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# ==================================================================== #
# TITLE #
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# Antimicrobial Resistance (AMR) Analysis for R #
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# #
# SOURCE #
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# https://github.com/msberends/AMR #
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# #
# LICENCE #
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# (c) 2018-2020 Berends MS, Luz CF et al. #
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# Developed at the University of Groningen, the Netherlands, in #
# collaboration with non-profit organisations Certe Medical #
# Diagnostics & Advice, and University Medical Center Groningen. #
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# #
# This R package is free software; you can freely use and distribute #
# it for both personal and commercial purposes under the terms of the #
# GNU General Public License version 2.0 (GNU GPL-2), as published by #
# the Free Software Foundation. #
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# We created this package for both routine data analysis and academic #
# research and it was publicly released in the hope that it will be #
# useful, but it comes WITHOUT ANY WARRANTY OR LIABILITY. #
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# #
# Visit our website for the full manual and a complete tutorial about #
# how to conduct AMR analysis: https://msberends.github.io/AMR/ #
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# ==================================================================== #
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#' Transform input to an antibiotic ID
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#'
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#' Use this function to determine the antibiotic code of one or more antibiotics. The data set [antibiotics] will be searched for abbreviations, official names and synonyms (brand names).
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#' @inheritSection lifecycle Stable lifecycle
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#' @param x character vector to determine to antibiotic ID
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#' @param flag_multiple_results logical to indicate whether a note should be printed to the console that probably more than one antibiotic code or name can be retrieved from a single input value.
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#' @param info logical to indicate whether a progress bar should be printed
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#' @param ... arguments passed on to internal functions
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#' @rdname as.ab
#' @inheritSection WHOCC WHOCC
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#' @details All entries in the [antibiotics] data set have three different identifiers: a human readable EARS-Net code (column `ab`, used by ECDC and WHONET), an ATC code (column `atc`, used by WHO), and a CID code (column `cid`, Compound ID, used by PubChem). The data set contains more than 5,000 official brand names from many different countries, as found in PubChem.
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#'
#' All these properties will be searched for the user input. The [as.ab()] can correct for different forms of misspelling:
#'
#' * Wrong spelling of drug names (like "tobramicin" or "gentamycin"), which corrects for most audible similarities such as f/ph, x/ks, c/z/s, t/th, etc.
#' * Too few or too many vowels or consonants
#' * Switching two characters (like "mreopenem", often the case in clinical data, when doctors typed too fast)
#' * Digitalised paper records, leaving artefacts like 0/o/O (zero and O's), B/8, n/r, etc.
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#'
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#' Use the [ab_property()] functions to get properties based on the returned antibiotic ID, see Examples.
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#'
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#' @section Source:
#' World Health Organization (WHO) Collaborating Centre for Drug Statistics Methodology: \url{https://www.whocc.no/atc_ddd_index/}
#'
#' WHONET 2019 software: \url{http://www.whonet.org/software.html}
#'
#' European Commission Public Health PHARMACEUTICALS - COMMUNITY REGISTER: \url{http://ec.europa.eu/health/documents/community-register/html/atc.htm}
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#' @aliases ab
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#' @return A [character] [vector] with additional class [`ab`]
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#' @seealso
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#' * [antibiotics] for the [data.frame] that is being used to determine ATCs
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#' * [ab_from_text()] for a function to retrieve antimicrobial drugs from clinical text (from health care records)
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#' @inheritSection AMR Reference data publicly available
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#' @inheritSection AMR Read more on our website!
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#' @export
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#' @examples
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#' # these examples all return "ERY", the ID of erythromycin:
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#' as.ab("J01FA01")
#' as.ab("J 01 FA 01")
#' as.ab("Erythromycin")
#' as.ab("eryt")
#' as.ab(" eryt 123")
#' as.ab("ERYT")
#' as.ab("ERY")
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#' as.ab("eritromicine") # spelled wrong, yet works
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#' as.ab("Erythrocin") # trade name
#' as.ab("Romycin") # trade name
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#'
#' # spelling from different languages and dyslexia are no problem
#' ab_atc("ceftriaxon")
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#' ab_atc("cephtriaxone") # small spelling error
#' ab_atc("cephthriaxone") # or a bit more severe
#' ab_atc("seephthriaaksone") # and even this works
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#'
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#' # use ab_* functions to get a specific properties (see ?ab_property);
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#' # they use as.ab() internally:
#' ab_name("J01FA01") # "Erythromycin"
#' ab_name("eryt") # "Erythromycin"
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as.ab <- function ( x , flag_multiple_results = TRUE , info = TRUE , ... ) {
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meet_criteria ( x , allow_class = c ( " character" , " numeric" , " integer" , " factor" ) , allow_NA = TRUE )
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meet_criteria ( flag_multiple_results , allow_class = " logical" , has_length = 1 )
meet_criteria ( info , allow_class = " logical" , has_length = 1 )
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check_dataset_integrity ( )
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if ( is.ab ( x ) ) {
return ( x )
}
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initial_search <- is.null ( list ( ... ) $ initial_search )
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already_regex <- isTRUE ( list ( ... ) $ already_regex )
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if ( all ( toupper ( x ) %in% antibiotics $ ab ) ) {
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# valid AB code, but not yet right class
return ( structure ( .Data = toupper ( x ) ,
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class = c ( " ab" , " character" ) ) )
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}
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x_bak <- x
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x <- toupper ( x )
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# remove diacritics
x <- iconv ( x , from = " UTF-8" , to = " ASCII//TRANSLIT" )
x <- gsub ( ' "' , " " , x , fixed = TRUE )
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x <- gsub ( " (specimen|specimen date|specimen_date|spec_date)" , " " , x , ignore.case = TRUE , perl = TRUE )
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x_bak_clean <- x
if ( already_regex == FALSE ) {
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x_bak_clean <- generalise_antibiotic_name ( x_bak_clean )
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}
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x <- unique ( x_bak_clean ) # this means that every x is in fact generalise_antibiotic_name(x)
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x_new <- rep ( NA_character_ , length ( x ) )
x_unknown <- character ( 0 )
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note_if_more_than_one_found <- function ( found , index , from_text ) {
if ( initial_search == TRUE & isTRUE ( length ( from_text ) > 1 ) ) {
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abnames <- ab_name ( from_text , tolower = TRUE , initial_search = FALSE )
if ( ab_name ( found [1L ] , language = NULL ) %like% " clavulanic acid" ) {
abnames <- abnames [ ! abnames == " clavulanic acid" ]
}
if ( length ( abnames ) > 1 ) {
message ( font_blue ( paste0 ( " NOTE: more than one result was found for item " , index , " : " ,
paste0 ( abnames , collapse = " , " ) ) ) )
}
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}
found [1L ]
}
if ( initial_search == TRUE ) {
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progress <- progress_ticker ( n = length ( x ) , n_min = ifelse ( isTRUE ( info ) , 25 , length ( x ) + 1 ) ) # start if n >= 25
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on.exit ( close ( progress ) )
}
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for ( i in seq_len ( length ( x ) ) ) {
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if ( initial_search == TRUE ) {
progress $ tick ( )
}
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if ( is.na ( x [i ] ) | is.null ( x [i ] ) ) {
next
}
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if ( identical ( x [i ] , " " ) |
# no short names:
nchar ( x [i ] ) <= 2 |
# prevent "bacteria" from coercing to TMP, since Bacterial is a brand name of it:
identical ( tolower ( x [i ] ) , " bacteria" ) ) {
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x_unknown <- c ( x_unknown , x_bak [x [i ] == x_bak_clean ] [1 ] )
next
}
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if ( isTRUE ( flag_multiple_results ) & x [i ] %like% " [ ]" ) {
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from_text <- suppressWarnings ( ab_from_text ( x [i ] , initial_search = FALSE , translate_ab = FALSE ) [ [1 ] ] )
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} else {
from_text <- character ( 0 )
}
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# exact name
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found <- antibiotics [which ( AB_lookup $ generalised_name == x [i ] ) , ] $ ab
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if ( length ( found ) > 0 ) {
x_new [i ] <- found [1L ]
next
}
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# exact AB code
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found <- antibiotics [which ( antibiotics $ ab == x [i ] ) , ] $ ab
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# exact ATC code
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found <- antibiotics [which ( antibiotics $ atc == x [i ] ) , ] $ ab
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# exact CID code
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found <- antibiotics [which ( antibiotics $ cid == x [i ] ) , ] $ ab
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# exact LOINC code
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loinc_found <- unlist ( lapply ( AB_lookup $ generalised_loinc ,
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function ( s ) x [i ] %in% s ) )
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found <- antibiotics $ ab [loinc_found == TRUE ]
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# exact synonym
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synonym_found <- unlist ( lapply ( AB_lookup $ generalised_synonyms ,
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function ( s ) x [i ] %in% s ) )
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found <- antibiotics $ ab [synonym_found == TRUE ]
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# exact abbreviation
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abbr_found <- unlist ( lapply ( AB_lookup $ generalised_abbreviations ,
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function ( s ) x [i ] %in% s ) )
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found <- antibiotics $ ab [abbr_found == TRUE ]
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# allow characters that resemble others, but only continue when having more than 3 characters
if ( nchar ( x [i ] ) <= 3 ) {
x_unknown <- c ( x_unknown , x_bak [x [i ] == x_bak_clean ] [1 ] )
next
}
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x_spelling <- x [i ]
if ( already_regex == FALSE ) {
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x_spelling <- gsub ( " [IY]+" , " [IY]+" , x_spelling , perl = TRUE )
x_spelling <- gsub ( " (C|K|Q|QU|S|Z|X|KS)+" , " (C|K|Q|QU|S|Z|X|KS)+" , x_spelling , perl = TRUE )
x_spelling <- gsub ( " (PH|F|V)+" , " (PH|F|V)+" , x_spelling , perl = TRUE )
x_spelling <- gsub ( " (TH|T)+" , " (TH|T)+" , x_spelling , perl = TRUE )
x_spelling <- gsub ( " A+" , " A+" , x_spelling , perl = TRUE )
x_spelling <- gsub ( " E+" , " E+" , x_spelling , perl = TRUE )
x_spelling <- gsub ( " O+" , " O+" , x_spelling , perl = TRUE )
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# allow any ending of -in/-ine and -im/-ime
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x_spelling <- gsub ( " (\\[IY\\]\\+(N|M)|\\[IY\\]\\+(N|M)E\\+)$" , " [IY]+(N|M)E*" , x_spelling , perl = TRUE )
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# allow any ending of -ol/-ole
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x_spelling <- gsub ( " (O\\+L|O\\+LE\\+)$" , " O+LE*" , x_spelling , perl = TRUE )
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# allow any ending of -on/-one
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x_spelling <- gsub ( " (O\\+N|O\\+NE\\+)$" , " O+NE*" , x_spelling , perl = TRUE )
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# replace multiple same characters to single one with '+', like "ll" -> "l+"
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x_spelling <- gsub ( " (.)\\1+" , " \\1+" , x_spelling , perl = TRUE )
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# replace spaces and slashes with a possibility on both
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x_spelling <- gsub ( " [ /]" , " ( .*|.*/)" , x_spelling , perl = TRUE )
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# correct for digital reading text (OCR)
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x_spelling <- gsub ( " [NRD8B]" , " [NRD8B]" , x_spelling , perl = TRUE )
x_spelling <- gsub ( " (O|0)" , " (O|0)+" , x_spelling , perl = TRUE )
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x_spelling <- gsub ( " ++" , " +" , x_spelling , fixed = TRUE )
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}
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# try if name starts with it
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found <- antibiotics [which ( AB_lookup $ generalised_name %like% paste0 ( " ^" , x_spelling ) ) , ] $ ab
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# try if name ends with it
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found <- antibiotics [which ( AB_lookup $ generalised_name %like% paste0 ( x_spelling , " $" ) ) , ] $ ab
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if ( nchar ( x [i ] ) >= 4 & length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# and try if any synonym starts with it
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synonym_found <- unlist ( lapply ( AB_lookup $ generalised_synonyms ,
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function ( s ) any ( s %like% paste0 ( " ^" , x_spelling ) ) ) )
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found <- antibiotics $ ab [synonym_found == TRUE ]
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if ( length ( found ) > 0 ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# INITIAL SEARCH - More uncertain results ----
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if ( initial_search == TRUE ) {
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# only run on first try
# try by removing all spaces
if ( x [i ] %like% " " ) {
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found <- suppressWarnings ( as.ab ( gsub ( " +" , " " , x [i ] , perl = TRUE ) , initial_search = FALSE ) )
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if ( length ( found ) > 0 & ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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}
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# try by removing all spaces and numbers
if ( x [i ] %like% " " | x [i ] %like% " [0-9]" ) {
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found <- suppressWarnings ( as.ab ( gsub ( " [ 0-9]" , " " , x [i ] , perl = TRUE ) , initial_search = FALSE ) )
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if ( length ( found ) > 0 & ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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}
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# transform back from other languages and try again
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x_translated <- paste ( lapply ( strsplit ( x [i ] , " [^A-Z0-9]" ) ,
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function ( y ) {
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for ( i in seq_len ( length ( y ) ) ) {
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y [i ] <- ifelse ( tolower ( y [i ] ) %in% tolower ( translations_file $ replacement ) ,
translations_file [which ( tolower ( translations_file $ replacement ) == tolower ( y [i ] ) &
! isFALSE ( translations_file $ fixed ) ) , " pattern" ] ,
y [i ] )
}
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generalise_antibiotic_name ( y )
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} ) [ [1 ] ] ,
collapse = " /" )
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x_translated_guess <- suppressWarnings ( as.ab ( x_translated , initial_search = FALSE ) )
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if ( ! is.na ( x_translated_guess ) ) {
x_new [i ] <- x_translated_guess
next
}
# now also try to coerce brandname combinations like "Amoxy/clavulanic acid"
x_translated <- paste ( lapply ( strsplit ( x_translated , " [^A-Z0-9 ]" ) ,
function ( y ) {
for ( i in seq_len ( length ( y ) ) ) {
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y_name <- suppressWarnings ( ab_name ( y [i ] , language = NULL , initial_search = FALSE ) )
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y [i ] <- ifelse ( ! is.na ( y_name ) ,
y_name ,
y [i ] )
}
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generalise_antibiotic_name ( y )
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} ) [ [1 ] ] ,
collapse = " /" )
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x_translated_guess <- suppressWarnings ( as.ab ( x_translated , initial_search = FALSE ) )
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if ( ! is.na ( x_translated_guess ) ) {
x_new [i ] <- x_translated_guess
next
}
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# try by removing all trailing capitals
if ( x [i ] %like_case% " [a-z]+[A-Z]+$" ) {
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found <- suppressWarnings ( as.ab ( gsub ( " [A-Z]+$" , " " , x [i ] , perl = TRUE ) , initial_search = FALSE ) )
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if ( ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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}
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# keep only letters
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found <- suppressWarnings ( as.ab ( gsub ( " [^A-Z]" , " " , x [i ] , perl = TRUE ) , initial_search = FALSE ) )
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if ( ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# try from a bigger text, like from a health care record, see ?ab_from_text
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# already calculated above if flag_multiple_results = TRUE
if ( isTRUE ( flag_multiple_results ) ) {
found <- from_text [1L ]
} else {
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found <- suppressWarnings ( ab_from_text ( x [i ] , initial_search = FALSE , translate_ab = FALSE ) [ [1 ] ] [1L ] )
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}
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if ( ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# first 5 except for cephalosporins, then first 7 (those cephalosporins all start quite the same!)
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found <- suppressWarnings ( as.ab ( substr ( x [i ] , 1 , 5 ) , initial_search = FALSE ) )
if ( ! is.na ( found ) && ! ab_group ( found , initial_search = FALSE ) %like% " cephalosporins" ) {
x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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found <- suppressWarnings ( as.ab ( substr ( x [i ] , 1 , 7 ) , initial_search = FALSE ) )
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if ( ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
# make all consonants facultative
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search_str <- gsub ( " ([BCDFGHJKLMNPQRSTVWXZ])" , " \\1*" , x [i ] , perl = TRUE )
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found <- suppressWarnings ( as.ab ( search_str , initial_search = FALSE , already_regex = TRUE ) )
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# keep at least 4 normal characters
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if ( nchar ( gsub ( " .\\*" , " " , search_str , perl = TRUE ) ) < 4 ) {
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found <- NA
}
if ( ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# make all vowels facultative
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search_str <- gsub ( " ([AEIOUY])" , " \\1*" , x [i ] , perl = TRUE )
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found <- suppressWarnings ( as.ab ( search_str , initial_search = FALSE , already_regex = TRUE ) )
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# keep at least 5 normal characters
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if ( nchar ( gsub ( " .\\*" , " " , search_str , perl = TRUE ) ) < 5 ) {
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found <- NA
}
if ( ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
# allow misspelling of vowels
x_spelling <- gsub ( " A+" , " [AEIOU]+" , x_spelling , fixed = TRUE )
x_spelling <- gsub ( " E+" , " [AEIOU]+" , x_spelling , fixed = TRUE )
x_spelling <- gsub ( " I+" , " [AEIOU]+" , x_spelling , fixed = TRUE )
x_spelling <- gsub ( " O+" , " [AEIOU]+" , x_spelling , fixed = TRUE )
x_spelling <- gsub ( " U+" , " [AEIOU]+" , x_spelling , fixed = TRUE )
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found <- suppressWarnings ( as.ab ( x_spelling , initial_search = FALSE , already_regex = TRUE ) )
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if ( ! is.na ( found ) ) {
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x_new [i ] <- note_if_more_than_one_found ( found , i , from_text )
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next
}
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# try with switched character, like "mreopenem"
for ( j in seq_len ( nchar ( x [i ] ) ) ) {
x_switched <- paste0 (
# beginning part:
substr ( x [i ] , 1 , j - 1 ) ,
# here is the switching of 2 characters:
substr ( x [i ] , j + 1 , j + 1 ) ,
substr ( x [i ] , j , j ) ,
# ending part:
substr ( x [i ] , j + 2 , nchar ( x [i ] ) ) )
found <- suppressWarnings ( as.ab ( x_switched , initial_search = FALSE ) )
if ( ! is.na ( found ) ) {
break
}
}
if ( ! is.na ( found ) ) {
x_new [i ] <- found [1L ]
next
}
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} # end of initial_search = TRUE
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# not found
x_unknown <- c ( x_unknown , x_bak [x [i ] == x_bak_clean ] [1 ] )
}
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if ( initial_search == TRUE ) {
close ( progress )
}
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# take failed ATC codes apart from rest
x_unknown_ATCs <- x_unknown [x_unknown %like% " [A-Z][0-9][0-9][A-Z][A-Z][0-9][0-9]" ]
x_unknown <- x_unknown [ ! x_unknown %in% x_unknown_ATCs ]
if ( length ( x_unknown_ATCs ) > 0 ) {
warning ( " These ATC codes are not (yet) in the antibiotics data set: " ,
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paste ( ' "' , sort ( unique ( x_unknown_ATCs ) ) , ' "' , sep = " " , collapse = " , " ) ,
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" ." ,
call. = FALSE )
}
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if ( length ( x_unknown ) > 0 ) {
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warning ( " These values could not be coerced to a valid antimicrobial ID: " ,
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paste ( ' "' , sort ( unique ( x_unknown ) ) , ' "' , sep = " " , collapse = " , " ) ,
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" ." ,
call. = FALSE )
}
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x_result <- data.frame ( x = x_bak_clean , stringsAsFactors = FALSE ) %pm>%
pm_left_join ( data.frame ( x = x , x_new = x_new , stringsAsFactors = FALSE ) , by = " x" ) %pm>%
pm_pull ( x_new )
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if ( length ( x_result ) == 0 ) {
x_result <- NA_character_
}
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structure ( .Data = x_result ,
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class = c ( " ab" , " character" ) )
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}
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#' @rdname as.ab
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#' @export
is.ab <- function ( x ) {
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inherits ( x , " ab" )
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}
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# will be exported using s3_register() in R/zzz.R
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pillar_shaft.ab <- function ( x , ... ) {
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out <- trimws ( format ( x ) )
out [is.na ( x ) ] <- font_na ( NA )
create_pillar_column ( out , align = " left" , min_width = 4 )
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}
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# will be exported using s3_register() in R/zzz.R
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type_sum.ab <- function ( x , ... ) {
" ab"
}
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#' @method print ab
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#' @export
#' @noRd
print.ab <- function ( x , ... ) {
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cat ( " Class <ab>\n" )
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print ( as.character ( x ) , quote = FALSE )
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}
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#' @method as.data.frame ab
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#' @export
#' @noRd
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as.data.frame.ab <- function ( x , ... ) {
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nm <- deparse1 ( substitute ( x ) )
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if ( ! " nm" %in% names ( list ( ... ) ) ) {
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as.data.frame.vector ( as.ab ( x ) , ... , nm = nm )
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} else {
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as.data.frame.vector ( as.ab ( x ) , ... )
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}
}
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#' @method [ ab
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#' @export
#' @noRd
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" [.ab" <- function ( x , ... ) {
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y <- NextMethod ( )
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attributes ( y ) <- attributes ( x )
y
}
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#' @method [[ ab
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#' @export
#' @noRd
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" [[.ab" <- function ( x , ... ) {
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y <- NextMethod ( )
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attributes ( y ) <- attributes ( x )
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y
}
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#' @method [<- ab
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#' @export
#' @noRd
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" [<-.ab" <- function ( i , j , ... , value ) {
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y <- NextMethod ( )
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attributes ( y ) <- attributes ( i )
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class_integrity_check ( y , " antimicrobial code" , antibiotics $ ab )
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}
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#' @method [[<- ab
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#' @export
#' @noRd
" [[<-.ab" <- function ( i , j , ... , value ) {
y <- NextMethod ( )
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attributes ( y ) <- attributes ( i )
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class_integrity_check ( y , " antimicrobial code" , antibiotics $ ab )
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}
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#' @method c ab
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#' @export
#' @noRd
c.ab <- function ( x , ... ) {
y <- NextMethod ( )
attributes ( y ) <- attributes ( x )
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class_integrity_check ( y , " antimicrobial code" , antibiotics $ ab )
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}
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#' @method unique ab
#' @export
#' @noRd
unique.ab <- function ( x , incomparables = FALSE , ... ) {
y <- NextMethod ( )
attributes ( y ) <- attributes ( x )
y
}
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generalise_antibiotic_name <- function ( x ) {
x <- toupper ( x )
# remove suffices
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x <- gsub ( " _(MIC|RSI|DIS[CK])$" , " " , x , perl = TRUE )
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# remove disk concentrations, like LVX_NM -> LVX
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x <- gsub ( " _[A-Z]{2}[0-9_.]{0,3}$" , " " , x , perl = TRUE )
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# remove part between brackets if that's followed by another string
x <- gsub ( " (.*)+ [(].*[)]" , " \\1" , x )
# keep only max 1 space
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x <- trimws2 ( gsub ( " +" , " " , x , perl = TRUE ) )
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# non-character, space or number should be a slash
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x <- gsub ( " [^A-Z0-9 -]" , " /" , x , perl = TRUE )
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# spaces around non-characters must be removed: amox + clav -> amox/clav
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x <- gsub ( " (.*[A-Z0-9]) ([^A-Z0-9].*)" , " \\1\\2" , x , perl = TRUE )
x <- gsub ( " (.*[^A-Z0-9]) ([A-Z0-9].*)" , " \\1\\2" , x , perl = TRUE )
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# remove hyphen after a starting "co"
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x <- gsub ( " ^CO-" , " CO" , x , perl = TRUE )
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# replace operators with a space
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x <- gsub ( " (/| AND | WITH | W/|[+]|[-])+" , " " , x , perl = TRUE )
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x
}