SCALE-UP II: protocol for a pragmatic randomised trial examining population health management interventions to increase the uptake of at-home COVID-19 testing in community health centres.

INTRODUCTION: SCALE-UP II aims to investigate the effectiveness of population health management interventions using text messaging (TM), chatbots and patient navigation (PN) in increasing the uptake of at-home COVID-19 testing among patients in historically marginalised communities, specifically, those receiving care at community health centres (CHCs). METHODS AND ANALYSIS: The trial is a multisite, randomised pragmatic clinical trial. Eligible patients are >18 years old with a primary care visit in the last 3 years at one of the participating CHCs. Demographic data will be obtained from CHC electronic health records. Patients will be randomised to one of two factorial designs based on smartphone ownership. Patients who self-report replying to a text message that they have a smartphone will be randomised in a 2×2×2 factorial fashion to receive (1) chatbot or TM; (2) PN (yes or no); and (3) repeated offers to interact with the interventions every 10 or 30 days. Participants who do not self-report as having a smartphone will be randomised in a 2×2 factorial fashion to receive (1) TM with or without PN; and (2) repeated offers every 10 or 30 days. The interventions will be sent in English or Spanish, with an option to request at-home COVID-19 test kits. The primary outcome is the proportion of participants using at-home COVID-19 tests during a 90-day follow-up. The study will evaluate the main effects and interactions among interventions, implementation outcomes and predictors and moderators of study outcomes. Statistical analyses will include logistic regression, stratified subgroup analyses and adjustment for stratification factors. ETHICS AND DISSEMINATION: The protocol was approved by the University of Utah Institutional Review Board. On completion, study data will be made available in compliance with National Institutes of Health data sharing policies. Results will be disseminated through study partners and peer-reviewed publications. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT05533918 and NCT05533359.

Glycoalkaloid responses of potato to Colorado potato beetle defoliation.

Two experiments were conducted to measure the glycoalkaloid concentrations of potato tubers in response to Colorado potato beetle and manual defoliation. For plants defoliated by Colorado potato beetles, there was a significantly greater production of glycoalkaloids than in control plants and manually defoliated plants for both skin and inner tissue of tubers in experiment 1. In experiment 1, there was a 58.1% and 48.3% increase in glycoalkaloids in skin and inner tissue of tubers, respectively, from plants defoliated at high levels by Colorado potato beetles compared to control plants. In experiment 2, although a significant difference in glycoalkaloid concentration was not observed among the treatments, the skin and inner tissue of tubers from plants defoliated at high levels by Colorado potato beetles increased glycoalkaloid concentration by 23.4% and 14.5%, respectively, compared to tubers from control plants. In experiment 1, the concentration of tuber extract required to reduce Chinese hamster ovary (CHO) cellular proliferation by 50% was 10-fold less for the skin versus the inner tissue, indicating that skin tissue was more toxic under the in vitro conditions of this assay.