In the autism field, there is increasing interest in translating evidence-based interventions (EBIs) into systems that serve young autistic children and their families. Public Early Intervention systems have been a focal point of research-based implementation efforts given that these systems are federally mandated to provide services to children birth to three years of age with developmental delays under Part C of the Individuals with Disabilities Education Act. Although a growing number of research studies are now training Early Intervention providers to deliver autism EBIs, this work has been conducted on a relatively small scale and has only just begun to consider the alignment of these models with Early Intervention systems and whether sufficient infrastructure exists to scale up these training efforts and to sustain their public health impact. This commentary aims to address this gap by reviewing factors that have been found to uniformly impact the scale-up of EBIs across diverse public systems (Fagan 20, 1147-1168, 2019), and to extend this framework to the implementation of EBIs within public Early Intervention systems. These factors include developer and funder capacity, the public\'s awareness of and support for EBIs, the system\'s leadership support for EBI use, the capacity for community engagement in implementation efforts, the availability of a skilled workforce capable of delivering EBIs, and the capacity for data monitoring and quality improvement. This commentary discusses how these factors may specifically impact the scale-up of autism EBIs within EI systems to support toddlers and young, autistic children, and implications for autism researchers.

ABSTRACTHealth systems analyses are touted as mechanisms through which health policy and planning may be implemented. An example is the WHO health systems approach that connects people (needs, rights, perspectives) with services and technologies (equitable access, quality of care, mix of interventions) and with policies and institutional capacities (laws, regulations, human/physical resources, management and financing). The approach is comprehensive and multi-faceted, which is a strength. We argue, however, that health systems analyses should be supplemented with a focus on reproductive justice. Using the WHO health systems approach as an exemplar, we show how the reparative reproductive justice approach outlined by the first author and colleagues assists with outlining comprehensive remedies to the inequities identified in the systems analysis. We argue for attention to remedies at individual and collective, material and symbolic levels. We illustrate our argument using unsafe abortion, legal abortion services and post-abortion care in Lesotho as a case study. We outline the policies, services and people components of abortion in Lesotho using the WHO systems model, followed by a reparative justice analysis of remedies.

Complex systems challenges like those facing 21st-century humanity, require system-level solutions that avoid siloed or unnecessarily narrow responses. System-level biomimicry aims to identify and adopt design approaches that have been developed and refined within ecosystems over 3.8 billion years of evolution. While not new, system-level biomimetic solutions have been less widely applied in urban design than the \'form\' and \'process\' level counterparts. This paper explores insights from a selection of system-level case studies in the built environment, using meta-analysis to investigate common challenges and priorities from these projects to support knowledge-sharing and continued development in the field. Using a grounded research approach, common themes are distilled, and findings presented regarding success and barriers to implementation and scaling. Considering the findings, and drawing on complex adaptive systems theory, the paper posits opportunities to facilitate broader implementation and mainstreaming of system-level biomimetic design approaches in the built environment.

BACKGROUND: Peripheral inflammation is often associated with major depressive disorder (MDD), and immunological biomarkers of depression remain a focus of investigation.
METHODS: We used microarray data on whole blood from two independent case-control studies of MDD: the GlaxoSmithKline-High-Throughput Disease-specific target Identification Program [GSK-HiTDiP] study (113 patients and 57 healthy control subjects) and the Janssen-Brain Resource Company study (94 patients and 100 control subjects). Genome-wide differential gene expression analysis (18,863 probes) resulted in a p value for each gene in each study. A Bayesian method identified the largest p-value threshold (q = .025) associated with twice the number of genes differentially expressed in both studies compared with the number of coincidental case-control differences expected by chance.
RESULTS: A total of 165 genes were differentially expressed in both studies with concordant direction of fold change. The 90 genes overexpressed (or UP genes) in MDD were significantly enriched for immune response to infection, were concentrated in a module of the gene coexpression network associated with innate immunity, and included clusters of genes with correlated expression in monocytes, monocyte-derived dendritic cells, and neutrophils. In contrast, the 75 genes underexpressed (or DOWN genes) in MDD were associated with the adaptive immune response and included clusters of genes with correlated expression in T cells, natural killer cells, and erythroblasts. Consistently, the MDD patients with overexpression of UP genes also had underexpression of DOWN genes (correlation > .70 in both studies).
CONCLUSIONS: MDD was replicably associated with proinflammatory activation of the peripheral innate immune system, coupled with relative inactivation of the adaptive immune system, indicating the potential of transcriptional biomarkers for immunological stratification of patients with depression.

OBJECTIVE: This case report describes the application of an integrated, systems-based theory of motor control to physical therapy practice.Client Description: The patient was a 5-year-old boy with spastic hemiplegic cerebral palsy who was entering kindergarten. Parent concerns related to the child\'s safety in playground activities such as playing on the slide.
METHODS: Motor-control theory, including factors related to the task, the environment, and the individual, was used to guide and direct physical therapy management related to the patient goal of safely and effectively climbing the ladder to the playground slide.Patient Outcomes: When the child entered kindergarten, he was able to safely ascend the ladder to the playground slide, using a modified movement pattern, when distractions were minimized. However, attentional issues continued to affect task execution when other children were present.
CONCLUSIONS: This case report demonstrates a means by which current knowledge and theory can be integrated into clinical practice.
CONCLUSIONS: Applying motor-control theory to this case led to the development of clinical questions for future research.