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Nutrient enrichment of surface waters degrades water quality. Municipalities need effective and economical solutions to remove nutrients from surface waters. From July 2016 to May 2020, full-scale (900 m2, 5% cover) floating treatment wetlands (FTWs) were deployed in Wickham Park pond, a eutrophic water body (0.13 mg/L total phosphorus (P), 0.96 mg/L total nitrogen (N)). The plants in FTWs in close proximity to a SB10000 mixer fixed N and P more efficiently. The rate of N (g/m2/year) fixed within tissues was highest for Juncus effusus (13.5), Agrostis alba (13.2), and Sagittaria lancifolia (12.1). The rate of P (g/m2/year) fixed within plant tissues was similar for all species (3.77, Agrostis alba, Canna spp., Iris hexagona, Juncus effusus, and Sagittaria lancifolia) save Pontederia cordata (2.52) volunteer species (1.41). The N and P removed with plant harvest were similar for non-mixed and mixed FTWs. Notably, the N:P ratio in plant tissues in 2017 (pre-mixer installation) was 11:1; after mixer installation (2018–2020), N:P ratios averaged 2.7:1, indicating increased P fixation within plant tissues. In 2017, 12,828 kg of plant tissues was harvested, removing 334 kg of N and 29.5 kg of P. In 2019, 32,958 kg of plant biomass was harvested from the pond, removing 425 kg of N and 138 kg of P. In 2020, 27,945 kg of biomass was harvested from FTWs, removing 267 kg of N and 95 kg of P. From 2016 to 2020, 73,000 kg of biomass was harvested, removing 1026 kg of N and 262 kg of P from Wickham Park pond. Knowing the total fresh biomass of tissues removed from FTWs at harvest is critical for accuracy in reporting nutrient removal aided by FTWs.

Understanding nutrient cycling patterns in plants deployed within constructed floating wetlands (CFWs) is critical for improving CFWs’ design and management practices. This study evaluated phosphorus (P) uptake and release patterns during fall/winter plant senescence and spring regrowth. Two mesocosm-scale CFW experiments were conducted characterizing plant growth, plant tissue P levels, and water quality (nutrients and phytoplankton). Experiment 1 quantified P uptake during spring regrowth after overwintering, and experiment 2 quantified P release during fall senescence. Plant treatments (CFWs with Pontederia cordata or Juncus effusus) were compared to an open-water control. In spring, J. effusus removed 0.056 g P m−2 d−1 (19.4% of the load), P. cordata removed 0.034 g P m−2 d−1 (10%), and the open-water control removed 0.03 g P m−2 d−1 (10%). In fall, J. effusus fixed 0.008 g P m−2 d−1 (2.1% of the load), P. cordata released 0.014 g P m−2 d−1 (−2.1%), and controls fixed 0.023 g P m−2 d−1 (6.3%). P was consistently released during the fall experiment and occasionally released in the spring experiment, likely from senescing plant tissues (fall) and from roots sloughing after new root growth (spring). Results demonstrate the potential for multi-season deployment of CFWs using J. effusus for reducing P loads year-round.

In June 2017, the International Committee of Medical Journal Editors (ICMJE) announced a requirement that authors reporting the results of clinical trials to journals that follow ICMJE recommendations must include an individual participant data (IPD) sharing statement with manuscripts submitted after 01 July 2018. Additionally, all new clinical trials for which enrollment began on or after 01 January 2019 must include a data sharing statement in the trial's publicly posted registration. This study sought to understand whether IPD sharing statements of clinical trials first registered on ClinicalTrials.gov before 01 January 2019 reflected comprehension of the expectations and a willingness to share. To establish baseline characteristics for the prevalence and quality of IPD sharing statements, we examined IPD sharing statements among 2,040 clinical trials first posted on ClinicalTrials.gov between 01 January 2018 and 06 June 2018. Two independent coders further analyzed the quality of the IPD sharing statements of trials whose registration records indicated the intent to share IPD. The vast majority of trials included in this study did not indicate an intent to share IPD (n = 1,928; 94.5%). Among the trials that did commit to sharing IPD (n = 112, 5.5%), significant variability existed in the content and structure of IPD sharing statements. The results of this study suggest that successful compliance with the IPD sharing statement requirements of the ICMJE will require further clarification, enhanced education, and outreach to investigators.

Policy Points Over the past several decades, states have adopted policies intended to address prenatal drug use. Many of these policies have utilized existing child welfare mechanisms despite potential adverse effects. Recent federal policy changes were intended to facilitate care for substance‐exposed infants and their families, but state uptake has been incomplete. Using legal mapping and qualitative interviews, we examine the development of state child welfare laws related to substance use in pregnancy from 1974 to 2019, with a particular focus on laws adopted between 2009 and 2019. Our findings reveal policies that may disincentivize treatment‐seeking and widespread implementation challenges, suggesting a need for new treatment‐oriented policies and refined state and federal guidance. Context Amid increasing drug use among pregnant individuals, legislators have pursued policies intended to reduce substance use during pregnancy. Many states have utilized child welfare mechanisms despite evidence that these policies might disincentivize treatment‐seeking. Recent federal changes were intended to facilitate care for substance‐exposed infants and their families, but implementation of these changes at the state level has been slowed and complicated by existing state policies. We seek to provide a timeline of state child welfare laws related to prenatal drug use and describe stakeholder perceptions of implementation. Methods We catalogued child welfare laws related to prenatal drug use, including laws that defined child abuse and neglect and established child welfare reporting standards, for all 50 states and the District of Columbia (DC), from 1974 to 2019. In the 19 states that changed relevant laws between 2009 and 2019, qualitative interviews were conducted with stakeholders to capture state‐level perspectives on policy implementation. Findings Twenty‐four states and DC have passed laws classifying prenatal drug use as child abuse or neglect. Thirty‐seven states and DC mandate reporting of suspected prenatal drug use to the state. Qualitative findings suggested variation in implementation within and across states between 2009 and 2019 and revealed that implementation of changes to federal law during that decade, intended to encourage states to provide comprehensive social services and linkages to evidence‐based care to drug‐exposed infants and their families, has been complicated by existing policies and a lack of guidance for practitioners. Conclusions Many states have enacted laws that may disincentivize treatment‐seeking among pregnant people who use drugs and lead to family separation. To craft effective state laws and support their implementation, state policymakers and practitioners could benefit from a treatment‐oriented approach to prenatal substance use and additional state and federal guidance.

Pneumococcal infection is an important cause of death and complications in adults with human immunodeficiency virus (HIV) infection, particularly in Africa. In this placebo-controlled, randomized trial involving 496 predominantly HIV-infected Malawian adults who had recently had an invasive pneumococcal infection, the 7-valent conjugated pneumococcal vaccine was found to have 74% efficacy in preventing subsequent invasive pneumococcal infection with a vaccine-associated serotype. In predominantly HIV-infected Malawian adults who had recently had an invasive pneumococcal infection, the 7-valent conjugated pneumococcal vaccine was found to have 74% efficacy in preventing subsequent invasive pneumococcal infection. Streptococcus pneumoniae is a leading cause of death and complications in adults with human immunodeficiency virus (HIV) infection, particularly in sub-Saharan Africa. 1 , 2 The risk of invasive pneumococcal disease is 30 to 100 times as high in patients with HIV infection as in age-matched controls without such infection. 3 , 4 Recurrent invasive pneumococcal disease is common, with up to 25% of patients having an additional episode, predominantly reinfection, in the subsequent 12 months. 1 , 5 Even among patients who have access to timely and effective care, the case fatality rate with invasive pneumococcal disease is at least 8% 6 and rises to 50% . . .

Given the production, environmental, and economic issues associated with the use of lower quality, alternative (e.g., recycled) water sources, researchers from 10 institutions worked on a Coordinated Agriculture Project sponsored by the National Institute of Food and Agriculture, U.S. Department of Agriculture—through the Specialty Crops Research Initiative. Clean WateR3—big picture outreach Bruno Pitton opened the session by presenting “Comparing the cost of high-quality and recycled irrigation runoff water in container plant production: A southern California nursery case study,” detailing the considerable cost savings associated with the use of recycled water in comparison with high-cost municipal water, despite the high initial infrastructure investment costs (Pitton et al., 2018). Abdi, D.E. & Fernandez, R.T. 2019 Reducing water and pesticide movement in nursery production HortTechnology (In Press) Garcia Chance, L.M., Albano, J.P., Lee, C.M., Wolfe, S.M. & White, S.A. 2019 Runoff pH influences nutrient removal efficacy of floating treatment wetland systems HortTechnology (In Press) Ingram, D.L., Hall, C.R. & Knight, J. 2017 Modeling global warming potential, variable, costs, and water use of young plant production system components using life cycle assessment HortScience 52 1356 1361 Ingram, D.L. & Hall, C.R. 2015 Life cycle assessment used to determine potential midpoint environment impact factors and water footprint of field-grown tree production inputs and processes J. Amer. Three case studies HortTechnology (In Press) Pitton, B.J.L., Hall, C.R., Haver, D.L., White, S.A. & Oki, L.R. 2018 A cost analysis of using recycled irrigation water in container nursery production: A southern California nursery case study Irr.

Background The messages used to communicate about harm reduction are critical in garnering public support for adoption of harm reduction interventions. Despite the demonstrated effectiveness of harm reduction interventions at reducing overdose deaths and disease transmission, the USA has been slow to adopt harm reduction to scale. Implementation of evidence-based interventions has been hindered by a historical framing of drug use as a moral failure and related stigmatizing attitudes among the public toward people who use drugs. Understanding how professional harm reduction advocates communicate to audiences about the benefits of harm reduction is a critical step to designing persuasive messaging strategies. Methods We conducted qualitative interviews with a purposively recruited sample of U.S. professional harm reduction advocates ( N  = 15) to examine their perspectives on which types of messages are effective in persuading U.S. audiences on the value of harm reduction. Participants were professionals working in harm reduction advocacy at national- or state-level organizations promoting and/or implementing harm reduction. Semi-structured interviews were audio-recorded, transcribed, and analyzed using a hybrid inductive/deductive approach. Results Interviewees agreed that messages about the scientific evidence demonstrating the effectiveness of harm reduction approaches are important but insufficient, on their own, to persuade audiences. Interviewees identified two overarching messaging strategies they perceived as persuasive: using messages about harm reduction that align with audience-specific values, for example centering the value of life or individual redemption; and positioning harm reduction as part of the comprehensive solution to current issues audiences are facing related to drug use and overdose in their community. Interviewees discussed tailoring messages strategies to four key audiences: policymakers; law enforcement; religious groups; and the family and friends of people who use, or have used, drugs. For example, advocates discussed framing messages to law enforcement from the perspective of public safety. Conclusions Interviewees viewed messages as most persuasive when they align with audience values and audience-specific concerns related to drug use and overdose death. Future research should test effectiveness of tailored messaging strategies to audiences using experimental approaches.

Landscape pest management is challenging and has historically relied on traditional pesticide rotations. Integrated pest management (IPM) is a combination of chemical and nonchemical control methods to reduce pesticide usage and reliance. Scant literature is available on consumer knowledge of IPM. To address this gap in knowledge, 1000 respondents were surveyed to evaluate their understanding of IPM. Questions were vetted using the Delphi method with nine industry and academic experts. More than 75% of respondents had some knowledge or were very knowledgeable of IPM. More education contributed strongly to more knowledge of IPM. The results of this study are comparable to those of another study and show that consumers are more knowledgeable than horticultural professionals may realize. Horticultural professionals could capitalize on this potential new market, with the understanding that some consumers would still need guidance to understand the myriad components of an IPM program. Future studies should evaluate consumer willingness to pay for plant products grown using IPM techniques such as biological controls and reduced chemical–pesticide inputs and, specifically, whether consumers are willing to pay for such biological control products or landscape scouting services. Future studies should also examine an IPM certification of ornamental plants and how they might perform compared to traditionally grown plants or certified organic-grown plants.

Routine, nonmedical and ancillary medical costs associated with participation in clinical research create barriers to enrollment for economically disadvantaged individuals. To the extent that race, ethnicity, and gender are linked to SES, such barriers impact efforts to diversify clinical research enrollment. But payment policies and practices often reflect the longstanding and singular concern that payment to participants will bias decision-making and compromise informed consent. We argue that this concern must be viewed in a larger ethical context in which the untoward consequences for the individual participant and for the broader research enterprise are considerable when either inadequate or no payment is provided for expenses incurred (“reimbursement”) and time committed (“compensation”). Fairness in payment and protection from undue influence of payment on the informed consent process are important but distinct ethical considerations. Fundamentally, approaches to payment that leave participants financially worse off as a consequence of taking part in research are inherently unjust as they have a differential impact on recruitment and retention based on socioeconomic status. Sponsors, funders, investigators, and IRBs must be cognizant of the impact of inadequate payment on clinical trial inclusion of historically understudied groups. We address practical and fair payment strategies to advance inclusion, the additional barrier of ancillary medical costs, and potential unintended consequences of payment.

The United States is experiencing a drug addiction and overdose crisis, made worse by the COVID-19 pandemic. Relative to other types of health services, addiction treatment and overdose prevention services are particularly vulnerable to disaster-related disruptions for multiple reasons including fragmentation from the general medical system and stigma, which may lead decisionmakers and providers to de-prioritize these services during disasters. In response to the COVID-19 pandemic, U.S. states implemented multiple policies designed to mitigate disruptions to addiction treatment and overdose prevention services, for example policies expanding access to addiction treatment delivered via telehealth and policies designed to support continuity of naloxone distribution programs. There is limited evidence on the effects of these policies on addiction treatment and overdose. This evidence is needed to inform state policy design in future disasters, as well as to inform decisions regarding whether to sustain these policies post-pandemic. The overall study uses a concurrent-embedded design. Aims 1-2 use difference-in-differences analyses of large-scale observational databases to examine how state policies designed to mitigate the effects of the COVID-19 pandemic on health services delivery influenced addiction treatment delivery and overdose during the pandemic. Aim 3 uses a qualitative embedded multiple case study approach, in which we characterize local implementation of the state policies of interest; most public health disaster policies are enacted at the state level but implemented at the local level by healthcare systems and local public health authorities. Triangulation of results across methods will yield robust understanding of whether and how state disaster-response policies influenced drug addiction treatment and overdose during the COVID-19 pandemic. Results will inform policy enactment and implementation in future public health disasters. Results will also inform decisions about whether to sustain COVID-19 pandemic-related changes to policies governing delivery addiction and overdose prevention services long-term.