How can we support research participants who stop taking part? Communications guidance developed through public-researcher collaboration.

BACKGROUND: Research study participants can stop taking part early, in various circumstances. Sometimes this experience can be stressful. Providing participants with the information they want or need when they stop could improve participants' experiences, and may benefit individual studies' objectives and research in general. A group of public contributors and researchers at the Clinical Trials Research Unit, University of Leeds, aimed to develop a communication template and researcher guidance. This would address how to provide information sensitively around the time when participants stop or significantly reduce their level of participation. METHODS: The project lead used scoping review methods to identify relevant prior evidence and derive a list of potential information topics to communicate to participants who stop taking part. The topic list was reviewed by research professionals and public contributors before finalisation. Further public contributors were identified from a range of networks. The contributors formed a 'development group', to work on the detail of the planned resources, and a larger 'review group' to review the draft output before finalisation. The involvement was planned so that the development group could shape the direction and pace of the work. RESULTS: The literature review identified 413 relevant reports, resulting in 94 information topics. The review suggested that this issue has not been well explored previously. Some evidence suggested early-stopping participants are sometimes excluded from important communications (such as study results) without clear justification. The development group agreed early to focus on guidance with reusable examples rather than a template. We took time to explore different perspectives and made decisions by informal consensus. Review group feedback was broadly positive but highlighted the need to improve resource navigability, leading to its final online form. CONCLUSIONS: We co-developed a resource to provide support to research participants who stop taking part. A strength of this work is that several of the public contributors have direct lived experience of stopping research participation. We encourage others to review the resource and consider how they support these participants in their studies. Our work highlights the value of researchers and participants working together, including on complex and ethically challenging topics.

Participants in research sometimes stop taking part early. This can sometimes be stressful or difficult for them. Giving them information they want or need around that time could help them and the research. Public contributors and researchers worked together on this project. We wanted to help researchers get information to research participants who stop taking part. Some of the public contributors had experiences of stopping research participation early.The project lead first made a rough plan for the project, with public contributors' help. He left the plan open so the public contributors could help shape the project. The project lead searched for relevant information in published literature. This search showed there has not been much work before on how to help participants who stop taking part. He used the search results to make a list of topics that could be useful to give participants who stop taking part. He asked public contributors and researchers to review the list.Public contributors then joined one of two groups. A smaller group worked on the detail of the planned guidance. A larger group reviewed the draft guidance.The smaller group worked together to make the final guidance in six online meetings. The guidance includes example wording for others to use in their own participant communications. The reviewer group generally liked the guidance but had comments on making it easier to use. The final resource is available online and a link is in the references to this article.

Executive functions in agenesis of the corpus callosum: Working memory and sustained attention in the BTBR inbred mouse strain.

INTRODUCTION: Agenesis of the corpus callosum (AgCC) is characterized by the congenital partial or complete absence of the corpus callosum. Several strains of mice have been reported to carry AgCC, with the BTBR T+ Itpr3tf /J (BTBR) inbred mouse strain consistently showing a complete absence of the corpus callosum, as well as a variable reduction in the size of the hippocampal commissure. While much research has focused on the social deficits of the BTBR strain, little research on its cognitive behavior has been conducted. The goal of our study was to compare two facets of executive functioning, spatial working memory, and sustained attention between the BTBR and C57BL/6J (B6) strains. METHODS: Spatial working memory was measured utilizing a delayed matching-to-position (DMTP) task and sustained attention was measured utilizing an operant task in which mice were trained to distinguish signal and nonsignal events. RESULTS: Both the BTBR and B6 mice demonstrated a predictable decline in performance on the DMTP task as the delay interval increased and predictable increase in performance on the sustained attention task as the duration of the signal event increased. Although no significant differences were found between strains on the performance of these tasks, there was a significant difference in learning the association between lever pressing and food reward. Histological investigation confirmed the complete absence of commissural fibers from the corpus callosum, but also the hippocampal commissure, counter to a previous study. CONCLUSION: The results suggest spatial working memory and sustained attention are unaffected by the absence of these commissural fibers alone.

Injury characteristics of the Pulse Nightclub shooting: Lessons for mass casualty incident preparation.

BACKGROUND: On the morning of June 12, 2016, an armed assailant entered the Pulse Nightclub in Orlando, Florida, and initiated an assault that killed 49 people and injured 53. The regional Level I trauma center and two community hospitals responded to this mass casualty incident. A detailed analysis was performed to guide hospitals who strive to prepare for future similar events. METHODS: A retrospective review of all victim charts and/or autopsy reports was performed to identify victim presentation patterns, injuries sustained, and surgical resources required. Patients were stratified into three groups: survivors who received care at the regional Level I trauma center, survivors who received care at one of two local community hospitals, and decedents. RESULTS: Of the 102 victims, 40 died at the scene and 9 died upon arrival to the Level I trauma center. The remaining 53 victims received definitive medical care and survived. Twenty-nine victims were admitted to the trauma center and five victims to a community hospital. The remaining 19 victims were treated and discharged that day. Decedents sustained significantly more bullet impacts than survivors (4 ± 3 vs. 2 ± 1; p = 0.008) and body regions injured (3 ± 1 vs. 2 ± 1; p = 0.0002). Gunshots to the head, chest, and abdominal body regions were significantly more common among decedents than survivors (p < 0.0001). Eighty-two percent of admitted patients required surgery in the first 24 hours. Essential resources in the first 24 hours included trauma surgeons, emergency room physicians, orthopedic/hand surgeons, anesthesiologists, vascular surgeons, interventional radiologists, intensivists, and hospitalists. CONCLUSION: Mass shooting events are associated with high mortality. Survivors commonly sustain multiple, life-threatening ballistic injuries requiring emergent surgery and extensive hospital resources. Given the increasing frequency of mass shootings, all hospitals must have a coordinated plan to respond to a mass casualty event. LEVEL OF EVIDENCE: Epidemiological Study, level V.

CArtesian sampling with Variable density and Adjustable temporal resolution (CAVA).

PURPOSE: To develop a variable density Cartesian sampling method that allows retrospective adjustment of temporal resolution for dynamic MRI applications and to validate it in real-time phase contrast MRI (PC-MRI). THEORY AND METHODS: The proposed method, called CArtesian sampling with Variable density and Adjustable temporal resolution (CAVA), begins by producing a sequence of phase encoding indices based on the golden ratio increment. Then, variable density is introduced by nonlinear stretching of the indices. Finally, the elements of the resulting sequence are rounded up to the nearest integer. The performance of CAVA is evaluated using PC-MRI data from a pulsatile flow phantom and real-time, free-breathing data from ten healthy volunteers. RESULTS: CAVA enabled image recovery at various temporal resolutions that were selected retrospectively. For the pulsatile flow phantom, image quality and flow quantification accuracy from CAVA were comparable to that from another pseudo-random sampling pattern with fixed temporal resolution. In addition, flow quantification results based on CAVA were in good agreement with a breath-held segmented acquisition. CONCLUSIONS: By allowing retrospective binning of the MRI data, CAVA provides an avenue to retrospectively adjust the temporal resolution of PC-MRI.

Genomic insights into the origin of farming in the ancient Near East.

We report genome-wide ancient DNA from 44 ancient Near Easterners ranging in time between ~12,000 and 1,400 bc, from Natufian hunter-gatherers to Bronze Age farmers. We show that the earliest populations of the Near East derived around half their ancestry from a 'Basal Eurasian' lineage that had little if any Neanderthal admixture and that separated from other non-African lineages before their separation from each other. The first farmers of the southern Levant (Israel and Jordan) and Zagros Mountains (Iran) were strongly genetically differentiated, and each descended from local hunter-gatherers. By the time of the Bronze Age, these two populations and Anatolian-related farmers had mixed with each other and with the hunter-gatherers of Europe to greatly reduce genetic differentiation. The impact of the Near Eastern farmers extended beyond the Near East: farmers related to those of Anatolia spread westward into Europe; farmers related to those of the Levant spread southward into East Africa; farmers related to those of Iran spread northward into the Eurasian steppe; and people related to both the early farmers of Iran and to the pastoralists of the Eurasian steppe spread eastward into South Asia.

Burrowing Owls, Pulex irritans, and Plague.

Western Burrowing Owls (Athene cunicularia hypugaea) are small, ground-dwelling owls of western North America that frequent prairie dog (Cynomys spp.) towns and other grasslands. Because they rely on rodent prey and occupy burrows once or concurrently inhabited by fossorial mammals, the owls often harbor fleas. We examined the potential role of fleas found on burrowing owls in plague dynamics by evaluating prevalence of Yersinia pestis in fleas collected from burrowing owls and in owl blood. During 2012-2013, fleas and blood were collected from burrowing owls in portions of five states with endemic plague-Idaho, Oregon, Washington, Colorado, and South Dakota. Fleas were enumerated, taxonomically identified, pooled by nest, and assayed for Y. pestis using culturing and molecular (PCR) approaches. Owl blood underwent serological analysis for plague antibodies and nested PCR for detection of Y. pestis. Of more than 4750 fleas collected from owls, Pulex irritans, a known plague vector in portions of its range, comprised more than 99.4%. However, diagnostic tests for Y. pestis of flea pools (culturing and PCR) and owl blood (PCR and serology) were negative. Thus, even though fleas were prevalent on burrowing owls and the potential for a relationship with burrowing owls as a phoretic host of infected fleas exists, we found no evidence of Y. pestis in sampled fleas or in owls that harbored them. We suggest that studies similar to those reported here during plague epizootics will be especially useful for confirming these results.

Validation of operant social motivation paradigms using BTBR T+tf/J and C57BL/6J inbred mouse strains.

BACKGROUND: As purported causal factors are identified for autism spectrum disorder (ASD), new assays are needed to better phenotype animal models designed to explore these factors. With recent evidence suggesting that deficits in social motivation are at the core of ASD behavior, the development of quantitative measures of social motivation is particularly important. The goal of our study was to develop and validate novel assays to quantitatively measure social motivation in mice. METHODS: In order to test the validity of our paradigms, we compared the BTBR strain, with documented social deficits, to the prosocial C57BL/6J strain. Two novel conditioning paradigms were developed that allowed the test mouse to control access to a social partner. In the social motivation task, the test mice lever pressed for a social reward. The reward contingency was set on a progressive ratio of reinforcement and the number of lever presses achieved in the final trial of a testing session (breakpoint) was used as an index of social motivation. In the valence comparison task, motivation for a food reward was compared to a social reward. We also explored activity, social affiliation, and preference for social novelty through a series of tasks using an ANY-Maze video-tracking system in an open-field arena. RESULTS: BTBR mice had significantly lower breakpoints in the social motivation paradigm than C57BL/6J mice. However, the valence comparison task revealed that BTBR mice also made significantly fewer lever presses for a food reward. CONCLUSIONS: The results of the conditioning paradigms suggest that the BTBR strain has an overall deficit in motivated behavior. Furthermore, the results of the open-field observations may suggest that social differences in the BTBR strain are anxiety induced.

Bullying - effects, prevalence and strategies for detection.

BACKGROUND: The mental, physical, social and academic consequences of bullying have an enormous impact on human and social capital. OBJECTIVE: This article describes the effects and prevalence of bullying on young people and presents strategies for its detection. Strategies for the facilitation of a multidisciplinary approach to bullying in adolescents are also presented. DISCUSSION: Given the existing high rate of bullying, assessment should be incorporated into a standard psychosocial screening routine in the general practitioner's clinic. Effective management is a multidisciplinary effort, involving parents, teachers and school officials, the GP, and mental health professionals. Given the variable effectiveness of schools in tackling bullying, GPs play an important role in identifying at risk patients, screening for psychiatric comorbidities, counselling families about the problem, and advocating for bullying prevention in their communities.

An innovative treatment programme for anorexia nervosa.

We present the case of an Australian girl with severe anorexia nervosa who had previously been resistant to treatment, and who was subsequently treated successfully by an innovative programme at the Karolinska Institute in Stockholm. The programme is based on a distinctive concept of causation of eating disorders in which it is postulated that they develop as a consequence of starvation rather than a primary mental disorder. The treatment focuses on relearning how to eat and perceive satiety using a unique feed-back system, together with provision of warmth, limitation of exercise and facilitating social adaptation.

Normal hematologic and biochemical values for prelaying greater sage grouse (Centrocercus urophasianus) and their influence on chick survival.

Declines in greater sage grouse (Centrocercus urophasianus) productivity and population numbers throughout their range demand a better understanding of how nutrition influences sage grouse populations. During March and April 1999-2001, blood samples were collected from 158 female (73 adult, 85 yearling), free-ranging, prelaying, greater sage grouse from an area in northwestern Nevada, USA, and southeastern Oregon, USA. These blood samples were evaluated to establish normal blood values for sage grouse and ascertain if certain blood parameters, as indices of nutrition, are useful for predicting if sage grouse hens would raise at least one chick to 1 August. Results of logistic regression indicated that three of six blood parameters analyzed--glucose, total plasma protein, and calcium: phosphorus ratio-affected the probability of a female sage grouse raising at least one chick to late summer. Ranking of the standardized estimates revealed that glucose and total plasma protein had the greatest impact on the likelihood of a female successfully raising chicks. Odds ratios indicated that a 1-unit increase in glucose (1 mg/dl) and plasma protein (0.1 g/dl) would result in a 4% and 113% positive increase, respectively, in the predicted odds of at least one chick surviving until 1 August. Odds ratios for calcium : phosphorus ratio revealed a 70% decline in the predicted odds of at least one chick surviving until 1 August if the level of this parameter increased one unit (e.g., 3:1 to 4:1). Based on these analyses, values of some blood parameters used as indices of nutrition, especially glucose, total plasma protein, and calcium : phosphorus ratio, can be successfully used to predict reproductive success of sage grouse. These parameters are not only indicative of the nutritional status of prelaying hens but may be associated with nutritional quality of the habitat and therefore have important management significance.

A gravitationally lensed quasar with quadruple images separated by 14.62 arcseconds.

Gravitational lensing is a powerful tool for the study of the distribution of dark matter in the Universe. The cold-dark-matter model of the formation of large-scale structures (that is, clusters of galaxies and even larger assemblies) predicts the existence of quasars gravitationally lensed by concentrations of dark matter so massive that the quasar images would be split by over 7 arcsec. Numerous searches for large-separation lensed quasars have, however, been unsuccessful. All of the roughly 70 lensed quasars known, including the first lensed quasar discovered, have smaller separations that can be explained in terms of galaxy-scale concentrations of baryonic matter. Although gravitationally lensed galaxies with large separations are known, quasars are more useful cosmological probes because of the simplicity of the resulting lens systems. Here we report the discovery of a lensed quasar, SDSS J1004 + 4112, which has a maximum separation between the components of 14.62 arcsec. Such a large separation means that the lensing object must be dominated by dark matter. Our results are fully consistent with theoretical expectations based on the cold-dark-matter model.

From tides to mixing along the Hawaiian ridge.

The cascade from tides to turbulence has been hypothesized to serve as a major energy pathway for ocean mixing. We investigated this cascade along the Hawaiian Ridge using observations and numerical models. A divergence of internal tidal energy flux observed at the ridge agrees with the predictions of internal tide models. Large internal tidal waves with peak-to-peak amplitudes of up to 300 meters occur on the ridge. Internal-wave energy is enhanced, and turbulent dissipation in the region near the ridge is 10 times larger than open-ocean values. Given these major elements in the tides-to-turbulence cascade, an energy budget approaches closure.

Risk-taking behaviour of young women in Australia: screening for health-risk behaviours.

Healthy risk-taking is a normal part of adolescence. Young people who participate in multiple risk-taking increase the chance of damaging their health. There appears to be a growing range and prevalence of health-risk behaviours among young women, notably in their use of alcohol and marijuana. Research suggests that such health-risk behaviours may be related to psychological factors such as stress and depression. General practitioners have a central role in identifying and preventing health-risk behaviours and associated mental health problems in young people. Comprehensive assessment includes a series of screening questions about home, education (or employment), activities, drugs, sexuality and suicide for young people, known as the HEADSS technique.

Reduced mixing from the breaking of internal waves in equatorial waters.

In the oceans, heat, salt and nutrients are redistributed much more easily within water masses of uniform density than across surfaces separating waters of different densities. But the magnitude and distribution of mixing across density surfaces are also important for the Earth's climate as well as the concentrations of organisms. Most of this mixing occurs where internal waves break, overturning the density stratification of the ocean and creating patches of turbulence. Predictions of the rate at which internal waves dissipate were confirmed earlier at mid-latitudes. Here we present observations of temperature and velocity fluctuations in the Pacific and Atlantic oceans between 42 degrees N and 2 degrees S to extend that result to equatorial regions. We find a strong latitude dependence of dissipation in accordance with the predictions. In our observations, dissipation rates and accompanying mixing across density surfaces near the Equator are less than 10% of those at mid-latitudes for a similar background of internal waves. Reduced mixing close to the Equator will have to be taken into account in numerical simulations of ocean dynamics--for example, in climate change experiments.