REDCap is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: 1) a brief description of the REDCap metadata-driven software toolset; 2) detail concerning the capture and use of study-related metadata from scientific research teams; 3) measures of impact for REDCap; 4) details concerning a consortium network of domestic and international institutions collaborating on the project; and 5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.

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A sharp transport barrier, accompanied by a bifurcated poloidal rotation and a radial electric field, is formed at the plasma edge by driving a radial current across the outer magnetic surfaces of a tokamak. A decrease in particle transport is observed for negative radial E fields. When the radial current is turned off, the E field and the rotation damp on a time scale comparable with the ion-ion collision time.PACS numbers: 52.25.Fi, 52.55.Pi, 52.70.Ds An intensive effort is in progress, worldwide, to correlate the large and growing data base of experimental observations on plasma transport in magnetic fusion containment devices with theoretical models. In particular, the so-called "//^-mode" regimes in tokamaks have attracted strong interest due to their enhanced particle and energy confinement properties. ^""^ The transition of a plasma into the H mode is marked by a sudden decrease in the hydrogenic light emission from the plasma edge, followed by a prolonged increase in the plasma density. The reduction of hydrogen light (H^ or H^) indicates that the incoming neutral particle flux is reduced, presumably because of a decrease of the outgoing plasma flux, leading to a reduction in "recycling." The improvement in the energy confinement is generally less than the increase in particle confinement, ^-mode measurements also reveal the formation of sharp density and temperature gradients inside the last closed magnetic surfaces, which represents a transport barrier. Despite the magnitude of the effort aimed at modeling the H mode, no clear mechanism has been identified, although radial electric fields are thought to play a role."*'^ In this Letter, experimental observations confirming the importance of the radial E field and the associated plasma rotation for 7/-mode confinement are presented.In 1979, electron injection was used to modify the edge potentials in order to reduce ion sputtering in the Macrotor tokamak.^ Subsequently, improved particle confinement and a concomitant impurity accumulation were observed,^ apparently giving rise to an H mode. These effects were attributed to the creation of edge radial electric fields and associated negative plasma potentials much larger in magnitude than Tgia), where a is the plasma radius. Recently we have extended this earlier work using the new, titanium-gettered. Continuous Current Tokamak (CCT) at the University of California, Los Angeles. The recent experiments clearly show the //-mode signatures found in other tokamaks in various limiter, divertor, and auxiliary-heating configurations. The previously seen impurity limitations^ have also been eased by new electrode designs. ^ For the //-mode-regime studies, CCT was operated in the pulsed neo-Alcator regime, with central parameters R^l.5 m, a =0,4 m, Bt=3 kG, /p=50 kA, ne=5 xlO*Vcm^ Kioop<1.5 V, Te>l50 eV, and T/> 100 e = 180 INSULATOR ELECTRODE = 0" C/2 Q 1.5 1.8 MAJOR RADIUS (M) FIG. 1. (a) Cross section of tokamak, a ^40 cm, showing the location of the exciting electrode, re ^25 cm, and the "rake" probe arrays used...

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Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

Abstract. A large data set of over 4,700 records of avian mercury (Hg) levels in northeastern North America was compiled and evaluated. As Hg emissions remain poorly regulated in the United States and Canada, atmospheric deposition patterns and associated ecological responses continue to elicit interest by landscape managers, conservation biologists, policy makers, and the general public. How avian Hg exposure is interpreted greatly influences decision-making practices. The geographic extent and size of this data set is valuable in understanding the factors that affect the exposure of Hg to birds. Featured are differences found among tissues, major aquatic habitats and geographic areas, between age class and gender, and among species. While Hg concentrations in egg and blood reflect short-term Hg exposure, Hg concentrations in liver and feather provide insight into long-term Hg exposure. Blood is a particularly important matrix for relating site-specific exposure to methylmercury (MeHg). The level of MeHg is generally 5-10x greater in adults compared to nestlings. Age also influences MeHg bioaccumulation, particularly for individuals where MeHg intake exceeds elimination. Gender is of interpretive concern when evaluating Hg exposure for species exhibiting sexual dimorphism and niche partitioning. Based on two indicator species, the belted kingfisher (Ceryle alcyon) and bald eagle (Haliaeetus leucocephalus), we found MeHg availability increased from marine, to estuarine and riverine systems, and was greatest in lake habitats. A large sample of >1,800 blood and egg Hg levels from the common loon (Gavia immer) facilitated a suitable comparison of geographic differences. Although some clusters of highly elevated Hg exposure (i.e., blood levels >3.0 lg/g, ww and egg levels >1.3 lg/g, ww) were associated with hydrological and biogeochemical factors known to increase MeHg production and availability, others were not. Geographic areas without a relationship between Hg exposure and biogeochemical processes were associated with emission or waterborne point sources. Differences in Hg exposure among species are primarily correlated with trophic position and availability of MeHg. Although piscivorous species were repeatedly *To whom correspondence should be addressed: Tel.: 207-839-7600; Fax: 207-839-7655; E-mail: david.evers@briloon.org Ecotoxicology, 14, 193-221, 2005 Ó 2005 shown to have some of the highest MeHg levels of the 38 species analyzed, insectivorous birds in both aquatic and terrestrial habitats (such as montane areas) were also found with elevated MeHg levels. A better understanding of the factors confounding interpretation of Hg exposure provides an effective basis for choice of indicator species and tissues according to 12 selected scenarios. This and the national need for spatiotemporal monitoring of MeHg availability require careful consideration of indicator species choice. Only then will local, regional, continental, and even global monitoring efforts be effective.

Anthropogenic input of mercury (Hg) into the environment has elevated risk to fish and wildlife, particularly in northeastern North America. Investigations into the transfer and fate of Hg have focused on inhabitants of freshwater aquatic ecosystems, as these are the habitats at greatest risk for methylmercury (MeHg) biomagnification. Deviating from such an approach, we documented MeHg availability in a terrestrial montane ecosystem using a suite of insectivorous passerines. Intensive and extensive sampling of Bicknell's thrush (Catharus bicknelli) indicated significant heterogeneity in MeHg availability across 21 mountaintops in northeastern North America. Southern parts of the breeding range tended to be at greater risk than northern parts. Mean blood Hg concentrations for Bicknell's thrush at 21 distinct breeding sites ranged from 0.08 to 0.38 ug/g (ww) and at seven Greater Antillean wintering sites ranged from 0.03 to 0.42 ug/g (ww). Overall concentrations were significantly greater in wintering than in breeding areas. Mercury exposure profiles for four passerine species on Mt. Mansfield, Vermont indicated greatest MeHg uptake in Bicknell's thrush and yellow-rumped warbler (Dendroica coronata) and lowest in blackpoll warbler (Dendroica striata) and white-throated sparrow (Zonotrichia albicollis). The MeHg and total Hg ratio in blood in these four species was nearly 1:1. There was no correlation between blood and feather Hg concentrations in breeding Bicknell's thrush, in part because of apparent retention of winter Hg body burdens, within-season variation of MeHg availability, and confounding factors such as influences from age. Adult thrushes had significantly higher concentrations of feather Hg than did young-of-the-year. Although individual patterns of inter-year feather Hg concentrations were disordered, some individuals exhibited bioaccumulation of MeHg. Female blood Hg concentrations were significantly lower than males', in part because females have additional depurating mechanisms through eggs. Older male Bicknell's thrushes that breed in New England are therefore likely at greatest risk. Mechanisms for Hg methylation in montane areas without standing water are not yet fully understood. However, recent studies indicate that MeHg is present in forest tree leaves and leaf detritus; saturated soils and other moist microhabitats may also contribute to MeHg availability. Our finding of a correlation between regional litterfall Hg flux patterns and Bicknell's thrush blood Hg concentrations demonstrates on-site availability of MeHg. Further investigations into MeHg availability in montane environments are recommended to assess risk to insectivorous passerines, particularly the Bicknell's thrush.

BackgroundGrowing evidence suggests respiratory syncytial virus (RSV) is an important cause of respiratory disease in adults. However, the adult burden remains largely uncharacterized as most RSV studies focus on children, and population-based studies with laboratory-confirmation of infection are difficult to implement. Indirect modelling methods, long used for influenza, can further our understanding of RSV burden by circumventing some limitations of traditional surveillance studies that rely on direct linkage of individual-level exposure and outcome data.MethodsMultiple linear time-series regression was used to estimate RSV burden in the United Kingdom (UK) between 1995 and 2009 among the total population and adults in terms of general practice (GP) episodes (counted as first consultation ≥28 days following any previous consultation for same diagnosis/diagnostic group), hospitalisations, and deaths for respiratory disease, using data from Public Health England weekly influenza/RSV surveillance, Clinical Practice Research Datalink, Hospital Episode Statistics, and Office of National Statistics. The main outcome considered all ICD-listed respiratory diseases and, for GP episodes, related symptoms. Estimates were adjusted for non-specific seasonal drivers of disease using secular cyclical terms and stratified by age and risk group (according to chronic conditions indicating severe influenza risk as per UK recommendations for influenza vaccination). Trial registration NCT01706302. Registered 11 October 2012.ResultsAmong adults aged 18+ years an estimated 487,247 GP episodes, 17,799 hospitalisations, and 8,482 deaths were attributable to RSV per average season. Of these, 175,070 GP episodes (36 %), 14,039 hospitalisations (79 %) and 7,915 deaths (93 %) were in persons aged 65+ years. High- versus low-risk elderly were two-fold more likely to have a RSV-related GP episode or death and four-fold more likely be hospitalised for RSV. In most seasons since 2001, more GP episodes, hospitalisations and deaths were attributable to RSV in adults than to influenza.ConclusionRSV is associated with a substantial disease burden in adults comparable to influenza, with most of the hospitalisation and mortality burden in the elderly. Treatment options and measures to prevent RSV could have a major impact on the burden of RSV respiratory disease in adults, especially the elderly.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1218-z) contains supplementary material, which is available to authorized users.