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Abstract Background As food insecurity and healthcare costs are linked, healthcare entities (i.e., providers, healthcare systems, insurers) are increasingly interested in identifying and providing solutions to address food insecurity among their patients. Home-delivered meals are one long-standing solution to address food insecurity among homebound older adults. However, there is limited evidence about what mode of delivery is most effective in promoting community independence, reducing healthcare utilization, and improving quality of life as well as how these outcomes may vary as a function of people’s preferences for how meals are delivered to them. Methods With extensive stakeholder input, we designed and implemented a pragmatic randomized comparative effectiveness study in which we will enroll 2300 older adults on waiting lists at home-delivered meals programs across the country and randomize them to receive for 6 months, either (1) weekday lunchtime meals delivered by a local volunteer or driver who also provides socialization and wellness checks or (2) biweekly delivery of 10 frozen meals to participants’ homes. Participant data will be combined with Centers for Medicare and Medicaid Services (CMS) data to calculate post-randomization institutional vs. community days. Baseline and 3-month surveys will evaluate secondary outcomes (e.g., food insecurity, loneliness, quality of life) and exploratory outcomes (e.g., nutritional risk). To examine heterogeneity of treatment effects, we will test for interactions between the two types of meal delivery and participants’ preferred mode of meal delivery as well as participants’ living arrangements. Discussion This research will be the first to prospectively evaluate the comparative effectiveness of the two predominant meal delivery options. The knowledge generated from this research will be of value to healthcare providers, health systems, payers, community-based organizations, older adults, and their families, because it will identify the mode of meal delivery that best meets homebound older adults’ needs and promotes community independence. In addition, the experience of working closely with stakeholders in designing and conducting this trial will be useful to researchers seeking to engage with stakeholders in the development and evaluation of complex social service interventions while balancing regulatory, resource, and human subjects research considerations. Trial registration ClinicalTrials.gov. NCT05357261 . Registered on May 02, 2022

Semiconductor based photocatalysis is considered as an effective and sustainable approach for the efficient treatment of effluents containing organic dyes and pharmaceuticals. Herein, visible light responsive g-C3N4/ NiFe2O4 (CN/NF) composite photocatalysts were designed by sol-gel auto-combustion assisted calcination method using ethylene glycol (EG) as a chelating agent. Bidentate nature and lower molecular weight of EG favour slow hydrolysis of Ni2+ and Fe3+ ions followed by formation of homogenous gel phase which under auto-combustion produced NF precursors. Calcination of the mixture of dicyandiamide (DCDA) and predetermined amount of NF precursors at 550 °C for 4 h resulted in the formation of CN/NF nanocomposites in which NF nanoparticles are anchored on thick plates of porous CN. The construction of CN/NF S-scheme heterojunctions was established through XPS studies and scavenging tests. The 10CN/NF nanocomposite exhibited superior photocatalytic Rhodamine B (RhB) degradation efficiency (98.6 %) which is 2.7 and 3.1 folds superior than that of pure NF and CN respectively. Additionally, the photocatalytic performance of 10CN/NF for tetracycline hydrochloride (TCH) degradation was found to be 84.32 %. The degradation efficiency was around 1.75 and 2.6 times higher than that was observed for pristine NF and CN correspondingly. The current study will bring fresh insights into the synthesis of CN/NF heterojunctions with an S-scheme charge transfer channel for the efficient treatment of waste waters containing dyes and antibiotics.

Objectives To summarise PEEP’s (Professionals for Ethical Engagement of Peers—a group of consultants with lived and living experience of substance use) outputs and gain insights into PEEP’s impact and suggestions for the future.Design Included an environmental scan to collate PEEP activities and outputs and a participatory qualitative design using thematic analysis.Setting British Columbia, Canada.Participants Eight members of PEEP and nine staff/people who consulted PEEP were interviewed.Results PEEP members are co-authors/acknowledged for their input in 25 peer review publications and 16 reports; PEEP members co-presented or were co-authors on 33 presentations. PEEP meets by Zoom two times per week and is paid monthly via honorarium from the Provincial Health Service Authority at a current rate of $C30 per hour. Four themes emerged from our interviews: (1) What is PEEP? (PEEP provides a sense of community, holds systems accountable and inspires others), (2) PEEP Process (suggestions for improvement: consultants should be prepared and involve PEEP throughout the process and report how PEEP’s insights were used), (3) PEEP Outcomes (PEEP members gain skills and confidence, PEEP provides a reality check, consultants learn from PEEP, and input leads to practice changes) and (4) Future of PEEP (sustainable funding and opportunities for growth are critical).Conclusion PEEP is a cohesive group whose input is well-respected and influences policy and programmes. Given the ongoing drug toxicity emergency, it is critical to continue to support and expand PEEP.

Beans are an important constituent of the Brazilian diet, and the search for cultivars with good culinary characteristics and adapted to the place of cultivation is necessary. It is known that there is a wide genetic diversity for common bean landrace cultivars. Still, little is known experimentally about the behavior of these cultivars when produced under organic cultivation. This work aimed to evaluate the technological quality of common bean landraces produced under organic cropping system. Twenty-six cultivars were used, four commercial and twenty-two landraces, originating from the Active Bean Germplasm Bank (BAF) of Santa Catarina State University – Agroveterinary Sciences Center (UDESC/CAV), produced in organic and conventional cultivation, in two crops. Cooking time and resistance, percentage of water absorption and broken grains and total soluble solids were evaluated. The shortest cooking time for the grains cultivated in the organic system (18 to 22 minutes) was obtained. The cultivars that had a percentage of unbroken grains between 60 and 80% showed a higher content of total soluble solids in the broth. Based on the genetic diversity for technological quality in organic cropping system, the use of cultivars, BAFs: 60, 23, 81, 13, 68, 55, 75 and 36 are indicated to integrate genetic improvement programs or to be used by small farmers for bean production.

Abstract Background With recent growth in the conduct of pragmatic clinical trials, the reliance on frontline staff to contribute to trial-related activities has grown as well. Active partnerships with staff members are often critical to pragmatic trial implementation, but rarely do research teams track and evaluate the specific “implementation strategies” used to support staff’s involvement in trial procedures (e.g., participant recruitment). Accordingly, we adapted implementation science methodologies and conducted an interim analysis of the strategies deployed with social service staff involved in one multi-site pragmatic clinical trial. Methods We used a naturalistic, observational study design to characterize strategies our research team deployed with staff during monthly, virtual meetings. Data were drawn from meeting notes and recordings from the trial’s 4-month Preparation phase and 8-month Implementation phase. Strategies were mapped to the Expert Recommendations for Implementing Change taxonomy and categorized into nine implementation clusters. Survey data were also collected from staff to identify the most useful strategies the research team should deploy when onboarding new staff members in the trial’s second year. Results A total of 287 strategies were deployed. Strategies in the develop stakeholder interrelationships cluster predominated in both the Preparation (35%) and Implementation (31%) phases, followed by strategies in the use iterative and evaluative approaches cluster, though these were more prevalent during trial Preparation (24%) as compared to trial Implementation (18%). When surveyed on strategy usefulness, strategies in the provide interactive assistance, use financial approaches, and support staff clusters were most useful, per staff responses. Conclusions While strategies to develop stakeholder interrelationships were used most frequently during trial Preparation and Implementation, program staff perceived strategies that provided technical assistance, supported clinicians, and used financial approaches to be most useful and should be deployed when onboarding new staff members. Research teams are encouraged to adapt and apply implementation strategy tracking methods when partnering with social service staff and deploy practical strategies that support pragmatic trial success given staff needs and preferences. Trial registration NCT05357261. May 2, 2022.

Abstract Background Alzheimer’s disease (AD), a progressive neurodegenerative disorder, is becoming increasingly prevalent as our population ages. It is characterized by the buildup of amyloid beta plaques and neurofibrillary tangles containing hyperphosphorylated-tau. The current treatments for AD do not prevent the long-term progression of the disease and pre-clinical models often do not accurately represent its complexity. Bioprinting combines cells and biomaterials to create 3D structures that replicate the native tissue environment and can be used as a tool in disease modeling or drug screening. Methods This work differentiated both healthy and diseased patient–derived human induced pluripotent stems cells (hiPSCs) into neural progenitor cells (NPCs) that were bioprinted using the Aspect RX1 microfluidic printer into dome-shaped constructs. The combination of cells, bioink, and puromorphamine (puro)-releasing microspheres were used to mimic the in vivo environment and direct the differentiation of the NPCs into basal forebrain-resembling cholinergic neurons (BFCN). These tissue models were then characterized for cell viability, immunocytochemistry, and electrophysiology to evaluate their functionality and physiology for use as disease-specific neural models. Results Tissue models were successfully bioprinted and the cells were viable for analysis after 30- and 45-day cultures. The neuronal and cholinergic markers β-tubulin III (Tuj1), forkhead box G1 (FOXG1), and choline acetyltransferase (ChAT) were identified as well as the AD markers amyloid beta and tau. Further, immature electrical activity was observed when the cells were excited with potassium chloride and acetylcholine. Conclusions This work shows the successful development of bioprinted tissue models incorporating patient derived hiPSCs. Such models can potentially be used as a tool to screen promising drug candidates for treating AD. Further, this model could be used to increase the understanding of AD progression. The use of patient derived cells also shows the potential of this model for use in personalized medicine applications.

Complete hydatidiform mole with coexisting fetus (CHMCF) is rare, and diagnosis is challenging due to limited data. Here, we present the case of a patient with noninvasive prenatal test (NIPT) resulting in “likely molar pregnancy” in the second trimester. Subsequent ultrasound confirmed a cystic appearing portion of the placenta. At 22 weeks, the patient delivered a demised fetus and two placentas. Pathology was consistent with CHMCF. This case is the first to show primary detection of a CHMCF with single-nucleotide polymorphism (SNP)-based NIPT prior to ultrasound identification. Our case suggests the use of SNP-based NIPT as an alternative noninvasive method to guide shared decision-making and clinical management for patients with this diagnosis.

Abstract Background When the novel coronavirus pandemic emerged in March 2020, many settings across Canada and the USA were already contending with an existing crisis of drug overdoses due to the toxic unregulated drug supply. In response, the Canadian province of British Columbia (BC) released innovative risk mitigation prescribing (RMP) guidelines for medical professionals to prescribe pharmaceutical alternatives to unregulated drugs in an effort to support the self-isolation of people who use unregulated drugs (PWUD) in preventing both SARS-CoV-2 virus infection and overdoses. We sought to assess the level of awareness of RMP and identify factors associated with this awareness among PWUD in Vancouver, BC. Methods Cross-sectional data were derived from participants enrolled in three community-recruited prospective cohort studies of PWUD in Vancouver, interviewed between July and November 2020. Multivariable logistic regression analysis was used to identify factors associated with awareness of RMP. Results Among 633 participants, 302 (47.7%) had heard of RMP. Of those 302 participants, 199 (65.9%) had never tried to access RMP services, ten (3.3%) made an unsuccessful attempt to access RMP, and 93 (30.8%) received RMP. In the multivariable analysis, participants who had awareness of RMP guidelines were more likely to self-identify as white (adjusted odds ratio [AOR] = 1.47; 95% confidence interval [CI]: 1.01, 2.13), to have completed secondary school education or higher (AOR = 1.67; 95% CI: 1.16, 2.39), to have used drugs at a supervised consumption or overdose prevention site in the past six months (AOR = 1.66; 95% CI: 1.10, 2.52), and to have received opioid agonist therapy as treatment for opioid use disorder in the past six months (AOR = 1.51; 95% CI: 1.02, 2.24). Conclusion At least four months after the release of the guidelines, RMP was known to less than half of our study participants, warranting urgent educational efforts for PWUD, particularly among racialized groups and those who were not accessing other harm reduction services. Furthermore, the majority of participants who were aware of RMP guidelines had never tried to access the service, suggesting the need to improve perceived accessibility and knowledge of eligibility criteria.

Abstract Community-based participatory research (CBPR) is increasingly standard practice for critical qualitative health research with young people who use(d) drugs in Vancouver, Canada. One aim of CBPR in this context is to redress the essentialization, erasure, and exploitation of people who use(d) drugs in health research. In this paper, we reflect on a partnership that began in 2018 between three university researchers and roughly ten young people (ages 17–28) who have current or past experience with drug use and homelessness in Greater Vancouver. We focus on moments when our guiding principles of shared leadership, safety, and inclusion became fraught in practice, forcing us in some cases to re-imagine these principles, and in others to accept that certain ethical dilemmas in research can never be fully resolved. We argue that this messiness can be traced to the complex and diverse positionalities of each person on our team, including young people. As such, creating space for mess was ethically necessary and empirically valuable for our CBPR project.

Abstract Background In pragmatic trials, on-site partners, rather than researchers, lead intervention delivery, which may result in implementation variation. There is a need to quantitatively measure this variation. Applying the Framework for Implementation Fidelity (FIF), we develop an approach for measuring variability in site-level implementation fidelity. This approach is then applied to measure site-level fidelity in a cluster-randomized pragmatic trial of Music & MemorySM (M&M), a personalized music intervention targeting agitated behaviors in residents living with dementia, in US nursing homes (NHs). Methods Intervention NHs (N = 27) implemented M&M using a standardized manual, utilizing provided staff trainings and iPods for participating residents. Quantitative implementation data, including iPod metadata (i.e., song title, duration, number of plays), were collected during baseline, 4-month, and 8-month site visits. Three researchers developed four FIF adherence dimension scores. For Details of Content, we independently reviewed the implementation manual and reached consensus on six core M&M components. Coverage was the total number of residents exposed to the music at each NH. Frequency was the percent of participating residents in each NH exposed to M&M at least weekly. Duration was the median minutes of music received per resident day exposed. Data elements were scaled and summed to generate dimension-level NH scores, which were then summed to create a Composite adherence score. NHs were grouped by tercile (low-, medium-, high-fidelity). Results The 27 NHs differed in size, resident composition, and publicly reported quality rating. The Composite score demonstrated significant variation across NHs, ranging from 4.0 to 12.0 [8.0, standard deviation (SD) 2.1]. Scaled dimension scores were significantly correlated with the Composite score. However, dimension scores were not highly correlated with each other; for example, the correlation of the Details of Content score with Coverage was τ b = 0.11 (p = 0.59) and with Duration was τ b = − 0.05 (p = 0.78). The Composite score correlated with CMS quality star rating and presence of an Alzheimer’s unit, suggesting face validity. Conclusions Guided by the FIF, we developed and used an approach to quantitatively measure overall site-level fidelity in a multi-site pragmatic trial. Future pragmatic trials, particularly in the long-term care environment, may benefit from this approach. Trial registration Clinicaltrials.gov NCT03821844. Registered on 30 January 2019, https://clinicaltrials.gov/ct2/show/NCT03821844 .