Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all stakeholders. On October 25–26, 2023, the Duke Clinical Research Institute brought together leaders from academia, industry, government agencies, patient advocacy, and nonprofit organizations to explore how different entities and influencers in drug development and healthcare can realign incentive structures to efficiently accelerate evidence generation that addresses the highest public health needs. Prominent themes surfaced, including competing research priorities and incentives, inadequate representation of patient population in clinical trials, opportunities to better leverage existing technology and infrastructure in trial design, and a need for heightened transparency and accountability in research practices. The group determined that together these elements contribute to an inefficient and costly clinical research enterprise, amplifying disparities in population health and sustaining gaps in evidence that impede advancements in equitable healthcare delivery and outcomes. The goal of addressing the identified challenges is to ultimately make clinical trials faster, more inclusive, and more efficient across diverse communities and settings.

The effect of tip geometry on discharge coefficient and heat transfer is investigated both experimentally and numerically using idealised models of an unshrouded rotor blade. A flat tip was compared with two squealer-type geometries (a cavity and suction-side squealer) under the transonic conditions expected in the gas turbine engine. Heat transfer measurements were performed using a transient liquid crystal technique while a duplicate test section was used for measuring the pressure field. Computations were carried out using an unstructured, fully compressible, three-dimensional RANS (Reynolds averaged Navier Stokes) solver. Initial computations performed using a low Reynolds number k-ε model demonstrated the inability of the model to predict the Nusselt number with reasonable accuracy. Further computations performed using a low Reynolds number k-ω model improved the predictions dramatically. The computed discharge coefficient and the average Nusselt number over the blade tip agreed well with the experiments. Three upstream-total to exit-static pressure ratios were used to create a range of engine-representative Mach numbers. Both experimental and numerical studies at the lower pressure ratio of 1·3 (exit Mach number ~ 0·65) established the cavity geometry as the best performer from an aerodynamic perspective by reducing the discharge through the tip. However, from the heat transfer perspective, both the peak Nusselt number and the average heat transfer to the tip were higher than the flat tip. At the higher pressure ratios of 1·85 and 2·27 (corresponding to exit Mach numbers ~ 0·98 and 1·12) the discharge coefficient and heat transfer to the tip increases. This paper explores the fluid dynamics associated with these flows and shows that the highest heat transfer is caused by reattachment and flow impingement. The fluid dynamic computations provide insight into the experimental measurements and were successfully compared with simple analytical models.

Marine fouling is a commercially important problem affecting abiotic and biotic surfaces. In this study we investigated the surface fouling on a colonial reef-building invertebrate, the bryozoan Pentapora fascialis, from the Welsh coast. We captured 300 scanning electron microscope (SEM) images of 5 colonies of the bryozoan P. fascialis in order to quantify the level of fouling on the exterior surfaces. Evidence for differential fouling was found to occur at several spatial scales, including between older and newer zooids, between proximal and distal regions of the same zooids and between colonies. The current year's growing zooids were found to have a higher level of fouling than older zooids. The difference in the mean level of fouling of proximal regions of zooids compared to distal regions was found to be significant in P. fascialis. In agreement with the differential fouling previously observed by other authors in the laminar bryozoan Flustra foliacea where the proximal region of a zooid was observed to have a higher level of fouling, the fouling coverage in P. fascialis was higher in the proximal region of zooids. A reduction of fouling on some bryozoan surfaces may be caused by production of antimicrobial compounds. Further studies of microbial fouling of a similar quantitative scale in other bryozoans could aid in the identification of novel antimicrobial agents useful for preventing microbial fouling on abiotic surfaces in the marine environment.

In Scotland, between 1995 and 2000 there were between 4 and 10 cases of illness per 100000 population per year identified as being caused by Escherichia coli O157, whereas in England and Wales there were between 1 and 2 cases per 100000 population per year. Within Scotland there is significant regional variation. A cluster of high rate areas was identified in the Northeast of Scotland and a cluster of low rate areas in central-west Scotland. Temporal trends follow a seasonal pattern whilst spatial effects appeared to be distant rather than local. The best-fit model identified a significant spatial trend with case rate increasing from West to East, and from South to North. No statistically significant spatial interaction term was found. In the models fitted, the cattle population density, the human population density, and the number of cattle per person were variously significant. The findings suggest that rural/urban exposures are important in sporadic infections.

Electroplated Cu was found to have a fine as-plated microstructure, 0.05 ±0.03 μm, with multiple grains through the film thickness and evidence of twins and dislocations within grains. Over time at room temperature, the grains grew to greater than 1 μm in size. Studied as a function of annealing temperature, the recrystallized grains were shown to be 1.6 ± 1.0 μm in size, columnar and highly twinned. The grain growth was directly related to the time dependent decrease in sheet resistance. The initial grain structure was characterized using scanning transmission electron microscopy (STEM) from a cross-section sample prepared by a novel focused ion beam (FIB) and lift-out technique. The recrystallized grain structures were imaged using FIB secondary electron imaging. From these micrographs, the grain boundary structures were traced, and an image analysis program was used to measure the grain areas. A Gaussian fit of the log-normal distribution of grain areas was used to calculate the mean area and standard deviation. These values were converted to grain size diameters by assuming a circular grain geometry.

Electroplated Cu was found to have a fine as-plated microstructure, 0.05 ± 0.03 μm, with multiple grains through the film thickness and evidence of twins and dislocations within grains. Over time at room temperature, the grains grew to greater than 1 μm in size. Studied as a function of annealing temperature, the recrystallized grains were shown to be 1.6 ± 1.0 μm in size, columnar and highly twinned. The grain growth was directly related to the time dependent decrease in sheet resistance. The initial grain structure was characterized using scanning transmission electron microscopy (STEM) from a cross-section sample prepared by a novel focused ion beam (FIB) and lift-out technique. The recrystallized grain structures were imaged using FIB secondary electron imaging. From these micrographs, the grain boundary structures were traced, and an image analysis program was used to measure the grain areas. A Gaussian fit of the log-normal distribution of grain areas was used to calculate the mean area and standard deviation. These values were converted to grain size diameters by assuming a circular grain geometry.