reconstruction de surface, texturation, sémantisation, apprentissage pro-fond. Abstract In this paper we present a fully automatic framework for the reconstruction of a 3D mesh, its texture mapping and its semantization using oriented images and LiDAR scans acquired in a large urban area by a terrestrial Mobile Mapping System (MMS). First, the acquired points and images are sliced into temporal chunks ensuring a reasonable size and time consistency between geometry (points) and pho-tometry (images). Then, a simple and fast 3D surface reconstruction relying on the sensor space topology is performed on each chunk after an isotropic sampling of the point cloud obtained from the raw LiDAR scans. The method of [31] is subsequently adapted to texture the reconstructed surface with the images acquired simultaneously, ensuring a high quality texture and global color adjustment. Finally, based on the texturing scheme a per-texel semantization is conducted on the final model

Acceptability in the Older Population: The Importance of an Appropriate Tablet Size

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Presenting many advantages, solid oral dosage forms (SODFs) are widely manufactured and frequently prescribed in older populations regardless of the specific characteristics of patients. Commonly, patients with dysphagia (swallowing disorders) experience difficulties taking SODFs, which may lead to non-adherence or misuse. SODF characteristics (e.g., size, shape, thickness) are likely to influence swallowability. Herein, we used the acceptability reference framework (the ClinSearch acceptability score test (CAST))—a 3D-map juxtaposing two acceptability profiles—to investigate the impact of tablet size on acceptability. We collected 938 observer reports on the tablet intake by patients ≥ 65 y in hospitals or care homes. As we might expect, tablets could be classified as accepted in older patients without dysphagia (n = 790), while not in those with swallowing disorders (n = 146). However, reducing the tablet size had a significant impact on acceptability in this subpopulation: tablets < 6.5 mm appeared to be accepted by patients with swallowing disorders. Among the 309 distinct tablets assessed in this study, ranging in size from 4.7 to 21.5 mm, 83% are ≥ 6.5 mm and consequently may be poorly accepted by institutionalized older people and older inpatients suffering from dysphagia. This underlines the need to develop and prescribe medicines with the best adapted characteristics to reach an optimal acceptability in targeted users.Peer reviewedFinal Published versio

More species, more trees: The role of tree packing in promoting forest productivity

Forests provide many ecosystem services that strongly depend on species diversity, as illustrated by the repeatedly observed diversity–productivity relationships (DPRs). These forest DPRs are assumed to result mostly from complementarity between species at the tree level whilst emerging community-level processes remain poorly explored. In this study, we propose that the 'tree packing effect' (TPE), where species diversity promotes productivity by positively impacting maximum stand density, is an important determinant of DPRs. We tested the two components of TPE: (i) whether maximum stand density increases with species richness and (ii) whether this higher stand density allowed by species richness promotes forest productivity. First, relying on national forest inventories of six European countries (NFIs, totaling 2,367,776 trees), we fitted self-thinning lines to examine whether these lines were influenced by plot species richness. We showed that maximum stand density increases with tree species richness in Europe, in all but one country. This trend was notably stronger in extreme climates. Second, we ran a large simulation-based experiment (including 7,024,815 simulations) with an individual-based forest dynamics model able to control for stand-density effects, to quantify DPRs for more than 1000 sites in Europe. Relying on an original method to quantify DPRs at the site level, we compared the strength of DPRs simulated with and without control for stand density. We found positive DPRs up to 10-times stronger when TPE is at play than when stand density is controlled. This positive effect of diversity on forest productivity through tree packing is also stronger in extreme climates, especially in warm and dry conditions. Synthesis. Highlighting the generality of the TPE in European forests, our results reveal that the effect of diversity on forest functioning is partly mediated by diversity-driven changes in stand density. This mechanism has been long overlooked in biodiversity—ecosystem functioning studies, but our findings strongly call for its reconsideration, especially in natural forests. It also opens key perspectives for management and climate change mitigation programmes

L’identification des levures et bactéries œnologiques par spectrométrie de masse de type MALDI-TOF

La spectrométrie de masse de type MALDI-TOF a été adaptée afin d’être utilisée comme outil innovant d’identification au niveau de l’espèce des levures et bactéries isolées d’échantillons variés (moûts, vins, boissons). L’analyse d’un grand nombre de clones permet d’apprécier la diversité des espèces de levures, bactéries acétiques et lactiques présentes dès les phases pré-fermentaires, au cours des fermentations, pendant l’élevage ou après conditionnement. Dans le cas d’altération de produits, cet outil innovant participera à une meilleure maitrise des risques microbiologiques

Species mixing reduces drought susceptibility of Scots pine (Pinus sylvestris L.) and oak (Quercus robur L., Quercus petraea (Matt.) Liebl.) – Site water supply and fertility modify the mixing effect

Tree species mixing has been widely promoted as a promising silvicultural tool for reducing drought stress. However, so far only a limited number of species combinations have been studied in detail, revealing inconsistent results. In this study, we analysed the effect of mixing Scots pine and oak (pedunculate oak and sessile oak) trees on their drought response along a comprehensive ecological gradient across Europe. The objective was to improve our knowledge of general drought response patterns of two fundamental European tree species in mixed versus monospecific stands. We focused on three null hypotheses: () tree drought response does not differ between Scots pine and oak, () tree drought response of Scots pine and oak is not affected by stand composition (mixture versus monoculture) and () tree drought response of Scots pine and oak in mixtures and monocultures is not modified by tree size or site conditions. To test the hypotheses, we analysed increment cores of Scots pine and oak, sampled in mixed and monospecific stands, covering a wide range of site conditions. We investigated resistance (the ability to maintain growth levels during drought), recovery (the ability to restore a level of growth after drought) and resilience (the capacity to recover to pre-drought growth levels), involving site-specific drought events that occurred between 1976 and 2015. In monocultures, oak showed a higher resistance and resilience than Scots pine, while recovery was lower. Scots pine in mixed stands exhibited a higher resistance, but also a lower recovery compared with Scots pine in monocultures. Mixing increased the resistance and resilience of oak. Ecological factors such as tree size, site water supply and site fertility were found to have significant effects on the drought response. In the case of Scots pine, resistance was increased by tree size, while recovery was lowered. Resistance of oak increased with site water supply. The observed mixing effect on the tree drought response of Scots pine and oak was in some cases modified by the site conditions studied. Positive mixing effects in terms of resistance and resilience of oak increased with site water supply, while the opposite was found regarding recovery. In contrast, site fertility lessened the positive mixing effect on the resistance of Scots pine. We hypothesise that the observed positive mixing effects under drought mainly result from water- and/or light-related species interactions that improve resource availability and uptake according to temporal and spatial variations in environmental conditions.This work was supported by the European Union as part of the ERA-Net SUMFOREST project REFORM – Mixed species forest management. Lowering risk, increasing resilience (2816ERA02S, PCIN2017-026) and the Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 778322. All contributors thank their national funding institutions for supporting the establishment, mensuration and analysis of the studied triplets. The first author wants to thank the German Federal Ministry of Food and Agriculture (BMEL) for financial support through the Federal Office for Agriculture and Food (BLE) (grant number 2816ERA02S), as well as the Bayerische Staatsforsten (BaySF) and Landesbetrieb Forst Brandenburg for providing suitable research sites. Research on the Lithuanian triplets (LT 1, LT 2) was made possible by the national funding institution Research Council of Lithuania (LMTLT) (agreement number S-SUMFOREST-17-1). The French site FR 1 belongs to the OPTMix experimental site (https://optmix.irstea.fr), which is supported annually by Ecofor, Allenvi, and the French national research infrastructure ANAEE-F. A special thank is due to Peter Biber for supporting the statistical analysis

Accuracy, realism and general applicability of European forest models

Forest models are instrumental for understanding and projecting the impact of climate change on forests. A considerable number of forest models have been developed in the last decades. However, few systematic and comprehensive model comparisons have been performed in Europe that combine an evaluation of modelled carbon and water fluxes and forest structure. We evaluate 13 widely used, state-of-the-art, stand-scale forest models against field measurements of forest structure and eddy-covariance data of carbon and water fluxes over multiple decades across an environmental gradient at nine typical European forest stands. We test the models\u27 performance in three dimensions: accuracy of local predictions (agreement of modelled and observed annual data), realism of environmental responses (agreement of modelled and observed responses of daily gross primary productivity to temperature, radiation and vapour pressure deficit) and general applicability (proportion of European tree species covered). We find that multiple models are available that excel according to our three dimensions of model performance. For the accuracy of local predictions, variables related to forest structure have lower random and systematic errors than annual carbon and water flux variables. Moreover, the multi-model ensemble mean provided overall more realistic daily productivity responses to environmental drivers across all sites than any single individual model. The general applicability of the models is high, as almost all models are currently able to cover Europe\u27s common tree species. We show that forest models complement each other in their response to environmental drivers and that there are several cases in which individual models outperform the model ensemble. Our framework provides a first step to capturing essential differences between forest models that go beyond the most commonly used accuracy of predictions. Overall, this study provides a point of reference for future model work aimed at predicting climate impacts and supporting climate mitigation and adaptation measures in forests