New Zealand and Australian governments rely heavily on voluntary industry initiatives to improve population nutrition, such as voluntary front-of-pack nutrition labelling (Health Star Rating [HSR]), industry-led food advertising standards, and optional food reformulation programmes. Research in both countries has shown that food companies vary considerably in their policies and practices on nutrition(1). We aimed to determine if a tailored nutrition support programme for food companies improved their nutrition policies and practices compared with control companies who were not offered the programme. REFORM was a 24-month, two-country, cluster-randomised controlled trial. 132 major packaged food/drink manufacturers (n=96) and fast-food companies (n=36) were randomly assigned (2:1 ratio) to receive a 12-month tailored support programme or to the control group (no intervention). The intervention group was offered a programme designed and delivered by public health academics comprising regular meetings, tailored company reports, and recommendations and resources to improve product composition (e.g., reducing nutrients of concern through reformulation), nutrition labelling (e.g., adoption of HSR labels), marketing to children (reducing the exposure of children to unhealthy products and brands) and improved nutrition policy and corporate sustainability reporting. The primary outcome was the nutrient profile (measured using HSR) of company food and drink products at 24 months. Secondary outcomes were the nutrient content (energy, sodium, total sugar, and saturated fat) of company products, display of HSR labels on packaged products, company nutrition-related policies and commitments, and engagement with the intervention. Eighty-eight eligible intervention companies (9,235 products at baseline) were invited to participate, of whom 21 accepted and were enrolled in the REFORM programme (delivered between September 2021 and December 2022). Forty-four companies (3,551 products at baseline) were randomised to the control arm. At 24 months, the model-adjusted mean HSR of intervention company products was 2.58 compared to 2.68 for control companies, with no significant difference between groups (mean difference -0.10, 95% CI -0.40 to 0.21, p-value 0.53). A per protocol analysis of intervention companies who enrolled in the programme compared to control companies with no major protocol violation also found no significant difference (2.93 vs 2.64, mean difference 0.29, 95% CI -0.13 to 0.72, p-value 0.18). We found no significant differences between the intervention and control groups in any secondary outcome, except in total sugar (g/100g) where the sugar content of intervention company products was higher than that of control companies (12.32 vs 6.98, mean difference 5.34, 95% CI 1.73 to 8.96, p-value 0.004). The per-protocol analysis for sugar did not show a significant difference (10.47 vs 7.44, mean difference 3.03, 95% CI -0.48 to 6.53, p-value 0.09).In conclusion, a 12-month tailored nutrition support for food companies did not improve the nutrient profile of company products.

Here, we explore variation in a new record of archaeological house-floor sizes from the southwestern United States relative to spatially explicit time series estimates of local precipitation. Our results show that inequality becomes more severe during periods of high precipitation. This supports the theory suggesting that inequality may emerge where resources are dense, predictable, and clumped within heterogenous and circumscribed environments. Our findings indicate that wealth inequality may emerge among populations with similar subsistence adaptations as a result of local socioenvironmental variation.

The kinetic stability of collisionless, sloshing beam-ion ($45^\circ$ pitch angle) plasma is studied in a three-dimensional (3-D) simple magnetic mirror, mimicking the Wisconsin high-temperature superconductor axisymmetric mirror experiment. The collisional Fokker–Planck code CQL3D-m provides a slowing-down beam-ion distribution to initialize the kinetic-ion/fluid-electron code Hybrid-VPIC, which then simulates free plasma decay without external heating or fuelling. Over $1$–$10\;\mathrm{\unicode{x03BC} s}$, drift-cyclotron loss-cone (DCLC) modes grow and saturate in amplitude. The DCLC scatters ions to a marginally stable distribution with gas-dynamic rather than classical-mirror confinement. Sloshing ions can trap cool (low-energy) ions in an electrostatic potential well to stabilize DCLC, but DCLC itself does not scatter sloshing beam-ions into the said well. Instead, cool ions must come from external sources such as charge-exchange collisions with a low-density neutral population. Manually adding cool $\mathord {\sim } 1\;\mathrm{keV}$ ions improves beam-ion confinement several-fold in Hybrid-VPIC simulations, which qualitatively corroborates prior measurements from real mirror devices with sloshing ions.

Inflammation and infections such as malaria affect concentrations of many micronutrient biomarkers and hence estimates of nutritional status. We aimed to assess the relationship between malaria infection and micronutrient biomarker concentrations in pre-school children (PSC), school-age children (SAC) and women of reproductive age (WRA) in Malawi and examine the potential role of malarial immunity on the relationship between malaria and micronutrient biomarkers. Data from the 2015/2016 Malawi micronutrient survey were used. The associations between current or recent malaria infection, detected by rapid diagnostic test and concentration of serum ferritin, soluble transferrin receptor (sTfR), zinc, serum folate, red blood cell folate and vitamin B12 were estimated using multivariable linear regression. Factors related to malarial immunity including age, altitude and presence of hemoglobinopathies were examined as effect modifiers. Serum ferritin, sTfR and zinc were adjusted for inflammation using the BRINDA method. Malaria infection was associated with 68 % (95 % CI 51, 86), 28 % (18, 40) and 34 % (13, 45) greater inflammation-adjusted ferritin in PSC, SAC and WRA, respectively (P < 0·001 for each). In PSC, the positive association was stronger in younger children, high altitude and children who were not carriers of the sickle cell trait. In PSC and SAC, sTfR was elevated (+ 25 % (16, 29) and + 15 % (9, 22) respectively, P < 0·001). Serum folate and erythrocyte folate were elevated in WRA with malaria (+ 18 % (3, 35) and + 11 % (1, 23), P = 0·01 and P = 0·003 respectively). Malaria affects the interpretation of micronutrient biomarker concentrations, and examining factors related to malarial immunity may be informative.

The problem of evil is an ideal topic for experimental philosophy. Suffering – which is at the heart of most prominent formulations of the problem of evil – is a universal human experience and has been the topic of careful reflection for millennia. However, interpretations of suffering and how it bears on the existence of God are tremendously diverse and nuanced. Why does suffering push some people toward atheism while pushing others toward deeper faith? What cultural, psychological, or sociological differences account for this diversity of responses? And, importantly, what light might this diversity of responses shed on the problem of evil and how it has been formulated by philosophers in recent years? The aim of this article is to highlight how the tools and resources of experimental philosophy might be fruitfully applied to the problem of evil. In the first section, we review some recent work in this area and describe the current state of this emergent body of literature. In the second section, we review the broader and more recent theoretical developments on the problem of evil. In the final section, we outline some potential areas of future empirical research that we see as especially promising given those developments.

Nearly 100 years ago, economist John Maynard Keynes predicted that, by today, technological advancements would allow the workweek to dwindle to just 15 hours, or 3 hours per day, and that the real problem of humanity would be filling their time with leisure. Although much has changed in the world of work since this prediction, such a drastic change has not taken place. In this article, several industrial-organizational psychology scholars discuss why this is the case. Why do we continue to work as much as we do, and how might that change? More fundamentally, what do these trends, contra Keynes’ prediction, tell us about the nature of work itself? We use this discussion to propose several research directions regarding the nature of work and how it might change in the future. We depict the phenomenon of working hours as multilevel in nature, and we consider both the positive and negative possible implications of working less than we do now.

Inflammation and infections such as malaria affect micronutrient biomarker concentrations and hence estimates of nutritional status. It is unknown whether correction for C-reactive protein (CRP) and α1-acid glycoprotein (AGP) fully captures the modification in ferritin concentrations during a malaria infection, or whether environmental and sociodemographic factors modify this association. Cross-sectional data from eight surveys in children aged 6–59 months (Cameroon, Cote d’Ivoire, Kenya, Liberia, Malawi, Nigeria and Zambia; n 6653) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anaemia (BRINDA) project were pooled. Ferritin was adjusted using the BRINDA adjustment method, with values < 12 μg/l indicating iron deficiency. The association between current or recent malaria infection, detected by microscopy or rapid test kit, and inflammation-adjusted ferritin was estimated using pooled multivariable linear regression. Age, sex, malaria endemicity profile (defined by the Plasmodium falciparum infection prevalence) and malaria diagnostic methods were examined as effect modifiers. Unweighted pooled malaria prevalence was 26·0 % (95 % CI 25·0, 27·1) and unweighted pooled iron deficiency was 41·9 % (95 % CI 40·7, 43·1). Current or recent malaria infection was associated with a 44 % (95 % CI 39·0, 52·0; P < 0·001) increase in inflammation-adjusted ferritin after adjusting for age and study identifier. In children, ferritin increased less with malaria infection as age and malaria endemicity increased. Adjustment for malaria increased the prevalence of iron deficiency, but the effect was small. Additional information would help elucidate the underlying mechanisms of the role of endemicity and age in the association between malaria and ferritin.

The COVID-19 pandemic accelerated the development of decentralized clinical trials (DCT). DCT’s are an important and pragmatic method for assessing health outcomes yet comprise only a minority of clinical trials, and few published methodologies exist. In this report, we detail the operational components of COVID-OUT, a decentralized, multicenter, quadruple-blinded, randomized trial that rapidly delivered study drugs nation-wide. The trial examined three medications (metformin, ivermectin, and fluvoxamine) as outpatient treatment of SARS-CoV-2 for their effectiveness in preventing severe or long COVID-19. Decentralized strategies included HIPAA-compliant electronic screening and consenting, prepacking investigational product to accelerate delivery after randomization, and remotely confirming participant-reported outcomes. Of the 1417 individuals with the intention-to-treat sample, the remote nature of the study caused an additional 94 participants to not take any doses of study drug. Therefore, 1323 participants were in the modified intention-to-treat sample, which was the a priori primary study sample. Only 1.4% of participants were lost to follow-up. Decentralized strategies facilitated the successful completion of the COVID-OUT trial without any in-person contact by expediting intervention delivery, expanding trial access geographically, limiting contagion exposure, and making it easy for participants to complete follow-up visits. Remotely completed consent and follow-up facilitated enrollment.

OBJECTIVES/GOALS: Supported by the State of Alabama, the Alabama Genomic Health Initiative (AGHI) is aimed at preventing and treating common conditions with a genetic basis. This joint UAB Medicine-HudsonAlpha Institute for Biotechnology effort provides genomic testing, interpretation, and counseling free of charge to residents in each of Alabama’s 67 counties. METHODS/STUDY POPULATION: Launched in 2017, as a state-wide population cohort, AGHI (1.0) enrolled 6,331 Alabamians and returned individual risk of disease(s) related to the ACMG SF v2.0 medically actionable genes. In 2021, the cohort was expanded to include a primary care cohort. AGHI (2.0) has enrolled 750 primary care patients, returning individual risk of disease(s) related to the ACMG SF v3.1 gene list and pre-emptive pharmacogenetics (PGx) to guide medication therapy. Genotyping is done on the Illumina Global Diversity Array with Sanger sequencing to confirm likely pathogenic / pathogenic variants in medically actionable genes and CYP2D6 copy number variants using Taqman assays, resulting in a CLIA-grade report. Disease risk results are returned by genetic counselors and Pharmacogenetics results are returned by Pharmacists. RESULTS/ANTICIPATED RESULTS: We have engaged a statewide community (>7000 participants), returning 94 disease risk genetic reports and 500 PGx reports. Disease risk reports include increased predisposition to cancers (n=38), cardiac diseases (n=33), metabolic (n=12), other (n=11). 100% of participants harbor an actionable PGx variant, 70% are on medication with PGx guidance, 48% harbor PGx variants and are taking medications affected. In 10% of participants, pharmacists sent an active alert to the provider to consider/ recommend alternative medication. Most commonly impacted medications included antidepressants, NSAIDS, proton-pump inhibitors and tramadol. To enable the EMR integration of genomic information, we have developed an automated transfer of reports into the EMR with Genetics Reports and PGx reports viewable in Cerner. DISCUSSION/SIGNIFICANCE: We share our experience on pre-emptive implementation of genetic risk and pharmacogenetic actionability at a population and clinic level. Both patients and providers are actively engaged, providing feedback to refine the return of results. Real time alerts with guidance at the time of prescription are needed to ensure future actionability and value.

The social sciences can help provide a deeper understanding of human-farm animal relations. However, social science research exploring problematic human-farm animal interactions can be of a sensitive nature. Studies that carry risks for participants and the researcher are known methodologically as sensitive research. However, there is little discussion in the animal welfare sciences on how best to conduct research of this nature on animal owners, despite recommendations being made for more interdisciplinary collaboration between the animal welfare sciences and social sciences. Drawing on social science research conducted in 2012 on the human element of on-farm animal welfare incidents in the Republic of Ireland, this short communication presents a case study of the sensitivities and challenges involved in carrying out social science research related to farm animal welfare. This communication details the steps involved in recruiting participants, the methodological challenges encountered, and the approaches used to overcome these challenges. Our experience suggests that when conducting socially sensitive research, careful consideration needs to be applied to the recruitment process, and the study design must aim to minimise the potential risks for all involved. Professionals in the field, such as veterinarians, can play an important role in outlining some of the implications involved, and in overcoming research challenges. Understanding the challenges to this form of research will help to maximise research potential.

This commentary expands the discussion of Cesario's Missing Forces Flaw by identifying and discussing variables that influence police shooting decisions but are often absent from bias-based research. Additionally, the closing identifies novel recommendations for future contextually related research.

Italian ryegrass is a major weed in winter cereals in the south-central United States. Harvest weed seed control (HWSC) tactics that aim to remove weed seed from crop fields are a potential avenue to reduce Italian ryegrass seedbank inputs. To this effect, a 4-yr, large-plot field study was conducted in College Station, Texas, and Newport, Arkansas, from 2016 to 2019. The treatments were arranged in a split-plot design. The main-plot treatments were (1) no narrow-windrow burning (a HWSC strategy) + disk tillage immediately after harvest, (2) HWSC + disk tillage immediately after harvest, and (3) HWSC + disk tillage 1 mo after harvest. The subplot treatments were (1) pendimethalin (1,065 g ai ha−1; Prowl H2O®) as a delayed preemergence application (herbicide program #1), and (2) a premix of flufenacet (305 g ai ha−1) + metribuzin (76 g ai ha−1; Axiom®) mixed with pyroxasulfone (89 g ai ha−1; Zidua® WG) as an early postemergence application followed by pinoxaden (59 g ai ha−1; Axial® XL) in spring (herbicide program #2). After 4 yr, HWSC alone was significantly better than no HWSC. Herbicide program #2 was superior to herbicide program #1. Herbicide program #2 combined with HWSC was the most effective treatment. The combination of herbicide program #1 and standard harvest practice (no HWSC; check) led to an increase in fall Italian ryegrass densities from 4 plants m−2 in 2017 to 58 plants m−2 in 2019 at College Station. At wheat harvest, Italian ryegrass densities were 58 and 59 shoots m−2 in check plots at College Station and Newport, respectively, whereas the densities were near zero in plots with herbicide program #2 and HWSC at both locations. These results will be useful for developing an improved Italian ryegrass management strategy in this region.