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BACKGROUND/OBJECTIVE: Although dietary supplement use has increased significantly among the general population, the interplay between vitamin D supplementation and other factors that influence vitamin D status remains unclear. The objective of this study was to identify predictor variables of vitamin D status in free-living subjects to determine the extent to which vitamin D supplements and other factors influence vitamin D status. SUBJECTS/METHODS: This was a retrospective, cross-sectional study involving 743 volunteers. Serum 25-hydroxy-vitamin D (25(OH)D) level and the variables diet, supplement usage, latitude of residence, ethnicity, age and body mass index (BMI) were used to predict vitamin D status in a summer and winter cohort. RESULTS: Supplemental vitamin D3 consumption was the most significant positive predictor, whereas BMI was the most significant negative predictor, of vitamin D status in each cohort. Other positive predictors were fortified beverage and dairy consumption in the summer and winter cohort, respectively. Negative predictors were: African American, Asian and Hispanic race in the summer; latitude of residence >36[degrees]N, Asian and Hispanic ethnicity in the winter. Mean ([+ or -]s.d.) 25(OH)D levels were 101.1 ([+ or -]42.1) and 92.6 ([+ or -]39.0) nmol/l in summer and winter, respectively. Comparing non-supplement vs supplement users, approximately 38 vs 2.5% in the winter and 18 vs 1.4% in the summer had vitamin D levels CONCLUSIONS: Vitamin D supplementation was the most significant positive predictor of vitamin D status. Collectively, these data point to the practicality of utilizing vitamin D supplements to reduce hypovitaminosis D in adults throughout the United States. European Journal of Clinical Nutrition (2015) 69, 84-89; doi: 10.1038/ejcn.2014.133; published online 16 July 2014, INTRODUCTION Numerous factors impact vitamin D status in humans, including dietary intake, skin color, season of the year and geographic latitude. (1,2) For most individuals, the latter three factors play [...]

The present study evaluates the mental health of participants 3 to 6 months after completing treatment at a shared mental health care clinic. Twenty-five participants completed the Patient Health Questionnaire (PHQ) and the World Health Organization Disability Assessment Scale version II (WHODAS-II) at entry, exit, and 3 to 6 months following treatment. Results for the PHQ found significant sustained improvement for major depression, other anxiety syndrome, and somatoform disorder. The WHODAS-II scale demonstrated that significant improvement was maintained 3 to 6 months following treatment completion. These findings suggest that patients receiving short-term therapy and psychiatric consultation in a shared care setting may show significant, sustained improvement in mental and physical functioning. [ABSTRACT FROM AUTHOR]

Aim: To describe symptom improvement and change in function in patients referred to a shared mental health care service (SMHC) that provided psychiatric consultation and brief counselling.Method: Pre (N = 1,310) and post (N = 395) measurements and comparisons with normative samples using the Patient Health Questionnaire (PHQ) and World Health Organization's Disability Assessment Schedule (WHO DAS II) among individuals who received care with SMHC over the first 5 years of service. Cognitive-behavioural, psycho-education and supportive counselling were provided by a psychiatrist in collaboration with a multi-disciplinary mental health team. Mean number of visits was 7.3 per episode of care.Results: Following the intervention, patients had significantly fewer days with difficulty caused by mental illness within the previous month (mean difference = 9.23 days) and fewer days of total incapacity (mean difference = 3.81 days). Statistically significant reductions in PHQ diagnoses occurred for major depressive syndrome (89% reduction from baseline; P < 0.001), panic syndrome (75% reduction from baseline; P < 0.001), somatic disorder (74% reduction from baseline; P < 0.001) and alcohol abuse (30% reduction from baseline; P = 0.02). PHQ-9 and WHO DAS II mean at exit was significantly within or above one standard deviation from the community sample norm.Conclusions: SMHC intervention appeared effective. At exit from the programme, patients displayed significant reductions in symptoms on all measures relative to their scores at entry, returning to or close to community sample norms. Limitations with the research include lack of a control group and random assignment, and absence of data from many patients upon exit from the programme. [ABSTRACT FROM AUTHOR]

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Abstract Background Transcription of the cathelicidin antimicrobial peptide (CAMP) gene is induced by binding of the bioactive form of vitamin D, 1,25-dihydroxyvitamin D, to the vitamin D receptor. Significant levels of the protein hCAP18/LL-37 are found in the blood and may protect against infection and/or sepsis. We hypothesized that serum vitamin D levels may modulate the circulating levels of hCAP18. Only three studies have shown a positive correlation between circulating 25-hydroxyvitamin D and hCAP18 levels. Here we provide additional evidence for such a correlation in healthy, middle-aged adults. Findings Serum levels of 25-hydroxyvitamin D [25(OH)D] and plasma levels of hCAP18 were determined in 19 healthy middle-aged (mean of 50.1 years) adult men and women. Plasma hCAP18 concentrations correlated with serum 25(OH)D concentrations in subjects with 25(OH)D levels ≤ 32 ng/ml (r = 0.81, p 32 ng/ml (r = 0.19, p = 0.63). Conclusions We conclude that plasma hCAP18 levels correlate with serum 25(OH)D levels in subjects with concentrations of 25(OH)D ≤ 32 ng/ml as opposed to those with concentrations > 32 ng/ml and that vitamin D status may regulate systemic levels of hCAP18/LL-37.

The role of von Willebrand factor (VWF) as a shear stress activated platelet adhesive has been related to a coiled-elongated shape conformation. The forces dominating this transition have been suggested to be controlled by the proteins polymeric architecture. However, the fact that 20% of VWF molecular weight originates from glycan moieties has so far been neglected in these calculations. In this study, we present a systematic experimental investigation on the role of N-glycosylation for VWF mediated platelet adhesion under flow. A microfluidic flow chamber with a stenotic compartment that allows one to mimic various physiological flow conditions was designed for the efficient analysis of the adhesion spectrum. Surprisingly, we found an increase in platelet adhesion with elevated shear rate, both qualitatively and quantitatively fully conserved when N-deglycosylated VWF (N-deg-VWF) instead of VWF was immobilized in the microfluidic channel. This has been demonstrated consistently over four orders of magnitude in shear rate. In contrast, when N-deg-VWF was added to the supernatant, an increase in adhesion rate by a factor of two was detected compared to the addition of wild-type VWF. It appears that once immobilized, the role of glycans is at least modified if not-as found here for the case of adhesion-negated. These findings strengthen the physical impact of the circulating polymer on shear dependent platelet adhesion events. At present, there is no theoretical explanation for an increase in platelet adhesion to VWF in the absence of its N-glycans. However, our data indicate that the effective solubility of the protein and hence its shape or conformation may be altered by the degree of glycosylation and is therefore a good candidate for modifying the forces required to uncoil this biopolymer. [ABSTRACT FROM AUTHOR]

Abstract: The gonadotropins, whose members are human chorionic gonadotropin (hCG), lutenizing hormone (LH) and follicle-stimulating hormone (FSH) are a well characterized hormone family known to regulate reproductive functions in both females and males. Recent studies indicate that they can modulate the vascular system of reproductive organs. It was shown that gonadotropins not only influence the expression of vascular endothelial growth factor (VEGF) and both its receptors VEGFR-1 and -2, but also modulate other ubiquitously expressed angiogenic factors like the angiopoietins and their receptor Tie-2, basic fibroblast growth factor or placental-derived growth factor. Some recent data indicates a possible direct action of gonadotropins on endothelial cells. Thus, the gonadotropins act as tissue-specific angiogenic factors providing an optimal vascular supply during the menstrual cycle and early pregnancy in the female reproductive tract as well as in testis. In pathological conditions (e.g. preeclampsia, intrauterine growth restriction, ovarian hyperstimulation or endometriosis), these tightly regulated interactions between the gonadotropins and the ubiquitous angiogenic factors appear to be disturbed. The intent of this short manuscript is to review the current knowledge of the regulatory role of the gonadotropins in vasculo- and angiogenesis. We also review angiogenic actions of thyroid-stimulating hormone (TSH), a glycoprotein closely related to gonadotropins, which display strong gonodal actions. [Copyright &y& Elsevier]

Partner notification (PN) is an essential element of sexually transmitted infection (STI) control. It enables identification, treatment and advice for sexual contacts who may benefit from additional preventive interventions such as HIV pre- and post-exposure prophylaxis. PN is most effective in reducing STI transmission when it reaches individuals who are most likely to have an STI and to engage in sexual behaviour that facilitates STI transmission, including having multiple and/or new sex partners. Outcomes of PN practice need to be measurable in order to inform standards. They need to address all five stages in the cascade of care: elicitation of partners, establishing contactable partners, notification, testing and treatment. In the United Kingdom, established outcome measures cover only the first three stages and do not take into account the type of sexual partnership. We report an evidence-based process to develop new PN outcomes and inform standards of care. We undertook a systematic literature review, evaluation of published information on types of sexual partnership and a modified Delphi process to reach consensus. We propose six new PN outcome measures at five stages of the cascade, including stratification by sex partnership type. Our framework for PN outcome measurement has potential to contribute in other domains, including Covid-19 contact tracing.

Background: A major clinical feature of severe coronavirus diease 2019 (COVID-19) is microvascular thrombosis linked to endothelial cell activation. Consistent with this, a number of studies have shown that patients with severe COVID-19 have highly elevated plasma levels of von Willebrand Factor (VWF) that may contribute to the prothrombotic phenotype. In the current study, we investigated the extent of endothelial activation in patients receiving hemodialysis who had either mild or severe COVID-19., Methods: Plasma VWF, ADAMTS-13, angiopoietin-2 (Ang2), and syndecan-1 levels were determined by ELISA. The sialic acid content of VWF was investigated using a modified ELISA to measure elderberry bark lectin, specific for sialic acid residues, binding to VWF., Results: Patients receiving hemodialysis with severe COVID-19 had significantly higher plasma levels of VWF and lower ADAMTS-13. VWF levels peaked and were sustained during the first 10 days after positive confirmation of infection. While Ang2 trended toward being higher in severely ill patients, this did not reach significance; however, severely ill patients had significantly higher soluble syndecan-1 levels, with high levels related to risk of death. Finally, higher VWF levels in severely ill patients were correlated with lower VWF sialic acid content., Conclusions: Severe COVID-19 in patients undergoing hemodialysis is associated with both acute and sustained activation of the endothelium, leading to alteration of the VWF/ADAMTS-13 axis. Lower VWF sialic acid content represents altered VWF processing and further confirms the disturbance caused to the endothelium in COVID-19., (© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).)

Background: A high prevalence of antiphospholipid antibodies has been reported in case series of patients with neurological manifestations and COVID-19; however, the pathogenicity of antiphospholipid antibodies in COVID-19 neurology remains unclear., Methods: This single-centre cross-sectional study included 106 adult patients: 30 hospitalised COVID-neurological cases, 47 non-neurological COVID-hospitalised controls, and 29 COVID-non-hospitalised controls, recruited between March and July 2020. We evaluated nine antiphospholipid antibodies: anticardiolipin antibodies [aCL] IgA, IgM, IgG; anti-beta-2 glycoprotein-1 [aβ 2 GPI] IgA, IgM, IgG; anti-phosphatidylserine/prothrombin [aPS/PT] IgM, IgG; and anti-domain I β 2 GPI (aD1β2GPI) IgG., Findings: There was a high prevalence of antiphospholipid antibodies in the COVID-neurological (73.3%) and non-neurological COVID-hospitalised controls (76.6%) in contrast to the COVID-non-hospitalised controls (48.2%). aPS/PT IgG titres were significantly higher in the COVID-neurological group compared to both control groups ( p  < 0.001). Moderate-high titre of aPS/PT IgG was found in 2 out of 3 (67%) patients with acute disseminated encephalomyelitis [ADEM]. aPS/PT IgG titres negatively correlated with oxygen requirement (FiO 2 R =-0.15 p  = 0.040) and was associated with venous thromboembolism ( p  = 0.043). In contrast, aCL IgA ( p  < 0.001) and IgG ( p  < 0.001) was associated with non-neurological COVID-hospitalised controls compared to the other groups and correlated positively with d-dimer and creatinine but negatively with FiO 2 ., Interpretation: Our findings show that aPS/PT IgG is associated with COVID-19-associated ADEM. In contrast, aCL IgA and IgG are seen much more frequently in non-neurological hospitalised patients with COVID-19. Characterisation of antiphospholipid antibody persistence and potential longitudinal clinical impact are required to guide appropriate management., Funding: This work is supported by UCL Queen Square Biomedical Research Centre (BRC) and Moorfields BRC grants (#560441 and #557595). LB is supported by a Wellcome Trust Fellowship (222102/Z/20/Z). RWP is supported by an Alzheimer's Association Clinician Scientist Fellowship (AACSF-20-685780) and the UK Dementia Research Institute. KB is supported by the Swedish Research Council (#2017-00915) and the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement (#ALFGBG-715986). HZ is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532), the European Research Council (#681712), Swedish State Support for Clinical Research (#ALFGBG-720931), the Alzheimer Drug Discovery Foundation (ADDF), USA (#201809-2016862), and theUK Dementia Research Institute at UCL. BDM is supported by grants from the MRC/UKRI (MR/V007181/1), MRC (MR/T028750/1) and Wellcome (ISSF201902/3). MSZ, MH and RS are supported by the UCL/UCLH NIHR Biomedical Research Centre and MSZ is supported by Queen Square National Brain Appeal., Competing Interests: LAB reports grants from GlaxoSmithKline, grants from Wellcome Trust, outside the submitted work.; RWP reports grants from Neurofilament light consortium, personal fees from GE healthcare educational talk, outside the submitted work.; CP is co-inventor for a patented Domain I-based potential therapeutic for APS.; KB reports personal fees from Abcam (advisory board / consultant), personal fees from Axon (advisory board / consultant), personal fees from Biogen (advisory board / consultant), personal fees from Julius Clinical (data monitoring committee), personal fees from Lilly (advisory board / consultant), personal fees from MagQu (advisory board / consultant), personal fees from Novartis (data monitoring committee), personal fees from Roche Diagnostic (advisory board / consultant), personal fees from Siemens Healthineers (advisory board / consultant), outside the submitted work; and is co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program.; CM reports personal fees from Biogen (sit on steering committee for aducanumab fees for time spent), personal fees from Roche (advisory board member fees for time spent), personal fees from Washington University (sit on therapeutic evalutation committee fees for time spent), outside the submitted work.; BS reports grants from UKRI/DHSC Global Effort on COVID-19 Research (Medical Research Council), non-financial support from UK National Institute for Health Research Global Health Research Group on Brain Infections, outside the submitted work.; MSZ reports receiving personal fees from UCB, for lecturing, outside the submitted work.; DJW reports personal fees from Bayer, personal fees from Alnylam, personal fees from Portola, outside the submitted work.; TS is on the Data Safety Monitoring Committee of Study to Evaluate the Safety and Immunogenicity of a Candidate Ebola Vaccine in Children GSK3390107A (ChAd3 EBO-Z) vaccine from GSK, is a panel member of Covid-19 Vaccine Benefit Risk Expert Working Group, which assesses the benefits and risks of Covid-19 vaccines at the Medicines and Healthcare Regulatory Agency (UK), is a member of COVID-19 Therapeutics Advisory Panel at the United Kingdom Department of Health & Social Care, and is Chair/Co-Chair of theCOVID-19 Rapid Response and Rolling Funding Initiatives, which supported development of the Oxford-Astra Zeneca Covid-19 vaccine, at the National Institute for Health Research, outside the submitted work. In addition, TS has a patent Test for bacterial meningitis based on a blood test, filed for patent pending.; HZ reports personal fees from Wave (Advisory board / consultant), personal fees from Roche Diagnostics (Advisory board / consultant), personal fees from Biogen (Sponsored lecture), personal fees (Advisory board / consultant) from Samumed, Eisai, Denali, Nervgen, Roche Diagnostics, Siemens Healthineers, Pinteon Therapeutics, AZTherapies, CogRx, personal fees (Sponsored lecture) from Alzecure, Cellectricon, and Fujirebio, outside the submitted work; and is Co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program.; JMS reports work support from National Institute for Health Research University College London Hospitals Biomedical Research Centre, during the conduct of the study; personal fees from Roche Pharmaceuticals (consulting), personal fees from Eli Lilly (consulting, lecturing), Drug Safety Monitoring Board at Axon Neuroscience, non-financial support from AVID Radiopharmaceuticals (PET tracer provision), consulting on educational activities from Biogen, personal fees from Merck (consulting), royalties from Oxford University Press, royalties from Henry Stewart Talks, grants from Wolfson Foundation, grants from Engineering and Physical Sciences Research Council (EP/J020990/1), grants from Medical Research Council Dementias Platform UK (MR/L023784/1), grants from Alzheimer's Research UK (ARUK-Network 2012-6-ICE; ARUK-PG2017-1946; ARUK-PG2017-1946), grants from Brain Research UK (UCC14191), grants from Weston Brain Institute (UB170045), grants from European Union's Horizon 2020 research and innovation programme (Grant 666,992), grants from British Heart Foundation (PG/17/90/33,415), personal fees from Alzheimer's Research UK (Chief Medical Officer), personal fees from UK Dementia Research Institute (Medical Advisor), outside the submitted work.; HC reports institutional research support and support to attend scientific meetings, and honoraria for lectures paid to UCLH charities from Bayer Healthcare, and consultancy fees paid to University College London Hospitals Charity from UCB Biopharma, outside the submitted work.; All other authors have nothing to disclose., (© 2021 The Author(s).)

Arundo donax (giant reed) is invasive in Mediterranean, sub-, and tropical riparian systems worldwide. The armored scale Rhizaspidiotus donacis is approved for biocontrol in North America, but an adventive population was recently discovered in southern California. We documented this population's distribution, phylogeny, phenology, potential host spillover to Phragmites spp ., and potential for parasitism by a common biocontrol parasitoid of citrus scale. The adventive scale was found within a single watershed and is genetically closest to Iberian scale genotypes. Rhizaspidiotus donacis developed on Phragmites haplotypes but at much lower densities than Arundo . The adventive population is univoltine, producing crawlers from March-June. Aphytis melinus parasitoids exhibited sustained interest in R. donacis during choice and no-choice trials and oviposition resulted in a small second generation. Rhizaspidiotus donacis appears limited in distribution by its univoltinism and sessile adult females. This presents challenges for broad biocontrol implementation but allows for targeted application. The genetic differentiation between imported biocontrol samples and adventive populations presents an opportunity for exploring benefits of hybrids and/or alternative genotypes where establishment has been difficult. While unlikely to occur in situ, spillover to vulnerable endemic Phragmites or deleterious parasitoid effects on scale biocontrol agents warrants consideration when planning use of R. donacis .

COVID-19 has had an unprecedented impact on society, global healthcare and daily life. The redeployment of research staff to patient-facing roles in the NHS left a depleted workforce to deliver critical urgent public health research (UPHR). We aimed to support UPHR studies and medical student training by developing and implementing a medical student Volunteers in Research programme. We further sought to gain insights about medical students' perceptions of this programme. We collected prospective data and conducted a retrospective survey as part of a service evaluation to assess the value of this clinical research experience to students, as well as motivators and barriers to taking part. The Volunteers in Research programme successfully supported UPHR studies during the COVID-19 pandemic. We generated important insights to help aid the wider implementation of this programme nationally to support essential research and medical student education., (© Royal College of Physicians 2021. All rights reserved.)

Background: Global Health is an emerging field that refers to the health and well-being of the world's population. It is crucial that the next generation of nurses is prepared as global health advocates. There is no prior research of self-assessed global health competencies among nursing faculty in U.S. prelicensure programs. The aim of this study was to determine the level of global health competencies (knowledge and skills) of nursing faculty in U.S. prelicensure programs., Method: Attendees at the National League for Nursing Education Summit completed the Global Health Competencies survey., Results: Survey participants (N = 161) reported a 66.76% confidence in their knowledge of global health and 61.4% confidence in global health skills with patients from different backgrounds. Three areas of educational needs were identified: (a) the relationship between health and access to clean water, sanitation, and nutrition; (b) cultural competency; and (c) understanding the relationship between health and human rights., Conclusion: Nursing faculty participants identified several areas for improvement in their knowledge of global health issues. [J Nurs Educ. 2021;60(1):20-24.]., (Copyright 2021, SLACK Incorporated.)

Rationale & Objective: A number of serologic tests for immunoglobulin G (IgG) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now commercially available, including multiple lateral flow immunoassays (LFIAs), which have the advantage of being inexpensive and easy to use, without the reliance on laboratory facilities. However, data on the development of humoral immunity to SARS-CoV-2 in patients with kidney disease is limited, and the utility of an LFIA to test for antibodies in these patients has not been assessed., Study Design: Observational study., Setting & Participants: 60 patients (40 hemodialysis and 20 kidney transplant recipients) with SARS-CoV-2 infection confirmed by viral reverse transcriptase-polymerase chain reaction (RT-PCR) testing and 88 historic negative-control samples (collected before September 2019)., Test: A commercially available LFIA to test for SARS-CoV-2 IgG in patients with infection confirmed by viral RT-PCR testing., Outcomes: Sensitivity and specificity of the LFIA to detect SARS-CoV-2 IgG in dialysis patients and transplant recipients., Results: 56/58 (96.6%) patients (38/39 hemodialysis and 18/19 transplant recipients) tested positive for SARS-CoV-2 IgG. 5/7 (71.4%) patients who were negative on preliminary testing had detectable IgG when retested more than 21 days postdiagnosis. Median times to first and second tests after diagnosis were 17 (interquartile range, 15-20) and 35 (interquartile range, 30-39) days, respectively. Calculation of test characteristics gave sensitivity of 96.6% (95% CI, 88.3%-99.4%) and specificity of 97.7% (95% CI, 92.0-99.6%)., Limitations: Possible exposure to other beta-coronaviruses that may cross-react with the antigen used in the LFIA cannot be excluded., Conclusions: Symptomatic dialysis patients and transplant recipients commonly develop an immune response against SARS-CoV-2 infection that can be detected using an LFIA. Used diligently, an LFIA could be used to help screen the dialysis populations or confirm exposure on a patient level, especially in facilities in which laboratory resources are limited., (© 2021 Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.)

Endogenous glutathione (GSH) and glutathione disulfide (GSSG) status is highly sensitive to oxidative conditions and have broad application as a surrogate indicator of redox status in vivo. Established methods for GSH and GSSG quantification in whole blood display limited utility in human plasma, where GSH and GSSG levels are ~3-4 orders of magnitude below those observed in whole blood. This study presents simplified sample processing and analytical LC-MS/MS approaches exhibiting the sensitivity and accuracy required to measure GSH and GSSG concentrations in human plasma samples, which after 5-fold dilution to suppress matrix interferences range from 200 to 500 nm (GSH) and 5-30 nm (GSSG). The utility of the methods reported herein is demonstrated by assay performance and validation parameters which indicate good sensitivity [lower limits of quantitation of 4.99 nm (GSH) and 3.65 nm (GSSG), and high assay precision (intra-assay CVs 3.6 and 1.9%, and inter-assay CVs of 7.0 and 2.8% for GSH and GSSG, respectively). These methods also exhibited exceptional recovery of analyte-spiked plasma samples (98.0 ± 7.64% for GSH and 98.5 ± 12.7% for GSSG). Good sample stability at -80°C was evident for GSH for up to 55 weeks and GSSG for up to 46 weeks, with average CVs <15 and <10%, respectively., (© 2020 The Authors. International Journal for Numerical Methods in Engineering published by John Wiley & Sons Ltd.)

This study examined eye-movement patterns of young adults, while they were viewing texting and driving prevention advertisements, to determine which format attracts the most attention. As young adults are the most at risk for this public health issue, understanding which format is most successful at maintaining young adults' attention is especially important. Participants viewed nondriving, general distracted driving, and texting and driving advertisements. Each of these advertisement types were edited to contain text-only, image-only, and text and image content. Participants were told that they had unlimited time to view each advertisement, while their eye-movements were recorded throughout. Participants spent more time viewing the texting and driving advertisements than other types when they comprised text only. When examining differences in attention to the text and image portions of the advertisements, participants spent more time viewing the images than the text for the nondriving and general distracted driving advertisements. However, for texting and driving-specific advertisements the text-only format resulted in the most attention toward the advertisements. These results indicate that in attracting young adults' attention to texting and driving public health advertisements, the most successful format would be text-based. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Introduction: Partner notification (PN) is a process aiming to identify, test and treat the sex partners of people (index patients) with sexually transmitted infections (STIs). Accelerated partner therapy (APT) is a PN method whereby healthcare professionals assess sex partners, by telephone consultation, before giving the index patient antibiotics and STI self-sampling kits to deliver to their sex partner(s). The Limiting Undetected Sexually Transmitted infections to RedUce Morbidity programme aims to determine the effectiveness of APT in heterosexual women and men with chlamydia and determine whether APT could affect Chlamydia trachomatis transmission at population level., Methods and Analysis: This protocol describes a cross-over cluster randomised controlled trial of APT, offered as an additional PN method, compared with standard PN. The trial is accompanied by an economic evaluation, transmission dynamic modelling and a qualitative process evaluation involving patients, partners and healthcare professionals. Clusters are 17 sexual health clinics in areas of England and Scotland with contrasting patient demographics. We will recruit 5440 heterosexual women and men with chlamydia, aged ≥16 years.The primary outcome is the proportion of index patients testing positive for C. trachomatis 12-16 weeks after the PN consultation. Secondary outcomes include: proportion of sex partners treated; cost effectiveness; model-predicted chlamydia prevalence; experiences of APT.The primary outcome analysis will be by intention-to-treat, fitting random effects logistic regression models that account for clustering of index patients within clinics and trial periods. The transmission dynamic model will be used to predict change in chlamydia prevalence following APT. The economic evaluation will use mathematical modelling outputs, taking a health service perspective. Qualitative data will be analysed using interpretative phenomenological analysis and framework analysis., Ethics and Dissemination: This protocol received ethical approval from London-Chelsea Research Ethics Committee (18/LO/0773). Findings will be published with open access licences., Trial Registration Number: ISRCTN15996256., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Background: Hospital Eye Services (HES) in the UK face an increasing number of optometric referrals driven by progress in retinal imaging. The National Health Service (NHS) published a 10-year strategy (NHS Long-Term Plan) to transform services to meet this challenge. In this study, we implemented a cloud-based referral platform to improve communication between optometrists and ophthalmologists., Methods: Retrospective cohort study conducted at Moorfields Eye Hospital, Croydon (NHS Foundation Trust, London, UK). Patients classified into the HES referral pathway by contributing optometrists have been included into this study. Main outcome measures was the reduction of unnecessary referrals., Results: After reviewing the patient's data in a web-based interface 54 (52%) out of 103 attending patients initially classified into the referral pathway did not need a specialist referral. Fourteen (14%) patients needing urgent treatment were identified. Usability was measured in duration for data input and reviewing which was an average of 9.2 min (median: 5.4; IQR: 3.4-8.7) for optometrists and 3.0 min (median: 3.0; IQR: 1.7-3.9) min for ophthalmologists. A variety of diagnosis was covered by this tool with dry age-related macular degeneration (n=34) being most common., Conclusion: After implementation more than half of the HES referrals have been avoided. This platform offers a digital-first solution that enables rapid-access eye care for patients in community optometrists, facilitates communication between healthcare providers and may serve as a foundation for implementation of artificial intelligence., Competing Interests: Competing interests: KB reports grants from Bayer AG, personal fees from Alimera, from Allergan, outside the submitted work; PAK reports other from Big Picture Eye Health, during the conduct of the study; personal fees from DeepMind, personal fees from Optos, personal fees from Novartis, personal fees from Bayer, personal fees from Allergan, personal fees from Heidelberg Engineering, personal fees from Topcon, personal fees from Carl Zeiss Meditec, personal fees from Haag Streit, personal fees from Santen, grants from National Institute for Health Research, grants from Fight For Sight UK, outside the submitted work; TM reports other from Big Picture Medical, outside the submitted work; In addition, TM has a patent 2016265973 pending; KK reports personal fees from Big Picture Eye Health, during the conduct of the study; grants and personal fees from Novartis Pharma, grants and personal fees from Bayer Pharma, personal fees from Zeiss, personal fees from Allergan, personal fees from Alcon, personal fees from Google Deepmind, AD has nothing to disclose; outside the submitted work; DS reports other from Big Picture Eye Health, during the conduct of the study; personal fees from Allergan, personal fees from Novartis, personal fees from Bayer, personal fees from Big Picture Eye Health, personal fees from Haag Streit, outside the submitted work; no other relationships or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: ; Early-onset preeclampsia is a rare pregnancy-specific disorder associated with significantly increased maternal and fetal morbidity and mortality. Whilst it is known that even normotensive pregnancies are associated with changes in clot formation and dissolution, the nature of how these changes differ in those with early onset preeclampsia has not been well established. We sought to evaluate parameters of fibrin formation and fibrinolysis in individuals with early onset preeclampsia in comparison to both pregnant and non-pregnant controls. Furthermore, such parameters were correlated with markers of disease severity in this patient cohort, including the presence of multiorgan involvement, the rate of disease progression and the extent of the anti-angiogenic state in this condition., Study Design: ; Patients with early onset preeclampsia (N = 20) and both pregnant (N = 16) and non -pregnant (N = 16) controls were recruited from the cohort at a large urban maternity hospital which saw over 15,000 deliveries during the study period. Platelet poor plasma was prepared from collected whole blood and analysed for parameters of fibrin formation and fibrinolysis (lagtime to and rate of fibrin formation; PAI-1; PAI-2; D-dimer; plasmin-antiplasmin; tPA) in addition to markers of angiogenesis (sFLT-1; Endoglin) using commercially available specific immunoassays., Results: ; The maximum rate of fibrin formation as well as PAI-1, PAI-2 and D-dimer levels were all significantly increased in those with early onset preeclampsia and pregnant controls when compared to non-pregnant controls without significant differences between the 2 former groups. Plasmin-antiplasmin levels were significantly reduced in a similar manner. tPA levels were significantly elevated in EOP compared to both pregnant and non-pregnant controls. EOP was associated with significantly increased anti-angiogenic factors (sFLT-1; Endoglin) when compared to both pregnant and non-pregnant controls., Conclusion: ; Markers of fibrin formation and fibrinolysis are significantly alerted in early onset preeclampsia; furthermore, certain markers correlate with disease severity in this patient cohort., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Aim: The study purpose was to describe current international clinical experience (ICE) practices in RN prelicensure programs in the United States., Background: There is interest in ICE to fulfill the goal of preparing global citizens; however, lack of evidence on developing, implementing, and evaluating best practices for ICE limits the enactment of this approach., Method: An electronic survey was completed by 900 deans and/or directors of diploma, associate, bachelor's, accelerated bachelor's, and master's-entry RN prelicensure programs., Results: Respondents (n = 241, 27 percent) indicated their programs included ICE. Across programs, ICE occurred most often in community health courses. The predominant reason for offering ICE was alignment with the institutional mission and vision., Conclusion: Wide variability exists in methods used to implement ICE for credit toward the nursing major. There is a need to continue to assess and disseminate best practices in implementing ICE to accomplish the goal of global health engagement.

Background: Von Willebrand disease (VWD) results from quantitative or qualitative deficiency of von Willebrand factor (VWF) and is treated using VWF-containing concentrates. Several studies have compared the function of various VWF containing concentrates however this has not been performed using shear based assays., Objectives: To compare the platelet-capture potential of 10 commercially available, plasma-derived VWF concentrates under shear conditions., Methods: VWF containing concentrates were assessed for VWF:Ag, VWF:CB, VWF:RCo, factor VIII:C ADAMTS13 content, VWF multimeric profile and glycan content using lectin binding assays. Free-thiol content of each concentrate was investigated using MPB binding assays. An in vitro flow assay was used to determine the ability of each concentrate to mediate platelet capture to collagen., Results: VWF multimeric analysis revealed reduction of high molecular weight (HMW) forms in four of the concentrates (Alphante, Octanate and Haemoctin, and 8Y). The high MW multimer distribution of the remaining six concentrates (Optivate, Wilate, Fandhi, Wilfactin, Haemate P, and Voncento) was similar to the plasma control. Lectin analysis demonstrated that 8Y had increased amount of T-antigen. Although platelet capture after 5 minutes perfusion was similar for all concentrates; Alphante, Octanate, and Haemoctin, demonstrated the lowest levels of platelet capture after 60 seconds of perfusion. Free-thiol content and ADAMTS13 levels varied widely between the concentrates but was not correlated with function., Conclusion: Alphanate, Octanate, and Haemoctin, lacked HMW multimers and had the lowest initial platelet capture levels suggesting that the presence of VWF HMW multimers are required for initial platelet deposition.

The podoplanin-CLEC-2 axis is critical in mice for prevention of hemorrhage in the cerebral vasculature during mid-gestation. This raises the question as to how platelets are captured by podoplanin on neuroepithelial cells in a high shear environment. In this study, we demonstrate that mouse platelets form stable aggregates on mouse podoplanin at arterial shear through a CLEC-2 and Src kinase-dependent pathway. Adhesion and aggregation are also dependent on the platelet glycoprotein (GP) receptors, integrin αIIbβ3 and GPIb, and the feedback agonists ADP and thromboxane A 2 (TxA 2 ). CLEC-2 does not bind to von Willebrand factor (VWF) suggesting that the interaction with podoplanin is sufficient to both tether and activate platelets. Consistent with this, the surface plasmon resonance measurements reveal that mouse CLEC-2 binds to mouse podoplanin with nanomolar affinity. The present findings demonstrate a novel pathway of hemostasis in which podoplanin supports platelet capture and activation at arteriolar rates of shear.