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New Findings: What is the central question of this study? Sodium–glucose cotransporter 2 (SGLT2) inhibitors reduce cardiovascular risk in patients with both diabetic and non-diabetic kidney disease: can SGLT2 inhibition improve renal pressure natriuresis (PN), an important mechanism for long-term blood pressure control, which is impaired in type 1 diabetes mellitus (T1DM)? What is the main finding and its importance? The SGLT2 inhibitor dapagliflozin did not enhance the acute in vivo PN response in either healthy or T1DM Sprague–Dawley rats. The data suggest that the mechanism underpinning the clinical benefits of SGLT2 inhibitors on health is unlikely to be due to an enhanced natriuretic response to increased blood pressure. Abstract: Type 1 diabetes mellitus (T1DM) leads to serious complications including premature cardiovascular and kidney disease. Hypertension contributes importantly to these adverse outcomes. The renal pressure natriuresis (PN) response, a key regulator of blood pressure (BP), is impaired in rats with T1DM as tubular sodium reabsorption fails to down-regulate with increasing BP. We hypothesised that sodium–glucose cotransporter 2 (SGLT2) inhibitors, which reduce cardiovascular risk in kidney disease, would augment the PN response in T1DM rats. Non-diabetic or T1DM (35–50 mg/kg streptozotocin i.p.) adult male Sprague–Dawley rats were anaesthetised (thiopental 50 mg/kg i.p.) and randomised to receive either dapagliflozin (1 mg/kg i.v.) or vehicle. Baseline sodium excretion was measured and then BP was increased by sequential arterial ligations to induce the PN response. In non-diabetic animals, the natriuretic and diuretic responses to increasing BP were not augmented by dapagliflozin. Dapagliflozin induced glycosuria, but this was not influenced by BP. In T1DM rats the PN response was impaired. Dapagliflozin again increased urinary glucose excretion but did not enhance PN. Inhibition of SGLT2 does not enhance the PN response in rats, either with or without T1DM. SGLT2 makes only a minor contribution to tubular sodium reabsorption and does not contribute to the impaired PN response in T1DM.

Introduction: This study aims to quantify the impact of the COVID-19 pandemic on access and inequalities in primary care dental services among children and adults in Scotland. Methods: Access was measured as any NHS Scotland primary care dental contacts derived from administrative data from January 2019 to May 2022, linked to the area-based Scottish Index of Multiple Deprivation (SIMD) for children and adults, and related to population denominator estimates from National Record Scotland. Inequalities for pre-pandemic (January 2019 – January 2020) and recent (December 2021 – February 2022 and March 2022 – May 2022) periods for both children and adults were calculated and compared using the slope index of inequality (SII) and relative index of inequality (RII). Results: Following the first lockdown (March 2020) there was a dramatic fall to near zero dental contacts, followed by a slow recovery to 64.8% of pre-pandemic levels by May 2022. There was initial widening of relative inequalities in dental contacts in early 2022, which, more recently, had begun to return to pre-pandemic levels. Conclusion: COVID-19 has had a major impact on access to NHS primary dental care, and while inequalities in access are apparent as services recover from lockdown, these inequalities are not a new phenomenon.

IntroductionA major transition for medical students is the change from the pre-clinical to clinical years of their curriculum. Interventions to help students manage this transition effectively, such as preparatory skills courses and peer mentoring, are used in many medical schools, yet students remain apprehensive about this period. This study aims to investigate student feelings and perceptions around the transition from the pre-clinical to clinical part of the curriculum to inform interventions for helping them better manage the experience.MethodA cross-sectional study of all students starting their first clinical placement was undertaken. Questionnaires were administered online. Ordinal data were collected via Likert-scale responses. Free text responses were analysed using thematic analysis.ResultsLikert-scale responses showed that most students (69%) agreed or strongly agreed that they looked forward to the range of wards they would spend time on. Respectively, 41% and 43% of students agreed they would be supported in taking histories or carrying out clinical. The majority of students disagreed (28%) or were not sure (27%) that they would have a clear role on the ward. Free text responses identified that students looked forward to patient contact and new ways of learning but were apprehensive about making mistakes, poor staff attitude, personal wellbeing and a lack of purpose in the clinical environment.ConclusionsThe transition into the clinical phase is complex, and students have a wide variety of concerns beyond skills or knowledge deficits. To address these worries, interventions for both improving psychological wellbeing and academic achievement should be developed.

In dogs, balloon valvuloplasty is considered the treatment of choice for severe pulmonary valve stenosis, and this technique is currently performed routinely in specialist referral practices with low morbidity and mortality. Stent angioplasty has also been recently proposed as a viable treatment option. The present case series describes the clinical course of four dogs with severe pulmonary valve stenosis, treated with balloon valvuloplasty or stent angioplasty at four different institutions, which developed non-cardiogenic pulmonary oedema perioperatively after apparently successful dilation of the pulmonary valve. In three cases, there was evidence of some degree of pulmonary hypertension before ballooning. Despite intensive care, the complication proved fatal in three cases. Clinicians should therefore be aware of this life-threatening complication, previously undescribed in dogs.

Semantic segmentation in surgical videos has applications in intra-operative guidance, post-operative analytics and surgical education. Segmentation models need to provide accurate and consistent predictions since temporally inconsistent identification of anatomical structures can impair usability and hinder patient safety. Video information can alleviate these challenges leading to reliable models suitable for clinical use. We propose a novel architecture for modelling temporal relationships in videos. The proposed model includes a spatio-temporal decoder to enable video semantic segmentation by improving temporal consistency across frames. The encoder processes individual frames whilst the decoder processes a temporal batch of adjacent frames. The proposed decoder can be used on top of any segmentation encoder to improve temporal consistency. Model performance was evaluated on the CholecSeg8k dataset and a private dataset of robotic Partial Nephrectomy procedures. Segmentation performance was improved when the temporal decoder was applied across both datasets. The proposed model also displayed improvements in temporal consistency., Comment: Accepted at IPCAI 2023

A key aspect of the public health response to COVID-19 in Scotland was enhanced community surveillance, including testing in dental settings. Across Scotland, dental settings offered patients over 5-years-old the opportunity to participate in community surveillance of COVID-19.A Health Inequalities Impact Assessment (HIIA) was conducted to understand the differential impacts the programme would have on the population and to improve the accessibility of the programme. HIIA is a tool to allow the assessment, understanding, and mitigation of impacts on people of a proposed policy or practice. It fulfils an organisational duty to meet the requirements of the Equality Act and Fairer Scotland Duty. The HIIA was conducted rapidly in parallel with the programme development. An action research approach included an online workshop, consultation, review of population data and a literature search.Adjustments were required to improve the programme's accessibility. Stakeholders, including dental teams from across Scotland were involved in the consultation and brought their front-line experience in different settings. Common issues identified included digital literacy and access, language and cultural barriers to participation, and issues relating to the implications of a positive COVID-19 result. Literature indicated limited evidence on the acceptability, accessibility, and equity of asymptomatic COVID-19 surveillance.This HIIA was conducted during the COVID-19 pandemic. As an example of good practice in tackling inequalities in access to programmes it should represent the benchmark for other similar initiatives.

This article discusses the implications of biologics on dental treatment and patient management. There is limited information available on the dental relevance of biologics, and, with increasing numbers of patients undertaking biological therapy for autoimmune diseases, cancer, and osteoporosis among other conditions, comprehensive research is needed. Information gathered from clinical trials and literature reviews was used to consolidate information for general dental practitioners (GDPs). CPD/Clinical Relevance: To update GDPs on biologics, highlight the importance of taking a thorough medical history and encourage discussion on management of patients taking biologics in general dental practice.

Using a novel physiologically relevant in vitro human whole blood neutrophil shape change assay, an aminopyrazine series of selective PI3Kγ inhibitors was identified and prioritized for further optimization. Severe solubility limitations associated with the series leading to low oral bioavailability and poor exposures, especially at higher doses, were overcome by moving to an aminopyridine core. Compound 33, with the optimal balance of on-target activity, selectivity, and pharmacokinetic parameters, progressed into in vivo studies and demonstrated good efficacy (10 mg/kg) in a rat model of airway inflammation. Sufficient exposures were achieved at high doses to support toxicological studies, where unexpected inflammatory cell infiltrates in cardiovascular tissue prevented further compound development.

The authors highlight the role of love and care as the ‘lifeblood of being-well’ for teachers in England. The COVID-19 pandemic has imposed unprecedented stressors on teachers. However, the article...

Background Therapeutic hypothermia is standard of care for babies with moderate to severe hypoxic–ischaemic encephalopathy. There is limited evidence to inform provision of nutrition during hypothermia. Objectives To assess the association during therapeutic hypothermia between (1) enteral feeding and outcomes, such as necrotising enterocolitis and (2) parenteral nutrition and outcomes, such as late-onset bloodstream infection. Design A retrospective cohort study using data held in the National Neonatal Research Database and applying propensity score methodology to form matched groups for analysis. Setting NHS neonatal units in England, Wales and Scotland. Participants Babies born at ≥ 36 gestational weeks between 1 January 2010 and 31 December 2017 who received therapeutic hypothermia for 72 hours or who died during treatment. Interventions Enteral feeding analysis – babies who were enterally fed during therapeutic hypothermia (intervention) compared with babies who received no enteral feeds during therapeutic hypothermia (control). Parenteral nutrition analysis – babies who received parenteral nutrition during therapeutic hypothermia (intervention) compared with babies who received no parenteral nutrition during therapeutic hypothermia (control). Outcome measures Primary outcomes were severe and pragmatically defined necrotising enterocolitis (enteral feeding analysis) and late-onset bloodstream infection (parenteral nutrition analysis). Secondary outcomes were survival at neonatal discharge, length of neonatal stay, breastfeeding at discharge, onset of breastfeeding, time to first maternal breast milk, hypoglycaemia, number of days with a central line in situ, duration of parenteral nutrition, time to full enteral feeds and growth. Results A total of 6030 babies received therapeutic hypothermia. Thirty-one per cent of babies received enteral feeds and 25% received parenteral nutrition. Seven babies (0.1%) were diagnosed with severe necrotising enterocolitis, and further comparative analyses were not conducted on this outcome. A total of 3236 babies were included in the matched enteral feeding analysis. Pragmatically defined necrotising enterocolitis was rare in both groups (0.5% vs. 1.1%) and was lower in babies who were fed during hypothermia (rate difference –0.5%, 95% confidence interval –1.0% to –0.1%; p = 0.03). Higher survival to discharge (96.0% vs. 90.8%, rate difference 5.2%, 95% confidence interval 3.9% to 6.6%; p p p = 0.03). Survival was lower in babies who did not receive parenteral nutrition (90.0% vs. 93.1%, rate difference 3.1%, 95% confidence interval 1.5% to 4.7%; p Limitations Propensity score methodology can address imbalances in observed confounders only. Residual confounding by unmeasured or poorly recorded variables cannot be ruled out. We did not analyse by type or volume of enteral or parenteral nutrition. Conclusions Necrotising enterocolitis is rare in babies receiving therapeutic hypothermia, and the introduction of enteral feeding is associated with a lower risk of pragmatically defined necrotising enterocolitis and other beneficial outcomes, including rates of higher survival and breastfeeding at discharge. Receipt of parenteral nutrition during therapeutic hypothermia is associated with a higher rate of late-onset infection but lower mortality. These results support introduction of enteral feeding during therapeutic hypothermia. Future work Randomised trials to assess parenteral nutrition during therapeutic hypothermia. Trial registration Current Controlled Trials ISRCTN474042962. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 36. See the NIHR Journals Library website for further project information.

This research focused on thermal stability, color fastness and UV protection properties enhancing cotton fabric coated with ZnO and carbon black nanoparticles and dyed with Terminalia catappa leaves powder. The XRD patterns of ZnO nanoparticles contained peaks associated with the hexagonal system, which can be attributed to the structure of ZnO wurtzite. The XRD pattern of carbon black showed a typical amorphous structure. SEM images of the coated cotton surface revealed a scattering of carbon and zinc oxide nanoparticles that increases in size in relation to the amount of carbon and zinc nanoparticles. The ATR-FT-IR spectra of cotton coated with ZnO and carbon revealed the presence of O-H bond, H-C-H bond, C-O-C bond, C-O bond and Zn-O bond. TGA analysis revealed that the cotton coated with zinc oxide and carbon exhibited a greater than 100 °C heat resistance. TGA analysis of cotton coated with CZ4 nanoparticles at 352 °C revealed a weight loss of 70.61%, whereas uncoated cotton lost 85.96 percent of its weight at 358 °C. Light fastness and washing fastness properties of cotton coated with zinc oxide and carbon nanoparticles were 4–5 (good to very good). The FE-SEM and EDS elemental analyses were used to confirm residual elements affected by the excellent UV protective functions of the coated cotton. Cotton fabrics coated with Zn3 and CZn4 are the optimal condition for enhancing the thermal stability, washability, and UV protection of dyed cotton. After 30 wash cycles, the EDS analysis revealed that the cotton fabrics coated with Zn3 and CZn4 retained their durability, with Zn element concentrations of 66.62 (%W) and 67.60 (%W), respectively. The coated cotton significantly outperforms uncoated cotton in terms of thermal stability, color fastness, UV blocking, tensile strength, and air permeability. As the results of this research established; the optimal dyeing protocol for cotton to obtain the desired textile properties.

Background The COVID-19 pandemic led to significant changes in the provision of dental services, aimed at reducing the spread of respiratory pathogens through restrictions on aerosol generating procedures (AGPs). Evaluating the risk that AGPs pose in terms of SARS-CoV-2 transmission is complex, and measuring dental aerosols is challenging. To date, few studies focus on intra-oral suction. This study sought to assess the effectiveness of commonly used intra-oral suction devices on aerosol mitigation. Methods Ultrasonic scaling and high-speed handpiece procedures were undertaken to generate aerosol particles. Multiple particle sensors were positioned near the oral cavity. Sensor data were extracted using single board computers with custom in-house Bash code. Different high-volume and low-volume suction devices, both static and dynamic, were evaluated for their efficacy in preventing particle escape during procedures. Results In all AGPs the use of any suction device tested resulted in a significant reduction in particle counts compared with no suction. Low-volume and static suction devices showed spikes in particle count demonstrating moments where particles were able to escape from the oral cavity. High-volume dynamic suction devices, however, consistently reduced the particle count to background levels, appearing to eliminate particle escape. Conclusions Dynamic high-volume suction devices that follow the path of the aerosol generating device effectively eliminate aerosol particles escaping from the oral cavity, in contrast to static devices which allow periodic escape of aerosol particles. Measuring the risk of SARS-CoV-2 transmission in a dental setting is multi-factorial; however, these data suggest that the appropriate choice of suction equipment may further reduce the risk from AGPs.

This article presents an innovative, video-based approach to the recruitment of research participants. A YouTube video was created and uploaded as part of a doctoral study exploring what it means to be struggling as a teacher. Following a review of the recruitment literature, which highlights a general lack of attention paid to the challenges of recruitment, the author explores the approach she took in planning the video. The video was the main promotional tool for the study and was communicated via Twitter and email. She also presents online survey findings on the perceived impact and influence of the video; the visual format, informal tone and the ability to see the researcher in person were rated very positively. A reflective analysis of the video transcript follows drawing on the literature as well as the survey findings. She concludes that video-based recruitment can be an inexpensive but powerful tool which allows a human connection with the researcher early on in the research process.

Background: Cats with subclinical hypertrophic cardiomyopathy (sHCM) have elevated serum insulin levels and serum amyloid A levels correlating with the degree of cardiac hypertrophy. Diet might affect these parameters and other cardiac variables.Objective: Evaluate the effect of a complete, balanced diet with restricted starch and supplemented with eicosapentanoic acid+docosahexaenoic acid (EPA+DHA) on echocardiographic parameters and cardiac biomarkers in cats with sHCM.Animals: Forty-four client-owned cats with sHCM. Methods: A prospective, randomized, double-blind, multicenter study enrolled cats with end-diastole interventricular septum thickness (IVSd) and/or left ventricular wall thickness (LVWd) ≥6 mm. Non-sedated, fasted cats were examined at baseline and after 6 and 12 months of Test (restricted starch and EPA+DHA supplements) (n=23) or Control (unrestricted starch without EPA+DHA supplementation) (n=21) diet. Assessments included auscultation, body weight, body condition score, echocardiography and blood analysis. Linear and generalized mixed models analyzed diet, time and diet*time interactions (5% significance level). Results: No differences between diet groups were significant for any variable at any timepoint. There were significant decreases in the Test but not Control group in maximum IVSd (P = .031; P = .524), maximum LVWd (P = .022; P = .905) and insulin-like growth factor-1 levels (P = .036; P = .987) after 12 months, and in ultra-sensitive cardiac troponin I (cTnI) (P = .001; P = .745) after 6 months only.Conclusions and clinical importance: Significant decreases in echocardiographic variables of sHCM, cTnI and IGF-1, were observed in the Test group. Further research is needed to evaluate effects on clinical outcomes.

© 2020 Taylor & Francis. This is an Accepted Manuscript of an article published by Taylor & Francis in School Leadership & Management on 17/09/2020, available online: https://doi.org/10.1080/13632434.2020.1811661.

Enemy‐risk effects, often referred to as non‐consumptive effects (NCEs), are an important feature of predator–prey ecology, but their significance has had little impact on the conceptual underpinning or practice of biological control. We provide an overview of enemy‐risk effects in predator–prey interactions, discuss ways in which risk effects may impact biocontrol programs and suggest avenues for further integration of natural enemy ecology and integrated pest management. Enemy‐risk effects can have important influences on different stages of biological control programs, including natural enemy selection, efficacy testing and quantification of non‐target impacts. Enemy‐risk effects can also shape the interactions of biological control with other pest management practices. Biocontrol systems also provide community ecologists with some of the richest examples of behaviourally mediated trophic cascades and demonstrations of how enemy‐risk effects play out among species with no shared evolutionary history, important topics for invasion biology and conservation. We conclude that the longstanding use of ecological theory by biocontrol practitioners should be expanded to incorporate enemy‐risk effects, and that community ecologists will find many opportunities to study enemy‐risk effects in biocontrol settings., We provide a synthetic review of enemy‐risk effects in biological control of arthropod pests. We provide a conceptual overview of enemy‐risk effects, review the current body of literature documenting risk effects in biocontrol systems and describe in detail ways in which risk effects may impact the implementation of biocontrol programs.

This is the first report of an aortic sinus aneurysm with a communication to the main pulmonary artery, resulting in left-to-right shunting, diagnosed in vivo in a dog. A second left-to right-shunt through a patent ductus arteriosus was also present. Computed tomography angiography was used to confirm the presence of both congenital anomalies and assess the relative contributions of the two left-to-right shunts to left-sided volume overload.

Metastable soils may collapse because of the nature of their fabric. Generally speaking, these soils have porous textures, high void ratios and low densities. They have high apparent strengths at their natural moisture content, but large reductions of void ratio take place upon wetting and, particularly, when they are loaded because bonds between grains break down upon saturation. Worldwide, there is a range of natural soils that are metastable and can collapse, including loess, residual soils derived from the weathering of acid igneous rocks and from volcanic ashes and lavas, rapidly deposited and then desiccated debris flow materials such as some alluvial fans; for example, in semi-arid basins, colluvium from some semi-arid areas and cemented, high salt content soils such as some sabkhas. In addition, some artificial non-engineered fills can also collapse. In the UK, the main type of collapsible soil is loess, though collapsible non-engineered fills also exist. Loess in the UK can be identified from geological maps, but care is needed because it is usually mapped as ‘brickearth’. This is an inappropriate term and it is suggested here that it should be replaced, where the soils consist of loess, by the term ‘loessic brickearth’. Loessic brickearth in the UK is found mainly in the south east, south and south west of England, where thicknesses greater than 1 m are found. Elsewhere, thicknesses are usually less than 1 m and, consequently, of limited engineering significance. There are four steps in dealing with the potential risks to engineering posed by collapsible soils: (1) identification of the presence of a potentially collapsible soil using geological and geomorphological information; (2) classification of the degree of collapsibility, including the use of indirect correlations; (3) quantification of the degree of collapsibility using laboratory and/or in situ testing; (4) improvement of the collapsible soil using a number of engineering options.

Supplemental material, sj-docx-1-cpc-10.1177_10556656221102043 for Raising a Child with Craniosynostosis: Psychosocial Adjustment in Parents by Bruna Costa, MSc, Wendy Edwards, PhD, Laura Culshaw, MSc, Karen Wilkinson-Bell, MBA, and Nicola Marie Stock, DPhil in The Cleft Palate-Craniofacial Journal

Additional file 2. Creating files for data storage and Bash code for processing of the raw particle sensor data.

Supplemental material, sj-docx-2-cpc-10.1177_10556656221102043 for Raising a Child with Craniosynostosis: Psychosocial Adjustment in Parents by Bruna Costa, MSc, Wendy Edwards, PhD, Laura Culshaw, MSc, Karen Wilkinson-Bell, MBA, and Nicola Marie Stock, DPhil in The Cleft Palate-Craniofacial Journal

Additional file 1. Study setup within the Clinical Research Facility. Plan and section view of the study setup within the Clinical Research Facility; and figures showing the positioning of the particle sensors relative to the incisal edges, for both the single and dual sensor setups (drawings created by Dr Piotr J. Lesniak).

Supplemental material, sj-docx-2-cpc-10.1177_10556656221102043 for Raising a Child with Craniosynostosis: Psychosocial Adjustment in Parents by Bruna Costa, MSc, Wendy Edwards, PhD, Laura Culshaw, MSc, Karen Wilkinson-Bell, MBA, and Nicola Marie Stock, DPhil in The Cleft Palate-Craniofacial Journal

CreERT2‐mediated gene recombination is widely applied in developmental biology research. Activation of CreERT2 is typically achieved by injection of tamoxifen in an oily vehicle into the peritoneal cavity of mid‐gestation pregnant mice. This can be technically challenging and adversely impacts welfare. Here we characterize three refinements to this technique: Pipette feeding (not gavage) of tamoxifen, ex vivo CreERT2 activation in whole embryo culture and injection of cell‐permeable TAT‐Cre into Cre‐negative cultured embryos. We demonstrate that pipette feeding of tamoxifen solution to the mother on various days of gestation reliably activates embryonic CreERT2, illustrated here using β‐Actin CreERT2, Sox2 CreERT2, T CreERT2, and Nkx1.2 CreERT2. Pipette feeding of tamoxifen induces dose‐dependent recombination of Rosa26 mTmG reporters when administered at E8.5. Activation of two neuromesodermal progenitor‐targeting Cre drivers, T CreERT2, and Nkx1.2 CreERT2, produces comparable neuroepithelial lineage tracing. Dose‐dependent CreERT2 activation can also be achieved by brief exposure to 4OH‐tamoxifen in whole embryo culture, allowing temporal control of gene deletion and eliminating the need to treat pregnant mice. Rosa26 mTmG reporter recombination can also be achieved regionally by injecting TAT‐Cre into embryonic tissues at the start of culture. This allows greater spatial control over Cre activation than can typically be achieved with endogenous CreERT2, for example by injecting TAT‐Cre on one side of the midline. We hope that our description and application of these techniques will stimulate refinement of experimental methods involving CreERT2 activation for gene deletion and lineage tracing studies. Improved temporal (ex vivo treatment) and spatial (TAT‐Cre injection) control of recombination will also allow previously intractable questions to be addressed.

Research is revealing an increasing number of positive effects of nature for humans. At the same time, biodiversity in cities, where most humans live, is often low or in decline. Tangible solutions are needed to increase urban biodiversity. Architecture is a key discipline that has considerable influence on the built-up area of cities, thereby influencing urban biodiversity. In general, architects do not design for biodiversity. Conversely, urban conservation planning generally focuses on the limited space free of buildings and does not embrace architecture as an important discipline for the creation of urban green infrastructure. In this paper, we argue that the promotion of biodiversity needs to become a key driving force of architectural design. This requires a new multi-species design paradigm that considers both human and non-human needs. Such a design approach needs to maintain the standards of the architectural profession, including the aim to increase the well-being of humans in buildings. Yet, it also needs to add other stakeholders, organisms such as animals, plants and even microbiota. New buildings designed for humans and other inhabitants can then increase biodiversity in cities and also increase the benefits that humans can derive from close proximity to nature. We review the challenges that this new design approach poses for both architecture and ecology and show that multi-species-design goes beyond existing approaches in architecture and ecology. The new design approach needs to make ecological knowledge available to the architectural design process, enabling practitioners to find architectural solutions that can facilitate synergies from a multi-species perspective. We propose that a first step in creating such a multi-species habitat is the design of buildings with an ecolope, a multi criteria-designed building envelope that takes into account the needs of diverse organisms. Because there is no framework to design such an ecolope, we illustrate how multi-species design needs to draw on knowledge from ecology, as well as architecture, and design computation. We discuss how architectures designed via a multi-species approach can be an important step in establishing beneficial human–nature relationships in cities, and contribute to human well-being and biodiversity conservation. Read the free Plain Language Summary for this article on the Journal blog.

BackgroundOral lichen planus (OLP) is a chronic inflammatory disorder of the oral mucosa. Currently there is no approved treatment for OLP. We report on the efficacy and safety of a novel mucoadhesive clobetasol patch (Rivelin®-CLO) for the treatment of OLP.MethodsPatients with confirmed OLP and measurable symptomatic ulcer(s) participated in a randomized, double-blind, placebo-controlled, multicenter clinical trial testing a novel mucoadhesive clobetasol patch (Rivelin®-CLO) in OLP across Europe, Canada, and the United States. Patients were randomized to placebo (nonmedicated), 1, 5, 20 µg Clobetasol/patch, twice daily, for 4 weeks. The primary endpoint was change in total ulcer area compared to baseline. Secondary endpoints included improvement from baseline in pain, disease activity, and quality of life.ResultsData were analyzed and expressed as mean [SD]. One hundred thirty-eight patients were included in the study; 99 females and 39 males, mean age was 61.1 [11.6] years. Statistical analyses revealed that treatment with 20-μg Rivelin®-CLO patches demonstrated significant improvement with ulcer area (p = 0.047), symptom severity (p = 0.001), disease activity (p = 0.022), pain (p = 0.012), and quality of life (p = 0.003) as compared with placebo. Improvement in OLP symptoms from beginning to the end of the study was reported as very much better (best rating) in the 20-µg group (25/32) patients compared to the placebo group (11/30), (p = 0.012). Adverse events were mild/moderate. Candidiasis incidence was low (2%).ConclusionsRivelin®-CLO patches were superior to placebo demonstrating statistically significant, clinically relevant efficacy in objective and subjective improvement and, with a favorable safety profile.

BACKGROUND AND AIM: The Belmont Forum, a partnership of over 30 funding organizations, international science councils and regional consortia across five continents, is committed to advancing intern...