Multicenter clinical trials are essential for evaluating interventions but often face significant challenges in study design, site coordination, participant recruitment, and regulatory compliance. To address these issues, the National Institutes of Health’s National Center for Advancing Translational Sciences established the Trial Innovation Network (TIN). The TIN offers a scientific consultation process, providing access to clinical trial and disease experts who provide input and recommendations throughout the trial’s duration, at no cost to investigators. This approach aims to improve trial design, accelerate implementation, foster interdisciplinary teamwork, and spur innovations that enhance multicenter trial quality and efficiency. The TIN leverages resources of the Clinical and Translational Science Awards (CTSA) program, complementing local capabilities at the investigator’s institution. The Initial Consultation process focuses on the study’s scientific premise, design, site development, recruitment and retention strategies, funding feasibility, and other support areas. As of 6/1/2024, the TIN has provided 431 Initial Consultations to increase efficiency and accelerate trial implementation by delivering customized support and tailored recommendations. Across a range of clinical trials, the TIN has developed standardized, streamlined, and adaptable processes. We describe these processes, provide operational metrics, and include a set of lessons learned for consideration by other trial support and innovation networks.

Potato production typically entails both greater soil disturbance and higher profits than alternative crops in the regions in which they are grown. This article provides an analysis of economically relevant outcomes from soil health practice trials conducted in potato production systems in four locations across the continental United States from 2019 to 2022. We compare revenue and profit estimates over several soil health-related practices: rotation duration, chemical fumigation, mustard biofumigation, and application of organic amendments. We find that longer rotations are positively correlated with revenues and profits. This finding is robust across a range of tests and several regression specifications, although we do observe some variation across locations. While in our data, 3-year rotations consistently produced better economic outcomes than 2-year rotations, over time periods longer than the 4 years in this study, at least some of the gains associated with longer rotations will be offset by the implied decreased frequency of potato years. We did not find consistent evidence of differences in revenue or profits corresponding to chemical fumigation, mustard biofumigation, or the application of organic amendments.

This paper aims to give an overview of child and adolescent mental health services (CAMHS) in Aotearoa New Zealand. We provide a brief overview of the demographics of the country and include the most up-to-date epidemiological data on child and adolescent mental health. To meet these psychiatric needs, we consider the present workforce, governance, funding and structure of CAMHS. Current psychiatric practice is heavily influenced by the country's unique history and cultural mix. Aotearoa New Zealand is noted for outstanding epidemiological research.

The significance of Abbo of Fleury’s time in England to the intellectual life of tenth- and eleventh-century Ramsey is widely appreciated. Less well understood is what English monks knew of Fleury’s claims of Abbo’s sanctity. The present article explores knowledge of Abbo’s cult in England through a close study of Oxford, Bodleian MS Lat. misc. c. 75, a twelfth-century witness to Aimo’s Vita et miracula s. Abbonis of which the Life’s editors were unaware. The manuscript is introduced, its textual relationship to the Vita’s other witnesses is examined and a stemma for the Vita’s textual transmission is proposed. Textual interpolations made at Ramsey are then analysed for the additional information which they provide about Abbo’s legacy there before a possible context for the Vita’s transmission to Ramsey is proposed. An appendix of variants between the Ramsey witness and the Vita’s printed edition is also provided.

Daily sodium intake in England is ∼3.3 g/day(1), with government and scientific advice to reduce intake for cardiovascular health purposes having varying success(2). Eccrine sweat is produced during exercise or exposure to warm environments to maintain body temperature through evaporative cooling. Sweat is primarily water, but also contains appreciable amounts of electrolytes, particularly sodium, meaning sweat sodium losses could reduce daily sodium balance without the need for dietary manipulation. However, the effects of sweat sodium losses on 24-h sodium balance are unclear.

Fourteen active participants (10 males, 4 females; 23±2 years, 45±9 mL/kg/min) completed a preliminary trial and two 24-h randomised, counterbalanced experimental trials. Participants arrived fasted for baseline (0-h) measures (blood/urine samples, blood pressure, nude body mass) followed by breakfast and low-intensity intermittent cycling in the heat (∼36⁰C, ∼50% humidity) to turnover ∼2.5% body mass in sweat (EX), or the same duration of room temperature seated rest (REST). Further blood samples were collected post-EX/REST (1.5-3 h post-baseline). During EX, sweat was collected from 5 sites and water consumed to fully replace sweat losses. During REST, participants drank 100 mL/h. Food intake was individually standardised over the 24-h, with bottled water available ad-libitum. Participants collected all urine produced over the 24-h and returned the following morning to repeat baseline measures fasted (24-h). Sodium balance was estimated over the 24-h using sweat/urine losses and dietary intake. Data were analysed using 2-way ANOVA followed by Shapiro-Wilk and paired t-tests/Wilcoxon signed-rank tests. Data are mean (standard deviation).

Dietary sodium intake was 2.3 (0.3) g and participants lost 2.8 (0.3) % body mass in sweat (containing 2.5 (0.9) g sodium). Sodium balance was lower for EX (-2.0 (1.6) g vs -1.0 (1.6) g; P = 0.022), despite lower 24-h urine sodium losses in EX (1.8 (1.2) g vs 3.3 (1.7) g; P = 0.001). PostEX/REST blood sodium concentration was lower in EX (137.6 (2.3) mmol/L vs 139.9 (1.0) mmol/L; P = 0.002) but did not differ at 0-h (P = 0.906) or 24-h (P = 0.118). There was no difference in plasma volume change (P = 0.423), urine specific gravity (P = 0.495), systolic (P = 0.324) or diastolic (P = 0.274) blood pressure between trials over the 24-h. Body mass change over 24-h was not different between trials (REST +0.25 (1.10) %; EX +0.40 (0.68) %; P = 0.663).

Sweat loss through low-intensity exercise resulted in a lower sodium balance compared to rest. Although urine sodium output reduced with EX, it was not sufficient to offset exercise-induced sodium losses. Despite this, body mass, plasma volume and blood sodium concentration were not different between trials, suggesting sodium may have been lost from non-osmotic sodium stores. This suggests sweat sodium losses could be used to reduce sodium balance, although longer studies are required to confirm this thesis.

Migrants and refugees face elevated risks for mental health problems but have limited access to services. This study compared two strategies for training and supervising nonspecialists to deliver a scalable psychological intervention, Group Problem Management Plus (gPM+), in northern Colombia. Adult women who reported elevated psychological distress and functional impairment were randomized to receive gPM+ delivered by nonspecialists who received training and supervision by: 1) a psychologist (specialized technical support); or 2) a nonspecialist who had been trained as a trainer/supervisor (nonspecialized technical support). We examined effectiveness and implementation outcomes using a mixed-methods approach. Thirteen nonspecialists were trained as gPM+ facilitators and three were trained-as-trainers. We enrolled 128 women to participate in gPM+ across the two conditions. Intervention attendance was higher in the specialized technical support condition. The nonspecialized technical support condition demonstrated higher fidelity to gPM+ and lower cost of implementation. Other indicators of effectiveness, adoption and implementation were comparable between the two implementation strategies. These results suggest it is feasible to implement mental health interventions, like gPM+, using lower-resource, community-embedded task sharing models, while maintaining safety and fidelity. Further evidence from fully powered trials is needed to make definitive conclusions about the relative cost of these implementation strategies.

OBJECTIVES/GOALS: Breast cancer survivors who experience psychological and physical symptoms after treatment ends have an increased risk for comorbid disease development, reduced quality of life, and premature mortality. However, survivors in satisfying marriages report lower stress and better health than those in dissatisfying marriages. METHODS/STUDY POPULATION: Research is needed to identify how survivors’ marriages provide these health benefits across the cancer continuum. Including both survivors and their partners’ perspectives can identify key pathways connecting relationships to better health. This study examined survivors’ and their partners’ psychological, physical, and relational health. Breast cancer survivors (stage 0-III) and their partners (n=34 individuals, 17 couples) completed a baseline online survey followed by a 7-day diary study with three ecological momentary assessments across the day. Questionnaires assessed their cancer-related communication, relationship distress, and psychological and physical symptoms. RESULTS/ANTICIPATED RESULTS: Survivors reported poorer sleep quality and greater fatigue than their partners. Survivors also reported disclosing more thoughts, feelings, and information about cancer compared to their partners. For both survivors and partners, feeling more satisfied with each other’s cancer-related discussions and reporting lower relational distress correlated with fewer physical symptoms, sleep problems, fatigue, and psychological distress. DISCUSSION/SIGNIFICANCE: For both survivors and their partners, feeling more satisfied with how often they talked about survivorship and the cancer experience was associated with better psychological and physical health. This research demonstrates the health benefits and importance of open communication for both survivors and their partners across the cancer continuum.