Abstract
Participatory research methods that involve co-design and co-creation by participants as well as researchers are becoming more common in the social sciences, but there is a general lack of guidance for researchers on how to most effectively do this. This study considers the range of methodologies and approaches for the co-creation of research that have been most commonly discussed in social science studies and, on the basis of this analysis, identifies recommendations for best practice for community-based research co-creation. The outcomes of this study should help guide future research in the social sciences in the Global South, and to enact research outcomes that are more equitable, collaborative and focused on empowering local communities.
Keywords
Introduction
In recent years there has been a shift from hierarchical, researcher-led data collection activities in the social sciences, where community members are merely passive participants or used as data sources in the research process, to a more inclusive and interactive approach where community members are seen as valued co-researchers and co-creators of research practices and outcomes (Busch et al., 2019; Van Anda et al., 2022). This paradigmatic shift is particularly important in the Global South (the developing world) where, historically, community-based research participants have been exploited by (commonly external and Western) researchers in various ways. This has included as participants in medical studies; through understanding of traditional (indigenous) knowledge systems (TKS); through obtaining ethnographic or similar ethnological data on pharmacology, linguistics, musicology or botany; or through the application of biological or genetic data derived from the community or its environment (Fournier et al., 2023; Knight et al., 2023). All of these examples reflect an asymmetry of power between researcher and participant, conflated under the concept of colonialization and in post-colonial contexts (Brear & Tsotetsi, 2022; Mata-Codesal et al., 2020).
This paradigmatic change in approach has come about for a number of reasons. (1) There has been a progressive movement towards the decolonization of knowledge in social science research (Omodan & Dastile, 2023; Seehawer, 2018), in which there is a change in focus from a neoliberal, Western and outcomes-based research narrative, to one in which TKS of local communities are acknowledged and valued (Fournier et al., 2023). (2) Many studies in the social sciences are now seeking inter- or multidisciplinarity in which certain research questions such as climate change adaptation are addressed from a number of different intersectional perspectives and using different data types and approaches (e.g. Caister et al., 2011; Cilliers et al., 2014; Hassan & Knight, 2023; Kaijser & Kronsell, 2014). This commonly means engaging with communities in different ways in order to obtain these different types of data. (3) Increased interest and capabilities in the genetics of traditional medicines (ethnomedicines and ethnobotany) are commonly investigated through culturally-sensitive methods, including ethnography, oral histories, and with respect to traditional beliefs (e.g. Alemu et al., 2024; Maliwichi-Nyirenda et al., 2011). (4) There has been an increasing use of participatory action research methods in which community-led engagement can lead to systematic change and societal benefits as research outcomes, especially in the fields of healthcare and education (Ayaya et al., 2020; Mathikithela & Wood, 2021; Omodan & Dastile, 2023). For these varied reasons, community-based co-creation and co-research are increasingly important research approaches adopted in the social sciences.
Despite these imperatives, however, there is a lack of overarching guidelines to aid social science researchers on how to engage with communities in a positive, productive and collaborative way. This may reflect the diversity of communities (globally and locally) and their internal dynamics; the varied types of projects that exist in different disciplinary fields; and the lack of skills and training that researchers have in this area. The aim of this study is to provide practical guidelines and advice for social science researchers on collaborative interactions with communities through research co-creation. This is done by (1) describing the methodological approach taken this study, including clarification of key terms; (2) discussing some specific examples of social science studies and their different modes of community engagement; and (3) drawing from such work to identify overarching guidelines for researchers across social science disciplines that may be useful in community engagement and research co-creation.
Methodological Approach Taken in This Study
This study is based on identifying key issues in research co-creation through a broad scoping review of relevant social science literature with particular reference to Africa. This follows the scoping study approach described by Arksey and O’Malley (2005) in which key gaps in the existing literature are identified through a systematic sequence of investigative steps. Thus, this is not a review study per se in which the literature is exhaustively reviewed and analyzed; instead this work takes an overview of relevant methodologies that cut across various disciplines, and draws these methodologies together. The steps involved in this study were (1) a literature search on peer-reviewed academic journal articles listed in the Scopus and Web of Science databases published up to and including 2024 and using the terms ‘co-research’ or ‘co-creation’. From these results (n = 314), only those studies dealing with specific examples or case studies of co-research or co-creation set in African communities were then selected. This yielded a dataset of 56 articles. Studies that did not include specific community-based examples or that did not describe their methodological steps were not considered. Of these final 56 articles, 17 (30%) had a theoretical focus and dealt with issues such as interpersonal relationships, group dynamics and resolving conflict. Sixteen articles (29%) were in the field of public health, four (7%) in education, and ten (18%) dealing with vulnerable communities in different contexts (agriculture, migration, urban pollution, water security). (2) From these 56 studies, the specific research methodologies employed by the researchers and the modes of engagement undertaken with community members were identified and synthesized. It is based on this analysis that the recommended practices described herein were developed. The key outcome of this analysis is a user-friendly guide on how to design and undertake better co-research projects, relevant to a range of disciplines, and leading to impactful and sustained community-based outcomes.
Understanding Knowledge as Co-created Practice
Different Terms Used in the Literature to Describe Researcher–Community Interactions, Their Meanings and Examples
Analysis of Co-creation Approaches Informed by the Literature
Different Methodological Models
A traditional three-step researcher-led methodological model of a typical social science research study is shown in Figure 1. In this model, research follows a largely linear pathway in which there are successive stages of research design, data collection, analysis and reporting that commonly do not give rise to feedback (where they mutually influence each other). In this model, the research stages are largely defined from the outset, including the aims and objectives of the study and the methodologies used to achieve them. This is because this is commonly part of formal research grant applications, graduate degree proposals, and academic research papers (Moher et al., 2020). In addition, data in such studies are extracted from community participants (community members, stakeholders, key informants) during the data collection phase only, and these participants have limited and in many cases no engagement with the researcher at any other stage. As such, these participants have a weakened, passive role in the research process compared to the role of the researcher, representing an asymmetry of power and decision-making. Model of a Researcher-led Methodology, where one Stage Leads to another as shown by the Direction of the Arrows. Dashed Lines Indicate Steps that sometimes take Place but not in all Instances
A co-creation research approach, however, has a different methodological sequence of research stages compared to a traditional research study (Figure 2). Here, it more inclusively describes the process by which research is developed and research ‘data’ created, collected and analyzed in an interactive, spontaneous and organic way by a range of actors. In this process, there is feedback and adjustment of the research activities throughout, with different research questions, issues and solutions arising and being addressed at different stages. This is achieved by talking and doing, and by different individuals engaging with each other on an equitable and iterative basis. Areljung et al. (2021) note that the engagement of community participants, and thus who has ‘ownership’ of a research activity, can vary through the research process, with different people or groups being engaged at different times. In addition, there may be unanticipated outcomes of these engagements that may take any study in a different direction to that originally planned. This poses problems for many academic research projects where aims, objectives and methodologies have to be stated at the proposal/application stage and where deviating from the agreed methodology becomes an issue (Wood, 2017). Model of a Co-creation Research Methodology, where There are Feedbacks and Engagements Between Different Parties Throughout the Research Process, Shown by the Direction of the Arrows. Items 1–8 are Discussed in the Text
Co-creation Approaches
There are relatively few studies in social science that have considered different modes of participatory research data co-creation associated with community engagement (e.g. Avila-Garzon & Bacca-Acosta, 2024; Bammer, 2019; Labib et al., 2024; Stier & Smit, 2021). For example, Caister et al. (2011) described how a shared social vision between different farmers in KwaZulu-Natal, South Africa, and between farmers and researchers, provided the basis for more meaningful and interactive co-research. Farmers noted with pride the fact that they taught student researchers about their farming practices, and this helped give them agency in the research process. Ahlberg et al. (2016) described how tree planting activities amongst school children and community members in Kenya served as a symbolic but also long-lived reminder of their engagement and interactions with researchers. The physical effort of tree planting was also identified with pride by child participants in reflecting their ownership in the research process. Cluver et al. (2021), in a study on community advisory groups in HIV research in South Africa, noted that, although the researchers initially facilitated bringing HIV-affected adolescents together, the adolescent group then spontaneously developed its own role through mentoring, support and personal development of individuals within the group. This was an emergent and unanticipated outcome of this community-based study.
An overarching theme in the literature is how co-creation of research can lead to a range of positive outcomes, such as on policy, society, the subject community, the environment, and academic discourse. Further, this is commonly framed in the context of the decolonization of knowledge, where knowledge and knowledge-creating practices are embedded into existing community structures, processes and TKS (Brear & Tsotetsi, 2022; Omodan & Dastile, 2023; Seehawer, 2018). The most common approach taken in community co-creation studies is through participatory research methods. These, by definition, involve different parties in interactive and creative activities that should in theory result in benefits for all (e.g. Anyolitho et al., 2024; Caister et al., 2011; Omodan & Dastile, 2023; Wamba, 2017). Participatory methods include activities such as storytelling; concept mapping; arts, craft or drama workshops; focus groups; anthropological and ethnographic observations; informal conversations rather than formal interviews; and the experiential embeddedness of researchers within families and communities. In more formal research contexts, especially for environmental monitoring, citizen science approaches also represent a form of participatory research (e.g. Fraisl et al., 2022). Participatory methods also allow participants to decide the extent to which they want to get involved in any study rather than this being determined from the outset by the researcher.
Establishing a Set of Principles and Sequential Steps for Research Co-creation
Engagement with local communities, especially those with higher vulnerabilities and from the Global South, has been examined from several different disciplinary perspectives (e.g. Caister et al., 2011; Horn, 2007; Paganini & Stöber, 2021; Van Anda et al., 2022; Wamba, 2017). In particular, there is a large literature in the field of community and public health, where healthcare workers/researchers are embedded within communities or are members of that community themselves (e.g. Blair et al., 2022; Grindell et al., 2022; Pearce et al., 2022; van Dijk-de Vries et al., 2020). There is also a range of guideline documents from funded projects, NGOs, professional organizations and others that can help researchers develop appropriate participatory co-creation approaches (e.g. Horner, 2016; McGlade et al., 2022). Despite this, there is an absence of specific guidance on how researchers can undertake co-creative data collection that is impactful, sustained and equitable.
Throughout, there is discussion of the ways in which researchers engage with participant communities. ‘Community’ is a somewhat contested and problematic concept. Even though is it usually the fundamental unit of inquiry in many social science research studies (Figure 1), ‘communities’ can be best considered as emergent, bottom-up, and self-identified phenomena that arise where individuals develop relationships with others on the basis of a range of shared attributes (e.g. Lindström, 2005; Palmer, 2016). They may also change over time and space. In Africa, ‘community’ is often framed in a cultural context first of all (related to kinship, cultural identity, ethnicity and language), and then to a subordinate extent as the simple population of a settlement (Palmer, 2016). This definition of community has implications for social cohesion, trust and altruism; and for xenophobia, otherness and exclusion (Fisher & Sonn, 1999; Khaile et al., 2022). For communities as a whole, this has implications for societal resilience and social capital, especially when faced with issues such as weather and climate hazards (Titz et al., 2018). For researchers, it has implications for participant selection, representativeness and social inclusion. As a result, a researcher-driven identification of their participant ‘community’, developed during study design, may be problematic (Figure 1).
Informed by the wider literature, a list of key points and recommendations for researcher engagement with participant communities are identified. These are presented in the sequential steps that are numbered as shown in Figure 2. Pre-engagement by the researcher with the study community is very important. The researcher needs to get to know the dynamics of the study community very well. This means, before any research has taken place, spending time in the community (at different times of day/year) is important. This may include engaging with formal and informal social structures; having casual but meaningful conversations with different types of people within the research community in public places (e.g. at the market, outside the school gates, at bus stops); taking part in community activities (e.g. festivals); understanding the physical context (e.g. landscape, environment, seasons, weather), social structures and dynamics of the community (e.g. community groups, neighborhoods) including community micro-politics; and understanding modes of local communication (social media groups, newspapers, radio stations) that reflect discourses of current community concerns or issues. The following step of pre-engagement, based on an initial understanding of the community, is then identifying the community members, stakeholders and key informants that are of relevance to a particular but broadly-defined area of research interest. Thus, these can be considered as a subset of the wider population. A researcher making links to these groups that are of broad relevance to a research area can then lead to other snowball referrals (note the feedback loop from stage 2 to 1 in Figure 2). This iterative process then yields a larger or more refined population subset. This step is also informed by the contextualization of the research site, the local communities and their needs, undertaken by the researcher in Step 1. A problem here, however, is where community ‘leaders’ or key informants are self-identified or dominate the community narrative. The researcher therefore needs to be aware of ‘silent’ or marginalized community groups whose voices may not otherwise be heard. This step concerns the development of a project research question, and its component aims, objectives and methodologies, through co-creation with different community parties identified in Step 2. This is the first major academic activity in the research process and therefore needs to ultimately led and conform to any specific academic or institutional requirements by the researcher. Identifying the study’s primary research question. Reaching this point in the research process requires detailed and sustained interactions between researcher and community members. Ideally this should be founded on the collective needs and aspirations of the community, established through collective dialogue, meetings and other types of activities (such as identifying priorities and trade-offs using scenarios, game theory, and willingness-to-pay approaches), and informed by the pre-engagement activities of steps 1 and 2. In this process, it is important to be aware of the nature of intra-community interactions, including dominant voices, the potential for coercion or the suppression of different viewpoints, community micro-politics, and issues important in the Global South related to education, social status, cultural background and ethnicity, and gender, that affect community dynamics or tensions. Thus, there may be a range of community viewpoints and priorities identified. It is also important to return to the wider community at this point and to establish whether the priorities identified by the population subset are broadly agreed upon (see feedback loop in Figure 2). This communication is essential in order to ensure that the community feels empowered and invested in the next research activity. An important element is that suggestions made by parties within the study community may be unrealistic or not possible given any constraints on the researcher (e.g. time, funding, interactions with government). Thus, a role at this step is for the researcher to manage community expectations or to reconcile different viewpoints, by emphasizing what Study aims and objectives established through co-design. Following 3.1 the next step, driven mainly by the researcher, is to take these community principles and aspirations and derive specific aims and objectives that meet the primary research question. This is done mainly through iterative workshopping, in which individual ideas are broken down into component parts. Workshop participants may be self-identified community members and other parties, or individuals invited by the researcher. It is important at this step to be inclusive and not just involve ‘leaders’ or strong voices. Co-designing through workshopping is best done through iterative and incremental engagement with all parties, and through presentation of idea in different formats rather than as a formal written academic ‘research proposal’. Although it is not always the case for all types of social science studies, it is helpful in project co-design if project outcomes are applied as well as theoretical, where these outcomes are proposed to have community-relevant impacts. There is also a need to balance the academic and applied contexts of any research activity, because these are in many cases linked to the requirements of any funding/grant-making body or institution (Step 4). Proposal writing is a necessary part of almost all academic research activity, for a graduate degree or grant application. The researcher is required to lead on this process as principal investigator (PI) but the extent to which community members and other parties are involved in the formal steps of proposal writing and completing application forms may vary. This may depend on the motivation, time and literacy of these parties. It should also be noted that for some grant funding sources, in particular from NGOs, charities or development agencies, community members or other parties such as local organizations may be listed co-PIs, and this is commonly favored in this case. Research proposal. Formal academic research especially for degree purposes requires a formal written research proposal, using language and formats that are difficult for non-academics to understand. Thus, although community members may not be involved in this process it is helpful if they are kept informed, and any final proposal can be presented verbally or restyled to the study community (see feedbacks in Figure 2). Furthermore, formal academic research proposals commonly require elements (e.g. a literature review) that do not easily allow for non-academic engagement, whilst other important activities such as community pre-engagement (steps 1 and 2) are not sufficiently recognized. This is a limitation on how research co-creation can be captured given the constraints of academic processes and standards (Wood, 2017). Research funding application. Commonly, research proposals and funding go together especially where the research is linked to NGOs or government support. In these instances, the proposal document for a funding organization may be very different in length and format to the requirements for an academic degree, and often requires evidence of pre-application community engagement (steps 1–3). Although funding (research grants) is a traditional and commonly used mechanism to support research activities (salaries, equipment, expenses), other types of research support should also be considered. This can include in-kind assistance, training and mentoring especially through community-based collaborative partners. This may be done by local organizations, industry/employers in the community, local government agencies or services (healthcare, education, agricultural extension). In addition, funding agencies may vary substantially, from international, national to local, governmental or NGOs, but may also include industry, community-based groups and charities. The scale and scope of these organizations and the types of research that they are concerned with may also vary, and this has implications for the timeframe of the research and the amount of money or in-kind support involved. It is therefore useful to co-design a project to fit the funding requirements rather than the other way round, and to manage community expectations in this process. Research ethics application. Before data collection can take place using human participants, relevant research ethics clearance is needed from a relevant institution. The role of community pre-engagement prior to project formulation and ethics clearance (steps 1–3) is often not clear in an ethics application, especially where observational ethnographic approaches are used. This is a limitation in how a relatively rigid and institutionalized ethics application process can apply to co-created projects. In addition, pre-testing (piloting) and receiving feedback on data collection instruments with a subsample of the desired population is also useful as an example of project co-design. The status of this activity is also often unclear in an ethics application. For projects with a co-design, co-creation approach, data collection methodologies are the most critical element. It should be noted that the aims and objectives of most studies can be achieved through a range of different data collection methods, so it is important to think widely about what these might include. The best method to use in any situation might be the one that yields the richest data, or that is quickest, cheapest or gives rise to the best outcomes for participants. There may also be trade-offs in these approaches. Co-creation methods are commonly iterative and cumulative, meaning that successive phases of different activities (and thus data collection) are needed where they build upon each other incrementally. The nature and expectations of these activities need to be communicated clearly to participants. Different participatory co-creation methods have been outlined in previous studies (e.g. Avila-Garzon & Bacca-Acosta, 2024; Bammer, 2019; Caister et al., 2011; Jones & Bice, 2021). These may involve group (e.g. workshops, focus groups, social media, storytelling) or individual activities undertaken by participants (questionnaires, journaling, diaries, interviews, photovoice, mental mapping), or activities undertaken by the researcher such as participant observations. However, the ways in which these methodological approaches are implemented will depend on the context of any study. e.g., using a participatory arts-based workshop to understand TKS will be undertaken completely differently if the aim is to understand traditional knowledge related to childbirth, compared to traditional knowledge related to climate change adaptation. It is also important that several different methods are used and that repetition of activities and participants is avoided. This is because different methods are likely to elicit different information when deployed appropriately, whereas doing similar things (e.g. questionnaires, interviews) with the same participant group will merely produce the same information and lead to data saturation. For co-creation to emerge, any data collection methods need to be structured appropriately, ensuring a balance between activities directed by the researcher and activities and outcomes that arise in an iterative, organic way where community participants are free to explore ideas in a less structured way, either as a group or individually. Support, praise and behavioral nudging may be needed from the researcher in this process. Where data collection takes place over a long period of time, participants should be reminded of what has been achieved so far and how the present activity builds from it. Data analysis from social science methods focuses mainly on thematic or content analysis, and this can be used for many different types of participatory research approaches. Triangulation between different research methods is also needed, especially for interdisciplinary research where connections are sought between different topics or data types. Data analysis, especially in co-created projects, may take place alongside data collection so that this information can be used to reframe the initial research question or to adjust the data collection methods if something did not work as anticipated. Data analysis is the role of the researcher but it is also useful to provide some selective feedback to participants to ensure that any interpretation is correct whilst also avoiding any bias in future data collection. Data reporting can take place in different ways and to a variety of different audiences. In formal studies, data reporting might be in the form of a PhD thesis or project report to funders. To community members and other stakeholders (such as government officials) multimedia and multiformat reporting is most useful, using appropriate terminology and translation into different languages. Verbal, written and pictorial communication should be used. There should also be opportunities for community members and stakeholders to comment on the findings, either positively or negatively, and to suggest any future ways forward, elements missed out, or alternative perspectives. Thus, this step can identify future research questions and priorities. A key outcome of community-based research, especially in the Global South and of concern to funders, is how the research process or specific research outcomes can be used to enact change. Influencing policy. Public policy, especially in the fields of public health, education, gender inequality, housing, environmental quality and sustainability, can be positively affected by community-based research (Grindell et al., 2022; van Dijk-de Vries et al., 2020). Furthermore, these are often the areas that are of most interest to local communities and thus are the subject of public discourse and debate. Building capacity. This includes upskilling and empowerment of local communities, including individuals who have been employed or trained as part of the research activities, such as training in computer skills, as enumerators or field workers. Practical skills or training of residents and householders can also take place in particular in public healthcare, food and water security, urban agriculture, environmental remediation, socioeconomic activity (e.g. entrepreneurship), and environmental stewardship. This can also be used positively to address gender and educational inequality. Enacting change. Researchers should consider the possibility of projects and community engagement continuing longer than the 3–5 years of a typical funded project. Maintaining community relationships is important for the continuity of any project and for building capacity by mentoring, recruiting and training research assistants from the community.
These recommendations highlight the advantages and challenges associated with co-designed and co-created community-based projects. They emphasize the importance of communication, openness and accountability at all steps, in building community trust. The general principles described here also conform to established international guidelines on research integrity, including the Hong Kong Principles (Moher et al., 2020), the FAIR principles on data management and stewardship (Wilkinson et al., 2016), the Montreal Statement on Research Integrity in Cross-Boundary Research Collaborations (2013) (see https://www.wcrif.org/guidance/montreal-statement), and the Cape Town Statement (Horn et al., 2023).
Discussion: Moving Forward in Co-creation Practices
The increasing interest in participatory research methods means that co-design and co-creation in research are becoming more common (Avila-Garzon & Bacca-Acosta, 2024; Mata-Codesal et al., 2020). However, whilst it is generally recognized that research, knowledge-creation and application of knowledge should be grounded in the communities from which the research is originally derived (Anyolitho et al., 2024; van Dijk-de Vries et al., 2020), there is no clear set of guidelines on how this can or should be done. This work makes specific recommendations and advice on how to do this.
Interaction with different community members and stakeholders requires researchers to be aware of and respond to internal community dynamics and micro-politics that are sometimes difficult to fathom. Negotiating with traditional tribal or cultural leaders, common in many African communities, may be difficult, and other local leaders may be self-identified or represent certain viewpoints or community members and not others. Local organizations or groups may be informal and have oral or historic ways of operating that may be difficult to navigate. Community relationships also develop over time and so it is useful at the outset to identify a framework for dialogue and communication that is mutually agreed upon by researcher and community members/parties alike. This may include agreeing the mode (face to face, online, open meetings, committee/representatives) and frequency of communication, and establishing which elements may be more formal (minuted, actioned) or informal (town-hall, social). Sometimes community research activities break down if there is a lapse in communication or a lack of trust between parties, whereas agreement of the principles of communication can help establish and manage expectations on all sides. This can also have the effect of reducing any perceived power imbalance and may reduce participant vulnerability in a project (Horn, 2007).
Although co-creation has many advantages, it is not suitable for all types of social science topics, or for all communities or situations. The nature or style of community engagement will vary depending on the research context and study aims which can be highly variable (Barugahare & Kass, 2022). The time-frame of a Masters or PhD study may not always allow for deep and sustained community engagement, and there are both ethical and methodological issues associated with either researchers recruiting participants from their own communities, or ‘helicopter’ research where researchers from outside of the community come in, collect data, and then disappear (McIntosh et al., 2023). In some social science projects the ‘data’ or ‘results’ may be more difficult to define, may be represented in different ways or contexts, and may not always fit with a traditional metrics-based evaluation of research outputs. This is a current area of contention throughout the social sciences and humanities (Tomaselli, 2019). Achieving such a transformative change in research practices may require researchers, institutions and funding agencies to reconsider what the process of ‘research’ may include in different contexts, and to focus more on different spheres of engagements between people, rather than outcomes, in measuring the success of any project.
Conclusions and Future Research Directions
Developing appropriate project co-design and co-creation research strategies requires balancing academic research outcomes with the needs and aspirations of participants’ communities. Done well, co-creation can lead to sustained and transformative change amongst study communities, but done poorly communities can become alienated and resentful towards researchers. This study, in discussing the major issues and recommendations for participatory co-design and co-creation, can be used as a practical guide for researchers in more effective project design and management. This emphasizes the importance of communication and providing a framework within which organic, iterative project development can take place.
However, these participatory methods also require researchers and others (such as funders or universities) to seek flexible and creative means to partake in and to evaluate the success or outcomes of community engagement and co-creation and deal with research ethics (Barugahare & Kass, 2022). Decolonizing research activities and promoting practical research outcomes such as sustainable development in local communities need to have greater recognition in funding criteria. It also suggests there needs to be a rethink of the ways in which research ‘projects’ and ‘outcomes’ are defined or evaluated, and that existing academic bureaucratic processes may not be currently adequate to capture these nuances.
Footnotes
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.