Despite much of the literature perceiving fish schooling as an organized system with a focus on fixed formations for theoretical analyses, experimental observations suggest that frequent positional rearrangement commonly occurs. Previous studies have also demonstrated that fish schools reduce locomotor costs relative to individuals swimming alone. This introduces an intriguing dichotomy. How can individual fish within schools exhibit dynamic interactions while also saving energy? We hypothesize that schooling dynamics are the result of positional and kinematic modulation of individuals responding to fluid dynamic stimuli from the movement of neighboring individuals. We propose a two-tier approach to studying kinematic modulation within fish schools. First, quantification of the variation of individual movement in a school relative to that of a solitary individual uses an analytical pipeline combining artificial-intelligence-enabled tracking and video processing. Second, the isolated study of inter-individual hydrodynamic interactions uses a mechanical flapping mechanism coupled with an enclosure to control fish position. We discovered that fish in schools exhibit higher levels of positional and kinematic modulation than individuals swimming alone. Fish swimming in enclosures can robustly respond to fluid stimuli from either a simple robotic fish or other fish located in proximity. This two-tier approach allows high-resolution analysis of positional and kinematic modulation within fish schools and their impacts on energy conservation resulting from collective movement.

Animals and robots encounter mud at the water-land interface. Like sand, mud can stay solid or flow like a fluid. Unlike sand, the yield strength of mud at which solid-fluid transitions occur depends on not only the amount of solid relative to fluid (water in mud, air in dry sand), but also how much coarse grains and fine clay are within the solid. Despite understanding of locomotion on/within dry sand dominated by coarse grains with repulsive normal forces and friction, little is known for mud dominated by fine clay with strong cohesion. Here, we developed methods to prepare uniform mud of controlled, variable yield strength and characterize and track its drift from water evaporation. Compared to other flowable substrates, mud strength measured by upward force during penetration is weaker and can vary more, and mud sticks more during extraction to pull downward, making it more challenging for locomotion.

SIGNIFICANCE Results of this study provide preliminary data on parent strategies for improving compliance with eyeglass treatment in young children, an age group for which previous data are limited. Parent responses provide important insights to support parents of young children who wear eyeglasses and provide preliminary data to guide additional research. PURPOSE The goal of this exploratory study was to learn more about parents' strategies to improve compliance with eyeglass treatment of young children. METHODS An online survey of parents of 1-year-old to less than 5-year-old children who wear eyeglasses was conducted. Parents indicated whether they used various strategies to encourage wear and were asked to provide advice for parents of young children recently prescribed eyeglasses. Use of various strategies by age was determined. Open-ended responses regarding advice for other parents were analyzed using qualitative content analysis. RESULTS The final sample included 104 parents who were predominantly White (81%), non-Hispanic (76%), and college graduates (68%). During the 2 weeks prior to survey completion, 74% of parents reported their child wore their eyeglasses ≥8 hours/day. Use of strategies for improving eyeglass wear varied by child age. The most frequent recommendations that parents provided for other parents were to be consistent in encouraging wear, use social modeling, provide positive reinforcement when the eyeglasses are worn, and ensure that the eyeglasses fit well and were comfortable. CONCLUSIONS Parents provided many useful insights into their experiences. However, results may not be broadly generalizable, because of the limited diversity and high rate of compliance in the study sample. Further research with more diverse populations and research on effectiveness of various strategies to increase compliance in this age group are recommended to support eyeglass treatment compliance in young children.

On-demand work platforms are attractive alternatives to traditional employment arrangements. However, several questions around employment classification, compensation, data privacy, and equitable outcomes remain open. The abilities of algorithmic management to structure different forms of platform-worker relationships compounds fraught regulatory debates. Understanding the conditions of algorithmic management that result in these variations could point us towards better worker futures. In this work, we studied the platform-worker relationships in Instacart work through the accounts of its workers. From a qualitative analysis of 400 Reddit posts by Instacart’s workers, we identified sources and types of ambiguity that gave rise to open-ended experiences for workers. Ambiguities supplemented gamification mechanisms to regulate worker behaviors. Yet, they also generated affective experiences for workers that enabled their playful participation in the Reddit community. We propose the frame of ludification to explain these seemingly contradicting findings and conclude with implications for accountability in on-demand work platforms.

Human-AI collaboration for decision-making strives to achieve team performance that exceeds the performance of humans or AI alone. However, many factors can impact success of Human-AI teams, including a user’s domain expertise, mental models of an AI system, trust in recommendations, and more. This article reports on a study that examines users’ interactions with three simulated algorithmic models, all with equivalent accuracy rates but each tuned differently in terms of true positive and true negative rates. Our study examined user performance in a non-trivial blood vessel labeling task where participants indicated whether a given blood vessel was flowing or stalled. Users completed 140 trials across multiple stages, first without an AI and then with recommendations from an AI-Assistant. Although all users had prior experience with the task, their levels of proficiency varied widely.Our results demonstrated that while recommendations from an AI-Assistant can aid in users’ decision making, several underlying factors, including user base expertise and complementary human-AI tuning, significantly impact the overall team performance. First, users’ base performance matters, particularly in comparison to the performance level of the AI. Novice users improved, but not to the accuracy level of the AI. Highly proficient users were generally able to discern when they should follow the AI recommendation and typically maintained or improved their performance. Mid-performers, who had a similar level of accuracy to the AI, were most variable in terms of whether the AI recommendations helped or hurt their performance. Second, tuning an AI algorithm to complement users’ strengths and weaknesses also significantly impacted users’ performance. For example, users in our study were better at detecting flowing blood vessels, so when the AI was tuned to reduce false negatives (at the expense of increasing false positives), users were able to reject those recommendations more easily and improve in accuracy. Finally, users’ perception of the AI’s performance relative to their own performance had an impact on whether users’ accuracy improved when given recommendations from the AI. Overall, this work reveals important insights on the complex interplay of factors influencing Human-AI collaboration and provides recommendations on how to design and tune AI algorithms to complement users in decision-making tasks.

Dr. Ramesh is Research Associate, Center for Advancement in Managing Pain, University of Connecticut School of Nursing, Storrs, Connecticut; and Dr. Starkweather is Chamings Professor and Assistant Dean for Research Development, Department of Biobehavioral Nursing Science, University of Florida College of Nursing, PO Box 100197, Gainesville, FL 32610; E-mail: [email protected]. The authors, faculty, and staff have no relevant financial relationship with any ineligible organizations regarding this educational activity. CME Accreditation Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. Please visit https://cme.lww.com/browse/sources/125. This CME activity expires at 5 pm EST on November 30, 2025. NCPD Accreditation Lippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 2.5 contact hours for this NCPD activity. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.5 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states. Instructions for earning ANCC contact hours are included on page 11 of the newsletter. This NCPD activity expires on September 5, 2025.

Importance Easy-to-administer anti-SARS-CoV-2 treatments may be used to prevent progression from asymptomatic infection to symptomatic disease and to reduce viral carriage. Objective To evaluate the effect of combination subcutaneous casirivimab and imdevimab on progression from early asymptomatic SARS-CoV-2 infection to symptomatic COVID-19. Design, Setting, and Participants Randomized, double-blind, placebo-controlled, phase 3 trial of close household contacts of a SARS-CoV-2-infected index case at 112 sites in the US, Romania, and Moldova enrolled July 13, 2020-January 28, 2021; follow-up ended March 11, 2021. Asymptomatic individuals (aged ≥12 years) were eligible if identified within 96 hours of index case positive test collection. Results from 314 individuals positive on SARS-CoV-2 reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) testing are reported. Interventions Individuals were randomized 1:1 to receive 1 dose of subcutaneous casirivimab and imdevimab, 1200 mg (600 mg of each; n = 158), or placebo (n = 156). Main Outcomes and Measures The primary end point was the proportion of seronegative participants who developed symptomatic COVID-19 during the 28-day efficacy assessment period. The key secondary efficacy end points were the number of weeks of symptomatic SARS-CoV-2 infection and the number of weeks of high viral load (>4 log10 copies/mL). Results Among 314 randomized participants (mean age, 41.0 years; 51.6% women), 310 (99.7%) completed the efficacy assessment period; 204 were asymptomatic and seronegative at baseline and included in the primary efficacy analysis. Subcutaneous casirivimab and imdevimab, 1200 mg, significantly prevented progression to symptomatic disease (29/100 [29.0%] vs 44/104 [42.3%] with placebo; odds ratio, 0.54 [95% CI, 0.30-0.97]; P = .04; absolute risk difference, -13.3% [95% CI, -26.3% to -0.3%]). Casirivimab and imdevimab reduced the number of symptomatic weeks per 1000 participants (895.7 weeks vs 1637.4 weeks with placebo; P = .03), an approximately 5.6-day reduction in symptom duration per symptomatic participant. Treatment with casirivimab and imdevimab also reduced the number of high viral load weeks per 1000 participants (489.8 weeks vs 811.9 weeks with placebo; P = .001). The proportion of participants receiving casirivimab and imdevimab who had 1 or more treatment-emergent adverse event was 33.5% vs 48.1% for placebo, including events related (25.8% vs 39.7%) or not related (11.0% vs 16.0%) to COVID-19. Conclusions and Relevance Among asymptomatic SARS-CoV-2 RT-qPCR-positive individuals living with an infected household contact, treatment with subcutaneous casirivimab and imdevimab antibody combination vs placebo significantly reduced the incidence of symptomatic COVID-19 over 28 days. Trial Registration ClinicalTrials.gov Identifier: NCT04452318.

Despite advances in a diversity of environments, snake robots are still far behind snakes in traversing complex 3-D terrain with large obstacles. This is due to a lack of understanding of how to control 3-D body bending to push against terrain features to generate and control propulsion. Biological studies suggested that generalist snakes use contact force sensing to adjust body bending in real time to do so. However, studying this sensory-modulated force control in snakes is challenging, due to a lack of basic knowledge of how their force sensing organs work. Here, we take a robophysics approach to make progress, starting by developing a snake robot capable of 3-D body bending with contact force sensing to enable systematic locomotion experiments and force measurements. Through two development and testing iterations, we created a 12-segment robot with 36 piezo-resistive sheet sensors distributed on all segments with compliant shells with a sampling frequency of 30 Hz. The robot measured contact forces while traversing a large obstacle using vertical bending with high repeatability, achieving the goal of providing a platform for systematic experiments. Finally, we explored model-based calibration considering the viscoelastic behavior of the piezo-resistive sensor, which will for useful for future studies.

Background Open-label platform trials and a prospective meta-analysis suggest efficacy of anti-interleukin (IL)-6R therapies in hospitalized patients with coronavirus disease 2019 (COVID-19) receiving corticosteroids. This study evaluated the efficacy and safety of sarilumab, an anti-IL-6R monoclonal antibody, in the treatment of hospitalized patients with COVID-19. Methods In this adaptive, phase 2/3, randomized, double-blind, placebo-controlled trial, adults hospitalized with COVID-19 received intravenous sarilumab 400 mg or placebo. The phase 3 primary analysis population included patients with critical COVID-19 receiving mechanical ventilation (MV). The primary outcome was proportion of patients with >= 1-point improvement in clinical status from baseline to day 22. Results There were 457 and 1365 patients randomized and treated in phases 2 and 3, respectively. In phase 3, patients with critical COVID-19 receiving MV (n = 298; 28.2% on corticosteroids), the proportion with >= 1-point improvement in clinical status (alive, not receiving MV) at day 22 was 43.2% for sarilumab and 35.5% for placebo (risk difference, +7.5%; 95% confidence interval [CI], -7.4 to 21.3; P =.3261), a relative risk improvement of 21.7%. In post hoc analyses pooling phase 2 and 3 critical patients receiving MV, the hazard ratio for death for sarilumab vs placebo was 0.76 (95% CI, .51 to 1.13) overall and 0.49 (95% CI, .25 to .94) in patients receiving corticosteroids at baseline. Conclusions This study did not establish the efficacy of sarilumab in hospitalized patients with severe/critical COVID-19. Post hoc analyses were consistent with other studies that found a benefit of sarilumab in patients receiving corticosteroids. Sarilumab did not lead to significant improvements in clinical status or mortality in hospitalized patients with coronavirus disease 2019, most of whom were not receiving corticosteroids. However, there may be benefit of anti-interleukin-6R therapy in patients receiving corticosteroids.

Introduction Yoga has been shown to reduce pain and improve function in populations with chronic low back pain (cLBP), yet the underlying molecular mechanisms remain elusive. This study examined the feasibility and acceptability of a yoga research protocol, including recruitment, retention, and data collection, and investigated the preliminary effects of yoga on psychological and neurophysiological functions, including gene expression and DNA methylation profiles, in participants with cLBP. Methods A one-arm trial was conducted with 11 participants with cLBP who enrolled in a 12-week yoga intervention. Data on subjective pain characteristics, quantitative sensory testing, and blood for analysis of differentially expressed genes and CpG methylation was collected prior to the start of the intervention and at study completion. Results Based on pre-determined feasibility and acceptability criteria, the yoga intervention was found to be feasible and highly acceptable to participants. There was a reduction in pain severity, interference, and mechanical pain sensitivity post-yoga and an increase in emotion regulation and self-efficacy. No adverse reactions were reported. Differential expression analysis demonstrated that the yoga intervention induced increased expression of antisense genes, some of which serve as antisense to known pain genes. In addition, there were 33 differentially hypomethylated positions after yoga (log2 fold change ≥ 1), with enrichment of genes involved in NIK/NF-kB signaling, a major pathway that modulates immune function and inflammation. Discussion/conclusions The study supports the feasibility and acceptability of the proposed protocol to test a specific mechanism of action for yoga in individuals with cLBP. These results also support the notion that yoga may operate through our identified psychological and neurophysiologic pathways to influence reduced pain severity and interference.

Background: The efficacy of an allergen-specific IgG cocktail to treat cat allergy suggests that allergen-specific IgG may be a major protective mechanism elicited by allergen immunotherapy. Objectives: Extending these findings, we tested a Bet v 1-specific antibody cocktail in birch-allergic subjects. Methods: This was a phase 1, randomized, double-blind, study with 2 parts. Part A administered ascending doses of the Bet v 1-specific antibody cocktail REGN5713/14/15 (150-900 mg) in 32 healthy adults. Part B administered a single subcutaneous 900-mg dose or placebo in 64 birch-allergic subjects. Total nasal symptom score response to titrated birch extract nasal allergen challenge and skin prick test (SPT) with birch and alder allergen were assessed at screening and days 8, 29, 57, and 113 (SPT only); basophil activation tests (n = 26) were conducted. Results: Single-dose REGN5713/14/15 significantly reduced total nasal symptom score following birch nasal allergen challenge relative to baseline. Differences in total nasal symptom score areas under the curve (0-1 hour) for subjects treated with REGN5713/14/15 versus those given placebo (day 8: -1.17, P = .001; day 29: -1.18, P = .001; day 57: -0.85, P = .024) and titration SPT with birch difference in area under the curve of mean wheal diameters for subjects treated with REGN5713/14/15 versus placebo (all P < .001) were sustained for >= 2 months; similar results were observed with alder SPT. REGN5713/14/15 was well tolerated. Basophil responsiveness to birch-related allergens was significantly decreased in subjects treated with REGN5713/14/15 versus those given placebo on days 8, 57, and 113 (all P < .01). Conclusions: Single-dose REGN5713/14/15 was well tolerated and provided a rapid (1 week) and durable (2 months) reduction in allergic symptoms after birch allergen nasal allergen challenge, potentially offering a new paradigm for the treatment of birch allergy symptoms.

Accountability, a requisite for responsible AI, can be facilitated through transparency mechanisms such as audits and explainability. However, prior work suggests that the success of these mechanisms may be limited to Global North contexts; understanding the limitations of current interventions in varied socio-political conditions is crucial to help policymakers facilitate wider accountability. To do so, we examined the mediation of accountability in the existing interactions between vulnerable users and a 'high-risk' AI system in a Global South setting. We report on a qualitative study with 29 financially-stressed users of instant loan platforms in India. We found that users experienced intense feelings of indebtedness for the 'boon' of instant loans, and perceived huge obligations towards loan platforms. Users fulfilled obligations by accepting harsh terms and conditions, over-sharing sensitive data, and paying high fees to unknown and unverified lenders. Users demonstrated a dependence on loan platforms by persisting with such behaviors despite risks of harms such as abuse, recurring debts, discrimination, privacy harms, and self-harm to them. Instead of being enraged with loan platforms, users assumed responsibility for their negative experiences, thus releasing the high-powered loan platforms from accountability obligations. We argue that accountability is shaped by platform-user power relations, and urge caution to policymakers in adopting a purely technical approach to fostering algorithmic accountability. Instead, we call for situated interventions that enhance agency of users, enable meaningful transparency, reconfigure designer-user relations, and prompt a critical reflection in practitioners towards wider accountability. We conclude with implications for responsibly deploying AI in FinTech applications in India and beyond.