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Abstract Objectives The interrupted time series (ITS) design is commonly used to investigate the impact of an intervention or exposure in public health. There are many statistical methods that can be used to analyse ITS data and to meta-analyse their results. We undertook two empirical studies to investigate: (i) how effect estimates (and associated statistics) compared when six statistical methods were applied to 190 real-world datasets; and (ii) how meta-analysis effect estimates (and associated statistics) compared when the combinations of two ITS analysis methods and five meta-analysis methods were applied to 17 real-world meta-analyses including 283 ITS datasets. Here we present a curated repository of a subset of ITS datasets from these studies. Data description The repository includes 430 ITS datasets curated from the two empirical studies. The datasets are diverse in the populations, interruptions and outcomes examined, and are methodologically diverse in the outcome types, aggregation time intervals, number of timepoints and segments. Most of the datasets are from public health. For each dataset, we provide the outcome value at each timepoint and the segment (indicating different interruptions), along with characteristics of the dataset. This repository may be of value for future research of ITS studies, and as a source of examples of ITS for use in teaching.

Abstract Background Miners exposed to silica dust are susceptible to silicotuberculosis (STB) outcome – the development of tuberculosis (TB) in miners with silicosis. STB is an important occupational and public health issue in the twenty-first century. This scoping review aimed to map the risk factors associated with STB. Methods A literature search was carried out to identify the available international literature on STB risk factors from four databases: MEDLINE, EMBASE, CINAHL, and COCHRANE LIBRARY. Various grey literature sources such as Google Scholar, Science.gov, and WHO Global Index Medicus were also searched. The main study outcome is STB; the selection criteria also included studies assessing TB and silicosis as comorbidities leading to STB. Results The final review included 22 studies. Findings identified various STB risk factors including demographic factors such as age and sex, lifestyle factors including smoking and alcohol intake, clinical factors such as history of TB, grades of silicosis, and human immunodeficiency virus (HIV), in addition to occupational factors encompassing silica exposure, duration of employment, and type of work setting. Conclusion The findings of this scoping review highlight the research gaps in the reviewed literature, including the dearth of longitudinal studies focusing on the directionality of the two comorbidities (TB and silicosis) that lead to STB, lack of gender considerations in research on this topic, and an absence of articles on vulnerable populations including children. The findings of this review may help guide future research and inform occupational health and safety policies addressing STB outcomes among miners.

Abstract Background Recent biomedical research has shown the unusual, multisystem effects of coronavirus disease 2019 in humans. One specific sequela of a primary severe acute respiratory syndrome coronavirus 2 infection is the reactivation of latent viruses in various tissues, such as Epstein–Barr virus. Epstein–Barr virus has been identified in many inflammatory gastrointestinal lesions, such as microscopic gastritides and colitides. One subtype of these diseases is collagenous disease. “Long COVID” may be related to the reactivation of these latent viruses, and the following case describes a patient who developed vague symptoms consistent with “long COVID.” Case presentation A non-Hispanic white male in his 50s, with previous collagenous gastritis and colitis, developed a 10-kg weight loss and diffuse leg cramps over 3 months. The patient had coronavirus disease 2019 about 3 months prior to presentation. He had iron deficiency and tested positive for human immunodeficiency virus antibody. His heterophile antibody was also positive. Confirmatory testing for human immunodeficiency virus was negative, and his Epstein–Barr virus antibody panel was positive for early antigen immunoglobulin G. His Epstein–Barr virus viral load was undetectable. Minimal improvement was achieved with a 4-week course of oral budesonide, and upper endoscopy showed diffuse gastritis. He is now improving with proton pump inhibitor therapy and ferrous sulfate supplementation. Conclusion This case report explores outpatient management of microscopic gastritides and colitides. The evidence around coronavirus disease 2019 causing reactivation of Epstein–Barr virus, and Epstein–Barr virus’ presence in chronic gastrointestinal inflammatory lesions, is discussed. Practice recommendations include corticosteroid and acid-suppression therapy for patients suspected of having a recurrence of inflammatory lesions.

Abstract Background The core vector control tools used to reduce malaria prevalence are currently long-lasting insecticidal nets (LLINs), and indoor residual spraying (IRS). These interventions are hindered by insecticide resistance and behavioural adaptation by malaria vectors. Thus, for effective interruption of malaria transmission, there is a need to develop novel vector control interventions and technologies to address the above challenges. Larviciding using drones was experimented as an innovative tool that could complement existing indoor interventions to control malaria. Methods A non-randomized larviciding trial was carried out in irrigated rice fields in sub-urban Kigali, Rwanda. Potential mosquito larval habitats in study sites were mapped and subsequently sprayed using multirotor drones. Application of Bacillus thuringiensis var. israelensis (Bti) (Vectobac® WDG) was followed by entomological surveys that were performed every two weeks over a ten-month period. Sampling of mosquito larvae was done with dippers while adult mosquitoes were collected using CDC miniature light traps (CDC-LT) and pyrethrum spraying collection (PSC) methods. Malaria cases were routinely monitored through community health workers in villages surrounding the study sites. Results The abundance of all-species mosquito larvae, Anopheles larvae and all-species pupae declined by 68.1%, 74.6% and 99.6%, respectively. Larval density was reduced by 93.3% for total larvae, 95.3% for the Anopheles larvae and 61.9% for pupae. The total adult mosquitoes and Anopheles gambiae sensu lato collected using CDC-Light trap declined by 60.6% and 80% respectively. Malaria incidence also declined significantly between intervention and control sites (U = 20, z = − 2.268, p = 0.023). Conclusions The larviciding using drone technology implemented in Rwanda demonstrated a substantial reduction in abundance and density of mosquito larvae and, concomitant decline in adult mosquito populations and malaria incidences in villages contingent to the treatment sites. The scaling up of larval source management (LSM) has to be integrated in malaria programmes in targeted areas of malaria transmission in order to enhance the gains in malaria control.

The 2024-10-05 Iran M 4.5 earthquake took place at a time of heightened tensions in the Middle East. We perform a discrimination and moment tensor analysis and identify a shallow-dipping, reverse fault source commensurate with the compressional setting of the Iranian interior. Nonetheless, the event's aftermath saw widespread dissemination of misinformation, and potentially active disinformation, concluding that it was in fact a test of an Iranian nuclear weapon. The `evidence' for many of these claims was based on inaccurate interpretation of seismic data. In this paper, we analyse how geophysical `fake news' propagated through social media (mainly Twitter/X) following this event, eventually gaining traction in mainstream, earned media. This event is an illustrative warning of how seismic data can be misinterpreted and/or manipulated in public discourse.

Introduction Infants born very preterm (VPT,

Background Interrupted time-series (ITS) studies are commonly used to examine the effects of interventions targeted at populations. Suppression of ITS studies or results within these studies, known as reporting bias, has the potential to bias the evidence-base on a particular topic, with potential consequences for healthcare decision-making. Therefore, we aim to determine whether there is evidence of reporting bias among ITS studies. Methods We will conduct a search for published protocols of ITS studies and reports of their results in PubMed, MEDLINE, and Embase up to December 31, 2022. We contact the authors of the ITS studies to seek information about their study, including submission status, data for unpublished results, and reasons for non-publication or non-reporting of certain outcomes. We will examine if there is evidence of publication bias by examining whether time-to-publication is influenced by the statistical significance of the study’s results for the primary research question using Cox proportional hazards regression. We will examine whether there is evidence of discrepancies in outcomes by comparing those specified in the protocols with those in the reports of results, and we will examine whether the statistical significance of an outcome’s result is associated with how completely that result is reported using multivariable logistic regression. Finally, we will examine discrepancies between protocols and reports of results in the methods by examining the data collection processes, model characteristics, and statistical analysis methods. Discrepancies will be summarized using descriptive statistics. Discussion These findings will inform systematic reviewers and policymakers about the extent of reporting biases and may inform the development of mechanisms to reduce such biases.

Abstract Climate change‐induced shifts in snow storage and snowmelt patterns pose risks for adverse impacts to people, the environment, and irrigated agriculture. Existing research primarily focuses on evaluating these risks to irrigated agriculture at large scales, overlooking the role of local context in shaping risk dynamics. Consequently, many “at‐risk” areas lack insight into how adaptation strategies for managing risk through water supply augmentation or water conservation vary across contexts and over time. To address this gap, we develop a comprehensive index for evaluating irrigated agriculture's risk and adaptation potential to changes in snow at local scales and apply it throughout the western US. Results confirm trends toward escalating risk for changes in snow storage and snowmelt patterns over the century. However, substantial heterogeneity in the extent and drivers of risk exists due to variability in localized interactions between declines in water supply (approximately −9% ± 13% by 2100) and increased agricultural demand (approximately 7% ± 5% by 2100). Despite an existing focus on supply augmentation as a critical adaptation strategy to reduce risk, we show its effectiveness diminishes for many areas over time, declining to an average of −54% of historical augmentation potential by 2100. Conserving water through historical changes in crop acreage and type emerges as a more stable adaptation measure, reducing demand by 7%–8% regardless of time. While particularly relevant for higher elevation, less intensive agricultural settings in snowmelt‐dependent regions, findings underscore the need for strategies that support local‐scale, context‐appropriate adaptation to effectively manage escalating risk as snow changes.

Abstract Background The Interrupted Time Series (ITS) is a robust design for evaluating public health and policy interventions or exposures when randomisation may be infeasible. Several statistical methods are available for the analysis and meta-analysis of ITS studies. We sought to empirically compare available methods when applied to real-world ITS data. Methods We sourced ITS data from published meta-analyses to create an online data repository. Each dataset was re-analysed using two ITS estimation methods. The level- and slope-change effect estimates (and standard errors) were calculated and combined using fixed-effect and four random-effects meta-analysis methods. We examined differences in meta-analytic level- and slope-change estimates, their 95% confidence intervals, p-values, and estimates of heterogeneity across the statistical methods. Results Of 40 eligible meta-analyses, data from 17 meta-analyses including 282 ITS studies were obtained (predominantly investigating the effects of public health interruptions (88%)) and analysed. We found that on average, the meta-analytic effect estimates, their standard errors and between-study variances were not sensitive to meta-analysis method choice, irrespective of the ITS analysis method. However, across ITS analysis methods, for any given meta-analysis, there could be small to moderate differences in meta-analytic effect estimates, and important differences in the meta-analytic standard errors. Furthermore, the confidence interval widths and p-values for the meta-analytic effect estimates varied depending on the choice of confidence interval method and ITS analysis method. Conclusions Our empirical study showed that meta-analysis effect estimates, their standard errors, confidence interval widths and p-values can be affected by statistical method choice. These differences may importantly impact interpretations and conclusions of a meta-analysis and suggest that the statistical methods are not interchangeable in practice.

Abstract Background: The knowledge, skills, and abilities needed for clinical research professionals (CRPs) are described in the Joint Task Force (JTF) for Clinical Trial Competencies Framework as a basis for leveled educational programs, training curricula, and certification. There is a paucity of literature addressing team science competencies tailored to CRPs. Gaps in training, research, and education can restrict their capability to effectively contribute to team science. Materials/Methods: The CRP Team Science team consisted of 18 members from 7 clinical and translational science awarded institutions. We employed a multi-stage, modified Delphi approach to define “Smart Skills” and leveled team science skills examples using individual and team science competencies identified by Lotrecchiano et al. Results: Overall, 59 team science Smart Skills were identified resulting in 177 skills examples across three levels: fundamental, skilled, and advanced. Two examples of the leveled skillsets for individual and team competencies are illustrated. Two vignettes were created to illustrate application for training. Discussion: This work provides a first-ever application of team science for CRPs by defining specific individual and team science competencies for each level of the CRP career life course. This work will enhance the JTF Domains 7 (Leadership and Professionalism) and 8 (Communication and Teamwork) which are often lacking in CRP training programs. The supplement provides a full set of skills and examples from this work. Conclusion: Developing team science skills for CRPs may contribute to more effective collaborations across interdisciplinary clinical research teams. These skills may also improve research outcomes and stabilize the CRP workforce.

Phosducin-like proteins (PhLP) are thioredoxin domain-containing proteins that are highly conserved across unicellular and multicellular organisms. PhLP family proteins are hypothesized to function as co-chaperones in the folding of cytoskeletal proteins. Here, we present the initial molecular, biochemical, and functional characterization of CG4511 as Drosophila melanogaster PhLP3. We cloned the gene into a bacterial expression vector and produced enzymatically active recombinant PhLP3, which showed similar kinetics to previously characterized orthologues. A fly strain homozygous for a P-element insertion in the 5' UTR of the PhLP3 gene exhibited significant downregulation of PhLP3 expression. We found these male flies to be sterile. Microscopic analysis revealed altered testes morphology and impairment of spermiogenesis, leading to a lack of mature sperm. Among the most significant observations was the lack of actin cones during sperm maturation. Excision of the P-element insertion in PhLP3 restored male fertility, spermiogenesis, and seminal vesicle size. Given the high level of conservation of PhLP3, our data suggests PhLP3 may be an important regulator of sperm development across species.

Heat shock protein AtHSP90–2 is one of the three constitutive cytosolic HSP90s of Arabidopsis thaliana, which are highly homologous and show mild expression activation in response to stressful impacts. To characterize the functioning of AtHSP90–2, we have analyzed tissue-specificity of its expression during seedling development using a DsG transgenic line carrying a loss-of-function mutation of AtHSP90–2 via translational fusions with the β-glucuronidase reporter gene (GUS). Histochemical analysis during the first two weeks of seedling growth revealed AtHSP90–2 expression in all organs, as well as differences in its intensity between tissues and showed its dynamics. The tissue-specific AtHSP90–2-GUS expression pattern was shown to be maintained under heat shock and water deficit. The most prominent GUS staining was detected in the vascular system and hydathodes of cotyledons, and stipules. The basipetal gradient of AtHSP90–2 expression during leaf formation, its dynamics in developing stipules, and the high level of its expression in cells with active transport function suggest a special role for the gene in certain cellular processes.

OBJECTIVES/GOALS: To describe team science training that can be tailored to specific audiences, in this case, Clinical Research Professionals (CRP) using discipline-specific vignettes, and to highlight the benefits of audience-specific training in team science. METHODS/STUDY POPULATION: Translational science teams are comprised of members from various disciplines. All members can benefit from team science training. Our education team has incorporated discipline-specific training into educational offerings. This project focuses on education tailored to CRPs and their role in clinical research. Historically, team science training has been focused on faculty and trainees. The exclusion of CRPs can limit the impact of this training. We’ve created workshops specifically geared toward CRPs. This presentation demonstrates how we tailor team science training to CRPs by using relevant examples and real-world vignettes to highlight concepts. RESULTS/ANTICIPATED RESULTS: The team science workshops conducted specifically for CRPs have been well received. CRPs have been eager to engage with team science-related material. The number of team science workshops requested by CRP groups is continuing to increase. We will share both quantitative and qualitative evaluation results from several team science workshops conducted to-date. The inclusion of scenarios that relate to common situations encountered by CRPs has been especially helpful in demonstrating team science concepts they have personally experienced. DISCUSSION/SIGNIFICANCE: Helping CRPs directly apply team science concepts to their work is very valuable for improving high-functioning team behavior. CRPs can use new knowledge and skills to enhance efficiency and reduce stress and burnout. The impact of team science is maximized when all members of the team are trained.

Abstract The hallmark of Parkinson’s disease (PD) is the loss of dopaminergic (DA) neurons in the brain. However, little is known about why DA neurons are selectively vulnerable to PD. We previously completed a screen identifying genes associated with the progressive degeneration of DA neurons. Here we describe the role of a previously uncharacterized gene, CG42339, in the loss of DA neurons using Drosophila Melanogaster. CG42339 mutants display a progressive loss of DA neurons and locomotor dysfunction, along with an accumulation of advanced glycation end products (AGEs) in the brain. Based on this phenotype, we refer to CG42339 as vexed. We demonstrate that vexed is specifically required within cortex glia to maintain neuronal viability. Loss of vexed function results in excessive activation of the innate immune response in the brain, leading to loss of DA neurons. We show that activation of the innate immune response leads to increased nitric oxide signaling and accumulation of AGEs, which ultimately result in neurodegeneration. These results provide further insight into the relationship between the role of the immune response in the central nervous system and how this impacts neuronal viability.

There have been rising global reported cases of suicidal behaviors in schools and universities. In this qualitative study, the authors sought to explore how self-directed thoughts and emotions of intrapersonal experience that come from school performance precipitate suicide ideation among university students. Semi-structured interviews were conducted to solicit self-reported information on self-directed thoughts and emotions of intrapersonal experience among 40 students from Kwame Nkrumah University of Science and Technology (KNUST), Kumasi-Ghana. Two counselors from the Guidance and Counseling unit of the same institution were also interviewed. Theoretically, the paper employed Weiner’s motivational theory. This study used a six-phase thematic analysis. The study noted that intrapersonal experiences of self-directed thoughts, particularly unachieved expectancy of success and self-directed emotions of pride, guilt, and shame emanated from poor academic performance. From the data, the authors discovered that prayer, institutional support, for instance, the Guidance and Counseling Unit of KNUST and off-campus extracurricular activities mediated in curtailing or reducing the burden of suicide ideation with the eventual act of suicide. In conclusion, this paper has established that intrapersonal experience is complementary to the interpersonal experience of university students in the study of suicide ideation to holistically comprehend the internal and external factors that generate suicide ideation. This study recommends that the judicial system of Ghana should rethink decriminalizing suicide and attempted suicide if students are to acknowledge their state of suicide ideation for the necessary intervention.

Initially, U.S. federally funded low-income rental housing was racially segregated and unequal. Activists decried this injustice and pressured legislators to introduce new practices and procedures. Since the passage of these initiatives in the 1960s, scholars have repeatedly documented ongoing racial inequality in housing at large. Yet rarely have researchers investigated whether racial inequality persists within governmentally subsidized housing units. By merging the restricted American Housing Survey with the American Community Survey at a Federal Statistical Research Data Center, the authors find that low-income renter subsidies are effective and beneficial but disproportionately grant White residents access to cheaper and higher quality units. Moreover, subsidized renters remain racially segregated across program type and neighborhoods. The authors discuss the implications of these findings for future research and policy decisions.

Abstract Background Evolutionary pressures lead to the selection of efficient malaria vectors either resistant or susceptible to Plasmodium parasites. These forces may favour the introduction of species genotypes that adapt to new breeding habitats, potentially having an impact on malaria transmission. Thioester-containing protein 1 (TEP1) of Anopheles gambiae complex plays an important role in innate immune defenses against parasites. This study aims to characterize the distribution pattern of TEP1 polymorphisms among populations of An. gambiae sensu lato (s.l.) in western Kenya. Methods Anopheles gambiae adult and larvae were collected using pyrethrum spray catches (PSC) and plastic dippers respectively from Homa Bay, Kakamega, Bungoma, and Kisumu counties between 2017 and 2020. Collected adults and larvae reared to the adult stage were morphologically identified and then identified to sibling species by PCR. TEP1 alleles were determined in 627 anopheles mosquitoes using restriction fragment length polymorphisms-polymerase chain reaction (RFLP-PCR) and to validate the TEP1 genotyping results, a representative sample of the alleles was sequenced. Results Two TEP1 alleles (TEP1*S1 and TEP1*R2) and three corresponding genotypes (*S1/S1, *R2/S1, and *R2/R2) were identified. TEP1*S1 and TEP1*R2 with their corresponding genotypes, homozygous *S1/S1 and heterozygous *R2/S1 were widely distributed across all sites with allele frequencies of approximately 80% and 20%, respectively both in Anopheles gambiae and Anopheles arabiensis. There was no significant difference detected among the populations and between the two mosquito species in TEP1 allele frequency and genotype frequency. The overall low levels in population structure (F ST = 0.019) across all sites corresponded to an effective migration index (Nm = 12.571) and low Nei’s genetic distance values (

Abstract Background Schools increasingly provide mental health services to students, but often lack access to implementation strategies to support school-based (and school professional [SP]) delivery of evidence-based practices. Given substantial heterogeneity in implementation barriers across schools, development of adaptive implementation strategies that guide which implementation strategies to provide to which schools and when may be necessary to support scale-up. Methods A clustered, sequential, multiple-assignment randomized trial (SMART) of high schools across Michigan was used to inform the development of a school-level adaptive implementation strategy for supporting SP-delivered cognitive behavioral therapy (CBT). All schools were first provided with implementation support informed by Replicating Effective Programs (REP) and then were randomized to add in-person Coaching or not (phase 1). After 8 weeks, schools were assessed for response based on SP-reported frequency of CBT delivered to students and/or barriers reported. Responder schools continued with phase 1 implementation strategies. Slower-responder schools (not providing ≥ 3 CBT components to ≥10 students or >2 organizational barriers identified) were re-randomized to add Facilitation to current support or not (phase 2). The primary aim hypothesis was that SPs at schools receiving the REP + Coaching + Facilitation adaptive implementation strategy would deliver more CBT sessions than SPs at schools receiving REP alone. Secondary aims compared four implementation strategies (Coaching vs no Coaching × Facilitation vs no Facilitation) on CBT sessions delivered, including by type (group, brief and full individual). Analyses used a marginal, weighted least squares approach developed for clustered SMARTs. Results SPs (n = 169) at 94 high schools entered the study. N = 83 schools (88%) were slower-responders after phase 1. Contrary to the primary aim hypothesis, there was no evidence of a significant difference in CBT sessions delivered between REP + Coaching + Facilitation and REP alone (111.4 vs. 121.1 average total CBT sessions; p = 0.63). In secondary analyses, the adaptive strategy that offered REP + Facilitation resulted in the highest average CBT delivery (154.1 sessions) and the non-adaptive strategy offering REP + Coaching the lowest (94.5 sessions). Conclusions The most effective strategy in terms of average SP-reported CBT delivery is the adaptive implementation strategy that (i) begins with REP, (ii) augments with Facilitation for slower-responder schools (schools where SPs identified organizational barriers or struggled to deliver CBT), and (iii) stays the course with REP for responder schools. Trial registration ClinicalTrials.gov, NCT03541317 , May 30, 2018.

While morphological and functional traits enable hydrophytes to survive under waterlogging and partial or complete submergence, the data on responses of psammophytes—sand plants—to flooding are very limited. We analyzed the effect of 5- and 10-day soil flooding on the photosynthetic apparatus and the synthesis of alcohol dehydrogenase (ADH), heat shock proteins 70 (HSP70), and ethylene in seedlings of psammophytes Alyssum desertorum and Secale sylvestre using electron microscopy, chlorophyll a fluorescence induction, and biochemical methods. It was found that seedlings growing under soil flooding differed from those growing in stationary conditions with such traits as chloroplast ultrastructure, pigment content, chlorophyll fluorescence induction, and the dynamics of ADH, HSP, and ethylene synthesis. Although flooding caused no apparent damage to the photosynthetic apparatus in all the variants, a significant decrease in total photosynthesis efficiency was observed in both studied plants, as indicated by decreased values of φR0 and PIABS,total. More noticeable upregulation of ADH in S. sylvestre, as well as increasing HSP70 level and more intensive ethylene emission in A. desertorum, indicate species-specific differences in these traits in response to short-term soil flooding. Meanwhile, the absence of systemic anaerobic metabolic adaptation to prolonged hypoxia causes plant death.

Abstract Axion-like particles (ALPs) interacting with the Standard Model can be abundantly produced in proton beam fixed-target experiments. Looking for their displaced decays is therefore an effective search strategy for ALPs with a mass in the MeV to GeV range. Focusing on the benchmark models where the ALP interacts dominantly with photons or gluons, we show that the proposed DarkQuest experiment at Fermilab will be able to test parameter space which has been previously inaccessible. We pay particular attention to the self-consistency of gluon-coupled ALP production and decay calculations, which has been recently shown to be a problem in many existing predictions. We also apply these results to explore existing constraints in the ALP parameter space.

Leiomyomas, or uterine fibroids as they are commonly known, are mostly seen in women of reproductive age. However, they can go undetected in most women, and approximately 25% of women show clinical symptoms. Although fibroids are a global burden impacting 80% of premenopausal women, they are more prevalent among Black women than among women of other races. Based on clinical diagnosis, the estimated cumulative incidence of fibroids in women ≤50 years old is significantly higher for black (>80%) versus white women (∼70%). The cause of leiomyomas is not clearly known, but studies have shown evidence of factors that drive the development or exacerbation of the disease. Evidence has linked risk factors such as lifestyle, age, environment, family history of uterine fibroids, and vitamin D deficiencies to an increased risk of uterine fibroids, which impact women of African descent at higher rates. Treatments may be invasive, such as hysterectomy and myomectomy, or non-invasive, such as hormonal or non-hormonal therapies. These treatments are costly and tend to burden women who have the disease. Sub-Saharan Africa is known to have the largest population of black women, yet the majority of uterine fibroid studies do not include populations from the continent. Furthermore, the prevalence of the disease on the continent is not well determined. To effectively treat the disease, its drivers need to be understood, especially with regard to racial preferences. This paper aims to review the existing literature and build a case for conducting future research on African women.

BackgroundProgrammed death-ligand 1 (PD-L1) expression has been shown to be prognostic in many cancer types and used in consideration of checkpoint inhibitor immunotherapy. However, there are very limited and conflicting data on the prognostic impact of PD-L1 in patients with anal squamous cell carcinoma (ASCC). The objectives of this study were to measure the expression of PD-L1 and CD8 in patients with ASCC treated with radical chemoradiotherapy (CRT) and to correlate tumor expression with progression-free survival (PFS) and overall survival (OS).MethodsNinety-nine patients with ASCC treated with primary CRT at two tertiary care cancer centers between 2000 and 2013, with available pre-treatment tumors, were included. Tissue microarrays (TMAs) from pre-treatment tumor specimens were stained for PD-L1 and CD8. PD-L1 expression in the tumor and stroma was quantified using HALO image analysis software, and results were interpreted using quantitative methods. The density of CD8 cells within the tumor was interpreted by a trained pathologist semi-quantitatively, using a 0-4 scoring system. Kaplan-Meier analysis with log-rank was used to determine the significance in the association of tumor markers with PFS and OS. Cox multivariate analysis was used to explore independent predictors of PFS and OS.ResultsOf the 99 patients, 63 (64%) had sufficient tumor samples available for full analysis. CD8 high status was documented in 32 of 63 (50.8%) % of cases. PD-L1 expression was positive in 88.9% of cases. Approximately half the patients had tumor PD-L1 ≥ 5%. Patients with tumor PD-L1 ≥ 5% had better OS vs those with lower expression, HR=0.32 (95% CI 0.11-0.87), p=0.027; 10 years OS: 84% for tumor PD-L1 ≥ 5% vs 49% for PD-L1 < 5%. PD-L1 expression was not associated with PFS. On multivariate analysis, tumor PD-L1 ≥ 5% showed a trend to statistical significance for better OS, HR=0.55 (95% CI 0.12- 1.00), p=0.052.ConclusionsTumor PD-L1≥5% is associated with OS in patients with ASCC treated with CRT. PD-L1 expression status using this unique cut-point warrants further validation for prognostication in patients with this disease. Future studies are required to determine the benefit of alternative treatment strategies based on PD-L1 status.

Abstract Multiparametric assays for risk stratification are widely used in the management of both node negative and node positive hormone receptor positive invasive breast cancer. Recent data from multiple sources suggests that different tests may provide different risk estimates at the individual patient level. The TEAM pathology study consists of 3284 postmenopausal ER+ve breast cancers treated with endocrine therapy Using genes comprising the following multi-parametric tests OncotypeDx®, Prosigna™ and MammaPrint® signatures were trained to recapitulate true assay results. Patients were then classified into risk groups and survival assessed. Whilst likelihood χ 2 ratios suggested limited value for combining tests, Kaplan–Meier and LogRank tests within risk groups suggested combinations of tests provided statistically significant stratification of potential clinical value. Paradoxically whilst Prosigna-trained results stratified Oncotype-trained subgroups across low and intermediate risk categories, only intermediate risk Prosigna-trained cases were further stratified by Oncotype-trained results. Both Oncotype-trained and Prosigna-trained results further stratified MammaPrint-trained low risk cases, and MammaPrint-trained results also stratified Oncotype-trained low and intermediate risk groups but not Prosigna-trained results. Comparisons between existing multiparametric tests are challenging, and evidence on discordance between tests in risk stratification presents further dilemmas. Detailed analysis of the TEAM pathology study suggests a complex inter-relationship between test results in the same patient cohorts which requires careful evaluation regarding test utility. Further prognostic improvement appears both desirable and achievable.

This article examines the relationship between irregular migration, access to information and migration decisions. Using semi-structured interviews of thirty irregular return migrants who failed to reach their European destinations through Libya, I show that irregular return migrants from Ghana rely predominantly on interpersonal sources, including colleagues, neighbors, friends and relatives, for information on migration. Return migrants seek information from those who have relevant experience with that kind of migration. Existing research focuses on information from ‘formal’ sources such as traditional print media, social media, library or workshops. Here I argue that this focus on access to information conceals the activities and practices of irregular return migrants who perceive European destinations as ‘greener pastures’ and seek information to travel through dangerous routes. Most irregular return migrants interviewed in this study indicated they had access to information from ‘informal’ sources often shared as ‘jokes.’ Although irregular return migrants perceive the information they gather through their everyday activities as reliable, their interactions involve complex and unstructured social processes.

Background: A national shortage of mental health providers for youth exists in the United States. Implementation support for mental health services in schools, where students are most likely to access care, can help to fill these gaps. Coaching consists of in vivo modeling and support during service delivery and is effective in supporting the implementation of evidence-based practices (EBPs). This implementation report describes the recruitment and training of community providers to become coaches as a part of a modified train-the-trainer model of implementation support. Method: An EBP implementation program, Transforming Research into Action to Improve the Lives of Students (TRAILS), trained community providers in Michigan to increase knowledge of cognitive behavioral therapy (CBT) and position them as coaches in schools. The development of the coach network involved five stages prior to the initiation of a randomized controlled trial: (1) recruitment, (2) a one-day clinical training, (3) 12 weeks of individualized consultation, (4) evaluation, and (5) training in the coaching protocol. Results: A total of 347 individuals attended an initial training, and 187 were paired with a consultant. Eighty-six clinicians from 47 of Michigan's 83 counties successfully became coaches by completing all required elements of training. Coaches showed significant improvements in the use and knowledge of CBT across consultation. Conclusion: Statewide networks of trained mental health professionals can address gaps in mental healthcare for youth. This article demonstrates one strategy for strengthening and leveraging community expertise to support the implementation of EPBs in schools. Plain Language Summary Although youth face many barriers in accessing effective mental health care, schools are one setting where they can more easily receive treatment. Research shows that training and supports are needed for school mental health professionals to provide effective care. Coaching, which involves in vivo support for school mental health professionals, is one helpful strategy. We describe the process of recruiting and training community clinicians to become coaches. The Transforming Research into Action to Improve the Lives of Students (TRAILS) program successfully recruited and trained a network of 86 community clinicians to become coaches. Clinicians attended two day-long trainings and participated in 12 weeks of personalized consultation. Clients to whom these clinicians provided CBT showed significant symptom improvement. Clinicians also reported that they increased their knowledge and use of core CBT strategies, including psychoeducation, exposure, and behavioral activation. Community mental health professionals who are trained as coaches can address gaps in access to care for youth. We demonstrate one strategy for strengthening and leveraging clinicians’ knowledge of CBT to support the school-based implementation of CBT.

Background and Aim: The aim of the study was to evaluate the effect of nonsurgical periodontal therapy on clinical, renal, and hematological parameters at baseline and 3 months postoperatively on chronic kidney disease (CKD) patients undergoing hemodialysis. This comparative interventional study was conducted among CKD patients undergoing hemodialysis. Materials and Methods: This study included chronic periodontitis (CP) patients divided into three groups Group I: CKD patients undergoing hemodialysis for less than a year; Group II: CKD patients undergoing hemodialysis for more than a year; and Group III: systemically healthy CP patients. Clinical parameters (bleeding on probing [BOP], probing pocket depth (PPD), and clinical attachment level [CAL]) were recorded at baseline (T0), 1 month (T1), and 3 months after scaling and root planing (SRP) (T2). C-reactive protein (CRP) and transferrin saturation (TSAT) were observed at T0 and at T2. Paired t-test and Chi-square test were applied to find the statistical significance (P < 0.05 was considered statistically significant at 95% confidence interval) between the T0 and T2 time within the groups. Results: Clinical parameters such as PPD and CAL decreased with statistical significance in Group III alone, whereas BOP decreased with statistical significance in all the three groups. The study showed statistically significant reduction of CRP (in Group I and Group III) and TSAT increased with statistical significance in all the three groups after SRP. Conclusion: This suggests that SRP can bring an improvement in the systemic markers in CP patients under hemodialysis. However, we need a longitudinal study with a larger sample size to confirm the results.

School professionals (SPs) are increasingly tasked with providing mental health treatment for students. Successful implementation of school-based mental health evidence-based practices (EBPs) can reduce students’ depression and anxiety, but requires identification of appropriate students to benefit from these interventions. We examined the ability of SPs to identify students appropriate for cognitive behavioral therapy (CBT), using baseline data collected from a large-scale implementation trial. One hundred sixty-nine SPs from 94 Michigan high schools were asked to identify up to 10 students whom they believed could benefit from CBT. Identified students were asked to complete a baseline survey. We examined the proportion of consented students who screened positive for depression or anxiety, based on the Patient Health Questionnaire modified for teens and the Generalized Anxiety Disorder questionnaire, overall and by key school- and SP-level factors. Of the 1,347 students identified by 149 SPs, 899 students completed the survey. Of those students, 87% exhibited any depression or anxiety symptoms (score of five or higher) and 66% showed moderate/severe symptoms (score of ten or higher). Per SP, the proportion of consented students who screened positive for any depression or anxiety symptoms was, on average, 0.88. The effectiveness of SPs’ student identification did not vary significantly by school-specific role, prior CBT training, or geography. Results suggest that SPs can effectively identify students appropriate for CBT given minimal training and resources, an important first step in increasing student access to school-based mental healthcare.

The need to study plant systems in space has a long history and space experiments on plants were recognized for their scientific value and as necessity to provide life support for humans and other non-photosynthetic organisms [...]

Background. Metastatic cancers in the oral cavity are usually very rare and are usually an indication of widespread malignancy. In some cases, oral metastasis was found to be the first presentation of distant site tumours. Even though oral metastatic lesions may be found anywhere in the oral cavity, they commonly present in the posterior areas of the jaw bones. Among the soft tissues, the gingiva is the most common site. The presence of inflammation in the gingiva and the role of periodontal microbiota are suggested to play a role in the attraction of metastatic cells. The purpose of this case report is to present a rare case of metastatic breast carcinoma presenting as a gingival enlargement in the maxillary anterior region. Case Presentation. A 37-year-old female patient who underwent modified radical mastectomy for invasive ductal breast carcinoma reported to the dental clinic with a gingival enlargement in the anterior maxillary region. Clinical and radiographic examination showed a rapidly enlarging gingival lesion with destruction of the underlying bone. A wide excision of the entire lesion was done. Histopathological and immunohistochemical (IHC) evaluations were suggestive of infiltrating poorly differentiated adenocarcinoma. Conclusion. This case report presents a metastatic oral lesion in the maxillary anterior region of the primary breast cancer site. The young age of patient and an uncommon site of metastatic lesion are the striking features of this case. We would like to highlight the importance of a thorough clinical, radiological, and histological evaluation of any gingival swelling as it could be a metastatic lesion. IHC staining helps in the diagnosis of the primary site of metastatic carcinomas. An early diagnosis and intervention could reduce the morbidity of the lesion and improve the survival rate.

У статті розглянуто передумови появи нового виду інформаційного джерела – інтегрованої звітності, її основні характеристики та концепції, цілі та завдання формування, переваги, обмеження. Особливу увагу приділено концепції інтегрованого мислення та його взаємозв'язку з факторами, що надають значний вплив на здатність організації створювати цінність. Зроблена порівняльна характеристика традиційної фінансової та інтегрованої звітності за різними критеріями. Розкрито зміст та елементи інтегрованого звіту згідно з Міжнародним стандартом. Пропонується розглядати нову модель звітності як можливий спосіб отримання більш повної картини про діяльність підприємства, що дозволить йому відобразити ризики і можливості, більш логічно пов'язати соціальні, екологічні фактори і фінансові результати. Запропоновано групу фінансових та нефінансових показників аналізу інтегрованої звітності, що стане інформаційною базою для управління бізнесом.

Objectives To characterise adoption and explore specific clinical and patient factors that might influence pulse oximetry and oxygen use in low-income and middle-income countries (LMICs) over time; to highlight useful considerations for entities working on programmes to improve access to pulse oximetry and oxygen.Design A multihospital retrospective cohort study.Settings All admissions (n=132 737) to paediatric wards of 18 purposely selected public hospitals in Kenya that joined a Clinical Information Network (CIN) between March 2014 and December 2020.Outcomes Pulse oximetry use and oxygen prescription on admission; we performed growth-curve modelling to investigate the association of patient factors with study outcomes over time while adjusting for hospital factors.Results Overall, pulse oximetry was used in 48.8% (64 722/132 737) of all admission cases. Use rose on average with each month of participation in the CIN (OR: 1.11, 95% CI 1.05 to 1.18) but patterns of adoption were highly variable across hospitals suggesting important factors at hospital level influence use of pulse oximetry. Of those with pulse oximetry measurement, 7% (4510/64 722) had hypoxaemia (SpO2

Aim: The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on serum levels of interleukin-1β (IL-1β) and interleukin-8 (IL-8) in smokers and nonsmokers with chronic periodontitis before and after scaling and root planing (SRP). Materials and Methods: This was a comparative interventional study including a total of 52 (26 smokers and 26 nonsmokers with chronic periodontitis) subjects. Clinical parameters (gingival index [GI], plaque index [PI], recession, probing pocket depth [PPD], and clinical attachment level [CAL]) were recorded at baseline and 4 weeks after initial periodontal therapy. Initial periodontal therapy included oral hygiene instructions and full mouth SRP. Venous blood sample of 5 mL was collected from each subject at baseline and 4 weeks after initial periodontal therapy to evaluate serum IL-1β and IL-8. These biochemical parameters were assayed using enzyme-linked immunosorbent assay (ELISA) method. Results: The periodontal parameters such as PI, GI, recession, PPD, and CAL were reduced after nonsurgical periodontal therapy. Smokers with chronic periodontitis showed statistically significant lower GI and higher PI, gingival recession, PPD, and CAL as compared to nonsmokers with chronic periodontitis. Statistically significant reduction in periodontal parameters was seen in both groups after periodontal therapy. IL-1β and IL-8 were increased in both groups at baseline; after SRP both groups showed statistically significant reduction in IL-1β and smokers with chronic periodontitis showed statistically significant increase in IL-8 after SRP. Conclusion: Smokers with chronic periodontitis showed more periodontal destruction and systemic inflammatory markers compared to nonsmokers with chronic periodontitis. After periodontal therapy both groups showed statistically significant improvement in clinical parameters and biochemical parameters excluding IL-8.

OBJECTIVES/GOALS: Our goal is to explore and collaboratively identify the team science competencies essential for Clinical Research Professionals at all experience levels and how these competencies relate to the Joint Task Force for Clinical Translational Research Professionals Competencies. METHODS/STUDY POPULATION: Team science competencies for clinical research professionals are poorly defined. The JTF Clinical Trial Competencies lack sufficient emphasis on team science, though it is briefly included in two JTF competency domains: Leadership & Professionalism, and Communication & Teamwork. The competencies primarily focus on tasks related to clinical research and basic knowledge of product development; however, a conceptual model for applying the competencies using a team science lens is needed. Currently, the JTF competency figure is often thought of as sequential, given the competencies are numbered, creating the misconception that the last competencies are less important. We support a new figure showing the permeability of team science across competencies and the connectedness and equality of the competencies. RESULTS/ANTICIPATED RESULTS: Our anticipated results are to show the integral nature of team science in clinical research professional communities of practice. Once complete, we will have identified measurable team science competency-based skills essential for clinical research professionals at various levels of expertise. Understanding the multi-dimensional team science competencies will inform targeted team science education and training for clinical research professionals. Our revised competency framework provides an improved team science conceptual model for clinical translational science. DISCUSSION/SIGNIFICANCE: Our work will define team science competencies as related to clinical research professionals at all experience levels. The interdependence of teams across clinical trial activities necessitates a consideration of an improved conceptual framework for clinical translational team science competencies.

The insect growth regulator NC-184, a juvenile hormone mimic, prevents moulting to the adult stage in the desert locust, Schistocerca gregaria (Forskål) (Orthoptera: Acrididae). Male nymphs treated in the penultimate or final nymphal instar with NC-184 exhibit precocious mating behaviour in the final instar. We examined whether this chemical affects the development of the internal reproductive organs of crowded nymphs. In treated males, both accessory glands and seminal vesicles were underdeveloped, and no sperm was found in the seminal vesicle, whereas these organs in control individuals had greatly increased in size 10 days after treatment, when all the insects had moulted to adults. Testis size in treated males was similar to that in controls, regardless of their smaller body size due to the inhibition of moulting. Oogenesis and development of spermatheca in females treated with NC-184 continued to some degree, but no eggs matured, unlike what occurred in the control. In conclusion, treatment of S. gregaria nymphs with NC-184 resulted in changes in the reproductive organs in both sexes.

This study deals with problematic features of Czech-Hungarian translation, focusing primarily on issues regarding translations of contemporary Hungarian literature, not only from the aesthetic point of view but from a linguistic one as well. The study examines possible methods and processes in Czech-Hungarian literary translations published from 2000, highlighting translation solutions for non-standard issues. Within translatological research, various translation solutions are examined, taking into account grammatical and lexical features of the two languages. The study includes a summary of Czech-Hungarian translation difficulties as a practical guide for novice translators. An analysis of frequent mistakes in translating from Hungarian to Czech makes up a portion of this work. The study presents a survey of the problems in translating calques, dialects, and slang. Translation solutions are demonstrated with specific examples from translations of three Hungarian novels: A kőszívű ember fiai by Mór Jókai; Feleségverseny by György Spiró; and A lány, aki nem beszélt by Krisztina Tóth.

Hydrocharis morsus-ranae is a free-floating species growing in lakes and slow-flowing rivers near the shore in Europe and Western Asia, and as an invasive plant in the USA and Canada. Light-requiring plants of this species can also grow in the shade, up to about 30% of full sunlight. In this paper we present the data about the photosynthetic apparatus of sunny and shady H. morsus-ranae plants grown in the sun and in the shade in nature. Methods of light and transmission electron microscopy, biochemistry, chlorophyll fluorescence induction as well as the principal component analysis were used. It was found that leaves of plants growing in shade differed from those in the sun with such traits as thickness of a blade, palisade and spongy parenchyma, ultrastructure of chloroplasts, and quantum efficiency of photosynthetic electron transport, the content of chlorophylls and carotenoids, anthocyanins and phenilpropanoids. By these traits, H. morsus-ranae shady plants are similar with shade-bearing plants that indicates their adaptation to light intensity lowering. The ordination plots (PCA) suggested a clear structural and functional shift of plants growing in different lighting showing relationship to light changes in the natural environment. Thus, our results displayed the high phenotypic plasticity of the H. morsus-ranae photosynthetic apparatus, which ensures its acclimation to changing light environment and wide distribution of this species.

School closures due to COVID-19 left students in Michigan without physical access to school mental health professionals (SMHPs) and other supports typically available in schools. This report examines the needs of SMHPs across Michigan during the early months of the COVID-19 pandemic and how those needs informed programming and resources provided by a University of Michigan school mental health training and implementation program. In April 2020, a web-based survey asking about student and SMHP mental health was sent to 263 SMHPs who had previously participated in this program. 155 SMHPs (58.9%) responded. Nearly half of SMHPs reported their students’ most pressing needs were support for self-care, anxiety, depression, and traumatic stress. Some SMHPs also met screening criteria themselves for depression and/or anxiety. This survey provided an overview of SMHPs’ concerns early in the COVID-19 pandemic and drove development of new COVID-19-related resources designed to support SMHPs.

Мета. Метою дослідження є визначення перспектив розвитку лісокористування на основі проведення статистичного аналізу динаміки основних показників протягом 2015–2020 рр. та прогнозування стану лісових ресурсів на прикладі Львівської та Харківської областей. Результати. У цьому дослідженні проаналізовано тенденції та сучасний стан лісових ресурсів у Львівській і Харківській областях; здійснено статистичну оцінку й аналіз взаємодії суспільства з лісовими ресурсами протягом 2015–2020 рр. Проведено аналіз за показниками площі рубок, лісових насаджень, лісовідновлення, кількості лісових пожеж і реалізації лісової продукції. Представлено пропозиції щодо поліпшення стану лісових ресурсів в аналізованих регіонах. Установлено, що Львівській області більш притаманне стале відтворення й екологізація лісокористування, ніж Харківській області. У Харківській області лісистість більше ніж удвічі менша, ніж у Львівській області; а враховуючи, що тут критично велика кількість лісових пожеж, лісовідновлення незначне, можна зробити висновок про критичний стан лісових ресурсів у Харківській області. Наукова новизна. Здійснено порівняльний аналіз тенденцій, сучасного стану та перспектив розвитку лісових ресурсів у двох прикордонних областях різних частин України (західної – Львівської області та східної – Харківської області). Установлено, що в цілому за досліджуваний період ліси Харківської області перебували в критичному стані порівняно з лісами Львівської області. Практична цінність. Результати дослідження можна застосувати для розробки заходів, що першочергово потрібні Харківської області, яка, згідно з розрахунками, більше потерпає від негативних факторів. Водночас результати прогнозування розвитку лісокористування можуть бути корисними для управлінь лісового та мисливського господарства обох областей під час визначення перспектив розвитку.

Plasmodium falciparum parasites have evolved genetic adaptations to overcome immune responses mounted by diverse Anopheles vectors hindering malaria control efforts. Plasmodium falciparum surface protein Pfs47 is critical in the parasite's survival by manipulating the vector's immune system hence a promising target for blocking transmission in the mosquito. This study aimed to examine the genetic diversity, haplotype distribution, and population structure of Pfs47 and its implications on malaria infections in endemic lowlands in Western Kenya. Cross-sectional mass blood screening was conducted in malaria endemic regions in the lowlands of Western Kenya: Homa Bay, Kombewa, and Chulaimbo. Dried blood spots and slide smears were simultaneously collected in 2018 and 2019. DNA was extracted using Chelex method from microscopic Plasmodium falciparum positive samples and used to genotype Pfs47 using polymerase chain reaction (PCR) and DNA sequencing. Thirteen observed haplotypes of the Pfs47 gene were circulating in Western Kenya. Population-wise, haplotype diversity ranged from 0.69 to 0.77 and the nucleotide diversity 0.10 to 0.12 across all sites. All the study sites displayed negative Tajima's D values although not significant. However, the negative and significant Fu's Fs statistical values were observed across all the study sites, suggesting population expansion or positive selection. Overall genetic differentiation index was not significant (FST = -0.00891, P > 0.05) among parasite populations. All Nm values revealed a considerable gene flow in these populations. These results could have important implications for the persistence of high levels of malaria transmission and should be considered when designing potential targeted control interventions.

Background: Systematic reviews are used to inform healthcare decision making. In reviews that aim to examine the effects of organisational, policy change or public health interventions, or exposures, evidence from interrupted time series (ITS) studies may be included. A core component of many systematic reviews is meta-analysis, which is the statistical synthesis of results across studies. There is currently a lack of guidance informing the choice of meta-analysis methods for combining results from ITS studies, and there have been no studies examining the meta-analysis methods used in practice. This study therefore aims to describe current meta-analysis methods used in a cohort of reviews of ITS studies. Methods: We will identify the 100 most recent reviews (published between 1 January 2000 and 11 October 2019) that include meta-analyses of ITS studies from a search of eight electronic databases covering several disciplines (public health, psychology, education, economics). Study selection will be undertaken independently by two authors. Data extraction will be undertaken by one author, and for a random sample of the reviews, two authors. From eligible reviews we will extract details at the review level including discipline, type of interruption and any tools used to assess the risk of bias / methodological quality of included ITS studies; at the meta-analytic level we will extract type of outcome, effect measure(s), meta-analytic methods, and any methods used to re-analyse the individual ITS studies. Descriptive statistics will be used to summarise the data. Conclusions: This review will describe the methods used to meta-analyse results from ITS studies. Results from this review will inform future methods research examining how different meta-analysis methods perform, and ultimately, the development of guidance.

Background: Systematic reviews are used to inform healthcare decision making. In reviews that aim to examine the effects of organisational, policy change or public health interventions, or exposures, evidence from interrupted time series (ITS) studies may be included. A core component of many systematic reviews is meta-analysis, which is the statistical synthesis of results across studies. There is currently a lack of guidance informing the choice of meta-analysis methods for combining results from ITS studies, and there have been no studies examining the meta-analysis methods used in practice. This study therefore aims to describe current meta-analysis methods used in a cohort of reviews of ITS studies. Methods: We will identify the 100 most recent reviews (published between 1 January 2000 and 11 October 2019) that include meta-analyses of ITS studies from a search of eight electronic databases covering several disciplines (public health, psychology, education, economics). Study selection will be undertaken independently by two authors. Data extraction will be undertaken by one author, and for a random sample of the reviews, two authors. From eligible reviews we will extract details at the review level including discipline, type of interruption and any tools used to assess the risk of bias / methodological quality of included ITS studies; at the meta-analytic level we will extract type of outcome, effect measure(s), meta-analytic methods, and any methods used to re-analyse the individual ITS studies. Descriptive statistics will be used to summarise the data. Conclusions: This review will describe the methods used to meta-analyse results from ITS studies. Results from this review will inform future methods research examining how different meta-analysis methods perform, and ultimately, the development of guidance.

INTRODUCTION: Pour améliorer l´accessibilité des méthodes contraceptives au Burkina Faso, il a été initié un projet pilote de transfert des compétences de l´offre du DIU et de l´implant aux agents de santé première ligne (APL) ainsi que l´offre des méthodes contraceptives injectables aux agents de santé communautaire (ASC) dans 20 centres de santé du district sanitaire de Tougan. La présente étude visait à apprécier la qualité des services de planification familiale (PF) offerts par ces délégataires (APL et ASC). METHODES: il s´est agi d´une étude transversale à visée descriptive et analytique. La collecte des données a combiné les méthodes quantitatives et qualitatives. Elle a porté sur l´ensemble des 20 centres de santé de la zone d´intervention du projet et sur tous les prestataires (54) impliqués dans l´offre des produits contraceptifs (délégants et délégataires). Dix-neuf (19) bénéficiaires dont 10 nouvelles utilisatrices d´une méthode contraceptive ont été interviewées. Les techniques de collecte étaient constituées de l´observation des prestations de services de PF et de l´environnement de travail, de la revue documentaire et des entretiens individuels. Les données ont été analysées à l´aide du logiciel Epi info 7 et Open Epi version 3.01. Le test du Chi carré et le test t de Student ont été utilisés pour déterminer s´il y existait une différence significative entre la qualité des services de PF offerts par les délégants et celle des délégataires. RESULTATS: le score de qualité générale du service de PF de la zone d´intervention était de 73% chez les délégataires contre 69% chez les délégants. Il n´y avait pas de différence statistiquement significative entre ces scores. Par contre, Il existait une différence statistiquement significative entre le score de qualité des agents de santé communautaire (75,8 %) et celui des délégants (87,5 %) en matière counseling (P =0.05). Il en était de même pour le score de qualité en matière de détermination des critères d´éligibilité des implants où la qualité chez les APL semble supérieure à celle des délégants: 79% pour les délégataires, 64% pour les délégants. CONCLUSION: cette expérience a eu l´avantage d´améliorer la couverture géographique de l´offre des méthodes contraceptives de longue durée d´action. Sous certaines conditions (renforcement des compétences, suivi, coaching), il est bien possible d´étendre l´offre des méthodes contraceptives de longues durées aux APL ainsi que celle des injectables aux ASC tout en conservant un niveau de qualité des services PF satisfaisant.

The data in this article focus on the F11 Receptor (F11R/JAM-A; Junctional Adhesion Molecule-A; JAM-A, F11R), a cell adhesion protein constitutively expressed on the membrane surface of circulating platelets and localized within the tight junctions of healthy endothelial cells (ECs). Previous reports have shown that F11R/JAM-A plays a critical role in the adhesion of platelets to an inflamed endothelium due to its’ pathological expression on the luminal surface of the cytokine-inflamed endothelium. Since platelet adhesion to an inflamed endothelium is an early step in the development of atherosclerotic plaque formation, and with time, resulting in heart attacks and stroke, we conducted a long-term, study utilizing the atherosclerosis-prone ApoE-/- mice to attempt a blockade of the formation of atherosclerotic plaques by preventing the adhesion of platelets to the inflamed vasculature in vivo. Utilizing a nonhydrolyzable peptide derived from an amino acid sequence of F11R/JAM-A, peptide 4D, we have shown in culture that the adhesion of platelets to the inflamed endothelial cells could be blocked by peptide 4D. The present data demonstrate the positive health benefits of chronic peptide 4D administration to the atherosclerosis-prone ApoE-/- mice, and provides new information for potential use of this F11R derived peptide in the prevention of atherosclerosis. The data presented in this article provide further experimental support for the study presented in Babinska et al., Atherosclerosis 284 (2019) 92-101.

Background Heavy smokers perform worse on neuropsychological assessment than age‐matched peers. However, traditional pulmonary measures of airflow limitation and hypoxemia explain only a modest amount of variance in cognition. The current objective was to determine whether carotid artery stiffness is associated with cognition in former smokers beyond the effects of amount of smoking and pulmonary function. Methods and Results Eighty‐four former smokers including individuals across a spectrum of airflow limitation severity were included: 30 without chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease [GOLD] 0 with normal spirometry and lung computed tomography), 31 with mild‐moderate chronic obstructive pulmonary disease (GOLD 1–2), and 23 with severe‐very severe chronic obstructive pulmonary disease (GOLD 3–4). Participants completed questionnaires, spirometry, carotid ultrasonography, and neuropsychological testing. Multiple linear regression was used to determine whether carotid artery stiffness is associated with neuropsychological performance in 4 cognitive domains after adjusting for age, sex, pack‐years of smoking, estimated premorbid intellectual functioning, and airflow limitation. Higher carotid artery β‐stiffness index was associated with reduced executive functioning‐processing speed in the fully adjusted model (β=−0.49, SE=0.14; P=0.001). Lower premorbid intellectual function, male sex, and presence of airflow limitation (GOLD 1 or 2 and GOLD 3 or 4) were also associated with worse executive functioning‐processing speed. β‐Stiffness index was not significantly associated with performance in other cognitive domains. Conclusions Carotid artery stiffness is associated with worse performance on executive functioning‐processing speed in former smokers beyond the effects of aging, amount of past smoking, severity of airflow limitation, and hypoxemia. Future research should examine whether carotid stiffness can be used to identify former smokers at risk for subsequent cognitive impairment.

Abstract Background Depressive and anxiety disorders affect 20–30% of school-age youth, most of whom do not receive adequate services, contributing to poor developmental and academic outcomes. Evidence-based practices (EBPs) such as cognitive behavioral therapy (CBT) can improve outcomes, but numerous barriers limit access among affected youth. Many youth try to access mental health services in schools, but school professionals (SPs: counselors, psychologists, social workers) are rarely trained adequately in CBT methods. Further, SPs face organizational barriers to providing CBT, such as lack of administrative support. Three promising implementation strategies to address barriers to school-based CBT delivery include (1) Replicating Effective Programs (REP), which deploys customized CBT packaging, didactic training in CBT, and technical assistance; (2) coaching, which extends training via live supervision to improve SP competence in CBT delivery; and (3) facilitation, which employs an organizational expert who mentors SPs in strategic thinking to promote self-efficacy in garnering administrative support. REP is a relatively low-intensity/low-cost strategy, whereas coaching and facilitation require additional resources. However, not all schools will require all three strategies. The primary aim of this study is to compare the effectiveness of a school-level adaptive implementation intervention involving REP, coaching, and facilitation versus REP alone on the frequency of CBT delivered to students by SPs and student mental health outcomes. Secondary and exploratory aims examine cost-effectiveness, moderators, and mechanisms of implementation strategies. Methods Using a clustered, sequential multiple-assignment, randomized trial (SMART) design, ≥ 200 SPs from 100 schools across Michigan will be randomized initially to receive REP vs. REP+coaching. After 8 weeks, schools that do not meet a pre-specified implementation benchmark are re-randomized to continue with the initial strategy or to augment with facilitation. Discussion EBPs need to be implemented successfully and efficiently in settings where individuals are most likely to seek care in order to gain large-scale impact on public health. Adaptive implementation interventions hold the promise of providing cost-effective implementation support. This is the first study to test an adaptive implementation of CBT for school-age youth, at a statewide level, delivered by school staff, taking an EBP to large populations with limited mental health care access. Trial registration NCT03541317—Registered on 29 May 2018 on ClinicalTrials.gov PRS