Transcription enhancement of a digitised multi-lingual pamphlet collection: a case study and guide for similar projects

UCL Library Services holds an extensive collection of over 9,000 Jewish pamphlets, many of these extremely rare. Over the past five years, UCL has embarked on a project to widen access to this collection through an extensive programme of cataloguing, conservation and digitisation. With the cataloguing complete and the most fragile items conserved, the focus is now on making these texts available to global audiences via UCL Digital Collections website. The pamphlets were ranked for rarity, significance and fragility and the highest-scoring selected for digitisation. Unique identifiers allocated at the point of cataloguing were used to track individual pamphlets through the stages of the project. This guide details the text-enhancement methods used, highlighting particular issues relating to Hebrew scripts and early-printed texts. Initial attempts to enable images of these pamphlets to be searched digitally relied on the Optical Character Recognition (OCR) embedded within the software used to create the PDF files. Whilst satisfactory for texts chiefly in Roman script, it provided no reliable means to search the extensive corpus of texts in Hebrew. Generous advice offered by the National Library of Israel led to our adoption of ABBYY FineReader software as a means of enhancing the transcriptions embedded within the PDF files. Following image capture, JPEG files were used to create multi-page PDF files of each pamphlet. Pre-processing in ABBYY FineReader consisted of: setting the language and colour mode; detecting page orientation; selecting and refining areas of the text to be read; reading the text to produce a transcription. The resultant files were stored in folders according to language of text. The software highlighted spelling errors and doubtful readings. A verification tool allowed transcribers to correct these as required. However, some erroneous or doubtful readings were nevertheless genuine words and not highlighted; it was therefore essential to proofread the text, particularly for early-printed scripts. Transcribers maintained logs of common errors; additionally, problems with Hebrew vocalisations, cursive and Gothic scripts were noted. During initial quality checks of the transcriptions, many text searches were unsuccessful due to previously unidentified spacings occurring within words. This was generally linked to the font size being too small. Maintaining logs of font sizes used led to the adoption of a minimum of Arial 8 or Times New Roman 10 in transcribed text. The methodology was revised to include the preliminary quality-checking of one page. We concluded that it was difficult to develop a standardised procedure applicable to all texts given the variance in language, script and typography. However, we concluded that the font Arial gave the most successful accuracy ratings for Hebrew script, minimum text size 17, minimum title size 25. ABBYY file preparation took a minimum of 1.5 hours per pamphlet; transcription correction took an average of 10.4 minutes per page; the final quality check took 30 minutes per pamphlet. On average, the work on each pamphlet took a minimum of 6 hours to complete. As a result of the project, average accuracy ratings improved from 60% to 89%, the greatest improvement being for pre-1800 and Hebrew script publications. We are therefore inclined to focus future transcription-enhancement activity on these types of publication for the remainder of our Jewish Pamphlet Collections

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362