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Research participants want to receive results from studies in which they participate. However, health researchers rarely share the results of their studies beyond scientific publication. Little is known about the barriers researchers face in returning study results to participants.
Using a mixed-methods design, health researchers (N=414) from more than 40 U.S. universities were asked about barriers to providing results to participants. Respondents were recruited from universities with Clinical and Translational Science Award (CTSA) programs and Prevention Research Centers (PRCs).
Respondents reported the percent of their research where they experienced each of the four barriers to disseminating results to participants: logistical/methodological, financial, systems, and regulatory. A fifth barrier, investigator capacity, emerged from data analysis. Training for research faculty and staff, promotion and tenure incentives, and funding agencies supporting dissemination of results to participants were solutions offered to overcoming barriers.
Study findings add to literature on research dissemination by documenting health researchers’ perceived barriers to sharing study results with participants. Implications for policy and practice suggest that additional resources and training could help reduce dissemination barriers and increase the return of results to participants.
Introduction: ex-specific diagnostic cutoffs may improve the test characteristics of high-sensitivity troponin assays for the diagnosis of myocardial infarction. Sex-specific cutoffs for ruling in MI improve the sensitivity of the assay for MI among women, and improve the specificity of diagnosis among men. We hypothesized that the use of sex-specific high-sensitivity Troponin T (hsTnT) cutoffs for ruling out MI at the time of ED arrival would improve the classification efficiency of the assay by enabling more patients to have MI ruled out at the time of ED arrival while maintaining diagnostic sensitivity. The objective of this study was to quantify the test characteristics of sex-specific cutoffs of an hsTnT assay for acute myocardial infarction (AMI) when performed at ED arrival in patients with chest pain. Methods: This retrospective study included consecutive ED patients with suspected cardiac chest pain evaluated in four urban EDs were, excluding those with ST-elevation AMI, cardiac arrest or abnormal kidney function. The primary outcomes was AMI at 7 days. Secondary outcomes included major adverse cardiac events (MACE: all-cause mortality, AMI and revascularization) and the individual MACE components. We quantified test characteristics (sensitivity, negative predictive value, likelihood ratios and proportion of patients ruled out) for multiple combinations of sex-specific rule-out cutoffs. We calculated net reclassification improvement compared to universal rule-out cutoffs of 5ng/L (the assays limit of detection) and 6ng/L (the FDA-approved limit of quantitation for US laboratories). Results: 7130 patients, including 3931 men and 3199 women, were included. The 7-day incidence of AMI was 7.38% among men and 3.78% among women. Universal cutoffs of 5 and 6 ng/L ruled out AMI with 99.7% sensitivity in 33.6 and 42.2% of patients. The best-performing combination of sex-specific cutoffs (8g/L for men and 6ng/L for men) ruled out AMI with 98.7% sensitivity in 51.9% of patients. Conclusion: Sex-specific hsTnT cutoffs for ruling out AMI at ED arrival may achieve substantial improvement in classification performance, enabling more patients to be ruled out at ED arrival, while maintaining acceptable diagnostic sensitivity for AMI. Universal and sex-specific rule-out cutoffs differ by only small changes in hsTnT concentration. Therefore, these findings should be confirmed in other datasets.
Introduction: Patients with chronic kidney disease (CKD) are at high risk of cardiovascular events, and have worse outcomes following acute myocardial infarction (AMI). Cardiac troponin is often elevated in CKD, making the diagnosis of AMI challenging in this population. We sought to quantify test characteristics for AMI of a high-sensitivity troponin T (hsTnT) assay performed at emergency department (ED) arrival in CKD patients with chest pain, and to derive rule-out cutoffs specific to patient subgroups stratified by estimated glomerular filtration rate (eGFR). We also quantified the sensitivity and classification performance of the assays limit of detection (5 ng/L) and the FDA-approved limit of quantitation (6 ng/L) for ruling out AMI at ED arrival. Methods: Consecutive patients in four urban EDs from the 2013 calendar year with suspected cardiac chest pain who had a Roche Elecsys hsTnT assay performed on arrival were included f. This analysis was restricted to patients with an eGFR< 60 ml/min/1.73m2. The primary outcome was 7-day AMI. Secondary outcomes included major adverse cardiac events (death, AMI and revascularization). Test characteristics were calculated and ROC curves were generated for eGFR subgroups. Results: 1416 patients were included. 7-day AMI incidence was 10.1%. 73% of patients had an initial hsTnT concentration greater than the assays 99th percentile (14 ng/L). TCurrently accepted cutoffs to rule out MI at ED arrival ( 5 ng/L and 6 ng/L) had 100% sensitivity for AMI, but no patients with an eGFR less than 30 ml/min/1.73M had hsTnT concentrations below these thresholds. We derived eGFR-adjusted cutoffs to rule out MI with sensitivity >98% at ED arrival, which were able to rule out 6-42% of patients, depending on eGFR category. The proportion of patients able to be accurately ruled-in with a single hsTnT assay was substantially lower among patients with an eGFR <30 ml/min/1.73m2 (6-20% vs 25-43%). We also derived eGFR-adjusted cutoffs to rule-in AMI with specificity >90%, which accurately ruled-in up to 18% of patients. Conclusion: Cutoffs achieving acceptable diagnostic performance for AMI using single hsTnT sampling on ED arrival may have limited clinical utility, particularly among patients with very low eGFR. The ideal diagnostic strategy for AMI in patients with CKD likely involves serial high-sensitivity troponin testing with diagnostic thresholds customized to different eGFR categories.
The cathodo-luminescence of minerals in thin sections of rocks has been examined with the aid of an electron-probe microanalyser and also with a simple electron source producing an unfocused beam. Experimental details of the technique are briefly described and colour photographs, taken at a primary magnification of 30 times, are included. The observed variations in colour and intensity of luminescence are interpreted in the light of electron-probe and spectrochemical determinations of trace elements. Applications of the technique are discussed.
We present initial results of a survey of the FUV spectra of disk-accreting cataclysmic variables obtained with the Far Ultraviolet Spectroscopic Explorer (FUSE).
FUSE covers the 905 - 1188 Å range at spectral resolutions ≃0.1 Å. To date, FUSE has observed more than 65 cataclysmic variables (CVs). Publicly-available data include observations of 11 dwarf novae (DN), 15 non-magnetic novalikes (NLs), 7 intermediate polars and DQ Her stars, at least 15 polars, and 4 super-soft X-ray binaries.
We consider pressure-driven flow of an ion-carrying viscous Newtonian fluid through a non-uniformly shaped channel coated with a charged deformable porous layer, as a model for blood flow through microvessels that are lined with an endothelial glycocalyx layer (EGL). The EGL is negatively charged and electrically interacts with ions dissolved in the blood plasma. The focus here is on the interplay between electrochemical effects, and the pressure-driven flow through the microvessel. To analyse these effects we use triphasic mixture theory (TMT) which describes the coupled dynamics of the fluid phase, the elastic EGL, ion transport within the fluid and electric fields within the microvessel. The resulting equations are solved numerically using a coupled boundary–finite element method (BEM-FEM) scheme. However, in the physiological regime considered here, ion concentrations and electric potentials vary rapidly over a thin transitional region (Debye layer) that straddles the lumen–EGL interface, which is difficult to resolve numerically. Accordingly we analyse this region asymptotically, to determine effective jump conditions across the interface for BEM-FEM computations within the bulk EGL/lumen. Our results demonstrate that ion–EGL electrical interactions can influence the near-wall flow, causing it to become reversed. This alters the stresses exerted upon the vessel wall, which has implications for the hypothesised role of the EGL as a transmitter of mechanical signals from the blood flow to the endothelial vessel surface.
Controlled feeding experiments demonstrate that the 14C content of the carbonate fraction of fossil avian eggshell should reliably reflect the 14C activity of feed and contemporary atmospheric CO2 regardless of amounts of 14C depleted scratch injested. Consideration of biochemical pathways and exchange rates across lung membranes leads to the possibility that the carbonate fraction may, in some instances, be slightly 14C depleted. 14C dates on eggshell carbonate should require little or no correction. As with marine shell carbonate, normal soil-forming processes may alter the surficial carbon isotopes in eggshell carbonate. 14C dates on the protein fraction should be even more reliable than those on the carbonate fraction, but only if special precautions or separation techniques exclude non-indigenous carbon from the sample. Original protein contents are likely to be too low for conventional 14C dating techniques.
Coeval shell and charcoal from Santa Catarina State, Brazil, differ systematically in 14C content, indicating a reservoir effect in marine samples. For modern samples (AD 1939–2000) and archeological samples (2500–1595 BP), the mean 14C age difference between marine and atmospheric carbon is 220 ± 20 years, the marine carbon being older. For three samples dated AD 1939–1944, a distinct reservoir correction of 510 ± 10 years is also observed. The ages of archeological shell samples from Jabuticabeira may be corrected by subtracting 220 years from the apparent 14C ages.
Existing catalogues of supernova remnants (SNRs) in external galaxies are very incomplete. Potentially however, such samples are of great importance in understanding SNRs, since the distances to objects in a given sample are essentially the same and since absorption is small (compared to galactic SNRs). We have recently obtained Hα+[NII], Hβ, [SII], [OIII], and 6100 Å continuum CCD images of nine selected areas in M33 using the KPNO 4m. In addition to the six SNRs already known to exist in the fields we have surveyed, we have identified 21 other nebulae with [SII]:Hα+[NII] ratios which may be SNRs. Spectra of seven of these nebulae were obtained subsequently and show that the majority are indeed SNRs. A more detailed analysis of regions containing significant HII region contamination and a search for very small diameter remnants is currently underway.
To assess the feasibility and clinical value of using the CellSearch system to detect circulating tumour cells in patients with advanced-stage head and neck squamous cell carcinoma.
Circulating tumour cells were isolated and counted via positive selection utilising magnetically labelled anti-epithelial cell adhesion molecule and immunocytochemical staining for cytokeratin. The correlation between circulating tumour cell presence and clinical features was evaluated in nine patients newly diagnosed with advanced-stage (stage III or IV) head and neck squamous cell carcinoma.
Circulating tumour cells were detected in three of the nine patients (33 per cent). Circulating tumour cell positivity was more prevalent in node stage 2 to 3 patients (3 of 5, 60 per cent) than node stage 0 to 1 patients (0 of 4, 0 per cent). Recurrent or progressive disease was observed in only one of the six patients (17 per cent) without circulating tumour cells, compared with two of the three patients (67 per cent) with circulating tumour cells.
In this preliminary study, circulating tumour cells were successfully isolated in patients with advanced-stage head and neck squamous cell carcinoma, using the CellSearch system. Further investigation is needed to evaluate the prognostic significance of circulating tumour cells.
The pulsed-laser induced photochemical production of metallic Ga islands on the surface of GaAs cleaved, irradiated, and studied in ultrahigh vacuum (UHV) is documented through photoelectron spectroscopy and subsequent scanning electron microscopy. Ga islands are detected for laser fluences as low as 1 mJ/cm2, far below those previously reported for modification of GaAs, and for which the temperature rise is negligible.
While its electrochemical oxidation is difficult, Cgg is readily oxidized in protic superacidic media. In order to exploit the reactive nature of the radical cations thus formed for the purpose of generating novel fullerene derivatives, a method involving nucleophilic trapping of oxidized Cgg has been developed. Thus, trapping oxidized Cgg with alcohols and aromatics results in the formation of alkoxylated and arylated C60, respectively, while trapping oxidized CgQ with x, y-diols results in the formation of x, y-difulleroxyalkanes (earmuff ethers).
The microstructure of low-density porous silica precursor (unsintered) bodies was studied as a function of starting chemistry. The ratio of colloidal silica sol to potassium silicate is known to have a marked effect on the size distribution of pores in this material, which in turn have a major impact on the resultant physical properties of the sintered product. In the present research, the sizes and the size distributions of particles underlying the pore microstructure was investigated, and it was found that the lower the amount of colloidal silica, the greater the size distribution of particle aggregates.
A new conducting polymer, poly (benzo[1,2-b:4,5-b′]dithiophene-4,8-diyl vinylene) (1), has been prepared by pyrolysis of a precursor polymer 2, which, in turn, was prepared by a multistep synthetic sequence (Scheme 1). The polymer has a UV-vis spectral maximum at 501 nm (2.48 eV), band-gap (band edge) of 1.92 eV and with FeC?3 doping a conductivity of 15 S cm1. Quantum Mechanical calculations using PRDDO, ab-initio and modified extended Hiickel Methodology on the Monomers, trimers and polymers, both aromatic and quinoid, provided structures and an absorption maximum band-gap which is consistent with either a planar aromatic polymer or a polymer which has both aromatic and quinoid units.
Dual Intercalating Molten Electrolyte (DIME) electrodes and cells have been examined using a number of low-melting and room-temperature molten salts. A cell with a chloroaluminate melt achieved a cycling efficiency of 85% with a discharge voltage of 2.92 V. Coke-elastomer composite electrodes underwent cation reductive intercalation without experiencing the exfoliation and degradation seen for graphite rods. Theoretical studies for an imidazolium-graphite intercalate predict the graphite layer spacing expands between 5.18 and 8.01 Å upon insertion of the imidazolium molecule into the graphite lattice.
Ultra-small-angle x-ray scattering provides quantitative and statistically significant information on the size distribution of electron density inhomogeneities with dimensions between ≈100 Å and ≈5 μm. All sizes are sampled simultaneously with a single experiment, removing the possibility of observational bias. In a material such as commercial silicon nitride, where the inhomogeneities are due to populations of intergranular secondary phases and voids of similar dimensions, the scattering contains contributions from each individual population. A single USAXS scan cannot separate overlapping populations of scatterers due to the different contrasts of the microstructural components. Anomalous USAXS (A-USAXS) is an elementspecific contrast variation method to vary the scattering contribution from one of the populations while holding that of the other populations fixed. To follow the size evolution under tensile creep of both the cavities and the Yb disilicate secondary phases, A-USAXS data was measured near the Yb LIII absorption edge. Creep cavity and disilicate size distributions were each determined as a function of deformation.
In the filled gallium-germanium clathrates, R8Ga16Ge30, where R is Ba, Sr, or Eu, the guests are located in two large cages and are weakly bound to the crystalline clathrate framework. The caged guests exhibit a localized “rattling” vibrational mode that provides an efficient mechanism for reducing the thermal conductivity. Inelastic neutron scattering and nuclear inelastic scattering measurements have yielded the phonon density of states in R8Ga16Ge30; the line width of the localized vibrational modes is found to be an important parameter in determining the lattice thermal conductivity. Neutron diffraction studies on R8Ga16Ge30 have shown that the guests in the larger cage are located off-center, and it was proposed that their jumping about the four off-center locations is responsible for the observed glass-like thermal conductivity at temperatures below 10 K. The detection of such slow guest motion is challenging because the typical time and energy scales involved are ca. 4 ns and 1 µeV, respectively. We have studied the slow europium tunneling dynamics in Eu4Sr4Ga16Ge30 by both Mössbauer and microwave absorption spectroscopy.