Journal of Public Health and

Determinants of long lasting insecticidal nets distribution, ownership and use in the Federal Capital Territory, Nigeria – implications for malaria programme

Growth and physiology of a dominant understory shrub, Hamamelis virginiana, following canopy disturbance in a temperate hardwood forest

As global climatic changes increase plant susceptibility to large-scale disturbances like drought and pathogens, understory responses to these disturbances will become increasingly important to long-term forest dynamics. To better understand understory responses to canopy disturbance, we measured changes in the growth and physiology of the dominant understory shrub, American witch-hazel (Hamamelis virginiana), in response to girdling of canopy oaks in a northeastern U.S. temperate hardwood forest. Changes in the growth and physiology of H. virginiana may be important to the regeneration of northeastern temperate forests, as this common shrub largely shapes the microenvironment for seedlings on the forest floor where it occurs. Canopy disturbance by girdling resulted in significant increases in light and soil nitrogen availability. In response to these environmental changes, basal-area growth of H. virginiana increased by an average 334%. This growth increase corresponded to significant increases in foliar nitrogen, respiration, and leaf chlorophyll and carotenoid concentrations. These findings indicate improved environmental conditions and increased growth for this understory shrub following the loss of dominant canopy trees. This study suggests that following large-scale canopy disturbance, H. virginiana and shrubs like it may play an important role in competing for soil N and shading seedlings of regenerating canopy species.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Recommendations for the development, implementation, and reporting of control interventions in efficacy and mechanistic trials of physical, psychological, and self-management therapies: the CoPPS Statement

Control interventions (often called “sham,” “placebo,” or “attention controls”) are essential for studying the efficacy or mechanism of physical, psychological, and self-management interventions in clinical trials. This article presents core recommendations for designing, conducting, and reporting control interventions to establish a quality standard in non-pharmacological intervention research. A framework of additional considerations supports researchers’ decision making in this context. We also provide a reporting checklist for control interventions to enhance research transparency, usefulness, and rigour

Academic domains as political battlegrounds : A global enquiry by 99 academics in the fields of education and technology

Academic cognition and intelligence are ‘socially distributed’; instead of dwelling inside the single mind of an individual academic or a few academics, they are spread throughout the different minds of all academics. In this article, some mechanisms have been developed that systematically bring together these fragmented pieces of cognition and intelligence. These mechanisms jointly form a new authoring method called ‘crowd-authoring’, enabling an international crowd of academics to co-author a manuscript in an organized way. The article discusses this method, addressing the following question: What are the main mechanisms needed for a large collection of academics to collaborate on the authorship of an article? This question is addressed through a developmental endeavour wherein 101 academics of educational technology from around the world worked together in three rounds by email to compose a short article. Based on this endeavour, four mechanisms have been developed: a) a mechanism for finding a crowd of scholars; b) a mechanism for managing this crowd; c) a mechanism for analyzing the input of this crowd; and d) a scenario for software that helps automate the process of crowd-authoring. The recommendation is that crowd-authoring ought to win the attention of academic communities and funding agencies, because, given the well-connected nature of the contemporary age, the widely and commonly distributed status of academic intelligence and the increasing value of collective and democratic participation, large-scale multi-authored publications are the way forward for academic fields and wider academia in the 21st century.peerReviewe

Academic domains as political battlegrounds:A global enquiry by 99 academics in the fields of education and technology

This article theorizes the functional relationship between the human components (i.e., scholars) and non-human components (i.e., structural configurations) of academic domains. It is organized around the following question: in what ways have scholars formed and been formed by the structural configurations of their academic domain? The article uses as a case study the academic domain of education and technology to examine this question. Its authorship approach is innovative, with a worldwide collection of academics (99 authors) collaborating to address the proposed question based on their reflections on daily social and academic practices. This collaboration followed a three-round process of contributions via email. Analysis of these scholars’ reflective accounts was carried out, and a theoretical proposition was established from this analysis. The proposition is of a mutual (yet not necessarily balanced) power (and therefore political) relationship between the human and non-human constituents of an academic realm, with the two shaping one another. One implication of this proposition is that these non-human elements exist as political ‘actors’, just like their human counterparts, having ‘agency’ – which they exercise over humans. This turns academic domains into political (functional or dysfunctional) ‘battlefields’ wherein both humans and non-humans engage in political activities and actions that form the identity of the academic domain. For more information about the authorship approach, please see Al Lily AEA (2015) A crowd-authoring project on the scholarship of educational technology. Information Development. doi: 10.1177/0266666915622044.</p

Academic Domains As Political Battlegrounds: A Global Enquiry By 99 Academics in The Fields of Education and Technology

This article theorizes the functional relationship between the human components (i.e., scholars) and non-human components (i.e., structural configurations) of academic domains. It is organized around the following question: in what ways have scholars formed and been formed by the structural configurations of their academic domain? The article uses as a case study the academic domain of education and technology to examine this question. Its authorship approach is innovative, with a worldwide collection of academics (99 authors) collaborating to address the proposed question based on their reflections on daily social and academic practices. This collaboration followed a three-round process of contributions via email. Analysis of these scholars' reflective accounts was carried out, and a theoretical proposition was established from this analysis. The proposition is of a mutual (yet not necessarily balanced) power (and therefore political) relationship between the human and non-human constituents of an academic realm, with the two shaping one another. One implication of this proposition is that these non-human elements exist as political actors', just like their human counterparts, having agency' - which they exercise over humans. This turns academic domains into political (functional or dysfunctional) battlefields' wherein both humans and non-humans engage in political activities and actions that form the identity of the academic domain. For more information about the authorship approach, please see Al Lily AEA (2015) A crowd-authoring project on the scholarship of educational technology. Information Development. doi: 10.1177/0266666915622044.Wo

Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial

BackgroundSparsentan, a novel, non-immunosuppressive, single-molecule, dual endothelin angiotensin receptor antagonist, significantly reduced proteinuria versus irbesartan, an angiotensin II receptor blocker, at 36 weeks (primary endpoint) in patients with immunoglobulin A nephropathy in the phase 3 PROTECT trial's previously reported interim analysis. Here, we report kidney function and outcomes over 110 weeks from the double-blind final analysis.MethodsPROTECT, a double-blind, randomised, active-controlled, phase 3 study, was done across 134 clinical practice sites in 18 countries throughout the Americas, Asia, and Europe. Patients aged 18 years or older with biopsy-proven primary IgA nephropathy and proteinuria of at least 1·0 g per day despite maximised renin–angiotensin system inhibition for at least 12 weeks were randomly assigned (1:1) to receive sparsentan (target dose 400 mg oral sparsentan once daily) or irbesartan (target dose 300 mg oral irbesartan once daily) based on a permuted-block randomisation method. The primary endpoint was proteinuria change between treatment groups at 36 weeks. Secondary endpoints included rate of change (slope) of the estimated glomerular filtration rate (eGFR), changes in proteinuria, a composite of kidney failure (confirmed 40% eGFR reduction, end-stage kidney disease, or all-cause mortality), and safety and tolerability up to 110 weeks from randomisation. Secondary efficacy outcomes were assessed in the full analysis set and safety was assessed in the safety set, both of which were defined as all patients who were randomly assigned and received at least one dose of randomly assigned study drug. This trial is registered with ClinicalTrials.gov, NCT03762850.FindingsBetween Dec 20, 2018, and May 26, 2021, 203 patients were randomly assigned to the sparsentan group and 203 to the irbesartan group. One patient from each group did not receive the study drug and was excluded from the efficacy and safety analyses (282 [70%] of 404 included patients were male and 272 [67%] were White) . Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6–110) was −2·7 mL/min per 1·73 m2 per year versus −3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2 per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1–week 110) was −2·9 mL/min per 1·73 m2 per year versus −3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI −0·03 to 1·94; p=0·058). The significant reduction in proteinuria at 36 weeks with sparsentan was maintained throughout the study period; at 110 weeks, proteinuria, as determined by the change from baseline in urine protein-to-creatinine ratio, was 40% lower in the sparsentan group than in the irbesartan group (−42·8%, 95% CI −49·8 to −35·0, with sparsentan versus −4·4%, −15·8 to 8·7, with irbesartan; geometric least-squares mean ratio 0·60, 95% CI 0·50 to 0·72). The composite kidney failure endpoint was reached by 18 (9%) of 202 patients in the sparsentan group versus 26 (13%) of 202 patients in the irbesartan group (relative risk 0·7, 95% CI 0·4 to 1·2). Treatment-emergent adverse events were well balanced between sparsentan and irbesartan, with no new safety signals.InterpretationOver 110 weeks, treatment with sparsentan versus maximally titrated irbesartan in patients with IgA nephropathy resulted in significant reductions in proteinuria and preservation of kidney function

Sparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial

Background: Sparsentan is a novel, non-immunosuppressive, single-molecule, dual endothelin and angiotensin receptor antagonist being examined in an ongoing phase 3 trial in adults with IgA nephropathy. We report the prespecified interim analysis of the primary proteinuria efficacy endpoint, and safety. Methods: PROTECT is an international, randomised, double-blind, active-controlled study, being conducted in 134 clinical practice sites in 18 countries. The study examines sparsentan versus irbesartan in adults (aged ≥18 years) with biopsy-proven IgA nephropathy and proteinuria of 1·0 g/day or higher despite maximised renin-angiotensin system inhibitor treatment for at least 12 weeks. Participants were randomly assigned in a 1:1 ratio to receive sparsentan 400 mg once daily or irbesartan 300 mg once daily, stratified by estimated glomerular filtration rate at screening (30 to 1·75 g/day). The primary efficacy endpoint was change from baseline to week 36 in urine protein-creatinine ratio based on a 24-h urine sample, assessed using mixed model repeated measures. Treatment-emergent adverse events (TEAEs) were safety endpoints. All endpoints were examined in all participants who received at least one dose of randomised treatment. The study is ongoing and is registered with ClinicalTrials.gov, NCT03762850. Findings: Between Dec 20, 2018, and May 26, 2021, 404 participants were randomly assigned to sparsentan (n=202) or irbesartan (n=202) and received treatment. At week 36, the geometric least squares mean percent change from baseline in urine protein-creatinine ratio was statistically significantly greater in the sparsentan group (-49·8%) than the irbesartan group (-15·1%), resulting in a between-group relative reduction of 41% (least squares mean ratio=0·59; 95% CI 0·51-0·69; p<0·0001). TEAEs with sparsentan were similar to irbesartan. There were no cases of severe oedema, heart failure, hepatotoxicity, or oedema-related discontinuations. Bodyweight changes from baseline were not different between the sparsentan and irbesartan groups. Interpretation: Once-daily treatment with sparsentan produced meaningful reduction in proteinuria compared with irbesartan in adults with IgA nephropathy. Safety of sparsentan was similar to irbesartan. Future analyses after completion of the 2-year double-blind period will show whether these beneficial effects translate into a long-term nephroprotective potential of sparsentan. Funding: Travere Therapeutics