Background: The coronavirus disease 2019 (COVID-19) pandemic is rapidly expanding across the world, with more than 100,000 new cases each day as of end-June 2020. Healthcare workers are struggling to provide the best care for COVID-19 patients. Approaches for invasive ventilation vary widely between and within countries and new insights are acquired rapidly. We aim to investigate invasive ventilation practices and outcome in COVID-19 patients in the Netherlands.Methods: PRoVENT-COVID ('study of PRactice of VENTilation in COVID-19') is an investigator-initiated national, multicenter observational study to be undertaken in intensive care units (ICUs) in The Netherlands. Consecutive COVID-19 patients aged 18 years or older, who are receiving invasive ventilation in the participating ICUs, are to be enrolled during a 10-week period, with a daily follow-up of 7 days. The primary outcome is ventilatory management (including tidal volume expressed as mL/kg predicted body weight and positive end-expiratory pressure expressed as cmH2O) during the first 3 days of ventilation. Secondary outcomes include other ventilatory variables, use of rescue therapies for refractory hypoxemia such as prone positioning and extracorporeal membrane oxygenation, use of sedatives, vasopressors and inotropes; daily cumulative fluid balances; acute kidney injury; ventilator-free days and alive at day 28 (VFD-28), duration of ICU and hospital stay, and ICU, hospital and 90-day mortality.Discussion: PRoVENT-COVID will be the largest observational study to date, with high density ventilatory data and major outcomes. There is urgent need for a better understanding of ventilation practices, and the effects of ventilator settings on outcomes in COVID-19 patients. The results of PRoVENT-COVID will be rapidly disseminated through electronic presentations, such as webinars and electronic conferences, and publications in international peer-reviewed journals. Access to source data will be made available through local, regional and national anonymized datasets on request, and after agreement of the PRoVENT-COVID steering committee.Trial Registration: PRoVENT-COVID is registered at clinicaltrials.gov (identifier NCT04346342).
The study of human factors in forensic science informs our understanding of the interaction between humans and the systems they use. The Expert Working Group (EWG) on Human Factors in Forensic DNA Interpretation used a systems approach to conduct a scientific assessment of the effects of human factors on forensic DNA interpretation with the goal of recommending approaches to improve practice and reduce the likelihood and consequence of errors. This effort resulted in 44 recommendations. The EWG designed many of these recommendations to improve the production, interpretation, evaluation, documentation, and communication of DNA comparison results.
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What options are open for peoplecitizens, politicians, and other nonscientiststo become actively involved in and anticipate new directions in the life sciences? In addressing this question, this article focuses on the start of the Human Genome Project (1985-1990). By contrasting various models of democracy (liberal, republican, deliberative), I examine the democratic potential the models provide for citizens' involvement in setting priorities and funding patterns related to big science projects. To enhance the democratizing of big science projects and give citizens opportunities to reflect, anticipate, and negotiate on newdirections in science and technology at a global level, liberal democracy with its national scope and representative structure does not suffice. Although republican (communicative) and deliberative (associative) democracy models meet the need for greater citizen involvement, the ways to achieve the ideal at a global level still remain to be developed.
