The quality by design (QbD) framework holds promise for improving success rates for completion of clinical studies, which often fail to complete on time. Initially used in manufacturing, the framework is now frequently applied to clinical trials to anticipate risks and avoid challenges that impact study completion or the credibility of results. The Southern California Clinical and Translational Science Institute created and implemented a program based on QbD to increase the success of research studies, including clinical trials and other study designs, being conducted by scholars in our Mentored Career Development Program and awardees in our Pilot Grant Programs. The program’s three components are QbD Design Studios, project management, and team science support. The overall goal is to increase study quality and efficiency, thereby improving study completion success rates and, ultimately, driving innovations in healthcare and public health. The current article describes QbD program elements in detail, along with preliminary results from initial implementation, approaches for evaluating the program’s implementation and impact on study success, and plans to disseminate the program widely.

Underrepresentation of people of color in clinical trials limits equity in research and treatment outcomes. This study evaluated the impact of a brief, community-focused educational intervention on perceptions and willingness to participate. Participants attended 30-minute sessions (9 virtual, 2 in-person). Identical pre- and post-surveys were analyzed using paired t-tests with Bonferroni correction. Eighty-three participants (90.5% Black, 88.4% female; mean age 46.3) showed significant improvements in comfort with participation, randomization, belief in protections, willingness to participate, and comfort in skin-related trials (all p < 0.05). Brief education may improve understanding and participation attitudes in underrepresented groups.

Mixed markets can enhance welfare compared to full public or private provision. However, this welfare gain depends on the extent to which market distortions exist. Recent literature demonstrates distortions in mixed long-term care markets worldwide. Our study explores potential distortions in the Dutch institutional market. While all Dutch residential nursing homes are non-profit, for-profit organisations, including private equity (PE) firms, have increasingly entered the market, offering round-the-clock care provided in home-like settings as an alternative to non-profit residential care.

We analysed claims data from 2017–2021 for dementia patients aged 70 and older using multinomial logit and Cox Proportional Hazards models. Specifically, we compared risk selection, upgrading, and care quality (measured by avoidable hospitalisations and mortality) between for-profit and non-profit providers.

Our findings do not suggest increased risk selection, higher upgrading, or lower care quality by for-profit (PE-owned) providers compared to non-profit providers. Consequently, we did not find evidence of strong market distortions in the Dutch institutional long-term care market. These results contrast with the existing international literature, suggesting that adverse incentives in the Netherlands may be influenced more by the way care is provided (in home-like settings versus in residential nursing homes) and financing structures rather than ownership type alone.

Interrupted aortic arch is a rare congenital heart anomaly characterised by a complete discontinuity between the ascending and descending aorta, accounting for approximately 1–1.5% of CHDs. Its incidence in live births ranges from 3 to 20 per million. Survival into adulthood is only possible with the presence of a well-developed collateral circulation. In this case, a 49-year-old male patient presented with acute anterior myocardial infarction, and during emergency coronary angiography, discontinuity of the aortic arch was noticed. The procedure was successfully completed via radial access after femoral access failed. Subsequent thoracic computed tomography angiography confirmed the diagnosis of Type A interrupted aortic arch and revealed widespread collateral arterial circulation. No blood pressure difference was detected between the right-left arms and lower extremities, and the patient remained asymptomatic. This case demonstrates that this rare anomaly in adults can be incidentally detected during emergency procedures and that radial access is an effective alternative in overcoming anatomical obstacles.

ER&K recurrently emphasize one side of three equations: (1) extrinsic rather than intrinsic mortality pressures; (2) developmental rather than genetic influence; and (3) individual rather than population-level effects. Furthermore, they insufficiently disambiguate extrinsic from intrinsic mortality, especially confounding how mortality evolutionarily constrains and developmentally calibrates genotypic life history speed, and struggle to explain population-level differences in fast maturation among modern populations.

The two-tiered life history model remains inadequate in addressing how social factors (particularly cultural norms and religious beliefs) interact with biological determinants to shape life history strategies. This limitation significantly constrains the model’s explanatory power when applied to certain historical demographic phenomena. We recommend introducing a third explanatory framework (the cultural-institutional tier) to augment the two-tiered model.

Species of the genus Rauschiella are trematodes of frogs and snakes in the Americas. The taxonomy of the group is complex, and most of the 18 currently valid species are known only from the original description. Moreover, genetic data are available only for two North American species (Rauschiella tineri and Rauschiella poncedeleoni). In this context, integrative taxonomy studies are necessary for Rauschiella spp. found in South America. Herein, during a long-term herpetological and helminthological study conducted in Selvíria, Mato Grosso do Sul, Brazil, between 2016 and 2019, 296 anurans from 17 species were necropsied. A plagiorchioid trematode found in the intestine of 7/12 Leptodactylus macrosternum, 10/106 Leptodactylus podicipinus, and 13/20 Pseudis platensis was subject to morphological and molecular characterisation. Samples of the trematodes were studied by optical and scanning electron microscopies and identified as Rauschiella proxima (Freitas, 1941), here reported in new anuran hosts and geographical area. Sequences of the nuclear gene 28S rDNA (1148 bp) were generated and subjected to phylogenetic analysis. Our isolates of R. proxima from Brazil grouped in a well-supported clade with R. poncedeleoni and R. tineri, and genetic divergences to these species were low (0.45% and 0.54%, respectively), supporting the congeneric status among them. However, the addition of a South American representative of Rauschiella and the construction of more comprehensive phylogenetic analyses, including 78 plagiorchioid species from 15 families, did not result in advances concerning the familial level of classification of this genus, which remains as incertae sedis in the superfamily Plagiorchoidea.

Life-history theory is a valuable framework to derive predictions about species-level and population-level adaptations, but it says little about variation between the individuals within a population. Conflating these different aggregate levels constitutes a mereological fallacy and may yield wrong conclusions. I argue that formal models are necessary to disentangle the mechanisms underlying individual-level and population-level variation in life-history traits.

The field of life history “theory” is in a state of heightened entropy; the paper by Ellis, Reid, and Kramer provides a proposal for structuring future research on this topic. I find their proposal a constructive one and describe its potential benefits. Furthermore, I propose several ways in which we can additionally develop the life history framework.

Building upon the two-tiered model of life history strategies introduced by Ellis, Reid, and Kramer (2024), we discuss avenues for future research that apply the theory to sexual and gender minority individuals. We propose that minority stress and suicide exposure may serve as extrinsic ambient mortality cues among sexual and gender minority (SGM) populations. We also identify a feature of pubertal development requiring more consideration.

Violence in early dating relationships can continue into adulthood. The literature usually focuses on the negative effects of violent relationships, but rarely includes the reasons for or antecedents of such behavior. The main objectives of this study were to identify different psychosocial profiles in terms of frustration tolerance and partner dependency and how they are correlated with psychological partner violence, as well as to analyze the justifications for such violence in adolescents and young adults. A total of 69.9% of the final 1044 participants (62.1% girls; age range = 15–22) were involved in a relationship at the time of the evaluation. From a person-centered approach, latent profile analyses yielded three profiles (anxious dependent, low anxious and exclusive dependency, and low exclusive dependency). Significant differences were found between groups, except for the scores between Profiles 2 and 3 in exclusive dependency and anxious attachment between Profiles 3 and 1, with Profile 3 having the highest correlation with violence despite scoring lower in emotional dependency and exclusive dependency than Profile 1. Moreover, significant differences were found among the three groups in terms of violence in the relationship, but all three groups experienced bidirectional violence. The justifications were similar in all three groups, with the concern response being the most reported, together with jealousy in many cases. This research increases knowledge about the psychosocial factors associated with offline and online psychological violence in young couples and allows us to deeply examine the motives that young people express to justify violence in their relationships.

After presenting their two-tier model, Ellis, Reid, and Kramer (2024) tentatively state that child mortality risk should predict offspring quantity, while adult mortality risk should accelerate reproductive timing. I test these assertions using mortality risk and fertility data from the Global Burden of Disease (GBD) project for 204 countries and territories over 32 years, finding partial support for their predictions.

Hierarchical response models are advancing our understanding of the facultative adjustment of development and reproduction to the environment. E, R, and K’s manuscript brings together a vast array of empirical data to support their Tier 2 model highlighting the importance of both the energetic and local mortality environments for reproductive development and timing. We propose that incorporating existing hierarchical response models, as well as analyses from industrial societies, will aid the hunt for underlying mechanisms that embody the local mortality environment impacting reproductive schedules.

This commentary expands Ellis et al.’s 2-tiered life history (LH) model by integrating shyness and insecure attachment as mediators of environmental adaptation. Shyness balances survival-reproduction trade-offs with mixed LH outcomes. Avoidant attachment accelerates LH strategies under harsh conditions; anxious attachment delays reproduction under unpredictable conditions. Incorporating social behaviors, which are related to survival and safety, enhances the model’s applicability across behavioral domains.