Furthermore, the quality of life in the domain of environmental health and work ability index score also demonstrated a significant difference between the groups . Conclusions: During the COVID-19 pandemic, this study found that the RTW program improved the quality of life and work abilities of disabled workers.Background: Occupational accidents are rising, but there is little evidence on the outcomes of patients who received case management during Return to work (RTW) programs. This study examined the case management-based on RTW program features that improve the work ability index (WAI) and quality of life (QoL). Methods: This cross-sectional research involved 230 disabled workers due to an occupational injury in Indonesia, 154 participated in RTW, and 75 did not participate in RTW (non-RTW) during the COVID-19 pandemic. Sociodemographic and occupational factors were used to examine the RTW results. We used the Finnish Institute of Occupational Health’s WAI questionnaires to measure the work ability index and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) for quality of life. Results: The study found a statistically significant difference in working duration and preferred treatment for RTW between the groups ( The outbreak of COVID-19 has affected every region of the world since November 2019. To combat the impact of this pandemic, governments have implemented measures such as adjustments to existing occupational accident insurance programs within their social security frameworks. These changes aimed to address the specific challenges posed by COVID-19 . As a reIndonesia has a unique social security system based on employment, which allows the government to provide a benefit from occupational accident insurance in the form of a specific disability management program called Return To Work (RTW). This program is distinct compared to those offered by other developing nations . The RTWIn this case, BPJS Ketenagakerjaan, the Indonesian social security organization, provides a combination of cash and in-kind benefits to a person who has experienced an occupational injury or occupational disease. A worker could receive a cash payout to compensate lost income due to an occupational accident as well as in-kind benefits to cover the cost of medical care, and rehabilitation services in the form of a case management system and the RTW program . In-kindThe RTW program in Indonesia is designed to support workers who have suffered a disability due to an occupational accident or disease and have been registered as customers of BPJS Ketenagakerjaan. The program provides employees with a range of support services including medical rehabilitation, vocational rehabilitation, and psychosocial rehabilitation to help them regain their physical and mental abilities and to make the transition back to work as smooth as possible. Eligibility for the RTW program is typically determined by BPJS Ketenagakerjaan based on medical indications such as the type of impairment and the employee’s ability to perform essential job tasks.Disability is a complex phenomenon that includes biological functions, activity limits, impediments to participation, and environmental influences, among others . NonetheRegulations about equal job opportunities initially sought to enhance the personal well-being of people with disabilities. Unfortunately, the participation of disabled people in the labor market is minimal, and their earnings are meagre. Measuring the quality of life as a kind of individual welfare for employees with disabilities is one way to evaluate the effectiveness of employment restrictions for people with impairments . DisabilBy examining their employment capability, businesses may better accommodate persons with disabilities and provide them with equal chances in the workforce. The work ability index, which accounts for factors such as mental and physical well-being and the capacity to manage obstacles in the physical realm ,16, may This descriptive cross-sectional study measured the QoL and WAI of workers with disabilities after participating in the RTW program. This study was conducted between January and June 2021, identifying the claims for RTW during the outbreak of COVID-19 in Indonesia. Workers who had been registered as customers with the Indonesian National Social Security Agency for Employment (BPJS Ketenagakerjaan) were recruited for participation in this study.The participants in the study were separated into two groups, RTW and non-RTW, based on their participation in the return to work (RTW) program after receiving workers’ compensation benefits from BPJS Ketenagakerjaan. The RTW group consisted of individuals who took part in the program, while the non-RTW group consisted of those who did not. This division aimed to examine the effect of participating in the RTW program on the individuals and compare it to those who did not participate. To be eligible for this study, individuals had to be between 18 and 65 years old, employed during the COVID-19 outbreak, and engaged in the RTW program.All data regarding participants in the RTW program were obtained from BPJS Ketenagakerjaan. The authors sent the invitation to potential applicants through a widespread email. A total of 165 individuals in the RTW program who had been asked to participate in the study and met all prerequisites were enrolled at the outset. During the starting procedure, only 154 people agreed to be interviewed and completed our questionnaires. Moreover, we extended invitations to an additional 165 disabled patients who had had an occupational injury but were hesitant to take part in the RTW program. However, only 75 people agreed to participate in this study.The data were collected by the first and third authors. The lead author conducted a three-hour training session on RTW, WAI, QoL, and instructions for data collection and ethical issues to 11 case managers of BPJS Ketenagakerjaan in 34 provinces throughout Indonesia before commencing the data collection. The case managers involved in this study were employees of BPJS Ketenagakerjaan and were not specifically added for the current study. The case managers acted as enumerators and collected data from patients participating in RTW programs at trauma centers and rehabilitation hospitals, and received training from the lead author on RTW, WAI, QoL, and data collection, and ethical issues. The data collection was carried out by 11 case managers in 34 provinces throughout Indonesia, who were assigned to hospitals based on their location. The data were collected through printed surveys to reduce nonresponse bias. The data collectors analyzed the recovered questionnaires to minimize missing responses and asked for responses in cases of missing items.The questionnaire included topics on sociodemographic variables as well as disability-related aspects. In addition, a questionnaire assessing the quality of life and work ability index was also included in the research. For the purpose of determining the quality of life (QOL) and the work ability index (WAI), respectively, the WHOQoL-BREF developed by the World Health Organization (WHO) and validated WAI questionnaires developed by the Finnish Institute of Occupational Health were used.The Shapiro–Wilk test was used to check for normality in the data, which was performed by the first author. The purpose of checking for normality in the data is to ensure that the data are normally distributed. A normally distributed dataset is essential for the validity of statistical tests. The categorical patient sociodemographic data were analyzed using frequency statistics. The Mann–Whitney U test was used to compare the RTW and non-RTW groups, while Pearson’s correlation was used to analyze the relationship between the free variables and both the dependent and independent variables (r). Free variables are variables that are not controlled by the researcher but can affect the outcome of the study. The Pearson’s correlation (r) was used to assess the strength of the relationship between the independent and dependent variables. r ranged from −1 to 1, with negative correlation indicating that one variable decreases as the other increases, and positive correlation indicating both variables increasing or decreasing together. The strength of the relationship was categorized as negligible (r < 0.2), low (r = 0.2–0.49), moderate (r = 0.5–0.69), high (r = 0.7–0.85), or very high (r = 0.86–1.00), with higher values indicating stronger linear relationships.t-tests (t), and for the ordinal data, we utilized Mann–Whitney tests. The Chi-square tests were used in order to investigate the differences in the categorical data. Multivariate logistic regression was used to investigate the association between several predictor factors and the outcome variable. To address the research question of this study in analyzing the relationship between the work ability index and quality of life between the RTW and non-RTW participants, multivariate logistic regression is the most suitable approach since it controls for the effects of other variables.For the continuous data, we used independent sample p-value of less than 0.05 and a 95% confidence interval.The study used logistic regression to assess the association between independent and dependent variables while controlling for other factors. The aim of the analysis was to examine the relationships between various factors and the outcome of interest, taking into account the influence of other variables. The independent and dependent variables were determined using a questionnaire that included sociodemographic and disability-related questions as well as assessments of QOL and WAI using validated questionnaires. The logistic regression was performed using SPSS version 26.0, with a In accordance with the foregoing concept, this study investigated the aspect of RTW implementation in Indonesia. The research was carried out during the COVID-19 pandemic and we compared the outcomes of the RTW program for employees with impairments and non-RTW participants. The study compared two groups of people: those who participated in the RTW program during COVID-19 and those who did not participate. The research was designed to shed light on the implementation of the RTW program and its outcomes for employees who were impaired due to occupational injuries or occupational diseases during the COVID-19 pandemic. The research began with an assessment of the sociodemographic characteristics of the subjects. The following factors were considered as variables: age, gender, marital status, occupation, level of education, work period, and place of living. In The data in p-value = 0.430), work period , quality of life , and work ability index . The multivariate logistic regression analysis revealed that the odds of RTW were 3.726 times higher in the older age group (95% CI: 0.847–15.726) and the odds of RTW were 0.430 times higher for those with a longer work period (95% CI: 0.039–0.737).The results of the Mann–Whitney test, t-test, and Chi-squared test indicated that there were statistically significant differences between the RTW and Non-RTW groups in terms of age  program for individuals with occupational injuries during the pandemic in Indonesia and provides insights into the support and resources available to disabled workers during this challenging time. To the best of our knowledge, this is the first study of its kind to assess the quality of life (QOL) and work ability index (WAI) among disabled workers who participated in a RTW program during this time.Our findings suggest that the RTW program was effective in improving the QOL and WAI scores for participants, indicating that it was successful in supporting disabled workers to return to work and maintaining their ability to work during the pandemic. These results have important implications for policy and practice in supporting disabled workers during challenging times such as the COVID-19 pandemic.Workers who are disabled because of an accident or disease at work are most concerned about their quality of life and their ability to work again after the injury. In order to protect workers from this risk, some countries include occupational injury insurance in their social security programs. Moreover, a study on rural–urban migrants in China highlights the challenges they faced during the COVID-19 pandemic including housing evictions and difficulties with travel . The impWorkers who have been disabled due to an accident or disease might have their dignity restored and their chances of returning to work improved by RTW programs . This isp-value of 0.000 for the Chi-square test and a p-value of 0.000 in the multivariate logistic regression. This suggests that the length of time an individual has been out of work plays a significant role in their preference for participating in a RTW program. Additionally, we found that the category of working period among workers in the RTW group was dominantly 10–14 years (69 ± 30.10%). In the non RTW group, the dominant category was 5–9 years (69 ± 30.10%). These findings suggest that those who have been out of work for a longer period of time are more likely to prefer the support and resources provided by the RTW program in order to return to work.Our study found that the variable of working period was significantly related to the preference for participating in the return to work (RTW) program, with a It is important to consider the potential implications of these findings for policy and practice. Employers and policy-makers may wish to consider implementing RTW programs that are targeted toward those who have been out of work for longer periods of time, as they may be more likely to benefit from the support and resources provided. Additionally, further research is needed to understand the specific factors that influence an individual’s preference for participating in a RTW program such as personal and professional goals, job availability, and health and wellness.This study shows an identical outcome to a study carried out in Malaysia ,30 that In addition, regarding the work ability index, this investigation used the work ability index questionnaire developed by the Finnish Institute of Occupational Health . This toThe work ability index results classified all participants in a range from moderate to excellent. The broad range of WAI scores in this study ranged from 29 to 49. The results of this study should therefore be seen as a response to specific previous findings . There iThe purpose of occupational health management that may be achieved by implementing WAI is to consider maintaining and making efforts to improve the quality of work for an inclusive society that includes people with disabilities in accordance with the UN’s Sustainable Development Goals (SDGs). It has been revealed that 54.2% (n = 84) of the total number of disabled workers who participated in the RTW program significantly improved their working abilities due to their participation. During the COVID-19 outbreak in Indonesia, it was observed that 27.3% (n = 42) of employees fell into the moderate group, while 18.2% (n = 28) had an exceptionally excellent work ability index.In conclusion, our study found that the return to work program was effective in improving the quality of life and work ability of disabled workers during the COVID-19 pandemic, as seen by the significant difference in scores between the RTW and non-RTW participants. Policy-makers and employers should consider using assessment tools and gathering feedback to regularly assess the program and make necessary improvements.There were some flaws in how the study was conducted that need to be pointed out. It is important to consider the limitations of our study including the sample size and specific geographic location. Further research with a larger sample size and diverse location is needed to further understand the effectiveness of RTW programs for disabled workers during the COVID-19 pandemic. The data collection was conducted using a purposive sample, which refers to situations during the pandemic that allowed researchers to approach the subjects through indirect encounters or online, which profoundly affected the willingness of participants to continue with the study, resulting in possible biases. There are, nevertheless, certain advantages to consider. We demonstrated the importance of contextual factors in implementing RTW, especially when examining the program’s outcomes in measuring the functional ability and quality of life of workers with disabilities. This was carried out by using various data from very different social and cultural backgrounds and a wide variety of social assistance background frameworks.


Rhizoctonia solani and Fusarium graminearum had similarities with viral siRNAs produced in plant hosts in regard to the size distributions, proportion of plus and minus senses, and nucleotide preference for the 5′ termini. Additionally, our results also determined that both F. graminearum DCL1 and DCL2 were involved in the production of TMV siRNAs. Thus, the fungal RNA silencing machineries have adaptive capabilities to recognize and process the genome of invading plant viruses.RNA silencing in fungi was shown to confer antiviral defense against plant viruses. In this study, using high-throughput sequencing and bioinformatic analyses, we showed that small interfering RNAs (siRNAs) of cucumber mosaic virus and tobacco mosaic virus (TMV) which replicated in phytopathogenic fungi Rhizoctonia solani and TMV infection in phytopathogenic fungus Fusarium graminearum. The relative abundances of CMV and TMV siRNAs in the respective fungal hosts were much lower than those in the respective experimental plant hosts, Nicotiana benthamiana and Nicotiana tabacum. However, CMV and TMV siRNAs in fungi had similar characteristics to those in plants, particularly in their size distributions, proportion of plus and minus senses, and nucleotide preference for the 5′ termini of vsiRNAs. The abundance of TMV siRNAs largely decreased in F. graminearum mutants with a deletion in either dicer-like 1 (dcl1) or dcl2 genes which encode key proteins for the production of siRNAs and antiviral responses. However, deletion of both dcl1 and dcl2 restored TMV siRNA accumulation in F. graminearum, indicating the production of dcl-independent siRNAs with no antiviral function in the absence of the dcl1 and dcl2 genes. Our results suggest that fungal RNA silencing recognizes and processes the invading plant RNA virus genome in a similar way as in plants.RNA silencing is a host innate antiviral mechanism which acts via the synthesis of viral-derived small interfering RNAs (vsiRNAs). We have previously reported the infection of phytopathogenic fungi by plant viruses such as cucumber mosaic virus (CMV) and tobacco mosaic virus (TMV). Furthermore, fungal RNA silencing was shown to suppress plant virus accumulation, but the characteristics of plant vsiRNAs associated with the antiviral response in this nonconventional host remain unknown. Using high-throughput sequencing, we characterized vsiRNA profiles in two plant RNA virus–fungal host pathosystems: CMV infection in phytopathogenic fungus  RNA silencing, also termed RNA interference (RNAi), is a cellular gene downregulation mechanism mediated by 20–30-nucleotide-long small RNAs (sRNAs) ,2. RNA sNeurospora crassa have revealed a post-transcriptional gene-silencing phenomenon termed quelling, which is associated with multiple copies of integrated transgenes [Cryptococcus neoformans and Mucor circinelloides [N. crassa have uncovered the presence of meiotic silencing by unpaired DNA (MSUD), an RNAi-related mechanism in which the fungus protects its genomic integrity during meiosis through the silencing of sequences that are unpaired during meiosis [Schizosaccharomyces pombe, RNA silencing machinery is required for heterochromatin formation through the involvement of RNA-induced transcriptional silencing complex (RITS) [As in other organisms, diverse RNA silencing-related pathways involved in the maintenance of genome stability and gene regulation have been uncovered in fungi ,18,19,20ansgenes ,27 and mansgenes . Subsequelloides ,30. Furt meiosis . In Schix (RITS) ,33. Asidx (RITS) ,34.N. crassa and some plant pathogenic ascomycetous fungi defective in genes encoding key RNA silencing proteins provide an understanding of the role of RNA silencing in antiviral defense in fungi. Ascomycetous fungi are generally known to encode two dcl genes, dcl1 and dcl2 [dcl genes in Cryphonectria parasitica, Colletotrichum higginsianum, Fusarium graminearum, Sclerotinia sclerotiorum, and N. crassa resulted in increases in mycovirus accumulation and/or symptom severity [Ago genes disrupted the ability of fungi to defend against mycovirus infection [Like other eukaryotes, fungi naturally host viruses, commonly called mycoviruses . Diverseand dcl2 . Deletioseverity ,41,42,43nfection ,44,45. Fnfection ,56,57,58Saccharomyces cerevisiae, a unicellular fungus (yeast), was demonstrated through artificial inoculation. S. cerevisiae has since been developed as a model host to study the mechanism of plant virus replication [Tobamovirus), among other plant RNA viruses, was shown to be capable of replicating in Colletotrichum acutatum and Phytophthora infestans (oomycete) [F. graminearum by inoculation through the transfection of fungal protoplasts [C. parasitica, Valsa mali, F. graminearum, and the oomycete Phytoptora infestans can also host plant viroids, the subviral agents [Cucumovirus) in Rhizoctonia solani strains isolated from a potato plant [C. acutatum induced gene silencing (virus-induced gene silencing) and is associated with the accumulation of vsiRNAs [dcl1 and dcl2 genes in F. graminearum drastically elevated accumulations of TMV and hop stunt viroid [Almost two decades ago, replication of a plant virus in lication ,60. Moreomycete) ,62. TMV toplasts . Moreovel agents ,65. Impoto plant . Followito plant . These f vsiRNAs . Deletiot viroid ,64. TogeR. solani and F. graminearum, respectively. In addition, F. graminearum mutants defective in dcl genes were also included in the analyses. Our results revealed that the features of CMV and TMV siRNAs accumulated in fungi were similar to those accumulated in plants and confirmed the role of F. graminearum DCL1 and DCL2 in the biosynthesis of vsiRNAs with effective antiviral function.In this study, we used deep sequencing analysis to characterize siRNAs derived from CMV and TMV that replicated in R. solani strain Ra1 infected with CMV Rs isolates and CMV cured, and R. solani strain infected with CMV Fny isolate, have been described previously [Fusarium graminearum (PH-1 strain) wild type, Δdcl1, Δdcl2, and Δdcl1-Δdcl2 mutants infected with TMV have been described previously [R. solani strain 80 (R. solani 80) was isolated from one of the potato tubers showing black scurf disease collected from potato-planting areas located in the middle and western parts of Inner Mongolia Province of China from the years 2008–2015 [R. solani 80 was identified through high-throughput sequencing carried out in the previous study [eviously . Fusariueviously . R. sola008–2015 . The preus study .N. benthamiana and N. tabacum plants, respectively. Noninoculated upper leaves were sampled seven days after inoculation.To inoculate plant viruses, CMV- and TMV-infected leaves were homogenized in 0.1 M phosphate buffer (pH 7.0) and rubbed onto carborundum-dusted leaves of Fungal total RNA was extracted from the mycelia of five-day-old PDB culture as described previously . BrieflyThe cDNA libraries of sRNA were prepared using Truseq SRNA Sample Preparation Kit  according to the supplied protocol. The sRNA cDNA library was amplified with TruSeq PE Cluster Kit  and then used for sequencing on an Illumina HiSeq2500 at Hanyu Bio-Tech . http://hannonlab.cshl.edu/fastx_toolkit/, Version 0.0.14, accessed on 15 September 2021). Reads which were less than 18 nt or more than 30 nt were removed using the Cutadapt software . The remaining reads with lengths of 18–30 nucleotides were mapped using Bowtie software  to the genome of TMV (NC_001367.1) with 1 mismatch allowed, CMV isolate Rs (RNA1 (MG025947), RNA2 (MG025948), and RNA3 (MG025949)), CMV isolate Fny (RNA1 (D00356), RNA2 (NC_002035) and RNA3 (D10538)) and Endorna-like virus (OP763640) with 0 mismatches allowed. The number of vsiRNA reads was normalized to “reads per million” (RPM) according to the number of total reads of the corresponding sRNA library. Homemade Perl scripts and Excel were used to analyze the 5′-terminal nucleotide and the distribution of vsiRNA in the genome. The ggplot2 package in R (Version 4.1.1) was used to facilitate making the plot of siRNA mapping. Raw data of sRNA libraries have been deposited to the SRA database with the accession number PRJNA900007.Adaptor sequences and poor-quality reads were removed by FASTX-toolkit (R. solani strain (designated as Ra1 strain) isolated from a potato plant collected from a field in the Inner Mongolia Province of China [R. solani strain by transfection of protoplasts of a virus-free R. solani strain with CMV Fny isolate (subgroup I CMV isolate). In a previous study, we discovered CMV infection in an of China . This fuR. solani, total RNAs were extracted from R. solani Ra1 and R. solani Ra1/CMV-cured  and R. solani/CMV Fny and then subjected to high-throughput sequencing of sRNAs followed by bioinformatic analyses to investigate the sequence characteristics of vsiRNAs. Total RNA extracted from N. benthamiana infected with CMV Fny was also included in the high-throughput sequencing. In addition, to characterize mycovirus siRNAs in R. solani, high-throughput sequencing was also performed on total RNA extracted from an R. solani strain (R. solani 80) infected with a novel mycovirus related to endornaviruses (R. solani Ra1 and R. solani/CMV Fny libraries) but no, or only very few, sRNAs were mapped to the CMV genome in R. solani Ra1/CMV-cured libraries (R. solani is associated with the accumulation of vsiRNAs. The proportion of CMV siRNAs was higher in the R. solani/CMV Fny library (0.07%) than in the R. solani Ra1 libraries (0.03% and 0.02%), but both were much lower than that in the N. benthamiana/CMV Fny library, which was around half (53.03%) of the total sRNA reads  and (−) strands of the genomes were much more dense, due to the high number of siRNAs  and (−) strands of the CMV RNA1, 2, and 3 genomes, with several prominent siRNA hotspots, most of which were located at the same genome positions across the f siRNAs . Notablyf siRNAs . F. graminearum is a compatible host for TMV replication [F. graminearum strain PH-1 wild-type, single dcl knockout mutants (Δdcl1 and Δdcl2), and a double dcl knockout mutant (Δdcl1-Δdcl2) [F. graminearum, total RNAs were extracted from each TMV-infected wild-type and dcl knockout mutant strain, including the virus-free (VF) fungus, and then subjected to high-throughput sequencing of sRNAs. Additionally, total RNA samples extracted from N. tabacum infected with TMV were also included for sequence analysis. Two biological replicate samples were collected from each TMV–host combination and analyzed independently.In a previous study, we reported that lication . TMV was1-Δdcl2) . To charF. graminearum wild-type VF sRNA libraries was mapped to the TMV genome, while considerable numbers of sRNAs in the TMV-infected F. graminearum wild-type sRNA libraries (0.02% and 0.04%) were derived from TMV genome sequences, albeit far fewer than those mapped to the TMV genome in the TMV-infected N. tabacum sRNA libraries (27.33% and 10.74%)  E. Notablibraries E. This rF. graminearum wild-type and all Δdcl mutant libraries were predominantly 21 and 22 nucleotides long, with peaks at 21 nucleotides  and (−) strands of the TMV genome, as the position of major and minor siRNA hotspots were parallel between these libraries  antiviral silencing. However, DCL2 can substitute for the antiviral functions of DCL4 when the latter is absent or repressed, although with lower efficiency [F. graminearum, siRNAs derived from different mycoviruses also have broad size distributions, with a slight peak at 21 nucleotides [Botrytis cinerea showed that 20, 21, and 22 nucleotides are the predominant sizes, with the most abundant size class at 21 nucleotides, or 22 nucleotides for a certain mycovirus [Aspergillus fumigatus, the most abundant vsiRNA size class is 20, 21, or 20–23 nucleotides, depending on the virus [Fusarium circinatum and C. parasitica have been found to have broad size distributions [The siRNAs and other classes of sRNAs play a central role in the RNA silencing pathway ,5. It isficiency ,73,74,75ficiency ,77. Thusleotides ,55. Charycovirus . In Aspehe virus . Likewisibutions ,58. TogeF. graminearum, DCL1 and DCL2 function redundantly in antiviral defense against TMV infection [F. graminearum single Δdcl1 and Δdcl2 mutant strains could not reveal the specific sizes of the vsiRNA products of each DCL. The abundance of TMV siRNA strongly decreased in both Δdcl1 and Δdcl2 mutant strains, but here vsiRNAs still retained lengths of predominantly 21 and 22 nucleotides, and the same 5′-terminal nucleotide preferences as in the wild-type strain  of antisense siRNAs that are associated with RNA silencing induced by the hairpin RNA-producing transgene [Our results showed that the abundances of CMV and TMV siRNAs in the fungal hosts were much lower compared to those in the host plants B,E. Thisnfection . The rese strain . Thus, iransgene . The difransgene .dcl1 or dcl2 gene markedly reduced TMV siRNA accumulation in F. graminearum, unexpectedly, deletion of both dcl1 and dcl2 genes restored TMV sRNA accumulation (dcl1-Δdcl2 mutant strain have similar size distributions, 5′-terminal nucleotide preferences, and distribution profiles along the viral genome to those accumulated in the wild-type strain (F. graminearum DCL1 and DCL2 are involved in the production of TMV siRNAs. However, in the absence of both DCL1 and DCL2, there is an activation of a hitherto DCL-independent pathway to produce virus-derived sRNAs that have similar signatures to DCL-dependent vsiRNAs. As deletion of both dcl1 and dcl2 genes highly elevated TMV accumulation levels in F. graminearum [dcl mutant strains of Cryphonectria parasitica and Colletotrichum higginsianum, but these DCL-independent vsiRNAs have different characteristics to DCL-dependent vsiRNAs [Mucor circinelloides, RdRP-dependent dicer-independent sRNAs are generated by RNase III-like protein specifically found in basal fungi and involved in the specific degradation of cellular mRNAs [N. crassa, DCL-independent siRNAs were found to mediate DNA methylation [Although deletion of either the mulation E. Moreove strain . These rminearum , these h vsiRNAs ,80. Togear mRNAs . In N. chylation ,82. FurtMycoviruses are mostly transmitted horizontally through hyphal anastomosis and vertically through sexual or asexual spores , but cur


The goal of clinical and translational science (CTS) is to fill gaps in medical knowledge toward improving human health. However, one of our most pressing challenges does not reside within the biological map we navigate to find sustainable cures but rather the moral compass to recognize and overcome racial and ethnic injustices that continue to influence our society and hinder diverse research rigor. The Georgetown-Howard Universities Center for Clinical and Translational Science includes an inter-institutional TL1-funded training program for predoctoral/postdoctoral trainees in Translational Biomedical Science (TBS).In the fall of 2020, the TBS program responded to the national social justice crisis by incorporating a curriculum focused on structural racism in biomedical research. Educational platforms, including movie reviews, Journal Clubs, and other workshops, were threaded throughout the curriculum by ensuring safe spaces to discuss racial and ethnic injustices and providing trainees with practical steps to recognize, approach, and respond to these harmful biases in the CTS. Workshops also focused on why individuals underrepresented in science are vital for addressing and closing gaps in CTS.Paring analysis using REDCap software de-identified participants after invitations were sent and collected in the system to maintain anonymity for pre- and post-analysis. The Likert scale evaluated respondents’ understanding of diverse scientific circumstances. The pre/Fall and post/Spring surveys suggested this curriculum was successful at raising institutional awareness of racial and ethnic biases. Evaluating the effectiveness of our program with other training Clinical and Translational Science Awards (CTSA) consortiums will strengthen both the academic and professional TBS programs. The death of George Floyd in the summer of 2020 instigated a wake-up call heard worldwide that racism continues to plague society. Introspection ensued, including within the medical educator community. Directors of training programs revisited their approach to addressing racism and prejudice in biomedical research. Required training in human subject research includes “The Tuskegee Study of Untreated Syphilis in the Negro Male” as the iconic exemplar of abuse of Blacks by the medical profession . HoweverShortly after the death of George Floyd, Dr. Francis Collins, then Director of the NIH, apologized for longstanding and continuing structural racism in the biomedical sciences. He acknowledged that significant changes at NIH were necessary to effectively address structural racism in biomedical research. Despite all previous efforts to raise awareness of the importance of diversity and inclusivity, the numbers continue to reflect a large discrepancy between Whites and minorities in grant applications, funding rates, and numbers of postdoctoral fellows, staff, and senior scientists . To thisSeveral NIH institute directors followed Dr. Collins’ lead and developed committees to address structural racism. On February 26, 2021, a special meeting of the advisory committee to the director announced the establishment of the UNITE initiative  to bring together all the NIH Institutes and Centers to focus on addressing racism and discrimination in science and advancing the goal of diversity and inclusion throughout the biomedical community through five separate committees including U: Understanding stakeholder experiences through listening and learning; N: New research on health disparities, minority health, and health equity; I: Improving the NIH culture and structure for equity, inclusion, and excellence; T: Transparency, communication, and accountability with our internal and external stakeholders; and E: Extramural research ecosystem: changing policy, culture, and structure to promote workforce diversity .On March 1, 2021, Dr. Joni L. Rutter, then Acting Director of the NCATS, voiced a commitment to join Dr. Collins and “stand alongside the rest of NIH in its commitment to end structural racism in biomedical research” and join the UNITE initiative. Dr. Rutter goes on to say, “At NCATS, we have committed ourselves — in words and in actions — to support diversity, equity and inclusion and to address the scientific, operational, organizational and cultural problems that have contributed to racial inequities across the biomedical research enterprise” .The Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) community was also shocked by the murder of George Floyd. In direct response to those events, our NCATS-supported TBS training program for predoctoral students and postdoctoral fellows tasked a Program Committee on July 13, 2020, to incorporate a focus on systemic racism in biomedical research throughout the TBS curriculum. Members included the co-directors of the TBS program (DLL and KS), a former TL1 trainee (MDG), the Associate Director (EAB), a biomedical scientist who studies the impact of racism on health (KAB), basic scientists , clinical research investigators , and a bioethicist educator (RCS). This paper describes our experience implementing a pilot program to raise awareness of systemic and structural racism in biomedical research in an early career clinical and translational science (CTS) cohort.The curriculum was integrated into the Translational Biomedical Science (TBS) program between September 2020 and August 2021. The curriculum included movie and Journal Clubs, workshops in the Responsible Conduct of Research (RCR), and Visiting Professor Series throughout the academic year. Additional resources beyond the program’s workshops were provided. The homework included the online Harvard Implicit Association Test, which measures attitudes and beliefs that people may be unwilling or unable to report . TraineeSomething the Lord Made, The Immortal Life of Henrietta Lacks, and Miss Evers’ Boys  presented  and Howard University (HU) TBS participants is as follows: ten predoctoral students which consisted of 8 GU and 2 HU, 5 female and 5 male, 8 White and 2 African American, and 1 Hispanic and 9 Non-Hispanic scholars. Furthermore, the program had two GU postdoctoral fellows, 1 female and 1 male, 1 Withheld and 1 White, respectively, and 2 Non-Hispanic scholars.S1: I know what to say when interacting with people from different cultures. Refer to . Refer to Fig. S8: I am aware of the specific obstacles that many individuals underrepresented in biomedical sciences have encountered in their careers. Refer to Fig. S9: I am confident in my ability to identify individuals from groups underrepresented in the biomedical sciences. Refer to Fig. S10: Scientists from different cultures improve biomedical research. Refer to Fig. S11: Do you seek out the perspectives from people of different cultures in your research? Refer to Fig. Statements 1 and 2 addressed the comfort level trainees have interacting with individuals from different cultures. The majority of the trainees expressed positive responses (agree or strongly agree) with knowing what to say to people from different cultures; none disagreed , especially considering minimal mentorship from Blalock. They voiced frustration regarding Blalock’s refusal to support Mr. Thomas’ pursuit of a medical degree and professional advancement, despite Thomas’ qualification for such. They also expressed anger over Mr. Thomas’ classification as a janitor, versus Surgical Assistant to Dr. Blalock, and the absence of support of Mr. Thomas from the larger medical community. Blalock’s lack of mentorship for Mr. Thomas evoked several reactions from the trainees ranging from resignation to sadness to resentment.Statements 3 through 7 centered on bias recognition. While 80% of the trainees at the beginning of the program answered affirmatively that they could recognize unconscious bias and stereotypes in general Fig. C as wellDiversity, Equity, Inclusion and Implicit Bias  community. Several events have focused on diversity and inclusion Table . It is nIn a recent publication, former NIH director Francis Collins et al.  refer brThe evaluation of our program consisted of a 5.0 Likert scale analysis, which measures perceptions, values, and behavioral changes. However, the scale is not able to capture the richness of our discussions. Another limitation was the small sample size of our TL-1 cohort, which prevented robust statistical analyses and conclusions. Furthermore, our cohort may not be representative of prior and future trainees. We also are not evaluating the lasting impact on future trainee motivation and behavior. Thus, it would be interesting to assess the effectiveness of this educational initiative across diverse training programs in CTS over time and during different social periods. Another limitation is the lack of a “control” group, that is, a similar cohort training in CTS that is not exposed to this educational initiative. This is especially relevant since the TBS program is intentionally diverse in terms of fields of CTS, levels of training, institutions, and departments. Thus, weekly exposure to a diverse cohort of peers and near peers may also have impacted the pre- and post-survey responses.The major aspect of our pilot curriculum addressing systemic and structural racism was threading this theme throughout the year-long TBS program. Pre- and post-surveys of our TL1 cohort suggest this integration is an effective educational strategy for early career trainees in CTS. Although the surveys and participation for this pilot program were optional, we had 100% participation. Unlike a stand-alone workshop, this integration enabled us to cover more material on how racism contributes to the pathophysiology of disease, adversely affecting health care, health policy, health outcomes as well as the biomedical scientist while at the same time, providing training in critical competencies of CTS. Incorporating this theme into the curriculum enabled reiteration of themes, a known strategy for reinforcing educational concepts. Furthermore, our emphasis on establishing a safe environment for sharing thoughts and experiences about racial and ethnic challenges, including those from individuals whose ethnicity is underrepresented in science, facilitated the experience. Empowering the trainees to lead and galvanize group conversations around cultural and racial disparities in human health, access to, and use of healthcare services was also instrumental to increasing trainee awareness of these disparities. This enhanced recognition of the negative impact of systemic and structural racism will likely shape their outlook as they pursue their careers. These workshops not only broadened their awareness of racial biases, it also equipped the trainees to approach, support, and advance the conversation to ultimately combat racial and ethnic inequalities in human health and break down systemic institutional barriers. Our program supports the goal of NCATS and other stakeholders to reduce health disparities in CTS. It will be valuable to assess and compare the effectiveness of our program with similar approaches taken by other training programs across the CTSA consortium.


Program targets professionals from Ministries of Health, including Immunization and Screening Program Managers, and cervical cancer stakeholders.Under the framework of the Global Strategy to Accelerate the Elimination of CC as a Public Health Problem, The University of Texas MD Anderson Cancer Center (MD Anderson), the US National Cancer Institute (NCI), and the Pan American Health Organization (PAHO) partnered to develop the Project ECHO for the elimination of CC in Latin America (ECHO ELA). ECHO ELA is modeled on Project ECHO®  a hub-and-spoke knowledge-sharing approach where expert teams lead virtual didactic lectures and case discussions, building capacity for participants to deliver best-practice programs to their regions.In the first year of the program (2020-2021), 294 participants from 22 countries were registered. Fourteen sessions were held averaging 77 participants per session on topics spanning comprehensive program planning, presenting country experiences on HPV vaccination strategies, new technologies for screening and treatment. Eighteen participants completed the post survey addressing priorities, capacity, and desired outcomes, and two focus groups collected facilitators/barriers to achieving goals.ECHO ELA is potentially an effective tool to enhance collaboration and support countries’ progress towards the elimination of CC.


Maternal mental illness is a major growing global concern which can affect parenting with serious negative implications for offspring. Group-based parenting programs for mothers which both enhance the parent-child relationship and address mental health symptoms in a supportive social setting may optimise better outcomes for mothers and children. The Acorn program in South Australia draws on attachment theory to integrate dance play, reflective diary keeping and therapeutic letters in a holistic program for a diversity of vulnerable mothers and children aged 1–36 months. The program seeks to nurture and enhance parental wellbeing and the quality of the parent-child relationship for mothers experiencing identified mental health illnesses that impinge upon their parenting. This study presents the evaluation of the program and its effectiveness.Action research approach for continuous monitoring and program improvement engaging Acorn program staff in evaluation data collection and interpretation of pre and post self-completion measures and standardized observations. Additional data was collected through a telephone interview of attending mothers 6–8 months after program completion to address sustainable impacts on parenting and wellbeing.The program engaged 353 diverse vulnerable mothers with their children. Many had profound overlapping mental health issues including borderline personality disorder (BPD) and depression. The quality of the parent-child interaction, parental confidence, competence and enjoyment were enhanced; mothers' wellbeing, ability to cope and lasting social supports were augmented. This occurred for a number of “most vulnerable” subgroups including single mothers, mothers with BPD, mothers from non-English speaking households and those with lower levels of education or household income. Mothers reported sustained improvements in their wellbeing, parenting, social and family lives, and feeling closer to their child as a result of participating in the program.Given the high prevalence of maternal mental health issues and substantial potential negative consequences for mothers and offspring, the Acorn parenting program offers an effective means of addressing this pressing public health issue potentially helping large numbers of vulnerable mothers and their children. This has additional gravitas in the shadow of COVID-19 due to expanded numbers of those experiencing greater parental stress, isolation and mental illness. Subsequently mothers' enjoyment of the parental role may be reduced affecting a delay in developing competency in parenting skills and potentially creating a detached, mechanistic caregiving experience . Given tThe profoundly negative effects maternal mental health can have on offspring have been broadly documented –40. HoweThere is accumulated evidence, that a variety of psychosocial and psychological programs including peer/social support, group treatment, and non-directive counselling where mothers are encouraged to explore their feelings and find their own solutions benefit mothers with postpartum depression –69. A maGiven the potential to modify parenting behaviour, there is a strong case for developing effective parenting interventions for mothers with maternal mental illness to mediate the effects of their illness on child outcomes . InterveThe effectiveness of a community-based program delivered to a relatively heterogeneous client base should include consideration of identified vulnerable subpopulations. Mothers who are single have been found to be particularly vulnerable to maternal mental illness , includiThe evaluation of the Acorn program has therefore examined its effects for a diverse client base of mothers with mental illness including the specific subpopulations: single mothers, those who speak a language other than English at home, those whose main source of household income is Government benefit, and mothers whose education level has not progressed beyond Year 12 school level. Mothers who indicate BPD, and those with more than one young child of the ages targeted by the Acorn intervention were also considered as additional vulnerable subpopulations to consider in order to assess the value of the program.2.The Acorn parenting program is a face-to-face group-based holistic intervention of 15 weekly sessions of two hours duration provided in South Australian community venues (mostly child care centres) to help mothers of young children (0–3 years) who are experiencing chronic, and in many cases profound mental health challenges which impinge upon the quality of their parenting. Mother-child dyads are referred by a broad range of sources including Child and Family Health Services, Perinatal and Infant Mental Health Services, general hospitals, and private psychiatric and psychology consultants. This enables a diverse range of mothers to be directed to the program by their referrers with the only exclusion criteria being a current diagnosis of a psychotic disorder which might render group work with other mothers inappropriate. Acorn groups were conducted across fifteen geographically dispersed locations in metropolitan and outer metropolitan Adelaide suburbs with the program being delivered in “waves” twice a year to between 4 and 10 groups at a time.The theoretical underpinnings of the Acorn program were informed by attachment research which reinforces how the quality of the parent child attachment has a significant role in the life trajectory of the child  and highEach Acorn session incorporates three evidence based “primary components”. “Dance Play”, “Reflective Journaling” and “Therapeutic Letters”. Dance Play activities are designed to encourage meaningful mutually enjoyable playful interactions between mothers and infants –115 and The groups are staffed by a dance and movement specialist  who facilitates Dance Play, a Mental Health Clinician , who facilitates the compilation of Therapeutic Letters, and a Family Support Practitioner  who leads the journaling and reflection components of the groups.Following the Acorn group session, the staff team conducts a ninety-minute group supervision and debriefing session facilitated by the Mental Health Clinician in which reflections on each dyad are shared to inform the tailored Therapeutic Letter, and any staff concerns are discussed. The Mental Health Clinicians also provide individual supervisory support for the other team members, and are supported themselves by an external clinical supervisor. An Acorn Coordinator, a qualified social worker with knowledge of attachment theory, organizes group referral allocation and program promotion activities, with the whole program being overseen by a Program Manager.Peer meetings of Acorn Dance Workers, Family Support Practitioners and Mental Health Clinicians are regularly conducted to enable shared reflections on practice and maintain program fidelity within their own discipline. Whole of program team meetings are conducted at the end of each program year in which evaluation findings are also presented and discussed.Facilitator capacity is enhanced through internal training using developed program resources and induction including observations of existing Acorn groups followed by staff debriefing. Externally sourced training needs are reviewed periodically through a Critical Reference Group  compriseTo holistically nurture and enhance parental wellbeing and the quality of the parent-child relationship for mothers experiencing identified mental health illnesses and their young children aged 0–36 months”. The four longer-term collectively agreed objectives of the program are: to enhance the quality of the parent-child interaction; to improve parenting confidence, competence and enjoyment for vulnerable mothers; to enhance mothers' wellbeing, coping skills, resilience and self-efficacy; to expand and strengthen Social/Community supports and build Social Connectedness. The program logic and full program details are included as part of the Acorn Manual available through the MeB4three website  from the first eleven Waves of Acorn over a period of 5.5 years. Qualitative findings from the open-ended questions and focus groups exploring in-depth experiences of mothers on the program will be reported in a separate paper.The evaluation adapted an action research approach , 128, prGiven the vulnerability of Acorn participants, and the concern to retain client engagement in Acorn, ensuring that the compounding burden of evaluation demands was acceptable and manageable was a primary concern, with this being monitored during client focus groups and regular feedback from Acorn staff interviews. The standardised psychometric tools were selected based on: the ability of the tool to provide reliable, valid, and relevant indications of objectives being met; the appropriateness of the tool for application with vulnerable Australian mothers of children aged between 0 and 36 months of mixed educational and cultural backgrounds; the ease of administration and completion for participating subjects in a community-based group setting. The Bellberry Human Research Ethics Committee scientifically and ethically reviewed all aspects of the evaluation.The tools applied throughout the 11 waves of the program were:The Parenting Stress Index Short Form [PSI-SF] . The post-measure included a Likert scale operationalising indicators addressing each objective ; and a separate scale under the heading “current parenting abilities or experiences have improved  as a result of attending the groupFor each area, please indicate the extent to which your ”, with this including items addressing parental understandings, feelings and reflections; all items appear in The group was not very helpful for me), to provide an indication of diligence in client response. Mothers were also asked to indicate the extent to which they would recommend the Acorn program to their peers. The questionnaires were piloted with a small group of mothers prior to the evaluation.Follow-Up” Telephone Interview was applied with mothers from Waves 1–9 who had consented to be contacted for the purpose at the beginning of the program. This was conducted by a trained female independent interviewer who had professional experience in social work and maternal mental health. The interview schedule included Likert scale items from the post Client Self-Completion Questionnaire which were read verbatim to participants to enable direct comparisons with responses provided on completion of the program. The interviews lasted between 25 and 60 min.A six-eight month “Two additional tools were introduced as the program developed:McLean Screening Instrument for Borderline Personality Disorder [MSI-BPD] (DSM-IV BPD criteria. Each endorsed item scores 1 point with a score of 7 or more indicating likely BPD. The tool has demonstrated good sensitivity (.81) and specificity (.85). For young adults between the ages of 18–25 years diagnostic efficiency of the tool was higher; sensitivity .90 and specificity .93. The tool has good internal consistency with a Cronbach's alfa of .74. The MSI-BPD was applied as a pre-measure only to provide indications of borderline personality disorder (BPD).The MSI-BPD] , appliedNursing Child Assessment Satellite Training [NCAST] ]Parent-Child Interaction Teaching Scale  was significant t(15) = 3.52, p = .003, representing a large effect size d = .91.Mothers who brought two children to the program appear to have benefitted most across the domains addressed by the PSI-SF with higher effect sizes evident in relation to both their younger and older attending children. “Total Parenting Stress” was noticeably higher in relation to the second older attending child on commencing Acorn but this improved substantially. Applying the bootstrapping technique, there was on average a decrease in this score from pre  indicating “strongly agree” with this item. This included mothers indicating BPD with 72 (88.9%) agreeing that Acorn had helped them in this regard (30.9% “strongly” agreeing). The proportions of completing mothers “strongly” agreeing with this item improved as the program matured from 23.4% in Waves 1–4 to 40.4% in Waves 9–11. 319 (90.4%) mothers indicated that the group has made me feel better about myself as a parent (38.8% “strongly”) including 71 mothers indicating BPD (87.7%) with 29 (35.8%) of these mothers “strongly” agreeing.Nearly nine in ten mothers indicated that the program the group has made me more confident to access other family services if I need them, with this lower level of agreement being partly explained by some mothers expressing existing confidence in this area prior to Acorn; this may be related to the fact that all mothers were referred to Acorn by existing services with which they had some degree of engagement. However, enhanced confidence to access suitable family services appeared to improve after completing Acorn and was accompanied by the almost universal recognition among Acorn mothers that I am not alone in the struggles I can face as a parent; 293 (83.0%) mothers indicated this had improved “a great deal” or “quite a lot” by the end of the program and 77.3% indicated this level of improvement six-eight months later.While 233 (66.0%) endorsed the item, Acorn mothers were less likely to agree that While around one third of mothers did not indicate a desire to improve family independence and resilience prior to beginning the program, most mothers in the post-measure  indicated that the group had helped in this area and this appears to have improved months after completing the program (67.4%). There were sixty mothers indicating BPD who expressed the wish for their family to be more independent and resilient at the beginning of Acorn and thirty-eight of these (63.3%) agreed that the group had helped them in this regard in the post-measure.5.3.4.I made friends with other parents in the group, with 134 (38.1%) strongly agreeing this was the case. Strength of agreement improved as the program matured (from 33.9% “strongly” agreeing in Waves 1–4 to 44.4% in Waves 9–11) and was sustained 6–8 months later (Over eight in ten (295 mothers) agreed hs later . For motI feel more connected to my community because of attending the group, with this proportion being similar for mothers indicating BPD (66.7%). Most mothers continued to endorse this change and attribute this to Acorn six-eight months after the program  indicated  program .I have shared what I have learnt from the group program with other parents like me, . The intention to share learnings from Acorn were also signified by 82.1% of mothers from households that spoke a non-English language at home (41.1% “strongly” agreeing), and by single mothers . Confirmation from these groups that this had occurred 6–8 months later was provided by 81.1% of non-English speaking household mothers and 77.8% of single mothers.It was also the case that 314 mothers (89.7%) indicated they “will share” their learnings from the Acorn program with their peers, and confirmation that this intention was enacted was indicated in the follow-up measure with 121 (89.6%) agreeing has helped our family to have better relationships, and this appears to have improved over time; taking those 122 mothers for whom both post, and follow-up measures are available, 58.2% of these mothers indicated Acorn had helped to improved family relationships in the post measure with this increasing to 76.9% in the follow-up measure.Most Acorn mothers  indicated that participation in the program 5.4.Mdiff = 15.37, t(18) = 3.50, p < .005, d .76); “Parental Distress”  = 4.00, p < .001, d .63); “Parent-Child Dysfunctional Interaction”  = 2.51, p < .05, d .45); “Difficult Child”  = 2.17, p < .05, d .49). However, improvement in depression scores was not significant for these mothers, and for the 16 mothers whose children were aged 1 year or less Perceived Parental Self-Efficacy (KPCS) did not improve significantly. Only two of the mothers who had attended 7 times or less completed pre NCAT observations. Mothers who completed the program but attended less than half of the Acorn sessions reported improvements across all the indicators addressing each objective listed in The extent to which program attendance effected outcomes was explored by considering the 21 mothers who completed Acorn and provided pre and post Client self-completion questionnaires but attended 7 sessions or less . The profile of these mothers was very similar demographically to the larger group of mothers. Applying paired sample t tests for all psychometric scales where pre and post scores were available for these mothers, significant improvements were found for all the PSI-SF measures: “Total Parenting Stress” , and 100% that the group had helped them to feel closer to their child (50% “strongly”). However, this small NCAT group of 19 observed dyads were culturally heterogeneous (speaking 7 different languages at home), and while the NCAT has been successfully applied with some ethnic communities it is possible that cultural barriers to be being observed and videoed with their children may have influenced behaviour for some of these dyads.The large majority of mothers indicated that they interacted better with their children because of the program, that their child had benefitted, and that the program had helped them feel closer to their child, and these positive indications endured six-eight months after completion. These benefits were also evident regarding the second older attending child to the program, and mothers almost universally indicated that the program has helped in their parenting of other non-attending children. The majority of Acorn mothers reported improving substantially across a range of parenting qualities including understanding their child's needs, feelings, and perspectives of the world and enhancing their ability to respond to their child appropriately, with these being reaffirmed six-eight months after leaving Acorn. Given the difficulties maternal mental illness can impose on mother-child interaction the above self-reported improvements are notable. These were accompanied by widespread reporting of improved (and sustained) parental confidence along with significant improvements in perceived parental self-efficacy (PPSE) with medium effect sizes for Acorn mothers across all the vulnerable subgroupings considered, including those for whom Government benefits were the main source of household income and those with low formal education . Given the importance of PPSE for successful parenting and its relationship to actual parenting competence this is very encouraging and supports the substantial reported improvements in parental competence indicated by over 9 in 10 Acorn mothers both on completing the program and six-eight months later. These included employing a range of new ways to interact with their child, and feeling more comfortable with interactive playing and child exploration.The standardized tools applied in this evaluation provide clear evidence that the well-being of most mothers attending Acorn has improved in the dimensions addressed. Additional self-reported indications provided after program completion and six-eight months later corroborate this improvement with mothers attributing this to their participation in the program. Many reported that they felt better about themselves as parents and were better able to cope as a parent . While many participating mothers experienced clinically significant improvements in depression and PPSE, we support the view that in promoting the wellbeing of mothers with mental illnesses, reducing sub-clinical symptoms for mothers with mental health difficulties is also important  and thisp = .093 and p = .054 respectively). In the latter case, there were 29 completing “Acorn mothers” with an older eligible child who did not attend Acorn. Given that the largest effect size for “Difficult Child” improvement was in relation to mothers with a second older attending child, further measures to encourage mothers to bring all their eligible children to the program could prove beneficial in this dimension. “Difficult Child” addresses the mother's perception of the child's temperament, defiance, noncompliance and demandingness, but this can be influenced by “external” factors .We were mindful of overburdening or alienating vulnerable women in the community setting with the demands of evaluation and focused specifically on tools that addressed the objectives of Acorn. The program did not screen for substance use disorder, and while the clinical diagnosis of psychotic disorder was an exclusion criterion, the program relied on referrers to identify this condition. We did not screen for bipolar disorder, the presence of which may interfere with the score for the MSI-BPD . We did Comparisons between post-measures and follow-up interviews employed different methods to obtain responses from Acorn mothers. It is possible that respondents may have been more inclined to provide positive answers in the follow-up because of these being elicited in an interview as opposed to the demonstrable anonymity of a self-completion questionnaire. However, given that the interviewer for the follow-up was independent, and that all mothers were clearly informed their responses and names would remain strictly confidential, participants had little motivation to provide misinformation about positive outcomes in their personal lives attributed to participating in a program they had completed months earlier. Moreover, it may have been expected that the perceived impact of a program would wane over time or possibly a contrast effect might occur whereby current impacts would be judged inferior in comparison to the largely positive impressions experienced immediately after the program. However, arguably the most striking finding has been the consistency of responses between the two measures taken six to eight months apart, and we are confident that this consistency coupled with the above considerations have yielded authentic responses from mothers.We employed an action research design for this evaluation which precluded using a comparison/control group. Given the heterogeneity of the client base, the range of impacts sought reflected in the objectives, and the combination of different program strategies to achieve them, the importance of utilizing the evaluation formatively was recognised in anticipation that program processes and outcomes would need to be monitored closely to inform potential program revision. There were ethical concerns raised by stakeholders about withholding the intervention from some vulnerable mothers and their young children for the purpose of establishing a comparison group. There was no “waiting list” available as the program expanded to accommodate all referrals. Causal attribution was premised on triangulating mixed methods addressing a range of dimensions germane to parental wellbeing and the quality of the parenting relationship articulated in Acorn's program logic. Participant own judgements of causality were obtained through the Client Self-Completion Questionnaires and through follow-up interviews in which former clients could personally reflect on how the program had (or had not) achieved its objectives in relation to their own lives. A range of deeply personal positive improvements were broadly attributed to the program, and often strongly indicated. Given the profound challenges experienced by Acorn mothers in the most intimate of their human relationships, providing this evidence supports the effectiveness of the Acorn program. While future studies may be able to include a waiting list control or randomised control design to establish efficacy, the case that the Acorn program has achieved its stated goal and objectives is strongly supported by this evaluation.There are several strengths to this study. The action research design of the evaluation enabled on-going monitoring, timely feedback, reflection and refinements to be integrated into this community program over a long period of time between “Waves” of delivery. The evaluation design also enabled the service providers to be enlisted in the efficient collection of data across the geographically dispersed groups of this multi-site program. While the three principal components remained constant throughout, supplemental adjustments to the program, its delivery and its evaluation were flexibly facilitated resulting in a matured program model detailed in its completed Manual . ParticiThe application of mixed methods in this study has provided comprehensive, consistent and triangulated evidence of the suitability of the program and its array of lasting beneficial impacts. The inclusion of direct standardized observations of the quality of the parenting interaction also answers the call to implement measures of parenting quality which are not wholly reliant on mothers' self reports  and for 8.The evaluation findings lend support to growing evidence of the benefits of psychotherapy approaches to enhancing mental health wellbeing in community settings , 167–169Given the global prevalence of maternal mental ill health and the alarming expansion in numbers of those experiencing greater parental stress, isolation and mental illness in the shadow of COVID-19 , 172, th


This paper analyzes the types of community-based integrated care programs based on the needs of consumers and estimates future costs through data on consumer-oriented integrated care for the elderly in the local community operated by Korea, which is experiencing rapid aging. By analyzing the types of programs and the composition of budget items, we check the composition of the program from the consumer side of the integrated care program in the local community and predict the national budget for each item to operate it. Through this, policy implications for business operation and implications for sustainable financial management are derived. In a community-centered integrated care program, complex programs are run organically, making it difficult to apply a uniform unit price to the total program. In the case of integrated care for the elderly, there is a lot of discussion about the importance of responding to various demand groups, but there is not much analysis on what types of programs are in demand.There is considerable discussion around the effectiveness of integrated care for the elderly , 2. StudFurthermore, there have also been analyses of the characteristics of each country and the effectiveness of programs on the effectiveness of integrated care . GoodwinIn addition, there have been studies on the taxonomy of integrated care. A representative study derives key features of integrated care work are through existing literature analysis and the Rainbow Model and provides a classification based on the key features .An important factor in operating a community-based integrated care program is the analysis of the needs of the program beneficiaries and a structural approach to the associated costs. However, not much research has been done on this topic. Rather, the existing literature has focused on providing a framework for cost analysis or analyzing the economic effects of integrated care , 14.Korea is experiencing the highest rate of population aging among OECD countries and is making mid- to long-term plans to operate integrated care programs subject to limited financial resources. One such plan was for the Korean government to decentralize its integrated care program and to conduct a pilot program for integrated care for the elderly targeting 13 local governments. The main feature of this program is that it was constructed by reflecting on the needs of the local community seniors, and the central government allocated financial resources in a top-down manner. The characteristics of this program provides us with information on the demand of the local governments, and based on this, it is possible to estimate the expected cost assuming that the integrated care program for the elderly will be expanded nationwide.Our research contributes to the existing studies and findings in several aspects. First, given the complexity of the integrated care program for the elderly, our data helps confirm the needs of actual consumers on a per program basis. In addition, our study presents a framework for conducting effective analysis of managing integrated care programs by classifying various programs into several major categories. Moreover, by analyzing each program by budget item, our study provides a basis for finding efficient management methods in terms of budget management. Finally, through long-term cost forecasting, we identify long-term fiscal demand forecasts and structural factors that can influence fiscal demand.Our paper is organized as follows. Section A Pilot Program of Integrated Care for the Elderly in the Local Community in Korea describes the features of the pilot program of integrated care for the elderly in Korea, as well as the budget for each local government and the method of classifying major programs, and based on this, 4 categories are formed. In section Mid- to Long-Term Cost Estimation for Integrated Care for Elderly, we forecast the financial need according to the scenario of future growth of the elderly population and business expansion based on the financial requirements of the pilot program in 2020. Section Conclusion and Policy Implications draws policy implications and provides the concluding remarks.The data we use is based on internal data on the contents and the budget of a pilot program of integrated care for the elderly in 13 local governments in 2020. The program is operated as follows. First, individual local governments submit their wishes to the central government about whether they want to run an integrated care pilot program for the elderly. Next, the local government to operate the pilot program is selected based on the proportion of the elderly population and whether existing programs are being operated. The local governments selected in this way design their programs and calculate their budgets by reflecting their needs. The central government then makes minimal interventions to adjust excessive unit prices, and the budget is allocated in a top-down manner.After budget allocation, the local government operates the program by reflecting on the needs of the elderly. During this process, the requests of the consumers are met as much as possible, except in cases where it is difficult to fulfill the requests due to legal issues or excessive demands that exceed the budget range. After that, the central government evaluates individual projects supported through the program.The fact that these programs are decentralized in the above manner makes it possible to select and operate projects that reflect the needs of individual local governments rather than having a central government-centered project selection and operation. Because of this, we are able to analyze the types of programs required for integrated care from the perspective of actual consumers.We now describe the social characteristics and budget allocation status of the 13 local governments selected for analysis. The population composition of the 13 local governments operating the program is as follows.As shown by The budget provided to the local governments for the program is as follows.As shown by Our study classifies the types of pilot programs in 13 local governments based on the program composition and purpose of each project and confirms the proportion of each budget item. First, as a criterion for classifying the program type, we classify the purpose of the program description by type. In the case that a single program has a complex nature, we classify the type based on the program that occupies the highest proportion in the budget.If the types of projects are classified based on this method, they can be broadly classified into housing support, health and medical support, daily care support, and common operating expenses. The major programs in each category are shown in Thus, the demand for integrated care for the elderly can be divided into housing services for integrated care for the elderly, health care support before medical treatment, and support and operating costs for daily living.We now break these programs down again by budget category for analysis. We use the budget item code that is utilized when composing the budget for this type of program and divide the program into labor cost, operating cost, and business cost. The reason for this classification is to classify the programs by budget items to increase the effectiveness of budget or public finance management. At the same time, this classification lays the basis for analysis of future changes in budget items. The composition of major program types by budget item is shown in The following describes the operation methods of the 13 local governments for each classification based on the number of services provided and the unit price. In the case of housing support, we are promoting facility improvement programs for about 1,671 households with an average program cost of KRW 3,300 per household, mainly for the improvement of care and safety housing facilities. For residential infrastructure installation and operation management and smart home installation and operation, an annual wage of 30 million won per person is provided, and an average of 18 people are in charge of related program operation. As we can see from the related contents, the proportion of related program costs is high in the case of integrated care, because it focuses on the organic connection process of existing program systems.In the case of health and medical support, an average of 2,642 medical treatment support services are provided for oriental doctors, doctors, dentists, and assistants by setting an average labor cost of KRW 193,000, KRW 181,000, KRW 75,000, and KRW 40,000 per local government, respectively. Also, for rehabilitation and exercise support, an average of 515 cases and 1,168 cases are provided by applying an average labor cost per session of KRW 504,000 for rehabilitation and KRW 80,000 for exercise. In addition, for the medication support program, an average of KRW 86,000 per session is provided to related personnel, providing an average of 2,704 services.In the case of daily care support, the average price per meal is set at KRW 5,990 per meal to provide lunchboxes or ingredients to an average of 594 people. A total of 161,805 laundry and cleaning services are provided based on the labor cost allowance. In addition, it provides an average of 27,743 opportunities to use the service by subsidizing expenses such as taxis and other means of transportation for an average of KRW 390,000 per month.For miscellaneous operation, funds are used for research services to create a care base and for supporting local care meetings and case meetings. In the case of local care meetings, an average of 95,000 won per local government is paid to about 20 meeting attendees and held 5 times a year on average. In order to revitalize local community care, an average of 1.2 studies is being conducted, and about KRW 23 million is paid per case. The budget is also used for publicity expenses and production of promotional materials.This section estimates mid- to long-term costs based on the content of the pilot program. In estimating the cost, we assume that the operation details and composition of the integrated care project pilot program of 13 local governments will remain as the basis for future operations. This is because the program has already reflected the needs of consumers. Based on this assumption, we estimate the cost if the program were to expand over the next 5 years while taking into consideration the coverage of the elderly population currently covered by the pilot program. The detailed calculation method and contents are described in the following section.In order to estimate the cost under the scenario where there is an expansion of the range of users of the pilot program, we first consider future population changes and the estimation of the elderly population. To do this, we apply the forecast for the population aged 65 and over for 5 years starting 2022 using the 2019 forecast of the Korean National Statistical Office, which is the most recent forecast on overall population and elderly population of Korea. The total population at the time of the study is expected to increase from 51.8 million to 51.9 million, while the elderly population over 65 is expected to increase significantly from 8,975 thousand to 11.1 million. As the community-based integrated care program targets the entire elderly population over 65, the expansion of related programs will be discussed based on the statistics above.In our study, we assume that costs and prices will increase 1.4% per annum, which is based on the inflation rate predicted by the National Statistical Office of Korea for the next 10 years, and that labor costs will increase 2.9% per annum, based on the 2020 supplementary guidelines for budgeting for local investment institutions.Based on the 2020 budget of the pilot program for integrated care for the elderly in the local community, the mid- to long-term budget for the program is estimated as follows. First, we confirmed what percentage of the elderly population in the area is targeted by the pilot program. Next, we predict the scope of the program based on the population estimate and the annual expansion plan of the program. The number of elderly people in the pilot program community is 805,983 and the number of elderly people who are provided integrated care through the pilot program is 14,337, which is about 1.78% of the total elderly population. In the future, the local government that will operate the program will increase the number of the relevant cities, counties, and town by 20% per year  for all 223 cities, counties, and town, and finally, in 2025, the local government is expected to provide priority service at the level of the current pilot program. The number of beneficiaries of the program is predicted as follows under the premise that the service level currently in charge of the pilot program is provided in connection with the future forecast for the elderly population. Based on these forecasts, the estimates for each program type and budget item given the expansion of the target of integrated care and the increase in cost are shown in From the perspective of the entire program, the cost of the expansion scenario of the integrated care program for the elderly in the community is estimated to be as follows in We also predict that the proportion of business expenses will be higher than other items in terms of establishing a system of integrated care programs. The expected totals and unit prices for each program in detail are shown in the The cost estimate of the community-centered integrated care program presented in the previous section is based on the number of elderly people in the area and the number of service recipients receiving services through the program based on the results of the pilot program currently being implemented. We calculated the cost conservatively, assuming a nationwide operation of the related program in the future. Therefore, in the expansion and operation of related programs in the future, the following should be considered, and changes in costs can be expected accordingly.In the previous section, the proportion of service recipients among the elderly population in the region appeared to be about 1.78% in the case of the regional integrated care pilot program, and we estimated the cost of the nationwide expansion of the program in stages from 2022 to 2026.However, the number of the potential beneficiaries of the project varies depending on the type and characteristics of the target(s). Given the number of people in the blind spot of welfare, the number of beneficiaries may be expanded from 179,000 to about 450,000 in 2026 .Assuming such a change in demand, the coverage due to the expansion of the service target will increase to 4.1% in 2026, and the related costs are will increase to about KRW 2.1 trillion as follows in We confirm that the proportion of labor and operating expenses rather than the program cost will increase in order to actually operate the integrated care program after establishing the program through phased expansion over the next 5 years. In this case, we predict that in the future, the cost of personnel expenses and labor costs will rise compared to the inflation, and additional costs will be required in the field of training and composition of related experts, and the proportion of program expenses will be adjusted.The complexity and diversity of the integrated care for the elderly in the community are important issues. For the global aging population, integrated care is becoming a major alternative to conventional care provision. Based on the data of Korea's consumer-centered integrated care pilot program, this paper analyzes program types based on consumer needs and classifies them by budget item, contributing to program operation and financial planning at the same time.We derive the following policy implications. First, program operation centered on the needs of consumers is necessary in the future. Efforts to save costs by deriving common areas of operation through analysis of program types are also important. In addition, by analyzing the types of expenses as well as the contents of the program, it is possible to derive the items of expenses that can be increased in the future and to confirm that it is necessary to prepare for them.For countries experiencing rapid aging, community care is becoming an alternative to improving the health and well-being of the elderly. Important factors for the success of community care are beneficiary satisfaction and sustainable financial operations. This study presents the service needs and cost estimates of beneficiaries in studies on the effectiveness and cost of existing community care. Future research may analyze cost-saving factors of community care programs for the elderly in terms of sustainable financial operation and analyze various types of services.This research was based on the results of the policy research project of the Ministry of Health and Welfare of Korea and may differ from the official opinion of the institution.The original contributions presented in the study are included in the article/The author confirms being the sole contributor of this work and has approved it for publication.This research was supported by the SungKyunKwan University, the BK21 FOUR (Graduate School Innovation) funded by the Ministry of Education , and National Research Foundation of Kore (NRF).The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


The choice of a manufacturing process, raw materials, and process parameters affects the quality of produced pre-consolidated tapes used in thermoplastic pultrusion. In this study, we used two types of pre-consolidated GF/PP tapes—commercially available  and inhouse-made tapes produced from commingled yarns —to produce pultruded thermoplastic Ø 6 mm bars and 75 mm × 3.5 mm flat laminates. Flat laminates produced from inhouse-made pre-consolidated tapes demonstrated higher flexural, tensile, and apparent interlaminar shear strength compared to laminates produced from commercial pre-consolidated tapes by as much as 106%, 6.4%, and 27.6%, respectively. Differences in pre-consolidated tape manufacturing methods determine the differences in glass fiber impregnation and, thus, differences in the mechanical properties of corresponding pultruded composites. The use of commingled yarns  makes it possible to achieve a more uniform impregnation of inhouse-made pre-consolidated tapes and to prevent formation of un-impregnated regions and matrix cracks within the center portion of the fiber bundles, which were observed in the case of commercial pre-consolidated tapes. The proposed method of producing pre-consolidated tapes made it possible to obtain pultruded composite laminates with larger cross sections than their counterparts described in the literature, featuring better mechanical properties compared to those produced from commercial pre-consolidated tapes. Recent decades have been marked by the wide adoption of fiber-reinforced polymer (FRP) materials . DependiIn traditional thermoset pultrusion, the reinforcement material in the form of unidirectional rovings, mats, fabrics, or veils is impregnated with a polymer matrix. Then, the impregnated pack is fed into the heated die where composite polymerization takes place . FurtherThis study investigated the mechanical properties and morphology of pultruded thermoplastic glass fiber/polypropylene (GF/PP) bars (Ø 6 mm) and flat laminates (75 mm × 3.5 mm) produced from two different types of PCTs manufactured by different processes. In the study we used commercially available PCTs and their inhouse-made counterparts based on glass fiber/polypropylene (GF/PP) commingled yarns. Pultruded composite elements were tested in tension, flexure, and interlaminar shear. The study also included optical microscopy analysis of inhouse-made and commercial PCTs and of pultruded composites based thereupon. The results showed that the proposed method for PCT manufacture, based on commingled yarns, had a considerable influence on the mechanical properties of the corresponding pultruded thermoplastic composite.Two types of PCTs were used to manufacture thermoplastic composites: commercial  and inhouse-made tapes. Commercial thermoplastic PCTs consist of 2400 TEX unidirectional glass fiber rovings and the Moplen RP388U polypropylene matrix. The volume fraction of reinforcement constituted 38.6%. The tapes had a width of 4.83 mm and a thickness of 0.66 mm. The commercial thermoplastic PCTs were produced by injecting the polypropylene resin into the die block where the glass fiber reinforcement was fed into. Due to confidentiality reasons, the manufacturer chose not to disclose the design of the die block used in the production of the commercial PCTs and the respective information on process parameters.Inhouse-made thermoplastic PCTs were produced at the Laboratory of Composite Materials and Structures of the Center for Materials Technologies , using a Plastron FLD 35  extrusion machine. In order to produce inhouse-made thermoplastic PCTs, we used the modified die block with corrugated cavity walls and glass fiber/polypropylene (GF/PP) commingled yarns .In order to produce thermoplastic composites, we used the Pultrex Px500-6T  pultrusion machine at the Laboratory of Composite Materials and Structures of the Center for Materials Technologies . Two types of pultruded thermoplastic GF/PP profiles were produced in the course of the study—Ø 6 mm bars and 75 mm × 3.5 mm flat laminates.1 = 7.1 mm, d2 = 6.5 mm, and d3 = 6.2 mm, respectively. The cooling die had an orifice of d4 = 6.1 mm in diameter . For the final grinding we used the Silicon Carbide Foils FEPA P#2000 . An Axio Scope A1  optical microscope was used for morphology analysis.Crystallinity of the commercial and inhouse-made PCTs, as well as the pultruded thermoplastic GF/PP flat laminates and bars, was determined in accordance with the technique described in  using diFlat laminate specimens were machined on a Shtalmark M1-912 M/2 CNC milling machine . Tensile, flexural, and interlaminar shear properties of flat laminate specimens were determined in accordance with ISO 527-2, ASTM D790-15e2, and ASTM D2344 procedures, respectively. Flat laminate specimens were tested on an Instron 5969 testing machine . In the tensile tests we used a clip-on extensometer to measure strain. For the bending modulus measurements we used crosshead displacement with compliance corrections as allowed by paragraph 6.1.5.1 of ASTM D790-15e2. Compliance correction was performed in advance on a rigid  specimen with the same configuration of the load string, in accordance with Appendix X1 of the standard. The Bluehill 3 software  later applied corrections automatically when testing specimens.To determine the mechanical properties of the pultruded thermoplastic bars we conducted a series of tensile, flexural, and short-beam shear tests in accordance with the ASTM D3039/D3039M, ASTM D4476/D4476M-14, and ASTM D4475-2002 procedures, respectively. Pultruded bars were tested on a DHY-10080 electronic universal testing machine . In the tensile tests we monitored strain by an extensometer with a gauge length of 25mm on the center surface of the effective test length of the bars. For bending modulus measurements we used crosshead displacement so the specimen did not slip with the loaded crosshead due to the applied fixture.Experimental setups used to manufacture inhouse-made PCTs, pultruded thermoplastic bars, and flat laminates are shown in 1 = 200 ± 5 °C, T2 = 185 ± 5 °C, T3 = 170 ± 5 °C, respectively. To maintain temperature conditions the heaters were installed at the top and bottom of the heated dies. In order to control the temperature, we used thermocouples placed in contact with the heated dies. The temperature of the cooling die was set at T4 = 40 ± 10 °C. The pulling speed constituted 0.3 m/min. In total, we produced ten meters of GF/PP bars for further mechanical testing and morphology analysis.To manufacture thermoplastic GF/PP bars with diameters of Ø 6 mm see b we usedThreshold segmentation was applied to the obtained micrographs of the seven inhouse-made and seven commercial PCTs, and their corresponding void content was calculated. The mean values of the void content were 11% and 14%, respectively. The largest and the lowest values of void content of all the studied inhouse-made PCTs a,b were In the central part of the inhouse-made PCT with 2% void content a, we couIn commercial PCTs with 7% void content c we obseTo calculate void content, threshold segmentation was applied to the obtained micrographs of the pultruded thermoplastic flat GF/PP laminates based on inhouse-made and commercial PCTs. Th mean values of void content were 12% and 15%, respectively. The flat laminates based on inhouse-made PCTs a,b contaThe flat laminates based on commercial PCTs c,d featuAccording to the results of TGA analysis and further calculations, the fiber volume fractions of pultruded GF/PP bars based on inhouse-made PCTs and flat GF/PP laminates based on commercial and inhouse-made PCTs were 34.1%, 32.0%, and 36.0%, respectively.The results of DSC, TGA analysis, and the calculated crystallinity values of commercial and inhouse-made PCTs, pultruded thermoplastic GF/PP, and flat laminates and bars are presented in ted from .The crystallinity of inhouse-made PCTs was higher than those of the commercial PCTs. As a result, the crystallinity of thermoplastic pultruded composites based on inhouse-made PCTs was also higher than their counterparts made of commercial PCTs. The manufacturing of inhouse-made PCTs and pultrusion of thermoplastic composites was performed at the laboratory under the same normal conditions. However, the crystallinity of thermoplastic composites was higher compared to the PCTs due to the difference in the cooling rate caused by the larger geometrical dimensions of the composite profiles. The cooling rate of GF/PP flat laminates in the cooling die was around 7 K/s, while the cooling rate of PCT after the die exit was around 10 K/s.Specimens of 75 mm × 3.5 mm flat GF/PP laminates prepared for flexural and short-beam shear tests had dimensions of 260 mm × 13 mm × 3.5 mm b and 30 Results of mechanical testing of pultruded thermoplastic GF/PP bars of Ø 6 mm and of 75 mm × 3.5 mm flat laminates are shown in For comparison purposes, the values of the mechanical properties of the pultruded thermoplastic composites manufactured from PCTs described in the previous studies ,23,26 arThe study investigated the influence of the PCT manufacturing method on the mechanical properties and morphology of pultruded thermoplastic composites and proposed a method for producing PCTs based on the use of commingled yarns. Two types of pultruded thermoplastic GF/PP profiles were produced in the course of the study—Ø 3.5 mm bars and 75 mm × 3.5 mm flat laminates. In order to study the mechanical properties of the produced composites, we conducted a series of tensile, flexural, and short-beam shear tests. We also studied the morphology of both of the inhouse-made and commercial PCTs and of pultruded composites based thereupon.Results showed that flat laminates produced from inhouse-made PCTs had better mechanical properties than those manufactured from commercial PCTs. This could be explained by a better impregnation of glass fiber reinforcement in the inhouse-made PCTs produced from commingled yarns, as shown by optical microscopy. On the contrary, the injection method could not provide uniform impregnation, which resulted in the formation of un-impregnated regions and matrix cracks over the whole cross section of the commercial PCTs, thus impairing the mechanical performance of corresponding pultruded composites. Defects formed during the manufacture of commercial PCTs coul not be corrected during pultrusion and led to the formation of debondings and branched matrix cracks in the pultruded composites. The comparison of mechanical characteristics and cross section dimensions of pultruded thermoplastic composites described earlier in the literature and those produced from inhouse-made PCTs demonstrated the great potential of the proposed method of PCT manufacturing.In further studies, the authors intend to investigate the influence of PCT quality on the durability of corresponding pultruded thermoplastic profiles subjected to water, seawater, and alkaline environments. Moreover, the effects of technological regimes of PCT manufacturing and thermoplastic pultrusion on mechanical properties, occurrence of manufacturing-induced shape distortions, porosity, and morphology of corresponding composites will be studied as well. In particular, the authors plan to investigate the influence of pulling speed ,40, temp