Preparing pathological data to develop an artificial intelligence model in the nonclinical study.

Artificial intelligence (AI)-based analysis has recently been adopted in the examination of histological slides via the digitization of glass slides using a digital scanner. In this study, we examined the effect of varying the staining color tone and magnification level of a dataset on the result of AI model prediction in hematoxylin and eosin stained whole slide images (WSIs). The WSIs of liver tissues with fibrosis were used as an example, and three different datasets (N20, B20, and B10) were prepared with different color tones and magnifications. Using these datasets, we built five models trained Mask R-CNN algorithm by a single or mixed dataset of N20, B20, and B10. We evaluated their model performance using the test dataset of three datasets. It was found that the models that were trained with mixed datasets (models B20/N20 and B10/B20), which consist of different color tones or magnifications, performed better than the single dataset trained models. Consequently, superior performance of the mixed models was obtained from the actual prediction results of the test images. We suggest that training the algorithm with various staining color tones and multi-scaled image datasets would be more optimized for consistent remarkable performance in predicting pathological lesions of interest.

Some fundamental elements for studying social-ecological co-existence in forest common pool resources.

For millennia, societies have tried to find ways to sustain people's livelihoods by setting rules to equitably and sustainably access, harvest and manage common pools of resources (CPR) that are productive and rich in species. But what are the elements that explain historical successes and failures? Elinor Ostrom suggested that it depends on at least eight axiomatic principles of good governance, whereas empirical results suggest that these principles are not sufficient to describe them, especially when applied to CPRs that possess great social and ecological diversity. The aim of this article is to explore the behavior of a mathematical model of multi-species forest dynamics that respects the foundations of ecology and Ostrom's governance theory, in order to detect possible constraints inherent to the functioning of these complex systems. The model reveals that fundamental structural laws of compatibilities between species life-history traits are indeed constraining the level of co-existence (average and variance) between a diversity of co-vulnerable timber resource users (RU) and of competing tree species. These structural constraints can also lead to unexpected outcomes. For instance in wetter forest commons, opening up the access to as many diverse RUs as there are competing tree species, produces a diversity of independently-controlled disturbances on species, collectively improving the chances of coexistence between species with different life-history traits. Similar benefits are observed on forest carbon and on profits from timber harvesting. However in drier forest commons, the same benefits cannot be observed, as predicted on the basis of the constraining laws. The results show that the successes and failures of certain management strategies can be reasonably explained by simple mechanistic theories from ecology and the social-ecological sciences, which are themselves constrained by fundamental ecological invariants. If corroborated, the results could be used, in conjunction with Ostrom's CPR theory, to understand and solve various human-nature coexistence dilemmas in complex social-ecological systems.

Patient-derived models: Promising tools for accelerating the clinical translation of breast cancer research findings.

Breast cancer has become the highest incidence of cancer in women. It was extensively and deeply studied by biologists and medical workers worldwide. However, the meaningful results in lab researches cannot be realized in clinical, and a part of new drugs in clinical experiments do not obtain as good results as the preclinical researches. It is urgently that promote a kind of breast cancer research models that can get study results closer to the physiological condition of the human body. Patient-derived models (PDMs) originating from clinical tumor, contain primary elements of tumor and maintain key clinical features of tumor. So they are promising research models to facilitate laboratory researches translate to clinical application, and predict the treatment outcome of patients. In this review, we summarize the establishment of PDMs of breast cancer, reviewed the application of PDMs in clinical translational researches and personalized precision medicine with breast cancer as an example, to improve the understanding of PDMs among researchers and clinician, facilitate them to use PDMs on a large scale of breast cancer researches and promote the clinical translation of laboratory research and new drug development.

Research Priorities for Interventions to Address Health Disparities in Lung Nodule Management: An Official American Thoracic Society Research Statement.

Background: Lung nodules are common incidental findings, and timely evaluation is critical to ensure diagnosis of localized-stage and potentially curable lung cancers. Rates of guideline-concordant lung nodule evaluation are low, and the risk of delayed evaluation is higher for minoritized groups. Objectives: To summarize the existing evidence, identify knowledge gaps, and prioritize research questions related to interventions to reduce disparities in lung nodule evaluation. Methods: A multidisciplinary committee was convened to review the evidence and identify key knowledge gaps in four domains: 1) research methodology, 2) patient-level interventions, 3) clinician-level interventions, and 4) health system-level interventions. A modified Delphi approach was used to identify research priorities. Results: Key knowledge gaps included 1) a lack of standardized approaches to identify factors associated with lung nodule management disparities, 2) limited data evaluating the role of social determinants of health on disparities in lung nodule management, 3) a lack of certainty regarding the optimal strategy to improve patient-clinician communication and information transmission and/or retention, and 4) a paucity of information on the impact of patient navigators and culturally trained multidisciplinary teams. Conclusions: This statement outlines a research agenda intended to stimulate high-impact studies of interventions to mitigate disparities in lung nodule evaluation. Research questions were prioritized around the following domains: 1) need for methodologic guidelines for conducting research related to disparities in nodule management, 2) evaluating how social determinants of health influence lung nodule evaluation, 3) studying approaches to improve patient-clinician communication, and 4) evaluating the utility of patient navigators and culturally enriched multidisciplinary teams to reduce disparities.

Building the foundation for a community-generated national research blueprint for inherited bleeding disorders: research priorities in health services; diversity, equity, and inclusion; and implementation science.

BACKGROUND: The National Hemophilia Foundation (NHF) conducted extensive all-stakeholder inherited bleeding disorder (BD) community consultations to inform a blueprint for future research. Sustaining and expanding the specialized and comprehensive Hemophilia Treatment Center care model, to better serve all people with inherited BDs (PWIBD), and increasing equitable access to optimal health emerged as top priorities. RESEARCH DESIGN AND METHODS: NHF, with the American Thrombosis and Hemostasis Network (ATHN), convened multidisciplinary expert working groups (WG) to distill priority research initiatives from consultation findings. WG5 was charged with prioritizing health services research (HSR); diversity, equity, and inclusion (DEI); and implementation science (IS) research initiatives to advance community-identified priorities. RESULTS: WG5 identified multiple priority research themes and initiatives essential to capitalizing on this potential. Formative studies using qualitative and mixed methods approaches should be conducted to characterize issues and meaningfully investigate interventions. Investment in HSR, DEI and IS education, training, and workforce development are vital. CONCLUSIONS: An enormous amount of work is required in the areas of HSR, DEI, and IS, which have received inadequate attention in inherited BDs. This research has great potential to evolve the experiences of PWIBD, deliver transformational community-based care, and advance health equity.

Research into how people get their health care, called health services research, is important to understand if care is being delivered equitably and efficiently. This research figures out how to provide the best care at the lowest cost and finds out if everyone gets equally good care. Diversity and inclusion research focuses on whether all marginalized and minoritized populations (such as a given social standing, race, ethnicity, sex, gender identity, sexuality, age, income, disability status, language, culture, faith, geographic location, or country of birth) receive equitable care. This includes checking whether different populations are all getting the care they need and looking for ways to improve the care. Implementation science studies how to make a potential improvement work in the real world. The improvement could be a new way to diagnose or treat a health condition, a better way to deliver health care or do research, or a strategy to remove barriers preventing specific populations from getting the best available care. The National Hemophilia Foundation focuses on improving the lives of all people with bleeding disorders (BD). They brought BDs doctors, nurses, physical therapists, social workers, professors, and government and industry partners together with people and families living with BDs to discuss research in the areas described above. The group came up with important future research questions to address racism and other biases, and other changes to policies, procedures, and practices to make BD care equitable, efficient, and effective.

Building the foundation for a community-generated national research blueprint for inherited bleeding disorders: research priorities for mucocutaneous bleeding disorders.

BACKGROUND: Excessive or abnormal mucocutaneous bleeding (MCB) may impact all aspects of the physical and psychosocial wellbeing of those who live with it (PWMCB). The evidence base for the optimal diagnosis and management of disorders such as inherited platelet disorders, hereditary hemorrhagic telangiectasia (HHT), hypermobility spectrum disorders (HSD), Ehlers-Danlos syndromes (EDS), and von Willebrand disease (VWD) remains thin with enormous potential for targeted research. RESEARCH DESIGN AND METHODS: National Hemophilia Foundation and American Thrombosis and Hemostasis Network initiated the development of a National Research Blueprint for Inherited Bleeding Disorders with extensive all-stakeholder consultations to identify the priorities of people with inherited bleeding disorders and those who care for them. They recruited multidisciplinary expert working groups (WG) to distill community-identified priorities into concrete research questions and score their feasibility, impact, and risk. RESULTS: WG2 detailed 38 high priority research questions concerning the biology of MCB, VWD, inherited qualitative platelet function defects, HDS/EDS, HHT, bleeding disorder of unknown cause, novel therapeutics, and aging. CONCLUSIONS: Improving our understanding of the basic biology of MCB, large cohort longitudinal natural history studies, collaboration, and creative approaches to novel therapeutics will be important in maximizing the benefit of future research for the entire MCB community.

More people experience mucocutaneous bleeding (MCB), affecting tissues like skin and gums, than have hemophilia A or B. MCB is not understood as well as hemophilia. Common types of MCB include nosebleeds, bleeding gums, heavy menstrual bleeding, and digestive tract bleeding. Mucocutaneous inherited bleeding disorders include inherited platelet disorders, hereditary hemorrhagic telangiectasia (HHT), hypermobility spectrum disorders (HSD) and Ehlers-Danlos syndromes (EDS), von Willebrand Disease (VWD), and others. Diagnosing and treating MCB is complicated and sometimes medical providers dismiss the bleeding that patients report when they cannot find a medical explanation for it. Many people with mucocutaneous bleeding (PWMCB) do not receive the care they need; for example, women with VWD live with symptoms for, on average, 16 years before they are diagnosed in the US. This struggle to obtain care has important negative impacts on patients' physical and psychological health and their quality-of-life. The National Hemophilia Foundation (NHF), a large US bleeding disorders patient advocacy organization, set out to develop a National Research Blueprint for Inherited Bleeding Disorders focused on community priorities. They brought together a group of patients, providers, and researchers with MCB expertise to identify the research that would most improve the lives of PWMCB through targeted and accessible diagnostics and therapies. We report in this paper that research is needed to better understand the biology of MCB and to define the mechanisms of disease in these disorders. We also describe high priority research questions for each of the main disorders, novel therapeutics, and aging.

Building the foundation for a community-generated national research blueprint for inherited bleeding disorders: research priorities to transform the care of people with hemophilia.

BACKGROUND: Decades of research have transformed hemophilia from severely limiting children's lives to a manageable disorder compatible with a full, active life, for many in high-income countries. The direction of future research will determine whether exciting developments truly advance health equity for all people with hemophilia (PWH). National Hemophilia Foundation (NHF) and American Thrombosis and Hemostasis Network conducted extensive inclusive all-stakeholder consultations to identify the priorities of people with inherited bleeding disorders and those who care for them. RESEARCH DESIGN AND METHODS: Working group (WG) 1 of the NHF State of the Science Research Summit distilled the community-identified priorities for hemophilia A and B into concrete research questions and scored their feasibility, impact, and risk. RESULTS: WG1 defined 63 top priority research questions concerning arthropathy/pain/bone health, inhibitors, diagnostics, gene therapy, the pediatric to adult transition of care, disparities faced by the community, and cardiovascular disease. This research has the potential to empower PWH to thrive despite lifelong comorbidities and achieve new standards of wellbeing, including psychosocial. CONCLUSIONS: Collaborative research and care delivery will be key to capitalizing on current and horizon treatments and harnessing technical advances to improve diagnostics and testing, to advance health equity for all PWH.

Hemophilia is the best known of the inherited bleeding disorders (BD). This is a rare condition that causes disproportionate bleeding, often into joints and vital organs. Factor replacement, injecting recombinant or plasma-based clotting factor products directly into the vein, became commonplace to control the disorder in the 1990s and 2000s. Prophylaxis, or injecting replacement factor every few days into people with hemophilia (PWH), has revolutionized patients' lives. In the last few years, other advances in new therapies have entered this space, such as non-factor replacement therapies and gene therapy. With many more research advances on the horizon, the National Hemophilia Foundation (NHF) initiated a State of the Science Research Summit in 2020. This event was attended by over 880 interested parties to help design an agenda of research priorities for inherited BDs for the next decade, based on community consultations. NHF formed multiple Working Groups (WG), each exploring a theme resulting from the community consultations, and presenting their results at the Summit. Led by 2 hematologists who manage and treat PWH daily, the 21-community member WG1 assigned to hemophilia A and B divided into 7 subgroups to identify and organize research priorities for different topic areas. The outcomes focused on prioritizing patients' needs, technological advances, and research in the areas of greatest potential for PWH and those who care for them. The results are a roadmap for the future execution of a research plan that truly serves the community.

Building the foundation for a community-generated national research blueprint for inherited bleeding disorders: research priorities for ultra-rare inherited bleeding disorders.

BACKGROUND: Ultra-rare inherited bleeding disorders (BDs) present important challenges for generating a strong evidence foundation for optimal diagnosis and management. Without disorder-appropriate treatment, affected individuals potentially face life-threatening bleeding, delayed diagnosis, suboptimal management of invasive procedures, psychosocial distress, pain, and decreased quality-of-life. RESEARCH DESIGN AND METHODS: The National Hemophilia Foundation (NHF) and the American Thrombosis and Hemostasis Network identified the priorities of people with inherited BDs and their caregivers, through extensive inclusive community consultations, to inform a blueprint for future decades of research. Multidisciplinary expert Working Group (WG) 3 distilled highly feasible transformative ultra-rare inherited BD research opportunities from the community-identified priorities. RESULTS: WG3 identified three focus areas with the potential to advance the needs of all people with ultra-rare inherited BDs and scored the feasibility, impact, and risk of priority initiatives, including 13 in systems biology and mechanistic science; 2 in clinical research, data collection, and research infrastructure; and 5 in the regulatory process for novel therapeutics and required data collection. CONCLUSIONS: Centralization and expansion of expertise and resources, flexible innovative research and regulatory approaches, and inclusion of all people with ultra-rare inherited BDs and their health care professionals will be essential to capitalize on the opportunities outlined herein.

Living with an ultra-rare inherited bleeding disorder is challenging. Patients can feel alone and unsure of where to find support because their disorder is so rare. In this paper, a group of ultra-rare bleeding disorder experts, including doctors, researchers, regulators, patient advocates, and patients, identify the research that could best improve the lives of people with these disorders. They propose a national network of specialists who can help doctors, who may never have seen these disorders before, to find the right diagnosis faster. A centralized laboratory specialized in ultra-rare bleeding disorders could also improve diagnosis and do research studies. This would help us learn, for example, how symptoms change throughout a patient's life, how effective different treatments are, and what it is like for patients to live with these disorders. A second research priority is to better understand each individual disorder so that the best treatments can be chosen or developed. A pathway showing doctors which treatment options to try, in which order, would help them help their patients. The third research priority is to make it easier to study new treatments for ultra-rare bleeding disorders. This requires designing studies with very small numbers of participants, identifying meaningful outcomes to measure, and convincing pharmaceutical companies to invest in these studies. International agreement on these requirements would allow more patients to participate and benefit from the research. These top-priority research goals should greatly improve knowledge about, and diagnosis and treatment of, ultra-rare inherited bleeding disorders.

Reglas y consejos para ser un buen revisor por pares de manuscritos científicos / Tips and guidelines for being a good peer reviewer

La publicación es el medio clave por el cual la ciencia se difunde. El propósito de las revistas científicas es publicar artículos novedosos y de calidad. Los editores de las revistas evalúan el contenido de los manuscritos sometiéndolos a un proceso denominado «revisión por pares» (peer review), considerado hoy en día el estándar de oro para garantizar la adecuada publicación de los artículos científicos. Un informe de revisión por pares crítico y bien elaborado es un tesoro, tanto para el autor como para el editor. En el presente manuscrito examinaremos los aspectos clave de la revisión por pares. Comenzaremos explicando en qué consiste exactamente este proceso y desde cuándo existe, para después aclarar por qué es tan importante. Luego argumentaremos por qué deberíamos querer ser evaluadores de artículos científicos. Repasaremos cuáles son las reglas fundamentales para llevar a cabo una buena revisión de un manuscrito y en qué aspectos de este nos deberíamos centrar. Posteriormente veremos qué formato debe tener un informe de revisión por pares y cómo redactar sus distintos apartados, así como las opciones de su dictamen final. Dedicaremos especial atención a comentar los aspectos éticos y los errores más frecuentes que se comenten en la evaluación de manuscritos. Finalmente, reconoceremos cuáles son las limitaciones fundamentales de la revisión por pares y terminaremos proponiendo algunas sugerencias para su mejora. Nuestro objetivo final no es otro que estimular a los investigadores –y autores– a dar un paso más y acometer el reto de ser revisores de manuscritos científicos.(AU)

Publication is the key means by which science spreads. The purpose of scientific journals is to publish novel and quality articles. The editors of the journals evaluate the content of the manuscripts by submitting them to a process called «peer review», considered today the gold standard to guarantee the adequate publication of scientific articles. A well-crafted and critical peer-review report is a treasure for both authors and editors. In the present manuscript we will examine the key aspects of the peer review process. We will begin by explaining what exactly this process consists of and since when it has existed, and then clarifying why it is so important. Then we will argue why we should want to be reviewers of scientific papers. We will then review what are the fundamental rules to carry out a good review of a manuscript and what aspects of it we should focus on. Later we will see what format a peer review report should have and how to write its different sections, as well as the options for its final resolution. We will pay special attention to commenting on the ethical aspects and the most frequent errors that are made in the evaluation of manuscripts. Finally, we will recognize what the fundamental limitations of peer review are, and we will end by proposing some suggestions for their improvement. Our ultimate goal is to stimulate researchers –and authors– to go one step further and undertake the challenge of being peer reviewers of scientific manuscripts.(AU)

Minimally invasive modification of the Goel-Harms atlantoaxial fusion technique: a case series and illustrative guide.

OBJECTIVE: The Goel-Harms atlantoaxial screw fixation technique for the treatment of atlantoaxial instability and unstable odontoid fractures is reliable and reproducible for a variety of anatomies. The drawbacks of the technique are the potential for significant bleeding from the C2 nerve root venous plexus and the risks associated with posterior midline exposure and retraction, such as pain and wound complications. The authors developed a minimally invasive surgical (MIS) modification of the Goel-Harms technique using intra-articular grafting to facilitate placement of percutaneous lateral mass and pars screws with extended tabs for minimally invasive subfascial rod placement. The objective of this study was to present the authors' first series of 5 patients undergoing minimally invasive modification in comparison with 51 patients undergoing open atlantoaxial fusion. METHODS: A retrospectiveanalysis of patient comorbid conditions, blood loss, length of surgery, and length of stay was performed on patients undergoing Goel-Harms instrumented fusion (GHIF) for unstable odontoid fractures performed between 2016 and 2021. RESULTS: Patients undergoing the minimally invasive procedure showed significantly less blood loss than those undergoing the open atlantoaxial fusion procedure, with a median blood loss of 30 ml compared with 150 ml using the open technique (p < 0.01). The patients showed no significant differences in length of stay (2 days for MIS vs 4 days for open atlantoaxial fusion, p = 0.25). There were no significant differences in length of surgery for MIS, but a possible trend toward increased operative duration (234 vs 151 minutes, p = 0.112). CONCLUSIONS: In this small pilot study, it was shown that MIS-GHIF can be performed with decreased blood loss in atlantoaxial instability and odontoid fractures. This technique may allow for greater and safer application of the procedure in the elderly and infirm.

[Pharma challenges to adoption of microphysiological system in drug research and development, especially safety assessment].

In the environment surrounding the pharma industries (1) declining productivity in research and development in pharma industries, (2) spreading of 3Rs in animal testing, and (3) diversifying of modalities, the regulatory authorities and pharmaceutical companies in US and EU are paying attention to the microphysiological system (MPS) to actively incorporate cutting-edge technologies into the evaluation assays used for approval applications for drug research and development. MPS generally refers to an in vitro culture system in which a culture environment close to that of a living body (in vivo) is reconstructed in a created minute space using a microfluidic device. Currently, many products have been put into practical use by US and EU companies and are sold all over the world. This time, the trends of MPS as a drug development tool, especially case of safety assessment, issues for implementation to pharma, and future perspectives are described in this article.

Vaccine research and development capacity in Central and West Asia: A path toward sustainable vaccine R&D programs.

The ability to support a comprehensive vaccine research and development (R&D) portfolio from a health security perspective has taken on enhanced significance over the past 3 years whereby countries that had existing vaccine R&D infrastructure (G7, Russia and China) have been at the forefront of global efforts to combat COVID-19. Few countries outside of these key players have the infrastructure necessary to develop national vaccine programs, though this is beginning to change with investment across many low- and middle-income countries. These same opportunities exist for countries in Central and West Asia, and in this perspective, we highlight the existing infrastructure and expertise across seven countries (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan) and propose opportunities for enhanced collaboration along with a bold proposal for establishing a new-build, regional vaccine translational research institute to facilitate the development of a robust, regional vaccine R&D environment to combat existing and future health challenges.

FAIR Island: real-world examples of place-based open science.

The relationship between people, place, and data presents challenges and opportunities for science and society. While there has been general enthusiasm for and work toward Findable, Accessible, Interoperable, and Reusable (FAIR) data for open science, only more recently have these data-centric principles been extended into dimensions important to people and place-notably, the CARE Principles for Indigenous Data Governance, which affect collective benefit, authority to control, responsibility, and ethics. The FAIR Island project seeks to translate these ideals into practice, leveraging the institutional infrastructure provided by scientific field stations. Starting with field stations in French Polynesia as key use cases that are exceptionally well connected to international research networks, FAIR Island builds interoperability between different components of critical research infrastructure, helping connect these to societal benefit areas. The goal is not only to increase reuse of scientific data and the awareness of work happening at the field stations but more generally to accelerate place-based research for sustainable development. FAIR Island works reflexively, aiming to scale horizontally through networks of field stations and to serve as a model for other sites of intensive long-term scientific study.

How Do R&D and Renewable Energy Consumption Lead to Carbon Neutrality? Evidence from G-7 Economies.

The discussion about whether research and development and advanced energy structure can efficiently control pollution has gained the consideration of researchers across the globe. However, there is a lack of enough empirical and theoretical evidence to support this phenomenon. To offer support of empirical evidence along with theoretical mechanism, we examine the net Impact of research and development (R&D) and renewable energy consumption (RENG) on CO2E utilizing panel data from G-7 economies for 1990-2020. Moreover, this study investigates the controlling role of economic growth and nonrenewable energy consumption (NRENG) in the R&D-CO2E models. The results obtained from the CS-ARDL panel approach verified a long-run and short-run relationship between R&D, RENG, economic growth, NRENG, and CO2E. Short- and long-run empirical results suggest that R&D and RENG improve environmental stability by decreasing CO2E, while economic growth and NRENG increase CO2E. Particularly, long-run R&D and RENG reduce CO2E with the effect of -0.091 and -0.101, respectively, while in the short run, they reduce CO2E with the effect of -0.084 and -0.094, respectively. Likewise, the 0.650% (long run) and 0.700% (short-run) increase in CO2E is due to economic growth, while the 0.138% (long run) and 0.136% (short run) upsurge in CO2E is due to an increase in NRENG. The findings obtained from the CS-ARDL model were also verified by the AMG model, while D-H non-causality approach was applied to check the pair-wise relationship among variables. The D-H causal relationship revealed that policies to focus on R&D, economic growth, and NRENG explain variation in CO2E but not vice versa. Furthermore, policies considering RENG and human capital can also affect CO2E and vice versa, meaning there is a round effect between the variables. All this indication may guide the concerned authorities to devise comprehensive policies that are helpful to environmental stability and in line with CO2E reduction.

Risk of interpersonal violence during and after pregnancy among people with schizophrenia: a population-based cohort study.

BACKGROUND: Schizophrenia is associated with increased risk of experiencing interpersonal violence. Little is known about risk specifically around the time of pregnancy. METHODS: This population-based cohort study included all individuals (aged 15-49 yr) listed as female on their health cards who had a singleton birth in Ontario, Canada, between 2004 and 2018. We compared those with and without schizophrenia on their risk of an emergency department (ED) visit for interpersonal violence in pregnancy or within 1 year postpartum. We adjusted relative risks (RRs) for demographics, prepregnancy history of substance use disorder and history of interpersonal violence. In a subcohort analysis, we used linked clinical registry data to evaluate interpersonal violence screening and self-reported interpersonal violence during pregnancy. RESULTS: We included 1 802 645 pregnant people, 4470 of whom had a diagnosis of schizophrenia. Overall, 137 (3.1%) of those with schizophrenia had a perinatal ED visit for interpersonal violence, compared with 7598 (0.4%) of those without schizophrenia, for an RR of 6.88 (95% confidence interval [CI] 5.66-8.37) and an adjusted RR of 3.44 (95% CI 2.86-4.15). Results were similar when calculated separately for the pregnancy (adjusted RR 3.47, 95% CI 2.68-4.51) period and the first year postpartum (adjusted RR 3.45, 95% CI 2.75-4.33). Pregnant people with schizophrenia were equally likely to be screened for interpersonal violence (74.3% v. 73.8%; adjusted RR 0.99, 95% CI 0.95-1.04), but more likely to self-report it (10.2% v. 2.4%; adjusted RR 3.38, 95% CI 2.61-4.38), compared with those without schizophrenia. Among patients who did not self-report interpersonal violence, schizophrenia was associated with an increased risk for a perinatal ED visit for interpersonal violence (4.0% v. 0.4%; adjusted RR 6.28, 95% CI 3.94-10.00). INTERPRETATION: Pregnancy and postpartum are periods of higher risk for interpersonal violence among people with schizophrenia compared with those without schizophrenia. Pregnancy is a key period for implementing violence prevention strategies in this population.