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In response to an increasing demand for bespoke or tailored regional ocean modelling configurations, we outline fundamental principles and practices that can expedite the process to generate new configurations. The paper develops the principle of reproducibility and advocates adherence by presenting benefits to the community and user. The elements of this principle are reproducible workflows and standardised assessment, with additional effort over existing working practices being balanced against the added value generated. The paper then decomposes the complex build process, for a new regional ocean configuration, into stages and presents guidance, advice and insight for each component. This advice is compiled from across the NEMO (Nucleus for European Modelling of the Ocean) user community and sets out principles and practises that encompass regional ocean modelling with any model. With detailed and region-specific worked examples in Sects. 3 and 4, the linked companion repositories and DOIs all target NEMOv4. The aim of this review and perspective paper is to broaden the user community skill base and to accelerate development of new configurations in order to increase the time available for exploiting the configurations.

Intro: Campylobacter is the most common bacterial cause of foodborne gastroenteritis in Australia, however outbreaks caused by the pathogen are relatively uncommon. On 4 March 2022, the Victorian Department of Health was notified of a gastrointestinal illness in 20 guests following attendance at a wedding reception on 12 February 2022. Four individuals were notified with laboratory confirmed campylobacteriosis, and an investigation was undertaken to determine the full extent of the outbreak and prevent further illness. Methods: A nested case-control study was conducted to determine the likely source of infection. Cases were defined as attendees of the wedding reception, with onset of diarrhoea and/or abdominal pain 1-10 days after attending the function. Controls were randomly selected from the remaining non-ill guests. Cases and controls were interviewed using a standardised menu-based questionnaire, and odds ratios (ORs) calculated of consumed foods. Food preparation processes were documented, and food samples collected. Findings: A total of 29 wedding guests met the case definition, with onset of illness between 2-5 days and major symptoms including diarrhoea (90%), abdominal pain (100%), headache (79%), and fever (62%). Two cases were hospitalised, one with ongoing neurological sequelae. Illness was found to be significantly associated with consumption of a duck breast brioche canape containing duck liver parfait following univariate analysis and stratification by other implicated foods (OR=2.85, 95% CI [1.03-7.86]). Cases aged 10-29 years were 13.2 times more likely to have eaten duck than controls in that age group. Discussion: The investigation found the duck canape was the likely vehicle of infection in this outbreak. Consistent with the literature on Campylobacter transmission, it is likely that inadequate cooking of the duck liver for the parfait was the contributing factor that led to illness. Conclusion: This outbreak investigation highlights the risks posed by poultry dishes if undercooked, and that education of food handlers remains a priority.

A dependable and consistent electron source is a crucial requirement for the achievement of high-power free electron lasers (FELs). Over the past two decades, it has been demonstrated that photoinjectors based on SRF technology (SRF guns) are suitable for continuous wave (CW) beam generation. SRF guns possess both the high accelerating field gradients of normal conducting RF photoinjectors and the low power dissipation thanks to mature SRF cavity technology, and therefore have the potential to provide the high-brightness, high-current beams required for CW-XFELs. After the demonstration of the first SRF gun in Dresden-Rossendorf, several SRF gun programs based on different approaches have achieved promising progress and even succeeded in routine operation. SRF guns are expected to play an important role in XFEL facilities in the near future. In this paper, we give an overview of design concepts, important parameters and development status of the worldwide SRF gun projects.

A new regional coupled modelling framework is introduced – the Regional Coupled Suite (RCS). This provides a flexible research capability with which to study the interactions between atmosphere, land, ocean, and wave processes resolved at kilometre scale, and the effect of environmental feedbacks on the evolution and impacts of multi-hazard weather events. A configuration of the RCS focussed on the Indian region, termed RCS-IND1, is introduced. RCS-IND1 includes a regional configuration of the Unified Model (UM) atmosphere, directly coupled to the JULES land surface model, on a grid with horizontal spacing of 4.4 km, enabling convection to be explicitly simulated. These are coupled through OASIS3-MCT libraries to 2.2 km grid NEMO ocean and WAVEWATCH III wave model configurations. To examine a potential approach to reduce computation cost and simplify ocean initialization, the RCS includes an alternative approach to couple the atmosphere to a lower resolution Multi-Column K-Profile Parameterization (KPP) for the ocean. Through development of a flexible modelling framework, a variety of fully and partially coupled experiments can be defined, along with traceable uncoupled simulations and options to use external input forcing in place of missing coupled components. This offers a wide scope to researchers designing sensitivity and case study assessments. Case study results are presented and assessed to demonstrate the application of RCS-IND1 to simulate two tropical cyclone cases which developed in the Bay of Bengal, namely Titli in October 2018 and Fani in April 2019. Results show realistic cyclone simulations, and that coupling can improve the cyclone track and produces more realistic intensification than uncoupled simulations for Titli but prevents sufficient intensification for Fani. Atmosphere-only UM regional simulations omit the influence of frictional heating on the boundary layer to prevent cyclone over-intensification. However, it is shown that this term can improve coupled simulations, enabling a more rigorous treatment of the near-surface energy budget to be represented. For these cases, a 1D mixed layer scheme shows similar first-order SST cooling and feedback on the cyclones to a 3D ocean. Nevertheless, the 3D ocean generally shows stronger localized cooling than the 1D ocean. Coupling with the waves has limited feedback on the atmosphere for these cases. Priorities for future model development are discussed.

Intellectual capital has aroused growing interest in higher education; however, one area for improvement in its study is how to measure it adequately. Therefore, it is necessary to have instruments based on current models of intellectual capital. This study aims to design and validate an intellectual capital measurement scale in accredited higher education institutions (HEIs) from the perspective of professors. The study was instrumental because a measurement scale was developed. The sample consisted of 341 professors from six accredited HEIs on the Colombian Caribbean Coast. The statistical analysis consisted of three stages: item analysis, collection of validity evidence based on the internal structure and the relationship with other variables, and reliability analysis using the internal consistency method. The scale's internal structure corroborated intellectual capital composition based on human, structural, and relational components. Regarding convergent evidence, all variables possess this source of validity evidence. Reliability levels were also good. Previously, an instrument has yet to be developed those measures intellectual capital in HEIs from the perspective of professors. This study provides a scale that focuses on the characteristics of this stakeholder and is based on an innovative model of intellectual capital composed of human, structural, and relational capital. The theoretical contribution of the study lies in developing a test based on two current models of intellectual capital: the Intellectus model and the Balanced Scorecard model. It also contributes to practice by providing a tool for measuring intellectual capital that allows its adequate management, improvement, and decision-making within higher education.

BACKGROUND: Undernutrition during pregnancy increases the risk of giving birth to a small vulnerable newborn. Small-quantity lipid-based nutrient supplements (SQ-LNSs) contain both macro- and micronutrients and can help prevent multiple nutritional deficiencies. OBJECTIVES: We examined the effects of SQ-LNSs provided during pregnancy compared with 1) iron and folic acid or standard of care (IFA/SOC) or 2) multiple micronutrient supplements (MMSs) and identified characteristics that modified the estimates of effects of SQ-LNSs on birth outcomes. METHODS: We conducted a 2-stage meta-analysis of individual participant data from 4 randomized controlled trials of SQ-LNSs provided during pregnancy (n = 5273). We generated study-specific and subgroup estimates of SQ-LNS compared with IFA/SOC or MMS and pooled the estimates. In sensitivity analyses, we examined whether the results differed depending on methods for gestational age dating, birth anthropometry, or study design. RESULTS: SQ-LNSs (compared with IFA/SOC) increased birth weight [mean difference: +49 g; 95% confidence interval (CI): 26, 71 g] and all birth anthropometric z-scores (+0.10-0.13 standard deviation); they reduced risk of low birth weight by 11%, newborn stunting by 17%, newborn wasting by 11%, and small head size by 15%. Only 2 trials compared SQ-LNSs and MMSs; P values for birth outcomes were >0.10 except for head circumference (e.g., z-score for gestational age: +0.11; 95% CI: -0.01, 0.23). Effect estimates for SQ-LNSs compared with IFA/SOC were greater among female infants and, for certain outcomes, among mothers with body mass index

This case explores a newly implemented Strategic Education Plan, spearheaded by Principal John Barlow, which has added some tensions and sparked concerns among parents and teachers that the myopic focus on standardized test scores risks erasing the cultural richness that defines the school. The narrative explores the complexities of balancing accountability and cultural responsiveness in an educational setting where both seem to be at odds. Readers are asked to consider the case through a plantation lens and consider the ways the traditions associated with it 'colors' the process of education and supervision. In this case, the reader explores how the plantation corporeally and discursively influences instructional and supervisory processes, most notably by erasing or reducing certain aspects of race, culture and diversity. The case is followed by a section that unpacks some of the issues of the plantation narrative and guides the reader through identifying these issues with a set of thought-provoking questions grounded in the literature. The article is concluded with a practical application section which outlines an emerging framework that centers and honors culture and race in the supervisory process. This framework is discussed as a way to move beyond superficial responses -- such as merely increasing oversight to regulate behaviors -- and affirm the power of history, race, and culture.

Background: Parent engagement in child-focused interventions is increasingly recognised as an important aspect of effective intervention delivery. While several fields have an emerging literature around parent engagement, no reviews currently exist which combine findings across allied health literatures. Objective: This review aimed to explore factors relevant to understanding parent engagement in child-focused interventions, as described in qualitative literature across allied health disciplines, toward informing the clinical practice of helping professionals in effectively engaging parents. Methods: A systematised qualitative literature review was carried out, with a comprehensive search of five online databases (CINAHL, Embase, MEDLINE, PsycINFO, Scopus) for allied health literature (specifically: behaviour analysis, occupational therapy, psychology, and speech-language therapy) using parent engagement key words. Reference searching and citation tracking steps supported the search. Thematic synthesis was used as the overarching framework and analysis approach. Results: 8824 unique studies were generated in the search. Of the 71 studies which met inclusion criteria, 38 reported qualitative findings and were included in the analysis. Five themes were identified including: societal context, interpersonal context, clinician features, family features, and relationship as engagement. Conclusions: Findings support conceptual explanations of parent engagement as a complex and dynamic process, emphasising the joint contributions of parents and clinicians in developing therapeutic relationships which promote engagement. Across allied health research there are consistency of understandings around parent engagement, supporting the conclusion that clinicians can look to literatures from various helping fields to inform clinical practice around engaging parents in interventions.

Student experience of Assessment for Learning (AfL) pedagogies ideally provides multiple entry points for students to take past learning forward into future learning. In practice, points of disconnection may confound the accessibility of AfL's repertoire of practices. This paper investigates the AfL experiences of students with likely language and attentional difficulties and their peers in three Australian secondary schools. Ninety-two students shared their insights in interviews and focus groups, with data analysed abductively through a conceptual frame of six dimensions. Common practical effects for students included recognition and value of a range of teacher practices. Students with language and attentional difficulties indicated more uneven recall of processes, especially when teacher practice of AfL was fragmented and classroom routines prioritised summative assessment. Fragmentation in turn compromised the emotional and evaluative dimensions of experience that catalyse continuity in learning. Critical insights from students about how they searched for and secured cohesive experiences points to how AfL offers agentic possibilities for learning beyond the immediate activities of the classroom.

This article describes our efforts to screen and enrol clinical trial participants conscientiously in the COVID-19 pandemic setting. We present the standard screening and enrolment process prior to, and our process of adapting to, the pandemic. Our goal was to develop a way to screen and enrol people for clinical trials that was both equitable and effective. In addition, we outline the steps our research department took to ensure that ethical, clinical and logistical factors were considered when matching a patient to a clinical trial.

Although community randomized trials have found a reduction in all-cause child mortality in communities receiving mass azithromycin distribution compared with placebo, individually randomized trials have not found similar protective effects. If a direct effect of azithromycin for prevention of child mortality exists, it is likely due to reduction in infectious mortality. Here, we assessed cause-specific mortality in a large randomized controlled trial of azithromycin administered during well-infant visits in Burkina Faso for prevention of mortality. Among 32,877 enrolled infants, the most common causes of death by 6 months of age were malaria, acute respiratory infections, and diarrheal disease. We found no evidence of a difference in the distribution of cause of death by randomized treatment assignment (P = 0.42) or in any infectious-specific cause of death. The results of this analysis are consistent with no direct effect of azithromycin on infant mortality when administered during well-infant visits.

Rare earth tris(alkyl) complexes such as M(CH2SiMe3)3(sol) n are widely used as precursors for many compounds and as homogeneous catalysts for alkene polymerization and alkane functionalization. However, the thermal instability of those most conveniently made from the commercially available lithium salt of the neosilyl anion, LiCH2SiMe3, Li(r), restricts their utility. We present a new range of synthetically useful, more kinetically stable rare earth neosilyl solvates, derived from a full kinetic study of the various possible decomposition mechanisms of 7 known and 12 new solvated rare earth neosilyl complexes M(CH2SiMe3)3(sol) n M = Sc(iii), Y(iii), Lu(iii), Sm(iii), and sol = THF; TMEDA; DMPE; diglyme ((CH3)2(OCH2CH2)2O, G2), triglyme ((CH3)2(OCH2CH2)3O, G3). Surprisingly, simply using higher-denticity donors to sterically disfavor neosilyl γ-H elimination is not effective. While Sc(r)3((CH3)2(OCH2CH2)2O) has a half-life, t 1/2, of 258.1 h, six times longer than for Sc(r)3(C4H8O)2 (t 1/2 = 43 h), Lu(r)3((CH3)2(OCH2CH2)2O) and Y(r)3((CH3)2(OCH2CH2)2O) do not show the expected, analogous increased t 1/2. This is because new decomposition pathways appear for poorly fitting donors. Finally, kinetic studies demonstrate the impact of small, and increasing amounts of LiCl on the kinetics of the reactivity of the smaller alkyls Y(r)3(THF)2 and Lu(r)3(THF)2; molecules used in hydrocarbon chemistry and catalysis for fifty years. A new route to pure Y(r)3(THF)2, which avoids the traditional use of Li(r), is presented.

CT is crucial for diagnosing chest diseases, with image quality affected by spatial resolution. Thick-slice CT remains prevalent in practice due to cost considerations, yet its coarse spatial resolution may hinder accurate diagnoses. Our multicenter study develops a deep learning synthetic model with Convolutional-Transformer hybrid encoder-decoder architecture for generating thin-slice CT from thick-slice CT on a single center (1576 participants) and access the synthetic CT on three cross-regional centers (1228 participants). The qualitative image quality of synthetic and real thin-slice CT is comparable (p = 0.16). Four radiologists accuracy in diagnosing community-acquired pneumonia using synthetic thin-slice CT surpasses thick-slice CT (p  0.99). For lung nodule detection, sensitivity with thin-slice CT outperforms thick-slice CT (p  0.05). These findings indicate the potential of our model to generate high-quality synthetic thin-slice CT as a practical alternative when real thin-slice CT is preferred but unavailable.

BACKGROUND: Diet quality during infancy can influence nutrient intake and ultra-processed foods (UPFs) consumption throughout later childhood. OBJECTIVES: This study investigated the predictive validity of Infant Diet Quality Index (IDQI) scores from 0 to 1 y of age and consumption of select nutrients and UPFs at different time points in low-income children aged 2-5 y. METHODS: Dietary surveys and 24-h dietary recalls collected between ages 0 and 12 months from 2613 Special Supplemental Women, Infants, and Children Infant Toddler Feeding Practices Study-2 participants were used to assess infant diet quality by final IDQI score ranging from 0 (nonadherence to dietary guidelines) to 1 (complete adherence to guidelines). Single 24-h recalls collected across multiple time points per child aged between 2 and 5 y were used to determine nutrient intakes: vitamin B12 (μg), vitamin D (μg), calcium (mg), iron (mg), zinc (mg), potassium (mg), saturated fat (g), dietary fiber (g), and added sugars (g). Likewise, Nova was used to classify foods (to estimate the percentage of energy from foods) by level of industrial processing at each point in time across ages 2-5 y. Survey-weighted regression analyses estimated associations between total IDQI score and nutrient intake and percentage of energy consumption from each Nova food group at each age between 2-5 y. RESULTS: IDQI scores based on diet quality from 0-1 y of age were positively associated with childrens dietary fiber and potassium intake at ages 2-5 y. Additionally, IDQI was negatively associated with added sugar intake. No associations were observed between IDQI and saturated fat consumption. IDQI scores at age 1 were positively associated with the percentage of energy attributed to unprocessed/minimally processed foods (20%-23%) and negatively associated with UPF consumption at ages 2-5 y (-24% to -29%). CONCLUSIONS: IDQI predicts intake of select nutrients and UPF consumption among low-income US children aged 2-5 y.This trial was registered at https://clinicaltrials.gov/study/NCT02031978 as Feeding My Baby - A National WIC Study, NCT02031978.

The tauopathies are defined by pathological tau protein aggregates within a spectrum of clinically heterogeneous neurodegenerative diseases. The primary tauopathies meet the definition of rare diseases in the United States. There is no approved treatment for primary tauopathies. In this context, designing the most efficient development programs to translate promising targets and treatments from preclinical studies to early-phase clinical trials is vital. In September 2022, the Rainwater Charitable Foundation convened an international expert workshop focused on the translation of tauopathy therapeutics through early-phase trials. Our report on the workshop recommends a framework for principled drug development and a companion lexicon to facilitate communication focusing on reproducibility and achieving common elements. Topics include the selection of targets, drugs, biomarkers, participants, and study designs. The maturation of pharmacodynamic biomarkers to demonstrate target engagement and surrogate disease biomarkers is a crucial unmet need. HIGHLIGHTS: Experts provided a framework to translate therapeutics (discovery to clinical trials). Experts focused on the "5 Rights" (target, drug, biomarker, participants, trial). Current research on frontotemporal degeneration, progressive supranuclear palsy, and corticobasal syndrome therapeutics includes 32 trials (37% on biologics) Tau therapeutics are being tested in Alzheimer's disease; primary tauopathies have a large unmet need.

BACKGROUND: Community health workers (CHWs) can support patient engagement in care for a variety of health conditions, including HIV. This paper reports on the experiences of HIV clinics and health departments that integrated CHWs into their health systems as part of a capacity-building initiative to address HIV-related disparities in the United States. METHODS: Semi-structured interviews were conducted with key informants (n = 14) in two Ryan White HIV/AIDS program jurisdictions: Mississippi (jurisdiction covers the entire state) and the city of New Orleans, Louisiana. This work was part of a larger evaluation of an initiative that used a Learning Collaborative model to facilitate the implementation of evidence-informed interventions to address HIV care continuum gaps in four jurisdictions. The two jurisdictions that focused on integrating CHWs into HIV care clinics and support service agencies were selected for this sub-analysis. Interview participants included HIV clinic leaders and staff, health department leaders, and other Learning Collaborative leaders. Interview transcripts were coded and analyzed for themes related to the acceptability, feasibility, and perceived impact of CHW integration. RESULTS: Overall, participants expressed interest in having support from CHWs at HIV clinics and service agencies to assist with patient retention and engagement efforts. However, there were challenges integrating CHWs into existing systems (e.g., gaining access to electronic health records, changing policies to conduct home visits, and clarifying roles and scope of work). Negotiating contracts and accessing funding for CHW positions presented major challenges that often contributed to turnover and conflicts around scope of practice. When health departments leveraged existing funding streams to support CHW positions, the clinics and agencies where the CHWs worked had limited flexibility over the hiring process. CONCLUSIONS: Our findings reinforce the value and acceptability of CHWs as part of the workforce in HIV clinical and support service settings; however, integrating CHWs into clinics and service agencies required effort. Training the CHWs was not sufficient; other staff and clinicians had to understand the role of CHWs to facilitate their integration into health systems. Resources are needed to support organizations in incorporating CHWs effectively, and long-term, flexible sources of funding are necessary for these positions.

PurposeElectronic health records (EHRs) contain a vast amount of clinical data. Improved automated classification approaches have the potential to accurately and efficiently identify patient cohorts for research. We evaluated if a rule-based natural language processing (NLP) algorithm using clinical notes performed better for classifying proliferative diabetic retinopathy (PDR) and nonproliferative diabetic retinopathy (NPDR) severity compared with International Classification of Diseases, ninth edition (ICD-9) or 10th edition (ICD-10) codes.DesignCross-sectional study.SubjectsDeidentified EHR data from an academic medical center identified 2366 patients aged ≥18 years, with diabetes mellitus, diabetic retinopathy (DR), and available clinical notes.MethodsFrom these 2366 patients, 306 random patients (100 training set, 206 test set) underwent chart review by ophthalmologists to establish the gold standard. International Classification of Diseases codes were extracted from the EHR. The notes algorithm identified positive mention of PDR and NPDR severity from clinical notes. Proliferative diabetic retinopathy and NPDR severity classification by ICD codes and the notes algorithm were compared with the gold standard. The entire DR cohort (N = 2366) was then classified as having presence (or absence) of PDR using ICD codes and the notes algorithm.Main outcome measuresSensitivity, specificity, positive predictive value (PPV), negative predictive value, and F1 score for the notes algorithm compared with ICD codes using a gold standard of chart review.ResultsFor PDR classification of the test set patients, the notes algorithm performed better than ICD codes for all metrics. Specifically, the notes algorithm had significantly higher sensitivity (90.5% [95% confidence interval 85.7, 94.9] vs. 68.4% [60.4, 75.3]), but similar PPV (98.0% [95.4-100] vs. 94.7% [90.3, 98.3]) respectively. The F1 score was 0.941 [0.910, 0.966] for the notes algorithm compared with 0.794 [0.734, 0.842] for ICD codes. For PDR classification, ICD-10 codes performed better than ICD-9 codes (F1 score 0.836 [0.771, 0.878] vs. 0.596 [0.222, 0.692]). For NPDR severity classification, the notes algorithm performed similarly to ICD codes, but performance was limited by small sample size.ConclusionsThe notes algorithm outperformed ICD codes for PDR classification. The findings demonstrate the significant potential of applying a rule-based NLP algorithm to clinical notes to increase the efficiency and accuracy of cohort selection for research.Financial disclosuresProprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

INTRODUCTION: The prevalence of neural tube defects (NTDs) is higher in Ethiopia than most other countries, and ~84% of Ethiopian women of reproductive age (WRA) have folate insufficiency, a major risk factor for NTDs. Salt fortification with folic acid is a potential strategy to improve womens folate status, but data are needed on the acceptability, nutritional impact and safety of folic acid fortification of iodised salt. METHODS AND ANALYSIS: The study is designed as a community-based, household-randomised, dose-response trial. A total of 360 non-pregnant WRA 18-49 years of age will be randomly assigned to one of three intervention arms: (1) iodised salt fortified with 30 ppm folic acid to provide ~200 µg folic acid/day; (2) iodised salt fortified with 90 ppm folic acid to provide ~600 µg folic acid/day; or (3) iodised salt (comparator). The preweighed salts will be delivered to participants homes biweekly for 26 weeks; unused salt will be collected and weighed. Fasting, venous blood samples will be collected at baseline, end line and a randomly assigned intermediate time point for assessment of folate, iodine, vitamin B12 and other micronutrient status biomarkers. Womens dietary intakes, including discretionary salt consumption, will be measured using weighed food records; 24-hour urine specimens will be analysed for sodium and iodine excretion. Primary outcomes are womens consumption of study salts, change in biomarkers of folate and iodine status and prevalence of adverse events. Results will be analysed using analysis of covariance models to estimate group mean differences for continuous outcomes, controlling for baseline measurements, and log-binomial or modified Poisson regressions for categorical outcomes. Prespecified effect modifications will be explored. ETHICS AND DISSEMINATION: The study has been approved by the Ethiopian Public Health Institutes Institutional Review Board, and the protocol has been registered with ClinicalTrials.gov (registration number NCT06223854). Study results will be published in open access scientific journals and disseminated nationally in Ethiopia. TRIAL REGISTRATION NUMBER: NCT06223854.

Inquiries into properties of brain structure and function have progressed due to developments in magnetic resonance imaging (MRI). To sustain progress in investigating and quantifying neuroanatomical details in vivo, the reliability and validity of brain measurements are paramount. Quality control (QC) is a set of procedures for mitigating errors and ensuring the validity and reliability of brain measurements. Despite its importance, there is little guidance on best QC practices and reporting procedures. The study of hippocampal subfields in vivo is a critical case for QC because of their small size, inter-dependent boundary definitions, and common artifacts in the MRI data used for subfield measurements. We addressed this gap by surveying the broader scientific community studying hippocampal subfields on their views and approaches to QC. We received responses from 37 investigators spanning 10 countries, covering different career stages, and studying both healthy and pathological development and aging. In this sample, 81% of researchers considered QC to be very important or important, and 19% viewed it as fairly important. Despite this, only 46% of researchers reported on their QC processes in prior publications. In many instances, lack of reporting appeared due to ambiguous guidance on relevant details and guidance for reporting, rather than absence of QC. Here, we provide recommendations for correcting errors to maximize reliability and minimize bias. We also summarize threats to segmentation accuracy, review common QC methods, and make recommendations for best practices and reporting in publications. Implementing the recommended QC practices will collectively improve inferences to the larger population, as well as have implications for clinical practice and public health.

Study designRetrospective cohort study of prospectively accrued data.ObjectiveTo evaluate a large, prospective, multicentre dataset of surgically treated degenerative cervical myelopathy (DCM) cases on the contemporary risk of C5 palsy with surgical approach.Summary of background dataThe influence of surgical technique on postoperative C5 palsy after decompression for DCM is intensely debated. Comprehensive, covariate-adjusted analyses are needed using contemporary data.MethodsPatients with moderate to severe DCM were prospectively enrolled in the multicenter, randomized, Phase III CSM-Protect clinical trial and underwent either anterior or posterior decompression between Jan 31, 2012 and May 16, 2017. The primary outcome was the incidence of postoperative C5 palsy, defined as the onset of muscle weakness by at least one grade in manual muscle test at the C5 myotome with slight or absent sensory disruption after cervical surgery. Two comparative cohorts were made based on the anterior or posterior surgical approach. Multivariate hierarchical mixed-effects logistic regression was used to estimate odds ratios (OR) with 95% confidence intervals (CI) for C5 palsy.ResultsA total of 283 patients were included, and 53.4% underwent posterior decompression. The total incidence of postoperative C5 palsy was 7.4% and was significantly higher in patients who underwent posterior decompression compared with anterior decompression (11.26% vs. 3.03%, P =0.008). After multivariable regression, the posterior approach was independently associated with greater than four times the likelihood of postoperative C5 palsy ( P =0.017). Rates of C5 palsy recovery were comparable between the two surgical approaches.ConclusionThe odds of postoperative C5 palsy are significantly higher after posterior decompression compared to anterior decompression for DCM. This may influence surgical decision-making when there is equipoise in deciding between anterior and posterior treatment options for DCM.Level of evidenceTherapeutic Level-II.

Mozambique is making progress towards elimination of trachoma as a public health problem, but in some districts trachomatous inflammation-follicular (TF) prevalence remains above the 5% elimination threshold despite years of various interventions, including antibiotic mass drug administration. To characterize transmission in four districts, we incorporated testing of ocular infection and serology into routine trachoma impact surveys (TIS) in August 2022. We examined residents aged ≥ 1 year for trachoma and collected information on household water, sanitation, and hygiene. Among children aged 1-9 years, we tested conjunctival swabs for Chlamydia trachomatis nucleic acid and dried blood spots for C. trachomatis antibodies. We modeled age-dependent seroprevalence to estimate seroconversion rate (SCR). We examined 4841 children aged 1-9 years. TF prevalence ranged between 1.1 and 6.0% with three districts below the 5% threshold. PCR-confirmed infection prevalence ranged between 1.1 and 4.8%, and Pgp3 seroprevalence ranged between 8.8 and 24.3%. Pgp3 SCR was 1.9 per 100 children per year in the district with the lowest TF prevalence. Two other districts with TF

INTRODUCTION: It remains uncertain whether Descemet membrane endothelial keratoplasty (DMEK) or Descemet stripping only (DSO) yields better outcomes in patients with symptomatic Fuchs endothelial corneal dystrophy (FECD). This paper presents the protocol for the Descemet Endothelial Thickness Comparison Trial II (DETECT II), a multicentre, outcome-masked, randomised, placebo-controlled, clinical trial comparing DMEK to DSO with ripasudil (DSO-R) for this patient population. METHODS AND ANALYSIS: A total of 60 patients with endothelial dysfunction due to symptomatic FECD will be enrolled from seven participating sites in the USA. The patients will be randomly assigned in a 1:1 ratio to one of the following treatment groups: group 1-DMEK plus topical placebo and group 2-DSO plus topical ripasudil 0.4%. The enrolment period is 24 months. The primary outcome is best spectacle-corrected visual acuity at 12 months. Secondary outcomes include peripheral and central endothelial cell density, visual acuity, vision-related quality of life and Pentacam Scheimpflug tomography. Study outcomes will be analysed using mixed effects linear regression. Adverse events, including rebubble procedures, endothelial failure and graft rejection, will be documented and analysed using appropriate statistical methods. DETECT II aims to provide evidence on the comparative effectiveness of DMEK and DSO-R. The results of this trial will contribute to optimising the treatment of FECD, while also exploring the cost-effectiveness of these interventions. Dissemination of findings through peer-reviewed publications and national/international meetings will facilitate knowledge translation and guide clinical practice in the field of corneal transplantation. ETHICS AND DISSEMINATION: A data and safety monitoring committee has been empanelled by the National Eye Institute. All study protocols will be subject to review and approval by WCG IRB as the single IRB of record. This study will comply with the National Institute of Health (NIH) Data Sharing Policy and Policy on the Dissemination of NIH-Funded Clinical Trial Information and the Clinical Trials Registration and Results Information Submission rule. Data from the trial will be made available on reasonable request. TRIAL REGISTRATION NUMBER: NCT05275972.