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Educational escape rooms (ER) are an instructional activity designed to incorporate many elements of recreational ERs, which have become popular in recent years. There are many reasons to consider incorporating educational ERs into K-12 math instruction or after-school programs/camps. First, they are highly motivating for students because they engage them in game-like elements, including solving puzzles (Stohlmann, 2020). Second, education ERs foster teamwork and communication and encourage productive struggle (Borrego et al., 2017; Fotaris & Mastoras, 2019). Third, educational ERs can help students explore mathematical concepts in a fun way; however, it is important to ensure that ER puzzles are aligned with relevant learning goals and content standards (National Council of Teachers of Mathematics, 2014). Based on the literature, the main obstacles to incorporating ERs into instruction seem to be that teachers view educational ERs as too complicated, costly, and time-consuming to develop. Thus, the purpose of this article is to provide a step-by-step process teachers can follow to efficiently design high-quality educational ERs without breaking the bank. The authors use their elementary-level Treasure Hunt example to illustrate our ER design process, but this process can be applied across all grades and involve a variety of context.

Asexuality is a sexual orientation in which someone may experience little, situational, or nosexual attraction. From its complicated existence in queer spaces to its complete invisibility insociety and media representation, why does it continue to lack an understanding even as queertopics continue to enter the mainstream conversation? How is this orientation, seeminglystraightforward, shrouded in confusion, mystification, and false stereotypes? As an asexual andaromantic woman, I believe that the cultural obsession with glamorizing sex and romance andportraying it as essential to a fulfilling life plays a part in confusing the general public on howone could live without the desire to participate fully or at all with these cultural norms andexpectations. To better represent these points and how they affect the lives of asexual people ofvarying intersecting identities, I intend to use an ethnographic approach in this study to betterunderstand these shared experiences and the diversity of the asexual subjectivity. My researchengages with an individual method, including descriptive survey, interview, interaction, andobservation, especially participant observation. My aim in this research is to establish a dialogueon asexuality for a better understanding of an orientation underdeveloped in theory. I identifythis as an opportunity to examine and better understand the spectrum of sexuality. In general, Iintend to interrogate the ways the mainstream norm of sexuality itself still seeps into media andqueer spaces and how to further encourage new forms of asexual inclusivity and acceptance invarious areas of society.

Understanding how residents feel about neighborhood changes due to new development along transit corridors (often referred to as transit-oriented development) remains understudied despite growing concerns over displacement and gentrification. Studies that examined these concerns are largely based on analyzing land use, housing values, and socio-economic shifts (i.e., who is moving in and out of neighborhoods), and do not provide conclusive evidence that transit-oriented development (TOD) is linked to neighborhood gentrification and displacement. Prior surveys of residents living near transit indicate a generally positive assessment of TOD in terms of improved walkability and accessibility but also express concerns over pedestrian safety and parking related to increased traffic and new commercial development. However, recent studies counter this relatively positive assessment of TOD, particularly among activists and community organizers in low-income communities of color.

PurposeTo develop a patient-reported outcome measure to assess the impact of glaucoma and treatment, including minimally invasive glaucoma surgery (MIGS).DesignObservational study before and after concomitant cataract and Food and Drug Administration-approved implantable MIGS device surgery.SettingSurvey administration was on a computer, iPad, or similar device.Patient population184 adults completed the baseline survey, 124 a survey 3 months after surgery, and 106 the 1-month test-retest reliability survey. The age range was 37 to 89 (average age = 72). Most were female (57%), non-Hispanic White (81%), and had a college degree (56%).Main outcome measuresThe Glaucoma Outcomes Survey (GOS) assesses functional limitations (27 items), vision-related symptoms (7 items), psychosocial issues (7 items), and satisfaction with microinvasive glaucoma surgery (1 item). These multiple-item scales were scored on a 0 to 100 range, with a higher score indicating worse health.ResultsInternal consistency reliability estimates ranged from 0.75 to 0.93, and 1-month test-retest intraclass correlations ranged from 0.83 to 0.92 for the GOS scales. Product-moment correlations among the scales ranged from 0.56 to 0.60. Improvement in visual acuity in the study eye from baseline to the 3-month follow-up was significantly related to improvements in GOS functional limitations (r = 0.18, P = .0485), vision-related symptoms (r = 0.19, P = .0386), and psychosocial concerns (r = 0.18, P = .0503). Responders to treatment ranged from 17% for vision-related symptoms to 48% for functional limitations.ConclusionsThis study supports using the GOS for ophthalmic procedures such as MIGS. Further evaluation of the GOS in different patient subgroups and clinical settings is needed.

This paper provides an introduction to a new tool that is designed to provide operationally useful vulnerability information to National Weather Service (NWS) Weather Forecasting Offices (WFOs). The Brief Vulnerability Overview Tool (BVOT) is a shapefile containing local known, spatially specific, and weather-hazard-related vulnerabilities in a format that is easily integrated into the existing forecasting, warning, and decision support responsibilities and tasks of NWS WFO meteorologists. The methods for gathering vulnerability data and then building a BVOT for a WFO leverage and strengthen the relationships that NWS WFOs already have with their local emergency managers (EMs) and core partners to work together to identify operationally useful, local vulnerability knowledge. The BVOT is populated with discrete, known vulnerabilities to provide NWS meteorologists spatial situational awareness of those people, places, and things of greatest concern to their core partners. Crucially, the BVOT is a subsample of all potential vulnerabilities; its primary purpose is to make meteorologists aware of those weather-hazard-specific vulnerabilities that, as we posed to them, "keep them awake at night." Here, we describe the development of the BVOT as a social science-informed operational tool; how the BVOT methods have evolved and how it can be integrated into the culture of the NWS as a tool for building and maintaining relationships with partners; and how the BVOT is designed to be used and its impact on operational decision-making as observed in NOAA's Hazardous Weather Testbed. SIGNIFICANCE STATEMENT: Operational meteorologists in the National Weather Service often rely on everyday knowledge of vulnerabilities to shape their messaging to communities threatened by hazardous weather. This study seeks to test methods that will permit meteorologists to work with local communities and emergency managers to collect knowledge about local vulnerabilities so that they can be formally shared and integrated into everyday operations. The results of this research provide an illustrative pathway demonstrating how social science-informed research can be used to improve meteorological operations. Future work should investigate how other findings from social science can be translated into real, operational impacts. KEYWORDS: Social science; Operational forecasting; Communication/ decision-making; Decision support; Vulnerability, 1. BVOT: An inductive approach to actionable vulnerability decision support The mission of the U.S. NWS is to "provide weather, water, and climate data, forecasts, warnings, and impact-based decision support [...]

Environmental DNA (eDNA) is an increasingly useful method for detecting pelagic animals in the ocean but typically requires large water volumes to sample diverse assemblages. Ship-based pelagic sampling programs that could implement eDNA methods generally have restrictive water budgets. Studies that quantify how eDNA methods perform on low water volumes in the ocean are limited, especially in deep-sea habitats with low animal biomass and poorly described species assemblages. Using 12S rRNA and COI gene primers, we quantified assemblages comprised of micronekton, coastal forage fishes, and zooplankton from low volume eDNA seawater samples (n = 436, 380-1800 mL) collected at depths of 0-2200 m in the southern California Current. We compared diversity in eDNA samples to concurrently collected pelagic trawl samples (n = 27), detecting a higher diversity of vertebrate and invertebrate groups in the eDNA samples. Differences in assemblage composition could be explained by variability in size-selectivity among methods and DNA primer suitability across taxonomic groups. The number of reads and amplicon sequences variants (ASVs) did not vary substantially among shallow (600 m), but the proportion of invertebrate ASVs that could be assigned a species-level identification decreased with sampling depth. Using hierarchical clustering, we resolved horizontal and vertical variability in marine animal assemblages from samples characterized by a relatively low diversity of ecologically important species. Low volume eDNA samples will quantify greater taxonomic diversity as reference libraries, especially for deep-dwelling invertebrate species, continue to expand.

BackgroundEating a high-quality diet or adhering to a given dietary strategy may influence weight loss. However, these 2 factors have not been examined concurrently for those following macronutrient-limiting diets.ObjectiveTo determine whether improvement in dietary quality, change in dietary macronutrient composition, or the combination of these factors is associated with differential weight loss when following a healthy low-carbohydrate (HLC) or healthy low-fat (HLF) diet.DesignGenerally healthy adults were randomly assigned to HLC or HLF diets for 12 mo (n = 609) as part of a randomized controlled weight loss study. Participants with complete 24-h dietary recall data at baseline and 12-mo were included in this secondary analysis (total N = 448; N = 224 HLC, N = 224 HLF). Participants were divided into 4 subgroups according to 12-mo change in HEI-2010 score [above median = high quality (HQ) and below median = low quality (LQ)] and 12-mo change in macronutrient intake [below median = high adherence (HA) and above median = low adherence (LA) for net carbohydrate (g) or fat (g) for HLC and HLF, respectively]. Baseline to 12-mo changes in mean BMI were compared for those in HQ/HA, HQ/LA, LQ/HA subgroups with the LQ/LA subgroup within HLC and HLF.ResultsFor HLC, changes (95 % confidence level [CI]) in mean BMI were -1.15 kg/m2 (-2.04, -0.26) for HQ/HA, -0.30 (-1.22, 0.61) for HQ/LA, and -0.80 (-1.74, 0.14) for LQ/HA compared with the LQ/LA subgroup. For HLF, changes (95% CI) in mean BMI were -1.11kg/m2 (-2.10, -0.11) for HQ/HA, -0.26 (-1.26, 0.75) for HQ/LA, and -0.66 (-1.74, 0.41) for LQ/HA compared with the LQ/LA subgroup.ConclusionWithin both HLC and HLF diet arms, 12-mo decrease in BMI was significantly greater in HQ/HA subgroups relative to LQ/LA subgroups. Neither HQ nor HA alone were significantly different than LQ/LA subgroups. Results of this analysis support the combination of dietary adherence and high-quality diets for weight loss.Clinical trial registryclinicaltrials.gov (Identifier: NCT01826591).

Abstract Symptoms of the Post-COVID-19 Condition are often non-specific making it a challenge to distinguish them from symptoms due to other medical conditions. In this study, we compare the proportion of emergency department patients who developed symptoms consistent with the World Health Organization’s Post-COVID-19 Condition clinical case definition between those who tested positive for Severe Acute Respiratory Syndrome Coronavirus-2 infection and time-matched patients who tested negative. Our results show that over one-third of emergency department patients with a proven acute infection meet Post-COVID-19 Condition criteria 3 months post-index visit. However, one in five test-negative patients who claim never having been infected also report symptoms consistent with Post-COVID-19 Condition highlighting the lack of specificity of the clinical case definition. Testing for SARS-CoV-2 during the acute phase of a suspected infection should continue until specific biomarkers of Post-COVID-19 Condition become available for diagnosis and treatment.

Current models of best practice in science education advocate for students to learn science by engaging in applied contexts that integrate the various science disciplines. Permaculture offers one such integrated context for elementary science. Although permaculture is relatively new in PK-12 education, the broader practice of school gardening has an established history of supporting student engagement in and conceptual understanding of science. However, many elementary teachers report feeling unprepared to implement garden-based lessons. This article examines preservice teacher (PST) ideas about permaculture and views toward teaching permaculture that emerged within an elementary science methods course. The course's pilot instructional intervention on permaculture included four components: background permaculture readings and videos, guided discussion, food forest design activity, and lesson plan analysis activity. We designed these components to engage preservice teachers both as current learners and future teachers of permaculture. Data was collected from pre/post-tests, the lesson analysis activity, and the PST daily endof-class reflections. After the permaculture intervention, PSTs self-reported higher levels of knowledge of permaculture topics and ways to use permaculture in their classrooms. They also effectively connected permaculture-based lesson plans to a variety of elementary learning standards. The PSTs positively viewed permaculture-based lessons as providing active, real-life learning experiences that support environmental consciousness, but viewed the cost and time required as barriers to implementing permaculture in their classrooms. Collectively, they positioned the developmental appropriateness and spatial resources required of the lessons as both advantages and disadvantages. Implications for teacher preparation and development are discussed.

This study examined the impact of a practice-based approach to in-service science teacher education, using small-group discussions about photovoltaic (PV) science to support teachers' instruction on sustainable energy transitions in response to climate change risks. Ultimately, we aimed to promote teachers' PV science comprehension as well as their ability to use small-group discussions productively in their future classrooms. In-service teachers (N = 6) participated in a five-week summer Solar Energy Engineering Research Experience for Teachers program where they read a series of scientific articles, attended presentations, and engaged in small-group Quality Talk discussions, all about solar energy as a sustainable technology for post-carbon energy futures. Using a qualitative content analysis approach, we gathered evidence associated with both the indicators of high-level comprehension evidenced within the talk as well as teachers' individual PV science knowledge before and after each discussion. We also collected data related to teachers' instructional intentions via lesson plans and their self-reported future use of classroom discussions. Numerous indicators of high-level comprehension were present within the talk and teachers evidenced growth in their PV science knowledge from pretest to posttest. Additionally, teachers not only infused their lesson plans with the PV science topics they discussed, but they also expressed intentions to teach PV science using discussions in their future classrooms. Findings suggest in-service teachers can benefit from opportunities to engage in a practice-based approach emphasizing discussions, resulting in not only enhanced PV science comprehension but also intentions to enact discussions about the learned content in their future classrooms.

Academic debate highlights the need to develop suitable teaching and training practices to accompany the implementation of universal design for learning (UDL) and inclusive higher education policies. This study addresses this need by investigating the relationship between knowledge and utilization of inclusive pedagogy, on the one hand, and the degree of implementation of UDL principles, on the other hand. While inclusive pedagogy is uniquely different from UDL, the two hold great value for one another and contribute equally to advancing inclusive education. This research is based on a quantitative analysis of original data from an international survey, comparing US and EU responses. It reveals that all the variance across gender and country of employment in UDL implementation is due to knowledge and utilization of inclusive pedagogy. Therefore, we argue that higher education institutions must invest in increasing faculty understanding and practical implementation of inclusive teaching through professional development to achieve scalable UDL implementation. This will contribute to tackling new developments in international education, such as ensuring inclusive and equitable education for an increasingly diverse student body and preparing students for engaging in social justice and positive global change, in line with United Nations Sustainable Development Goals.

ObjectiveThe aim of this study was to understand the usability and acceptability of virtual reality (VR) among a racially and ethnically diverse group of patients who experience chronic pain.Materials and methodsUsing the Technology Acceptance Model theory, we conducted semistructured interviews and direct observation of VR use with English-speaking patients who experience chronic pain treated in a public healthcare system (n = 15), using a commercially available VR technology platform. Interviews included questions about current pain management strategies, technology use, experiences and opinions with VR, and motivators for future use.ResultsBefore the study, none of the 15 participants had heard about or used VR for pain management. Common motivators for VR use included a previous history of substance use and having exhausted many other options to manage their pain and curiosity. Most participants had a positive experience with VR and 47% found that the VR modules distracted them from their pain. When attempting the navigation-based usability tasks, most participants (73%-92%) were able to complete them independently.DiscussionVR is a usable tool for diverse patients with chronic pain. Our findings suggest that the usability of VR is not a barrier and perhaps a focus on improving the accessibility of VR in safety-net settings is needed to reduce disparities in health technology use.ConclusionsThe usability and acceptability of VR are rarely studied in diverse patient populations. We found that participants had a positive experience using VR, showed interest in future use, and would recommend VR to family and friends.

This study aimed to investigate the effectiveness of implementing the Sport Education Model on college students' well-being and motivation in physical education (PE) during the COVID-19 pandemic. Healthy college students (49.8% female; 50.2% male; N = 255; Mage = 18.87 [+ or -] 0.92 years) were recruited from two waves of data collection. The experimental group (n = 130) was enrolled in courses that implemented the Sport Education model. Comparisons were made to the control group (n = 125), which was enrolled in courses with direct instruction. Both groups engaged in a 15-week face-to-face intervention. Student motivation, goal orientation, perceived climate, self-efficacy in exercise, perceived stress, and psychological distress were measured through an omnibus electronic questionnaire at pre- and posttest. A series of 2 (group) x 2 (time) mixed factorial multivariate analyses of variance and analyses of variance with follow-up post hoc analysis demonstrated small-to-moderate effects for the intervention. Intrinsic motivation (interest enjoyment and effort importance), task orientation, and task-involving climate significantly increased from pre- to posttest in the Sport Education group. Mental wellness improved, and psychological distress symptoms and perceived stress decreased significantly from pre- to posttest for both groups. The findings demonstrate the effectiveness of implementing Sport Education in creating a student-centered, task-involving climate and cultivating college students' motivation in PE. Engaging in face-to-face PE sessions is likely to improve college students' well-being in COVID-19 era., Accumulating evidence shows that students transitioning into higher education are at risk due to significant declines in physical activity (PA) participation (Centers for Disease Control and Prevention, 2016) and motivation [...]

Abstract Uveitis is characterised by breakdown of the blood-retinal barrier (BRB), allowing infiltration of immune cells that mediate intraocular inflammation, which can lead to irreversible damage of the neuroretina and the loss of sight. Treatment of uveitis relies heavily on corticosteroids and systemic immunosuppression due to limited understanding of disease pathogenesis. We performed single-cell RNA-sequencing of retinas, as well as bulk RNA-sequencing of retinal pigment epithelial (RPE) cells from mice with experimental autoimmune uveitis (EAU) versus healthy control. This revealed that the Th1/Th17-driven disease induced strong gene expression changes in response to inflammation in rods, cones, Müller glia and RPE. In particular, Müller glia and RPE cells were found to upregulate expression of chemokines, complement factors, leukocyte adhesion molecules and MHC class II, thus highlighting their contributions to immune cell recruitment and antigen presentation at the inner and outer BRB, respectively. Additionally, ligand-receptor interaction analysis with CellPhoneDB revealed key interactions between Müller glia and T cell / natural killer cell subsets via chemokines, galectin-9 to P4HB/TIM-3, PD-L1 to PD-1, and nectin-2/3 to TIGIT signalling axes. Our findings elucidate mechanisms contributing to breakdown of retinal immune privilege during uveitis and identify novel targets for therapeutic interventions.

Abstract Hard ticks (Acari: Ixodidae) have been historically identified by morphological methods which require highly specialized expertise and more recently by DNA-based molecular assays that involve high costs. Although both approaches provide complementary data for tick identification, each method has limitations which restrict their use on large-scale settings such as regional or national tick surveillance programs. To overcome those obstacles, the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been introduced as a cost-efficient method for the identification of various organisms, as it balances performance, speed, and high data output. Here we describe the use of this technology to validate the distinction of two closely related Dermacentor tick species based on the development of the first nationwide MALDI-TOF MS reference database described to date. The dataset obtained from this protein-based approach confirms that tick specimens collected from United States regions west of the Rocky Mountains and identified previously as Dermacentor variabilis are the recently described species, Dermacentor similis. Therefore, we propose that this integrative taxonomic tool can facilitate vector and vector-borne pathogen surveillance programs in the United States and elsewhere.

Abstract Background Food insecurity, an ongoing and accelerating problem in the U.S., is an economic and social condition involving limited or uncertain access to adequate food. Some of the highest rates of food insecurity in 2022 were found among individuals who were Hispanic/Latinx (20.8%), a population that already faces disproportionate health and socioeconomic disadvantages. There remains an urgent health-related need to identify sustainable strategies to prevent food insecurity in the Latinx population. Methods A first-generation pilot investigation was conducted using data derived from a sub-study connected to the Computerized Physical Activity Support for Seniors (COMPASS) Trial, a 12-month cluster-randomized controlled trial among older Latinx adults. The sub-study focused on two nutrition interventions that included (1) the Food Literacy and Nutrition (FLAN) curriculum, and (2) a nutrition information-only control. Research hypotheses aimed to determine whether the FLAN intervention reduced food insecurity and increased daily fruit and vegetable servings. Results On average, participants (n = 39) were 61.5 years of age (SD = 6.7), mostly female (69%), and reported Spanish as their primary language (69%). The FLAN intervention was associated with decreased odds of food insecurity at 12 months (AOR = 0.71, 95% CI = 0.54, 0.95; p = 0.03) when compared to the nutrition-information only control intervention. Although no between-group differences in daily fruit and vegetable servings were found, there was a significant correlation between changes in daily fruit and vegetable servings from baseline to six months and changes in food insecurity from baseline to 12 months (r = -0.51, p = 0.01). Conclusions The FLAN intervention, a bilingual and culturally tailored educational curriculum, yielded 12-month improvements in food security among a small sample of older Latinx adults. Evidence from this investigation highlights the potential utility of implementing the FLAN curriculum among individuals who are at an increased risk of food insecurity. Further investigation in a larger sample is merited to determine whether the 12-month decreases in food insecurity that were produced by the FLAN intervention can be replicated. Trial Registration ClinicalTrials gov Identifier: NCT02111213. Registered on 04/02/2014.

Abstract Background Pulmonary rehabilitation (PR) is accepted as standard care for individuals with COPD. We conducted an international, multi-centred randomized controlled trial (RCT) to determine if adding balance training to PR would reduce the incidence of falls in people with COPD. While there have been many trials investigating the effectiveness of PR, few have involved international collaboration. Successful execution of rehabilitation trials requires a significant investment of time, staffing, and resources. With the recent completion of the Balance Training for Fall Reduction in COPD RCT, we report on the design, implementation, and execution of our trial using project management phases. We also highlight our lessons learned for consideration in future multi-centre rehabilitation trials. Methods This was a retrospective review of the planning, preparation, timelines, and personnel training involved in the execution of this study using four of the five project management phases described by Farrell et al. in 2010: (1) initiation, (2) planning, (3) execution, and (4) monitoring and controlling. We report descriptive statistics as percentages and counts and summarize our lessons learned. Results Ten outpatient PR programs in three continents participated. Thirty-one personnel worked on the trial across all sites. Enrolment began in January 2017 and was suspended in March 2020 due to the COVID-19 pandemic. Approximately 1275 patients were screened, 455 (36%) were eligible, 258 (57%) consented, 243 (53%) participated, and 130 (61%) completed the 12-month follow-up assessment. Lessons learned through our experience included (1) ensuring awareness of funder policies and considering the impact on collaborating sites; (2) preparing for the possibility of human resource and program disruptions; (3) anticipating site dropout and having a contingency plan in place; (4) planning and monitoring process measure data before, during, and after trial initiation; (5) ensuring frequent and consistent communication with and between collaborating sites; (6) maximizing features of database platform to ensure data set completeness and controlled data access; and (7) identifying strategies for increasing patient engagement in a high-demand study. Conclusions We identify seven lessons learned through our experience conducting an international, multicentre rehabilitation-based RCT. These lessons can provide guidance to other trialists conducting studies with similar logistics and may assist with future trial planning and implementation.

Abstract Background Leveraging Alzheimer’s disease (AD) imaging biomarkers and longitudinal cognitive data may allow us to establish evidence of cognitive resilience (CR) to AD pathology in-vivo. Here, we applied latent class mixture modeling, adjusting for sex, baseline age, and neuroimaging biomarkers of amyloid, tau and neurodegeneration, to a sample of cognitively unimpaired older adults to identify longitudinal trajectories of CR. Methods We identified 200 Harvard Aging Brain Study (HABS) participants (mean age = 71.89 years, SD = 9.41 years, 59% women) who were cognitively unimpaired at baseline with 2 or more timepoints of cognitive assessment following a single amyloid-PET, tau-PET and structural MRI. We examined latent class mixture models with longitudinal cognition as the dependent variable and time from baseline, baseline age, sex, neocortical Aβ, entorhinal tau, and adjusted hippocampal volume as independent variables. We then examined group differences in CR-related factors across the identified subgroups from a favored model. Finally, we applied our favored model to a dataset from the Alzheimer’s Disease Neuroimaging Initiative (ADNI; n = 160, mean age = 73.9 years, SD = 7.6 years, 60% women). Results The favored model identified 3 latent subgroups, which we labelled as Normal (71% of HABS sample), Resilient (22.5%) and Declining (6.5%) subgroups. The Resilient subgroup exhibited higher baseline cognitive performance and a stable cognitive slope. They were differentiated from other groups by higher levels of verbal intelligence and past cognitive activity. In ADNI, this model identified a larger Normal subgroup (88.1%), a smaller Resilient subgroup (6.3%) and a Declining group (5.6%) with a lower cognitive baseline. Conclusion These findings demonstrate the value of data-driven approaches to identify longitudinal CR groups in preclinical AD. With such an approach, we identified a CR subgroup who reflected expected characteristics based on previous literature, higher levels of verbal intelligence and past cognitive activity.

Summary: Background: Intermittent preventive treatment for malaria in pregnancy (IPTp) can improve birth outcomes, but whether it confers benefits to postnatal growth is unclear. We investigated the effect of IPTp on infant growth in Uganda and its pathways of effects using causal mediation analyses. Methods: We analysed data from 633 infants born to mothers enrolled in a randomised trial of monthly IPTp with dihydroartemisinin-piperaquine (DP) vs. sulfadoxine-pyrimethamine (SP) (NCT02793622). Weight and length were measured from 0 to 12 months of age. Using generalised linear models, we estimated effects of DP vs. SP on gravidity-stratified mean length-for-age (LAZ) and weight-for-length Z-scores (WLZ). We investigated mediation by placental malaria, gestational weight change, maternal anaemia, maternal inflammation-related proteins, preterm birth, birth length, and birth weight. Mediation models adjusted for infant sex, gravidity, gestational age at enrolment, maternal age, maternal parasitaemia at enrolment, education, and wealth. Findings: SP increased mean LAZ by 0.18–0.28 Z from birth through age 4 months compared to DP, while DP increased mean WLZ by 0.11–0.28 Z from 2 to 8 months compared to SP among infants of multigravidae; at these ages, confidence intervals for mean differences excluded 0. We did not observe differences among primigravida. Mediators of SP included birth weight, birth length, maternal stem cell factor, and DNER. Mediators of DP included placental malaria and birth length, maternal IL-18, CDCP1, and CD6 at delivery. Interpretation: In high malaria transmission settings, this exploratory study suggests different IPTp regimens may influence infant growth among multigravidae, potentially through distinct pathways, in the exclusive breastfeeding period, when few other interventions are available. Funding: Stanford Center for Innovation in Global Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bill & Melinda Gates Foundation.