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Marine protected areas (MPAs) are valuable tools for marine conservation that aim to limit human impacts on marine systems and protect valuable species or habitats. However, as species distributions shift due to ocean warming, acidification, and oxygen depletion from climate change, the areas originally designated under MPAs may bear little resemblance to their past state. Different approaches have been suggested for coping with species on the move in conservation. Here, we test the effectiveness of different MPA designs, including dynamic, network, and different directional orientations on protecting shifting species under climate change through ecosystem modeling in a theoretical ecosystem. Our findings suggest that dynamic MPAs may benefit some species (e.g., whiting and anchovy) and fishing fleets, and these benefits can inform the design or adaptation of MPAs worldwide. In addition, we find that it is important to design MPAs with specific goals and to account for the effects of released fishing pressure and species interactions in MPA design.

Effective interdisciplinary collaboration is essential for addressing complex clinical and translational research challenges. This paper presents and evaluates a structured team science training program developed by the Colorado Clinical and Translational Sciences Institute (CCTSI), while also introducing and validating a novel assessment tool used to measure changes in key teaming competencies. We evaluated the effectiveness of this program between 2020 and 2022 using pre- and post-program surveys ( = 221). Our evaluation tool was designed to capture familiarity with teaming concepts and the frequency of applying collaborative practices. Principal component analysis (PCA) was applied to validate the grouping of these competencies, and paired -tests were used to measure changes over time. PCA revealed three distinct components of team science competencies: Team Planning, Managing a Team, and Interpersonal Relations, all demonstrating strong internal reliability. Participants showed statistically significant improvements ( < 0.05) in all three domains. Gains were robust in Team Planning and Managing a Team, emphasizing structured tools and practices. Although improvement was also observed in Interpersonal Relations, the overall gains were smaller. These findings highlight the self-reported value of Team Science Training programs in CTR settings. The TEAMS instrument described in this manuscript offers a novel approach for CTSAs to evaluate their Team Science training programs. Future applications could include longitudinal tracking and integration metrics to support future program planning, particularly fostering interdisciplinary collaboration and team integration.

OBJECTIVES/GOALS: Involving community partners in translational research improves impact. Yet, community-engaged research is challenging, and teams vary in their success. This study builds the evidence of key barriers and facilitators to effective community-engaged team science by drawing on the perspectives of seasoned researchers and community partners. METHODS/STUDY POPULATION: We conducted 3 focus groups with academic researchers (n=9) and 2 focus groups with community research partners (n=8). All participants were adults from the Southern California area, and had experience working on research teams that included academics and community partners. The focus group guide included questions about the participant’s experience with community-engaged research, including the value of these partnerships, examples of success and challenges, and opportunities for improvement. Transcriptions of the focus group recordings were analyzed to identify key themes and insights, and to explore similarities and differences between academic and community participant perspectives. RESULTS/ANTICIPATED RESULTS: Both researchers and community partners saw the potential value of participating in community-engaged research. However, they identified challenges to address, including: 1) Community partners should be invited to participate in early stages of the research process as equal partners to help frame the objectives. 2) Community partner’s knowledge should be valued through the use of their ideas and input, and providing monetary compensation for their time. 3) Academic researchers should aim to build long-term meaningful relationships with the community and build cultural competency (language, culture, and trust). 4) Community partners should be closely involved with the interpretation of results to confirm accuracy and identify valuable insights, and these contributions should be acknowledged. DISCUSSION/SIGNIFICANCE: Community partners being undervalued is a central challenge of community-engaged research teams. Greater adoption of best practices in team science could empower community partners and increase the value of this research. Structural barriers related to research funding and academic promotion should align to support these efforts.

Mook reviews Building Integrated Economies in West Africa: Lessons in Managing Growth, Inclusiveness, and Volatility edited by Alexi P Kireyev.

Background A significant proportion of patients and informal caregivers favor an active role in decisions concerning their health. Simultaneously, governments aim to shift treatment from a professional care setting to a community setting, in light of an ageing population, a decreasing number of health workers and allocation of scarce resources. This transition of care solicits patients’ and informal caregivers’ ability to self-manage. Therefore, the Maastricht University Medical Centre + has established the Academy for Patients and Informal caregivers. The aim is to proactively and professionally support patients and their informal caregivers to enhance their self-management. For that, the Academy offers activities in three categories: (1) instruction of nursing techniques, (2) training of e-health competencies and (3) the provision of self-management programs. Both patients with an episodic care need, as well as patients and informal caregivers with chronic illness, are eligible to participate in the Academy’s activities. However, little is known about the experience of these interventions from the perspective of patients, informal caregivers and healthcare professionals. Methods We conducted semi-structured interviews with 15 patients, 8 informal caregivers and 19 health care professionals who either participated in, referred to or received patients from the Academy. Topics revolved around self-management and the Quadruple aim, covering topics such as patient experiences, healthcare costs, health and well-being of the population and improving work life for health professionals. Data were analyzed using thematic analysis. Results Patients and caregivers experienced an increase in the ability to manage health needs independently, leading to increased mental well-being and self-efficacy. They felt recognized as partners in care, although managing illness needs came with its own burdens. Health care professionals indicated that they felt assured of the quality, uniformity and availability of activities due to its central organization, with instruction nurses finding greater meaning in their work. On the level of health care systems, participants in this study mentioned a decrease in use of formal healthcare, whilst enabling a more equitable division of care. Conclusion Stakeholders’ experiences with the Academy for Patients and Informal caregivers indicate that participation contributes to development of self-management, whilst also improving working conditions, reducing the appeal to formal care and advancing equity in healthcare. The burden for patients and informal caregivers is to be considered in future developments.

Sarcopenia and visceral obesity have been suggested to aggravate each other, resulting in a vicious cycle. However, evidence based on prospective study is very limited. Our purpose was to investigate whether visceral fat promotes a decrease in skeletal muscle mass and vice versa. We observed changes in anthropometric and body composition data during a follow-up period of 27.6 ± 2.8 months in 379 Korean men and women (mean age 51.9 ± 14.6 years) from the Korean Sarcopenic Obesity Study (KSOS). Appendicular lean soft tissue (ALST) mass was calculated using dual-energy X-ray absorptiometry, and visceral fat area (VFA) was measured using computed tomography at baseline and follow-up examination. ALST mass significantly decreased, whereas trunk and total fat mass increased in both men and women despite no significant change in weight and body mass index. In particular, women with visceral obesity at baseline had a greater decrease in ALST mass than those without visceral obesity (P = 0.001). In multiple linear regression analysis, baseline VFA was an independent negative predictor of the changes in ALST after adjusting for confounding factors including age, gender, life style and body composition parameters, insulin resistance, high sensitivity C-reactive protein and vitamin D levels (P = 0.001), whereas the association between baseline ALST mass and changes in VFA was not statistically significant (P = 0.555). This longitudinal study showed that visceral obesity was associated with future loss of skeletal muscle mass in Korean adults. These results may provide novel insight into sarcopenic obesity in an aging society.

Standardized narratives or profiles can facilitate identification of poor professional behaviour of medical students. If unprofessional behaviour is identified, educators can help the student to improve their professional performance. In an earlier study, based on opinions of frontline teachers from one institution, the authors identified three profiles of medical students’ unprofessional behaviour: (1) Poor reliability, (2) Poor reliability and poor insight , and (3) Poor reliability, poor insight and poor adaptability . The distinguishing variable was Capacity for self - reflection and adaptability . The current study used Nominal Group Technique and thematic analysis to refine these findings by synthesizing experts’ opinions from different medical schools, aiming to develop a model of unprofessional behaviour profiles in medical students. Thirty-one experienced faculty, purposively sampled for knowledge and experience in teaching and evaluation of professionalism, participated in five meetings at five medical schools in the Netherlands. In each group, participants generated ideas, discussed them, and independently ranked these ideas by allocating points to them. Experts suggested ten different ideas, from which the top 3 received 60% of all ranking points: (1) Reflectiveness and adaptability are two distinct distinguishing variables (25%), (2) The term reliability is too narrow to describe unprofessional behaviour (22%), and (3) Profiles are dynamic over time (12%). Incorporating these ideas yielded a model consisting of four profiles of medical students’ unprofessional behaviour ( accidental behaviour , struggling behaviour , gaming - the - system behaviour and disavowing behaviour ) and two distinguishing variables ( reflectiveness and adaptability ). The findings could advance educators’ insight into students’ unprofessional behaviour, and provide information for future research on professionalism remediation.

Background Extra-hepatic vitamin K-status, measured by dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP), maintains vascular health, with high levels reflecting poor vitamin K status. The occurrence of extra-hepatic vitamin K deficiency throughout the disease of COVID-19 and possible associations with pulmonary embolism (PE), and mortality in intensive care unit (ICU) patients has not been studied. The aim of this study was to investigated the association between dp-ucMGP, at endotracheal intubation (ETI) and both ICU and six months mortality. Furthermore, we studied the associations between serially measured dp-ucMGP and both PE and mortality. Methods We included 112 ICU patients with confirmed COVID-19. Over the course of 4 weeks after ETI, dp-ucMGP was measured serially. All patients underwent computed tomography pulmonary angiography (CTPA) to rule out PE. Results were adjusted for patient characteristics, disease severity scores, inflammation, renal function, history of coumarin use, and coronary artery calcification (CAC) scores. Results Per 100 pmol/L dp-ucMGP, at ETI, the odds ratio (OR) was 1.056 (95% CI: 0.977 to 1.141, p  = 0.172) for ICU mortality and 1.059 (95% CI: 0.976 to 1.059, p  = 0.170) for six months mortality. After adjustments for age, gender, and APACHE II score, the mean difference in plasma dp-ucMGP over time of ICU admission was 167 pmol/L (95% CI: 4 to 332, p  = 0.047). After additional adjustments for c-reactive protein, creatinine, and history of coumarin use, the difference was 199 pmol/L (95% CI: 50 to 346, p  = 0.010). After additional adjustment for CAC score the difference was 213 pmol/L (95% CI: 3 to 422, p  = 0.051) higher in ICU non-survivors compared to the ICU survivors. The regression slope, indicating changes over time, did not differ. Moreover, dp-ucMGP was not associated with PE. Conclusion ICU mortality in COVID-19 patients was associated with higher dp-ucMGP levels over 4 weeks, independent of age, gender, and APACHE II score, and not explained by inflammation, renal function, history of coumarin use, and CAC score. No association with PE was observed. At ETI, higher levels of dp-ucMGP were associated with higher OR for both ICU and six month mortality in crude and adjusted modes, although not statistically significantly.