Rationale and Study Checklist for Ethical Rejection of Participants on Crowdsourcing Research Platforms.

Online participant recruitment ("crowdsourcing") platforms are increasingly being used for research studies. While such platforms can rapidly provide access to large samples, there are concomitant concerns around data quality. Researchers have studied and demonstrated means to reduce the prevalence of low-quality data from crowdsourcing platforms, but approaches to doing so often involve rejecting work and/or denying payment to participants, which can pose ethical dilemmas. We write this essay as an associate professor and two institutional review board (IRB) directors to provide a perspective on the competing interests of participants/workers and researchers and to propose a checklist of steps that we believe may support workers' agency on the platform and lessen instances of unfair consequences to them while enabling researchers to definitively reject lower-quality work that might otherwise reduce the likelihood of their studies producing true results. We encourage further, explicit discussion of these issues among academics and among IRBs.

Healthy Sleep Practices for Consumers of Home Total Parenteral Nutrition: A Mixed-Methods Community-Based Participatory Study.

Background: Consumers of overnight home parenteral nutrition (HPN) often experience sleep disruption; however, existing healthy sleep recommendations are widely inapplicable to consumers. Objectives: The aim of this mixed-methods, community-based participatory research study was to develop tailored recommendations on healthy sleep practices for HPN consumers. Methods: The multipart study involved the following: 1) an initial draft of sleep recommendations based on the evaluation of existing general sleep hygiene guidelines by an expert panel of clinicians and consumers with lived experience; 2) semi-structured focus groups with consumers and clinicians; 3) pre- and post-knowledge tests completed by consumers, and 4) final approval of the recommendations by the expert panel. Results: The literature synthesis resulted in 51 recommendations evaluated for relevance for HPN consumers. Focus groups with 20 HPN consumers and clinicians contributed additional recommendations based on lived experience. Ultimately, the final resource included recommendations spanning 4 sections: getting ready for bed, preparing the bedroom for sleep, daytime behaviors, and overall strategies for better sleep. Of the 36 recommendations, 58% were derived from existing general sleep hygiene guidelines, and the remaining 42% addressed sleep challenges experienced uniquely by consumers, including nocturnal polyuria, noise/light from medical equipment, and infusion schedules. Knowledge tests completed by 10 additional consumers indicated a modest increase in sleep health knowledge. Conclusions: The curated healthy sleep resource tailored for HPN consumers was facilitated by a multidisciplinary expert panel, a strategic collaboration with members of the HPN community and their clinicians, and in partnership with patient advocacy and support organizations. The wide distribution of these resources may improve the overall well-being of HPN consumers.

Smoothies, bone broth, and fitspo: the historicity of TikTok postpartum bounce-back culture.

TikTok, a now iconoclastic social media platform, hosts millions of videos on health, wellness and physical fitness, including content on postpartum wellness and 'bouncing back'. At present, few studies analyse the content of postpartum videos urging viewers to bounce-back or the potential influence of these videos. Given the acknowledged relationship between social media use and adverse mental health outcomes (eg, lowered self-esteem, increased stress, disordered eating risk), an investigation of bounce-back-related postpartum content on TikTok explores important intersections between wellness and fitness cultures and the embodied experience of postpartum recovery. Using a qualitative thematic analysis of bounce-back videos (n=175), we explore three themes: (1) Smoothies: eat, but don't be fat; (2) Bone broth: bounce-back with today's wellness trends; (3) Fitspo: moving your body matters. Importantly, videos recycle historically constructed thinking about what makes a 'good' or 'bad' body, invoke vintage diet-culture tropes (ie, drinking water to fill up before eating), and maintain potentially dangerous expectations for caregivers rooted in historical gender, race and class constructs. This results in a postfeminist mishmash of modern maternity practices and traditional hierarchies. Unpacking the historicity of TikTok content assists health practitioners, scholars and users in understanding the potential impacts of video content on new parents, as well as how to flag and contextualise potentially harmful content. Future studies should examine other TikTok subcultures, including teen mothers and trans parents, and explore the messaging directed at and the impact on those communities.

Returning Clinically Relevant Research Results to Participants: Guidelines for Investigators and the IRB.

In 2019, the revised Common Rule required informed consent documents for research to include a statement about whether clinically relevant research results would be returned to research participants. While there are national discussions regarding the return of results, these do not provide specific guidance about how institutional review boards (IRBs) should address this issue. Through a year-long process involving IRB staff and leadership, science and bioethics faculty members, community IRB members, and others, Indiana University's human research protection program created a framework that offers a clear categorization of types of results for researchers to consider returning, provides language for informed consent documents, and describes an active but intentionally limited role for the IRB. In this article, we describe this framework and its rationale as a model for other universities and, more generally, as a model for balancing the need to protect human subjects with efforts to limit the burdens on researchers and the IRB.

What counts as STEM, and does it matter?

BACKGROUND: To accurately measure students' science, technology, engineering and mathematics (STEM) career interest, researchers must get inside the 'black box' to understand students' conceptualizations of STEM careers. AIMS: The aim of Study 1 was to explore whether students' conceptualizations of STEM included medical careers. The aim of Study 2 was to explore whether predictors of STEM career interest (e.g., gender and motivation) varied by STEM definition (inclusion/exclusion of medical careers). SAMPLES: In Study 1, the sample was US college students (N = 125) who were mostly White (80%). In Study 2, the sample was US 10th-grade high school students (N = 455) who were mostly Black (79%). METHODS: In Study 1, students completed an online questionnaire. In Study 2, students completed various measures of math achievement, motivation (science and math expectancies of success, interest and importance value) and career interest with an importance. RESULTS: In Study 1, medical careers were less often classified as STEM careers than traditional STEM careers, but more often classified as STEM than non-STEM careers. In Study 2, science importance value was the only motivational predictor of students' STEM+Medicine career interest, and no motivation constructs predicted traditional STEM career interest. Boys expressed greater interest in traditional STEM careers, while girls expressed greater interest in STEM+Medicine careers. CONCLUSIONS: Students' conceptualizations of STEM are not binary. Thus, we recommend researchers are explicit about their definition of STEM with study participants, in their coding and in their publications.

Developing and validating a measure of parental knowledge about early math development.

Parents' knowledge about the math skills that most preschool-aged children can develop might be an important component of the Home Math Environment (HME) as it might shape their math beliefs and efforts to support their preschoolers' math development. This study aimed to systematically develop measures of parents' knowledge about two critical early math topics, numeracy, and patterning, across five studies conducted with a total of 616 U.S. parents of 3- to 5-year-olds (66% mothers, 54% sons, 73% White, 60% college-educated). Parents were recruited via CloudResearch or a university database. Study 1 focused on item generation to revise a previous measure to capture a wider set of children's early math skills and analysis of the psychometric properties of the measure after it was completed by 161 parents via a survey. Study 2 included an analysis of a new sample of parents (n = 21) who responded to the measures twice across two weeks to explore test-retest reliability. The measures were iteratively revised, administered to new samples, and analyzed in Studies 3 (n = 45), 4 (n = 46), and 5 (n = 344). The measures demonstrated adequate internal consistency and validity (construct, convergent, and discriminant) in Study 5 such as being positively related to parents' numeracy and patterning beliefs about their children. Overall, the newly developed measures satisfy standards for the development of an adequate measure and can be used to better understand what parents know about early math development and how this relates to the HME that they facilitate.

Patients, family members and healthcare professionals' top ten research priorities for adults receiving home parenteral nutrition for malignant or benign disease.

BACKGROUND & AIMS: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (CIF) due to non-malignant disease and is increasingly used in patients with a diagnosis of cancer. This project engaged with patients, family members and healthcare professionals to ascertain what questions they want researched. METHODS: This study followed the five-stage process of the James Lind Alliance that involved (1) setting up a steering group, (2) carrying out an initial survey to gather participants' questions, (3) data processing, (4) an interim priority setting survey and (5) final priority setting workshop. Surveys were translated and back translated into Italian, Danish and French. RESULTS: The project was delivered by an international steering committee with representation from Denmark, Italy, the United Kingdom and United States consisting of three patients, six healthcare professionals and facilitated by University researchers. For the first survey, 633 questions were submitted by 292 respondents from 12 countries. There were 79 questions removed as out of scope or already in the published literature. Responses were collated into two interim surveys of 41 questions for benign CIF and 13 questions for HPN and cancer. In the second survey, 216 respondents prioritised their top ten questions. The ordering from the cancer and HPN survey was taken as definitive; top priorities were quality of life, survival, when to commence HPN, using HPN with anti-cancer treatments, access barriers, measuring benefit and ethical implications. For CIF with benign disease, 18 questions were discussed in two workshops attended by 13 patients and 7 healthcare professionals. The questions were ranked using a modified nominal group technique; the top research priorities were prevention and treatment of liver disease, improving central infusion lines, oral absorption, avoiding long-term negative consequences, vascular access, side effects, line infections, decreasing stoma output, quality of life and sleep. CONCLUSIONS: Priorities identified will assist researchers to focus on research questions important to patients, family members and healthcare professionals.

Low-dose aspirin confers protection against acute cellular allograft rejection after primary liver transplantation.

This study investigated the effect of low-dose aspirin in primary adult liver transplantation (LT) on acute cellular rejection (ACR) as well as arterial patency rates. The use of low-dose aspirin after LT is practiced by many transplant centers to minimize the risk of hepatic artery thrombosis (HAT), although solid recommendations do not exist. However, aspirin also possesses potent anti-inflammatory properties and might mitigate inflammatory processes after LT, such as rejection. Therefore, we hypothesized that the use of aspirin after LT has a protective effect against ACR. This is an international, multicenter cohort study of primary adult deceased donor LT. The study included 17 high-volume LT centers and covered the 3-year period from 2013 to 2015 to allow a minimum 5-year follow-up. In this cohort of 2365 patients, prophylactic antiplatelet therapy with low-dose aspirin was administered in 1436 recipients (61%). The 1-year rejection-free survival rate was 89% in the aspirin group versus 82% in the no-aspirin group (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.63-0.94; p = 0.01). The 1-year primary arterial patency rates were 99% in the aspirin group and 96% in the no-aspirin group with an HR of 0.23 (95% CI, 0.13-0.40; p < 0.001). Low-dose aspirin was associated with a lower risk of ACR and HAT after LT, especially in the first vulnerable year after transplantation. Therefore, low-dose aspirin use after primary LT should be evaluated to protect the liver graft from ACR and to maintain arterial patency.

Chaos is not rare in natural ecosystems.

Chaotic dynamics are thought to be rare in natural populations but this may be due to methodological and data limitations, rather than the inherent stability of ecosystems. Following extensive simulation testing, we applied multiple chaos detection methods to a global database of 172 population time series and found evidence for chaos in >30%. In contrast, fitting traditional one-dimensional models identified <10% as chaotic. Chaos was most prevalent among plankton and insects and least among birds and mammals. Lyapunov exponents declined with generation time and scaled as the -1/6 power of body mass among chaotic populations. These results demonstrate that chaos is not rare in natural populations, indicating that there may be intrinsic limits to ecological forecasting and cautioning against the use of steady-state approaches to conservation and management.

Parents' numeracy beliefs and their early numeracy support: A synthesis of the literature.

Parents' academic beliefs influence the academic support they provide to their children. In this chapter, we review the published literature on empirical studies conducted with parents of preschoolers and propose a conceptual model for how different parental numeracy beliefs uniquely and differentially influence parents' early numeracy support and vary with their demographic characteristics. Parents' numeracy beliefs about their children were more consistently related to their numeracy support than their other numeracy beliefs but were inconsistently related to demographic characteristics. Parents' numeracy beliefs about themselves were significantly related to their socioeconomic status and the extent to which their numeracy support focused on advanced early numeracy skills, but were not significantly related to how often they provided numeracy support. We also discuss parents' beliefs regarding where and how children should learn numeracy. Overall, evidence to date highlights the role of parents' beliefs about their children as well as their socioeconomic status. We discuss several future directions.

SmartPhrase: Development of an Electronic Health Record System to Promote Chemotherapy and Immunotherapy Safety.

A collaborative interprofessional team of healthcare providers from a regional comprehensive community cancer program established standardized chemotherapy and immunotherapy preadministration documentation in the electronic health record. This quality improvement project facilitated adherence to administration considerations defined within Oncology Nursing Society chemotherapy and immunotherapy guidelines and established organizational accreditation goals. The goal was to foster safe and seamless patient-centered care.

Finding patterns in objects and numbers: Repeating patterning in pre-K predicts kindergarten mathematics knowledge.

Both recent evidence and research-based early mathematics curricula indicate that repeating patterns-predictable sequences that follow a rule-are a topic of major importance for mathematics development. The purpose of the current study was to help build a theory for how early repeating patterning knowledge contributes to early math development, focusing on development in children aged 4-6 years. The current study examined the relation between 65 preschool children's repeating patterning knowledge (via a fast, teacher-friendly measure) and their end-of-kindergarten broad math and numeracy knowledge, controlling for verbal and visual-spatial working memory (WM) skills as well as end-of-pre-K (pre-kindergarten) broad math knowledge. Relations were also examined between repeating patterning and specific aspects of numeracy knowledge-knowledge of the count sequence to 100 and the successor principle. Children's repeating patterning knowledge was significantly predictive of their broad math and general numeracy knowledge, as well as one specific aspect of their numeracy knowledge (counting to 100), even after controlling for verbal and visual-spatial WM skills. Further, repeating patterning knowledge remained a unique predictor of general numeracy knowledge and counting to 100 after controlling for end-of-pre-K broad math knowledge. The relation between repeating patterning and mathematics may be explained by the central role that identifying predictable sequences based on underlying rules plays in both. Theories of math development and early math instruction standards should thus give even greater attention to the role of children's repeating patterning knowledge.

Pharmacokinetics and renal safety of tenofovir alafenamide with boosted protease inhibitors and ledipasvir/sofosbuvir.

BACKGROUND: Ledipasvir/sofosbuvir increases tenofovir plasma exposures by up to 98% with tenofovir disoproxil fumarate (TDF), and exposures are highest with boosted PIs. There are currently no data on the combined use of the newer tenofovir prodrug, tenofovir alafenamide (TAF), boosted PIs and ledipasvir/sofosbuvir. OBJECTIVES: To compare the plasma and intracellular pharmacokinetics and renal safety of TAF with ledipasvir/sofosbuvir when co-administered with boosted PIs. METHODS: Persons with HIV between 18 and 70 years and on a boosted PI with TDF were eligible. The study was comprised of four phases: (1) TDF 300 mg with boosted PI; (2) TAF 25 mg with boosted PI; (3) TAF 25 mg with boosted PI and ledipasvir/sofosbuvir; and (4) TAF 25 mg with boosted PI. Pharmacokinetic sampling, urine biomarker collection [urine protein (UPCR), retinol binding protein (RBP) and ß2 microglobulin (ß2M) normalized to creatinine] and safety assessments occurred at the end of each phase. Plasma, PBMCs and dried blood spots were collected at each visit. RESULTS: Ten participants were enrolled. Plasma tenofovir exposures were 76% lower and tenofovir-diphosphate (TFV-DP) concentrations in PBMCs increased 9.9-fold following the switch to TAF. Neither of these measures significantly increased with ledipasvir/sofosbuvir co-administration, nor did TAF plasma concentrations. No significant changes in estimated glomerular filtration rate or UPCR occurred, but RBP:creatinine and ß2M:creatinine improved following the switch to TAF. CONCLUSIONS: Ledipasvir/sofosbuvir did not significantly increase plasma tenofovir or intracellular TFV-DP in PBMCs with TAF. These findings provide reassurance that the combination of TAF, boosted PIs and ledipasvir/sofosbuvir is safe in HIV/HCV-coinfected populations.

The role of recalling previous errors in middle-school children's learning.

BACKGROUND: Committing errors is a common part of the learning process, and adults are more likely to correct errors that they can recall. However, preadolescent children's recall of previous errors (i.e., memory for errors) may be limited. AIMS: We examined children's ability to recall their past errors and tested whether recalling an error aids error correction. SAMPLES: We worked with 102 (Study 1) and 173 (Study 2) middle-school children in the United States. METHODS: In Study 1, children studied and were tested on their memory for math definitions. After reviewing the correct answers, children recalled their initial test answers and then took a final test. Reminders of past errors were provided for some children in Study 2. In two other conditions, children either recalled their past errors or studied the correct answers only. RESULTS: Children's recall of their past errors was poor, and errors that were recalled were no more likely to be corrected than errors that were not recalled. Across children, there was a positive association between memory for errors and error correction even after controlling for covariates. Being reminded of past errors and recalling past errors reduced error correction relative to studying the correct answers only. CONCLUSIONS: Preadolescents' memory for errors is very limited, their ability to recall past errors predicts error correction overall, and recalling an error or being reminded of an error does not facilitate error correction.

Preschoolers' broad mathematics experiences with parents during play.

The current study broadens our understanding of preschoolers' early math experiences with parents, recognizing that math knowledge and experiences are inclusive of numeracy as well as non-numeracy domains. Parents and preschoolers (N = 45) were observed exploring three domains of early mathematics knowledge (i.e., number, space, and pattern) during play in three activities (playing cards, building with blocks, and stringing beads, all with activity suggestions). Children were administered a broad math and numeracy measure and individual measures of spatial and patterning skills concurrently and 7 months later. Dyads explored math broadly across most activities but emphasized number more than space or patterning. In addition, there was more overall math exploration during card and bead play than during block play, with the greatest parent support during card play. Parent support was not linked to children's skills, although children's exploration of space and patterns related moderately to their concurrent spatial and pattern skills. Overall, parents and young children explored a variety of early math domains in guided play contexts, with an emphasis on numeracy. Future work should aim to increase the breadth and rigor of individual concepts that parents and preschoolers explore during play.

#Motherhoodishard: Narrating Our Research and Mothering in the Postpartum Stage through Texting and Social Media.

We narrate our personal journey through the political minefield that is postpartum crisis by examining our communicative strategies across friendship, research partnership and as mothers on social media platforms. In a country with the highest postpartum maternal death rate in the industrialized world, we argue sharing narratives is a radical feminist act and one that must continue to draw attention to marginalized bodies. We hope to elevate the study of communication challenges mothers may experience for personal and political reasons.

DooR to DooR's Acoustics of Care: Interrupting and Transforming the Biomedical Landscapes of Western Hospitals.

The present study was conducted at the University of North Carolina Hospitals. Data were collected from DooR to DooR (D2D), a healing arts program that brings professional artists into the hospital. Drawing from ethnographic data, we forefront music in health communication literature by exploring its performance by D2D artists in hospital settings that range from in-patient oncology wards, waiting rooms, and even burn units. From a narrative theoretical approach, we situate art programming in the historical development of the contemporary hospital system in the U.S. and our analysis amidst growing bodies of literature on the narrative and aesthetic potentials of healthcare. We offer an in-depth analysis of how D2D's music disrupts the soundscape of UNC hospitals, distracts patients from troubling exigencies, and fosters self-expression and storytelling among participants.

The ChlD subunit links the motor and porphyrin binding subunits of magnesium chelatase.

Magnesium chelatase initiates chlorophyll biosynthesis, catalysing the MgATP2--dependent insertion of a Mg2+ ion into protoporphyrin IX. The catalytic core of this large enzyme complex consists of three subunits: Bch/ChlI, Bch/ChlD and Bch/ChlH (in bacteriochlorophyll and chlorophyll producing species, respectively). The D and I subunits are members of the AAA+ (ATPases associated with various cellular activities) superfamily of enzymes, and they form a complex that binds to H, the site of metal ion insertion. In order to investigate the physical coupling between ChlID and ChlH in vivo and in vitro, ChlD was FLAG-tagged in the cyanobacterium Synechocystis sp. PCC 6803 and co-immunoprecipitation experiments showed interactions with both ChlI and ChlH. Co-production of recombinant ChlD and ChlH in Escherichia coli yielded a ChlDH complex. Quantitative analysis using microscale thermophoresis showed magnesium-dependent binding (Kd 331 ± 58 nM) between ChlD and H. The physical basis for a ChlD-H interaction was investigated using chemical cross-linking coupled with mass spectrometry (XL-MS), together with modifications that either truncate ChlD or modify single residues. We found that the C-terminal integrin I domain of ChlD governs association with ChlH, the Mg2+ dependence of which also mediates the cooperative response of the Synechocystis chelatase to magnesium. The interaction site between the AAA+ motor and the chelatase domain of magnesium chelatase will be essential for understanding how free energy from the hydrolysis of ATP on the AAA+ ChlI subunit is transmitted via the bridging subunit ChlD to the active site on ChlH.

A simulation framework for evaluating multi-stage sampling designs in populations with spatially structured traits.

Selecting an appropriate and efficient sampling strategy in biological surveys is a major concern in ecological research, particularly when the population abundance and individual traits of the sampled population are highly structured over space. Multi-stage sampling designs typically present sampling sites as primary units. However, to collect trait data, such as age or maturity, only a sub-sample of individuals collected in the sampling site is retained. Therefore, not only the sampling design, but also the sub-sampling strategy can have a major impact on important population estimates, commonly used as reference points for management and conservation. We developed a simulation framework to evaluate sub-sampling strategies from multi-stage biological surveys. Specifically, we compare quantitatively precision and bias of the population estimates obtained using two common but contrasting sub-sampling strategies: the random and the stratified designs. The sub-sampling strategy evaluation was applied to age data collection of a virtual fish population that has the same statistical and biological characteristics of the Eastern Bering Sea population of Pacific cod. The simulation scheme allowed us to incorporate contributions of several sources of error and to analyze the sensitivity of the different strategies in the population estimates. We found that, on average across all scenarios tested, the main differences between sub-sampling designs arise from the inability of the stratified design to reproduce spatial patterns of the individual traits. However, differences between the sub-sampling strategies in other population estimates may be small, particularly when large sub-sample sizes are used. On isolated scenarios (representative of specific environmental or demographic conditions), the random sub-sampling provided better precision in all population estimates analyzed. The sensitivity analysis revealed the important contribution of spatial autocorrelation in the error of population trait estimates, regardless of the sub-sampling design. This framework will be a useful tool for monitoring and assessment of natural populations with spatially structured traits in multi-stage sampling designs.

Data on preschool children׳s math, patterning, and spatial knowledge.

Initial participants were 79 children who were recruited from six preschool programs in the U.S. Full assessment data was available for 73 children (average age of 4 years 7 months), including demographic data (gender, ethnicity, financial need, language(s) spoken at home and special education status). Children׳s math, repeating patterning, spatial and verbal skills were assessed at the beginning of the pre-kindergarten year. Assessments included the brief version of the Research-Based Early Mathematics Assessment, two measures of repeating patterning skills, three measures of spatial skills (the Block Design subtest of the Wechsler Preschool and Primary Scale of Intelligence, the Position in Space subtest of the Developmental Test of Visual Perception, and a Corsi Block Tapping Task), the Picture Vocabulary Test from the NIH Toolbox app and a backward letter span task. Near the end of the school year, their math knowledge was re-assessed using the same math measure, as was their memory span (forward and backward digit span task from the Wechsler Intelligence Scale for Children). Findings on the relations between patterning, spatial and math skills are published elsewhere (Rittle-Johnson et al., 2018) [1].