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ed without a pretreatment ultrasound. This method of service delivery has the potential to greatly improve access to abortion care in the United States.

Medical abortion using telemedicine and mail is effective and can be safely provided without a pretreatment ultrasound. This method of service delivery has the potential to greatly improve access to abortion care in the United States.

To explore the relationship between abortion restrictions and maternal mortality in the United States.

This was a retrospective study examining maternal mortality in the United States from 1995 to 2017. We used the Global Health Data Exchange and the Centers for Disease Control and Prevention WONDER databases to extract maternal mortality data for all 50 states for each year from 1995 to 2017. We categorized states as restrictive, neutral, or protective of abortion access according to policy information published by the Guttmacher Institute. We assessed associations between abortion restrictions and maternal mortality ratios (maternal deaths per 100,000 live births).

In 1995, the mean maternal mortality ratios were similar across all groups of states (Restrictive 12.6, 95% CI 11.4-13.6; Neutral 12.2, 95% CI 10.9-13.4; Protective 10.9, 95% CI 9.6-11.9). Maternal mortality ratios increased for each group of states over time and in 2017, the mean maternal mortality ratio was higher in restrictive states thorities of individual states as restrictive states are less likely to pass proactive legislation demonstrated to improve maternal outcomes.

Medication abortion is safe and effective, yet access is limited by a strict Risk Evaluation and Mitigation Strategy (REMS) that prohibits pharmacy dispensing of mifepristone. Given the ability of primary care providers (PCPs) to expand medication abortion access, we assessed PCP perspectives on how lifting the mifepristone REMS would affect the provision of medication abortion in primary care.

We conducted a qualitative study of PCPs and administrators in Illinois with experience or interest in providing medication abortion care at their practice. The final sample (N=19) consisted of seven family medicine physicians, three nurse practitioners, four certified nurse midwives, and five administrators. We queried participants on how removing the REMS to allow pharmacy dispensing of mifepristone would affect their ability to provide medication abortion. We conducted interviews via telephone and used ATLAS.ti to manage our transcripts; we analyzed these data for major themes regarding pharmacy dispensing.

Prtion of pharmacy dispensing. Combined with prior literature, these results support prompt reevaluation and removal of the REMS to align medication abortion care with evidence-based practices.

We describe provision of contraception to adolescents at Oregon school-based health centers (SBHCs). Selleckchem Birinapant We examine trends over time, by race/ethnicity, and by Title X clinic status and test whether these factors are associated with provision of long-acting reversible contraception (LARC; intrauterine devices/IUDs and implants).

We conducted a retrospective cohort study of 33 SBHCs participating in a shared electronic health record 2012-2016. We identified 20,339 contraception provision visits to 5,934 adolescent females ages 14-19 using diagnosis and procedure codes. We used logistic regression to evaluate the association of clinic Title X status, race/ethnicity, and year with receipt of LARC, controlling for individual-, clinic-, and residence-level factors. We calculated adjusted probabilities.

Provision of IUDs and implants increased at Oregon SBHCs between 2012 and 2016. IUD provision increased almost 5-fold, (from 0.9% to 4.4% of contraception provision visits), and implants increased approximately 6.5-fold (from 1.1% to 7.2%). More adolescent contraception provision visits occurred at Title X SBHCs, which had greater than twice the adjusted probability of providing LARCs than non-Title X SBHCs (4.4% versus 1.7%). After adjusting for adolescent-, clinic-, and residence-level covariates, non-white adolescents had lower probabilities of receiving LARC methods than white adolescents.

SBHCs play an important role in providing access to contraceptive services to adolescents in Oregon. Access to IUDs and implants is increasing over time in SBHCs, particularly those that participate in the Title X program.

Adolescents have expanding access to IUDs and implants in SBHCs over time in Oregon. Participation in the Title X program can help further increase access to effective contraception in SBHCs.

Adolescents have expanding access to IUDs and implants in SBHCs over time in Oregon. Participation in the Title X program can help further increase access to effective contraception in SBHCs.Recent years have seen a dramatic improvement in protein-design methodology. Nevertheless, most methods demand expert intervention, limiting their widespread adoption. By contrast, the PROSS algorithm for improving protein stability and heterologous expression levels has been successfully applied to a range of challenging enzymes and binding proteins. Here, we benchmark the application of PROSS as a stand-alone tool for protein scientists with no or limited experience in modeling. Twelve laboratories from the Protein Production and Purification Partnership in Europe (P4EU) challenged the PROSS algorithm with 14 unrelated protein targets without support from the PROSS developers. For each target, up to six designs were evaluated for expression levels and in some cases, for thermal stability and activity. In nine targets, designs exhibited increased heterologous expression levels either in prokaryotic and/or eukaryotic expression systems under experimental conditions that were tailored for each target protein. Furthermore, we observed increased thermal stability in nine of ten tested targets. In two prime examples, the human Stem Cell Factor (hSCF) and human Cadherin-Like Domain (CLD12) from the RET receptor, the wild type proteins were not expressible as soluble proteins in E. coli, yet the PROSS designs exhibited high expression levels in E. coli and HEK293 cells, respectively, and improved thermal stability. We conclude that PROSS may improve stability and expressibility in diverse cases, and that improvement typically requires target-specific expression conditions. This study demonstrates the strengths of community-wide efforts to probe the generality of new methods and recommends areas for future research to advance practically useful algorithms for protein science.