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Individuals experiencing different medical conditions, as well as healthy volunteers, may often be interested in trial participation, and researchers similarly need to find participants to advance medical knowledge. The ResearchMatch Trials Today clinical trial searching tool leverages clinicaltrials.gov data to enable potential participants to look for trial opportunities relevant to their situation. To facilitate expanded use of this tool, we undertook a national digital public awareness campaign to increase awareness of Trials Today among members of the general public.
The awareness campaign promoted Trials Today using Facebook and digital banner messages in 2017, encompassing nine cities across the US. The digital strategy was complemented by print media in several outlets. We employed descriptive statistics to summarize campaign metrics and site usage data during the campaign.
The campaign was successful in increasing visits to Trials Today, with 142,303 sessions logged during its run, as compared to pre-campaign data indicating 104,688 total sessions during the entire two year period since the site’s inception. The city-specific click-through rate for all digital impressions, combining Facebook and banner messaging, ranged from 0.50% to 1.09%, resulting in a cost-per-click range of $0.69 to $1.15. In addition, visitors conducted 29,697 searches and viewed individual trial records 173,512 times.
The public awareness campaign was successful in increasing use of the ResearchMatch Trials Today clinical trial searching tool. Our findings support the value of digital media messaging as a cost-effective vehicle for promoting clinical trial awareness, especially for chronic ailments.
Inefficiencies in the national clinical research infrastructure have been apparent for decades. The National Center for Advancing Translational Science—sponsored Clinical and Translational Science Award (CTSA) program is able to address such inefficiencies. The Trial Innovation Network (TIN) is a collaborative initiative with the CTSA program and other National Institutes of Health (NIH) Institutes and Centers that addresses critical roadblocks to accelerate the translation of novel interventions to clinical practice. The TIN’s mission is to execute high-quality trials in a quick, cost-efficient manner. The TIN awardees are composed of 3 Trial Innovation Centers, the Recruitment Innovation Center, and the individual CTSA institutions that have identified TIN Liaison units. The TIN has launched a national scale single (central) Institutional Review Board system, master contracting agreements, quality-by-design approaches, novel recruitment support methods, and applies evidence-based strategies to recruitment and patient engagement. The TIN has received 113 submissions from 39 different CTSA institutions and 8 non-CTSA Institutions, with projects associated with 12 different NIH Institutes and Centers across a wide range of clinical/disease areas. Already more than 150 unique health systems/organizations are involved as sites in TIN-related multisite studies. The TIN will begin to capture data and metrics that quantify increased efficiency and quality improvement during operations.
Potential participants seek information about clinical trials for many reasons, but the process can be challenging. We analyzed 101,249 searches in ResearchMatch Trials Today, a free interface to recruiting trials from ClinicalTrials.gov. Searches from March 2015 to November 2016 included a broad range of conditions and healthy volunteer concepts, including 12,649 unique topics. Trials Today data indicate that it is being used to identify trials on a variety of topics.
The use of monthly intranasal mupirocin was associated with a significant reduction in the rate of methicillin-resistant Staphylococcus aureus transmission and Staphylococcus aureus invasive infection in a large neonatal intensive care unit. Resistance to mupirocin emerged over time, but it was rare and was not associated with adverse clinical outcomes.
This review considers the likely impact of changing consumer requirements, political pressure, economics and technological advances on the dairy production industry of the future. The vision is one of diverse strategies of production, the majority of milk being produced from cows managed technologically with much greater regard for welfare, with a number of ‘romantic’ strategies such as organic, extensive or dual-purpose production supplying niche markets. The important novel feature of the technological strategy will be an escape from the intensive twelve-month lactation cycle to extended lactations of, say, eighteen months, since this will reduce the number of times the cow is exposed to metabolic and other stresses associated with parturition, peak lactation and rebreeding.
Reliable and affordable technology for collecting and managing livestock production process information is being developed. The advances in data measurement, collection and transfer technology enable us to retrieve information from one or more remote sites to be processed and managed centrally. This opens up the opportunity to advance from open loop, prescriptive production to closed loop systems where factors influencing the actual performance of animals are used to modify and improve their production parameters (feed, environment, medication). We strive from producing animals by predicting what is needed using outdated data, to measuring what is actually happening as they grow, processing this information and acting to optimise animal performance by modifying production parameters in real time.
This paper describes commercially available systems that make possible the retrieval, collection, processing and distribution of near real time production information. Various aspects of production management using this technology are discussed, and examples of how it can be applied to monitor water usage, how it relates to pig performance and how energy usage can be influenced, are considered.
In this paper, first results comparing modified Longin and ninhydrin collagen extraction methodologies are presented. The goal of this study is to investigate the bones of several species with different ages, preservation conditions, and collagen contents to determine the most suitable preparation method. Different types of samples are used such as VIRI samples, previously dated bones, and background samples. Each bone has undergone elemental analysis, infrared analysis, and 14C measurement. The results are presented and the advantages and disadvantages of each preparation method are discussed. In general, results obtained by the two methods are in accordance with the consensus value for 2σ uncertainty. For VIRI I and a mammoth bone, the ninhydrin preparation gives, respectively, 8450±70 BP and 14,870±60 BP whereas the modified Longin process gives 8365±45 BP and 14,750±100 BP in agreement with the expected values. From the experimental point of view, the modified Longin process is easier to implement than the ninhydrin protocol. From this approach, we can conclude that the modified Longin process could be preferred in most cases and particularly when the amount of bone is small and the sample is not too contaminated.
Determination of the proportion of bovine tuberculosis (bTB) breakdowns attributed to a herd purchasing infected animals has not been previously quantified using data from the Animal and Public Health Information System (APHIS) database in Northern Ireland. We used a case–control study design to account for the infection process occurring in the disclosing bTB breakdown herds. Cases (N = 6926) were cattle moving to a future confirmed bTB breakdown where they would disclose as a confirmed bTB reactor or a Lesion at Routine Slaughter (LRS). Controls (N = 303 499) were cattle moving to a future confirmed bTB breakdown where they did not become a bTB reactor or LRS. Our study showed that the cattle leaving herds which disclosed bTB within 450 days had an increased odds of becoming a confirmed bTB reactor or LRS compared with the cattle which left herds that remained free for 450 days (odds ratio (OR) = 2·09: 95% CI 1·96–2·22). Of the 12 060 confirmed bTB breakdowns included in our study (2007–2015 inclusive), 31% (95% CI 29·8–31·5) contained a confirmed bTB reactor(s) or LRS(s) at the disclosing test which entered the herd within the previous 450 days. After controlling for the infection process occurring in the disclosing bTB breakdown herd, our study showed that 6·4% (95% CI 5·9–6·8) of bTB breakdowns in Northern Ireland were directly attributable to the movement of infected animals.
The Taipan galaxy survey (hereafter simply ‘Taipan’) is a multi-object spectroscopic survey starting in 2017 that will cover 2π steradians over the southern sky (δ ≲ 10°, |b| ≳ 10°), and obtain optical spectra for about two million galaxies out to z < 0.4. Taipan will use the newly refurbished 1.2-m UK Schmidt Telescope at Siding Spring Observatory with the new TAIPAN instrument, which includes an innovative ‘Starbugs’ positioning system capable of rapidly and simultaneously deploying up to 150 spectroscopic fibres (and up to 300 with a proposed upgrade) over the 6° diameter focal plane, and a purpose-built spectrograph operating in the range from 370 to 870 nm with resolving power R ≳ 2000. The main scientific goals of Taipan are (i) to measure the distance scale of the Universe (primarily governed by the local expansion rate, H0) to 1% precision, and the growth rate of structure to 5%; (ii) to make the most extensive map yet constructed of the total mass distribution and motions in the local Universe, using peculiar velocities based on improved Fundamental Plane distances, which will enable sensitive tests of gravitational physics; and (iii) to deliver a legacy sample of low-redshift galaxies as a unique laboratory for studying galaxy evolution as a function of dark matter halo and stellar mass and environment. The final survey, which will be completed within 5 yrs, will consist of a complete magnitude-limited sample (i ⩽ 17) of about 1.2 × 106 galaxies supplemented by an extension to higher redshifts and fainter magnitudes (i ⩽ 18.1) of a luminous red galaxy sample of about 0.8 × 106 galaxies. Observations and data processing will be carried out remotely and in a fully automated way, using a purpose-built automated ‘virtual observer’ software and an automated data reduction pipeline. The Taipan survey is deliberately designed to maximise its legacy value by complementing and enhancing current and planned surveys of the southern sky at wavelengths from the optical to the radio; it will become the primary redshift and optical spectroscopic reference catalogue for the local extragalactic Universe in the southern sky for the coming decade.
The APM QSO survey is a quantitative survey aimed at finding a large sample (∼ 1000) of QSOs using broadly-based selection criteria applied to machine-scanned UK Schmidt Telescope direct and objective-prism plates. The survey is currently entering its third year and, as of August 1988, the sample consists of ∼ 700 QSOs with mJ ≥ 18.75 in the range 0.2 ≤ z ≤ 3.3. Preliminary analysis suggests that the sample is relatively free of the selection effects endemic to most QSO surveys based on slitless spectroscopy.
Objectives: To investigate the use, challenges and opportunities associated with using patient-reported outcomes (PROs) in studies with patients with rare lysosomal storage diseases (LSDs), we conducted interviews with researchers and health technology assessment (HTA) experts, and developed the methods for a systematic review of the literature. The purpose of the review is to identify the psychometrically sound generic and disease-specific PROs used in studies with patients with five LSDs of interest: Fabry, Gaucher (Type I), Niemann-Pick (Type B) and Pompe diseases, and mucopolysaccharidosis (Types I and II).
Methods: Researchers and HTA experts who responded to an email invitation participated in a telephone interview. We used qualitative content analysis to analyze the anonymized transcripts. We conducted a comprehensive literature search for studies that used PROs to investigate burden of disease or to assess the impact of interventions across the five LSDs of interest.
Results: Interviews with seven researchers and six HTA experts representing eight countries revealed five themes. These were: (i) the importance of using psychometrically sound PROs in studies with rare diseases, (ii) the paucity of disease-specific PROs, (iii) the importance of having PRO data for economic analyses, (iv) practical and psychometric limitations of existing PROs, and (v) suggestions for new PROs. The systematic review has been completed.
Conclusions: The interviews highlight current challenges and opportunities experienced by researchers and HTA experts involved in work with rare LSDs. The ongoing systematic review will highlight the experience, opportunities, and limitations of PROs in LSDs and provide suggestions for future research.
It is now almost 10 yr since radiocarbon dating of cremated bone was first developed using the small carbonate component contained within the hydroxyapatite-based inorganic fraction. Currently, a significant number of 14C laboratories date cremated bone as part of their routine dating service. As a general investigation of cremated bone dating since this initial development, a small, cremated bone intercomparison study took place in 2005, involving 6 laboratories. Six cremated bone samples (including 2 sets of duplicates), with ages spanning approximately 1500–2800 BP, were sent to the laboratories. The results, which showed relatively good agreement amongst the laboratories and between the duplicate samples, are discussed in detail.
Nearly a decade ago, “yellow giants” were introduced as a new class of low-amplitude radial-velocity variable stars. In this report we discuss new results for 12 spectral type K and early-M giants based on long-term monitoring using both the hydrogen-fluoride and iodine-cell techniques. We compare these results with those of published data for 3 additional stars (ϒ Cephei, β Geminorum, and β Ophiuchi), and discuss possible implications for the underlying physical mechanism(s).
Despite the fact that Mohenjo-daro is of world-wide interest, and is such a rich field for discussion and speculation, until recently only two books had been written giving an authoritative account of the excavations, and the remains and the culture which they disclosed. These have now been joined by a third, namely, Dr. Mackay's full-length monograph on the excavations from 1927 to 1931.
When one has viewed the excavations, and read the works of Sir John Marshall and Dr. Mackay, and one realizes the immense amount of hard work and scholarship which has been lavished on them, it seems petty and churlish to raise the carping voice of criticism. Mohenjo-daro is not easily reached, and once the traveller has arrived there, without a well-prepared scheme of provisioning it is a difficult place in which to maintain oneself for a period of days while engaged in study. The fact that the available works of authority are so few and the visits of competent observers so rare makes it necessary that some more independent voice should be heard, even though it be a critical one. Without this, the few works would gain an almost Biblical authority and infallibility; this would be most deplorable, as it is almost always the least fortunate observations that secure the most frequent repetition. There is another point also which often escapes attention, and that is the relative proportion of certain objects, styles, and fabrics to the whole, stress being laid on them often in such a way as unintentionally to mislead the student and to give a false impression of quantitative importance.
The atmospheric structures of magnetic CP2 (Ap) stars are notoriously difficult to model: line blanketing is severe, surface gravities are extremely uncertain, and the surface abundance inhomogeneities lead to different atmospheric properties as a function of position on the star. Seismology of the p-modes of rapidly oscillating Ap (roAp) stars (Kurtz 1990), which vary with periods of a few minutes and amplitudes below 0.01 mag and 1 km/s in light and velocity, has already helped constrain the luminosities – and hence, the logg values – of some cool CP2 stars (Kurtz 1992, these proceedings). We show here that the pulsations of an roAp star can also directly probe the temperature structure of a CP2 atmosphere.
Rapidly oscillating Ap (roAp) stars are cool magnetic CP2 stars which vary with periods of a few minutes and amplitudes less than 0.01 mag and 1 km/s in light and velocity. Analysis of their p-mode eigenfrequency patterns and splittings gives information about evolutionary state, rotation rate, magnetic field geometry and internal field strength (see Kurtz 1990; Matthews 1991).
We present here an example of how roAp pulsations can be used to obtain an estimate of the temperature structure of an Ap atmosphere.
The pulsation amplitudes of roAp stars decline more rapidly with increasing wavelength than other known pulsators. Matthews et al. (1990) explained this by the wavelength dependence of limb darkening and its weighting effect on the integrated amplitude of an (l, m) = (1,0) mode.
Early identification of problems with psychosocial stress regulation is important for supporting mental and physical health. However, we currently lack knowledge about when reliable individual differences in stress-responsive physiology emerge and which aspects of maternal behavior determine the unfolding of infants' stress responses. Knowledge of these processes is further limited by analytic approaches that do not account for multiple levels of within- and between-family effects. In a low-risk sample (n = 100 dyads), we observed infant cortisol and mother/infant behavior during regular play and stress sessions longitudinally from age 1 to 3, and used a three-level model to separately examine variability in infant cortisol trajectories within sessions, across years, and across infants. Stable individual differences in hypothalamus–pituitary–adrenal axis regulation were observed in the first 3 years of life. Infants of less sensitive and more intrusive mothers manifested stress sensitization, that is, elevated cortisol levels during and following stress exposure, a profile related to behavioral distress. These findings have important practical implications, suggesting that children at risk for long-term stress dysregulation may be identified in the earliest years of life.
Background: Painful diabetic neuropathy (PDN) is a frequent complication of diabetes mellitus. Current treatment recommendations are based on short-term trials, generally of duration ≤3 months. Limited data are available on the long-term outcomes of this chronic disease. This study aims to determine the long-term clinical effectiveness of the management of chronic PDN at tertiary pain centres. Methods: From a prospective observational cohort study of patients with chronic neuropathic non-cancer pain recruited from seven Canadian tertiary pain centres, 43 patients diagnosed with PDN were identified for analysis. Data were collected according to Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) guidelines including Brief Pain Inventory (BPI). Results: At 12-month follow-up, 37.2% of 43 patients achieved pain reduction of ≥30%, 51.2% achieved functional improvement with a reduction of ≥1 on the Pain Interference Scale (0-10, BPI), and 30.2% (95% CI: 17.2% to 46.1%) had achieved both these measures. Symptom management included at least 2 medication classes in 55.3%, and 3 medications classes (opioids, antidepressants, anticonvulsants) in 25.5%. Conclusions: A sizable minority of patients being managed for PDN in a tertiary care setting achieve meaningful improvement. Polypharmacy, including analgesic antidepressants, anticonvulsants and opioids, is often necessary to attain symptom management.