250 research outputs found

    Double bubbles in the three-torus

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    13 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200113 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200113 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200113 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200

    Facilitators and barriers to the successful implementation of pediatric antibacterial drug trials: Findings from CTTI's survey of investigators.

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    An urgent need exists to develop new antibacterial drugs for children. We conducted research with investigators of pediatric antibacterial drug trials to identify facilitators and barriers in the conduct of these trials. Seventy-three investigators completed an online survey assessing the importance of 15 facilitators (grouped in 5 topical categories) and the severity of 36 barriers (grouped in 6 topical categories) to implementing pediatric antibacterial drug trials. Analysis focused on the identification of key factors that facilitate the successful implementation of pediatric antibacterial drug trials and the key barriers to implementation. Almost all investigators identified two factors as very important facilitators: having site personnel for enrollment and having adequate funding. Other top factors were related to staffing. Among the barriers, factors related to parent concerns and consent were prominent, particularly obtaining parental consent when there was disagreement between parents, concerns about the number of blood draws, and concerns about the number of invasive procedures. Having overly narrow eligibility criteria was also identified as a major barrier. The survey findings suggest three areas in which to focus efforts to help facilitate ongoing drug development: (1) improving engagement with parents of children who may be eligible to enroll in a pediatric antibacterial drug trial, (2) broadening inclusion criteria to allow more participants to enroll, and (3) ensuring adequate staffing and establishing sustainable financial strategies, such as funding pediatric trial networks. The pediatric antibacterial drug trials enterprise is likely to benefit from focused efforts by all stakeholders to remove barriers and enhance facilitation

    Perceived barriers to pediatrician and family practitioner participation in pediatric clinical trials: Findings from the Clinical Trials Transformation Initiative.

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    Despite legislation to stimulate pediatric drug development through clinical trials, enrolling children in trials continues to be challenging. Non-investigator (those who have never served as a clinical trial investigator) providers are essential to recruitment of pediatric patients, but little is known regarding the specific barriers that limit pediatric providers from participating in and referring their patients to clinical trials. We conducted an online survey of pediatric providers from a wide variety of practice types across the United States to evaluate their attitudes and awareness of pediatric clinical trials. Using a 4-point Likert scale, providers described their perception of potential barriers to their practice serving as a site for pediatric clinical trials. Of the 136 providers surveyed, 52/136 (38%) had previously referred a pediatric patient to a trial, and only 17/136 (12%) had ever been an investigator for a pediatric trial. Lack of awareness of existing pediatric trials was a major barrier to patient referral by providers, in addition to consideration of trial risks, distance to the site, and time needed to discuss trial participation with parents. Overall, providers perceived greater challenges related to parental concerns and parent or child logistical barriers than study implementation and ethics or regulatory barriers as barriers to their practice serving as a trial site. Providers who had previously been an investigator for a pediatric trial were less likely to be concerned with potential barriers than non-investigators. Understanding the barriers that limit pediatric providers from collaboration or inhibit their participation is key to designing effective interventions to optimize pediatric trial participation

    Perceptions of Equipoise, Risk/Benefit Ratios, and ‘Otherwise Healthy Volunteers’ in the Context of Early-Phase HIV Cure Research in the United States – A Qualitative Inquiry

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    Early-phase HIV cure research is conducted against a background of highly effective antiretroviral therapy, and involves risky interventions in individuals who enjoy an almost normal life expectancy. To explore perceptions of three ethical topics in the context of HIV cure research—(a) equipoise, (b) risk–benefit ratios, and (c) “otherwise healthy volunteers”—we conducted 36 in-depth interviews (IDIs) with three groups of purposively selected key informants: clinician-researchers (n = 11), policy-makers and bioethicists (n = 13), and people living with HIV (PLWHIV; n = 12). Our analysis revealed variability in perceptions of equipoise. Second, most key informants believed there was no clear measure of risk–benefit ratios in HIV cure research, due in part to the complexity of weighing (sometimes unknown) risks to participants and (sometimes speculative) benefits to science and society. Third, most clinician-researchers and policy-makers/bioethicists viewed potential HIV cure study participants as “otherwise healthy volunteers,” but this perception was not shared among PLWHIV in our study

    Using Formative Research to Develop a Context-Specific Approach to Informed Consent for Clinical Trials

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    Participant understanding is of particular concern when obtaining informed consent. Recommendations for improving understanding include disclosing information using culturally appropriate and innovative approaches. To increase the effectiveness of the consent process for a clinical trial in Malawi on interventions to prevent mother-to-child transmission of HIV during breastfeeding, formative research was conducted to explore the community’s understanding of medical research as well as how to explain research through local terms and meanings. Contextual analogies and other approaches were identified to explain consent information. Guided by theory, strategies for developing culturally appropriate interventions, and recommendations from the literature, we demonstrate how the formative data were used to develop culturally appropriate counseling cards specifically for the trial in Malawi. With appropriate contextual modifications, the steps outlined here could be applied in other clinical trials conducted elsewhere, as well as in other types of research

    Leichtbautilger fĂŒr Fahrwerke

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    Konventionelle, passive Fahrwerkskonzeple bestehen aus einem Feder- und einem DĂ€mpferelement und das Systemverhalten ist mit der Abstimmung der Steifigkeils- und DĂ€mpfungswerte fest vorgegeben. Bei der Fahrwerksabstimmung werden die Zielfunktionen Fahrsicherheit und -komfort fĂŒr das jeweilige Fahrzeugkonzept ausgelegt. Jede optimale Lösung stellt ein Kompromiss zwischen Fahrsicherheit und -komfort dar, da die beiden Zielfunktionen gegenlĂ€ufig sind. Alle optimalen Lösungen liegen im sogenannten Konfliktdiagramm auf einer Pareto-Linie. In dieser Arbeit wird gezeigt, wie ein hydraulisch ĂŒbersetzter Leichtbautilger - Fluid Dynamic Absorber - in das Fahrwerk integriert und das Systemverhalten durch die VerĂ€nderung der Systemtopologie verbessert wird. Prinzip bedingt bringt ein Tilger immer zusĂ€tzliche Masse in das System ein. Dieses unerwĂŒnschte Verhalten wird durch die hydraulische Übersetzung (Prinzip der virtuellen Masse) minimiert. Hierzu wird der Leichtbautilger an das Chassis, das als Quasi-Inertialsystem dient, angebunden

    Conference Report: AISB Members Workshop VII: Serendipity Symposium

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    On the 15th June 2017, a diverse group of researchers in computing, arts, sciences, and other fields of cultural endeavour met at the Waldegrave Drawing Room, St Mary’s University, to discuss serendipity – “the art of making an unsought finding” [11]. The core goals of the symposium were to relate various understandings of serendipity from different disciplines, and to discuss contentious questions such as whether/how serendipity can be supported or simulated by computational means

    Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi

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    BACKGROUND: To prevent postnatal transmission of HIV in settings where safe alternatives to breastfeeding are unavailable, the World Health Organization (WHO) recommends exclusive breastfeeding followed by early, rapid cessation of breastfeeding. Only limited data are available on the attitudes of health workers toward this recommendation and the impact of these attitudes on infant feeding counselling messages given to mothers. METHODS: As part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) clinical trial, we carried out an in-depth qualitative study of the attitudes, beliefs, and counselling messages of 19 health workers in Lilongwe, Malawi. RESULTS: Although none of the workers had received formal training, several reported having counseled HIV-positive mothers about infant feeding. Health workers with counselling experience believed that HIV-infected mothers should breastfeed exclusively, rather than infant formula feed, citing poverty as the primary reason. Because of high levels of malnutrition, all the workers had concerns about early cessation of breastfeeding. CONCLUSION: Important differences were observed between the WHO recommendations and the attitudes and practices of the health workers. Understanding these differences is important for designing effective interventions

    Couple communication and contraception use in urban Senegal

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    Objectives: Couple communication about family planning has been shown to increase uptake of contraception. However, couple communication is often measured based solely on one partner?s report of communication. This research investigates the influence of couple-reported communication about family planning on current and future use of contraception using couple-level data. Methods: We used baseline data from the Measurement, Learning, and Evaluation (MLE) project collected through household surveys in 2011 from a cross-sectional representative sample of women and men in urban Senegal to conduct secondary data analysis. We used multivariable logit models to estimate the average marginal effects of couple communication about family planning on current contraception use and future intention to use contraception. Results: Couple communication about family planning reported by both partners was significantly associated with an increased likelihood of current use of contraception and with future intention to use contraception among non-contracepting couples. Couples where one partner reported discussing family planning had a 25% point greater likelihood of current contraception use than couples where neither partner reported discussing, while couples where both partners reported discussing family planning had a 56% point greater likelihood of current contraception use, representing more than twice the effect size. Among couples not using contraception, couples where one partner reported discussing family planning had a 15% point greater likelihood of future intention to use contraception than couples where neither partner reported discussing, while couples where both partners reported discussing family planning had a 38% point greater likelihood of future intention to use contraception. Conclusion: These findings underscore the importance of the inclusion of both partners in family planning programs to increase communication about contraception and highlight the need for future research using couple-level data, measures, and analysis
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