Assessing Photostability of mAb Formulations In Situ Using Light-Coupled NMR Spectroscopy.

Biopharmaceuticals, such as monoclonal antibodies (mAbs), need to maintain their chemical and physical stability in formulations throughout their lifecycle. It is known that exposure of mAbs to light, particularly UV, triggers chemical and physical degradation, which can be exacerbated by trace amounts of photosensitizers in the formulation. Although routine assessments of degradation following defined UV dosages are performed, there is a fundamental lack of understanding regarding the intermediates, transient reactive species, and radicals formed during illumination, as well as their lifetimes and immediate impact post-illumination.

The perspective of school leaders on the implementation of evidence-based practices: A mixed methods study.

Background: School leaders play an integral role in the use of implementation strategies, which in turn support special education teachers in the implementation of evidence-based practices (EBPs). In this convergent mixed methods study, we explored school leaders' perceptions of the facilitators and barriers to EBP implementation, particularly for students receiving special education, as well as the importance and feasibility of 15 implementation strategies.

Method: School leaders (  =  22, principals, assistant principals, school psychologists, etc.

Core Components and Implementation Determinants of Multilevel Service Delivery Frameworks Across Child Mental Health Service Settings.

Multilevel service delivery frameworks are approaches to structuring and organizing a spectrum of evidence-based services and supports, focused on assessment, prevention, and intervention designed for the local context. Exemplar frameworks in child mental health include positive behavioral interventions and supports in education, collaborative care in primary care, and systems of care in community mental health settings. Yet, their high-quality implementation has lagged.

Comparing Informants for Mental Health Screening at the Preschool Level.

Universal screening for mental health in preschools provides the opportunity for early identification and early intervention, but guidance regarding which informants to use is needed. Preschoolers' ( = 535) parent and teacher reports across two screening forms were analyzed to determine similarities and discrepancies for classification results and screener scores. The analyses also examined if an additional rater provided incrementally valid information to the prediction of longitudinal kindergarten outcomes.

Interactional quality in middle schools: Latent profiles and their associations with teacher, classroom, and school compositional factors.

High quality teacher-student interactions are critical for the healthy social-emotional, behavioral, and academic development of middle school students. However, few studies have explored patterns of teacher-student interactions in middle school classrooms or the relation between teacher-, classroom-, and school-level factors and patterns of interaction. The current study employed latent profile analyses (LPA) to identify patterns of teacher-student interactional quality in a sample of 334 teachers from 41 schools serving middle school students within the Mid-Atlantic region of the U.

Moving towards Implementation of Universal Mental Health Screening by Examining Attitudes toward School-based Practices.

Universal mental health screening is a proactive approach to identify students who may benefit from prevention or early intervention services. Despite known benefits, few schools are engaging in screening efforts and it is critical to examine factors that may impede or enhance implementation. Following implementation of a universal screening program across five preschools and elementary schools, this study investigated the attitudes of teachers ( = 40) and parents ( = 330) and found strong agreement among stakeholders about the acceptability and appropriateness of universal mental health screening.

Organizational Context in General and Special Education: An Exploratory Investigation to Describe the Perspective of School Leaders.

Organizational context (e.g., climate, culture, resources) can impede or enhance implementation of evidence-based practices in general education settings or special education settings serving students with autism spectrum disorder.

Structural School Characteristics and Neighborhood Risk Factors: Associations with Student-Reported School Climate in a Large, Urban Public School District in the United States.

School climate consistently predicts youth academic success, social-emotional well-being, and substance use, and positive school climate can buffer the negative effects of community violence exposure on youth development. Various structural school and neighborhood factors have been associated with school climate, but prior research has not examined these relations comprehensively. We examined the relation between 18 school building and school neighborhood factors with student-reported school climate among 15,833 students in 124 public schools in a large, urban district in the United States.

Specifying and Reporting Implementation Strategies Used in a School-Based Prevention Efficacy Trial.

Background: Implementation strategies used to enhance the implementation of interventions during efficacy and effectiveness studies are rarely reported. Tracking and reporting implementation strategies during these phases has potential to improve future research studies and real-world implementation. We present an exemplar of how this might be executed by specifying and reporting the implementation strategies that were used during a school-based efficacy trial, Project POWER, which tested a trauma-informed prevention program delivered by a university research team, community members, and school staff facilitators in 29 schools.

Metabolic Architecture of Acute Exercise Response in Middle-Aged Adults in the Community.

Background: Whereas regular exercise is associated with lower risk of cardiovascular disease and mortality, mechanisms of exercise-mediated health benefits remain less clear. We used metabolite profiling before and after acute exercise to delineate the metabolic architecture of exercise response patterns in humans.

Methods: Cardiopulmonary exercise testing and metabolite profiling was performed on Framingham Heart Study participants (age 53±8 years, 63% women) with blood drawn at rest (n=471) and at peak exercise (n=411).

Clinical and Hemodynamic Associations and Prognostic Implications of Ventilatory Efficiency in Patients With Preserved Left Ventricular Systolic Function.

Background: Ventilatory efficiency (minute ventilation required to eliminate carbon dioxide, VE/VCO2) during exercise potently predicts outcomes in advanced heart failure with reduced ejection fraction, but its prognostic significance for at-risk individuals with preserved left ventricular systolic function is unclear. We aimed to characterize mechanistic determinants and prognostic implications of VE/VCO2 in a single-center dyspneic referral cohort (MGH-ExS [Massachusetts General Hospital Exercise Study]) and in a large sample of community-dwelling participants in the FHS (Framingham Heart Study).

Methods: Maximum incremental cardiopulmonary exercise tests were performed.

An Empirical Approach to Complete Mental Health Classification in Adolescents.

Using latent profile analysis (LPA), this study empirically identified dual-factor mental health subtypes, with a goal of examining structural stability of emerging latent classes over three high school years. Profiles' relations with distal indicators of well-being, psychosocial distress, and self-reported grades were examined to explore the validity of emerging classes. A sample of 332 high school students reported on their social-emotional strengths and psychological distress during the fall term of their ninth-, tenth-, and eleventh-grade years.

Languishing Students: Linking Complete Mental Health Screening in Schools to Tier II Intervention.

Despite innovations in the screening and early identification of students who may benefit from school mental health services, many schools struggle to link screening to intervention decisions, particularly at the Tier II level. Universal complete mental health screening, which measures strengths along with risk factors, is a strength-based approach that enables identification of students who do not report active mental health risk yet have limited psychosocial strengths. These languishing students are ideal candidates for Tier II interventions.

A latent transition analysis of the longitudinal stability of dual-factor mental health in adolescence.

Dual-factor models of mental health are increasingly supported but little is known about longitudinal trends in dual-factor mental health. The current study used latent profile analysis (LPA) to empirically identify dual-factor mental health classes at each of Grades 9 through 12 and latent transition analysis (LTA) to examine stability of classes over four academic years. A sample of 875 adolescents from two cohorts reported on their social-emotional strengths and psychological distress.

Social and Contextual Influences on Mental Health Following an Episode of Mass Violence.

Few studies explore how the recovery context following an episode of mass violence affects posttragedy mental health (MH), despite clear implications for developing posttrauma supports. Following a mass murder, this prospective, longitudinal study examined how reactions to media coverage, family reactions, and disappointment in social support influenced posttragedy MH (posttraumatic stress, depression, anxiety), above and beyond the influence of pretragedy MH, pretragedy victimization, and objective exposure. University students who participated in a study of college adjustment prior to the mass murder ( = 593) were recontacted and provided information on their posttragedy life ( = 142).

Patient engagement with a mobile web-based telemonitoring system for heart failure self-management: a pilot study.

Background: Intensive remote monitoring programs for congestive heart failure have been successful in reducing costly readmissions, but may not be appropriate for all patients. There is an opportunity to leverage the increasing accessibility of mobile technologies and consumer-facing digital devices to empower patients in monitoring their own health outside of the hospital setting. The iGetBetter system, a secure Web- and telephone-based heart failure remote monitoring program, which leverages mobile technology and portable digital devices, offers a creative solution at lower cost.

Progressive ventricular dysfunction among nonresponders to cardiac resynchronization therapy: baseline predictors and associated clinical outcomes.

Background: Cardiac resynchronization therapy (CRT) nonresponders have poor outcomes. The significance of progressive ventricular dysfunction among nonresponders remains unclear.

Objective: We sought to define predictors of and clinical outcomes associated with progressive ventricular dysfunction despite CRT.

Usefulness and consequences of cardiac resynchronization therapy in dialysis-dependent patients with heart failure.

Cardiac resynchronization therapy (CRT) is often deferred in dialysis-dependent patients with heart failure (HF) because of a perceived lack of benefit and potentially higher risks, although the outcomes associated with CRT in dialysis have not been reported. We therefore studied our center's experience with CRT in dialysis-dependent patients. We constructed a descriptive assessment of these patients (n = 15) and performed a case-control analysis matching for age, gender, bundle branch morphology, diabetes mellitus, cardiomyopathy origin, and β-blocker and angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker use.

Photophysical behaviour of cyclometalated iridium(III) complexes with phosphino(terthiophene) ligands.

Six new Ir(III) complexes containing the 3'-phosphino-2,2':5',2''-terthiophene (PT3) ligand in three different coordination modes are reported. The electronic properties of the complexes are characterized by cyclic voltammetry, absorption, emission and time-resolved transient absorption spectroscopies and DFT/TDDFT calculations. The electrochemical and photophysical behaviour of the complexes was found to be dominated by the PT3 ligand.

Interleukin receptor family member ST2 concentrations in patients following heart transplantation.

Objective: To evaluate soluble (s) ST2 as a biomarker of rejection, allograft vasculopathy and mortality after orthotopic heart transplantation (OHT).

Methods: sST2 concentrations were measured in 241 patients following OHT.

Results: Elevated sST2 was associated with cellular rejection (CR) ≥ 1R, with highest rates of CR in the 4th sST2 quartile (p = 0.

Characterization and prediction of natriuretic peptide "nonresponse" during heart failure management: results from the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) and the NT-proBNP-Assisted Treatment to Lessen Serial Cardiac Readmissions and Death (BATTLESCARRED) study.

Many proven heart failure (HF) therapies decrease N-terminal pro B-type natriuretic peptide (NT-proBNP) values over time, yet some patients have an NT-proBNP >1000 pg/mL following treatment, which is associated with poor outcomes. A total of 151 patients with left ventricular systolic dysfunction were treated with aggressive HF therapy in the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) study. Clinical characteristics and NT-proBNP were measured at each visit during 10 months.

Quality of life and chronic heart failure therapy guided by natriuretic peptides: results from the ProBNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) study.

Background: Heart failure (HF) treatment guided by amino-terminal pro-B type natriuretic peptide (NT-proBNP) may reduce cardiovascular event rates compared to standard-of-care (SOC) management. Comprehensive understanding regarding effect of NT-proBNP guided care on patient-reported quality of life (QOL) remains unknown.

Methods: One hundred fifty-one subjects with HF due to left ventricular systolic dysfunction were randomized to either SOC HF management or care with a goal to reduce NT-proBNP values ≤1000 pg/mL.

Improvement in structural and functional echocardiographic parameters during chronic heart failure therapy guided by natriuretic peptides: mechanistic insights from the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) study.

Aims: We sought to determine if heart failure (HF) care with a goal to lower N-terminal pro B-type natriuretic peptide (NT-proBNP) concentrations, compared with standard of care (SOC) management, is associated with improvement in echocardiographic parameters of cardiac structure and function.

Methods And Results: Of 151 subjects with HF due to left ventricular systolic dysfunction (LVSD) prospectively randomized to NT-proBNP-guided vs. SOC HF care, 116 had serial echocardiographic data.