The UK has set itself the ambitious target of zero new HIV transmissions by 2030. HIV stigma is a significant barrier to achieving this target. Media reporting plays an important role in shaping social representations of HIV and of stigma. Between 2016 and 2018, the media in the UK reported on the Daryll Rowe case – the first criminal prosecution for intentional transmission of HIV in the UK. This article examines the way that UK newspapers reported this case, which may have exacerbated HIV stigma. Using Nexis, 178 UK newspaper articles were extracted and subjected to qualitative thematic analysis through a social constructionist lens. Informed by social representations theory, the analysis yielded three discursive themes: (1) Representing the perpetrator through HIV-focussed metaphors; (2) Constructing volitional ambiguity; and (3) Anchoring the lived experience of HIV to misery and death. UK newspapers constructed an ‘evil vs victimhood’ dichotomy in relation to Rowe and the men infected with HIV, respectively. This article argues that news coverage of the Rowe story constructs HIV in ways that are inconsistent with public health messaging. Reporting failed to note innovations in HIV treatment and prevention but instead disseminated stigmatising social representations of HIV. This is important because stigma impedes effective HIV prevention, engagement with HIV care and ultimately our ability to achieve the zero-infections target. Between 2012 and 2018, HIV incidence in gay, bisexual and other men who have sex with men in the UK decreased by 71% . The UK  The epidemic is relatively small in the UK, with an estimated 103,800 people living with the condition, which disproportionately affects gay, bisexual and other men who have sex with men  in December 2016. On 15 November 2017, Daryll Rowe became the first person in England and Wales to be convicted of causing GBM under the Offences Against the Person Act 1861 for deliberately infecting, or attempting to infect, male sexual partners with HIV. He was sentenced to life imprisonment and will serve at least 12 years in prison before being considered for parole.There have been a handful of criminal convictions for the sexual transmission of HIV in England and Wales and some of these cases, including that of Rowe, have been the subject of legal research . Given iThere has, so far, only been one article examining media reporting of this case as compared to another case in Italy . The autThe media constitute a key source of societal information regarding science, medicine and health . In thisAnchoring refers to the process of making something unfamiliar understandable by linking it to something that we already know about. HIV may be linked to imagery of death and destruction, which in turn leads people to think of it as a life-limiting condition.Objectification is the process whereby unfamiliar and abstract objects are transformed into concrete and ‘objective’ common-sense realities – most notably through the use of metaphor – allowing us to map aspects of more familiar knowledge  onto more unfamiliar knowledge  . For insAs an unprecedented legal case about a poorly understand health condition, the Daryll Rowe case is anchored to, and objectified in terms of, existing constructs in the popular media so that it resonates among readers and can become a topic for thought and discussion. Social representations theory enables the analyst to understand the origins, development and repercussions of emerging representations in this forum.This study contributes to a vibrant tradition of research into social representations of infectious diseases from The newspaper media may set the tone for public understanding about, and engagement with, such issues by influencing and reflecting policy agendas . They ar® news database, we conducted a search of all national and regional/local newspapers in the UK and extracted all articles published between 26 February 2016 (the first article to be published on this case) and 30 September 2019 (the last article to be published). Using the ‘Hide Duplicate Results’ function on Nexis®, which excluded duplicate stories, this process yielded a total of 178 newspaper articles, all of which were relevant and therefore included in the analysis. We decided not to include articles published in the lesbian, gay, bisexual and transgender (LGBT) media, such as Pink News (in which 22 articles were published on the case), which tend to be aimed at, and consumed by, LGBT people. We were interested in the mainstream press and its role in shaping public understanding of HIV .Using the keyword ‘Daryll Rowe’ on the NexisThe Daily Record and Sunday Mail (a Scottish tabloid newspaper based in Glasgow) and The Herald (a Scottish broadsheet newspaper). These outlets included in the analysis reflect a wide range of political perspectives (both right- and left-wing politics); feature both national and local newspapers; and are available both online and in hardcopy format. The first articles to mention the case were published in We analysed the corpus using a social constructionist variant of qualitative thematic analysis, which has been described as ‘a method for identifying, analysing and reporting patterns (themes) within data’ : 78. Thi®. We read and re-read the articles to familiarise ourselves with the broader themes that we subsequently discussed analytically. First, initial observations were made which captured the essential qualities of each article, the units of meaning, and dominant rhetorical techniques. Second, we discussed our respective initial codes, which included inter alia general tone, particular forms of language, comparisons, categorisations and emerging patterns in the data. Third, the initial codes were collated into preliminary themes, which reflected the content of the analysis, and subsequently arranged into a coherent structure that reflected the overall thematic analysis.Both the headline and the main body of each article was subjected to thematic analysis. Images were not included in the analysis, as they are not available on NexisIn addition to describing dominant themes in the corpus, we identified linguistic elements , which performed the functions of anchoring and objectification. The superordinate themes can be considered social representations because they ‘assume a configuration where concepts and images can coexist without any attempt at uniformity, where uncertainty as well as misunderstandings are tolerated, so that discussion can go on and thoughts circulate’ : 233. InIn this section, the following three discursive themes are described: (1) ‘Representing the perpetrator through HIV-focussed metaphors’; (2) ‘Constructing volitional ambiguity’; and (3) ‘Anchoring the lived experience of HIV to misery and death’. and ‘HIV Scot’  with the elaboration that he had been ‘charged’, that he had ‘set out to infect more partners’, that he had ‘drunk his own urine’ as a means of attempting to treat his infection, and that he had been ‘charged’ with a crime.In the headlines of articles reporting the case, Rowe’s name was seldom used and was instead replaced by a variety of epithets which focused mainly on HIV. In some cases, he was simply referred to as ‘HIV man’ The epithet ‘HIV hairdresser’ was frequently juxtaposed with judicial metaphors, such as ‘Key events that brought HIV hairdresser to justice’ and ‘HIV hairdresser freed on bail’. Similarly, several headlines focused explicitly on his criminal status, as an ‘HIV suspect’, ‘HIV trial man ‘HIV fugitive’ or as a ‘ HIV attacker’. There was also some use of medicalised epithets, such as ‘HIV carrier’ which were juxtaposed with judicial metaphors such as ‘gets life’. Some articles referred to Rowe as an ‘HIV spreader’, and coupled this with the observation that he had been ‘jailed for life’, thereby establishing a connection between HIV transmission and life imprisonment (discussed in more detail below).In some cases, his occupation as a hairdresser was foregrounded invariably in conjunction with ‘HIV’, which was again used adjectivally: ‘HIV hairdresser’. ‘brute’ and ‘fiend’. The animalistic metaphor ‘fiend’ was used as the subject of the sentence ‘A fiend who infected lovers with HIV’ and that of ‘brute’ was qualified with ‘guilty of infecting sex dates’. Moreover, in some articles, the animalistic metaphor that Rowe ‘preyed’ on men was used to describe his actions. When used in relation to a human being, animalistic metaphors such as ‘fiend’ and ‘brute’ construct the individual as evil, devious and immoral. Indeed, there were several instances in which Rowe was described explicitly as a ‘devious and deceptive predator’, often through the discourse of key stakeholders in his case, such as the detective inspector and prosecutor involved in his case.In most cases, however, ‘HIV’ was combined with animalistic metaphors, such as ‘predator’, thereby constructing a relationship between (gay) sex and Rowe’s behaviour. In the same article, this sexualising epithet was used alongside the notion that Rowe had a ‘porn secret’, that is, that he had featured in the gay adult porn films. There was an element of stigma appended to gay sexuality with one article referring to ‘unprotected romps’ between Rowe and the men whom he infected, and to Rowe as ‘lining up trysts’. This constructed the act of condomless sex as necessarily irresponsible and the use of geospatial social networking applications, such as Grindr, to seek sexual partners as clandestine. More generally, in attempting to explore the possible motives underpinning Rowe’s actions, one article noted that Rowe ‘came out as gay at the age of 15, in the same year that he experienced his first sexual encounter’, suggesting gay sexuality and early sexual debut as possible explanations for his behaviour.‘HIV’ was sometimes used in conjunction with ‘sex fiend’, was also common in the corpus, as well as ‘Grindr monster’ and ‘Date app fiend’. These epithets were often juxtaposed with other animalistic metaphors, such as ‘Virus brute caged in UK’, and with criminal metaphors, such as ‘HIV fiend extra jail’. In some cases, these labels were associated with the utterances of key figures in authority, such as Detective Inspector Andy Wolstenholme, who reportedly ‘blasted the monster’. Although the detective inspector did not actually use this word himself, its use with the detective inspector as the subject of the sentence served to distance the epithet from the journalist and to associate it with the detective inspector, thereby bestowing on the label a degree of legitimacy. In a further exploration of others’ responses to Rowe, the headline of an article focusing on other prisoners’ hostility towards Rowe after he was incarcerated reported ‘HIV fiend hounded from jail; lags target hated predator’. This article served to extend the animalistic metaphor of Rowe as a predator to that of other prisoners as now preying on him, thereby positioning him in a metaphorical field of the animal kingdom. Furthermore, the representation that convicted criminals ‘hate’, ‘hound’ and ‘target’ Rowe further legitimised use of stigmatising terms to describe him.Yet, HIV was not the only component of the descriptions used for Rowe – ‘virus brute’ ‘HIV GHB charges’, ‘HIV sex charges’, ‘HIV offences’ (for which Rowe was reportedly ‘charged’), ‘HIV violence’ (for which he was reportedly ‘jailed’) and ‘HIV attacks’. These might be referred to as ‘compound crimes’ which in turn serve to anchor HIV transmission to criminal activity  and to judicial consequences . Similarly, articles which focused on the judicial case that followed Rowe’s actions used HIV-focused compounds, such as ‘HIV court case’ and ‘HIV life sentence’, thereby reiterating the anchoring of HIV to judicial consequences and entrenching negative connotations of the illness. Throughout the corpus, there was, unsurprisingly, a focus on Rowe’s crime but, in most newspaper headlines, the crime was poorly defined and the real focus shifted to HIV, equally ill-defined.‘HIV’ was also used as part of a number of verbal compounds to describe Rowe’s actions. Judicial metaphors were used alongside ‘HIV’ and included ‘HIV rampage’,volition explicitly, there was a tendency for ambiguity and many of the headlines, in particular, left open the possibility that HIV transmission was non-volitional, that is, unintended.Most article headlines in the corpus were characterised by ‘volitional ambiguity’ in relation to the crime, that is, ambiguity about the degree to which Rowe intentionally attempted to infect his sexual partners with HIV. Rather than stating  or a ‘man charged over HIV’, without elaborating on the nature of his crime or focusing on the notion of intentional HIV transmission. Here, unlike the HIV compounds discussed above, the focus was squarely on the illness or infection, framing it as a criminal tool, even weapon. In another article, the epithet ‘HIV infection accused’ which constructed his crime as the transmission of HIV to others, without clarifying the circumstances under which HIV transmission had occurred or, crucially, the degree to which the act of transmission had been volitional. In several articles, it was noted that Rowe  was ‘accused of giving lovers HIV’ and that he ‘gets second jail term for giving partners HIV’. The verb ‘to give’ in relation to HIV transmission was neutral and could include non-volitional HIV transmission, but, in this context, it rather came to mean ‘inflicting’. Similarly, in other articles, it was observed, sometimes through the discourse of the prosecutor, that Rowe ‘was HIV positive’ and that his offences involved ‘him sleeping with his alleged victims’. This served to construct the act of having sex with others  when living with HIV as a criminal offence, rather than the intentional transmission of HIV to unsuspecting sexual partners.Article headlines were often very ambiguous, referring simply to a ‘man held over HIV infection’ In the absence of more information about his case, this contrast between action (‘infecting victims’) and self-presentation (as genuine) suggested that HIV transmission is necessarily indicative of disingenuity towards ‘victims’, that is, unsuspecting individuals. The headline foregrounded the social representation that HIV transmission is volitional and the constructed intentionality in HIV transmission extended beyond the specific case of Rowe. Thus, HIV transmission was anchored to disingenuity, thereby suggesting a sinister motive underpinning the transmission of HIV to others.In some articles, a contrast was drawn between Rowe ‘who infected victims with HIV’ and others’ perception of him as ‘a genuine person’.charged over HIV infection’, that he ‘pleads guilty to infecting victims’, and that he had been ‘jailed for life for infecting men with HIV’. Moreover, there was reference to a ‘manhunt for a suspect’ which culminated in ‘cops making an arrest’. The anchoring of HIV transmission to judicial metaphors served to construct HIV transmission invariably as a criminal act and to establish a discursive connection between the act of transmitting HIV and judicial retribution.In most article headlines, the act of HIV transmission was anchored to judicial metaphors. For instance, the specific observation was often made that Rowe had been ‘ ‘people’, and ‘Grindr dates’ as the indirect object. Moreover, there was sometimes no reference to those who acquired HIV as a result of Rowe’s actions – one headline reported, ‘man jailed for spreading HIV’.The article headlines referred to the indirect object, that is, the individuals who acquired HIV as a result of Rowe’s actions, in a variety of ways. In some articles, they were referred to as ‘victims’, which suggested, but did not confirm, volitional HIV transmission. The reference to these individuals anchored HIV acquisition to victimhood, thereby suggesting that the perpetrator is invariably the person who is living with HIV and transmits it. Moreover, as discussed in the next subsection, the emphasis on victimhood constructed the experience of living with HIV in adverse terms. In other articles, the anchoring of HIV transmission to judicial metaphors appeared with ‘men’, which can be contrasted with the HIV-focussed epithets used to describe Rowe. Several articles used the judicial metaphor that the men were ‘living with a life sentence’, which referred to their HIV infection. Furthermore, in describing the men’s experiences in the aftermath of their encounters with Rowe, the media focused on both the physical and psychological experience of living with HIV, both of which were represented negatively as being conducive to significant psychological distress. Articles referred to ‘having to live with the “devastating consequences” of contracting the virus’, which constructed HIV invariably as being distressing.Although the majority of media reporting focused on Rowe, there was consistent reference to the health and wellbeing of the men who acquired HIV as a result of Rowe’s actions. The men’s reported experiences (mainly through direct quotes from the men themselves) were often represented as evidence of that Rowe was an evil person. A consistent tendency across the corpus was the emphasis of the men’s victimhood and, accordingly, they were referred to as ‘HIV victims’, or a ‘deadly sexual disease’ which anchored HIV to imagery of death. This is consistent with dominant social representations of HIV in the pre-treatment era but inconsistent with modern developments in medical science which ensure a good prognosis and normal life expectancy if one is diagnosed and treated early. Furthermore, a quote from one of the men who acquired HIV was reproduced in order to illustrate the lived experience of HIV: ‘I felt like I had been left with a poison inside me’, which referred to his infection with HIV. Alongside anchoring to death imagery, use of the poison metaphor objectified HIV in terms of a life-limiting condition.Several articles referred to HIV as ‘the deadly virus’ His experience of GBH  was constructed as more serious, enduring and indeed life-limiting than other forms of GBH which reportedly might be more easily tolerated. Conversely, his acquisition of HIV was anchored to death imagery, which was qualified as ‘horrible and painful’. In other words, HIV was positioned as being even worse than death due to the suffering that it could cause before death. Similarly, another individual was quoted as saying ‘it [HIV] was a lifelong sentence, which would eventually kill me off’, further anchoring HIV to death imagery.Similarly, another man who acquired HIV contrasted his lived experience of HIV with that of victims of other forms of GBH: ‘While for some cases of GBH it might be possible for victims to put the acts behind them, unfortunately this will never be the case for me. . . There is a virus inside me which will give me a horrible and painful death unless I take pills for the rest of my life’.per se. A quote from one of men  constructed HIV infection as a rupture in his sense of continuity, that is, between past, present and future: ‘the old me is no longer. The new me is constantly sad, thinking about how my life has changed’. The construction of discontinuity is consistent with the aforementioned anchoring to death imagery since the ‘old me’ was said to be defunct and to be replaced by an undesirable ‘me’.Most articles focusing on the lived experience of HIV also emphasised the psychological trauma experienced by the men who had acquired HIV and constructed their overall experience of living with the condition as psychologically distressing. The psychological distress was attributed not to the specific circumstances of their acquisition of HIV  but rather to the experience of living with the condition  This quote foregrounded the social representation that individuals living with HIV are treated as social pariahs, which is questionable in the advent of decreasing HIV stigma and ‘U=U’. Furthermore, this quote served to construct the experience of living with HIV as socially isolating and, thus, the destruction metaphor ‘ruined my life’ was used to describe his experience with the condition. Similarly, another individual noted that ‘Rowe claimed he was clean so we didn’t use condoms. Then I caught HIV. He has ruined my life’. In this quote, first, the individual used the term ‘clean’ to refer to being HIV-negative which implied that those living with HIV are, conversely, dirty. This clearly accentuated the stigma surrounding HIV. Second, Rowe was said to have transmitted HIV to him and, thus, ‘ruined’ his life, which anchored HIV to destruction beyond repair.An article included a quote from another individual, which constructed HIV as destructive to his life because of the stigma associated with his condition: ‘I just felt like my life had been ruined, and that nobody would want to know me. There is still a huge stigma to HIV and I thought that no men would want to come near me’. Another was quoted as referring to HIV as having a ‘shattering effect’ on his life. The experience of being diagnosed with HIV was constructed as being worse than death itself – indeed, an individual was quoted as saying ‘I would rather he had murdered me than left me to live my life like this’. This suggested that the experience of living with HIV rendered life unbearable, thereby representing death as preferable to living with HIV. Similarly, some of the men were said to be contemplating suicide: ‘many told how they had considered suicide, having suffered physical and psychological damage, needing to take daily medication’. One of the men was quoted as saying, ‘I think about committing suicide most of the time. Daryll has destroyed my life. I lost a lot of weight and felt very ill for a long time. I can’t see myself having a relationship ever again’, while another reportedly said, ‘I think about committing suicide most of the time. Daryll has destroyed my life.’ The consistent anchoring of HIV to death and destruction imagery in the corpus contributed to the social representation that HIV is worse than death.In view of both the physical and psychological trauma to which HIV was anchored, articles also represented a proclivity for the men who acquired HIV to contemplate suicide. A victim was quoted as saying that his diagnosis felt like being ‘hit by a bus’ and that ‘you feel like your life is over. You feel like you should go to a high place and jump’. The article proceeded to invite readers to ‘Imagine the horror these poor men lived through in court, only to have a smart QC claim their lives were going to carry on as before, belittling their situation’.Most articles in the corpus focused on representing Rowe as malevolent through the use of negative epithets. This tendency appeared to be the discursive priority which superseded the discussion of innovations in medical science that have transformed HIV from a life-limiting into a life-changing illness. All but one of the articles in the corpus failed to mention innovations in medical science – the one article that did directly challenged the legitimacy of outlining these innovations in the context of Rowe’s case: ‘. . .the arguments advanced by his [Rowe’s] defence team give cause for concern. Felicity Gerry QC claimed that HIV was “not a terminal illness”, stating: “Those that live with HIV have good and high life expectancies. There is a need for therapy and not incarceration.”’Thus, innovations in HIV medicine were constructed not only as irrelevant in this context but also as insult to the men who contracted HIV as a result of Rowe’s actions. The focus was clearly on representing Rowe as evil, his compound crimes as malevolent and the men who acquired HIV as victims. The social representation that Rowe is evil overshadowed broader public health messages about HIV prevention and the reality of living with HIV in the era of antiretroviral therapy. Within this discursive context, the social representation that HIV is worse than death was able to thrive.In our study, we show that there is an overarching focus on communicating the evil of Daryll Rowe, the perpetrator of the crime, on the one hand, and on emphasising the victimhood and plight of those who acquired HIV as a result of his actions, on the other hand. There were three main social representations which were constructed and drawn upon in order to substantiate this ‘evil vs victimhood’ dichotomy in media reporting of the case: first, there was a social representation that HIV is a social, moral and legal flaw; second, HIV was socially represented as a criminal tool; and, third, the corpus constructed a social representation that HIV is a psychologically, emotionally and physically destructive disease. These three discursive themes demonstrated the social and linguistic mechanisms  which were used in order to construct and legitimise the three social representations. These included representing Daryll Rowe using negative epithets with HIV-focussed metaphors; ambiguity in the level of volition underlying his actions; and anchoring the lived experience of HIV to misery and death.There has been a focus on reducing HIV stigma in the UK with some success. The Indeed, the use of HIV-related metaphors and compounds to construct negative epithets, which replaced Daryll Rowe’s name in article headlines, appended animalistic characteristics to Rowe, dehumanised him and constructed his brutality . Yet, HIHIV (rather than deliberate transmission) as a criminal tool, which was further bolstered by the animalistic, judicial and war metaphors that were frequently used in conjunction with HIV in reporting. Yet, it is noteworthy that most infections occur because people are actually unaware of their HIV status and, thus, transmit HIV when they are untreated and have a high viral load  remains a key comorbidity of HIV infection .In his study, An analysis of media reporting of HIV  found thHaving said this, one has to acknowledge that journalists find themselves grappling with a dilemma, namely writing sensationalised and headline-grabbing stories that, intentionally or not, amplify stigma, or counterbalancing such reporting with messages that attenuate this trend which runs counter to public health messages. This is not easy, but we suggest that journalists should at least be made aware of the dilemma that they face in HIV reporting.Pink News. It would be advantageous to examine how the case was reported on these media platforms, which tend to take a more critical view of HIV stigma, because HIV stigma also remains a significant challenge in the gay community (There are some limitations, which should be addressed in future research. First, our study focused on media reporting in the mainstream national and regional press, though it is acknowledged that the case was also covered in the LGBT press, such as in ommunity . Second,This article argues that news coverage of the Rowe story constructed HIV in ways that are inconsistent with public health messaging. Reporting reinforced dominant social representations of HIV in the pre-treatment era but did not acknowledge, or explain, modern developments in HIV science which ensure a good prognosis and normal life expectancy if one is diagnosed and treated early. None of the articles noted the advent of antiretroviral therapy, pre-exposure prophylaxis or ‘U=U’, all of which play a key role in reducing HIV stigma and in promoting effective HIV prevention and wellbeing. Media reporting of the Rowe case understandably focused on the events, the motivations of Rowe, and the voices of those he infected. However, social stigma is a recurring motif which may have significant implications for how people think, talk and behave in relation to HIV and, consequently, for our ambition to prevent new HIV transmissions by 2030.


What are the self-reported practices of frontline dispensary staff who interact with customers purchasing cannabis for medical purposes?In this survey study of responses from 434 staff from 351 unique dispensaries, recommendations were most often based on experiences of the respondent, other customers, and other staff recommendations. Higher medicalization scores were associated with physician or clinician input as a basis for recommendation.The results of this survey study suggest a need for clinicians to be aware of dispensary staff practices and to engage in discussions about the benefits and harms of cannabis use with their patients. Over the last decade, cannabis has become more accessible through the proliferation of dispensaries in states that have legalized its use. Most patients using cannabis for medical purposes report getting advice from dispensaries, yet there has been little exploration of frontline dispensary staff practices.To describe the practices of frontline dispensary workers who interact with customers purchasing cannabis for medical purposes and assess whether dispensary practices are associated with medicalization of state cannabis laws (degree to which they resemble regulation of prescription or over-the-counter drugs) and statewide adult use.This nationwide cross-sectional survey study was conducted from February 13, 2020, to October 2, 2020, using an online survey tool. Potential respondents were eligible if they reported working in a dispensary that sells tetrahydrocannabinol-containing products and interacting with customers about cannabis purchases.Participant responses to questions about formulating customer recommendations and talking to customers about risks.The 434 survey responses from 351 unique dispensaries were most often completed by individuals who identified as budtenders (40%), managers (32%), and pharmacists (13%). Most respondents reported basing customer recommendations on the customer’s medical condition (74%), the experiences of other customers (70%), the customer’s prior experience with cannabis (67%), and the respondent’s personal experience (63%); fewer respondents relied on clinician input (40%), cost (45%), or inventory (12%). Most respondents routinely advised customers about safe storage and common adverse effects, but few counseled customers about cannabis use disorder, withdrawal, motor vehicle collision risk, or psychotic reactions. A higher state medicalization score was significantly associated with using employer training  and physician or clinician input  as a basis for recommendation. Medicalization score was not associated with counseling about cannabis risks.This survey study provides insight into how frontline dispensary staff base cannabis recommendations and counsel about risks. The findings may have utility for clinicians to counsel patients who purchase cannabis, customers who want to be prepared for a dispensary visit, and policy makers whose decisions affect cannabis laws. This survey study describes the practices of frontline dispensary staff who interact with customers purchasing cannabis for medical purposes and assesses whether dispensary practices vary according to state cannabis law medicalization. In this context, clinicians may encounter increasing numbers of patients with questions about using cannabis for medical purposes. It is not known what proportion of cannabis used is obtained from dispensaries; a 2020 study1 suggests that individuals obtain cannabis from dispensaries as well as from alternative sources . However, dispensary sales are increasing, underscoring their importance in the US cannabis market.2 Moreover, most patients who use cannabis for medical purposes report receiving specific advice about cannabis formulations and use patterns directly from dispensaries rather than from clinicians.3Cannabis access has substantially increased over the past decade in the US,4 describe the “void in clinician counseling of cannabis use,” which they propose is due to federal laws that prohibit physicians from prescribing cannabis and lack of evidence-based recommendations about benefits and harms. The health care clinician’s role is relegated to assessing whether the patient has a state-sanctioned qualifying condition, resulting in a phenomenon the authors describe as “cannabis dispensary workers as proxy clinicians.” There has been little exploration of frontline dispensary staff practices.Understanding how dispensary staff interact with consumers is key to knowing how consumers make cannabis purchasing decisions. Calcaterra et al5 of all states with legal medical cannabis identified substantial variability in requirements across several domains, including manufacturing or testing, product labeling, and types of products permissible for sale, as well as limits on the supply or dose that can be dispensed. The degree to which these regulations resemble regulation of prescription and over-the-counter drugs has been termed medicalization.5One factor that complicates understanding dispensary practices is state law variability. A recent studyThis study describes the practices of frontline dispensary staff who interact with customers purchasing cannabis for medical purposes. We assessed whether dispensary practices varied according to state cannabis law medicalization and whether the state allowed adult use. We hypothesized that respondents from states with more medicalized programs vs less medicalized programs would rely on traditional sources of information  and would talk with customers more about risks.10 and finding no detailed survey querying staff practices, our team developed a survey specifically to query dispensary staff practices. The eMethods in the AAPOR) reporting guideline for survey studies. This study was classified as exempt from review and informed patient consent by the University of Pittsburgh Institutional Review Board because of the study type.After reviewing relevant literature11 but since dispensaries open and close frequently, the true denominator of dispensaries cannot be definitively determined.To identify US dispensaries, we purchased a list of 4715 dispensaries across 34 states from a marketing company. We identified additional dispensaries through internet searches of state databases and websites such as Leafly.com and WeedMaps.com. This is an accepted method of locating dispensaries that are operating at a given time,We initially planned to recruit respondents with telephone calls to a representative random sample of all identified US dispensaries. We generated random samples of 1000 dispensaries stratified by state, and research staff called these dispensaries using a standard script. The script involved asking for a manager who could send the survey to frontline staff. We found that dispensary managers were often difficult to reach, and managers and higher-level administrators expressed concern about the potentially proprietary nature of the information we wished to gather  and our intentions regarding speaking directly to staff . This recruitment method led to few completed surveys.To increase responses, we mailed hard copies of the survey to all identified US dispensaries including instructions for online completion, and used a snowball sampling approach by sending an electronic link to leaders at 2 large national dispensary chains and a cannabis retailers association. Although not specifically encouraged, the electronic link could be forwarded so that survey responses were not limited to the dispensaries we directly recruited. To calculate the response rate for telephone calls and mailers, responses were attributed to the most recent method of contact.Participants were eligible to complete the survey if they reported working in a dispensary and interacting with customers about cannabis product purchases. To be considered a cannabis dispensary, the dispensary had to sell tetrahydrocannabinol (THC)–containing products, whether for medical or adult-use purposes or both; we excluded stores that sold only cannabidiol products. We excluded employees under the age of 18 years and those who had been in their current position for less than 3 months.All surveys were delivered online via Qualtrics. The survey was developed and then piloted from May 2019 to January 2020. It opened for completion by respondents on February 13, 2020, and closed on October 2, 2020. Respondents were given the choice of receiving a $10 payment card immediately on completion of the survey or the option of being randomly selected to receive a $250 payment card at the end of the study.5 This score includes 7 domain scores  and a summary score for each state that had enacted medical cannabis laws as of July 2019. Herein, we used the summary scores, which range from 23  to 86 . The statewide adult use variable was whether the state had legal adult use as of July 2019.A state cannabis medicalization score was developed based on a review of cannabis laws.Continuous variables are presented as mean (SD); categorical variables are presented as frequencies and percentages. Multivariable regression analyses were used to estimate associations between state regulations and the 2 practices of interest: basis of recommendations and talking to customers about risks. A separate regression was performed with each basis of recommendation and risk as the outcome. For each regression, the 2 independent variables of interest were state medicalization score  and statewide adult use (dichotomous). All models included the following prespecified covariates: age, role , years working in the cannabis industry, receipt of sales commission, and level of education.P < .05.Logistic regression analyses were conducted for the basis-of-recommendation outcome variables; results are reported as odds ratios (ORs) with 95% CIs. The talking-to-customers-about-risk outcome variables were modeled using ordinary least-squares regression; results are presented as regression coefficients and standard errors. All statistical analyses were performed using R version 3.6.0 . Statistical significance was set at 2-sided 11 or whose website did not confirm sales of THC-containing products.Our survey was mailed and emailed widely and could have been forwarded to unanticipated respondents, and came with a small financial incentive. To ensure that our analyses included only responses that could be legitimate, the primary analytic set included surveys that were at least 95% complete, from states in which sales of THC-containing products are legal, and from respondents not affiliated with major chain pharmacies or grocery stores where THC-containing products are not sold. We conducted a sensitivity analysis in which we removed dispensaries that were not on our list to contact that did not have a website Of 1988 dispensaries who received at least 1 telephone call attempt, 127 (6%) returned at least 1 completed survey. Of the 4733 identified US dispensaries who received a mailer, 352 (7.4%) returned at least 1 completed survey. We received 735 total responses, of which 222 were more than 95% complete, 38 were from states in which sales of THC-containing products are not legal, and 41 were from chain pharmacies or grocery stores in which cannabis is not sold, leaving 434 eligible for the primary analysis (from 351 unique dispensaries). These 351 responding dispensaries were from states with mean (SD) medicalization scores of 46 (5) vs 40 (10) from dispensaries that did not respond, and were less often from adult use states (42%) than dispensaries that did not respond (50%). Of the 434 surveys eligible for the primary analysis, 43 did not have a website confirming THC-containing product sales, leaving 391 eligible for the sensitivity analysis (from 308 unique dispensaries). The results of the sensitivity analyses were similar to the primary analyses and are presented as The largest number of surveys were from New York, Oregon, California, and Florida  and physician or clinician input  as a basis for recommendation, and was negatively associated with using product appearance , the respondent’s personal experience , or what needs to get moved out of inventory  as a basis for customer recommendations. Statewide adult use was associated with using trade literature , app or website , experience of friends or colleagues , product appearance  and product smell  as a basis for customer recommendations.Regression analyses were conducted to assess the association between state medicalization score  and statewide adult use (yes) and respondent’s use of a given basis for recommendations to customers . A higheP = .03). Otherwise state medicalization score and adult use were not associated with counseling about cannabis risks.In this national survey study, most dispensary staff had worked in the cannabis industry for 1 or more years, were college-educated, and many used cannabis for medical or adult-use purposes. Staff often relied on personal and coworker experience to make recommendations. While most staff reported routinely counseling customers about safe storage of cannabis and routine cannabis adverse effects such as sleepiness, few reported routinely counseling customers about cannabis-related risks such as psychosis, motor vehicle collisions, cannabis withdrawal syndrome, or cannabis use disorder.State medicalization and adult use were associated with how respondents based their recommendations. Being in a state with a higher medicalization score was associated with an increased likelihood of using employer training and physician or clinician input as a basis for clinical recommendations. This finding may indicate that medicalization is associated with an environment where physician or clinician input is more likely to be incorporated. Additionally, respondents who lived in states with legalized adult and medical use were more likely to endorse using personal experience and cannabis product smell or appearance as a basis for recommendations, perhaps indicating more product familiarity. However, state medicalization and adult use were generally not associated with counseling about cannabis-related risks. Although cannabis risks have been well-characterized, our findings suggest that state regulations have not been associated with dispensaries where such risks are emphasized.12 To our knowledge, no current research clearly outlines the balance of cannabis benefits and harms. Despite customers’ potential reliance on dispensaries for health-related information about cannabis,4 it may not be reasonable to expect dispensaries, which are retail and not medical establishments, to bear primary responsibility for such counseling, much as alcohol retailers may not provide counseling about alcohol-related harms.It could be expected that dispensary workers do not routinely counsel customers about risks. A survey of the US general population found that less than half of respondents who had reported any past year cannabis use were concerned about risks such as cannabis use disorder, and that perceived risk of regular cannabis use has decreased over time.13 including reviewing cannabis-related harms, and to counsel patients about potential ways to mitigate these harms, such as previously-published guidance for low-risk cannabis use.14Clinicians may not be aware of dispensary staff practices, and engagement in discussions about the benefits and harms of cannabis use with their patients is warranted. For example, clinicians might alert patients that dispensary staff purchasing recommendations may be based on nonprofessional anecdotal experience and they should not expect counseling about harms. This approach could be an opportunity for the health care clinician to have evidence-based discussions with their patients about cannabis5 has shown, there is substantial variability in states’ degree of medicalization. Therefore, we suggest that dispensary environments are highly variable and cannot be assumed to be medical environments. Certifying clinicians, particularly in less medicalized states, should be aware that the decision-making that occurs at a dispensary is often different from that which occurs in a medical environment such as a pharmacy.Although a higher degree of medicalization was associated with using health care clinician input and information from training, legal statewide adult use was associated with using personal experiences of friends or colleagues. Additionally, as research15 and the uncertainties in the evidence base, leading to a low comfort level related to recommending medical cannabis.8There is likely a gap between the way cannabis is perceived by dispensary staff and the way it is perceived by clinicians. Our findings suggest that dispensary staff are comfortable giving advice from an experiential standpoint. Conversely, clinicians may view cannabis through a traditional pharmacotherapeutic lens and be troubled at the lack of standardized dosing, regulatory oversight,6 reported results from a smaller sample of dispensary workers in 2 cities but focused on comparing characteristics and practice among workers who had and had not received training and on their online behaviors. The procedural revisions we made to our initial recruitment approach could help advance knowledge in the field about dispensary staff research recruitment methods. We attempted to call a large number of randomly selected dispensaries from a comprehensive list. However, dispensary lists may be obsolete due to dispensaries opening and closing, such that a denominator for response rates cannot be determined. Given the importance of research in the industry, we recommend that metrics assess the use and success of a best possible approach. Such metrics could include reach of a survey across states in which cannabis is legal and the absolute number of responses. In this case, we had hundreds of responses from most states in which cannabis is legal, suggesting that this approach is viable for addressing frontline dispensary practices.This study has strengths. To our knowledge, this is the first national study to examine self-reported dispensary staff practices. A prior studyThis study also has limitations. Responses are based on self-report; actual staff practices are unknown. Additionally, the degree to which the respondents are representative of dispensary workers nationally, or the responses are representative of dispensary practices nationally, is not known. Respondents may be fundamentally different from nonrespondents in unmeasured ways that could confound findings or limit generalizability. Our sample size is fairly modest, limiting statistical power to detect small effects. Finally, the field is dynamic: dispensaries open and close and laws and policies change.This survey study provides insight into frontline dispensary staff cannabis recommendations and counsel about risks. Our findings may have utility for clinicians to counsel patients who purchase cannabis from dispensaries, customers who want to be prepared for a dispensary visit, and policy makers whose decisions affect state cannabis laws.


To face the rapidly growing world human population, an increase in agricultural productivity and production is necessary to overcome the enhanced food demand. This can be achieved either by increasing the cultivated area or by deploying improved crop plants and yield using next-generation plant breeding. The application of advanced technologies in plants has accelerated the generation of multi-omic data at various levels, such as the genome, proteome, transcriptome, epigenome, and metabolome levels. To take full advantage of this, integrative approaches using mathematical or relational models are needed to sequentially or parallelly combine the available multi-omics data to understand molecular interactions and physiological mechanisms at an organism-wide level ,2. In otRecent improvements in high-throughput genotyping methods have fueled the development of analytical methods for QTL identification. Macko-Podgórni et al.  provide Advances in genomics also illustrate the high complexity of quantitative host–pathogen interactions. Thus, in the current issue, Miedaner et al.  review tPodwyszyńska et al.  have estFurthermore, Kibe et al.  have conConsidering that extrinsic and intrinsic sources of stress can damage DNA, plants have developed highly conserved DNA damage–response pathways to protect them from this harmful effect. Jaskowiak et al.  analyzed–phenotype relationship prediction with GS and ML is becoming a powerful approach in plant genetic and breeding.Góralska et al.  successfTaken together, it is not only the sequence of plant DNA that matters: how do some genes get activated, and why are others silenced? How can genomics facilitate the study of complex traits in plant breeding? In this regard, Salgotra and Stewart  review tFurthermore, RNA sequencing has emerged as a powerful tool for analyzing transcriptomes to identify genes that show differential expression between unstressed and various stress conditions. However, the transcripts obtained from RNA-Seq require reference genome or transcriptome sequences for read-mapping and annotation. In this context, Schaarschmidt et al.  used PacThe advances in next-generation genome sequencing and the rapid development of cost-effective and easy-to-use genome engineering editing methods have facilitated researchers’ use of these tools for the functional characterization of many genes that are useful for crop improvement. In this regard, genome-editing tools such as CRISPR/Cas9, which can be exploited to explore the genetic resources for improving the various economic traits of crop plants in terms of stress tolerance and nutritional quality, are reviewed by Salava et al. . This reFinally, Kloc et al.  show thaDue to the current demand for nutritional security, the obtained data can be used as a resource to address the need to generate resilience to climate change in crop plants by targeting several traits of interest ,11. TherWe wish to thank all contributors to this Special Issue and hope that it will raise interest in and understanding of how genomics and related technologies can drive the next generation of plant breeding. Nevertheless, the current Special Issue can only cover a small part of our scope, and since the subject is of the utmost importance, we are proud to announce the opening of the second part of this Special Issue, “Functional Genomics for Plant Breeding 2.0” and invite our readers to follow and contribute to it.


Like arboviruses, chronic neurodegenerative diseases, like Alzheimer’s and Parkinson’s disease, are found wherever there are humans. Significant differences in baseline gene and protein expression have been determined between human-induced pluripotent stem cell lines derived from non-Parkinson’s disease individuals and from individuals with Parkinson’s disease. It was hypothesized that these inherent differences could impact cerebral organoid responses to viral infection. (2) Methods: In this study, cerebral organoids from a non-Parkinson’s and Parkinson’s patient were infected with Chikungunya virus and observed for two weeks. (3) Results: Parkinson’s organoids lost mass and exhibited a differential antiviral response different from non-Parkinson’s organoids. Neurotransmission data from both infected non-Parkinson’s and Parkinson’s organoids had dysregulation of IL-1, IL-10, and IL-6. These cytokines are associated with mood and could be contributing to persistent depression seen in patients following CHIKV infection. Both organoid types had increased expression of CXCL10, which is linked to demyelination. (4) Conclusions: The differential antiviral response of Parkinson’s organoids compared with non-Parkinson’s organoids highlights the need for more research in neurotropic infections in a neurologically compromised host. There are over 100 medically relevant arboviruses recognized, and anyone who experiences an insect bite is at risk for exposure. Medically significant arboviruses are commonly found in the Togaviridae, Bunyaviridae, and Flaviviridae families. These families contain viruses that cause encephalitis or hemorrhagic fever, and vaccines or treatments are not available for most infections. Death rates are roughly 20,000–50,000 per year for any given arbovirus ,4,5. OftInfected individuals present with a spectrum of disease ranging from subclinical to death. The role of chronic diseases on intrinsic and innate immune defense is emerging as a significant player in a patient’s ability to respond to viral infections ,13,14,15Viral parkinsonism has been documented for a variety of human pathogens though there are few studies that evaluate the effects of viral infection on degenerative neurological diseases . Post-viHow viruses cause parkinsonism is not known. Animal models of neurological infections do not translate to nor mimic changes in the human cerebral cortex documented in postmortem reports and imaging studies. Evaluation of central spinal fluid in human and rodent studies indicate that an inappropriate neuroimmune response is responsible . This beThe use of human-induced pluripotent stem cells (hiPSC) in disease research is increasing not only because relevant data can be generated but because these cells can be differentiated systems that directly translate to a human model. Research on different hiPSCs and organoids has shown that products derived from patients with a disease state exhibit different morphology and gene expression compared with products derived from a normal patient ,29,30,31Since significant differences in gene and protein expression exist between hiPSC lines derived from individuals with and without PD, we hypothesized that these differences could impact response to viral infection . This st2) to the 12th day post infection (p.i.) (6.5338 mm2) (p = 0.2855) (2 (p = 0.0149), while all days of the experiment, PD and non-PD organoids did not differ in size (p = 0.0792–0.492) (The size of non-PD organoids did not significantly differ between the day of inoculation (6.2454 mm 0.2855) A. Over t2–0.492) B,C. Ther2–0.492) C.p = 0.0347) (p = 5.531 × 10−7 (non-PD), p = 2.046 × 10−6(PD)) (p = 0.0002) (p = 0.00257 (PD), p = 0.02076 (non-PD)) (p = 0.1213) (Immunofluorescence for morphology markers showed that both PD and non-PD organoids expressed sex-determining region Y-box 2 (SOX2), beta-III tubulin (Tuj1), neurofilament, and glial fibrillary acidic protein (GFAP). SOX2 is expressed in proliferating neural progenitors, and Tuj1 is a neuron-specific β-Tubulin. Both markers had increased fluorescence on the outer margins of the organoids, indicating growth of new neurons in both infected and control organoids A. GFAP i 0.0347) A,B. When0−6(PD)) A,B). Cas0−6(PD)) A,B. Sign 0.0002) A,B. PD onon-PD)) A,B. When 0.1213) A,B.p = 2.883 × 10−7)  A. The vi × 10−7) B. RT-PCR × 10−7) C.∆∆Ct comparison of Parkinson’s and Non-PD organoids with a non-infected non-PD control showed unique expression patterns for each organoid type. Of 208 genes with significant changes in expression, both organoid types had similar patterns of expression  for 143 targets. A total of 65 genes displayed opposite patterns of differential expression for both organoid types.∆∆Ct comparison of PD and non-PD organoids with their non-infected control showed that global expression of neurotransmitters was down-regulated in PD organoids in response to CHIKV . The datSince endogenous differences in expression exist for PD and non-PD cells ,38,39, wOverall, markers associated with cholinergic neurotransmission displayed decreased expression in non-PD organoids, while PD organoids tended to have no expression or increased expression of the same targets . Of noteFourteen GABA receptors displayed significant differential expression for non-PD organoids, and 13 receptors were differentially expressed in PD organoids . Twelve Four glycine receptors  showed increased expression for both PD organoids when compared with the non-PD non-infected control. Reduced expression was observed in non-PD organoids both in relation to housekeeping gene and in relation to PD organoids . Both orSix glutamate receptors were evaluated, and PD organoids exhibited decreased expression of all targets over non-PD organoids when comparing their ∆∆Ct values to their respective non-infected controls . Of noteEight genes associated with serotonin neurotransmission were examined. Here, PD organoids displayed increased expression of HTR2A, HTR3A, and HTR3B and decreased expression of HTR7, MAOA, and TPH1 . In non-Thirty-six targets representing a spectrum of transporters involved in neurotransmission were examined. ∆∆Ct values showed that non-PD organoids exhibited decreased expression of all targets except SLC6A16, SLC32A1, and SLC6A7 . ∆∆Ct vap = 0.00081, p = 0.000011)  (p = 2.976 × 10−5) but similar fluorescence with the mock-infected control (p = 0.17156)  (Immunofluorescence for neurotransmission markers for glutamate receptors NMDA1 and NMDAR2c indicated that PD organoids had stronger fluorescence of both markers compared to non-PD organoids (.000011) A,B. STX1 × 10−9) A,B. Non-0.17156) A,B. PD o × 10−5) A,B.Both PD and non-PD organoids were evaluated for immune response to CHIKV infection. Markers included surface receptors, stress response, oxidoreductases, cytokines including multiple chemokine receptors, and markers for cell lysis. Overall, PD organoids exhibited increased expression of all markers evaluated on the array when compared with their non-infected control A. ∆∆Ct aMarkers for stress response exhibited a similar pattern of expression for both organoids types though non-PD organoids were down-regulated −3.2 logs for AGTR2, while PD organoids were up-regulated 4.99 logs . FurtherEight chemokine receptors were evaluated, and here, too, both organoid types had a similar expression pattern of up-regulation B. Of notTwenty-three surface receptors comprising a variety of interleukins, tumor necrosis factors, and chemokine ligands were evaluated. CCL2, CCL3, IL-6, IL-10, and TBX21 were significantly up-regulated in expression in PD organoids but down-regulated in non-PD organoids . IL-1A, p = 2.115 × 10−6, p = 9.004 × 10−5)   (p = 0.00822) but significantly increased in PD organoids (p = 2.376 × 10−7)  A,B. SELE × 10−6) A,B. CYP4 × 10−6) . ICAM fl × 10−7) .p = 0.3789), while PD organoids had increased expression of Iba1 (p = 0.0004) (p = 0.002), GBA (p = 0.0014), and CRYM (p = 0.0002) (p = 0.0281) (p = 0.019)  . CRYM, T 0.0002) . DRD1 wa 0.0281) . CCR5, I= 0.019) . PD orga= 0.019) . For the= 0.019) .Research of viral encephalitis and other viral infections of the CNS are crippled by necessary ethical restraints. This field relies on autopsy findings, which are then typically applied to rodent models. Rodents do not present with symptoms of CNS pathologies unless they are genetically modified to be immune-deficient or have large quantities of virus administered via intracerebral injection or injection into other parts of the CNS. This has provided useful insights into the pathogenesis of these viruses but unfortunately has not translated to treatment or prevention of human disease.While animals are valid and useful models, organoids could serve as a preliminary platform for screening that can better inform the design of animal studies and choice of genetic background. Ongoing advances with stem-cell research have provided a platform for producing specific cell types or organoids from human stem cells. Within the last few years, significant advances in human health have been made using stem cells and organoids ,47,48,49+ T-cell response to establish persistent infections [+ T-cell response [When infected with CHIKV, non-PD and PD organoids produced similar amounts of virus for the same period, but after two weeks post-infection, PD organoids started to shrink. Immunofluorescence showed unique virus distribution patterns for non-PD and PD organoids. While non-PD organoids displayed uniform distribution of the CHIKV E2 protein, PD organoids exhibited local accumulation of CHIKV E2. This matches postmortem and necropsy data showing focal distribution of West Nile virus in brain tissue ,53. Unfofections . Gene exresponse . It coulThe distribution and density of astrocytes in non-infected organoids is comparable to other studies that document organoid morphology ,58. GFAPSOX2 and Tuj1 were used to observe neuron proliferation in response to CHIKV. When compared to non-infected organoids, SOX2 fluorescence was similar in CHIKV-infected non-PD organoids but was reduced in CHIKV-infected PD organoids. SOX2 is a transcription factor that regulates pluripotency and neurogenesis and is integral to the growth and repair of neurons . The red∆∆Ct was used to analyze changes in gene expression. When infected organoids were compared to their respective non-infected controls, PD organoids showed a pattern of up-regulation, while non-PD organoids showed a pattern of down-regulation. While this is interesting in and of itself, this analysis did not provide much insight as to whether PD organoids were mounting an antiviral response that reflected the response of non-PD organoids. Previous work has documented that endogenous expression of most genes is different for PD and non-PD cells and patients ,38. ThusThis study showed an overall pattern of excitation of GABA, glycine, glutamate, and serotonin receptors in PD organoids when infected with CHIKV, while non-PD organoids exhibited a decreased pattern of expression for the same markers. While it is well documented that CHIKV can cause long-term or permanent depressive sequelae, there are no studies describing changes in neurotransmission. Two studies have reported the potential antiviral activity of serotonergic drugs on CHIKV replication though viral inhibition assays though impacts on serotonin neurotransmission are not described ,63. GABRWhile the gene expression data shows that the response to CHIKV involves changes in neurotransmission and immune response, clinical trials have shown that dysregulation of the inflammatory response can remodel neurotransmission, leading the changes in mood and cognition ,65,66. TThe data show that both PD organoids have increased expression of NFKB2, a transcription control protein that functions in the innate antiviral response . In PD, Oxidoreductases determine MHC class I surface exposure and influence the activation of inflammation cascades. When found on the plasma membrane, oxidoreductases signal intracellular stress status to the immune system . In partCytokines direct the innate immune response and play an important role in regulating the adaptive immune response. Specific cytokines can serve as biomarkers for viral infections . Our datChemokines are a subset of cytokines that are activated in response to tissue damage as well as foreign proteins and antigens. Overproduction of chemokines is associated with a variety of autoimmune diseases. Most chemokines we examined were expressed at greater levels in PD than non-PD organoids at 14 days post infection. This state of inflammation could potentially cause complications for responding to viral infections. CCL19 is a chemokine that binds to the CCR7 receptor and acts to recruit dendritic cells. CCL19 was up-regulated in PD and non-PD organoids. CCR7 was down-regulated in non-PD organoids but up-regulated in PD organoids. The expression profiles of PD organoids reflect expression profiles documented from cerebrospinal fluid from patients infected with Varicella–Zoster virus . Also, sCCL3 interacts with CCR4 and CCR5 during the acute inflammatory response and functions to recruit monocytes, which can have an impact on neuroimmunity . The incThe complement system is a part of the innate immune response that can lyse cells, activate inflammation, target virus to phagocytic cells, and clear non-cytopathic viruses from the circulatory system. Here, we evaluated the expression of C3 as it functions in both classical and alternative complement activation pathways, and deficiency of C3 can make humans more susceptible to viral and bacterial infections ,92. In oThe use of only two cell lines  is a limitation of this study due to the extensive genetic variation of PD. There are nearly 400 hiPSC cell lines derived from PD patients available for research . While tCercopithecus aethiops kidney cell line Vero E6 (ATCC CRL-1586) were grown in Dulbecco’s modified Eagle’s medium (DMEM) with 10% FBS, supplemented with penicillin/streptomycin, 1× non-essential amino acids, 1× Glutamax, and 1 mM HEPES. All cell lines were incubated at 37 °C/5% CO2. CHIKV (181/25) was obtained from BEI Resources (NR-50345) and expanded once in Vero E6 cells in a biosafety level 2 laboratory. This specific strain of CHIKV, which is a live attenuated strain derived from a human isolate in Asia, was selected based on recent peer-reviewed reports for CHIKV persistence in tissues and use in stem-cell models [Two cell lines were cultured: human-induced pluripotent stem cells  and human-induced pluripotent stem cells (hiPSC) with Parkinson’s disease , which has mutations at the marker for tyrosine hydroxylase 1 . The expl models ,104,105.l models . Infecti+ surges with glutamate release, which can be affected when a virus is present [For this preliminary, observational study, cerebral organoids were utilized because they have cortical neurons that contain functional synapses that produce Ca present . Cerebra present . While m present . Cerebra present , brain d present , and a h present . Briefly present ,111.At 53 days, organoids were transferred to ultra-low attachment 24-well plates at 1 organoid per well. Organoids were infected with 100,000 (~MOI 0.001) PFU per well. Controls included mock-infected cerebral organoids. Supernatant was taken at 48 h, 4 days, 7 days, 10 days, and 14 days post infection and pooled amongst similar treatments. Samples of cerebral organoid tissue were also taken at 48 h, 3 days, 7 days, and 14 days post infection, and preserved in 4% paraformaldehyde solution in PBS (ThermoScientific Cat# J19943-K2) at 4 °C.Plaque assays were performed using the pooled supernatant samples from each treatment at each time point taken during the experiment, following methods described elsewhere , and cDNA was generated using Applied Biosystems High-Capacity cDNA Reverse Transcription Kit (Applied Biosystems #4368814). Gene expression studies were then conducted using TaqMan Array Human Neurotransmitters (Applied Biosystems Cat #4414094), TaqMan Array Human Immune Response (Applied Biosystems #4414204), and TaqMan Array Human Alzheimer’s Disease (Applied Biosystems Cat #4414070) with Applied Biosystems TaqMan Gene Expression Master Mix (Applied Biosystems Cat #4369016). Results were analyzed using the ∆∆CT method.Additional RT-PCR was performed to validate gene expression data and to measure expression of astrocytes, microglia, and markers associated with Parkinson’s disease. RNA and cDNA were obtained as described above. RT-PCR was performed using PowerTrack SYBR Green Master Mix (ThermoFisher Cat #A46012), per manufacturer’s instructions. Primers were designed in Primerquest (IDT SciTools) from human transcripts obtained NCBI Nucleotide. RT-PCR primers were designed for glial fibrillary acidic protein (GFAP), ionized calcium binding adaptor molecule 1 (Iba1), chemokine receptor 5 (CCR5), dopamine receptor D1 (DRD1), tyrosine hydroxylase (TH), crystallin mu (Crym), and glucosylceramidase beta (GBA) . DRD1 ist-test was used to identify significance between organoids size pre-inoculation and at 13 days post infection.Organoids were imaged using ImageQuant LAS 4000 with the bright field filter under high resolution with automatic exposure. Organoid size was determined by using ImageJ . The scale of the program was set to 13.9327 pixels/mm, and the area of each organoid was recorded. Results are expressed as an average between at least 12 organoids per treatment. ANOVA was performed to determine significance between PD and non-PD organoids. A Student’s t-test was used to perform pairwise comparisons of the fluorescence of non-PD organoids and PD organoids.Immunofluorescence was used to validate gene expression and PCR data. Organoids were fixed in 4% paraformaldehyde in PBS (ThermoScientific Cat# J19943-K2) overnight at 4 °C and then cryoprotected in 30% sucrose prior to sectioning. After freezing samples at −80 °C, organoid sections of 18 micrometers thick were produced using a cryomicrotome . Afterwards, organoid sections were blocked in 5% fetal sheep serum, and primary staining was conducted overnight at 4 °C . SecondaThe data show that neurophysiology is dramatically different between a non-PD and PD organoids and the response to viral infection is altered in PD organoids. This is of significant concern given the rising numbers of persons with neurodegenerative/neurological disease. Could viral infection with a neurotropic virus cause or exacerbate the development of neurological disease in persons predisposed for such conditions? The differential antiviral response of PD organoids highlights the need for more research in neurotropic infections in a neurologically compromised host.


Implementation Science and Implementation Science Communications. We remain most interested in rigorous empirical studies of the implementation of evidence-based healthcare practices  and the de-implementation of practices that are demonstrated to be of low or no benefit. Implementation strategies  are of central interest to the journals. We see the field as large and complex, with a wide literature that is published in many venues. We urge people for whom it is new to spend some time reading the existing literature, and learning the scope of the work that has already been done, and published, in our journals and in an increasing number of other journals in the field.This editorial provides a comprehensive consolidated overview of the scope and expectations of  Implementation Science declared that it was the journal’s mission to publish scientific contributions to implementation science in health, which they defined as “the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services” [Implementation Science receives over 800 submissions annually and publishes around 120 papers. The number of downloads was 2.3 million last year. These numbers demonstrate the continued high interest among researchers, practitioners, managers, policymakers, and research funders.In 2006, the founding editors of ervices” . ImplemeImplementation Science. We felt that these studies deserve to be published in an implementation science journal. In 2020, we launched the companion journal Implementation Science Communications to serve the same mission, but to enable consideration of a broader range of submissions [Implementation Science Communications published more than 100 papers in its first year, more than we had anticipated. It is on target to receive about 400 submissions in 2021. The success of the journals has reinforced the need to reflect on the journals’ scope and expectations, a desire that was further enhanced by developments in healthcare and society—not least the global COVID-19 pandemic [Despite being an open-access journal, we inevitably have limited editorial and reviewer resources. A substantial proportion of the rejected manuscripts are in scope, scientifically sound, but do not meet the expectations of pandemic .. Implementation strategies, or implementation interventions, are of central interest: interventions that aim to enhance the uptake, sustainment, and scale-up of practices and those that aim to remove, reduce, replace, or restrict the use of ineffective interventions or practices. Our focus on health is broad and includes physical and mental health conditions, including addiction and other behavioral health areas. We consider clinical practice, preventive care, and health promotion interventions delivered in healthcare and other settings . The effectiveness of these interventions has been the topic of public health research, while other interventions have been examined in clinical or health services research.This editorial does not represent a change in scope compared to our latest comprehensive editorial . We remaImplementation Science is particularly interested in studies that substantially advance the field by providing innovative, analytical, and generalizable insights (including non-mainstream approaches). Implementation Science Communications is interested in methodologically sound studies that contribute to new knowledge, which extend existing concepts and methods. Contributions may have a narrow focus in terms of clinical topic, patient population, or setting. In addition to empirical research, both journals publish systematic reviews and other types of contributions that we describe in the next section.We are open to a variety of methodological approaches, including qualitative, quantitative, and mixed-methods approaches. Our focus on implementation strategies means that we focus on approaches to enhance the uptake of evidence-based practices . Given the absence of widely accepted definitions of implementation strategies, we are open to various terms, including quality improvement, knowledge translation, and knowledge transfer. For instance, quality improvement is in scope, if the focus is clearly on the implementation of evidence-based practices. However, we do not publish on the implementation of research procedures . We recognize that implementation strategies are frequently applied in combination with clinical interventions, but we only consider studies that focus on the effects, processes, costs, and contextual factors associated with the implementation of these interventions. We focus on implementation strategies targeted at “agents of implementation,” such as health workers, patient navigators , school teachers, and policymakers. This excludes most interventions to inform patients or populations about healthcare improvements or interventions to involve patients more actively in their healthcare . Such interventions are covered by other fields . The implementation of these interventions may be in scope, if the evidence for the interventions is sufficiently robust, and the primary research question is associated with strategies to incorporate these into everyday clinical practice. The implementation of broadly phrased recommendations on desirable states in healthcare  is out of scope, if specific strategies to achieve these states are not specified.Outcomes of most interesting to us are observable aspects of healthcare delivery and healthcare providers’ behaviors, such as adoption, fidelity, penetration, and sustainability of changes in practice. These aspects may actually impact the health of patients and populations. We are less interested in studies that consider perceptions or cognitions of targeted individuals  as primary outcomes, but we do consider these in the context of process evaluations. We also are less inclined to publish studies that focus exclusively or primarily on clinical outcomes or patient-reported health.evidence-based practices implies that we do not consider effectiveness trials of clinical and public health interventions, or other studies of interventions with uncertain effectiveness. Interventions for which evidence of effectiveness comes from a single study are borderline in scope. We prefer interventions that are supported by consolidated and synthesized research evidence, such as a systematic review or a systematically developed clinical guideline. We realize that emerging data-driven, individualized medical treatments  may complicate the distinction between the generation and implementation of research evidence, and we will consider submissions in this domain on a case-by-case basis. We note that the use of an established framework that derives from implementation research  does not equate to the study of implementation. Frameworks are increasingly used, particularly in the evaluation of novel interventions, but such use does not necessarily imply a contribution to the knowledge in implementation science .The focus on Better implementation of evidence-based practices frequently contributes to a reduction of disparities in health and greater equity in societies, given the unequal distribution of access to healthcare across subgroups in the population, as well as across nations. Health equity has become high on the societal agenda in recent years, which has also reinforced the attention for the topic in implementation science . A substhttps://www.nice.org.uk/corporate/ecd7). We are interested in the implementation of evidence-based digital interventions, but not in the technical implementation of infrastructures .Given the rise of submissions on the implementation of digital technologies in health settings , we will elaborate on the journal scope in this domain. We will examine submissions in this field on a case-by-case basis. Given our focus on evidence-based practice, we would expect to see any technology underpinned by recognized evidence standards for effectiveness regarding the improvements on health and population outcomes , if the focus in the manuscript is clearly on consequences for implementation into practice. Mere analyses of change in healthcare practice  are not considered. We also do not publish studies that merely document gaps between recommended and actual healthcare (“evidence-practice gaps”), but we do consider studies of factors associated with these gaps  and studies that develop implementation interventions. Given the descriptive nature of many of the latter two categories (barrier identification and intervention development), many of these studies will be transferred to added value to the field of implementation science. Manuscripts with a strong analytical approach  and a study design that facilitates generalizability  are likely to be reviewed at Implementation Science. Replication of previously conducted studies may also be considered, if the rationale is convincingly presented. Some manuscripts relate to implementation science, but they mainly have added value for a particular field of application . Others provide new insights or in-depth analyses, but have limited generalizability, given the study design, methods, or narrow focus. Implementation Science Communications welcomes such manuscripts, while Implementation Science is less likely to publish these. The boundary between relatively simple reports of lessons learned, with little to no analytic or theoretical insight, and small studies that provide thoughtful analyses, is not always easy to distinguish. At both journals, we receive large numbers of manuscripts in which little analytic insight is applied to the findings, and increasingly, these are being rejected at both journals.Obviously, one of our priorities is to publish studies (and other types of articles) that have This section provides further information on the boundaries of scope in relation to specific types of articles. The main considerations are summarized in Table Many theories and frameworks for implementation science are available. We are careful about adding new ones to the literature, as we feel that the field is better served by empirical testing of available theories and frameworks. Before we consider publication, the rationale for a new concept, theory, or framework (including extensions of published ones) needs to be convincingly presented. We welcome manuscripts adopting a critical approach to existing theories and frameworks, acknowledging their limitations  and building on previous conceptual knowledge to develop new generalizable insights from empirical data. However, it is essential that a comprehensive  review of existing theories and frameworks is included in any critical reflection or proposal for a new theory. When deploying existing theories and frameworks in studies, the authors should ensure that these are not applied in a superficial, tokenistic fashion. Instead, we recommend an in-depth engagement with selected theories and frameworks throughout the manuscript. Both journals are increasingly reluctant to publish studies that categorize data according to a framework without offering interpretations that relate to the underlying theory. Theories and frameworks should explicitly inform research aims and objectives, guide data collection and data analysis, shape the presentation of findings, and provide a basis for articulating the study’s contribution in the discussion section.We publish various types of reviews of published research, including traditional (“Cochrane style”) systematic reviews, scoping reviews, syntheses of qualitative research, and rapid reviews. At a minimum, the literature search needs to be transparent and generally exhaustive, cover at least three databases, and not be more than two years old at the date of submission.Implementation Science expects a study design that optimizes internal validity, such as a (cluster) randomized trial. We regard pragmatic trial designs as important in implementation research. The journal also considers rigorous non-randomized controlled studies, difference-in-differences, and interrupted time-series designs, if a clear rationale for the choice of study design is provided. Implementation Science Communications considers a broader range of designs for outcome evaluation, including uncontrolled before-after comparisons when well justified. However, weak designs and poorly conducted studies will likely be rejected by both journals.Outcome evaluations are studies that aim to determine the effectiveness of, or changes associated with, implementation interventions. We consider hybrid designs that place emphasis on the evaluation of implementation outcomes rather than clinical or population health effects. Evaluations of novel or existing interventions with limited or no evidence are not considered. We welcome outcome evaluations that show that implementation strategies had little or no impacts, provided that the rationale for the chosen strategies was plausible. As outcomes, we prefer validated measures of observable aspects of healthcare delivery or professional performance, which have clear relevance for clinical and population health. Studies reporting only self-report outcomes are unlikely to be considered. Studies that exclusively examine the effects of interventions on participants’ knowledge, cognitions, or perceptions are unlikely to be considered as outcome evaluations, but we may consider these as process evaluations. For outcome evaluations, Implementation Science prefers the use of a theory or framework for the guidance of the process evaluation and a study design that facilitates generalization. Implementation Science Communications also considers process evaluations that are more pragmatic or less generalizable. Within these parameters, both journals welcome submissions of process evaluations that help to explain null results of trials as well as those with positive findings.Process evaluations of implementation interventions examine the degree of uptake of implementation interventions, processes, and factors associated with changes in implementation outcomes (or absence of it), side effects of the interventions, and/or factors that influence the sustainability and scalability of the implementation interventions. Both journals expect that the focus is on implementation interventions of known effectiveness, so that the findings of the process evaluation explain and contextualize the findings of the main study. We reject a large proportion of submissions because the effects of the implementation interventions of interest are not reported (elsewhere or in the same manuscript). Process evaluations of complex clinical or public health interventions, which have a strong implementation science component and are part of large multi-center cluster randomized trials, are considered on a case-by-case basis. Implementation Science Communications.We welcome economic evaluations of implementation interventions, preferably those that analyze both effects and costs. Cost-benefit and cost-effectiveness evaluations of implementation interventions essentially need to meet the same requirements as outcome evaluations. Manuscripts that describe cost analyses (ignoring effects) are only considered if the effectiveness of the implementation interventions is reported . Cost analyses without examinations of outcomes are usually transferred to Implementation Science Communications welcomes manuscripts on the development, pilot testing, and feasibility of implementation interventions. Few if any of these will be published in Implementation Science. To be considered, intervention development and testing should be based on systematic methods and, at least to some extent, empirical research in healthcare settings. They must be focused on implementation interventions, not other types of intervention . We prefer comprehensive reports of intervention development and testing over manuscripts that focus on specific aspects of the intervention development.Implementation Science prefers studies that relate to existing theories, frameworks, or concepts, seeking to yield new theoretical insights applicable to a wide range of settings and useful for guiding future empirical enquiry [Implementation Science Communication also considers more pragmatic studies, although lack of any theoretical insights is increasingly resulting in rejection, often with a recommendation to revise and provide stronger analytical and theoretical insights.We welcome qualitative and mixed-methods studies but have rejected many because of poor methodological design, conduct, and reporting. Like in all research papers, the methods need to be specified and described in sufficient detail to be able to understand what has been done. We are open to a variety of qualitative methods, but it is important that the chosen method matches the research question and field of application. For instance, it may be hard to justify a purely inductive analysis in a study of barriers for implementation, given the large number of available conceptual frameworks that could be used to categorize the items.  enquiry . ImplemeImplementation Science, but they may be considered by Implementation Science Communications. In all studies, we prefer that the study protocol and data analysis plan are pre-specified. We are increasingly inclined to reject studies that pick a framework and mechanically present measures or data categorized by its constructs, yielding little to no further analysis.We welcome theory-guided, quantitative observational studies, which use up-to-date or advanced analysis methods to explore or confirm determinants, processes, costs, and mechanisms of implementation. Quantitative observational studies may use concepts and methods from a variety of sciences, such as psychology, economics, and sociology. Some of these studies are (quantitative) process evaluations of implementation interventions. Quantitative observational studies that are outcome evaluations  are usually not considered by Implementation Science is particularly interested in the validation of new measures of implementation constructs, except if many similar measures have already been validated. Implementation Science Communications also considers manuscripts on the adaptation and validation of existing measures for specific healthcare settings, countries, or languages. In both journals, we prefer comprehensive reports rather than a series of incremental reports about parts of the validation study.An increasing number of submitted manuscript report on the development and validation of measures of implementation constructs. This is an important type of research, because valid measures are required for scientific progress. Implementation Science Communications, but Implementation Science remains interested in study protocols of large and innovative research projects or programs of research that are submitted within 12 months of ethical approval. We require prospective registration of all studies meeting the WHO definition of clinical trials , and note that we include behavior change, on the part of providers as well as patients, to constitute outcomes under the WHO definition. We continue to reflect on our policies regarding study protocols, with a particular view on countries that offer little opportunity to get funding from recognized research agencies.We publish  protocols that have been through competitive peer review to receive funding from a nationally or internationally recognized research agency and that have received ethical approval or exemption. We will publish these increasingly in The field of implementation science needs well-trained researchers and practitioners. Therefore, we also consider manuscripts concerning education and building capacity in implementation science, provided that they include empirical research—ideally, longitudinal evaluation of a program . We prioBoth journals welcome contributions on research methods, which are relevant for implementation science . We prefer that the use of these methods is demonstrated through concrete examples, which relate to implementation science rather than other fields and are generally in scope for both journals. Both journals usually reject descriptive accounts of largely established methods without any associated novel methodological insights.Commentaries are considered if they convey new or important ideas on implementation science. We carefully consider whether the contribution is sufficiently embedded in the implementation science literature. Some commentaries have been invited, because the journal editors feel that specific themes need to be highlighted. We also receive unsolicited commentaries, and have published a few, but we often feel that the added value is limited and inadequately contextualized in the existing literature. We therefore strongly recommend making an enquiry with the senior editors before making any submission. The journals will continue to invite commentaries on specific topics, which are internally prioritized.We receive numerous debate manuscripts at both journals. We welcome debate and discussion in the field and review these carefully. However, many submissions provide only highly selective reviews of the literature, often setting up arguments that are easy to critique. We commonly reject these. As the field is evolving, we consider it essential to ground arguments in a full view of an increasingly large and complex literature, so we strongly recommend that the authors conduct a careful and comprehensive  review of the literature before drafting a debate manuscript.We encourage the use of letters to the editor, noting that they should be short (800 words or less), and focus on a critique of a specific published paper in the journal to which they are submitted. Letters that address issues from multiple manuscripts without a clear focus on a specific paper will likely not be accepted as letters. As with all publications, letters to the editors will be peer reviewed.Implementation Science Communications encourages the use of short reports as well as the use of online additional files that provide added information.Manuscripts on empirical studies can also be submitted as short reports, provided that they are sufficiently comprehensive despite their format. Given its focus on sound research with moderate added value, http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html). For manuscripts with large numbers of authors , we increasingly ask that a writing group is named that then appears in the article byline. We appreciate that authors may be concerned that their contribution will not be recognized, but MEDLINE indexing can handle group authorship. We also recognize a growing trend towards the designation of more than one “first” or “last” author. We do not explicitly make these designations as part of our publications. Regarding submissions from low- and middle-income countries, we recommend to include at least one author from the countries of interest; these authors should obviously meet the ICJME criteria for authorship. We expect ethics approval (or a waiver/exemption) by a recognized, independent ethics committee for all empirical studies. Authors of all empirical studies and systematic reviews are requested to use an appropriate reporting guideline, most of which can be found online (www.equator-network.org). We require prospective registration in a recognized trial register for all studies that meet the criteria for clinical trials according to WHO or NIH . For other studies, particularly studies that are designed to test hypotheses and systematic reviews of intervention studies, prospective registration is strongly encouraged and may become obligatory in the future.Both journals have a number of expectations regarding the reporting of studies, which are summarized here. We expect that authors adhere to the principles of scientific integrity, including those that apply to the authorship of scientific papers. We perceive a trend towards increasing number of authors on manuscripts, but it is not feasible for journal editors to examine whether all fulfill the requirements for authorship. We therefore expect those designated as authors to demonstrate that they meet all four ICJME criteria for authorship (Empirical studies should obviously be scientifically sound, which implies that objective, methods, results, and conclusions are adequate and logically linked. As journals, we remain committed to improving the quality of intervention description; implementation strategies are often inconsistently labeled and poorly described. Without sufficient detail, it can be difficult for readers to determine what was actually implemented or for researchers to use or replicate a strategy in other studies. TIDieR  is most Implementation science is a fast-moving field, and we expect all manuscripts to be well-embedded in the contemporary literature. For empirical papers, this requirement relates both to the literature review presented in the front end of the manuscript and to the discussion section, which should aim to interpret the findings in light of relevant scientific literature rather than merely describe empirical results. We receive many submissions across both journals which do not fulfill this criterion and that are either sent back to authors or deemed to be of insufficient priority for review. Both journals are international in scope, which implies that authors are expected to relate their study to the global scientific literature or fully justify why orientation to a single jurisdiction is necessary. In addition, sufficient contextual information is essential for readers from other jurisdictions. We also encourage the authors to acknowledge the limitations of their studies, articulate their implications for policy and practice, and outline directions for future research. Finally, we require that each manuscript includes 2–3 statements on what this study adds to knowledge and understanding in implementation science. Authors will be increasingly requested to revise these statements, if they do not provide pertinent information. These should not be duplicative of the abstract.For a regular research paper, we allow a maximum of 5500 words but encourage authors to use fewer words as we believe that many readers prefer concise papers. The number and size of supplements to a manuscript are unlimited, and these can be used to provide additional information.Implementation Science Communications was to support publishing a broader variety of papers reporting on aspects of the science of implementation. We are still working out clear principles for transfer, many of which are articulated below. It is important to note that transfer from Implementation Science to Implementation Science Communications does not imply that a manuscript will be accepted for publication, although the likelihood of review is higher than average. We make independent editorial decisions at both journals and may deem a manuscript out of scope when assessed at Implementation Science Communications even when it is transferred from Implementation Science. In addition, although we make every effort to streamline processes for transferred manuscripts, if comments were provided before transfer, and particularly if the manuscript was reviewed, we expect that appropriate revisions will be made prior to transferring to Implementation Science Communications.Our primary purpose in launching Implementation Science Communications is committed to sound science [. While the identity of Implementation Science Communications as a new journal is still emerging, our intention is to promote the development of its distinct scope, contributing to advancing the field in the following directions. First, in its openness to publish smaller-scale empirical contributions, pilot studies, and alternative viewpoints, the journal aims to increase the diversity within the field, helping new ideas enter the mainstream. Second, by inviting research conducted outside healthcare settings, Implementation Science Communications aspires to facilitate dialog among implementation scholars working in a wider range of settings, such as education, social services, and public policy, and thus better understand sector-specific contextual influences on implementation. Finally, Implementation Science Communications encourages submissions that engage with theory, either through theoretically informed or theoretically informative approaches [It is also worth reiterating that  science . While tproaches , but do Implementation Science and now also publishing Implementation Science Communications, we see the field as large and complex, with a wide literature that is published in many venues, and urge people for whom it is new to spend some time reading the existing literature, and learning the scope of the work that has already been done, and published, in our journals and in an increasing number of other journals in the field.As we note, implementation research is a rapidly growing field, with growing efforts to dedicate funding in some jurisdictions. This draws new entrants into the field, many of whom come from other health research backgrounds, and for whom implementation science seems novel and highly emergent. With over 15 years of publishing Implementation Science and Implementation Science Communications and highlighted some differences between the journals. We intend to support authors in their consideration on whether to submit to the journals, and hope we will continue to receive many high-quality submissions in the coming years.This editorial described the mission, scope, and expectations of