Transformation and evaluation of the MIMIC Database in the OMOP Common Data Model (Preprint)

2021 ◽  
Author(s):  
Nicolas Paris ◽  
Antoine Lamer ◽  
Adrien Parrot
Keyword(s):  
Intensive Care ◽  
Common Data Model ◽  
Electronic Health Record Data ◽  
Data Set ◽  
Structural Mapping ◽  
Conceptual Mapping ◽  
Open Access Database ◽  
Set Up ◽  
The Right ◽  
Three Phases

BACKGROUND In the era of big data, the intensive care unit (ICU) is very likely to benefit from real-time computer analysis and modeling based on close patient monitoring and Electronic Health Record data. MIMIC is the first open access database in the ICU domain. Many studies have shown that common data models (CDMs) improve database searching by allowing code, tools and experience to be shared. OMOP-CDM is spreading all over the world. OBJECTIVE The objective was to to transform MIMIC into an OMOP database, and to evaluate the benefits of this transformation for analysts. METHODS We transformed MIMIC (version 1.4.21) in the OMOP format (5.3.3.1), through a semantic and structural mapping. The structural mapping aimed at moving the MIMIC data into the right place in OMOP with some data transformations. It parted into three phases: conception, implementation and evaluation. The conceptual mapping aimed at aligning the MIMIC local terminologies to the OMOP's standard ones. It consisted of three phases: integration, alignment and evaluation. A documented, tested, versioned, exemplified and open repository has been set up to support the transformation and improvement of the MIMIC community's source code. The resulting data set was evaluated over a 48-hour datathon. RESULTS With an investment of 2 people for 500 hours, 64% of the data items of the 26 MIMIC tables have been standardized into the OMOP CDM and 78% of the source concepts mapped to reference terminologies. The model proved its ability to support community contributions and was well received during the datathon with 160 participants and 15,000 requests executed with a maximum duration of one minute. CONCLUSIONS The resulting MIMIC-OMOP dataset is the first MIMIC-OMOP dataset available free of charge with real disidentified data ready for replicable intensive care research. This approach can be generalized to any medical field.

scholarly journals MIMIC in the OMOP Common Data Model

2020 ◽  
Author(s):  
nicolas paris ◽  
adrien parrot
Keyword(s):  
Data Model ◽  
Common Data Model ◽  
Database Searching ◽  
Medical Field ◽  
Electronic Health Record Data ◽  
Data Set ◽  
Maximum Duration ◽  
Record Data ◽  
Open Access Database ◽  
Set Up

Objectives : In the era of big data, the intensive care unit (ICU) is very likely to benefit from real-time computer analysis and modeling based on close patient mon- itoring and Electronic Health Record data. MIMIC is the first open access database in the ICU domain. Many studies have shown that common data models (CDMs) improve database searching by allowing code, tools and experience to be shared. OMOP-CDM is spreading all over the world. The objective was to evaluate the difficulty to transform MIMIC into an OMOP (MIMIC-OMOP) database and the benefits of this transformation for analysts. Material & Method: A documented, tested, versioned, exemplified and open repository has been set up to support the transformation and improvement of the MIMIC community's source code. The resulting data set was evaluated over a 48- hour datathon. Result: With an investment of 2 people for 500 hours, 64% of the data items of the 26 MIMIC tables have been standardized into the OMOP CDM and 78% of the source concepts mapped to reference terminologies. The model proved its ability to support community contributions and was well received during the datathon with 160 participants and 15,000 requests executed with a maximum duration of one minute. Conclusion: The resulting MIMIC-OMOP dataset is the first MIMIC-OMOP dataset available free of charge with real disidentified data ready for replicable in- tensive care research. This approach can be generalized to any medical field.

Process design and equipment selection for optimized steam and power concepts – the “zero” process steam sugar factory

2020 ◽  
pp. 40-50
Author(s):  
Boris Morgenroth ◽  
Thomas Stark ◽  
Julian Pelster ◽  
Harjeet Singh Bola
Keyword(s):  
Process Design ◽  
Sugar Industry ◽  
Electrical Power ◽  
Power Requirement ◽  
Equipment Selection ◽  
Good Potential ◽  
Set Up ◽  
The Right ◽  
Key Aspects ◽  
Steam Drying

Optimization of process steam requirement in order to maximize sugar recovery and export power along with manpower optimization is a must for sugar factories to survive under difficult conditions and to earn additional revenues. The process steam demand of greenfield and revamped plants has been reduced to levels of 32–38% from originally more than 50% steam on cane in the case of the brownfield plants. In addition, significant improvement in the power requirement of the plants has been achieved. Bagasse drying offers a good potential to improve the power export. Different available concepts are compared with a focus on bagasse steam drying and low temperature bagasse drying. In order to set up an optimized highly efficient plant or to optimize an existing plant to achieve competitive benchmarks, good process design and the right equipment selection are very important. Experience has been gained with multiple stage or double effect crystallization in the beet sugar industry offering further steam optimization potential. Vapour recompression is also an option to substitute live steam by electrical power. This even provides options to reduce the steam demand from the power plant for the sugar process down to zero. Key aspects concerning the process design and equipment selection are described.

Method for drawing forest maps by means of an office computer

1970 ◽  
Vol 22 ◽  
Author(s):  
R. Goossens ◽  
J. De Schuyter
Keyword(s):  
Classical Method ◽  
Similar Form ◽  
Code Number ◽  
Growing Stock ◽  
Forest Maps ◽  
Set Up ◽  
The Right ◽  
Computer Unit ◽  
Fixed Network

In  this article, we tried to perform the drawing of forest maps, together with  the calculations involved, automatically by means of relatively simple aids.      The computer unit used is an office computer Olivetti P203. As an example  the growing stock (in m3/ha) was mapped out. The proper inventory in the field is done  according to the classical method by means of a previously fixed network of  squares (70,7 m x 70,7 m), which corresponds to two plots a ha.     The quantity which is measured and mapped out (in this case the growing  stock) is in a similar form not very useful in mapping. Therefore a division  in classes (Ku) numbered from 0 to 9, is set up. An appropriate program  calculates for a certain number of points within this elementary square, to which  class they have to be assigned, whereas the typewriter prints the  corresponding code number on the right place.     Fig. 1 and the formulas (1), (2) and (3) represent the principle o[ the  calculations while fig. 2A and B reproduce the results printed by the  typewriter for a elementary square of respective 1” X 1” and 2” X 2”. The  whole of similar network of squares eventually results in a basical document,  on which the existing forest map with an adapted scale is laid (see appendix  3) and the class limits are drawn.     If desirable, the scale may be adapted when the forest map under discussion  is definitely reproduced.

New Mexico

2017 ◽  
Author(s):  
David K. Jones
Keyword(s):  
New Mexico ◽  
Board Of Directors ◽  
The State ◽  
Governance Model ◽  
The Board Of Directors ◽  
Set Up ◽  
The Right

The fight over an exchange had a very different dynamic in New Mexico because there were no loud voices on the right calling for the state to reject control. Republican Governor Susanna Martinez supported retaining control, but strongly preferred a governance model that allowed insurers to serve on the board of directors and limited the degree of oversight by the board on the types of plans that could be sold on the exchange. Governor Martinez vetoed legislation in 2011 that would have set up a different model of an exchange. Institutional quirks meant the legislature did not have the opportunity to weigh in again for two years, until 2013. By this point it was too late and the state had to rely on the federal website despite passing legislation to run its own exchange.

scholarly journals Contamination of Healthcare Worker Personal Protective Equipment with MRSA Outside the Intensive Care Unit Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s27-s28
Author(s):  
Gita Nadimpalli ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
David Calfee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Direct Patient Care ◽  
Care Group ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Contact Precautions ◽  
Patient Interactions ◽  
The Right

Background: Estimates of contamination of healthcare personnel (HCP) gloves and gowns with methicillin-resistant Staphylococcus aureus (MRSA) following interactions with colonized or infected patients range from 17% to 20%. Most studies were conducted in the intensive care unit (ICU) setting where patients had a recent positive clinical culture. The aim of this study was to determine the rate of MRSA transmission to HCP gloves and gown in non-ICU acute-care hospital units and to identify associated risk factors. Methods: Patients on contact precautions with history of MRSA colonization or infection admitted to non-ICU settings were randomly selected from electronic health records. We observed patient care activities and cultured the gloves and gowns of 10 HCP interactions per patient prior to doffing. Cultures from patients’ anterior nares, chest, antecubital fossa and perianal area were collected to quantify bacterial bioburden. Bacterial counts were log transformed. Results: We observed 55 patients (Fig. 1), and 517 HCP–patient interactions. Of the HCP–patient interactions, 16 (3.1%) led to MRSA contamination of HCP gloves, 18 (3.5%) led to contamination of HCP gown, and 28 (5.4%) led to contamination of either gloves or gown. In addition, 5 (12.8%) patients had a positive clinical or surveillance culture for MRSA in the prior 7 days. Nurses, physicians and technicians were grouped in “direct patient care”, and rest of the HCPs were included in “no direct care group.” Of 404 interactions, 26 (6.4%) of providers in the “direct patient care” group showed transmission of MRSA to gloves or gown in comparison to 2 of 113 (1.8%) interactions involving providers in the “no direct patient care” group (P = .05) (Fig. 2). The median MRSA bioburden was 0 log 10CFU/mL in the nares (range, 0–3.6), perianal region (range, 0–3.5), the arm skin (range, 0-0.3), and the chest skin (range, 0–6.2). Detectable bioburden on patients was negatively correlated with the time since placed on contact precautions (rs= −0.06; P < .001). Of 97 observations with detectable bacterial bioburden at any site, 9 (9.3%) resulted in transmission of MRSA to HCP in comparison to 11 (3.6%) of 310 observations with no detectable bioburden at all sites (P = .03). Conclusions: Transmission of MRSA to gloves or gowns of HCP caring for patients on contact precautions for MRSA in non-ICU settings was lower than in the ICU setting. More evidence is needed to help guide the optimal use of contact precautions for the right patient, in the right setting, for the right type of encounter.Funding: NoneDisclosures: None

scholarly journals Inappropriateness of Antibiotic Prescribing in Medical, Surgical and Intensive Care Units: Results of a Multicentre Observational Study

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 475
Author(s):  
Margherita Macera ◽  
Federica Calò ◽  
Lorenzo Onorato ◽  
Giovanni Di Caprio ◽  
Caterina Monari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Units ◽  
Case Report Form ◽  
Antibiotic Prescribing ◽  
Duration Of Treatment ◽  
Campania Region ◽  
Stewardship Program ◽  
Surgical Units ◽  
Set Up

The objectives of the present study were to provide a snapshot analysis of antibiotic appropriateness in two hospitals in Southern Italy in three specific areas, surgical, medical and intensive care, and to evaluate the risk factors associated with inappropriateness in antimicrobial prescriptions. We conducted a multicentre observational study in two hospitals in the Campania region. We collected data of all patients admitted on the day of evaluation to antibiotic therapy or prophylaxis through a case report form. The primary outcome was to assess the inappropriateness of antibiotic prescribing, related to the spectrum, dose, route of administration and duration of treatment—in particular, to assess whether there was a difference in the adequacy of the prescriptive practice in the medical, surgical and intensive sectors. Prescriptive inappropriateness was more frequently observed in surgical units (79.8% of the 104 antimicrobial prescriptions) than in medical units (53.8% of the 65 prescriptions, p = 0.0003) or in intensive care units (64.1% of the 39 prescriptions, p = 0.052). The reasons for the inappropriate antimicrobial prescriptions were similar in the three areas evaluated: antimicrobial unnecessary and antimicrobial not recommended were the most frequent reasons for inappropriateness. Not participating in an antimicrobial stewardship program (ASP) was identified as a factor associated with inappropriate antimicrobial prescriptions in medical and surgical units, but not in Intensive Care Units (ICUs). ASPs may enhance the appropriateness of antimicrobial prescriptions especially in medical and surgical units. In ICUs, specific programs able to limit empirical therapies and encourage the collection of microbiological samples may be useful to set up targeted therapies and to design antimicrobial protocols.

Centros Ltd—A Complete U-Turn in the Right of Establishment for Companies?

2000 ◽  
Vol 49 (3) ◽  
pp. 621-642 ◽  
Author(s):  
Anne Looijestijn-Clearie
Keyword(s):  
United Kingdom ◽  
Member State ◽  
European Court Of Justice ◽  
The United Kingdom ◽  
Court Of Justice ◽  
European Court ◽  
Registered Office ◽  
Set Up ◽  
The Right ◽  
A Company

InCentros Ltd and Erhvers-og Selskabsstyrelesen (hereinafter Centros),1 the European Court of Justice ruled that it is contrary to Article 52 (now Article 432) and Article 58 (now Article 48) of the EC Treaty for the authorities of a member State (in casu Denmark) to refuse to register a branch of a company formed under the law of another member State (in casu the United Kingdom) in which it has its registered office, even if the company concerned has never conducted any business in the latter State and intends to carry out its entire business in the State in which the branch is to be set up. By avoiding the need to form a company there it would thus evade the application of the rules governing the provision for and the paying-up of a minimum share capital in force in that State. According to the Court, this does not, however, prevent the authorities of the member State in which the branch is to be set up from adopting appropriate measures for preventing or penalising fraud, either with regard to the company itself, if need be in co-operation with the member State in which it was formed, or with regard to its members, where it has been determined that they are in fact attempting, by means of the formation of a company, to evade their obligations towards creditors established in the territory of the member State of the branch.

Colonial Origins of Maoist Insurgency in India

2017 ◽  
Vol 62 (10) ◽  
pp. 2232-2274 ◽  
Author(s):  
Shivaji Mukherjee
Keyword(s):  
Ethnic Inequality ◽  
Long Term Effects ◽  
Security Threat ◽  
Data Set ◽  
Internal Security ◽  
New Instrument ◽  
Maoist Insurgency ◽  
Rule Set ◽  
Set Up ◽  
Indirect Rule

What are the long-term effects of colonial institutions on insurgency? My article shows the historical origins of insurgency by addressing the puzzle of why the persistent Maoist insurgency, considered to be India’s biggest internal security threat, affects some districts along the central eastern corridor of India but not others. Combining archival and interview data from fieldwork in Maoist zones with an original district-level quantitative data set, I demonstrate that different types of British colonial indirect rule set up the structural conditions of ethnic inequality and state weakness that facilitate emergence of Maoist control. I address the issue of selection bias, by developing a new instrument for the British choice of indirect rule through princely states, based on the exogenous effect of wars in Europe on British decisions in India. This article reconceptualizes colonial indirect rule and also presents new data on rebel control and precolonial rebellions.

scholarly journals Patients in intensive care unit for COVID-19 pneumonia: the lung ultrasound patterns at admission and discharge. An observational pilot study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Persona Paolo ◽  
Valeri Ilaria ◽  
Zarantonello Francesco ◽  
Forin Edoardo ◽  
Sella Nicolò ◽  
...  
Keyword(s):  
Intensive Care ◽  
Lung Ultrasound ◽  
Low Cost ◽  
Low Frequency ◽  
Specific Pattern ◽  
University Hospital ◽  
Left Hemithorax ◽  
Significant Difference ◽  
The Right ◽  
B Lines

Abstract Background During COVID-19 pandemic, optimization of the diagnostic resources is essential. Lung Ultrasound (LUS) is a rapid, easy-to-perform, low cost tool which allows bedside investigation of patients with COVID-19 pneumonia. We aimed to investigate the typical ultrasound patterns of COVID-19 pneumonia and their evolution at different stages of the disease. Methods We performed LUS in twenty-eight consecutive COVID-19 patients at both admission to and discharge from one of the Padua University Hospital Intensive Care Units (ICU). LUS was performed using a low frequency probe on six different areas per each hemithorax. A specific pattern for each area was assigned, depending on the prevalence of A-lines (A), non-coalescent B-lines (B1), coalescent B-lines (B2), consolidations (C). A LUS score (LUSS) was calculated after assigning to each area a defined pattern. Results Out of 28 patients, 18 survived, were stabilized and then referred to other units. The prevalence of C pattern was 58.9% on admission and 61.3% at discharge. Type B2 (19.3%) and B1 (6.5%) patterns were found in 25.8% of the videos recorded on admission and 27.1% (17.3% B2; 9.8% B1) on discharge. The A pattern was prevalent in the anterosuperior regions and was present in 15.2% of videos on admission and 11.6% at discharge. The median LUSS on admission was 27.5 [21–32.25], while on discharge was 31 [17.5–32.75] and 30.5 [27–32.75] in respectively survived and non-survived patients. On admission the median LUSS was equally distributed on the right hemithorax (13; 10.75–16) and the left hemithorax (15; 10.75–17). Conclusions LUS collected in COVID-19 patients with acute respiratory failure at ICU admission and discharge appears to be characterized by predominantly lateral and posterior non-translobar C pattern and B2 pattern. The calculated LUSS remained elevated at discharge without significant difference from admission in both groups of survived and non-survived patients.

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