Search

A valued goal of Higher Education is the furthering of students' ability to monitor and regulate their performance. When exemplars are purposefully integrated into teaching they have the potential to cultivate knowledge and skills that develop this ability. As the voices of educators have been largely silent in exemplar-focused studies, the current study sought to canvas educators' views about why and how they use exemplars. This paper draws on data from 44 educators who responded to prompts in a Likert-scale survey and 14 educators who completed individual interviews. Findings identified three explicit and one implicit reason for using exemplars, with educators using these tools in ways that facilitate realization of each purpose. Educators appeared to hold an implicit expectation that as a consequence of working with exemplars, students would inevitably apply insights gained to their own work. Further, educators did not make any explicit reference to using exemplars to develop student self-monitoring or self-regulation. We concluded the full potential of exemplars can only be realized when educators acknowledge self-regulation as the overarching rationale informing use, and use exemplars alongside works-in-progress with the intention of facilitating the transfer of evaluative and productive knowledge and skills to current and future tasks.

Student self-assessment research underscores the significance of honestly recognizing strengths and weaknesses, facilitating self-regulated learning and progress. The Integrated Quality Assessment (IQA) in China combines self-assessment with other data to evaluate achievement, serving dual purposes: promoting students' awareness of their strengths and weaknesses, and providing summative scores and grades that contribute to the allocation of scholarships and other valued outcomes. This association creates tension in Chinese students' self-assessment intentions due to the high-stakes consequences. Using a large-scale, cross-sectional survey of 2,063 Chinese undergraduate students, the factors influencing students' self-assessment intentions were examined. Structural equation modeling revealed that positive perceptions of academic integrity and conceptions of IQA as improvement predicted learning-oriented self-assessment intentions, while increased perceptions of peer misconduct and negative conceptions of IQA significantly predicted impression management intentions.

Abstract Background We study geographic variation within one community in the City of Calgary using a more fine-grained geographic unit than the Census tract, the Census Dissemination Area (DA). While most Riverside residents consider their neighbourhood to be a fairly cohesive community, we explore the effect of socio-economic variation between these small geographic areas on individuals' self-reported health, net of individual level determinants. Methods We merge data from the 2001 Census for Riverside, Calgary with a 2004 random telephone survey of Riverside residents. Our data are unique in that we have information on individuals from every DA wholly contained in the Riverside community. These data enable us to conduct multinomial logistic regression analyses of self-reported health using both individual-level and DA-level variables as predictors. Results We find significant variation in measures of DA socio-economic status within the Riverside community. We find that individual self-reported health is affected by variation in an index of DA-level socio-economic disadvantage, controlling for individual variation in gender, age, and socio-economic status. We investigate each aspect of the DA index of disadvantage separately, and find that average education and the percent of households that are headed by a lone parent are most important. Conclusions These findings demonstrate that, even within a cohesive community, contextual effects on health can be located at a smaller geographic level than the Census tract. Research on the effects of local area socio-economic disadvantage on health that combines administrative and survey data enables researchers to develop more comprehensive measures of social and material deprivation. Our findings suggest that both social and material deprivation affect health at the local level.

Abstract Background Endometriosis affects 190 million women and those assigned female at birth worldwide. For some, it is associated with debilitating chronic pelvic pain. Diagnosis of endometriosis is often achieved through diagnostic laparoscopy. However, when isolated superficial peritoneal endometriosis (SPE), the most common endometriosis subtype, is identified during laparoscopy, limited evidence exists to support the common decision to surgically remove it via excision or ablation. Improved understanding of the impact of surgical removal of isolated SPE for the management of chronic pelvic pain in women is required. Here, we describe our protocol for a multi-centre trial to determine the effectiveness of surgical removal of isolated SPE for the management of endometriosis-associated pain. Methods We plan to undertake a multi-centre participant-blind parallel-group randomised controlled clinical and cost-effectiveness trial with internal pilot. We plan to randomise 400 participants from up to 70 National Health Service Hospitals in the UK. Participants with chronic pelvic pain awaiting diagnostic laparoscopy for suspected endometriosis will be consented by the clinical research team. If isolated SPE is identified at laparoscopy, and deep or ovarian endometriosis is not seen, participants will be randomised intraoperatively (1:1) to surgical removal (by excision or ablation or both, according to surgeons’ preference) versus diagnostic laparoscopy alone. Randomisation with block-stratification will be used. Participants will be given a diagnosis but will not be informed of the procedure they received until 12 months post-randomisation, unless required. Post-operative medical treatment will be according to participants’ preference. Participants will be asked to complete validated pain and quality of life questionnaires at 3, 6 and 12 months after randomisation. Our primary outcome is the pain domain of the Endometriosis Health Profile-30 (EHP-30), via a between randomised group comparison of adjusted means at 12 months. Assuming a standard deviation of 22 points around the pain score, 90% power, 5% significance and 20% missing data, 400 participants are required to be randomised to detect an 8-point pain score difference. Discussion This trial aims to provide high quality evidence of the clinical and cost-effectiveness of surgical removal of isolated SPE. Trial registration ISRCTN registry ISRCTN27244948. Registered 6 April 2021.

Abstract Background Traditional methods of process evaluation encompass what components were delivered, but rarely uncover how practitioners position themselves and act relative to an intervention being tested. This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness. Methods We undertook a narrative analysis of in-depth, unstructured field diaries kept by nine community development practitioners for two years. The practitioners were responsible for implementing a multi-component, preventive, community-level intervention for mothers of new babies in eight communities, as part of a cluster randomised community intervention trial. We constructed a narrative typology of approaches to practice, drawing on the phenomenology of Alfred Schutz and Max Weber's Ideal Type theory. Results Five types of practice emerged, from a highly 'technology-based' type that was faithful to intervention specifications, through to a 'romantic' type that held relationships to be central to daily operations, with intact relationships being the final arbiter of intervention success. The five types also differed in terms of how others involved in the intervention were characterized, the narrative form (e.g., tragedy, satire) and where and how transformative change in communities was best created. This meant that different types traded-off or managed the priorities of the intervention differently, according to the deeply held values of their type. Conclusions The data set constructed for this analysis is unique. It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern. The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions.

In this paper we identify and systematically analyse research regarding student voice in the classroom, with the aim of suggesting areas and questions to strengthen the research base. The introductory section presents a rationale for, and definition of, voice, followed by details of how the systematic analysis was conducted. A consideration of what has been termed pedagogic voice leads to our offering a definition with more encompassing parameters in terms of the dimensions research should consider. The components of our definition are then applied to existing studies of pedagogic voice. Our analyses show that few consider the whole picture; specifically, few present evidence of response to student voice or of outcomes from that response. Such evidence is needed to evaluate the extent to which student voice is instrumental in the enhancement of teaching and learning. Researchers of voice, particularly as it relates to the classroom, need to design studies to trace more systematically the soliciting of voice or the opportunity for voice to be employed; through to the hearing, the reception and response; to the outcome of that response in terms of changed practice, including student awareness of their part in the changed practice, to the outcomes for learning.

Recombinant adeno-associated viruses (rAAVs) are attractive therapeutic viral vectors for gene delivery. To ensure the efficacy and safety of rAAV-based therapies, comprehensive characterization of the adeno-associated virus (AAV) capsids is essential. Mass photometry (MP) provides the advantage of short analysis times, low sample consumption, and high accuracy of molecular mass determination. Despite having just recently emerged, MP has already been used to characterize AAV genome content and quantify filled/empty capsid ratios. In this study, we explored three approaches for the application of MP to assess genome length in AAVs. In approach 1, genome length in intact AAVs was approximated with good precision (coefficient of variation [%CV]

Freeze-drying is a time and cost-intensive process. The primary drying phase is the main target in a process optimization exercise. Biopharmaceuticals require an amorphous matrix for stabilization, which may collapse during primary drying if the critical temperature of the formulation is exceeded. The risk of product collapse should be minimized during a process optimization to accomplish a robust process, while achieving an economical process time. Mechanistic models facilitate the search for an optimal primary drying protocol. We propose a novel two-stage shelf temperature optimization approach to maximize sublimation during the primary drying phase, without risking product collapse. The approach includes experiments to obtain high-resolution variability data of process parameters such as the heat transfer coefficient, vial dimensions and dried layer resistance. These process parameters variability data are incorporated into an uncertainty analysis to estimate the risk of failure of the protocol. This optimization approach enables to identify primary drying protocols that are faster and more robust than a classical approach. The methodology was experimentally verified using two formulations which allow for either aggressive or conservative freeze-drying of biopharmaceuticals.

Background: A number of ways to conduct research are designed to maximise the likelihood that evidence from research is quickly transferred into practice. This includes action research and partnership research between researchers and policy makers. Such approaches focus research effort on questions of highest relevance to practice and policy so as to create ownership of the results. However, such approaches on their own do not necessarily visualise or illuminate possible pathways of action or create a sense of personal connection to these possible actions. Aims and objectives: Our intent is to foster high-level engagement with possible project findings by policymakers and researchers involved in partnership research. We describe a simple, creative, innovative device: production of co-authored mock (i.e., fake) in-house abstracts of peer reviewed papers as an aid in this process This occurs in advance of knowing real results of the study. The fake abstracts process described here occurs within a research-policy maker-practitioner partnership studying the scaling-up of childhood statewide obesity prevention programs and the electronic monitoring system being used to track progress. Key conclusions: The fake abstracts are a tool for identifying priority interests among a large data set. They act as a trigger to uncovering different interpretations of findings among the team. They foster discussion and mental rehearsal of actions based on different scenarios. And they help the team coordinate participation in the analysis and writing-up of the real findings. They also represent a hypothetical variety of research endpoints which also assist with maintaining project momentum during long phases of analysis.

Abstract Background Molecular measurements of the genome, the transcriptome, and the epigenome, often termed multi-omics data, provide an in-depth view on biological systems and their integration is crucial for gaining insights in complex regulatory processes. These data can be used to explain disease related genetic variants by linking them to intermediate molecular traits (quantitative trait loci, QTL). Molecular networks regulating cellular processes leave footprints in QTL results as so-called trans-QTL hotspots. Reconstructing these networks is a complex endeavor and use of biological prior information can improve network inference. However, previous efforts were limited in the types of priors used or have only been applied to model systems. In this study, we reconstruct the regulatory networks underlying trans-QTL hotspots using human cohort data and data-driven prior information. Methods We devised a new strategy to integrate QTL with human population scale multi-omics data. State-of-the art network inference methods including BDgraph and glasso were applied to these data. Comprehensive prior information to guide network inference was manually curated from large-scale biological databases. The inference approach was extensively benchmarked using simulated data and cross-cohort replication analyses. Best performing methods were subsequently applied to real-world human cohort data. Results Our benchmarks showed that prior-based strategies outperform methods without prior information in simulated data and show better replication across datasets. Application of our approach to human cohort data highlighted two novel regulatory networks related to schizophrenia and lean body mass for which we generated novel functional hypotheses. Conclusions We demonstrate that existing biological knowledge can improve the integrative analysis of networks underlying trans associations and generate novel hypotheses about regulatory mechanisms.

Outcome research that supports guideline recommendations for primary and secondary preventions largely depends on the data obtained from clinical trials or selected hospital populations. The exponentially growing amount of real-world medical data could enable fundamental improvements in cardiovascular disease (CVD) prediction, prevention, and care. In this review we summarize how data from health insurance claims (HIC) may improve our understanding of current health provision and identify challenges of patient care by implementing the perspective of patients (providing data and contributing to society), physicians (identifying at-risk patients, optimizing diagnosis and therapy), health insurers (preventive education and economic aspects), and policy makers (data-driven legislation). HIC data has the potential to inform relevant aspects of the healthcare systems. Although HIC data inherit limitations, large sample sizes and long-term follow-up provides enormous predictive power. Herein, we highlight the benefits and limitations of HIC data and provide examples from the cardiovascular field, i.e. how HIC data is supporting healthcare, focusing on the demographical and epidemiological differences, pharmacotherapy, healthcare utilization, cost-effectiveness and outcomes of different treatments. As an outlook we discuss the potential of using HIC-based big data and modern artificial intelligence (AI) algorithms to guide patient education and care, which could lead to the development of a learning healthcare system and support a medically relevant legislation in the future.

Cognisant of the benefits and shortcomings of peer review in the enhancement of student learning, the current study investigated how Year 12 students engaged in this activity. Specifically, attention has been paid to how 14 secondary school statistics students experienced peer review, their perceptions of the value of feedback, and the conditions that supported or detracted from their engagement in the review process. Datasets comprised individual semistructured and focus group interviews, with students and classroom observations. Of note was the differential engagement of students when participating in peer review in formal, teacher-driven and informal, student-created settings and their reasoning for doing so. In order to mitigate student reluctance to engage in formal, teacher-driven peer review opportunities, recommendations are made in relation to the creation of alternative learning spaces that have the potential to facilitate student willingness to access their peers as learning and instructional resources (Wiliam, 2011).

The Integrated Quality Assessment (IQA) in China is an officially mandated system that uses student self-assessment in addition to information provided by tests and examinations and other sources to make judgements about student achievement across a range of qualities. Officially, this system of assessment serves two purposes: to help students become more aware of their strengths and weaknesses and to provide summative scores and grades that are used to allocate scholarships and other valued outcomes. The small-scale exploratory study reported in this article investigated People's Republic of China (PRC) students' experiences and perceptions of IQA and self-assessment within the IQA system. Fifteen Chinese students studying at a New Zealand university who had the experience of IQA self-assessment in their undergraduate degrees participated in individual semistructured interviews. Findings highlighted how, when individuals perceived IQA self-assessment as low stakes, they went through the motions without any deep engagement, while those who perceived the same situation as high stakes did whatever was deemed necessary to achieve their goals. For this latter group of students, IQA self-assessment encouraged, reinforced, and rewarded less-than-honest and inaccurate self-evaluations, calling into question the validity of IQA and self-assessment within this system.

While it is argued that use of rubrics and exemplars has the potential to develop students' ability to distinguish quality, make evaluative judgments and take productive action, few studies have directly investigated the latter. To address this gap the current study employed classroom observations, eight focus groups interviews with 18 students and the collection of teaching-learning artefacts to investigate how two teacher educators and their students used rubrics and exemplars. Data analysis yielded two themes. The first theme spoke to a series of inter-connected supports deliberately set in place to foster and utilize students' evaluative and productive knowledge and skill. The second theme highlighted ways in which students compared understandings from in-class experiences with exemplars and rubrics to works-in-progress, bringing the latter closer to the expected standard of achievement. These findings provide an authentic picture of student engagement with rubrics and exemplars and offer insights into ways in which they applied evaluative and productive knowledge and skills to works-in-progress. It was concluded that the ways in which these tools were used not only supported development of students' evaluative and productive knowledge and skill, they played a key role in stimulating task related self-monitoring and self-regulation.

In this article we focus on how an experiential based approach to teacher learning about assessment for learning (AfL) provided opportunities for teachers to examine: their deep-seated beliefs about effective learning (and teaching); how these beliefs permeated their day-to-day actions and interactions with students, and the consequence of these actions and interactions for student learning. It also pays attention to how teacher self-efficacy in the use of various AfL strategies was developed through a heightened awareness of the beneficial effects of these strategies on teachers' own learning in particular.

Academic self-efficacy is critical to academic success. Hence those working in higher education need to make deliberate and substantial attempts to foster academic competence, confidence, persistence and resilience in the students they teach, given they are essential components of academic self-efficacy. Addressing an identified gap in the exemplars literature, this article pays particular attention to how exemplars can be used in an embedded and sustained manner with the intent of fostering and supporting these components. Taking into account the three dimensions of self-efficacy -- strength, magnitude and generality -- and the various sources of information students draw upon to make judgements about their capabilities, four inter-dependent and inter-related practices and associated experiences are identified. We argue that collectively these practices and experiences can accentuate the positive effects and ameliorate the potential negative effects of exemplar use on student academic self-efficacy.

Supervision is intrinsic to institutional-based research projects as it acts as a catalyst for the successful execution and completion of said projects. If students are to be independent in research and learning, they need to experience a supervision approach that supports their engagement in learning dialogues alongside their supervisors. This article explored undergraduate research supervision in a Malaysian university. Data were collected using individual, semi-structured interviews with students and supervisors. Findings indicated that undergraduate supervision was perceived and practised as a traditional, supervisor-centric process. The paper argues that a psy-supervision approach which focuses on the academic and pastoral aspects of supervision is catalytic to producing independent and active students in research and learning

The project reported in this article focused on evaluating the use of a pre-existing observation schedule to document dimensions of primary teachers' AfL practice with the intent of using this information to enhance teacher assessment capability. Using the voices of the participant teachers, challenges teachers faced were identified when observing colleagues in relation to noticing and recognising what was significant and thus worthy of note. The article highlights the importance of teacher assessment literacy when using an observation schedule for professional learning purposes such as the enhancement of assessment capability. The need for a schedule to reflect "everyday practice" as it is known to teachers is also highlighted.

Abstract Background The mechanisms typically used to fund health promotion in communities, either as part of an effort to scale-up programs or to support the design of local activities, often pay insufficient attention to the foundational means of enhancing well-being. Only recently have researchers begun to critically ‘unpack’ how funding processes connect with and activate local community capacities. Methods We conducted a thematic analysis of 33 interviews with policy and program administrators in public health and local community workers and volunteers. We invited them to expound on their understandings of resources - specifically, what needs to be in place to make funded programs successful and/or what do communities draw on to make funded programs effective. Results Policy and program administrators reflected mostly on the importance of traditional resources, such as adequate funding and staffing. Community-based participants often went further to describe psychological and sociological resources – the “soft infrastructure” which included trust and hope. Both groups emphasised the importance of building networks and relationships at multiple levels. Community workers also provided examples of how resources grow and improve in value in combination with other processes or through pathways of resource use or resource distribution. So, resources like information/knowledge are made more valuable when relayed locally. Physical amenities (e.g., meeting spaces, kitchens) have an instrumental role, but also act powerfully as a symbolic resource for identity. Participants reported that funding processes can damage the resources required for community health improvement. Funding instability undermines capacity. The ongoing threat of funding removal was described by one administrator as community “bullying”. Conclusions Processes of health promotion funding, and even standard processes of program scale-up and readiness assessment, risk underestimating the range of resources that are fundamental for community health improvement, particularly among disadvantaged communities. Funders should design ways to resource communities so that there is constant attention to and coaching of critically important diverse processes of resource growth, independent of program-specific funds.

Abstract Background Population-level health promotion is often conceived as a tension between “top-down” and “bottom-up” strategy and action. We report behind-the-scenes insights from Australia’s largest ever investment in the “top-down” approach, the $45m state-wide scale-up of two childhood obesity programmes. We used Normalisation Process Theory (NPT) as a template to interpret the organisational embedding of the purpose-built software designed to facilitate the initiative. The use of the technology was mandatory for evaluation, i.e. for reporting the proportion of schools and childcare centres which complied with recommended health practices (the implementation targets). Additionally, the software was recommended as a device to guide the implementation process. We set out to study its use in practice. Methods Short-term, high-intensity ethnography with all 14 programme delivery teams across New South Wales was conducted, cross-sectionally, 4 years after scale-up began. The four key mechanisms of NPT (coherence/sensemaking, cognitive participation/engagement, collective action and reflexive monitoring) were used to describe the ways the technology had normalised (embedded). Results Some teams and practitioners embraced how the software offered a way of working systematically with sites to encourage uptake of recommended practices, while others rejected it as a form of “mechanisation”. Conscious choices had to be made at an individual and team level about the practice style offered by the technology—thus prompting personal sensemaking, re-organisation of work, awareness of choices by others and reflexivity about professional values. Local organisational arrangements allowed technology users to enter data and assist the work of non-users—collective action that legitimised opposite behaviours. Thus, the technology and the programme delivery style it represented were normalised by pathways of adoption and non-adoption. Normalised use and non-use were accepted and different choices made by local programme managers were respected. State-wide, implementation targets are being reported as met. Conclusion We observed a form of self-organisation where individual practitioners and teams are finding their own place in a new system, consistent with complexity-based understandings of fostering scale-up in health care. Self-organisation could be facilitated with further cross-team interaction to continuously renew and revise sensemaking processes and support diverse adoption choices across different contexts.

Plague remains endemic in many parts of the world, and despite efforts, no preventative vaccine is available. We performed a systemic review of available randomised controlled trials (RCTs) of live, attenuated, or killed plague vaccines vs. placebo, no intervention, or other plague vaccine to evaluate their efficacy, safety, and immunogenicity. Data sources included MEDLINE, Embase, and the Cochrane Library; clinical trial registers; and reference lists of included studies. Primary outcomes were efficacy, safety, and immunogenicity. Risk of bias was assessed using the Cochrane Collaborations tool. Only 2 RCTs, both on subunit vaccines, were included out of the 75 screened articles. The 2 trials included 240 participants with a follow-up of 3 months and 60 participants with a follow-up of 13 months, respectively. Safety evidence was limited, but both vaccines were well tolerated, with only mild to moderate adverse events. Both vaccines were immunogenic in a dose-dependent manner. However, given the limited data identified in this systematic review, we are unable to quantify the efficacy of vaccines to prevent plague, as well as their long-term safety and immunogenicity. More trials of plague vaccines are needed to generate additional evidence of their long-term effects.

More sustainable solutions are needed to produce chemicals and fuels, mainly to face rising demands and mitigate climate change. Light, as a reagent, has emerged as a route to activate small molecules, e.g., H2O, CO2, N2, and make complex chemicals in a process called photocatalysis. Several photosystems have been proposed, with plasmonic technology emerging as one the most promising technologies due to its high optical absorption and hot-carrier formation. However, the lifetime of hot carriers is unsuitable for direct use; therefore, they are normally coupled with suitable charge-accepting materials, such as semiconductors. Herein, a system is reported consisting of Au supported in p-Cu2O. The combination of p-Cu2O intrinsic photoactivity with the plasmonic properties of Au extended the system’s optical absorption range, increasing photocatalytic efficiency. More importantly, the system enabled us to study the underlying processes responsible for hot-hole transfer to p-Cu2O. Based on photocatalytic studies, it was concluded that most of the holes involved in aniline photo-oxidation come from hot-carrier injections, not from the PIRET process.

BackgroundTo reduce person-to-person contact, the COVID-19 pandemic has driven a massive shift to virtual care. Defined as the use of technology (synchronous or asynchronous) to support communication between health care providers and patients, rural-urban differences in virtual care are relatively unexplored. ObjectiveThe 2-fold purpose of this study was to examine rural and urban virtual care access, use, and satisfaction during the pandemic and to identify any unmet needs. MethodsThis study was a cross-sectional online survey exploring virtual care among rural and urban adults in summer 2021 using a combination of fixed and open-ended response options. Quantitative data were analyzed using both descriptive and inferential statistics, and qualitative data were analyzed using inductive thematic content analysis. ResultsOverall, 501 (373, 74.4% female; age range 19-86 years; 237, 47.3% rural-living) Western Canadians completed the survey. Virtual care use was high among both rural (171/237, 72.2%) and urban (188/264, 71.2%) participants, with over one-half (279/501, 55.7%) reporting having only started to use virtual care since the pandemic. The self-reported need for mental health programs and services increased during the pandemic, compared with prior for both rural and urban participants. Among virtual care users, interest in its continuation was high. Our analysis also shows that internet quality (all P

In this paper, we explore first-year undergraduate students' experiences and perceptions regarding the use of exemplars, with reference to the development of student self-regulation. The study was carried out at a tertiary education institution in New Zealand where the second author was a lecturer. This author used exemplars with two classes of first-year students enrolled in a core introductory paper taught as part of the students' undergraduate business studies degree. Data were gathered through three complementary approaches: students' responses to a short anonymous survey at the end of each of the four sessions where exemplars were used, written notes in the teacher's Teaching journal and semi-structured interviews with student volunteers. When strategically employed as part of the teaching design, it was found that exemplars have the capacity to motivate, enhance students' self-efficacy, promote understanding of task requirements, expand knowledge, understanding and skills in relation to the structure of academic tasks, support and advance subject knowledge, and develop evaluative and productive knowledge and expertise. We concluded the use of exemplars with these students demonstrated their potential as tools for the promotion of student self-efficacy, self-monitoring and to a lesser extent, self-regulation.

Abstract Much of our understanding of motor control deficits in children with developmental coordination disorder (DCD) comes from upper limb assessments focusing on the dominant limb. Here, using two robotic behavioural tasks, we investigated motor control in both the dominant and non-dominant limbs of children with DCD. Twenty-six children with diagnosed DCD (20 males; mean age 10.6 years ± 1.3 years) and 155 controls were included in this cross-sectional study. Participants completed a visually guided reaching task with their dominant and non-dominant limbs and a bimanual object hitting task. Motor performance was quantified across nine parameters. We determined the number of children with DCD who fell outside of the typical performance range of the controls on these parameters and compared the DCD and control groups using ANCOVAs, accounting for age. Children with DCD demonstrated impairments in six out of nine parameters; deficits were more commonly noted in the non-dominant limb. Interestingly, when looking at individual performance, several children with DCD performed in the range of controls. These findings indicate that children with DCD display deficits in motor control in both the dominant and non-dominant limb and highlight the importance of including detailed assessments of both limbs when investigating children with DCD. They also demonstrate the variability in motor control performance evidenced by children with DCD.

Abstract Background While motor deficits are the hallmark of hemiparetic cerebral palsy, children may also experience impairments in visuospatial attention that interfere with participation in complex activities, including sports or driving. In this study, we used a robotic object hitting task to assess bilateral sensorimotor control and visuospatial skills in children with hemiparesis due to perinatal arterial ischemic stroke (AIS) or periventricular venous infarct (PVI). We hypothesized that performance would be impaired bilaterally and be related to motor behavior and clinical assessment of visuospatial attention. Methods Forty-nine children with perinatal stroke and hemiparetic cerebral palsy and 155 typically developing (TD) children participated in the study. Participants performed a bilateral object hitting task using the KINARM Exoskeleton Robot, in which they used virtual paddles at their fingertips to hit balls that fell from the top of the screen with increasing speed and frequency over 2.3 min. We quantified performance across 13 parameters including number of balls hit with each hand, movement speed and area, biases between hands, and spatial biases. We determined normative ranges of performance accounting for age by fitting 95% prediction bands to the TD children. We compared parameters between TD, AIS, and PVI groups using ANCOVAs accounting for age effects. Lastly, we performed regression analysis between robotic and clinical measures. Results The majority of children with perinatal stroke hit fewer balls with their affected arm compared to their typically developing peers. We also found deficits with the ipsilesional (“unaffected”) arm. Children with AIS had greater impairments than PVI. Despite hitting fewer balls, we only identified 18% of children as impaired in hand speed or movement area. Performance on the Behavioral Inattention Test accounted for 21–32% of the variance in number of balls hit with the unaffected hand. Conclusions Children with perinatal stroke-induced hemiparetic cerebral palsy may have complex bilateral deficits reflecting a combination of impairments in motor skill and visuospatial attention. Clinical assessments and interventions should address the interplay between motor and visuospatial skills.

AimTo identify challenges of combining robotic upper extremity rehabilitation with tDCS in children with upper extremity bilateral cerebral palsy (CP) by assessing feasibility, tolerability and safety.MethodsThis was an unblinded, open-label, pilot clinical trial. Participants completed 10 × 1 h sessions of robotic rehabilitation combined with motor cortex anodal tDCS. Feasibility, acceptability and practicality, were assessed including the number of participants completing the protocol, factors limiting participation, time required for sessions, and completion of functional assessments and tolerability scales. To assess safety, standardized clinical and robotic measures of sensorimotor function were performed. The trial was registered at clinicaltrials.gov (NCT04233710).ResultsEight children were recruited (mean age 8y ± 1.8y, range 6–11 years) and 5 completed the intervention. There were no serious adverse events. One child developed focal seizures 6 weeks after the trial that were deemed to be unrelated. Barriers to completion included time and scheduling demands and patient factors, specifically cognitive/behavioral impairments and dyskinesia. No decline in clinical function was appreciated.ConclusionsRobotic upper extremity rehabilitation combined with tDCS may be feasible in children with bilateral CP. Careful participant selection, family engagement, and protocol adaptations are recommended to better understand the feasibility and tolerability of future trials.

FFLUX is a machine learning force field that uses the maximum expected prediction error (MEPE) active learning algorithm to improve the efficiency of model training. MEPE uses the predictive uncertainty of a Gaussian process (GP) to balance exploration and exploitation when selecting the next training sample. However, the predictive uncertainty of a GP is unlikely to be accurate or precise immediately after training. We hypothesize that calibrating the uncertainty quantification within MEPE will improve active learning performance. We develop and test two methods to improve uncertainty estimates: post-hoc calibration of predictive uncertainty using the CRUDE algorithm, and replacing the GP with a student- t process. We investigate the impact of these methods on MEPE for single sample and batch sample active learning. Our findings suggest that post-hoc calibration does not improve the performance of active learning using the MEPE method. However, we do find that the student- t process can outperform active learning strategies and random sampling using a GP if the training set is sufficiently large.

Understanding how social support and anxiety influence academic engagement in boys and girls is important to ensure that we effectively promote academic engagement. This study examined the relationship between gender, social support, anxiety, and academic engagement in elementary and junior high school students. Students in Grades 5 to 9 (N = 1,904) completed self-reports measuring academic engagement, anxiety, and perceived social support from family, friends, and school staff. Results indicated that girls were more likely to perceive social support and to score higher on the anxiety scale than boys were. Grade level was a significant predictor of academic engagement for boys but not for girls, while anxiety classification was a significant predictor of academic engagement for girls but not for boys. This study highlights the importance of understanding the multiple factors that influence academic engagement to provide targeted prevention and intervention strategies and how these factors differ for boys and girls.

Understanding the goals for learning is fundamental to students' success as writers. We investigated how Year 6 students in New Zealand experienced, understood and responded to goals during a writing unit. The study took place over seven weeks. Data were gathered through interviews with two teachers and six student participants; field notes from lesson observations; informal chats with students; and the collection of teacher documents, resources and student artefacts. Student selected goals, success criteria and rubric statements served as points of reference for a number of writing experiences. Findings indicated that the discourses underpinning students' goals and the way they were framed resulted in the checking, highlighting, adding and ticking off of elements of persuasive writing. It was concluded if writing is to be understood and practised as an art rather than a technical activity, goals for learning need to address the more substantive aspects of the genre and the writing process.

Coronary artery disease (CAD) is a complex, multifactorial disease caused, in particular, by inflammation and cholesterol metabolism. At the molecular level, the role of tissue-specific signaling pathways leading to CAD is still largely unexplored. This study relied on two main resources: (1) genes with impact on atherosclerosis/CAD, and (2) liver-specific transcriptome analyses from human and mouse studies. The transcription factor activating transcription factor 3 (ATF3) was identified as a key regulator of a liver network relevant to atherosclerosis and linked to inflammation and cholesterol metabolism. ATF3 was predicted to be a direct and indirect (via MAF BZIP Transcription Factor F (MAFF)) regulator of low-density lipoprotein receptor (LDLR). Chromatin immunoprecipitation DNA sequencing (ChIP-seq) data from human liver cells revealed an ATF3 binding motif in the promoter regions of MAFF and LDLR. siRNA knockdown of ATF3 in human Hep3B liver cells significantly upregulated LDLR expression (p < 0.01). Inflammation induced by lipopolysaccharide (LPS) stimulation resulted in significant upregulation of ATF3 (p < 0.01) and subsequent downregulation of LDLR (p < 0.001). Liver-specific expression data from human CAD patients undergoing coronary artery bypass grafting (CABG) surgery (STARNET) and mouse models (HMDP) confirmed the regulatory role of ATF3 in the homeostasis of cholesterol metabolism. This study suggests that ATF3 might be a promising treatment candidate for lowering LDL cholesterol and reducing cardiovascular risk.

Background. Tic disorders may reflect impaired inhibitory control. This has been evaluated using different behavioural tasks, yielding mixed results. Our objective was to test inhibitory control in children with tics through simultaneous presentation of multiple, mobile stimuli. Methods. Sixty-four children with tics (mean age 12.4 years; 7.5-18.5) were evaluated using a validated robotic bimanual exoskeleton protocol (Kinarm) in an object-hit-and-avoid task, in which target and distractor objects moved across a screen and participants aimed to hit only the targets while avoiding distractors. Performance was compared to 146 typically developing controls (mean age 13 years; 6.1-19.9). The primary outcome was the percentage of distractors struck. Results. ANCOVA (age as covariate) showed participants struck significantly more distractors (participants without comorbid ADHD, 22.71% [SE 1.47]; participants with comorbid ADHD, 23.56% [1.47]; and controls, 15.59% [0.68]). Participants with comorbid ADHD struck significantly fewer targets (119.74 [2.77]) than controls, but no difference was found between participants without comorbid ADHD (122.66 [2.77]) and controls (127.00 [1.28]). Participants and controls did not differ significantly in movement speed and movement area. Just over 20% of participants with tics fell below the age-predicted norm in striking distractors, whereas fewer than 10% fell outside age-predicted norms in other task parameters. Conclusions. In children with tics (without comorbid ADHD), acting upon both targets and distractors suggests reduced ability to suppress responses to potential triggers for action. This may be related to increased sensorimotor noise or abnormal sensory gating.

The development of students as lifelong, self-regulating learners is a valued outcome of higher education. To this end, the current project investigated how students in an undergraduate course experienced and responded to a teaching-learning environment where they were expected to take responsibility for their learning. The pedagogic environment of this course was grounded in strategies and activities associated with assessment for learning (AfL). As such, students were expected to participate in activities that provided them with opportunities to exercise control over their learning. Data gathering comprised individual semi-structured interviews and the collection of artefacts. Findings indicated goals helped students know where they were going; exemplars provided insights into what was expected and what constituted quality work; course activities elicited evidence of learning; dialogic interactions around these generated feedback about understandings and progress; the evaluation of exemplars developed evaluative knowledge, skill and expertise; peer review and feedback provided an authentic context for evaluation and monitoring of works-in-progress. It was concluded that, while each of the AfL strategies contributed to student self-regulation, the full impact of AfL as a catalyst for self-regulated learning was realised in the cumulative and recursive effect these strategies had on students' thinking, actions and feelings.

This study investigates conditions designed to optimize learning where professionals utilize the expertise and support of one another. It describes a research--practice collaboration to enhance teacher knowledge and practice through peer observation of, and feedback about, classroom practice in writing. A collaboratively designed observation guide, containing key elements of effective practice in teaching writing, helped focus classroom observations and discussions. The feedback-after-observation discussions, aimed at improving practice, were facilitated through employing principles to help ensure the conversation maximized learning. All teachers at a school (11 pairs) engaged in seven rounds of observation and feedback over one year. Several data sources tracked progress and outcomes including observation ratings and notes; post-feedback discussion questionnaires; and written responses during professional learning meetings. Data show that most feedback discussion contained specific change or enhancement messages and, over time, the degree of specificity increased. There was evidence for the utilization of feedback in the form of changed practice. Perceived usefulness of feedback varied. The process of observing and engaging peers in dialogic feedback was challenging. Teacher responses confirmed the need to build content knowledge about writing and writing pedagogy, together with skills to engage in professional learning conversations to promote and support changed practice.

Introduction In patients with venous thromboembolism (VTE), direct oral anticoagulants (DOACs) such as edoxaban, apixaban, dabigatran, and rivaroxaban are more convenient, safer, and just as effective as vitamin K antagonists (VKAs). Limited information is known about the effects of patient characteristics on VTE efficacy and safety of DOACs compared with VKAs, without appropriate effect modifier adjustment comparisons of DOACs may be biased. This study considers the effect of variables that can modify the efficacy and safety of edoxaban and warfarin, using patient-level data. Materials and Methods The primary efficacy and safety outcomes in the HOKUSAI-VTE study were VTE recurrence and clinically relevant bleeding, respectively. Potential effect modifiers were age, creatinine clearance, and weight. The relationship between the percentage of time in international normalized ratio (INR) control and outcomes were considered for the warfarin arm. Univariate and multivariate regression were performed for each patient characteristic. Results The relationship between treatment and VTE recurrence differed by age (interaction p = 0.007) and by creatinine clearance (p = 0.05). VTE recurrence differed by age for patients in the warfarin arm but not for those in the edoxaban arm and differed by INR control in the warfarin arm (p