We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The Philippines, being prone to natural disasters, often faces challenges in securing real-time data, hindering effective decision-making. In response, the Philippine Emergency Medical Assistance Team (PEMAT) of Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium (DJNRMHS) developed the PEMAT Information System (PIS) to enhance real-time reporting and support the functions of EMT-Type 1 Fixed facilities during disaster responses. The PIS was successfully launched and fully implemented during the 7.8 Magnitude Earthquake in Türkiye in February 2023.
Objectives:
The PIS aims to enhance the efficiency and effectiveness of Emergency Medical Team (EMT) Type-1 facilities, improve healthcare service quality and patient safety, and deliver real-time data to stakeholders like the Emergency Medical Teams Coordination Cell (EMTCC) and local government agencies for informed planning and action. It also assists in patient tracking during disaster response and recovery phases.
Method/Description:
During the Türkiye earthquake response from February 11-24, 2023, PEMAT used the PIS for data collection and reporting per international standards like the International Classification of Diseases and the EMT Minimum Data Set. Timely reports on patient numbers were provided to the EMTCC.
Results/Outcomes:
PEMAT catered to 1,022 patients, primarily aged 18-64 (68.59%), with a majority (54.60%) being male. The top reasons for consultation were Acute Upper Respiratory Infection (36.30%), Minor Injury (6.36%), and Skin Disease (6.07%). Notably, 74.16% of cases were unrelated to the earthquake. Timely reporting to the EMT MDS Portal earned commendation from the EMTCC.
Conclusion:
The PIS significantly improved healthcare service quality and provided crucial real-time data for decision-making during disaster response and recovery.
Rates of childhood mental health problems are increasing in the UK. Early identification of childhood mental health problems is challenging but critical to children’s future psychosocial development. This is particularly important for children with social care contact because earlier identification can facilitate earlier intervention. Clinical prediction tools could improve these early intervention efforts.
Aims
Characterise a novel cohort consisting of children in social care and develop effective machine learning models for prediction of childhood mental health problems.
Method
We used linked, de-identified data from the Secure Anonymised Information Linkage Databank to create a cohort of 26 820 children in Wales, UK, receiving social care services. Integrating health, social care and education data, we developed several machine learning models aimed at predicting childhood mental health problems. We assessed the performance, interpretability and fairness of these models.
Results
Risk factors strongly associated with childhood mental health problems included age, substance misuse and being a looked after child. The best-performing model, a gradient boosting classifier, achieved an area under the receiver operating characteristic curve of 0.75 (95% CI 0.73–0.78). Assessments of algorithmic fairness showed potential biases within these models.
Conclusions
Machine learning performance on this prediction task was promising. Predictive performance in social care settings can be bolstered by linking diverse routinely collected data-sets, making available a range of heterogenous risk factors relating to clinical, social and environmental exposures.
Objectives/Goals: Unsafe sleep practices contribute to sleep-related infant mortality, a leading cause of preventable sudden unexplained infant death (SUID). Infant illness represents a risk for SUID. However, the mechanism behind this increased risk is unknown. The objective of this study was to measure changes to safe sleep practices during infant illness. Methods/Study Population: We performed a prospective cohort survey study of infants aged 0–12 months presenting to the pediatric emergency department. We assessed sleep practices prior to illness, during illness, and 2 weeks and 1 month following illness. We assessed adherence to American Academy of Pediatrics safe sleep recommendations at each point in time. Wilcoxon sign rank test was used to examine changes between time points. Regression models compared caregivers who reported a change to unsafe sleep practices with those who did not. Results/Anticipated Results: Of enrolled participants (n = 142), 110 (77%) completed all three follow-up surveys. For those with complete follow-up, 62.4% were female, 60.3% were Black, non-Hispanic, 25.7% were White, non-Hispanic. The most common chief complaint was respiratory illness (35.7%), followed by fever (22.7%), and 70.3% of patients were discharged home. Across all sleep behaviors surveyed, caregivers reported, on average, a 12% change to unsafe sleep practices during illness. These changes were sustained at the 2-week and 1-month follow-ups. Factors associated with a change to unsafe sleep practice were parental age. Discussion/Significance of Impact: Over 10% of infants experienced a change to unsafe sleep practices during illness, sustained at 2-week and 1-month follow-ups. This may explain the association of infant illness with SUID. Interventions promoting safe sleep adherence during illness are key to decreasing sleep-related infant mortality.
Objectives/Goals: Academic research centers struggle to recruit and retain a diverse, competent clinical and translational science (CTS) workforce. The clinical research professional career pathway is particularly underrecognized among undergraduates, despite offering multiple career opportunities. Methods/Study Population: To address these challenges, two undergraduate outreach programs were developed. First, an undergraduate certificate program in CTS (UC-CTS) was designed to equip students with the skills and knowledge needed to enter the workforce immediately after graduation. Second, a “CTS Roadshow” was launched to build awareness of CTS careers within a variety of undergraduate programs and majors. In this recruitment initiative, principal investigators (PIs) and CRPs visit classrooms to share information about CTS career pathways and offer insights into the roles, responsibilities, and professional opportunities available in the field. Results/Anticipated Results: The UC-CTS program launched in Fall 2024 as a 12-credit certificate that includes two paid internships: one in patient care and one in research. Currently, the program has 5 students enrolled with an anticipated increase in enrollment to 20 students by Spring 2025. Similarly, the CTS Roadshow has reached an increasing number of students each year. Since its inception in Spring 2023, the CTS Roadshow has introduced over 750 undergraduates across 21 courses to CTS careers. The CTS Roadshow has engaged students from a variety of majors, including biology, psychology, medical sciences, legal, finance, accounting, and pre-health programs, increasing awareness of and interest in CTS careers. Discussion/Significance of Impact: Both programs aim to expose students to CTS careers early in their education, better preparing them for full-time CTS roles after graduation. A rise in qualified applicants pursuing CTS careers locally and regionally is expected, improving job satisfaction and retention through enhanced preparation for the career field.
Patients with Opioid Use Disorder (OUD) are prone to Multidrug-Resistant Organism (MDRO) colonization and infections, thus at risk for worse outcomes during critical illness. Understanding the prevalence and predictors of MDRO infections is essential to optimize interventions and treatments.
Design:
Retrospective cohort study.
Methods:
The study evaluated the prevalence of MDRO isolation among adults with OUD admitted to an intensive care unit (ICU) between January 1, 2018, and July 31, 2023. It included adults admitted to an ICU with bacterial infections and positive cultures obtained within 48 hours of admission. Demographics, clinical traits, and MDRO isolation rates were analyzed using descriptive statistics, univariate methods, and Least Absolute Shrinkage and Selection Operator (LASSO) regression.
Results:
MDRO isolation occurred in 178 of 790 patients (22.5%), with methicillin-resistant Staphylococcus aureus as the most frequently isolated organism. LASSO regression identified housing insecurity (OR: 1.79, 95% CI 1.09–2.93, P = .022), no receipt of medications for OUD treatment (OR: 1.56, 95% CI 1.06–2.29, P = .023), positive hepatitis C virus (HCV) status (OR: 2.19, 95% CI 1.19–4.03, P = .012), and intravenous antibiotic use in the prior 90 days (OR: 1.04 per 24 h, 95% CI 1.01–1.07, P = .007) as significant predictors of MDRO isolation.
Conclusions:
The study highlights a high prevalence of MDRO isolation in critically ill OUD patients admitted for infection-related issues with positive cultures obtained within 48 hours of admission, influenced by factors like housing insecurity, no receipt of medications for OUD treatment, HCV status, and prior antibiotic use.
Changing sea-ice conditions have significant societal impacts and implications across Alaska and the Arctic. This research examined the relationship between sea ice and extreme weather events with socio-economic impacts in Nome, Alaska (1990–2020), a community that has experienced notable changes in sea ice and impacts from extreme weather events. The research is based on the analysis of sea-ice concentrations from passive microwave data, socio-economic impacts of extreme weather events from an archival analysis of newspaper coverage, and an examination of the relationship between sea-ice concentrations and impacts. We found that sea-ice concentrations at the time of the reported socio-economic impacts were all characterised by ice-free conditions. Additionally, extreme events linked to socio-economic impacts occurred when sea-ice concentrations were at or below their historical (1979–2000) median for the day. Key implications for the observed increased probability of ice-free conditions in the autumn include a greater likelihood that a given coastal storm from November to mid-December may contribute to socio-economic impacts, which may have been mitigated by sea ice in the past, as well as an increased potential for impacts to occur when they have previously not been experienced.
To retrospectively observe procalcitonin (PCT) and antibiotic ordering practices in patients hospitalized with community-acquired pneumonia (CAP).
Design:
Retrospective, exact matched, multicenter cohort study from October 1, 2018 – March 31, 2023.
Setting:
All hospitals across the Mayo Clinic Enterprise.
Participants:
Adult patients with CAP, identified using pneumonia diagnosis codes and receipt of systemic antibiotics with an indication of “respiratory tract infection” within 48 hours of hospitalization.
Methods:
PCT testing within the first 7 days of hospitalization was compared to non-PCT care (nPCT). The primary outcomes were treatment duration, antibiotic days of therapy (DOT), and length of stay (LOS).
Results:
15364 patients met inclusion criteria. PCT testing occurred in 42.4% (6515/15364) of encounters, totaling 8214 PCT results. 12880 unique patient encounters were matched 1:1, 6440 in each group. Treatment duration was longer in the PCT group compared to the nPCT group (5.1 vs 4.6 days, respectively, P < 0.001). Patients in the PCT group also received more DOT (8.6 vs 7.6 DOT, P < 0.001) and had a longer LOS (6.8 vs 5.9 days, P < 0.001), respectively. There was no difference in 30-day all-cause mortality or C. difficile infection between groups. In a sensitivity analysis of nPCT patients compared to those with a peak value <0.25 ng/mL (i.e. normal result) there was no difference in treatment duration (4.6 days nPCT vs 4.7 days normal PCT, P = 0.104) or LOS (5.9 days nPCT vs 6.0 days normal PCT, P = 0.134).
Conclusion:
PCT testing in patients hospitalized with CAP was not associated with reduced antimicrobial utilization, LOS, or 30-day all-cause mortality.
Australia’s botanical diversity has shaped its literature of the environment. Through a selection of novels, short stories, and poetry, this overview focuses on the literary depiction of native species such as the coolabah, paperbark, and wattle. Structured chronologically, the discussion begins with Indigenous Australian narratives of plants, arguably the world’s oldest literary representations of botanical life. In the narratives of Aboriginal and Torres Strait Islander people, plants are wellsprings of material and spiritual sustenance. Between British settlement and Federation, non-Indigenous narratives of Australian flora begin to appear. In these decades, literature negotiates the strangeness of antipodean plants in comparison to familiar European species. In post-Federation literature, the relationship between flora and nation becomes more pronounced. During this period, writers increasingly foreground the clearance of forests in the post-colonial state. Contemporary literature reveals an expanded understanding of plant ecologies and conservation realities. The work of Judith Wright and Oodgeroo Noonuccal during these years establishes a precedent for later literary activism. The Anthropocene literature of recent decades confronts humanity’s escalating impacts on plants especially in Australian regions. Literary works critique climate disturbance, habitat degradation, urban development, and related exigencies that continue to imperil the future of plants in Australia.
Weekly cycles in emotion were examined by combining item response modeling and spectral analysis approaches in an analysis of 179 college students' reports of daily emotions experienced over 7 weeks. We addressed the measurement of emotion using an item response model. Spectral analysis and multilevel sinusoidal models were used to identify interindividual differences in intraindividual cyclic change. Simulations and incomplete data designs were used to examine how well this combination of analysis techniques might work when applied to other practical data problems. Empirically, we found systematic individual differences in the extent to which individuals' emotions follow a weekly cycle, and in how such cycles are exhibited. Weekly cycles accounted for very little variance in day to day emotions at the individual level. Analytically, we illustrate how measurement, change, and interindividual difference models from different traditions may be combined in a practical manner to describe some of the complexities of human behavior.
Improving access to and quality of maternal and infant healthcare are important leverage points to address worsening maternal and infant health disparities in the USA. This study evaluates the comprehensiveness of existing maternal and infant quality-of-care measures to identify aspects of quality that need greater attention in quality measurement.
Study design:
We conducted a structured, team-based qualitative review of 88 maternal and infant health measures indexed by the National Quality Forum (NQF), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare and Medicaid Services (CMS), and the National Committee for Quality Assurance (NCQA). We assessed discrete elements relevant to meaningfulness, feasibility, and usability following AHRQ National Quality Strategy (NQS) criteria, with input from researcher, clinician, and citizen scientist investigators. Descriptive statistics on coded measures were calculated using SPSS.
Results:
The most common AHRQ NQS priorities addressed were mortality (60%) and safety (48%). Average scores across elements were 59% for feasibility, 61% for practice usability, and 31% for policy usability. Fewer measures addressed coordination, affordability, or patient engagement in the postpartum period. Only 23% of measures were endorsed by NQF, only 17% of measures had publicly available benchmarks, and only 14% had specifications updated in the year prior to review.
Conclusions:
Findings from this study can inform the specification of a comprehensive, updated system for maternal and infant quality-of-care evaluation and can facilitate the development of new quality-of-care measures that address underrepresented maternal and infant health issues.
In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.
Methods:
A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.
Results:
We performed 1,351 transfusions in 16 months. The transparency of the digital inventory at each site was critical to facilitate qualification, randomization, and overnight shipments of blood group-compatible plasma for transfusions into trial participants. While inventory challenges were heightened with COVID-19 convalescent plasma, the cloud-based system, and the flexible approach of the plasma coordination center staff across the blood bank network enabled decentralized procurement and distribution of investigational products to maintain inventory thresholds and overcome local supply chain restraints at the sites.
Conclusion:
The rapid creation of a plasma coordination center for outpatient transfusions is infrequent in the academic setting. Distributing more than 3,100 plasma units to blood banks charged with managing investigational inventory across the U.S. in a decentralized manner posed operational and regulatory challenges while providing opportunities for the plasma coordination center to contribute to research of global importance. This program can serve as a template in subsequent public health emergencies.
Countries frequently use health technology assessment (HTA) to set priorities for introducing new interventions or evaluating existing interventions; however, applying the tool effectively is heavily dependent on a country’s resources and capacity. Infrastructure and data, technical expertise, broad stakeholder involvement, and financial support are required to improve HTA processes. In the Asia-Pacific, HTAsiaLink was established to facilitate this practice, but strengthening and legitimizing this organization are needed to maximize its potential to support HTA institutionalization in the region. To realize this objective, HTAsiaLink can serve as a center of excellence while providing experiential learning and sharing information. As a learning hub, HTAsiaLink can share resources—particularly data—that can contribute to joint HTAs as done in the European Union and strengthen capacity in countries needing to develop their HTA expertise.
Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk.
Methods
Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11–36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones.
Results
Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20).
Conclusions
Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.
OBJECTIVES/GOALS: The goals of the present study were to examine levels and potential changes in oxytocin and HPL over the course of pregnancy. We assessed the potential predictive value of oxytocin and HPL on maternal-fetal attachment, anxiety and depression at three timepoints during pregnancy. METHODS/STUDY POPULATION: Pregnant women (n=70) enrolled in a longitudinal, rolling protocol study. Eligibility criteria included 1) singleton pregnancy confirmed at early pregnancy screen (EPS) ultrasonography, 2) mother aged 19 or greater, and 3) fluent in English. Predictors (oxytocin and HPL levels) were measured via blood draws at the same three times (early-stage, mid-stage, and late-stage) that MFA, anxiety and depression questionnaires were completed. RESULTS/ANTICIPATED RESULTS: An increased OT level compared to a mother’s average OT level did not have a statistically significant effect on MFA (within-person estimate = 0.02, 95% CI: -0.03 to 0.05, p = 0.427. An increased HPL level compared to a patient’s average HPL level did not have a statistically significant effect on MFA (within-person estimate = -0.10, 95% CI: -0.67 to 0.47, p = 0.730). The main effect of between-person HPL was significant; such that a one-unit increase in average HPL level was associated with a 0.52 higher anxiety score (between-person 95% CI: 0.08 to 0.96, p = 0.022). The main effect of between-person HPL was significant, such that an increased average HPL level was associated with a 0.45 higher depression score (between-person estimate = 0.45, 95% CI: 0.04 to 0.86, p=0.031). DISCUSSION/SIGNIFICANCE: To our knowledge, our study is the first to measure HPL and MFA over the course of a pregnancy. At this point, perhaps the best we can say is that HPL is a promising new target hormone that may be related to psychological symptoms surrounding pregnancy.
We review successes and challenges from five recent subglacial bedrock drilling campaigns intended to find evidence for Antarctic Ice Sheet retreat during warm periods in the geologic past. Insights into times when the polar ice sheets were smaller than present serve as guiding information for modeling efforts that aim to predict the rate and magnitude of future sea level rise that would accompany major retreat of the Antarctic Ice Sheet. One method to provide direct evidence for the timing of deglaciations and minimum extent of prior ice sheets is to extract subglacial bedrock cores for cosmogenic nuclide analysis from beneath the modern ice sheet surface. Here we summarize the lessons learned from five field seasons tasked with obtaining bedrock cores from shallow depths (<120 m beneath ice surface) across West Antarctica since 2016. We focus our findings on drilling efforts and technology and geophysical surveys with ground-penetrating radar. Shallow subglacial drilling provides a high risk, high reward means to test for past instabilities of the Antarctic Ice Sheet, and we highlight key challenges and solutions to increase the likelihood of success for future subglacial drilling efforts in polar regions.
In recent decades, the term “politics” has become almost synonymous with conflict. Results from eight studies show that individuals averse to conflict tend to select out of surveys and discussions explicitly labeled as “political.” This suggests that the inferences researchers draw from “political” surveys, as well as the impressions average Americans draw from explicitly “political” discussions, will be systematically biased toward conflict. We find little evidence that these effects can be attenuated by emphasizing deliberative norms. However, conflict averse individuals are more willing to discuss ostensibly political topics such as the economy, climate change, and racial inequality, despite reluctance to discuss “politics” explicitly. Moreover, they express greater interest in politics when it is defined in terms of laws and policies and debate is deemphasized. Overall, these findings suggest the expectation of conflict may have a self-fulfilling effect, as contexts deemed explicitly “political” will be composed primarily of conflict seekers.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
This chapter introduces themes that recur throughout this book, and reflects on a collection of topics that are covered. One key theme concerns the common areas and differences in people’s responses and needs before, during, and after emergencies, incidents, disasters, and disease outbreaks (EIDD). It presents a strategic approach to meeting people’s mental health needs. Four areas common to EIDD are identified. First, preparedness before EIDD is critical to shaping how societies, communities, families, and people respond and recover. Second, a wide range of stressors have impacts on people affected by EIDD, and adversity and socioeconomic disadvantage play substantial parts in how people react, cope, and adapt. Third, the impacts of displacement are huge. Fourth, the wellbeing, psychosocial, and mental health agendas of care are extremely important aspects of the care that is required to meet the needs of survivors of EIDD and, often, those of their relatives.
The effects of maternal postpartum depression (PPD) on offspring emotion regulation (ER) are particularly deleterious as difficulties with ER predict an increased risk of psychopathology. This study examined the impact of maternal participation in a public health nurse (PHN)-delivered group cognitive behavioral therapy (CBT) intervention on infant ER. Mothers/birthing parents were ≥ 18 years old with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10, and infants were < 12 months. Between 2017 and 2020, 141 mother–infant dyads were randomized to experimental or control groups. Infant ER was measured at baseline (T1) and nine weeks later (T2) using two neurophysiological measures (frontal alpha asymmetry (FAA) and high-frequency heart rate variability (HF-HRV)), and informant-report of infant temperament. Mothers were a mean of 30.8 years old (SD = 4.7), 92.3% were married/ common-law, and infants were a mean of 5.4 months old (SD = 2.9) and 52.1% were male. A statistically significant group-by-time interaction was found to predict change in HF-HRV between T1 and T2 (F(1,68.3) = 4.04, p = .04), but no significant interaction predicted change in FAA or temperament. Results suggest that PHN-delivered group CBT for PPD may lead to adaptive changes in a neurophysiological marker of infant ER, highlighting the importance of early maternal intervention.
We present results from a pitcher-catcher experiment utilizing a proton beam generated with nanostructured targets at a petawatt-class, short-pulse laser facility to induce proton-boron fusion reactions in a secondary target. A 45-fs laser pulse with either 400 nm wavelength and 7 J energy, or 800 nm and 14 J, and an intensity of up to 5 × 1021 W/cm2 was used to irradiate either thin foil targets or near-solid density, nanostructured targets made of boron nitride (BN) nanotubes. In particular, for 800 nm wavelength irradiation, a BN nanotube target created a proton beam with about five times higher maximum energy and about ten times more protons than a foil target. This proton beam was used to irradiate a thick plate made of boron nitride placed in close proximity to trigger 11B (p, α) 2α fusion reactions. A suite of diagnostics consisting of Thomson parabola ion spectrometers, postshot nuclear activation measurements, neutron time-of-flight detectors, and differentially filtered solid-state nuclear track detectors were used to measure both the primary proton spectrum and the fusion products. From the primary proton spectrum, we calculated (p, n) and (α,n) reactions in the catcher and compare with our measurements. The nuclear activation results agree quantitatively and neutron signals agree qualitatively with the calculations, giving confidence that primary particle distributions can be obtained from such measurements. These results provide new insights for measuring the ion distributions inside of proton-boron fusion targets.
Drill-interseeding cover crops into corn (Zea mays L.) is an emerging establishment method in northern U.S. production regions. However, cover crop performance in interseeded systems remains variable, and creating environments that are conducive to cover crop but not weed growth is challenging. Cultural practices that partition resources between corn and interseeded cover crops have potential to improve performance if weeds are adequately managed. This study evaluated interactions among corn hybrids differing in leaf architecture (upright, pendulum), corn row spacing (76 cm, 152 cm), and interseeding timing (V3, V6) on light transmittance, relative fitness of cover crop species (cereal rye [Secale cereale L.], annual ryegrass (Lolium multiflorum Lam), red clover [Trifolium pratense L.]) and weeds, and corn grain yield at three U.S. Northeast locations. Results showed that light transmittance through the corn canopy was greater in 152-cm row spacing compared with 76-cm row spacing at the V6 growth stage, with the magnitude of difference increasing at the V10 corn growth stage. Corn hybrids had a marginal effect on light transmittance. The effect of row spacing and interseeding timing on fall cover crop biomass varied across cover crop species and locations. In 76-cm rows, interseeding earlier (V3) increased cover crop biomass production. The relative fitness of cover crops was greater than that of weeds in each combination of cultural practices that included narrow spacing (76 cm), whereas the relative fitness of weeds was greater than that of cover crops when interseeding in wide rows (152 cm). The effect of row spacing on corn yield varied among locations, with higher yields observed in 76-cm row spacing compared with 152-cm at two of three locations. Our results show that interseeding early (V3) on 76-cm row spacing can balance cover crop and corn production management goals, while placing cover crops at a relative fitness advantage over weeds.