Youth-friendly services in two rural districts of West Bengal and Jharkhand, India: definite progress, a long way to go.

It is a continuing challenge to reach rural youth in India with sexual and reproductive health services. Drawing on a large survey among 6,572 young people aged 15-24 and 264 rural health providers accessed by them in rural West Bengal and Jharkhand, we witnessed a long-awaited response to national efforts to promote birth spacing. That 31% of young, married women without children were using contraception to delay a first birth was evidence of cracks in the persistent tradition of demonstrating fertility soon after marriage. The coverage of public sector services for reproductive and sexual health is highly variable and the scope largely restricted to married women, with unmarried young women and men relying mainly on the informal private sector, and seriously underserved. Strong social norms proscribing pre-marital sexual relationships perpetuate barriers in meeting their needs. Access to contraception is affected by negative provider attitudes and reluctance to report having sex underestimates the real scale of unmet need. Yet, 30% of providers reported unmarried young women seeking abortion services. To address the needs of all rural youth, the public sector needs to expand its remit or engage with informal providers, train them to deliver youth-friendly services and give them a recognised role in abortion referral

Roadmap on Li-ion battery manufacturing research

Growth in the Li-ion battery market continues to accelerate, driven primarily by the increasing need for economic energy storage for electric vehicles. Electrode manufacture by slurry casting is the first main step in cell production but much of the manufacturing optimisation is based on trial and error, know-how and individual expertise. Advancing manufacturing science that underpins Li-ion battery electrode production is critical to adding to the electrode manufacturing value chain. Overcoming the current barriers in electrode manufacturing requires advances in materials, manufacturing technology, in-line process metrology and data analytics, and can enable improvements in cell performance, quality, safety and process sustainability. In this roadmap we explore the research opportunities to improve each stage of the electrode manufacturing process, from materials synthesis through to electrode calendering. We highlight the role of new process technology, such as dry processing, and advanced electrode design supported through electrode level, physics-based modelling. Progress in data driven models of electrode manufacturing processes is also considered. We conclude there is a growing need for innovations in process metrology to aid fundamental understanding and to enable feedback control, an opportunity for electrode design to reduce trial and error, and an urgent imperative to improve the sustainability of manufacture

Roadmap on Li-ion battery manufacturing research

Growth in the Li-ion battery market continues to accelerate, driven by increasing need for economic energy storage in the electric vehicle market. Electrode manufacture is the first main step in production and in an industry dominated by slurry casting, much of the manufacturing process is based on trial and error, know-how and individual expertise. Advancing manufacturing science that underpins Li-ion battery electrode production is critical to adding value to the electrode manufacturing value chain. Overcome the current barriers in the electrode manufacturing requires advances in material innovation, manufacturing technology, in-line process metrology and data analytics to improve cell performance, quality, safety and process sustainability. In this roadmap we present where fundamental research can impact advances in each stage of the electrode manufacturing process from materials synthesis to electrode calendering. We also highlight the role of new process technology such as dry processing and advanced electrode design supported through electrode level, physics-based modelling. To compliment this, the progresses in data driven models of full manufacturing processes is reviewed. For all the processes we describe, there is a growing need process metrology, not only to aid fundamental understanding but also to enable true feedback control of the manufacturing process. It is our hope this roadmap will contribute to this rapidly growing space and provide guidance and inspiration to academia and industry

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Elusive Employment: Understanding the Role of Disability and Rehabilitation in Post-conflict El Salvador

In the developing world, persons with disabilities tend to be concentrated in the poorest segments of society, in which they have limited access to education, training, and employment. When they do work, this is generally at a lower level than their true potential, and in temporary or unstable markets. In El Salvador, poor skill development, lack of awareness and neglect have further marginalized those with disabilities from contributing to the economic welfare of their families and communities.Using two pilot communities in El Salvador, this investigation highlights how the economic needs and challenges of persons with disabilities differ within rural and urban settings. Among individuals with disabilities residing in urban areas, discrimination and inaccessibility prevail as challenges in attaining employment, whereas a lack of training and skills is more commonly noted as a barrier to employment among respondents from rural areas.Although the economic barriers faced by persons with disabilities vary widely between communities, these differences have not been addressed by current rehabilitation models. This research provides guidance to local Salvadoran agencies in the development and implementation of needs-based rehabilitation programming at the community level.Dans les pays en voie de développement, les personnes handicapées tendent à se concentrer dans les tranches les plus pauvres de la société, où elles ont un accès limité à l’éducation, à la formation et à l’emploi. Lorsqu’elles travaillent, elles réalisent des tâches ne mobilisant pas leurs aptitudes réelles, et ce, dans des marchés de l’emploi temporaires ou instables. En El Salvador, le faible niveau du développement des compétences, le manque de connaissances et la négligence dont les personnes handicapées font l’objet ont contribué à les marginaliser davantage et à les empêcher de contribuer au bien-être de leurs familles et de leurs communautés.Au moyen de la comparaison de deux communautés pilotes salvadoriennes, la présente recherche soulignera les différences entre les besoins économiques et les défis que doivent affronter les personnes handicapées selon qu’elles habitent dans un contexte urbain ou rural : celles vivant dans un milieu urbain ont identifié l’inaccessibilité et les discriminations comme facteurs limitant leur accès à un emploi, tandis que celles vivant dans un milieu rural ont signalé le manque de formation et de compétences.Malgré le fait que les barrières économiques rencontrées par les personnes handicapées soient différentes selon leur lieu de résidence, les modèles de réadaptation actuels ne tiennent pas compte de cette réalité. Cette recherche a pour objectif d’orienter les agences locales salvadoriennes dans le développement et la mise en place de programmes locaux de réadaptation axés sur les besoins des personnes handicapées

PCC Media: Interviews

The Political Cartooning and Peace-Building project was funded by the GCRF (Research England) in 2020/2021, working with partners in South Africa, Kenya and Ivory Coast. The goal of the project was to explore the use of political cartooning as a tool for addressing conflict and building peace with marginalised young people living in challenging circumstances.  Interviews were held with the project leads in South Africa, Ivory Coast and Kenya, and transcripts can be found here.  </p

CIC Datasets: Focus Group Dictionary

The Covid in Cartoons project engaged 15-18 year olds with political cartoons and cartoonists to foster processes of meaning-making in relation to the pandemic. Working with Cartooning for Peace and ShoutOut UK we engaged young people in building critical narratives of the crisis and its impact on their lives. We aimed to promote an inclusive, socially-responsive curriculum that supports young people's ability to cope in difficult circumstances. We used surveys, focus groups, and records of the participants' experiences in the form of workbooks to gather data. The project was led by Dr Fransiska Louwagie (PI) and Dr Diane Levine (Co-I), with postdoctoral associates Dr Kara Blackmore and Dr Sarah Weidman, and ran between January 2021 and July 2022. During the focus groups, Covid in Cartoons participants contributed to co-building a dictionary of words they felt were important in reflecting their Covid experience, and their responses to that experience.  </p

CIC Instruments: Surveys

The Covid in Cartoons project engaged 15-18 year olds with political cartoons and cartoonists to foster processes of meaning-making in relation to the pandemic. Working with Cartooning for Peace and ShoutOut UK we engaged young people in building critical narratives of the crisis and its impact on their lives. We aimed to promote an inclusive, socially-responsive curriculum that supports young people's ability to cope in difficult circumstances. We used surveys, focus groups, and records of the participants' experiences in the form of workbooks to gather data. The project was led by Dr Fransiska Louwagie (PI) and Dr Diane Levine (Co-I), with postdoctoral associates Dr Kara Blackmore and Dr Sarah Weidman, and ran between January 2021 and July 2022. Covid in Cartoons participants completed surveys before and after completing the minicourse focused on meaning making through political cartooning during the pandemic. The composite instrument, derived from other validated measures, can be found here.  </p