Background: Gaps remain in achieving retention in care and durable HIV viral load suppression for people with HIV in Washington, DC (hereafter DC). Although people with HIV seeking care in DC have access to a range of supportive services, innovative strategies are needed to enhance patient engagement in this setting. Mobile health (mHealth) interventions have shown promise in reaching previously underengaged groups and improving HIV-related outcomes in various settings. Objective: This study will evaluate the implementation and effectiveness of a clinic-deployed, multifeature mHealth intervention called PositiveLinks (PL) among people with HIV enrolled in the DC Cohort, a longitudinal cohort of people with HIV receiving care in DC. A cluster randomized controlled trial will be conducted using a hybrid effectiveness-implementation design and will compare HIV-related outcomes between clinics randomized to PL versus usual care. Methods: The study aims are threefold: (1) We will perform a formative evaluation of PL in the context of DC Cohort clinics to test the feasibility, acceptability, and usability of PL and tailor the platform for use in this context. (2) We will conduct a cluster randomized controlled trial with 12 DC Cohort clinics randomized to PL or usual care (n=6 [50%] per arm) and measure the effectiveness of PL by the primary outcomes of patient visit constancy, retention in care, and HIV viral load suppression. We aim to enroll a total of 482 participants from DC Cohort clinic sites, specifically including people with HIV who show evidence of inconsistent retention in care or lack of viral suppression. (3) We will use the Consolidated Framework for Implementation Research (CFIR) and the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework to measure implementation success and identify site, patient, provider, and system factors associated with successful implementation. Evaluation activities will occur pre-, mid-, and postimplementation. Results: Formative data collection was completed between April 2021 and January 2022. Preliminary mHealth platform modifications have been performed, and the first round of user testing has been completed. A preimplementation evaluation was performed to identify relevant implementation outcomes and design a suite of instruments to guide data collection for evaluation of PL implementation throughout the trial period. Instruments include those already developed to support DC Cohort Study activities and PL implementation in other cohorts, which required modification for use in the study, as well as novel instruments designed to complete data collection, as guided by the CFIR and RE-AIM frameworks. Conclusions: Formative and preimplementation evaluations will be completed in spring 2022 when the trial is planned to launch. Specifically, comprehensive formative data analysis will be completed following data collection, coding, preliminary review, and synthesis. Corresponding platform modifications are ready for beta testing within the DC Cohort. Finalization of the platform for use in the trial will follow beta testing. Trial Registration: ClinicalTrials.gov NCT04998019; https://clinicaltrials.gov/ct2/show/NCT04998019

Background: For years, in Catalonia and in the rest of Spain, there has been a deficit and an unequal geographical distribution of health professionals specializing in pediatrics, especially in rural areas. Among the proposals to improve this situation is the promotion of the use of information and communication technologies (ICT) among users and professionals. Moreover, with the outbreak of COVID-19, the use of telehealth has become an essential tool, with an overall increase in non–face-to-face visits, including in primary care pediatrics. In this context, telemedicine, when used in primary care pediatrics, can be an effective means of improving families’ access to medical care. Currently, in Catalonia, telemedicine involving patients and health professionals is used in pediatric primary care through telephone consultation and asynchronous teleconsultation (eConsulta). Video consultation is in practice not used, although it could have different applications. Objective: The aim of this study is to evaluate the feasibility of a video consultation process with physical examination in acute pediatric pathology in rural areas among primary care professionals. In addition, the level of satisfaction with these remote consultations will be assessed from the perspective of both the users and the health care professionals. Methods: We will conduct a prospective experimental study to analyze the possibility of using video consultation in pediatric acute care in primary care in central Catalonia (Spain). A minimum of 170 children aged between 0 and 14 years attending the primary care center (PCC) for acute illness for a period of 1 year will be included in the study. Initially, the telemetric visit, including a physical examination, will include a nurse at the patient and family’s side and a pediatrician who will participate remotely. Subsequently, the pediatrician will visit the patient in person and the physical examination and diagnosis made during the remote visit will be compared with the physical examination and diagnosis of the face-to-face visit, which is considered the gold standard. Results: Recruitment was planned to begin in the second half of 2023 and continue for at least 1 year. It is anticipated to be a good resource for a variety of acute pediatric conditions in primary care. The evaluation will focus on the feasibility of performing live remote visits and comparing their diagnostic accuracy with that of face-to-face visits. Conclusions: We believe that this study could provide evidence on the feasibility and diagnostic accuracy of video consultation in pediatric acute primary care in a rural setting, as well as on satisfaction with video consultations among both users and professionals. If proven useful in addressing the acute needs of children in a variety of situations, it could become a digital health tool that improves the overall pediatric primary care service in rural areas, for both families and professionals.

Background Poor management of mental illnesses is associated with lower treatment adherence, chronification, avoidable re-hospitalisations, and high costs. Remote measurement based care (RMBC) interventions have gained increasing relevance due to its potential in providing a comprehensive and patient-centric approach to mental health management. Objectives The systematic review and meta-analysis aims to provide a comprehensive overview and analysis of existing evidence on the use of RMBC for patients with mental illness and to examine the effectiveness of RMBC interventions in alleviating disorder-specific symptoms, reducing relapse and improving recovery-oriented outcomes, global functioning, and quality of life. Methods and analysis Our multidisciplinary research team will develop a comprehensive search strategy, adapted to each electronic database (PubMed, Medline, Embase, and PsychINFO) to be examined systematically. Studies with patients formally diagnosed by the International Classification of Diseases or the Diagnostic and Statistical Manual of Mental Disorders which include assessment of self-reported psychiatric symptoms will be included. Publications will be reviewed by teams of independent researchers. Quality of studies will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias. Outcomes cover symptom-focused or disease-specific outcomes, relapse, recovery-focused outcomes, global functioning, quality of life and acceptability of the intervention. Further data that will be extracted includes study characteristics, target population, intervention, and tracking characteristics. Data will be synthesised qualitatively, summarising findings of the systematic review. Randomised controlled trials (RCTs) will be considered for meta-analysis if data is found comparable in terms of mental illness, study design and outcomes. Cumulative evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation framework. Trial registration Trial registration number: PROSPERO CRD42022356176.

Background: Asthma is the most common chronic childhood illness and is a leading cause of emergency department visits in the United States. Obesity increases the risk of poor health outcomes, reduced quality of life, and increased health care expenditures among youth with asthma. Weight loss is crucial for improving asthma outcomes in children with obesity. Our study team developed the Childhood Health and Asthma Management Program (CHAMP), a 16-session behavioral family lifestyle intervention (BFI) for school-age children with asthma and obesity and evaluated CHAMP in a randomized controlled trial compared with attention control. There were medium effect sizes favoring CHAMP for changes in body mass index z-scores, asthma control, and lung function among completers (ie, those who attended ≥9 of 16 sessions). Despite high rates of satisfaction reported by families, attendance and trial attrition were suboptimal, which raised concerns regarding the feasibility of CHAMP. Qualitative feedback from participants indicated 3 areas for refinement: (1) a less burdensome intervention modality, (2) a more individually tailored intervention experience, and (3) that interventionists can better answer health-related questions. Objective: We propose to improve upon our pilot intervention by developing the Mobile Childhood Health and Asthma Management Program (mCHAMP), a nurse-delivered BFI, delivered to individual families, and supported by a mobile health (mHealth) app. This study aims to (1) identify structural components of mCHAMP and (2) develop and test the usability of our mCHAMP app. Methods: Participants will be recruited from an outpatient pediatric pulmonary clinic. We will identify the structural components of mCHAMP by conducting a needs assessment with parents of children with asthma and obesity. Subsequently, we will develop and test our mCHAMP app using an iterative process that includes usability testing with target users and pediatric nurses. Results: This study was funded in 2018; 13 parents of children with asthma and obesity participated in the needs assessment. Preliminary themes from focus groups and individual meetings included barriers to engaging in health-promoting behaviors, perceived relationships between asthma and obesity, facilitators to behavior change, and intervention preferences. Participatory design sessions and usability testing are expected to conclude in late 2019. Conclusions: Outcomes from this study are expected to include an mHealth app designed with direct participation from the target audience and usability data from stakeholders as well as potential end users. International Registered Report Identifier (IRRID): DERR1-10.2196/13549

The use of active comprehension strategies that encourage students to explain what they have read can improve students' comprehension of complex scientific texts. Most research has focused on either ...

Stage 1 IPA at PCI RR

Background: Our current understanding of how computerized brain training drives cognitive and functional benefits remains incomplete. This paper describes the protocol for Improving Neurological Health in Aging via Neuroplasticity-based Computerized Exercise (INHANCE), a randomized controlled trial in healthy older adults designed to evaluate whether brain training improves cholinergic signaling. Objective: INHANCE evaluates whether 2 computerized training programs alter acetylcholine binding using the vesicular acetylcholine transporter ligand [18F] fluoroethoxybenzovesamicol ([18F] FEOBV) and positron emission tomography (PET). Methods: In this phase IIb, prospective, double-blind, parallel-arm, active-controlled randomized trial, a minimum of 92 community-dwelling healthy adults aged 65 years and older are randomly assigned to a brain training program designed using the principles of neuroplasticity (BrainHQ by Posit Science) or to an active control program of computer games designed for entertainment (eg, Solitaire). Both programs consist of 30-minute sessions, 7 times per week for 10 weeks (35 total hours), completed remotely at home using either loaned or personal devices. The primary outcome is the change in FEOBV binding in the anterior cingulate cortex, assessed at baseline and posttest. Exploratory cognitive and behavioral outcomes sensitive to acetylcholine are evaluated before, immediately after, and 3 months following the intervention to assess the maintenance of observed effects. Results: The trial was funded in September 2019. The study received approval from the Western Institutional Review Board in October 2020 with Research Ethics Board of McGill University Health Centre and Health Canada approvals in June 2021. The trial is currently ongoing. The first participant was enrolled in July 2021, enrollment closed when 93 participants were randomized in December 2023, and the trial will conclude in June 2024. The study team will be unblinded to conduct analyses after the final participant exits the study. We expect to publish the results in the fourth quarter of 2024. Conclusions: There remains a critical need to identify effective and scalable nonpharmaceutical interventions to enhance cognition in older adults. This trial contributes to our understanding of brain training by providing a potential neurochemical explanation of cognitive benefit.

Proposal for cross-sectional dyadic study

Contrary to the claim that loneliness routinely impairs the decoding of social cues such as emotion displays, Knowles, Lucas, Baumeister, and Gardner (2015) proposed that lonely adults “choke under pressure,” experiencing impairments only when social monitoring is framed as diagnostic of general social skill. In four experiments, Knowles et al. showed that lonely individuals performed worse than nonlonely individuals at decoding social cues when the decoding task was framed as a test of social aptitude, but not when it was framed as a test of academic aptitude. The studies were small (N's ranging from 78 to 203), and all employed a convenience sample of mostly female undergraduate students, impairing both statistical power and external validity. In addition, the lack of a true control group precluded the studies from establishing whether loneliness inhibits social monitoring ability if no frame is offered. This study conceptually replicates the central hypothesis of Knowles et al. using a sample of adults that is substantially larger and more diverse demographically and geographically, and using a true control group in addition to the comparison group. Results revealed a significant main effect of loneliness on social monitoring ability but did not replicate the choking under pressure phenomenon.

Are experiences that bring meaning different from experiences that bring happiness? If so, do people seek out different experiences in pursuing meaning versus happiness? In an adversarial collabora...

Multiple external representations (MERs) play an important role in the learning field of mathematics. Whereas the CTML and the ITPC model assume that the heterogeneous combination of symbolic and analogous representations fosters learning, the Design, Functions and Tasks framework implicates that learning benefits depend on the specific functions of MERs. The current paper will be a conceptual replication study of one of the few studies comparing single representations, heterogeneous and homogeneous MERs in the context of mathematics learning. In a balanced incomplete block design, the participants will be provided single representations (graphic, text, or formula) or a heterogeneous (e.g., text + graphic) or homogeneous (text + formula) combination of these to solve linear system of equations problems. Gaze behavior, task performance, and time on task will be recorded. On the basis of previous research, learning with MERs is expected to be superior to learning with single representations. Moreover, heterogeneous representations are expected to be superior to homogeneous ones. The relationship between MERs and performance is assumed to be (serially) mediated by cognitive load and number of transitions. Additionally, text is expected to be fixated more often and longer than formula or graphic.

Children's knowledge of arithmetic principles is a key aspect of early mathematics knowledge. Knowledge of arithmetic principles predicts how children approach solving arithmetic problems and the likelihood of their success. Prior work has begun to address how children might learn arithmetic principles in a classroom setting. Understanding of arithmetic principles involves understanding how numbers in arithmetic equations relate to another. For example, the relation to operands principle is that for subtracting natural numbers (A - B = C), the difference (C) must be smaller than the minuend (A). In the current study we evaluate if individual differences in arithmetic principle knowledge can be predicted by the learners' spontaneous focus on relations and if feedback can increase their focus on relations. We also evaluate the role of parent talk and the home environment in individual differences. Parent talk regarding number predicts variations in learner's performance on some early number tasks. We evaluate if the amount of parent's talk specifically about relations is associated with learner's spontaneous focus on relations and arithmetic principle knowledge.

Previous research has asserted that individuals hold cognitive associations between the constructs of hot temperatures and aggression. However, subsequent studies have cast doubt on whether these previously used methods reliably produce effects that support this assertion. Thus, the evidence for the existence of a cognitive heataggression association is mixed. To test for this hypothetical association using a different method, and to address shortcomings in the previously-used methods, the current studies used a modified Affect Misattribution Procedure to examine whether exposure to heatrelated words increased the accessibility of aggressive cognitions. Both a pilot study and a Registered Report showed that exposure to heat-related words increased the accessibility of aggressive cognitions. However, exposure to cold-related words also, and unexpectedly, increased the accessibility of aggressive cognitions. In addition, these results were only found for participants who reported that the primes influenced their Misattribution Task performance. Thus, although the current results found that exposure to heat-related stimuli caused theoretically predicted effects, the overall evidence is somewhat mixed as to whether this is due to a cognitive association between hot temperatures and aggression.

Background: Mental health problems among workers cause enormous losses to companies in Japan. However, workers have been considered to have limited access to psychological support because of time constraints, which makes it difficult for them to engage in face-to-face psychological support interventions. Objective: This study aimed to present an intervention protocol that describes a randomized controlled trial to examine whether brief guided mindfulness meditation (MM) or self-compassion meditation (SCM) provided by a smartphone app is effective for mental health and work-related outcomes among workers. Methods: This is an open-label, 3-arm randomized controlled trial. The participants will be recruited through an open call on relevant websites with the following inclusion criteria: (1) employees who are working more than 20 hours per week, (2) between the ages of 18 and 54 years, (3) not on a leave of absence, (4) not business owners or students, and (5) not currently diagnosed with a mental disorder and have a Kessler Psychological Distress Scale-6 score below 13 points. We will include 200 participants and randomly assign them to an SCM course (n=67), an MM course (n=67), and a waitlist group (n=66). The intervention groups (SCM and MM) will be instructed to engage in daily guided self-help, self-compassion, and MMs lasting 6-12 minutes per day over 4 weeks. Primary outcomes will include psychological distress and job performance, and secondary outcomes will include somatic symptoms, cognitive flexibility, self-esteem, self-compassion, perceived stress, well-being, emotion regulation, work engagement, anger, psychological safety, and creativity. All procedures were approved by the ethics committee of the University of Tokyo (22-326). All participants will be informed of the study via the websites, and written informed consent will be collected via web-based forms. Results: The recruitment of participants began in December 2022, and the intervention began in January 2023. As of September 2023, a total of 375 participants have been enrolled. The intervention and data collection were completed in late October 2023. Conclusions: This study will contribute to the development of effective self-care intervention content that will improve mental health, work performance, and related outcomes and promote mindful and self-compassionate attitudes when faced with distress. Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000049466; https://tinyurl.com/23x8m8nf

Background: With the expected increase in the number of people needing care and the increasing shortage of skilled care workers, new care concepts are required. Therefore, digital assistive technologies (DATs), especially robotics, can improve the situation of people with different needs and create opportunities for participation. For a human-technology interaction to have a high level of usability, DAT’s meaningfulness and effectiveness must be accessible to end users. Significant barriers to the use of DATs in health care are the lack of controllability and adaptivity, as well as control functions that are too complex. Objective: The objective of this paper is to develop an interaction and control platform that is understandable to a layperson and has a programming interface for DAT interactions. The innovation consists of the expansion of usage and interaction options for carers of existing DAT in a more individual manner. This is to be achieved by combining modern interactive media, a modular software architecture, and already available DAT. Methods: The project is planned as a mixed methods study with a longitudinal design, with multiple user involvements and measurement times in collaboration with 3 care facilities in Germany. When assessing technologies, the satisfaction of the basic human needs of competence, connection, and autonomy plays an important role in the actual use of the technology. These needs can be measured in the form of usability (System Usability Scale), intention to use (Technology Usage Inventory), and satisfaction with the carers’ needs (Technology-Based Experience of Need Satisfaction). In the qualitative assessment, user experience is recorded using the think-aloud method and focus groups in order to obtain information about potential improvements of the platform. Results: The EduXBot (Educational Exploration Robot Application Platform) project was initiated in January 2023 and is scheduled to conclude in December 2025, at which point the project’s final results are expected to be available. The initial results were attained in the summer of 2024 when the final concept for the platform prototype was developed. In November 2024, an initial prototype of a functional platform for the simplified interaction and control of DAT was evaluated. Conclusions: It is expected that the open DAT system architecture enables caregivers without any previous technical knowledge to assemble their individual DAT functional portfolio. The results of the project will provide low-threshold access to interaction options for existing DAT as well as expand the usage of such technologies in an individual and patient-centered way. Trial Registration: Deutsches Register Klinischer Studien DRKS00034195; https://drks.de/search/de/trial/DRKS00034195

This project is an attempt to replicate the findings of Axelrod et al. (2015) who found an increase using anodal stimulation of the DLPFC. Axelrod, V., Rees, G., Lavidor, M., & Bar, M. (2015). Increasing propensity to mind-wander with transcranial direct current stimulation. Proceedings of the National Academy of Sciences, 112(11), 3314-3319.

In this registered report, we propose an evaluation of how sleep is related to school functioning. Vulnerable populations including children with disabilities, children of color, and children experiencing socioeconomic disadvantage are more likely to both experience learning difficulties (e.g., in achievement, classroom behavior, and executive function) and to experience suboptimal sleep health. Understanding which aspects of sleep have the strongest relations with school functioning is important to better direct resources to policies and programs that promote healthy sleep during childhood. Using data from the Fragile Families and Child Wellbeing Study, we propose a series of structural equation models evaluating whether sleep at age 5 has a direct or indirect nonlinear effect on academic achievement, executive function, and classroom behavior at age 9, and whether this relation is moderated by race or ethnicity, poverty, maternal education, or disability. Our project will provide insight into whether interventions for suboptimal sleep health are especially likely to benefit vulnerable populations including children with disabilities, those who are non-white, and those from economically disadvantaged homes.

Infants are able to use the contexts in which familiar words appear to guide their inferences about the syntactic category of novel words (e.g., “This is a” + “dax”; dax = object). The current study examined whether 18-month-old infants can rapidly adapt these expectations by tracking the distribution of syntactic structures in their input. In French, la petite can be followed by both nouns (la petite balle, “the little ball”) and verbs (la petite mange, “the little one is eating”). Infants were habituated to a novel word, as well as to familiar nouns or verbs (depending on the experimental group), all appearing after la petite. The familiar words served to create an expectation that la petite would be followed by either nouns or verbs. If infants can utilize their knowledge of a few frequent words to adjust their expectations, then they could use this information to infer the syntactic category of a novel word – and be surprised when the novel word is used in a context that is incongruent with their expectations. However, infants in both groups did not show a difference between noun and verb test trials. Thus, no evidence for adaptation-based learning was found. We proposed that it is necessary that infants have strong expectations about syntactic contexts before they can adapt these expectations based on recent input.

Background: The Knee OsteoArthritis, Linking Activity and Pain (KOALAP) study is the first to test the feasibility of using consumer-grade cellular smartwatches for health care research. Objective: The overall aim was to investigate the feasibility of using consumer-grade cellular smartwatches as a novel tool to capture data on pain (multiple times a day) and physical activity (continuously) in patients with knee osteoarthritis. Additionally, KOALAP aimed to investigate smartwatch sensor data quality and assess whether engagement, acceptability, and user experience are sufficient for future large-scale observational and interventional studies. Methods: A total of 26 participants with self-diagnosed knee osteoarthritis were recruited in September 2017. All participants were aged 50 years or over and either lived in or were willing to travel to the Greater Manchester area. Participants received a smartwatch (Huawei Watch 2) with a bespoke app that collected patient-reported outcomes via questionnaires and continuous watch sensor data. All data were collected daily for 90 days. Additional data were collected through interviews (at baseline and follow-up) and baseline and end-of-study questionnaires. This study underwent full review by the University of Manchester Research Ethics Committee (#0165) and University Information Governance (#IGRR000060). For qualitative data analysis, a system-level security policy was developed in collaboration with the University Information Governance Office. Additionally, the project underwent an internal review process at Google, including separate reviews of accessibility, product engineering, privacy, security, legal, and protection regulation compliance. Results: Participants were recruited in September 2017. Data collection via the watches was completed in January 2018. Collection of qualitative data through patient interviews is still ongoing. Data analysis will commence when all data are collected; results are expected in 2019. Conclusions: KOALAP is the first health study to use consumer cellular smartwatches to collect self-reported symptoms alongside sensor data for musculoskeletal disorders. The results of this study will be used to inform the design of future mobile health studies. Results for feasibility and participant motivations will inform future researchers whether or under which conditions cellular smartwatches are a useful tool to collect patient-reported outcomes alongside passively measured patient behavior. The exploration of associations between self-reported symptoms at different moments will contribute to our understanding of whether it may be valuable to collect symptom data more frequently. Sensor data–quality measurements will indicate whether cellular smartwatch usage is feasible for obtaining sensor data. Methods for data-quality assessment and data-processing methods may be reusable, although generalizability to other clinical areas should be further investigated. International Registered Report Identifier (IRRID): DERR1-10.2196/10238

The motivated reasoning paradigm states that ideological beliefs and goals bias individuals’ information processing particularly regarding socio-political information. However, most individuals are unaware of the potential that ideological biases shape their perception and judgement making them easy targets for political polarization and disinformation. This leads to the strong need to identify pivotal junctures to address and mitigate this bias. Utilizing an ideological bias task that assesses the degree of expressing one’s ideological bias in the estimation of evidence-based socio-political facts, we test the effects of two of feedback conditions on the reduction of ideological bias. For this purpose, a 3 between-factor (feedback-only vs. feedback + social norm nudge vs. no feedback control) design is used to test a representative German sample at two time points (Nt1 = 1229 , Nt2 = 1001). Participants who received feedback on the extent of their ideological bias displayed a significant bias reduction between t1 and t2 compared to the control group. An additional social norm nudge emphasizing the value of unbiased decision-making for society, did not result in a stronger reduction of ideological bias. Moreover, general bias awareness did not moderate the effect of feedback on bias reduction. Our findings contribute to a growing understanding about the suggestibility of ideological bias and point to the (limited) potential of bias awareness in mitigating biased information processing.

These are the supporting documents for the pre-registered report titled "Romantic Relationship Distress, Gender, Socioeconomic Status, and Inflammation: A Pre-Registered Report" in Personal Relationships.

This page contains the materials, data, analysis code, and preregistration for the Language Learning paper titled above.

Children with poor reading comprehension tend to have oral language weaknesses leading to the suggestion that poor language in the early years is a proximal cause of later reading comprehension difficulties. Yet, longitudinal studies have not been able to reliably predict which children go on to have comprehension weaknesses and evidence comprises small sample sizes and a narrow focus on language in isolation. In this registered report, we will examine early predictors of later outcomes using a sample of 879 children identified as having comprehension weaknesses at 9 years in the Avon Longitudinal Study of Parents and Children (ALSPAC). Study 1 will test whether they had language weaknesses at ages 15, 24, and 38 months relative to peers who did not go on to develop reading difficulties (n=4516). We will examine the extent to which preschool language measures predict later group outcomes, and whether early language risk is exacerbated by an impoverished language and communication environment. Study 2 builds on this multiple risk approach to examine broader cognitive predictors alongside language. Using a subsample of 125 children with comprehension weaknesses and 562 typically developing readers, we will ask whether the breadth (number) or depth (severity) of risk factors predict reading outcomes. Together, these findings will improve our understanding of who is at risk of later comprehension difficulty, and the breadth of support that may be necessary for successful intervention.

The widespread decline of insect pollinators poses a conservation concern and threatens both the pollination of wild plants and crops. Primary drivers of pollinator decline are habitat loss, degradation and fragmentation, which to a large extent result from agricultural intensification. Numerous tools have been developed to aid decision-making relating to insect pollinators and pollination in agricultural landscapes. These tools provide valuable information for understanding the drivers of insect population changes in agricultural areas and projecting future population trends in response to various actions. However, there is currently no comprehensive list of available tools, and their usability (ease of use and acceptability for conducting tasks) for decision-making purposes. Therefore, there is an urgent need to understand what tools have been designed, their commonalities and their suitability for different decision context, to ensure the effectiveness of pollinator-friendly management and conservation actions. In this study, we present a systematic map methodology that will collate and catalogue relevant tools relating to insect pollinators and/or pollination in agricultural landscapes. We will conduct searches in bibliographic databases such as ‘Web of Science Core Collection’ and ‘Scopus’ using a tested search string. Additionally, we will manually search grey literature using web-based engines (Google Scholar and ProQuest) and websites. After removing duplicates, the search results will be screened sequentially based on predetermined eligibility criteria, including title, abstract, and full text. The extracted data will provide metadata for mapping the usability of the tools, utilising descriptive tables, statistics and figures. Usability will be assessed across three categories: the tool itself, the user and the user-context. The results from this mapping exercise can support researchers in synthesising progress in terms of pollinator-related tools, and direct research and development efforts to bridge the identified gaps and shortcomings. It will also have significant implications for managers, stakeholders and policymakers, by providing guidance on existing tools and supporting informed tool choices.

Objective: Anorexia nervosa (AN) is a serious psychiatric condition often associated with poor outcomes. Biologically informed treatments for AN, such as brain stimulation, are lacking, in part due to the unclear nature of the neurobiological contributions to the illness. However, recent research has suggested a specific neurobiological target for the treatment of AN, namely stimulation of the inferior parietal lobe (IPL). The aim of this study was to stimulate—noninvasively—the left IPL in individuals with AN using high‐definition transcranial direct current stimulation (HD‐tDCS). Method: Twenty participants will be randomized to receive 10 daily sessions of HD‐tDCS or sham HD‐tDCS (placebo). Assessments will be carried out at baseline and end point, as well as 4‐ and 12‐week follow‐ups. Discussion: This pilot investigation will primarily determine the feasibility and acceptability of this intervention.

Background: Academic procrastination is a widespread problem among college students. It is linked to poor academic performance and increased college dropout intentions, as well as several mental health problems such as depression, anxiety, and stress. Guided web-based interventions can help reduce procrastination. However, guidance by professional clinicians draws upon valuable and limited societal resources, and a more efficient, scalable form of guidance is needed. Guidance by trained clinical psychology students has not yet been examined. Objective: The aim of this open trial is to examine the feasibility and acceptability of a web-based procrastination intervention for college students under the guidance of student digital coaches (e-coaches). Methods: We developed a single-arm trial of a guided web-based intervention targeting procrastination for the Dutch student population. Guidance is delivered by trained clinical psychology students asynchronously in the form of textual feedback on intervention progress, with the aim of supporting and motivating the participant. Participants are recruited at 7 Dutch universities. Primary outcomes are intervention satisfaction, usability, and adherence, which are assessed by the Client Satisfaction Scale (CSQ-8), System Usability Scale (SUS-10), and number of completed modules, respectively. The primary outcomes will be examined by calculating descriptive statistics. Secondary outcomes are e-coach satisfaction and changes to procrastination, depression, stress, and quality of life from pre- to posttest and follow-up. Results: The project was funded in 2019, and recruitment began in January 2021. As of May 2023, a total of 985 participants were enrolled, of which 372 had completed the posttest and 192 had completed the follow-up. The expected date of analysis and publication of the results is 2024. Conclusions: The results are expected to contribute to the body of literature regarding eHealth in 3 ways. First, we will examine whether students who procrastinate adhere to and are satisfied with an eHealth intervention targeting this problem. Second, we will explore whether an intervention targeting procrastination can also decrease depression and stress. Lastly, we will investigate whether trained psychology students can effectively guide their peers in web-based interventions. Given the shortage of licensed psychologists, exploring alternative sources of guidance is much needed in order to provide students with the mental health support they need.

Background Smartphone applications and wearable devices are promising mobile health interventions for hypertension self‐management. However, most mobile health interventions fail to use contextual data, potentially diminishing their impact. The myBPmyLife Study is a just‐in‐time adaptive intervention designed to promote personalized self‐management for patients with hypertension. Methods and Results The study is a 6‐month prospective, randomized‐controlled, remotely administered trial. Participants were recruited from the University of Michigan Health in Ann Arbor, Michigan or the Hamilton Community Health Network, a federally qualified health center network in Flint, Michigan. Participants were randomized to a mobile application with a just‐in‐time adaptive intervention promoting physical activity and lower‐sodium food choices as well as weekly goal setting or usual care. The mobile study application encourages goal attainment through a central visualization displaying participants' progress toward their goals for physical activity and lower‐sodium food choices. Participants in both groups are followed for up for 6 months with a primary end point of change in systolic blood pressure. Exploratory analyses will examine the impact of notifications on step count and self‐reported lower‐sodium food choices. The study launched on December 9, 2021, with 484 participants enrolled as of March 31, 2023. Enrollment of participants was completed on July 3, 2023. After 6 months of follow‐up, it is expected that results will be available in the spring of 2024. Conclusions The myBPmyLife study is an innovative mobile health trial designed to evaluate the effects of a just‐in‐time adaptive intervention focused on improving physical activity and dietary sodium intake on blood pressure in diverse patients with hypertension. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT05154929.

Aim To develop a working definition of the concept of “clinical credibility” in nursing science. Background In both academic and clinical settings, the phrase “clinical credibility” is used when discussing the education of health professionals. No clear definition for the concept is evident in the academic literature. To date, there has not been a study undertaken to develop a working definition of clinical credibility in nursing science. Methods This protocol is stage 1 of a registered report. We will use concept mapping to compare and organise views of three stakeholder groups: nursing students (n = 20) from years 2 or 3 of a three-year Bachelor of Nursing Programme, nurses and other health professionals (n = 20) still practising within a clinical setting, and people who have recently been inpatients in hospital (n = 20). First, participants will take part in separate stakeholder focus groups to generate statements about “What is clinical credibility?”. Second, the same participants will complete two tasks: (1) rank the importance of each statement (prioritising) and (2) put the statements that appear to go together into groups (clustering). The data will then be analysed using a specialised software program called Ariadne. A visual “concept map” will be produced showing the importance and relationship of each statement as viewed by the participants. The projected timeline for the study is one year. The paper complies with the SPIRIT 2013 guidelines for study protocols adapted for mixed methods research. Conclusion The findings of this study will provide a working definition of the concept of “clinical credibility” in nursing science. Relevance to clinical practice The findings can be used to develop a measure of clinical credibility to predict student satisfaction and patient safety outcomes.

Background: The use of naloxone, an opioid antagonist, is a critical component of the US response to fatal opioid-involved overdoses. The importance and utility of naloxone in preventing fatal overdoses have been widely declaimed by medical associations and government officials and are supported by strong research evidence. Still, there are gaps in the current US national strategy because many opioid-involved overdose fatalities have no evidence of naloxone administration. Improving the likelihood that naloxone will be used to prevent fatal overdoses is predicated on facilitating an environment wherein naloxone is available near each overdose and can be accessed by someone who is willing and able to use it. How to accomplish this on a national scale has been unclear. However, there exists a national network of >1 million cardiopulmonary resuscitation (CPR) layperson responders and 4800 emergency responder agencies linked through a mobile phone app called PulsePoint Respond. PulsePoint responders certify that they are trained to administer CPR and are willing to respond to possible cardiac events in public. When such an event occurs near their mobile phone’s location, they receive an alert to respond. These motivated citizens are ideally positioned to carry naloxone and reverse overdoses that occur in public. Objective: This randomized controlled trial will examine the feasibility of recruiting first responder agencies and layperson CPR responders who already use PulsePoint to obtain overdose education and carry naloxone. Methods: This will be a 3-arm parallel-group randomized controlled trial. We will randomly select 180 first responder agencies from the population of agencies contracting with the PulsePoint Foundation. The 3 study arms will include a standard recruitment arm, a misperception-correction recruitment arm, and a control arm (1:1:1 allocation, with random allocation stratified by zip code designation [rural or nonrural]). We will study agency recruitment and, among the agencies we successfully recruit, responder certification of receiving overdose and naloxone education, carrying naloxone, or both. Hypothesis 1 contrasts agency recruitment success between arms 1 and 2, and hypothesis 2 contrasts the ratios of layperson certification across all 3 arms. The primary analyses will be a logistic regression comparing the recruitment rates among the arms, adjusting for rural or nonrural zip code designation. Results: This study was reviewed by the Indiana University Institutional Review Board (20218 and 20219). This project was funded beginning September 14, 2023, by the National Institute on Drug Abuse. Conclusions: The hypotheses in this study will test whether a specific type of messaging is particularly effective in recruiting agencies and layperson responders. Although we hypothesize that arm 2 will outperform the other arms, our intention is to use the best-performing approach in the next phase of this study if any of our approaches demonstrates feasibility. Trial Registration: OSF Registries osf.io/egn3z; https://osf.io/egn3z

Considerable evidence attests to a relationship between executive function and falls. Notable among cognitive elements related to fall risk is the ability to suppress a highly automatic but unwanted action—that is, response inhibition. Although the ability to stop may seem like an unlikely foundation for maintaining balance, there are many situations in daily life where the ability to adapt planned action is critical to reducing instability. Most of what we know about the role of inhibition in balance control is based on correlations between cognitive test performance and self-reported falls, leaving a sizable gap in understanding mechanisms linking inhibition and balance control. Here, we expand from traditional balance assessments that accentuate reflexive action and instead impose a need to suppress a prepotent balance recovery step. We leveraged techniques developed in cognitive neuroscience to expose neuromuscular events leading to successful inhibition. Specifically, we used high-density electroencephalography to measure neural markers previously shown to predict successful inhibition in seated voluntary reaction tasks using hand responses (ß-bursts) and applied this to a balance recovery step task. Contrary to our hypothesis, higher ß-burst volume after a stop cue was associated with failed step suppression. Other ß oscillation characteristics revealed slightly earlier ß-burst onsets in successful suppression trials and higher average ß power prior to the stop signal for successful versus failed stop trials. The current study offers insight into potential key markers underlying suppression of a recovery step, and we highlight unique challenges associated with studying cognitive processes during rapid, whole-body balance recovery.

The N2pc is widely employed as an electrophysiological marker of an attention allocation. This interpretation was largely driven by the observation of an N2pc elicited by an isolated relevant target object, which was reported as Experiment 2 in Eimer (1996). All subsequent refined interpretations of the N2pc had to take this crucial finding into account. Despite its central role for neurocognitive attention research, there have been no direct replications and only few conceptual replications of this seminal work. Within the context of #EEGManyLabs, an international community-driven effort to replicate the most influential EEG studies ever published, the present study was selected due to its strong impact on the study of selective attention. We revisit the idea of the N2pc being an indicator of attentional selectivity by delivering a high powered direct replication of Eimer's work through analysis of 779 datasets acquired from 22 labs across 14 countries. Our results robustly replicate the N2pc to form stimuli, but a direct replication of the more influential N2pc to color stimuli technically failed. We believe that this pattern not only sheds further light on the functional significance of the N2pc as an electrophysiological marker of attentional selectivity, but also highlights a methodological problem with selecting analysis windows a priori. By contrast, the consistency of observed ERP patterns across labs and analysis pipelines is stunning and this consistency is preserved even in datasets that were rejected for (ocular) artifacts, attesting the robustness of the ERP technique and the feasibility of large-scale EEG replication studies.

Background: Integrating algorithm-based clinical decision support (CDS) systems poses significant challenges in evaluating their actual clinical value. Such CDS systems are traditionally assessed via controlled but resource-intensive clinical trials. Objective: This paper presents a review protocol for preimplementation in silico evaluation methods to enable broadened impact analysis under simulated environments before clinical trials. Methods: We propose a scoping review protocol that follows an enhanced Arksey and O’Malley framework and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to investigate the scope and research gaps in the in silico evaluation of algorithm-based CDS models—specifically CDS decision-making end points and objectives, evaluation metrics used, and simulation paradigms used to assess potential impacts. The databases searched are PubMed, Embase, CINAHL, PsycINFO, Cochrane, IEEEXplore, Web of Science, and arXiv. A 2-stage screening process identified pertinent articles. The information extracted from articles was iteratively refined. The review will use thematic, trend, and descriptive analyses to meet scoping aims. Results: We conducted an automated search of the databases above in May 2023, with most title and abstract screenings completed by November 2023 and full-text screening extended from December 2023 to May 2024. Concurrent charting and full-text analysis were carried out, with the final analysis and manuscript preparation set for completion in July 2024. Publication of the review results is targeted from July 2024 to February 2025. As of April 2024, a total of 21 articles have been selected following a 2-stage screening process; these will proceed to data extraction and analysis. Conclusions: We refined our data extraction strategy through a collaborative, multidisciplinary approach, planning to analyze results using thematic analyses to identify approaches to in silico evaluation. Anticipated findings aim to contribute to developing a unified in silico evaluation framework adaptable to various clinical workflows, detailing clinical decision-making characteristics, impact measures, and reusability of methods. The study’s findings will be published and presented in forums combining artificial intelligence and machine learning, clinical decision-making, and health technology impact analysis. Ultimately, we aim to bridge the development-deployment gap through in silico evaluation-based potential impact assessments.

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In laboratory faking research, participants are often instructed to respond honestly (generic instructions [GIs], control condition) or to fake (personnel-selection scenario [PSS], faking condition). Considering the research on instruction-level contextualization, a PSS might not only motivate participants to fake but might also promote the adoption of a work frame of reference (FOR). Thus, differences in responses between faking and control conditions could partly result from FOR effects. (Full) item-level contextualization can also be used to promote the adoption of a work FOR, and the adoption through this route is stronger than through instruction manipulation. We combined the two approaches to disentangle FOR and faking, conducted a 4-wave longitudinal study with a 2 (instructions: GIs vs. PSS) x 2 (full item-level work contextualization absent vs. present) repeated-measures design (N = 309), and compared the effects of these conditions on three HEXACO-PI-R scales (Conscientiousness, Emotionality, Honesty-Humility). Irrespective of the investigated personality trait, the ANOVAs revealed significant main effects. As expected, compared with GIs, the PSS increased the adoption of a work FOR, and the effects were smaller than the effects of full item-level work contextualization present (vs. absent). Also, as expected, the PSS (vs. GIs) and full item-level work contextualization present (vs. absent) changed participants’ scale mean scores. However, importantly, there were no interaction effects. Exploratory mediation analyses indicated direct rather than indirect (mediator: adoption of a work FOR) effects of instructions on participants’ scale mean scores. In conclusion, the internal validity of faking research is not threatened by confounding FOR effects.