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Bicycling has individual and collective health benefits. Safety concerns are a deterrent to bicycling. Incomplete data on bicycling volumes has limited epidemiologic research investigating safety impacts of bicycle infrastructure, such as protected bike lanes. In this case-control study, set in Atlanta, Georgia, USA between 2016-10-01 and 2018-08-31, we estimated the incidence rate of police-reported crashes between bicyclists and motor vehicles (n = 124) on several types of infrastructure (off-street paved trails, protected bike lanes, buffered bike lanes, conventional bike lanes, and sharrows) per distance ridden and per intersection entered. To estimate underlying bicycling (the control series), we used a sample of high-resolution bicycling data from Strava, an app, combined with data from 15 on-the-ground bicycle counters to adjust for possible selection bias in the Strava data. We used model-based standardization to estimate effects of treatment on the treated. After adjustment for selection bias and confounding, estimated ratio effects on segments (excluding intersections) with protected bike lanes (incidence rate ratio [IRR] = 0.5 [95% confidence interval: 0.0, 2.5]) and buffered bike lanes (IRR = 0 [0,0]) were below 1, but were above 1 on conventional bike lanes (IRR = 2.8 [1.2, 6.0]) and near null on sharrows (IRR = 1.1 [0.2, 2.9]). Per intersection entry, estimated ratio effects were above 1 for entries originating from protected bike lanes (incidence proportion ratio [IPR] = 3.0 [0.0, 10.8]), buffered bike lanes (IPR = 16.2 [0.0, 53.1]), and conventional bike lanes (IPR = 3.2 [1.8, 6.0]), and were near 1 and below 1, respectively, for those originating from sharrows (IPR = 0.9 [0.2, 2.1]) and off-street paved trails (IPR = 0.7 [0.0, 2.9]). Protected bike lanes and buffered bike lanes had estimated protective effects on segments between intersections but estimated harmful effects at intersections. Conventional bike lanes had estimated harmful effects along segments and at intersections.

OBJECTIVE: Emergency medical services (EMS) transport for mental and behavioral health (MBH) emergencies occurs frequently in children, yet little is understood regarding prehospital physical restraint use despite the potential for serious adverse events. We aim to describe restraint use prevalence and primary impressions among children with MBH emergencies. METHODS: This is a retrospective cross-sectional study of children with MBH emergencies evaluated by Alameda County (ALCO), California EMS from January 1, 2012 to December 31, 2018. Patient demographics and clinical variables were collected from the EMS records including sex, age at time of encounter, year of encounter, transport destination, medication use, and primary impression(s). The primary outcome was the use of physical restraints. Descriptive statistics were used to characterize the primary outcome and associated demographic and diagnostic features, as well as temporal use patterns. Sex and age were compared between restrained and non-restrained youth using chi-square analysis. RESULTS: Over the 7-year study period, ALCO EMS transported 9775 children with MBH emergencies. Of these transports, 1205 (12.3%) were physically restrained. Most children restrained had the primary impression of behavioral/psychiatric crisis (51.1%), psychiatric crisis (27.4%), and behavioral-other (12.4%) and the remaining children (9.1%) had a non-psychiatric/behavioral health primary impression. Over time, there was no statistically significant change in either number of children with MBH emergencies transported or physical restraint rate. CONCLUSIONS: More than 1 in 8 children with MBH emergencies are being physically restrained during EMS transport. Restraint rate did not substantially change over time. Further studies to understand existing restraint rates and EMS resources available to address acute agitation in children are needed to inform quality and care enhancing initiatives.

ABSTRACT Clinical research studies are becoming increasingly complex resulting in compounded work burden and longer study cycle times, each fueling runaway costs. The impact of protocol complexity often results in inadequate recruitment and insufficient sample sizes, which challenges validity and generalizability. Understanding the need to provide an alternative model to engage researchers and sponsors and bringing clinical research opportunities to the broader community, clinical research networks (CRN) have been proposed and initiated in the United States and other parts of the world. We report on the Johns Hopkins Clinical Research Network (JHCRN), established in 2009 as a multi‐disease research collaboration between the academic medical centers and community hospitals/health systems. We have discussed vision, governance, infrastructure, participating hospitals' characteristics, and lessons learned in creating this partnership. Designed to leverage organized patient communities, community‐based investigators, and academic researchers, the JHCRN provides expedited research across nine health systems in the mid‐Atlantic region. With one IRB of record, a centralized contracting office, and a pool of dedicated network coordinators, it facilitates research partnerships to expand research collaborations among the differing sizes and types of hospitals/health systems in a region. As of August 2024, total 81 studies‐clinical trials, cohort studies, and comparative effectiveness research have been conducted, with funding from the NIH, private foundations, and industry. The JHCRN experience has enhanced understanding of the complexity of participating sites and associated ambulatory practices. In conclusion, the CRN, as an academic–community partnership, provides an infrastructure for multiple disease studies, shared risk, and increased investigator and volunteer engagement.

Summary: Background: Perivascular spaces (PVS) on brain MRI are surrogates for small parenchymal blood vessels and their perivascular compartment, and may relate to brain health. However, it is unknown whether PVS can predict dementia risk and brain atrophy trajectories in participants without dementia, as longitudinal studies on PVS are scarce and current methods for PVS assessment lack robustness and inter-scanner reproducibility. Methods: We developed a robust algorithm to automatically assess PVS count and size on clinical MRI, and investigated 1) their relationship with dementia risk and brain atrophy in participants without dementia, 2) their longitudinal evolution, and 3) their potential use as a screening tool in simulated clinical trials. We analysed 46,478 clinical measurements of cognitive functioning and 20,845 brain MRI scans from 10,004 participants (71.1 ± 9.7 years-old, 56.6% women) from three publicly available observational studies on ageing and dementia (the Alzheimer’s Disease Neuroimaging Initiative, the National Alzheimer’s Coordinating Centre database, and the Open Access Series of Imaging Studies). Clinical and MRI data collected between 2004 and 2022 were analysed with consistent methods, controlling for confounding factors, and combined using mixed-effects models. Findings: Our fully-automated method for PVS assessment showed excellent inter-scanner reproducibility (intraclass correlation coefficients >0.8). Fewer PVS and larger PVS diameter at baseline predicted higher dementia risk and accelerated brain atrophy. Longitudinal trajectories of PVS markers differed significantly in participants without dementia who converted to dementia compared with non-converters. In simulated placebo-controlled trials for treatments targeting cognitive decline, screening out participants at low risk of dementia based on our PVS markers enhanced the power of the trial independently of Alzheimer’s disease biomarkers. Interpretation: These robust cerebrovascular markers predict dementia risk and brain atrophy and may improve risk-stratification of patients, potentially reducing cost and increasing throughput of clinical trials to combat dementia. Funding: US National Institutes of Health.

Melamine, its analogues, and aromatic amines (AAs) were commonly detected in a previous study of pregnant women in the Environmental influences on Child Health Outcomes (ECHO) Cohort. While these chemicals have identified toxicities, little is known about their influences on fetal development. We measured these chemicals in gestational urine samples in 3 ECHO cohort sites to assess associations with birth outcomes (n = 1,231). We estimated beta coefficients and 95% confidence intervals (CIs) using adjusted linear mixed models with continuous dilution-standardized concentrations (log2 transformed and scaled by interquartile range, IQR) or binary indicators for detection. As secondary analyses, we repeated analyses using categorical outcomes. Forty-one of 45 analytes were detected in at least one sample, with > 95 % detection of melamine, cyanuric acid, ammelide, and aniline. Higher melamine concentration was associated with longer gestational age (β^ per IQR increase of log2-transformed: 0.082 [95 % CI: −0.012, 0.177]; 2nd vs 1st tertile: 0.173 [-0.048, 0.394]; 3rd vs 1st tertile: 0.186 [-0.035, 0.407]). Similarly in secondary analyses using categorical outcomes, an IQR increase in log2(melamine) was associated with 1.22 [0.99, 1.50] higher odds of post-term (>40 & ≤42 weeks) as compared to full-term (≥38 & ≤40 weeks). Several AAs were associated with birthweight and gestational length, with the direction of associations varying by AA. Some stronger associations were observed in females. Our findings suggest melamine and its analogs and AAs may influence gestational length and birthweight.

IntroductionExtracellular vesicles (EVs) can potently inhibit inflammation yet there is a lack of understanding about the impact of donor characteristics on the efficacy of EVs. The goal of this study was to determine whether the sex and age of donor platelet-derived EVs (PEV) affected their ability to inhibit viral myocarditis.MethodsPEV, isolated from men and women of all ages, was compared to PEV obtained from women under 50 years of age, which we termed premenopausal PEV (pmPEV). Because of the protective effect of estrogen against myocardial inflammation, we hypothesized that pmPEV would be more effective than PEV at inhibiting myocarditis. We injected PEV, pmPEV, or vehicle control in a mouse model of viral myocarditis and examined histology, gene expression, protein profiles, and performed proteome and microRNA (miR) sequencing of EVs.ResultsWe found that both PEV and pmPEV significantly inhibited myocarditis; however, PEV was more effective, which was confirmed by a greater reduction of inflammatory cells and proinflammatory and profibrotic markers determined using gene expression and immunohistochemistry. Proteome and miR sequencing of EVs revealed that PEV miRs specifically targeted antiviral, Toll-like receptor (TLR)4, and inflammasome pathways known to contribute to myocarditis while pmPEV contained general immunoregulatory miRs.DiscussionThese differences in EV content corresponded to the differing anti-inflammatory effects of the two types of EVs on viral myocarditis.

Background: Few studies have evaluated antibiotic prescribing practices for bacterial enteric infections. Unnecessary antibiotics can result in adverse events and contribute to the emergence of antimicrobial resistance. We assessed treatment practices among patients with laboratory-confirmed enteric infections in a regional healthcare system in Wisconsin, USA. Methods: We used electronic health records to identify patients with laboratory-confirmed nontyphoidal Salmonella, Shigella, Shiga toxin-producing Escherichia coli (STEC), and Campylobacter infections during 2004–2017. Relevant clinical data, including diagnosis codes for chronic conditions and receipt of immunosuppressive medications and antibiotic prescriptions, were extracted. We defined appropriate treatment based on pathogen, patient characteristics, and practice guidelines for the study period. Results: We identified 2064 patients infected with Campylobacter (1251; 61 %), Salmonella (564; 27 %), STEC (199; 10 %), or Shigella (50; 2 %). Overall, 425 (20 %) patients were immunocompromised, ranging from 17 % with Salmonella to 46 % with STEC. There were 220 (11 %) hospitalizations. Antibiotics were prescribed most frequently for Campylobacter (53 %), followed by Shigella (46 %) and Salmonella (44 %) infections. Among those prescribed antibiotics, prescriptions were appropriate for 71 % of Campylobacter, 100 % of Shigella, and 81 % of Salmonella infections. Antibiotics were prescribed for 24 % of STEC infections, despite recommendations against use. Guideline adherence generally decreased with age, except for Shigella infections, where adherence was highest for adults ≥ 50 years. Conclusions: Antibiotic prescribing for laboratory-confirmed enteric infections was usually appropriate but did not follow practice guidelines in a substantial minority of cases, presenting opportunity for improvement. Antibiotic stewardship initiatives should address acute bacterial gastrointestinal infections in addition to other common infections.

This paper examines one way that colonial logic is embedded in western academic practices. It argues that the conventional dichotomy between primary and secondary sources in the humanities and social sciences reflects western monocultural hegemony in its application to non-western knowledges. In these fields, primary sources are treated as objects, analysed as evidence, and used as data, while secondary sources get to act as subjects and are engaged with as experts. This paper identifies a problematic dynamic where Indigenous authorities whose expertise does not align with western academic norms are categorised and used as primary sources, thereby stripping them of their agency and subjectivity. Their knowledge is extracted, commodified, and appropriated for the benefit of the west. Further, the paper critiques the role of librarians and archivists in perpetuating this colonial logic through their instruction practices and professional frameworks and standards, especially around primary source literacy and evaluating authority. These practices promulgate monocultural tools through which knowledge is extracted and evaluated. This paper calls on librarians to critically assess their role in maintaining colonial structures that continue to marginalise Indigenous Knowledge.

Introduction Overweight and obesity are growing public health problems worldwide. Both diet and physical activity have been the primary interventions for weight reduction over the past decade. With increasing rates of overweight and obesity, it is evident that a primary focus on diet and exercise has not resulted in sustained obesity reduction within the global population. There is now a case to explore other weight management strategies such as psychological therapies. However, there is a dearth of literature that has mapped the types of psychological interventions and the characteristics of these interventions as a means of achieving weight reduction.Objectives The key objectives focused on mapping the types and characteristics of psychological interventions versus usual care for weight reduction and sustained weight reduction in adults with overweight or obesity. The study followed the scoping review methodology by Arksey and O’Malley and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Eligibility criteria Intervention studies were included if participants were 18 years and over, classified as overweight or obese (body mass index ≥25 kg/m2) and had received a psychological therapy intervention. Studies were excluded if they included a comparison with other active lifestyle interventions (unless classified as usual care), were not available in English, were not full-text articles or were non-peer-reviewed articles.Sources of evidence Six electronic databases were searched from inception to April 2023 to identify relevant articles.Charting methods The study employed a systematic charting method and narrative synthesis to organise and synthesise the data.Results A total of 31 studies met the eligibility criteria and were included in the review. 13 unique psychological interventions for weight reduction in adults with overweight or obesity were identified, with cognitive–behavioural therapy and motivational interviewing being the most common. Eight types of usual care were identified, which largely included education and training on nutrition and physical activity. Gaps in the current research were also identified.Conclusion The findings highlighted several gaps within the existing literature, largely due to a lack of evidence relating to adults with low socioeconomic status, non-white participants, individuals under 40 years of age and the integration of digital health technologies.

Abstract Ionic liquids (ILs) have emerged as promising biomaterials for enhancing drug delivery by functionalizing polymeric nanoparticles (NPs). Despite the biocompatibility and biofunctionalization they confer upon the NPs, little is understood regarding the degree in which non‐covalent interactions, particularly hydrogen bonding and electrostatic interactions, govern IL‐NP supramolecular assembly. Herein, we use salt (0‐1 M sodium sulfate) and acid (0.25 M hydrochloric acid at pH 4.8) titrations to disrupt IL‐functionalized nanoassembly for four different polymeric platforms during synthesis. Through quantitative 1H‐nuclear magnetic resonance spectroscopy and dynamic light scattering, we demonstrate that the driving force of choline trans‐2‐hexenoate (CA2HA 1:1) IL assembly varies with either hydrogen bonding or electrostatics dominating, depending on the structure of the polymeric platform. In particular, the covalently bound or branched 50:50 block co‐polymer systems (diblock PEG‐PLGA [DPP] and polycaprolactone [PCl]‐poly[amidoamine] amine‐based linear‐dendritic block co‐polymer) are predominantly affected by hydrogen bonding disruption. In contrast, a purely linear block co‐polymer system (carboxylic acid terminated poly[lactic‐co‐glycolic acid]) necessitates both electrostatics and hydrogen bonding to assemble with IL and a two‐component electrostatically bound system (electrostatic PEG‐PLGA [EPP]) favors hydrogen‐bonding with electrostatics serving as a secondary role.

In recent years, the global market for novel psychoactive substances (NPS) has continued to grow rapidly, presenting significant challenges for analytical toxicologists. Indeed, the constant emergence and the evolving nature of NPS requires their rapid detection and identification; studies on their pharmacokinetics; and ideally the prediction of future analogues to try and stay ahead of the competition with illicit NPS manufacturers. This presentation will provide an overview, from the analytical toxicologists’ point of view, of the current challenges and future outlooks for detecting, identifying, and predicting NPS. It will explore both recent efforts in my group, and what we plan to do in the near future to tackle the emergence of NPS using multidisciplinary approaches. I will discuss the importance of both emerging analytical tools and techniques, including portable instruments, for the rapid and on-site detection and identification of NPS. Finally, I will briefly mention how computational methods could simplify substance identification and aid in predicting the emergence of NPS. It is hoped that some of the described approaches will have positive implications for public health and safety and will create opportunities to promote exchange between various stakeholders, including basic scientists/toxicologists, clinicians, and policy makers.

Introduction: This presentation will cover two areas of work. Firstly, we will provide a summary of the current trends of substance misuse across prisons in South Wales, where novel psychoactive substances continue to be widely used, including the market value for these substances in the prison system. The second element of the presentation will share the findings of our research in the attempt to better understand the lived experience of those affected and provide a more informed support and intervention to other prisoners. Methods: The analysis of trends across Welsh prisons will utilise data from the following sources: Mandatory Drug Test results, drug testing sample data from WEDINOS, prison data on drug finds, intelligence reports and substance misuse observation records being opened. The research into prisoner peer mentoring will utilise standardised interviews with both prisoners with lived experience providing support, and prisoners receiving support. The standardised interviews will aim to identify consistent themes, proposals for good practice and wider mainstream implementation. Results: Early data shows a significant prevalence of Synthetic Cannabinoids and the emergence of new trends related to the consumption of Synthetic Opioids. Conclusions: More attention should be paid to the diffusion on NPS in prison settings. Full results of our investigation will be available and be discussed at the time of the conference.

Abstract To meet the turfgrass standards that players expect, golf course superintendents rely on intense irrigation, fertilization, and cultivation programs. However, the overapplication of irrigation water and fertilizer has been shown to have negative effects on water quality. Precision turfgrass management (PTM) is an emerging area of interest as more golf course superintendents are looking to increase input efficiency while simultaneously reducing water and fertilizer input costs, as well as environmental impacts. Our objectives were to (1) use electromagnetic induction (EMI) to determine the spatial variability of apparent electrical conductivity (EC) in sand‐capped fairways and (2) correlate EC to measured soil and turfgrass characteristics to determine the applicability of mapping EC for PTM. Soil samples and EC data were collected in spring 2021 on four sand‐capped fairways from two golf courses (one hybrid bermudagrass and one zoysiagrass) belonging to the same facility in southeast Texas. Apparent EC was found to be positively and significantly correlated with soil volumetric water content (VWC, 0.40 0.62) and turfgrass normalized difference vegetation index (NDVI; 0.21 0.46) in three of four fairways, while EC was negatively and significantly correlated with penetration resistance (PR, −0.29 −0.48) in two of four fairways studied. The strengths of these relationships were corroborated by strong visual similarities when comparing spatial maps of EC with those of VWC, NDVI, and PR, indicating that EMI‐based EC data have potential for use in delineating site‐specific management zones for water and fertilizer applications, as well as targeted aeration.

CD73 is a cell surface 5’nucleotidase (NT5E) and key node in the catabolic process generating immunosuppressive adenosine in cancer. Using a murine monoclonal antibody surrogate of Oleclumab, we investigated the effect of CD73 inhibition in concert with cytotoxic therapies (chemotherapies as well as fractionated radiotherapy) and PD-L1 blockade. Our results highlight improved survival in syngeneic tumor models of colorectal cancer (CT26 and MC38) and sarcoma (MCA205). This therapeutic outcome was in part driven by cytotoxic CD8 T-cells, as evidenced by the detrimental effect of CD8 depleting antibody treatment of MCA205 tumor bearing mice treated with anti-CD73, anti-PD-L1 and 5-Fluorouracil+Oxaliplatin (5FU+OHP). We hypothesize that the improved responses are tumor microenvironment (TME)-driven, as suggested by the lack of anti-CD73 enhanced cytopathic effects mediated by 5FU+OHP on cell lines in vitro. Pharmacodynamic analysis, using imaging mass cytometry and RNA-sequencing, revealed noteworthy changes in specific cell populations like cytotoxic T cells, B cells and NK cells in the CT26 TME. Transcriptomic analysis highlighted treatment-related modulation of gene profiles associated with an immune response, NK and T-cell activation, T cell receptor signaling and interferon (types 1 & 2) pathways. Inclusion of comparator groups representing the various components of the combination allowed deconvolution of contribution of the individual therapeutic elements; highlighting specific effects mediated by the anti-CD73 antibody with respect to immune-cell representation, chemotaxis and myeloid biology. These pre-clinical data reflect complementarity of adenosine blockade with cytotoxic therapy, and T-cell checkpoint inhibition, and provides new mechanistic insights in support of combination therapy.

AbstractBackground Opioid overdoses have continued to increase at higher rates among Black Americans compared to people from other racial groups. Despite demonstrated effectiveness of MOUD in reducing risk of opioid overdose, Black Americans face decreased access to and uptake of MOUD. The current study aimed to examine the knowledge, perceptions, and experiences with MOUD among a sample of Black adults who use prescription opioids nonmedically in order to inform tailored efforts to improve MOUD uptake.Methods Data were derived from a larger study assessing cultural and structural influences on drug use and drug treatment among people who use prescription opioids nonmedically. Semi-structured qualitative interviews were conducted with 34 Black men and women across four generational cohorts: born 1955–1969; 1970–1979; 1980–1994; and 1995–2001. Participant responses were analyzed using thematic analysis.Results Nearly half of participants (44.1%) reported no knowledge or experience with MOUD. Among participants who had any knowledge about MOUD, four major themes regarding their perceptions emerged: MOUD Helps with Recovery; Not Needed for Level of Drug Use; Side Effects and Withdrawal; Equivalence with Illicit Drug Use. The majority reported negative perceptions of MOUD (52.6%), and the youngest cohort (born 1995–2001) had a higher proportion of negative perceptions (80%) relative to other age cohorts (born 1980–1994: 50%; 1970–1979: 75%; 1955–1969: 16.6%).Discussion Findings indicate a significant knowledge gap and clear points of intervention for improving MOUD uptake. Interventions to improve communication of health information in ways that are culturally relevant and tailored by age group can be used in conjunction with efforts to improve MOUD access among Black individuals who use opioids nonmedically.

Nicotine and tobacco use disproportionally affects sexual and gender minority (SGM) populations in the United States. Social media narratives may contribute to these disparities. This qualitative study delineated perceptions and experiences depicted in SGM-related videos about nicotine vaping on TikTok. Young adult researchers engaged in every step of the research process, adding an insider perspective. Using four TikTok accounts, we used vaping and SGM-related search terms to sample videos in March–April 2022. Three TikTok accounts collected SGM-specific videos; a fourth provided non-SGM specific videos for comparison. We iteratively sorted 303 unique videos into 32 a priori and emergent codes and identified themes in SGM videos and comparison videos. In their videos, creators displayed awareness of and ambivalence toward vaping and nicotine dependence. SGM videos reflected vaping as a salient feature of identity and a consideration in romantic partnership. Studying video-based social media platforms, like TikTok, using an insider-engaged qualitative lens promotes rich interpretation of content to identify prevalent and emerging messages, which can inform appropriate interventions for SGM young people.

Summary: The partner and localizer of BRCA2 (PALB2) is a scaffold protein linking BRCA1 with BRCA2 and RAD51 during homologous recombination (HR). PALB2 interaction with DNA strongly enhances HR in cells, while the PALB2 DNA-binding domain (PALB2-DBD) supports DNA strand exchange in vitro. We determined that PALB2-DBD is intrinsically disordered beyond a single N-terminal α-helix. Coiled-coil mediated dimerization is stabilized by interaction between intrinsically disordered regions (IDRs) leading to a 2-fold structural compaction. Single-stranded (ss)DNA binding promotes additional structural compaction and protein tetramerization. Using confocal single-molecule FRET, we observed bimodal and oligomerization-dependent compaction of ssDNA bound to PALB2-DBD, suggesting a novel strand exchange mechanism. Bioinformatics analysis and preliminary observations indicate that PALB2 forms protein-nucleic acids condensates. Intrinsically disordered DBDs are prevalent in the human proteome. PALB2-DBD and similar IDRs may use a chaperone-like mechanism to aid formation and resolution of DNA and RNA multichain intermediates during DNA replication, repair and recombination.

Background: Researchers and participants who are members of minoritized populations experience negative psychosocial and wellness outcomes like burnout. Burnout may manifest uniquely for Black women in academia conducting research with Black women participants navigating similar sociocultural contexts. Objectives: This article qualitatively interprets our experiences as 15 Black women scholar-practitioners at a midwestern university conducting community-engaged research. We discuss our experiences of care and burnout while working to reduce opioid use disparities among Black women community members as we simultaneously navigate multilevel challenges in academia. Design: We employ collaborative autoethnography, an autobiographical writing method, using a Black feminist framework and intersectionality methodology. Methods: We are 15 Black women researcher-subjects on the REFOCUS study—a mixed-methods National Institute on Health-funded project examining nonmedical prescription opioid misuse among Black Kentuckians. We examined a series of multigenerational sista circles and individual journal entries we completed to understand the multilevel power dynamics impacting our individual and collective work, burnout, and care. Results: Themes were: (1) “I see me in you”: Research with Black Women, (2) “Pervasive, cellular, and epigenetic”: Burnout Experiences; (3) “Taxing but rewarding”: The Price We Pay to See an Outcome, and (4) “Thank God for the collective”: Complexities of Caring Through the Process. Conclusion: We highlight the importance of continued efforts to address workload inequities among Black women in academia, particularly for those working to combat health disparities among Black women or within Black communities. We make recommendations for structural, institutional, and interpersonal steps to improve the support of Black women across career stages.

BackgroundYoung Black male individuals are 24 times more likely to be impacted by firearm injuries and homicides but encounter significant barriers to care and service disengagement, even in program-rich cities across the United States, leaving them worryingly underserved. Existing community-based interventions focus on secondary and tertiary prevention after firearm violence has occurred and are typically deployed in emergency settings. To address these service and uptake issues, we developed BrotherlyACT—a nurse-led, culturally tailored, multicomponent app—to reduce the risk and effects of firearm injuries and homicides and to improve access to precrisis and mental health resources for young Black male individuals (aged 15-24 years) in low-resource and high-violence settings. Grounded in Acceptance and Commitment Therapy, the app provides life skills coaching, safety planning, artificial intelligence–powered talk therapy, and zip code–based service connections directly to young Black male individuals at risk for violence and substance use. ObjectiveThe primary aim of this study is to evaluate the usability, engagement, and satisfaction of BrotherlyACT among target young Black male users and mobile health (mHealth) experts, using a combination of formative usability testing (UT) and heuristic evaluation (HE). MethodsUsing a convergent mixed methods approach, we evaluated the BrotherlyACT app using HE by 8 mHealth specialists and conducted UT with 23 participants, comprising 15 young Black male users (aged 15-24 years), alongside 4 adult internal team testers and 4 high school students who were part of our youth advisory board. UT included the System Usability Scale and thematic analysis of think-aloud interviews and cognitive walkthroughs. HE involved mHealth experts applying the Nielsen severity rating scale (score 0-3, with 3 indicating a major issue). All testing was conducted via REDCap (Research Electronic Data Capture) and Zoom or in person. ResultsQualitative usability issues were categorized into 8 thematic groups, revealing only minor usability concerns. The app achieved an average System Usability Scale score of 79, equivalent to an A-minus grade and placing it in the 85th percentile, indicating near-excellent usability. Similarly, the HE by testers identified minor and cosmetic usability issues, with a median severity score of 1 across various heuristics (on a scale of 0-3), indicating minimal impact on user experience. Overall, minor adjustments were recommended to enhance navigation, customization, and guidance for app users, while the app’s visual and functional design was generally well received. ConclusionsBrotherlyACT was considered highly usable and acceptable. Testers in the UT stage gave the app a positive overall rating and emphasized that several key improvements were made. Findings from our UT prompted revisions to the app prototype. Moving forward, a pilot study with a pretest-posttest design will evaluate the app’s efficacy in community health and emergency care settings. International Registered Report Identifier (IRRID)RR2-10.2196/43842

Introduction A literature review provides a synthesis on a selection of papers about a specific topic. This is used by health practitioners in critical care as in other specialities when making clinical practice decisions. The task of knowledge transfer through the review process of scientific papers involves a variety of methodologies with differing expectations on the quality and rigour that is applied. Exploration on the types of review methodologies selected by the authors of critical care literature may reveal the extent that choice of methodology has on how papers are selected and appraised may influence evidence-based practice recommendations. This scoping review aims to systematically map the breadth of current literature with the objective of identifying the types of review methodologies used by interdisciplinary authors synthesising the literature in adult critical care.Methods and analysis Arksey and O’Malley’s approach in conducting a scoping review will be followed and use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines in the reporting of findings. Papers with diverse review methodologies will be identified by searching four electronic databases (CINAHL/EBSCO, MEDLINE/PubMed, Scopus and Embase). Grey literature will be excluded due to the clinical nature of the review question. Search results will be reviewed independently by two researchers based on title and abstract followed by full-text papers that meet inclusion criteria. Characteristics of review methodologies will be collected and analysed using a tool developed by the interdisciplinary research team.Ethics and dissemination This scoping review will provide an overview of the types of review methodologies most often undertaken with the interdisciplinary research team synthesising the quality of critical care literature. Scrutiny will be applied to the review methodologies selected, the challenges faced and current trends in the transfer of knowledge towards evidence-based practice. The results will be disseminated by publication through a peer-reviewed journal and by presentation as a part of conference proceedings. Ethics approval is not applicable for this scoping review.

Background Person-centred community-based support services (PCCBSS) are an array of non-clinical services provided by organisations such as NHS Trusts, voluntary sector organisations, or local authorities. All PCCBSS involve an individual (variously known as a 'social prescriber’, ‘link worker’, ‘signposter’, ‘navigator’, ‘connector’ or ‘neighbourhood coach’) who talks with a service user before directing them to a range of relevant community sources of social, emotional, and practical support. Despite much recent investment in social prescribing, and its increased prominence within the policy context across England, little is understood about how PCCBSS are implemented. Research is required across different contexts to describe PCCBSS implementation; in particular, how social care providers successfully interact to support the implementation of PCCBSS, and how services responded to circumstances imposed by the COVID-19 pandemic. Purpose The aim of this post-implementation mixed-methods study is to explore how PCCBSS are implemented and become part of usual working practice. Using three services in North West England as case studies, we will examine factors influencing PCCBSS implementation and establish where there is learning for the wider adult social care system. Focus The study comprises two work packages (WPs): WP1: collecting data by reviewing service documents from three PCCBSS case studies; WP2: interviewing staff and service users (≤20 participants per PCCBSS); Key implementation data will be systematically abstracted (from WPs1&2) into a coding frame; combining contextual determinants from the Consolidated Framework for Implementation Research (CFIR) with process-related domains from Normalization Process Theory (NPT). Key outputs The findings from WP1 and WP2 will be presented in the form of an illustrated ‘pen portrait’, developed collaboratively with Applied Research Collaboration North West Coast (ARC NWC) public advisers, to illustrate how implementation evolved for each of the PCCBSS across key time-points in the process (initiation; operation; maintenance). The findings will also inform an online implementation toolkit providing recommendations for setting up future PCCBSS.