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Research-intensive institutions rely on specialized central offices to support research administrators and investigators through various processes and requirements. This helps researchers successfully and compliantly conduct and manage research. However, when these support offices communicate their processes and resources from disparate locations, it can be challenging for research administrators and investigators to locate what they need at the time they need it, and to understand how this information relates with that provided by other research support offices. This can result in research administrators and investigators lacking a clear understanding of critical information and an underutilization of available support. Duke University sought to address this issue by developing a web-based interactive research roadmap to consolidate and organize information from research support offices around the institution. In this roadmap, all support office content is integrated by topic and organized across the research project life cycle. To achieve this, a dedicated project team (1) convened the research support offices to develop integrated content and a process for contributing their resources on the website, (2) solicited researcher feedback to determine the critical features and functionality of the site, (3) engaged a technical development partner to build the site, (4) engaged researchers for beta-testing, and (5) devised a communication strategy to raise awareness and adoption of the site. The interactive research roadmap, "myRESEARCHpath," launched in 2021, and has experienced steady growth in utilization. Initial data shows that users are accessing the site to find relevant information for research information and guidance, and research support offices are encouraged by the improved discoverability of resources and services. This model of a single location to access research support office information needed to navigate the research project life cycle could be beneficial for other research-intensive institutions.

Purpose: An official autism diagnosis is required to access timely intervention and is associated with better long-term wellbeing and mental health. Certain demographic characteristics, such as being female or a racially or ethnically minoritized youth, have been associated with significant diagnostic lag. However, it remains unclear how assigned sex, race, and ethnicity interact with each other in predicting the prevalence and age of autism diagnosis. Methods: To examine the interactions between assigned sex, race, and ethnicity, we used data from the National Survey of Children's Health (NSCH; 2016 > 2021). Results: One in 38 children had an autism diagnosis and 3.8 males were diagnosed per 1 female. Hierarchical linear regressions yielded diagnostic delays in some females, particularly those who were non-Hispanic white, Black, and Asian. Ethnic and racial minority children had significantly earlier diagnoses than white and non-Hispanic children when not accounting for sex. Conclusion: This study demonstrates slight increases in reported autism prevalence, a diagnostic lag in some autistic females that was strongly associated with ethnicity, and earlier diagnoses in racial and ethnic minority youth, a finding that may be explained by factors associated with phenotypic differences. This study has important implications for the diagnosis of minority autistic youth, particularly females and females who are non-Hispanic, who may experience a greater propensity for diagnostic delays.

BACKGROUND: Bladder dysfunction (BD) is common in people with multiple sclerosis (MS) and can reduce participation in daily life. Detecting BD early allows for effective prevention-focused treatments such as pelvic floor physical therapy. Pairing neurotechnology with patient-reported outcomes to remotely measure BD could significantly improve monitoring and treatment of BD. Therefore, we describe the process and findings of stakeholder engagement from a human-centered design process to assemble a wearables for the bladder (WeB) kit. METHODS: Four people with MS with varying BD severity, and 5 MS clinical/research experts had 4 virtual meetings. Commercially available bladder tools were graded for ability to evaluate, monitor, or treat BD. The Health Information Technology Usability Evaluation Scale (utility, usability, feasibility) was used for evaluation. Scoring was performed individually and as a group. RESULTS: Of the 11 devices, 5 obtained mean scores of greater than 6 of 10 for likability, usability, and device utility. The 2 highest scoring (9/10) devices were selected for the pilot. One device measures bladder urine levels, reporting the number/frequency of voids/leaks; the other guides pelvic floor exercises by pairing games on an app with biofeedback from intravaginal sensors. We uncovered critical differences in experts and patients appreciation of the tools, and the collaborative engagement led to substantial revisions of initial tool scores. CONCLUSIONS: This process underscores the critical role of stakeholder engagement in the selection of digital tools, especially in sensitive domains like pelvic function. Ongoing clinical validation of the selected tools will yield a validated, user-friendly WeB kit that is able to fill gaps in our ability to evaluate BD treatments in people with MS, ultimately reducing the impact of BD on quality of life.

The efficacy of science communication can be influenced by the cultural values and cognitions of target audiences, yet message framing rarely accounts for these cognitive factors. To explore the effects of message framing tailored to specific audiences, we investigated relationships between one form of cultural cognition—political ideology—and perceptions about the zoonotic origins of the COVID-19 pandemic using a nationally representative Qualtrics XM panel (n = 1,554) during August 2020. First, we examined differences in attitudes towards science (in general) and COVID-19 (specifically) based on political ideology. We found that, compared to conservatives and moderates, liberals trusted science more, were less skeptical of science, perceived greater risk from COVID-19, were more likely to believe in a wildlife origin of COVID-19, and were more likely to support restrictions on wildlife trade. Second, we examined the influence of cultural framing on the perceived validity of science related to COVID-19. Respondents were randomly assigned to one of three treatment groups: 1) a technocratic framing that highlighted feats of human ingenuity to overcome zoonoses; 2) a regulatory framing that highlighted regulations and expansions of protected areas for wildlife as a means to prevent zoonoses, and 3) a control article about traffic lights with no cultural framing. After reading the initial framing article, all three groups read the same fictional, yet factually accurate, ‘Nature Science study’ generated by the authors. An OLS regression model revealed a significant interaction between the technocratic framing and political ideology. Relative to the control group, the technocratic framing slightly increased perceived validity of the Nature Science study for conservatives, significantly lowered perceived validity for liberals, and had no impact on moderates. We did not detect any significant interaction between framing and political ideology for the regulatory framing. Findings of this study highlight the need to account for cultural cognitions when communicating about COVID-19 and other zoonotic diseases. Communication strategies carefully designed to resonate with ideologically diverse audiences may ultimately lead to bipartisan support for actions required to promote “One Health” approaches that reduce the impacts of zoonoses on human and environmental health.

Theories of psychotic illness suggest that abnormal intrinsic functional connectivity may explain its characteristic positive and disorganization symptoms as well as lead to impaired general functioning. Here we used resting state functional magnetic resonance imaging (fMRI) to evaluate associations between these symptoms and the degree to which global connectivity is abnormal in early psychosis (EP). Eighty-six healthy controls (HCs) and 108 individuals with EP with resting state fMRI data were included in primary analyses. The EP group included 83 participants with schizophrenia-spectrum disorders and 25 with bipolar disorder type I with psychotic features. A global intrinsic connectivity "similarity index" for each EP individual was determined by calculating its correlation with the average HC connectivity matrix extracted using Schaefer atlases of multiple parcellations (100, 200, 300, and 400 region parcellations). As hypothesized, connectivity similarity with the average HC matrix was negatively associated with Brief Psychiatric Rating Scale total score, Scale for the Assessment of Positive Symptoms total score, and disorganization symptoms. Similarity was also positively associated with Global Assessment of Functioning score. Results were not driven by sex or diagnosis effects and were consistent across parcellation schemes. These results support the hypothesis that changes in whole-brain connectivity patterns are associated with psychosis symptoms and support the use of functional connectivity as a biomarker for these symptoms in EP.

PURPOSE We undertook a trial to test the efficacy of a technology-assisted health coaching intervention for weight management, called Goals for Eating and Moving (GEM), within primary care. METHODS This cluster-randomized controlled trial enrolled 19 primary care teams with 63 clinicians; 9 teams were randomized to GEM and 10 to enhanced usual care (EUC). The GEM intervention included 1 in-person and up to 12 telephone-delivered coaching sessions. Coaches supported goal setting and engagement with weight management programs, facilitated by a software tool. Patients in the EUC arm received educational handouts. We enrolled patients who spoke English or Spanish, were aged 18 to 69 years, and either were overweight (body mass index 25-29 kg/[m.sup.2]) with a weight-related comorbidity or had obesity (body mass index [greater than or equal to] 30 kg/[m.sup.2]). The primary outcome (weight change at 12 months) and exploratory outcomes (eg, program attendance, diet, physical activity) were analyzed according to intention to treat. RESULTS We enrolled 489 patients (220 in the GEM arm, 269 in the EUC arm). Their mean (SD) age was 49.8 (12.1) years; 44% were male, 41% Hispanic, and 44% non- Hispanic Black. At 12 months, the mean adjusted weight change (standard error) was -1.4 (0.8) kg in the GEM arm vs -0.8 (1.6) kg in the EUC arm, a nonsignificant difference (P =.48). There were no statistically significant differences in secondary outcomes. Exploratory analyses showed that the GEM arm had a greater change than the EUC arm in mean number of weekly minutes of moderate to vigorous physical activity other than walking, a finding that may warrant further exploration. CONCLUSIONS The GEM intervention did not achieve clinically important weight loss in primary care. Although this was a negative study possibly affected by health system resource limitations and disruptions, its findings can guide the development of similar interventions. Future studies could explore the efficacy of higher-intensity interventions and interventions that include medication and bariatric surgery options, in addition to lifestyle modification. Key words: obesity; overweight; comorbidity; health coaching; motivation; self-management; primary care; lifestyle; goal setting; diet; weight loss; physical activity; veterans; ethnic and racial minorities; vulnerable populations; barriers; practice-based research; health informatics, https://doi.org/10.1370/afm.3150 INTRODUCTION Obesity is a serious global public health problem. (1,2) Veterans and racial and ethnic minority groups experience considerable disparities in obesity rates (2-4) and are thus at higher [...]

The complex nature of microbiome data has made the differential abundance analysis challenging. Microbiome abundance counts are often skewed to the right and heteroscedastic (also known as overdispersion), potentially leading to incorrect inferences if not properly addressed. In this paper, we propose a simple yet effective framework to tackle the challenges by integrating Poisson (log-linear) regression with standard error estimation through the Bootstrap method and Sandwich robust estimation. Such standard error estimates are accurate and yield satisfactory inference even if the distributional assumption or the variance structure is incorrect. Our approach is validated through extensive simulation studies, demonstrating its effectiveness in addressing overdispersion and improving inference accuracy. Additionally, we apply our approach to two real datasets collected from the human gut and vagina, respectively, demonstrating the wide applicability of our methods. The results highlight the efficacy of our covariance estimators in addressing the challenges of microbiome data analysis. The corresponding software implementation is publicly available at https://github.com/yimshi/robustestimates.

Developing as a scholar is a critical aspect of graduate school. In this article, we use an autoethnographic approach to explore our experiences in a newly redeveloped interdisciplinary graduate course. The course was designed to emphasize interdisciplinary scholarship and to encourage students' awareness of their own developing epistemological, ontological, and axiological commitments. In this paper, we identify themes that arose from the final class paper, in which the students/researchers reflected on our development as emerging scholars. Through this course we developed an understanding of the value of interdisciplinarity, the cultural embeddedness of knowledge, and our own responsibilities as researchers in relation to social structures of power and marginalization. Our analyses of our experiences suggests that reflections on our own positionality and axiology are important for developing our identities as emerging scholars and that becoming a scholar may be more about the process than an end goal. We conclude with a discussion of how our learning in this course may be relevant for other instructors and emerging scholars.

Children's knowledge of the ordinal relations among number symbols is related to their mathematical learning. Ordinal knowledge has been measured using judgment (i.e., decide whether a sequence of three digits is in order) and ordering tasks (i.e., order three digits from smallest to largest). However, the question remains whether performance on these two ordinal tasks tap into similar cognitive processes. Canadian children (N = 87; Age M = 8.7 years, Grade 3) completed symbolic number tasks (i.e., number comparison, ordering, and order judgment) and measures of arithmetic fluency (i.e., addition and subtraction) and working memory (i.e., digit span backward). For both ordinal tasks, there was a reverse distance effect for ordered sequences such that children responded faster to adjacent than to non-adjacent sequences (e.g., 2 3 4 vs. 4 7 9) and a canonical distance effect for unordered sequences such that children responded faster to non-adjacent than to adjacent sequences (e.g., 4 2 3 vs. 4 9 7). Working memory and number comparison each predicted unique variance in the ordinal measures (ordering, order judgment, and a latent ordinal factor based on the two measures). Furthermore, ordinal skills superseded the role of number comparison as the key predictor of arithmetic, controlling for children's gender and working memory skills. In summary, although both ordering and order judgment tasks index ordinal knowledge, a latent factor that excludes task-specific error may be a better index than either task separately.

Post-transplant lymphoproliferative disorders (PTLDs) remain a feared complication of transplantation, with significant morbidity and mortality. The oncogenic Epstein-Barr virus (EBV) is a key pathogenic driver in 50%–80% of cases. Numerous prognostic indices, comprising multiple clinical, epidemiological and tumor characteristics, including EBV tumor positivity, do not consistently associate with worse patient survival, suggesting a potential role for EBV genome variants in determining outcome. However, the precision medicine tools for determining if a viral genome variant is pathogenic are very limited compared with human genome variants. Further, targeted studies have not implicated a specific viral etiological agent in EBV-negative PTLD. Using novel cutting-edge technologies, we are extracting viral nucleic acids from formalin-fixed, paraffin-embedded archived, or frozen PTLD tissues or plasma, to test for all vertebrate viruses simultaneously in an unbiased fashion, using metagenomic shotgun sequencing (MSS). We are collecting such samples from multiple transplant centers to address the following specific aims and close the following knowledge gaps: (1) Validate our novel observation that PTLD tissue positivity by MSS for anellovirus (and confirmed by PCR) serves as a biomarker for higher transplant recipient mortality after the diagnosis of PTLD; (2) determine the role of other oncogenic viruses in EBV-negative PTLD by unbiased MSS of multiple viral groupings, confirmed by other techniques; and (3) develop the necessary computational, algorithmic and software analytic tools required to determine association of EBV genome variants with worse presentations or outcomes in PTLD. Study completion will contribute to better patient care and may provide avenues for novel therapies.

The glycosylation of IgG plays a critical role during human severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, activating immune cells and inducing cytokine production. However, the role of IgM N-glycosylation has not been studied during human acute viral infection. The analysis of IgM N-glycosylation from healthy controls and hospitalized coronavirus disease 2019 (COVID-19) patients reveals increased high-mannose and sialylation that correlates with COVID-19 severity. These trends are confirmed within SARS-CoV-2-specific immunoglobulin N-glycan profiles. Moreover, the degree of total IgM mannosylation and sialylation correlate significantly with markers of disease severity. We link the changes of IgM N-glycosylation with the expression of Golgi glycosyltransferases. Lastly, we observe antigen-specific IgM antibody-dependent complement deposition is elevated in severe COVID-19 patients and modulated by exoglycosidase digestion. Taken together, this work links the IgM N-glycosylation with COVID-19 severity and highlights the need to understand IgM glycosylation and downstream immune function during human disease.

Post-acute sequelae of SARS-CoV-2 (PASC) is a significant public health concern. We describe Patient Reported Outcomes (PROs) on 590 participants prospectively assessed from hospital admission for COVID-19 through one year after discharge. Modeling identified 4 PRO clusters based on reported deficits (minimal, physical, mental/cognitive, and multidomain), supporting heterogenous clinical presentations in PASC, with sub-phenotypes associated with female sex and distinctive comorbidities. During the acute phase of disease, a higher respiratory SARS-CoV-2 viral burden and lower Receptor Binding Domain and Spike antibody titers were associated with both the physical predominant and the multidomain deficit clusters. A lower frequency of circulating B lymphocytes by mass cytometry (CyTOF) was observed in the multidomain deficit cluster. Circulating fibroblast growth factor 21 (FGF21) was significantly elevated in the mental/cognitive predominant and the multidomain clusters. Future efforts to link PASC to acute anti-viral host responses may help to better target treatment and prevention of PASC.

Over the past 10-15 years, the Volunteer Program at the Natural History Museums of Los Angeles County has undergone an immense transition. This program overhaul tackled historical methodology that had been creating barriers to participation, addressed the changing needs of modern volunteer audiences, and worked to highlight access and inclusion in all aspects of program offerings. Today, the Volunteer Program is one of NHMLAC's largest and most successful community engagement programs, centering the needs and interests of a diverse volunteer cohort by crafting accessible, learning-centered service offerings, while also providing quality support for museum projects. Through this sometimes difficult process of change, NHMLAC partnered closely with longtime docents and other stakeholders to ensure that all parties could move into this new future together. This article outlines the steps of this transition, highlighting the changes, challenges, and opportunities experienced along the way.

This study examines the culturally responsive teaching self-efficacy (CRTSE) of graduates from an undergraduate Physical Education Teacher Education (PETE) program focused on social justice issues. We examined experiences that facilitated CRT and the areas alumni felt most efficacious. Graduates (n = 43) of a PETE program completed the CRTSE Scale via Qualtrics, and 13 with urban teaching experience completed 45-60 min interviews. Data was analysed using descriptive statistics, comparative data analysis, and reflexive thematic analysis [Braun, V., & Clarke, V. (2013). "Successful qualitative research: A practical guide for beginners." Sage]. Two major themes were identified from the data: (1) positive clinical experiences within urban schools, and (2) the ability to build relationships within their school communities through respect and trust. Future considerations for clinical experiences, as well as opportunities for teacher candidates to confront their own biases are discussed. As schools become increasingly diverse, PETE programs need to consistently review and revise curricula and experiences to meet culturally diverse students' needs.

The series of responses in this article were gathered as part of an online mini conference held in September 2021 that sought to explore different ideas and articulations of school autonomy reform across the world (Australia, Canada, England, Ireland, the USA, Norway, Sweden and New Zealand). It centred upon an important question: what needs to happen for school autonomy to be mobilised to create more equitable public schools and systems of education? There was consensus across the group that school autonomy reform creates further inequities at school and system levels when driven by the logics of marketisation, competition, economic efficiency and public accountability. Against the backdrop of these themes, the conference generated discussion and debate where provocations and points of agreement and disagreement about issues of social justice and the mobilisation of school autonomy reform were raised. As an important output of this discussion, we asked participants to write a short response to the guiding conference question. The following are these responses which range from philosophical considerations, systems and governance perspectives, national particularities and teacher and principal perspectives.

A workshop titled Beyond the Symptom: The Biology of Fatigue was held virtually September 27-28, 2021. It was jointly organized by the Sleep Research Society and the Neurobiology of Fatigue Working Group of the NIH Blueprint Neuroscience Research Program. For access to the presentations and video recordings, see: https://neuroscienceblueprint.nih.gov/about/event/beyond-symptom-biology-fatigue. The goals of this workshop were to bring together clinicians and scientists who use a variety of research approaches to understand fatigue in multiple conditions and to identify key gaps in our understanding of the biology of fatigue. This workshop summary distills key issues discussed in this workshop and provides a list of promising directions for future research on this topic. We do not attempt to provide a comprehensive review of the state of our understanding of fatigue, nor to provide a comprehensive reprise of the many excellent presentations. Rather, our goal is to highlight key advances and to focus on questions and future approaches to answering them.