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This mixed-method quasi-experimental study examined whether metaconceptual grammar teaching impacts on (a) students’ L1 grammatical understanding, (b) their ‘blind’ use of grammatical concepts and (c) their preference of using explicit grammatical concepts over everyday concepts in explaining grammatical problems. Previous research, involving single group pre-postintervention designs, found positive effects for metaconceptual interventions on secondary school students’ grammatical reasoning ability, although a negative side effect seemed to be that some students started using grammatical concepts ‘blindly’ (i.e., in an inaccurate way). While there are thus important clues that metaconceptual grammar teaching may lead to increased grammatical understanding, there is a great need for more robust empirical research. The current study, involving 196 Dutch 14-year old pre-university students, is a methodological improvement of previous work, adopting a switching replications design. Bayesian multivariate analyses indicate medium to large effects from the metaconceptual intervention on students’ grammatical understanding. The study found a similar effect of the intervention on students’ ability to use explicit grammatical concepts over everyday concepts in tackling grammatical problems. No evidence for increased ‘blind’ concept use as a negative byproduct of the intervention was found. Additional qualitative analyses of in-intervention tasks provided further evidence for the effectiveness of metaconceptual interventions, and seemed to indicate that cases of blind concept use, rather than being a negative side effect, might actually be part of a gradual process of students’ growing understanding of grammatical (meta)concepts. We discuss these findings in relation to previous work and conclude that linguistic metaconcepts can improve L1 grammatical understanding.

Objective The relevance of communication in medical education is continuously increasing. At the Medical Faculty of Hamburg, the communication curriculum was further developed and optimized during this project. This article aims to describe the stakeholders’ perceived challenges and supporting factors in the implementation and optimization processes. Methods The initial communication curriculum and its development after a one-year optimization process were assessed with a curricular mapping. A SWOT analysis and group discussions were carried out to provide information on the need for optimization and on challenges the different stakeholders faced. Results The curricular mapping showed that the communication curriculum is comprehensive, coherent, integrated and longitudinal. In both the implementation and the project-related optimization processes, support from the dean, cooperation among all stakeholders and structural prerequisites were deemed the most critical factors for successfully integrating communication content into the curriculum. Conclusion The initiative and support of all stakeholders, including the dean, teachers and students, were crucial for the project’s success. Practice implications Although the implementation of a communication curriculum is recommended for all medical faculties, their actual implementation processes may differ. In a “top-down” and “bottom-up” approach, all stakeholders should be continuously involved in the process to ensure successful integration.

Introduction With the emergence of the COVID-19 pandemic, universities immediately responded to protect students’ lives by implementing e-learning in order to stop the spread of the communicable disease within the academic population. This study aimed to describe iranian nursing students’ experiences of e-learning during the COVID-19 pandemic. Materials and methods The current study used a qualitative descriptive study. Ten nursing undergraduate students from a single Iranian university identified using purposive sampling methods. Face-to-face semi-structured interview conducted from May to July 2021 and analyzed through thematic analysis. Lincoln and Goba criteria were used to obtain data validity and reliability. Results Four themes emerged including"novelty of e-learning","advantages of e-learning", "disadvantages of e-learning"and"passage of time and the desire to return to face education". Participants evaluated e-learning as a novel method without proper infrastructure, it was initially confusing but became the new normal as their knowledge of the way to use it improved. Advantages included self-centered flexible learning and reduction in their concerns experienced with face-to-face learning. Disadvantages including changing the way they interact with teachers, decreasing interactions with classmates, problems with education files, superficial learning, hardware problems, family members’ perceptions of the student role, interference of home affairs with e-learning, cheating on exams and assignments and being far away from the clinical context. Conclusion The findings revealed that e-learning has been introduced as a new method for the current research participants and despite the perceived benefits, these students believed that e-learning could supplement face education but not replace it.

Sport-based life skills interventions offer compelling pathways to understanding the role of physical activity and sport on youth psychosocial and other development outcomes. This is because of evidence that shows the benefits of sport programs to health and well-being of youth, and more lately other areas such as academic achievement and various life skills such as teamwork, leadership and goal setting. However, much of the research in this area of youth development is largely descriptive, with limited capacity to infer causal relationships and application across contexts. Therefore, this study examines the effects of a sport-based intervention program on life skills and entrepreneurial mindsets of youth from three African countries (n = 146, average age = 15.9 years, female = 48.6%). Half of the recruited participants were assigned to a three-week life skills intervention program and the remaining half to a sport-only control program. Both groups completed a demographic information questionnaire, Life Skills for Sport Scale and the General Enterprising Tendency v2 test. Two-way mixed ANOVAs showed significant post-intervention changes in life skills for both groups but changes in entrepreneurial mindsets for the intervention group only. This demonstrates the relevance of sport-based interventions to youth development outcomes in different contexts and the transformative potential of youth sport reported in previous studies. The findings have important implications for intentional and targeted delivery of programs to enhance specific youth development outcomes.

We conducted a scoping systematic review with respect to how consumer engagement with interactive advertising is evaluated and if interactive features influence consumer recall, awareness, or comprehension of product claims and risk disclosures for informing regulatory science. MEDLINE, PsycINFO, Business Source Corporate, and SCOPUS were searched for original research published from 1997 through February 2021. Two reviewers independently screened titles/abstracts and full-text articles for inclusion. Outcomes were abstracted into a structured abstraction form. We included 32 studies overall. The types of interactive ads evaluated included website banner and pop up ads, search engine ads, interactive TV ads, advergames, product websites, digital magazine ads, and ads on social network sites. Twenty-three studies reported objective measures of engagement using observational analyses or laboratory-based experiments. In nine studies evaluating the association between different interactivity features and outcomes, the evidence was mixed on whether more interactivity improves or worsens recall and comprehension. Studies vary with respect to populations, designs, ads evaluated, and outcomes assessed.

Introduction The world is awash with claims about the effects of health interventions. Many of these claims are untrustworthy because the bases are unreliable. Acting on unreliable claims can lead to waste of resources and poor health outcomes. Yet, most people lack the necessary skills to appraise the reliability of health claims. The Informed Health Choices (IHC) project aims to equip young people in Ugandan lower secondary schools with skills to think critically about health claims and to make good health choices by developing and evaluating digital learning resources. To ensure that we create resources that are suitable for use in Uganda’s secondary schools and can be scaled up if found effective, we conducted a context analysis. We aimed to better understand opportunities and barriers related to demand for the resources, how the learning content overlaps with existing curriculum and conditions in secondary schools for accessing and using digital resources, in order to inform resource development. Methods We used a mixed methods approach and collected both qualitative and quantitative data. We conducted document analyses, key informant interviews, focus group discussions, school visits, and a telephone survey regarding information communication and technology (ICT). We used a nominal group technique to obtain consensus on the appropriate number and length of IHC lessons that should be planned in a school term. We developed and used a framework from the objectives to code the transcripts and generated summaries of query reports in Atlas.ti version 7. Findings Critical thinking is a key competency in the lower secondary school curriculum. However, the curriculum does not explicitly make provision to teach critical thinking about health, despite a need acknowledged by curriculum developers, teachers and students. Exam oriented teaching and a lack of learning resources are additional important barriers to teaching critical thinking about health. School closures and the subsequent introduction of online learning during the COVID-19 pandemic has accelerated teachers’ use of digital equipment and learning resources for teaching. Although the government is committed to improving access to ICT in schools and teachers are open to using ICT, access to digital equipment, unreliable power and internet connections remain important hinderances to use of digital learning resources. Conclusions There is a recognized need for learning resources to teach critical thinking about health in Ugandan lower secondary schools. Digital learning resources should be designed to be usable even in schools with limited access and equipment. Teacher training on use of ICT for teaching is needed.

Background Cognitive models indicated that social anxiety disorder (SAD) would be caused and maintained by a biased attentional processing of threatening information. This study investigates whether socially anxious children may present impaired attentional engagement and disengagement from negative emotional faces, as well as their underlying event-related potential responses. Methods and findings Fifteen children with high levels of social anxiety (HSA; 9 boys; mean age = 9.99y; SD = 1.14) and twenty low socially anxious children (LSA; 16 boys; mean age = 10.47y; SD = 1.17) participated in a spatial cueing task in which they had to detect targets following neutral/disgusted faces in a valid or invalid location. No group effect was reported on reaction times [p>.05]. However, electrophysiological data showed lower P3a amplitude in HSA children compared with the LSA group when processing facial stimuli. They also reported larger N2 amplitudes for valid-disgusted targets and a larger P3a amplitude for the invalid-disgusted ones. Conclusion In terms of electrophysiological data, our results validated, the hypothesis of attentional disengagement difficulties in SAD children. We also confirm the idea that high levels of social anxiety are associated with cognitive control impairments and have a greater impact on the processing efficiency than on the performance effectiveness.

Online virtual museum tours combine museum authority and an academic approach with the diversity and interactivity of online resources; such tours have become an essential resource for online scientific research and education. Many important museums around the world are developing this type of online service. Comprehensive evaluation of such tours is, however, urgently needed to ensure effectiveness. This paper establishes a heuristic evaluation scale based on the literature. Taking the online virtual tour of the Exhibition of Architecture of the Forbidden City as a case study, confirmatory factor analysis was then carried out to improve the scale. Interviews were conducted to discuss and analyze the research results. The developed evaluation scale has four dimensions: authenticity, interaction, navigation, and learning. The results from the case study showed, first, that the exhibition had visual authenticity, but the behavioral authenticity was insufficient; second, the exhibition was generally interactive, but this aspect could be improved by enriching the links; third, the lack of effective navigation design for the exhibit was the main factor affecting experience quality. Fourth, the exhibition was informative and supported learning, but needs further improvement to the quantity and quality of information provided. Finally, the interviews revealed that the online exhibition did not entirely support people of different ages and abilities, so it needs further improvement to be wholly inclusive.

Alzheimer’s disease (AD) is the leading cause of dementia in the elderly, but therapeutic options are lacking. Despite long being able to effectively treat the ill-effects of pathology present in various rodent models of AD, translation of these strategies to the clinic has so far been disappointing. One potential contributor to this situation is the fact that the vast majority of AD patients have other dementia-contributing comorbid pathologies, the most common of which are vascular in nature. This situation is modeled relatively infrequently in basic AD research, and almost never in preclinical studies. As part of our efforts to develop small molecule, anti-inflammatory therapeutics for neurological injury and disease, we have recently been exploring potentially promising treatments in preclinical multi-morbidity contexts. In the present study, we generated a mouse model of mixed amyloid and hyperhomocysteinemia (HHcy) pathology in which to test the efficacy of one of our anti-inflammatory compounds, MW151. HHcy can cause cerebrovascular damage and is an independent risk factor for both AD dementia and vascular contributions to cognitive impairment and dementia. We found that MW151 was able to partially rescue hippocampal-dependent spatial memory and learning deficits in this comorbidity context, and further, that the benefit is associated with a normalization of hippocampal metabolites detectable via magnetic resonance spectroscopy. These findings provide evidence that MW151 in particular, and potentially anti-inflammatory treatment more generally, may be beneficial in AD patients with comorbid vascular pathology.

Visual Question Answering (VQA) is a learning task that combines computer vision with natural language processing. In VQA, it is important to understand the alignment between visual concepts and linguistic semantics. In this paper, we proposed a Pre-training Model Based on Parallel Cross-Modality Fusion Layer (P-PCFL) to learn the fine-grained relationship between vision and language. The P-PCFL model is composed of three Encoders: Object Encoder, Language Encoder, and Parallel Cross-Modality Fusion Encoder, with Transformer as the core. We use four different Pre-training missions, namely, Cross-Modality Mask Language Modeling, Cross-Modality Mask Region Modeling, Image-Text Matching, and Image-Text Q&A, to pre-train the P-PCFL model and improve its reasoning and universality, which help to learn the relationship between Intra-modality and Inter-modality. Experimental results on the platform of Visual Question Answering dataset VQA v2.0 show that the Pre-trained P-PCFL model has a good effect after fine-tuning the parameters. In addition, we also conduct ablation experiments and provide some results of Attention visualization to verify the effectiveness of P-PCFL model.

Shared medical appointments (SMAs) offer a means for providing knowledge and skills needed for chronic disease management to patients. However, SMAs require a time and attention investment from health care providers, who must understand the goals and potential benefits of SMAs from the perspective of patients and providers. To better understand how to gain provider engagement and inform future SMA implementation, qualitative inquiry of provider experience based on a knowledge-attitude-practice model was explored. Semi-structured interviews were conducted with 24 health care providers leading SMAs for heart failure at three Veterans Administration Medical Centers. Rapid matrix analysis process techniques including team-based qualitative inquiry followed by stakeholder validation was employed. The interview guide followed a knowledge-attitude-practice model with a priori domains of knowledge of SMA structure and content (understanding of how SMAs were structured), SMA attitude/beliefs (general expectations about SMA use), attitudes regarding how leading SMAs affected patients, and providers. Data regarding the patient referral process (organizational processes for referring patients to SMAs) and suggested improvements were collected to further inform the development of SMA implementation best practices. Providers from all three sites reported similar knowledge, attitude and beliefs of SMAs. In general, providers reported that the multi-disciplinary structure of SMAs was an effective strategy towards improving clinical outcomes for patients. Emergent themes regarding experiences with SMAs included improved self-efficacy gained from real-time collaboration with providers from multiple disciplines, perceived decrease in patient re-hospitalizations, and promotion of self-management skills for patients with HF. Most providers reported that the SMA-setting facilitated patient learning by providing opportunities for the sharing of experiences and knowledge. This was associated with the perception of increased comradery and support among patients. Future research is needed to test suggested improvements and to develop best practices for training additional sites to implement HF SMA.

Concept learning have been studied widely in non-human animal species within or not an ecological context. Here we tested whether cleaner fish Labroides dimidiatus, which show generalised rule learning in an ecologically relevant context; they generalise that any predator may provide protection from being chased by other fish; can also learn a general concept when presented with abstract cues. We tested for this ability in the matching-to-sample task. In this task, a sample is shown first, and then the subject needs to choose the matching sample over a simultaneously presented different one in order to obtain a food reward. We used the most general form of the task, using each stimulus only once in a total of 200 trials. As a group, the six subjects performed above chance, and four individuals eventually reached learning criteria. However, individual performance was rather unstable, yielding overall only 57% correct choices. These results add to the growing literature that ectotherms show the ability of abstract concept learning, though the lack of stable high performance may indicate quantitative performance differences to endotherms.

We devised and assessed open recruitment of host families for medical student homestays in a rural area of Hyogo Prefecture, Japan, so that program organizers would not have to depend on professional and personal connections. The duration of the homestays was one night and two days, and they were conducted in August 2016, 2017, and 2018. The purpose of this community-based medical education program was to promote interactions between medical students and residents of Tamba area. The study asked one family member from each host family to complete a questionnaire after the homestay, and their experiences were evaluated in the study. The questionnaire results were analyzed using a visual analog scale (VAS; 0–100 mm). Thirty-three host families participated in the homestay program over three years. Results showed that VAS scores were high for enjoyment of homestays (VAS; 92.4 ± 13.0), continuation of the homestay program (91.7 ± 12.7), continuation of participation in the homestay program (89.2 ± 16.2), and desire for the homestay students to work in the area in the future (95.4 ± 6.3). The recruitment of host families through advertising was an efficient method for this community-based medical education homestay program. The results indicate that it is possible to attract more host families through open recruitment, which will contribute to the sustainability of the homestay program. Further research, including a follow-up of the students who participated and whether they chose a rural area or Tamba to practice is needed in the future. Since this is an ongoing program, further research in a similar format can be conducted in the future.

There is increasing awareness of the need for pre- and post-doctoral professional development and career guidance, however many academic institutions are only beginning to build out these functional roles. As a graduate career educator, accessing vast silos and resources at a university and with industry-partners can be daunting, yet collaboration and network development are crucial to the success of any career and professional development office. To better inform and direct these efforts, forty-five stakeholders external and internal to academic institutions were identified and interviewed to gather perspectives on topics critical to career development offices. Using a stakeholder engagement visualization tool developed by the authors, strengths and weaknesses can be assessed. General themes from interviews with internal and external stakeholders are discussed to provide various stakeholder subgroup perspectives to help prepare for successful interactions. Benefits include increased engagement and opportunities to collaborate, and to build or expand graduate career development offices.

BackgroundThe education sector experienced substantial impacts during the COVID-19 pandemic resulting from worldwide restrictions.PurposeTo examine differences in the sleep patterns, sexual activity, screen use, and food intake of students and non-students during the COVID-19 pandemic.MethodsThis was a global cross-sectional study conducted in the second half of 2020 using multiple social media platforms to recruit study participants globally. A close-ended questionnaire was administered anonymously in English, French, Spanish, Portuguese, and Arabic to adults ages 18 and older. The outcome variables considered in analyses were changes in sleep pattern, sexual activity, screen use, and food intake. The explanatory variable was student status categorized as students vs. non-student. T-test, chi-square, and Mann Whitney U tests were used to assess differences between student and non-student populations. One logistic regression model was built for each outcome variable. Country of residence and country income level were included in the adjusted models.ResultsThere were 17,008 participants of which 3,793 (22.3%) were students. Of the total sample, 4,889 (28.7%) reported changes in sleep, 4,642 (31.8%) reported increases in sexual activity, 10,278 (70.7%) reported increases in screen use, and 5,662 (40.2%) reported increases in food intake during the pandemic. Compared to non-students, students had significantly higher odds of reporting changes in sleep (AOR = 1.52), increases in sexual activity (AOR = 1.79), and increases in screen use (AOR = 1.36) but lower odds of reporting increase in food intake (AOR = 0.87).ConclusionStudents displayed higher risk of experiencing changes in sleep, sexual behavior, and screen use during the COVID-19 pandemic. This has the potential to lead to broader adverse effects on students' overall wellbeing. The findings and implications raise further obligations on the education sector to put extra-curricular support systems in place that address COVID-19 related behavior changes that have the potential to adversely impact students' wellbeing.

To improve the teaching effect of western music history, the curriculum reform of history education needs to be promoted under the background of the Internet of Things (IoT). At first, a discussion is made on the characteristics of history course, which is combined with the characteristics of teaching data easy to collect under the background of IoT. An analysis is conducted on the related theory of educational data mining. Then, the concept of personalized recommendation is proposed based on deep learning (DL) algorithm. Finally, online and offline experiments are designed to verify the performance of the algorithm from review and investigation, smoothness, and participation of difficulty. The research results show that in terms of offline recommendation accuracy, the average record length in Math data set is 24.5, which is much smaller than that in range data set. The research has obvious innovation significance compared with other studies. In the process of target review and investigation, it is found that the research method here involves a wider range of knowledge and higher reliability. In terms of the difficulty of recommending questions, the Deep Reinforcement Exercise (DRE) recommendation algorithm can adaptively adjust the difficulty of recommending questions. It also allows students to set different learning goals through participation goals. But in the experiments on Math data set, Step 10’s recommendation results are not very good, and the difficulty level varies greatly. If the goal setting is high, the problem recommended to students is too difficult, students may answer these questions wrongly, forcing the algorithm to adjust the difficulty adaptively. According to the above results, DRE recommendation algorithm can adapt to different learning needs and customize the recommendation results, thus opening up a new path for the teaching of western music history. Besides, the combination of DL algorithm and western music history teaching design can recommend learning materials, which is of great significance in the teaching of history courses.

High resolution in situ hybridization (ISH) images of the brain capture spatial gene expression at cellular resolution. These spatial profiles are key to understanding brain organization at the molecular level. Previously, manual qualitative scoring and informatics pipelines have been applied to ISH images to determine expression intensity and pattern. To better capture the complex patterns of gene expression in the human cerebral cortex, we applied a machine learning approach. We propose gene re-identification as a contrastive learning task to compute representations of ISH images. We train our model on an ISH dataset of ~1,000 genes obtained from postmortem samples from 42 individuals. This model reaches a gene re-identification rate of 38.3%, a 13x improvement over random chance. We find that the learned embeddings predict expression intensity and pattern. To test generalization, we generated embeddings in a second dataset that assayed the expression of 78 genes in 53 individuals. In this set of images, 60.2% of genes are re-identified, suggesting the model is robust. Importantly, this dataset assayed expression in individuals diagnosed with schizophrenia. Gene and donor-specific embeddings from the model predict schizophrenia diagnosis at levels similar to that reached with demographic information. Mutations in the most discriminative gene, Sodium Voltage-Gated Channel Beta Subunit 4 (SCN4B), may help understand cardiovascular associations with schizophrenia and its treatment. We have publicly released our source code, embeddings, and models to spur further application to spatial transcriptomics. In summary, we propose and evaluate gene re-identification as a machine learning task to represent ISH gene expression images.

Deployment of the deep neural networks (DNNs) on resource-constrained devices is a challenging task due to their limited memory and computational power. In most cases, the pruning techniques do not prune the DNNs to full extent and redundancy still exists in these models. Considering this, a mixed filter pruning approach based on principal component analysis (PCA) and geometric median is presented. First, a pre-trained model is analyzed by using PCA to identify the important filters for every layer. These important filters are then used to reconstruct the network with a fewer number of layers and a fewer number of filters per layer. A new network with optimized structure is constructed and trained on the data. Secondly, the trained model is then analyzed using geometric median as a base. The redundant filters are identified and removed which results in further compression of the network. Finally, the pruned model is fine tuned to regain the accuracy. Experiments on CIFAR-10, CIFAR-100 and ILSVRC 2017 datasets show that the proposed mixed pruning approach is feasible and can compress the network to greater extent without any significant loss to accuracy. With VGG-16 on CIFAR-10, the number of operations and parameters are reduced to 18.56× and 3.33×, respectively, with almost 1% loss in the accuracy. The compression rate for AlexNet on CIFAR-10 dataset is 2.61× and 4.85× in terms of number of operations and number of parameters, respectively, with a gain of 1.2% in the accuracy. On CIFAR-100, VGG-19 is compressed by 16.02 X in terms of number of operations and 36× in terms of number of parameters with a 2.6% loss of accuracy. Similarly, the compression rate for VGG-19 network on ILSVRC 2017 dataset is 1.87× and 2.4× for operations and parameters with 0.5% loss in accuracy.

Aggression and trait anger have been linked to attentional biases toward angry faces and attribution of hostile intent in ambiguous social situations. Memory and emotion play a crucial role in social-cognitive models of aggression but their mechanisms of influence are not fully understood. Combining a memory task and a visual search task, this study investigated the guidance of attention allocation toward naturalistic face targets during visual search by visual working memory (WM) templates in 113 participants who self-reported having served a custodial sentence. Searches were faster when angry faces were held in working memory regardless of the emotional valence of the visual search target. Higher aggression and trait anger predicted increased working memory modulated attentional bias. These results are consistent with the Social-Information Processing model, demonstrating that internal representations bias attention allocation to threat and that the bias is linked to aggression and trait anger.

Introduction Globally, medical students have demonstrated knowledge gaps in emergency care and acute stabilization. In Colombia, new graduates provide care for vulnerable populations. The World Health Organization (WHO) Basic Emergency Care (BEC) course trains frontline providers with limited resources in the management of acute illness and injury. While this course may serve medical students as adjunct to current curriculum, its utility in this learner group has not been investigated. This study performs a baseline assessment of knowledge and confidence in emergency management taught in the BEC amongst medical students in Colombia. Methods A validated, cross-sectional survey assessing knowledge and confidence of emergency care congruent with BEC content was electronically administered to graduating medical students across Colombia. Knowledge was evaluated via 15 multiple choice questions and confidence via 13 questions using 100 mm visual analog scales. Mean knowledge and confidence scores were compared across demographics, geography and prior training using Chi-Squared or one-way ANOVA analyses. Results Data were gathered from 468 graduating medical students at 36 institutions. The mean knowledge score was 59.9% ± 23% (95% CI 57.8–62.0%); the mean confidence score was 59.6 mm ±16.7 mm (95% CI 58.1–61.2). Increasing knowledge and confidence scores were associated with prior completion of emergency management training courses (p Conclusion Knowledge and confidence levels of emergency care management for graduating medical students across Colombia demonstrated room for additional, specialized training. Higher scores were seen in groups that had completed emergency care courses. Implementation of the BEC as an adjunct to current curriculum may serve a valuable addition.

Background Adverse childhood experiences (ACEs) are linked to numerous health conditions but understudied in multiple sclerosis (MS). This study’s objective was to test for the association between ACEs and MS risk and several clinical outcomes. Methods We used a sample of adult, non-Hispanic MS cases (n = 1422) and controls (n = 1185) from Northern California. Eighteen ACEs were assessed including parent divorce, parent death, and abuse. Outcomes included MS risk, age of MS onset, Multiple Sclerosis Severity Scale score, and use of a walking aid. Logistic and linear regression estimated odds ratios (ORs) (and beta coefficients) and 95% confidence intervals (CIs) for ACEs operationalized as any/none, counts, individual events, and latent factors/patterns. Results Overall, more MS cases experienced ≥1 ACE compared to controls (54.5% and 53.8%, respectively). After adjusting for sex, birthyear, and race, this small difference was attenuated (OR = 1.01, 95% CI: 0.87, 1.18). There were no trends of increasing or decreasing odds of MS across ACE count categories. Consistent associations between individual ACEs between ages 0–10 and 11–20 years and MS risk were not detected. Factor analysis identified five latent ACE factors, but their associations with MS risk were approximately null. Age of MS onset and other clinical outcomes were not associated with ACEs after multiple testing correction. Conclusion Despite rich data and multiple approaches to operationalizing ACEs, no consistent and statistically significant effects were observed between ACEs with MS. This highlights the challenges of studying sensitive, retrospective events among adults that occurred decades before data collection.

Human observers can rapidly perceive complex real-world scenes. Grouping visual elements into meaningful units is an integral part of this process. Yet, so far, the neural underpinnings of perceptual grouping have only been studied with simple lab stimuli. We here uncover the neural mechanisms of one important perceptual grouping cue, local parallelism. Using a new, image-computable algorithm for detecting local symmetry in line drawings and photographs, we manipulated the local parallelism content of real-world scenes. We decoded scene categories from patterns of brain activity obtained via functional magnetic resonance imaging (fMRI) in 38 human observers while they viewed the manipulated scenes. Decoding was significantly more accurate for scenes containing strong local parallelism compared to weak local parallelism in the parahippocampal place area (PPA), indicating a central role of parallelism in scene perception. To investigate the origin of the parallelism signal we performed a model-based fMRI analysis of the public BOLD5000 dataset, looking for voxels whose activation time course matches that of the locally parallel content of the 4916 photographs viewed by the participants in the experiment. We found a strong relationship with average local symmetry in visual areas V1-4, PPA, and retrosplenial cortex (RSC). Notably, the parallelism-related signal peaked first in V4, suggesting V4 as the site for extracting paralleism from the visual input. We conclude that local parallelism is a perceptual grouping cue that influences neuronal activity throughout the visual hierarchy, presumably starting at V4. Parallelism plays a key role in the representation of scene categories in PPA.

Problem-based learning (PBL) allows students to learn medical statistics through problem solving experience. The aim of this study was to assess the efficiency of PBL modules implemented in the blended learning courses in medical statistics through knowledge outcomes and student satisfaction. The pilot study was designed as a randomized controlled trial that included 53 medical students who had completed all course activities. The students were randomized in two groups: the group with access to PBL modules within the blended learning course (hPBL group) and the group without access to PBL modules–only blended learning course (BL group). There were no significant differences between the groups concerning socio-demographic characteristics, previous academic success and modality of access to course materials. Students from hPBL group had a significantly higher problem solving score (p = 0.012; effect size 0.69) and the total medical statistics score (p = 0,046; effect size 0.57). Multivariate regression analysis with problem solving as an outcome variable showed that problem solving was associated with being in hPBL group (p = 0.010) and having higher grade point average (p = 0.037). Multivariate regression analysis with the medical statistics score as an outcome variable showed the association between a higher score on medical statistics with access to PBL modules (p = 0.045) and a higher grade point average (p = 0.021). All students in hPBL group (100.0%) considered PBL modules useful for learning medical statistics. PBL modules can be easily implemented in the existing courses within medical statistics using the Moodle platform, they have high applicability and can complement, but not replace other forms of teaching. These modules were shown to be efficient in learning, to be well accepted among students and to be a potential missing link between teaching and learning medical statistics. The authors of this study are planning to create PBL modules for advanced courses in medical statistics and to conduct this study on other universities with a more representative study sample, with the aim to overcome the limitations of the existing study and confirm its results.

Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists’ awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar’s tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement.

There is growing interest in the role that morphological knowledge plays in literacy acquisition, but there is no research directly comparing the efficacy of different forms of morphological instruction. Here we compare two methods of teaching English morphology in the context of a memory experiment when words were organized by affix during study (e.g., a list of words was presented that all share an affix, such as , , , , etc.) or by base during study (e.g., a list of words was presented that all share a base, such as , , , ). We show that memory for morphologically complex words is better in both conditions compared to a control condition that does not highlight the morphological composition of words, and most importantly, show that studying words in a base-centric format improves memory further still. We argue that the morphological matrix that organizes words around a common base may provide an important new tool for literacy instruction.

Due to the prolonged COVID-19 pandemic, wearing masks has become essential for social interaction, disturbing emotion recognition in daily life. In the present study, a total of 39 Korean participants (female = 20, mean age = 24.2 years) inferred seven emotions (happiness, surprise, fear, sadness, disgust, anger, surprise, and neutral) from uncovered, mask-covered, sunglasses-covered faces. The recognition rates were the lowest under mask conditions, followed by the sunglasses and uncovered conditions. In identifying emotions, different emotion types were associated with different areas of the face. Specifically, the mouth was the most critical area for happiness, surprise, sadness, disgust, and anger recognition, but fear was most recognized from the eyes. By simultaneously comparing faces with different parts covered, we were able to more accurately examine the impact of different facial areas on emotion recognition. We discuss the potential cultural differences and the ways in which individuals can cope with communication in which facial expressions are paramount.

Differences in expressing facial emotions are broadly observed in people with cognitive impairment. However, these differences have been difficult to objectively quantify and systematically evaluate among people with cognitive impairment across disease etiologies and severity. Therefore, a computer vision-based deep learning model for facial emotion recognition trained on 400.000 faces was utilized to analyze facial emotions expressed during a passive viewing memory test. In addition, this study was conducted on a large number of individuals (n = 493), including healthy controls and individuals with cognitive impairment due to diverse underlying etiologies and across different disease stages. Diagnoses included subjective cognitive impairment, Mild Cognitive Impairment (MCI) due to AD, MCI due to other etiologies, dementia due to Alzheimer’s diseases (AD), and dementia due to other etiologies (e.g., Vascular Dementia, Frontotemporal Dementia, Lewy Body Dementia, etc.). The Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive performance across all participants. A participant with a score of less than or equal to 24 was considered cognitively impaired (CI). Compared to cognitively unimpaired (CU) participants, CI participants expressed significantly less positive emotions, more negative emotions, and higher facial expressiveness during the test. In addition, classification analysis revealed that facial emotions expressed during the test allowed effective differentiation of CI from CU participants, largely independent of sex, race, age, education level, mood, and eye movements (derived from an eye-tracking-based digital biomarker for cognitive impairment). No screening methods reliably differentiated the underlying etiology of the cognitive impairment. The findings provide quantitative and comprehensive evidence that the expression of facial emotions is significantly different in people with cognitive impairment, and suggests this may be a useful tool for passive screening of cognitive impairment.

Introduction Recent reports indicate that COVID-19 pandemic has significant influence on medical professionals’ mental health. Strict limitations in clinical practice and social interactions within academic community, which had to be introduced, could lead to significant psychological distress in medical students. The aim of the study was to assess resilience, well-being and burnout among Polish medical students in the COVID-19 era. Methods The online survey consisting of validated questionnaires assessing resilience (Resilience Scale 14; RS-14), well-being (Medical Student Well-Being Index) and burnout (Maslach Burnout Inventory) as well as self-created survey concerning mental health problems, use of stimulants, SARS-CoV-2 infection, work in COVID-19 units, medical education and social attitude towards health care professionals in the pandemic era was distributed via Facebook and other online students’ platforms. 1858 MSs from all polish medical schools agreed to fill in the survey. Results ‘Very low’, ‘low’ and ‘on the low end’ levels of resilience were found in 26%, 19.1% and 26.9% of the study group, respectively. Students with higher resilience level presented better attitude towards online and hybrid classes. 16.8% of respondents stated that they worked, currently work or plan to work voluntarily at the pandemic frontline. In terms of burnout, these respondents presented lower exhaustion (p = 0.003) and cynicism (p = 0.02), and higher academic efficacy (p = 0.002). That group also showed greater resilience (p = 0.046). The SARS-CoV-2 infection among respondents, their relatives and friends did not influence the results. 39.1% of respondents declared the need of the psychological or psychiatric consultation in relation to pandemic challenges. 231 (26.4%) participants previously diagnosed with mental health disorders noticed worsening of their symptoms. Increased intake of alcohol, cigarettes or other stimulants was noticed by 340 (28.6%) respondents. 80.2% of respondents thought that social aversion and mistrust towards doctors increased during the pandemic and part of them claimed it affected their enthusiasm toward medical career. Conclusions The majority of medical students presented low levels of resilience and high burnout at the time of pandemic. Providing necessary support especially in terms of mental health and building up the resilience of this vulnerable group seems crucial to minimize harm of current pandemic and similar future challenges.

Visuospatial working memory (VSWM) is essential to human cognitive abilities and is associated with important life outcomes such as academic performance. Recently, a number of reliable measures of VSWM have been developed to help understand psychological processes and for practical use in education. We sought to extend this work using Item Response Theory (IRT) and Computerised Adaptive Testing (CAT) frameworks to construct, calibrate and validate a new adaptive, computerised, and open-source VSWM test. We aimed to overcome the limitations of previous instruments and provide researchers with a valid and freely available VSWM measurement tool. The Jack and Jill (JaJ) VSWM task was constructed using explanatory item response modelling of data from a sample of the general adult population (Study 1,N= 244) in the UK and US. Subsequently, a static version of the task was tested for validity and reliability using a sample of adults from the UK and Australia (Study 2,N= 148) and a sample of Russian adolescents (Study 3,N= 263). Finally, the adaptive version of the JaJ task was implemented on the basis of the underlying IRT model and evaluated with another sample of Russian adolescents (Study 4,N= 239). JaJ showed sufficient internal consistency and concurrent validity as indicated by significant and substantial correlations with established measures of working memory, spatial ability, non-verbal intelligence, and academic achievement. The findings suggest that JaJ is an efficient and reliable measure of VSWM from adolescent to adult age.

Objectives This study intends to build and compare two kinds of forecasting models at different time scales for hemorrhagic fever incidence in China. Methods Autoregressive Integrated Moving Average (ARIMA) and Long Short-Term Memory Neural Network (LSTM) were adopted to fit monthly, weekly and daily incidence of hemorrhagic fever in China from 2013 to 2018. The two models, combined and uncombined with rolling forecasts, were used to predict the incidence in 2019 to examine their stability and applicability. Results ARIMA (2, 1, 1) (0, 1, 1)12, ARIMA (1, 1, 3) (1, 1, 1)52 and ARIMA (5, 0, 1) were selected as the best fitting ARIMA model for monthly, weekly and daily incidence series, respectively. The LSTM model with 64 neurons and Stochastic Gradient Descent (SGDM) for monthly incidence, 8 neurons and Adaptive Moment Estimation (Adam) for weekly incidence, and 64 neurons and Root Mean Square Prop (RMSprop) for daily incidence were selected as the best fitting LSTM models. The values of root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) of the models combined with rolling forecasts in 2019 were lower than those of the direct forecasting models for both ARIMA and LSTM. It was shown from the forecasting performance in 2019 that ARIMA was better than LSTM for monthly and weekly forecasting while the LSTM was better than ARIMA for daily forecasting in rolling forecasting models. Conclusions Both ARIMA and LSTM could be used to build a prediction model for the incidence of hemorrhagic fever. Different models might be more suitable for the incidence prediction at different time scales. The findings can provide a good reference for future selection of prediction models and establishments of early warning systems for hemorrhagic fever.

Introduction During the last century, the inclusion of all kinds of diversity became a social imperative in all social spaces but above all in some institutions such as the educational ones. Among these, inclusion has been least studied in the tertiary education organizations. This communication proposes and evaluates the psychometric properties of a new instrument, named Inclusive Management in Tertiary Institutions Scale (IMTIS), to assess inclusive management in universities. Method The researchers used a quantitative research model through survey. We based on the Index for Inclusion to design the IMTIS. We first submitted it to the assessment of experts. Then we applied the resulting version in an online survey including a sample of 1557 students from two universities and 121 different undergraduate careers. A panel of experts judged the content validity of the instrument. Participants answered the IMTIS after informed consent. We used confirmatory factor analysis to assess the construct validity of the instrument. We also evaluated the reliability of the measurements. Results From a kit of 33 originally proposed items, we obtained a version of 22 items with CVR between 0.60 and 1.00, and a IVC = 0.78. The confirmatory factor analysis showed that the six-factor solution had a better adjustment than the one and three factors solutions (RMSEA = 0.059; CFI = 0.947; TLI = 0.937). The McDonald ω coefficients were between 0.864 and 0.922. Conclusion The results deliver evidence that supports the validity and reliability of the IMTIS measurements to carry out research and diagnosis of inclusive management in higher education institutions.

Individuals with severe mental illness have long been segregated from living in communities and participating in socio- cultural life. In recent years, owing to progressive legislations and declarations (in India and globally), there has been a growing movement towards promoting social inclusion and community participation, with emphasis on the need to develop alternative and inclusive care paradigms for persons with severe mental illness. However, transitions from inpatient care to community settings is a complex process involving implications at multiple levels involving diverse stakeholders such as mental health service users, care providers, local communities and policy makers. This article studies how the transition from a hospital setting to a community-based recovery model for personals with severe mental illness can be facilitated. It reflects on the innovative process of creating a Supported Housing model in South India, where 11 MH Service users transitioned from a psychiatric ECRC to independent living facilities. Experiences in various phases of the project development, including care provider- and community level responses and feedback were scrutinised to understand the strategies that were employed in enabling the transition. Qualitative methods (including in-depth interviews and naturalistic observations) were used with residents and staff members to explore the challenges they encountered in stabilizing the model, as well as the psychosocial benefits experienced by residents in the last phase. These were complemented with a Brief Psychiatric Rating Scale (BPRS) and WHO Quality of Life scale to compare baseline and post-assessment results and an increase of quality of life. Results display a significant reduction of psychiatric symptoms in patients (p< 0.5). It also describes the challenges encountered in the current context, and strategies that were used to respond and adapt the model to address these concerns effectively. Positive behavioural and psychoemotional changes were observed amongst the residents, significant amongst those being enhanced in their mobility and participation. The article concludes by discussing the implications of this study for the development of innovative community-based models in wider contexts.

Existing research indicates that learning about the Pavlovian 'signal value' of stimuli can induce attentional biases: findings suggest that our attentional system prioritises detection of stimuli that have previously signalled availability of high reward. These findings potentially provide a human analogue of sign-tracking behaviour previously reported in studies of non-human animals. Here we examine a visual search task that has been developed to demonstrate the Pavlovian influence of reward on attention, in which the critical reward-signalling stimuli are never explicit targets of search. This procedure has previously yielded robust effects of reward on attention; however it remains unclear whether this pattern reflects a persistent and automatic bias in attentional capture based on prior experience of stimulus-reward pairings, or whether it results from participants strategically attending to reward-signalling distractors because they provide useful information about reward magnitude. To investigate this issue, in the current study participants initially completed a rewarded visual search task, in which colours of distractor stimuli signalled availability of high or low reward. Participants then completed a test phase in which rewards were no longer available, such that distractor colours no longer provided useful information on reward availability. Performance during the initial rewarded phase was impaired by the presence of a distractor signalling availability of high relative to low reward. Crucially, the magnitude of this reward-related distraction effect did not reduce in the subsequent unrewarded test phase. This suggests that participants' experience of differences in reward value signalled by distractor stimuli in this task can induce persistent biases in the extent to which these stimuli involuntarily capture attention, even when they are entirely task-irrelevant.

Teaching about the nervous system has become a challenging task in secondary biology and science education because of the fast development in the field of neuroscience. A major challenge is to determine what content to teach. Curricula goals are often too general to guide instruction, and information about the nervous system has become overwhelming and diverse with ubiquitous relevance in society. In addition, several misconceptions and myths are circulating in educational communities causing world-wide confusion as to what content is correct. To help teachers, textbook authors, and curricula developers in this challenging landscape of knowledge, the aim of the present study is to identify the expert view on what knowledge is important for understanding the nervous system in the context of secondary biology and science education. To accomplish this, we have conducted a thematic content analysis of textbooks followed by a Delphi study of 15 experts in diverse but relevant fields. The results demonstrate six curriculum themes including gross anatomy and function, cell types and functional units, the nerve signal, connections between neurons, when nerve signals travel through networks of neurons, and plasticity in the nervous system, as well as 26 content principles organized in a coherent curriculum progression from general content to more specific content. Whereas some of the principles clarify and elaborate on traditional school biology knowledge, others add new knowledge to the curriculum. Importantly, the new framework for teaching about the nervous system presented here, meets the needs of society, as expressed by recent international policy frameworks of OECD and WHO, and it addresses common misconceptions about the brain. The study suggests an update of the biology and science curriculum.

The aim of this study was to examine whether positive and negative mood states affect auditory distraction in a serial-recall task. The duplex-mechanism account differentiates two types of auditory distraction. The changing-state effect is postulated to be rooted in interference-by-process and to be automatic. The auditory-deviant effect is attributed to attentional capture by the deviant distractors. Only the auditory-deviant effect, but not the changing-state effect, should be influenced by emotional mood states according to the duplex-mechanism account. Four experiments were conducted to test how auditory distraction is affected by emotional mood states. Mood was induced by autobiographical recall (Experiments 1 and 2) or the presentation of emotional pictures (Experiments 3 and 4). Even though the manipulations were successful in inducing changes in mood, neither positive mood (Experiments 1 and 3) nor negative mood (Experiments 2 and 4) had any effect on distraction despite large samples sizes (N = 851 in total). The results thus are not in line with the hypothesis that auditory distraction is affected by changes in mood state. The results support an automatic-capture account according to which the auditory-deviant effect and the changing-state effect are mainly stimulus-driven effects that are rooted in the automatic processing of the to-be-ignored auditory stream.

Children can identify who is benevolent or malevolent not only through first-hand experiences and observations but also from the testimony of others. In this study, we investigated whether 5- and 7-year-olds (N = 128) would form their attitudes toward others after hearing testimony about that person’s past moral behavior and whether the valence of testimony would differently influence the children. In the positive condition, half of the participants gained information about three puppets: puppet A’s prosocial behavior by their own first-hand observation, testimony about puppet B’s past prosocial behavior, and testimony about puppet C’s past neutral behavior. In the negative condition, the other half also learned information about the three puppets: puppet A’s antisocial behavior by their own first-hand observation, testimony about puppet B’s past antisocial behavior, and testimony about puppet C’s past neutral behavior. Then they engaged in tasks that measured their behavioral attitudes toward the puppets and evaluated the goodness of each puppet to assess their attitudes at a cognitive level. Our results concluded that the children form their behavioral attitudes toward others based on testimony starting at the age of 7, and attitude formation at the cognitive level based on testimony is seen at age 5. Negative testimony, rather than positive testimony, influences the children’s attitudes toward others. In addition, the 7-year-olds’ use of testimony differs depending whether they are the allocators or the receivers of rewards. Our findings deepen understanding of how children rely on the verbal information around themselves when they navigate interactions with others.

This study aims to solve the overfitting problem caused by insufficient labeled images in the automatic image annotation field. We propose a transfer learning model called CNN-2L that incorporates the label localization strategy described in this study. The model consists of an InceptionV3 network pretrained on the ImageNet dataset and a label localization algorithm. First, the pretrained InceptionV3 network extracts features from the target dataset that are used to train a specific classifier and fine-tune the entire network to obtain an optimal model. Then, the obtained model is used to derive the probabilities of the predicted labels. For this purpose, we introduce a squeeze and excitation (SE) module into the network architecture that augments the useful feature information, inhibits useless feature information, and conducts feature reweighting. Next, we perform label localization to obtain the label probabilities and determine the final label set for each image. During this process, the number of labels must be determined. The optimal K value is obtained experimentally and used to determine the number of predicted labels, thereby solving the empty label set problem that occurs when the predicted label values of images are below a fixed threshold. Experiments on the Corel5k multilabel image dataset verify that CNN-2L improves the labeling precision by 18% and 15% compared with the traditional multiple-Bernoulli relevance model (MBRM) and joint equal contribution (JEC) algorithms, respectively, and it improves the recall by 6% compared with JEC. Additionally, it improves the precision by 20% and 11% compared with the deep learning methods Weight-KNN and adaptive hypergraph learning (AHL), respectively. Although CNN-2L fails to improve the recall compared with the semantic extension model (SEM), it improves the comprehensive index of the F1 value by 1%. The experimental results reveal that the proposed transfer learning model based on a label localization strategy is effective for automatic image annotation and substantially boosts the multilabel image annotation performance.

Certain facial features provide useful information for recognition of facial expressions. In two experiments, we investigated whether foveating informative features of briefly presented expressions improves recognition accuracy and whether these features are targeted reflexively when not foveated. Angry, fearful, surprised, and sad or disgusted expressions were presented briefly at locations which would ensure foveation of specific features. Foveating the mouth of fearful, surprised and disgusted expressions improved emotion recognition compared to foveating an eye or cheek or the central brow. Foveating the brow led to equivocal results in anger recognition across the two experiments, which might be due to the different combination of emotions used. There was no consistent evidence suggesting that reflexive first saccades targeted emotion-relevant features; instead, they targeted the closest feature to initial fixation. In a third experiment, angry, fearful, surprised and disgusted expressions were presented for 5 seconds. Duration of task-related fixations in the eyes, brow, nose and mouth regions was modulated by the presented expression. Moreover, longer fixation at the mouth positively correlated with anger and disgust accuracy both when these expressions were freely viewed (Experiment 2b) and when briefly presented at the mouth (Experiment 2a). Finally, an overall preference to fixate the mouth across all expressions correlated positively with anger and disgust accuracy. These findings suggest that foveal processing of informative features is functional/contributory to emotion recognition, but they are not automatically sought out when not foveated, and that facial emotion recognition performance is related to idiosyncratic gaze behaviour.

Over the centuries, iconographic representations of St Anthony of Padua, one of the most revered saints in the Catholic world, have been inspired by literary sources, which described the Saint as either naturally corpulent or with a swollen abdomen due to dropsy (i.e. fluid accumulation in the body cavities). Even recent attempts to reconstruct the face of the Saint have yielded discordant results regarding his outward appearance. To address questions about the real appearance of St Anthony, we applied body mass estimation equations to the osteometric measurements taken in 1981, during the public recognition of the Saint’s skeletal remains. Both the biomechanical and the morphometric approach were employed to solve some intrinsic limitations in the equations for body mass estimation from skeletal remains. The estimated body mass was used to assess the physique of the Saint with the body mass index. The outcomes of this investigation reveal interesting information about the body type of the Saint throughout his lifetime.

It has been proposed that ecological theory develops in a pragmatic way. This implies that ecologists are free to decide what, from the knowledge available to them, they will use to build models and learn about phenomena. Because in fields that develop pragmatically knowledge generation is based on the decisions of individuals and not on a set of predefined axioms, the best way to produce theoretical synthesis in such fields is to assess what individuals are using to support scientific studies. Here, we present an approach for producing theoretical syntheses based on the propositions most frequently used to learn about a defined phenomenon. The approach consists of (i) defining a phenomenon of interest; (ii) defining a collective of scientists studying the phenomenon; (iii) surveying the scientific studies about the phenomenon published by this collective; (iv) identifying the most referred publications used in these studies; (v) identifying how the studies use the most referred publications to give support to their studies and learn about the phenomena; (vi) and from this, identifying general propositions on how the phenomenon is approached, viewed and described by the collective. We implemented the approach in a case study on the phenomenon of ecological succession, defining the collective as the scientists currently studying succession. We identified three propositions that synthesize the views of the defined collective about succession. The theoretical synthesis revealed that there is no clear division between “classical’’ and “contemporary’’ succession models, and that neutral models are being used to explain successional patterns alongside models based on niche assumptions. By implementing the pragmatic approach in a case study, we show that it can be successfully used to produce syntheses based on the actual activity of the scientific community studying the phenomenon. The connection between the resulting synthesis and research activity can be traced back through the methodological steps of the approach. This result can be used to understand how knowledge is being used in a field of study and can guide better informed decisions for future studies.

School closures due to the COVID-19 global pandemic are likely to have a range of negative consequences spanning the domains of child development, education and health, in addition to the widening of inequalities and inequities. Research is required to improve understanding of the impact of school closures on the education, health and wellbeing of pupils and school staff, the challenges posed during reopening and importantly to identify how countries can ensure a safe return to education and to inform policy. This qualitative study aimed to reflect on the experience of primary school staff (pupils aged 3-11) in Wales regarding school closures and the initial reopening of schools and to identify recommendations for the future. A total of 208 school staff completed a national online survey through the HAPPEN primary school network, consisting of questions about school closures, the phased reopening of schools and a return to full-time education. Thematic analysis of survey responses identified five recommendations; (i) prioritise the health and wellbeing of pupils and staff. This includes more focus on wellbeing activities and less focus on attainment/assessments and protecting staff breaks to promote workplace wellbeing; (ii) focus on enabling parental engagement and support. Introduce support sessions for parents and include regular check ins during periods of home learning; (iii) improve digital competence amongst pupils, teachers and parents. Ensure the provision of equipment and training in building digital skills. Offer a combination of paper-based and digital home learning activities; (iv) consider opportunities for smaller class sizes and additional staffing. Ensure support is directed to need whilst providing pastoral care; and (v) improve the mechanism of communication between schools and families, and between government and schools. Ensure that schools receive advance notice of local or national changes in guidance.

SARS-CoV-2 infection elicits a robust B cell response, resulting in the generation of long-lived plasma cells and memory B cells. Here, we aimed to determine the effect of COVID-19 severity on the memory B cell response and characterize changes in the memory B cell compartment between recovery and five months post-symptom onset. Using high-parameter spectral flow cytometry, we analyzed the phenotype of memory B cells with reactivity against the SARS-CoV-2 spike protein or the spike receptor binding domain (RBD) in recovered individuals who had been hospitalized with non-severe (n = 8) or severe (n = 5) COVID-19. One month after symptom onset, a substantial proportion of spike-specific IgG+ B cells showed an activated phenotype. In individuals who experienced non-severe disease, spike-specific IgG+ B cells showed increased expression of markers associated with durable B cell memory, including T-bet and FcRL5, as compared to individuals who experienced severe disease. While the frequency of T-bet+ spike-specific IgG+ B cells differed between the two groups, these cells predominantly showed an activated switched memory B cell phenotype in both groups. Five months post-symptom onset, the majority of spike-specific memory B cells had a resting phenotype and the percentage of spike-specific T-bet+ IgG+ memory B cells decreased to baseline levels. Collectively, our results highlight subtle differences in the B cells response after non-severe and severe COVID-19 and suggest that the memory B cell response elicited during non-severe COVID-19 may be of higher quality than the response after severe disease.

PLOS ONE 16(11), e0246709 (2021). doi:10.1371/journal.pone.0246709, Published by PLOS, San Francisco, California, US

It is well-recognized that increasingly polarized American partisans subscribe to sharply diverging worldviews. Can partisanship influence Americans to view the world around them differently from one another? In the current research, we explored partisans’ recollections of objective events that occurred during identical footage of a real protest. All participants viewed the same 87-second compilation of footage from a Women’s March protest. Trump supporters (vs. others) recalled seeing a greater number of negative protest tactics and events (e.g., breaking windows, burning things), even though many of these events did not occur. False perceptions among Trump supporters, in turn, predicted beliefs that the protesters’ tactics were extreme, ultimately accounting for greater opposition to the movement and its cause. Our findings point to the possibility of a feedback loop wherein partisanship underlies different perceptions of the exact same politically relevant event, which in turn may allow observers to cling more tightly to their original partisan stance.

Background Stigma and limited mental health literacy impede adolescents getting the help they need for depressive symptoms. A serious game coupled with a classroom session led by lived experience workers (LEWs) might help to overcome these barriers. The school-based Strong Teens and Resilient Minds (STORM) preventive program employed this strategy and offered a serious game, Moving Stories. The current study was carried out to assess inhibiting and promoting factors for scaling up Moving Stories once its effectiveness has been ascertained. Methods Moving Stories was offered in three steps: (1) introductory classroom session, (2) students playing the game for five days, (3) debriefing classroom session led by lived experience worker. Data was collected on the number of participating students, costs of offering Moving Stories, and was further based on the notes of the debriefing sessions to check if mental health first aid (MHFA) strategies were addressed. Results Moving Stories was offered in seven high-schools. Coverage was moderate with 982 participating students out of 1880 (52%). Most participating students (83%) played the Moving Stories app three out of the five days. Qualitative data showed that the MHFAs were discussed in all debriefing sessions. Students showed great interest in lived experience workers’ stories and shared their own experiences with depression. Conclusions Bringing Moving Stories to scale in the high-school setting appears feasible, but will remain logistically somewhat challenging. Future implementation and scale-up of Moving Stories could benefit from improved selection and training of LEWs that played such an important role in grabbing the full attention of students and were able to launch frank discussions about depressive disorder and stigma in classrooms. Trial registration The study is registered in the Dutch Trial Register: Trial NL6444 (NTR6622: https://www.trialregister.nl/trial/6444).

Simulation may be an effective educational strategy for undergraduate nursing students to experience evidence-based practice. The aim of this scoping review is to explore such simulations to discover the design characteristics that best achieve this goal. In this review, we will consider studies in which the focus was on evidence-based practice-related simulation programs for undergraduate students in academic, clinical, or virtual settings. We will also focus on the active learning strategies applied in such simulation programs. This scoping review will be conducted in accordance with the Joanna Briggs Institute methodology. Studies will be searched in Medical Literature Analysis and Retrieval System Online (MEDLINE; PubMed), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), and the Excerpta Medica database (EMBASE). Sources of unpublished studies/gray literature will not be included in this scoping review. Data extraction will be undertaken by using a data-extraction tool developed by the reviewers, based on the National League for Nursing Jeffries Simulation Theory. Via a narrative summary and tabulated results, we will describe how the simulation programs were designed or implemented in an undergraduate curriculum.

Background Literature, individual experiences and common considerations suggest that prior professional qualification can be an advantage for later career development. For instance, in Germany, professional pre-qualification has been honored by medical faculties in selection procedures for several years. However, a systematic evaluation of this relationship lacks. This scoping review summarizes existing literature and addresses the role of prior professional pre-qualifications on objective or subjective study success and the choice of a specialization. Methods The scoping review was performed oriented on the PRISMA guidelines. PsycINFO and PubMed databases were searched for relevant studies that included data of medical students with and without professional pre-qualifications. To answer the underlying research questions, this scoping review also includes studies that examine professional pre-qualifications in association with non-cognitive "soft" criteria. Results and further directions 1055 items were identified and reviewed by two independent reviewers with final 11 studies were included for this scoping review. The results of identified studies that report possible effects of prior pre-professional qualifications are inconclusive but suggest that prior professional qualifications tend not to have rather an advantage on study success. Medical school success for students with prior professional qualifications tended to be below average in the preclinical setting, and there were no differences in the clinical setting compared with students without prior professional qualifications. The influence of professional pre-qualifications has not yet been adequately studied without the moderator variable “waiting time” and “A-levels grade”. The scoping review indicates insufficient number of articles stating a co-relation of prior pre-qualifications and subjective data. Again, the results found are not sufficient to state a clear relationship between professional pre-qualifications and the choice of a specific speciality preference. However, professional pre-qualifications, both in medicine and as "practical experience in rural areas", tend to be beneficial for the choice of becoming a rural physician. Large-scale cross-sectional and longitudinal studies are needed to investigate the influence of professional pre-qualifications on different study trajectory parameters.

The structural and functional brain characteristics associated with the excessive use of the internet have attracted substantial research attention in the past decade. In current study, we used voxel-based morphometry (VBM) and multiple regression analysis to assess the relationship between internet addiction tendency (IAT) score and regional gray and white matter volumes (rGMVs and rWMVs) and brain activity during a WM task in a large sample of healthy young adults (n = 1,154, mean age, 20.71 ± 1.78 years). We found a significant positive correlation between IAT score and gray matter volume (GMV) of right supramarginal gyrus (rSMG) and significant negative correlations with white matter volume (WMV) of right temporal lobe (sub-gyral and superior temporal gyrus), right sublobar area (extra-nuclear and lentiform nucleus), right cerebellar anterior lobe, cerebellar tonsil, right frontal lobe (inferior frontal gyrus and sub-gyral areas), and the pons. Also, IAT was significantly and positively correlated with brain activity in the default-mode network (DMN), medial frontal gyrus, medial part of the superior frontal gyrus, and anterior cingulate cortex during a 2-back working memory (WM) task. Moreover, whole-brain analyses of rGMV showed significant effects of interaction between sex and the IAT scores in the area spreading around the left anterior insula and left lentiform. This interaction was moderated by positive correlation in women. These results indicate that IAT is associated with (a) increased GMV in rSMG, which is involved in phonological processing, (b) decreased WMV in areas of frontal, sublobar, and temporal lobes, which are involved in response inhibition, and (c) reduced task-induced deactivation of the DMN, indicative of altered attentional allocation.

Due to COVID-19 precautions, the Vanderbilt University summer biomedical undergraduate research program, the Vanderbilt Summer Science Academy (VSSA), rapidly transitioned from offering an in-person training program to a virtual seminar format. Our program typically supports undergraduate development through research and/or clinical experience, meeting with individuals pursuing postgraduate training, and providing career development advice. Evidence supports the idea that summer programs transform undergraduates by clarifying their interest in research and encouraging those who haven’t previously considered graduate studies. We were interested in exploring whether a virtual, synchronous program would increase participants’ scientific identity and clarify postgraduate career planning. Rather than create a virtual research exposure, our 5-week "Virtual VSSA" program aimed to simulate the casual connections that would naturally be made with post-undergraduate trainees during a traditional summer program. In seminars, presenters discussed 1) their academic journey, explaining their motivations, goals, and reasons for pursuing a career in science as well as 2) a professional story that illustrated their training. Seminars included Vanderbilt University and Medical School faculty, M.D., MD/Ph.D., as well as Ph.D. students from diverse scientific and personal backgrounds. In addition, weekly informational sessions provided an overview of the nature of each degree program along with admissions advice. Through pre-and post-program surveys, we found that students who registered for this experience already strongly identified with the STEMM community (Science, Technology, Engineering, Mathematics, and Medicine). However, participation in the Virtual VSSA increased their sense of belonging. We also uncovered a gap in participants’ understanding of postgraduate pathways prior to participation and found that our program significantly increased their self-reported understanding of postgraduate programs. It also increased their understanding of why someone would pursue a Ph.D. or Ph.D./MD versus M.D. These changes did not uniformly impact participants’ planned career paths. Overall, by providing personal, tangible stories of M.D., MD/Ph.D., and Ph.D. training, the Virtual VSSA program offered seminars that positively impacted students’ sense of belonging with and connection to the STEMM disciplines.