Direct-to-participant recruitment of mothers and infants: A strategic approach during challenging pandemic times.

Under traditional circumstances, most clinical trials rely on in-person operations to identify, recruit, and enroll study participants and to complete study-related visits. During unusual circumstances, such as the COVID-19 pandemic, the typical clinical trial model is challenged and forced to explore alternative approaches to implementing study recruitment, participant enrollment, and data collection strategies. One such alternative is a direct-to-participant approach which leverages electronic resources and relevant technological devices (e.g., smart phones) available to researchers and patients. This approach functions under the assumption that a participant has access to a device that connects to the internet such as a smart phone, tablet, or computer. Researchers are then able to transition a typical paper-based, in-person model to an electronic-based, siteless, remote study. This article describes the challenges clinicians and researchers faced when implementing a direct-to-participant study approach during the COVID-19 pandemic. The lessons learned during this study of infant populations could help increase efficiency of future trials, specifically, by lessening the burden on participants and clinicians as well as streamlining the process for enrollment and data collection. While direct-to-adult participant recruitment is not a novel approach, our findings suggest that studies attempting to recruit the infant population may benefit from such a direct-to-participant approach.

The "Baby Moses" Law: A Case for Improving Medicolegal Education for Pediatric Trainees.

Medicolegal education is not standardized for medical student or pediatric resident trainees throughout the United States. However, trainees will inevitably face patient encounters in which knowing state and federal laws are integral in properly treating and caring for the patient. Here, we present the case of treating an abandoned infant in Texas, the Baby Moses law, and how knowing state and federal laws enhance trainees' understanding and ability to care for their patients. We then discuss the paucity of medical literature surrounding medicolegal education curricula and the need for the development of a national curriculum on medicolegal education that starts in medical school and extends throughout residency and subspecialty training.

Impact of Early Life Antibiotic Exposure and Neonatal Hyperoxia on the Murine Microbiome and Lung Injury.

Cross talk between the intestinal microbiome and the lung and its role in lung health remains unknown. Perinatal exposure to antibiotics disrupts the neonatal microbiome and may have an impact on the preterm lung. We hypothesized that perinatal antibiotic exposure leads to long-term intestinal dysbiosis and increased alveolar simplification in a murine hyperoxia model. Pregnant C57BL/6 wild type dams and neonatal mice were treated with antibiotics before and/or immediately after delivery. Control mice received phosphate-buffered saline (PBS). Neonatal mice were exposed to 95% oxygen for 4 days or room air. Microbiome analysis was performed using 16S rRNA gene sequencing. Pulmonary alveolarization and vascularization were analyzed at postnatal day (PND) 21. Perinatal antibiotic exposure modified intestinal beta diversity but not alpha diversity in neonatal mice. Neonatal hyperoxia exposure altered intestinal beta diversity and relative abundance of commensal bacteria in antibiotic treated mice. Hyperoxia disrupted pulmonary alveolarization and vascularization at PND 21; however, there were no differences in the degree of lung injury in antibiotic treated mice compared to vehicle treated controls. Our study suggests that exposure to both hyperoxia and antibiotics early in life may cause long-term alterations in the intestinal microbiome, but intestinal dysbiosis may not significantly influence neonatal hyperoxic lung injury.

Begging behavior as an honest signal of need and parent-offspring association during the postfledging dependency period.

Honest signaling mechanisms can function to appropriate care to hungry offspring and avoid misdirected care of unrelated offspring. Begging, the behavior by which offspring solicit food and parental care, may be an honest signaling mechanism for need, as well as association of parents and offspring. Roseate terns (Sterna dougallii) exhibit prolonged parental care during the postbreeding staging period, offering an ideal system in which to study begging as an honest signaling mechanism. We conducted focal sampling during two premigratory staging seasons (2014 and 2015) at Cape Cod National Seashore, Massachusetts, USA to determine whether postfledging tern begging behavior was an honest signal for need and parent-offspring association. Based on honest signaling theory, we expected begging behavior to be highest during times of high perceived need, and we expected to see a decrease in begging behavior as young terns became increasingly independent of the care-giving parent. Also, we predicted that young terns would be more likely to beg at parents than nonparents. We found that young roseate terns begged at their parents more often than nonparents; however, they did not always beg at parents. Model predictions of begging probability showed a linear relationship between begging and time of day and date of season, such that begging increased with time of day and decreased with date of season, respectively. Our results provide evidence for honest parent-offspring interactions and are inconsistent with parent-offspring conflict theory but suggest that begging may play a complex role in postfledging parent-offspring interactions. OPEN RESEARCH BADGES: This article has been awarded Open Data, Open materials Badges. All materials and data are publicly accessible via the Open Science Framework at https://doi.org/10.5281/zenodo.2656718.