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Pre-enrolment self-assessments are a promising way to address student commitment and retention in an early stage. Such assessments aim to inform study decisions by evoking reflection and providing advice for further preparation. Though these assessments require a solid validation process, so far the consequential validity aspect tends to be ignored. To address this gap, the current study investigates self-assessment impact on study choice certainty and enrolment as well as self-assessment fairness. Prospective students (N = 662) orienting towards studying in higher online education took a self-assessment consisting of six subtests. The impact appeared in line with the assessment's purpose for 68.9% of the prospective students: their study choice certainty was adapted or remained unchanged in accordance with their obtained scores. Study choice certainty after the self-assessment related positively to enrolment probability. Additionally, the impact appeared fair (similar across subgroups), though men's study choice certainty appeared relatively robust against unfavourable scores.

The results of a reflective survey, used for program evaluation, demonstrate how EdD scholars used their learning about Improvement Science as an insightful lifeline and for practical guidance within their professional practice in an uncertain time. Scholars imparted valuable information to EdD faculty about the strains and challenges they were under. Faculty, in turn, enhanced their choice of content and approaches to teaching about how to manage actionable change and becoming a more reflective and resilient practitioner. In CPED-influenced programs such as ours, this exchange of learning is ongoing and natural, as scholars pitch up problems of practice in need of immediate progress and improvement--sharing insights into strategies (successful or failed)--with faculty. Program learning and enhancements, in light of our students' lived experience and learnings, are discussed. We conclude with guidance about tools and procedures to navigate turbulence in educational systems.

The researchers aimed to assess the effects of the COVID-19 pandemic on nursing education through semi-structured interviews with undergraduate nursing students. The researchers explored themes related to online education, clinical placements, and mental health. Findings revealed that the sudden shift to online learning caused increased stress, and decreased confidence. Clinical placements were affected, leading to missed time and altered learning experiences. Mental health suffered as students faced stressors and challenges brought on by the pandemic. These interviews elucidate the challenges faced by nursing students during the COVID-19 pandemic and provide valuable information for future planning in nursing education during crises. [Articles in this journal were presented at the University of Calgary Conference on Postsecondary Learning and Teaching.]

We investigate the emergence, mutation profile, and dissemination of SARS-CoV-2 lineage B.1.214.2, first identified in Belgium in January 2021. This variant, featuring a 3-amino acid insertion in the spike protein similar to the Omicron variant, was speculated to enhance transmissibility or immune evasion. Initially detected in international travelers, it substantially transmitted in Central Africa, Belgium, Switzerland, and France, peaking in April 2021. Our travel-aware phylogeographic analysis, incorporating travel history, estimated the origin to the Republic of the Congo, with primary European entry through France and Belgium, and multiple smaller introductions during the epidemic. We correlate its spread with human travel patterns and air passenger data. Further, upon reviewing national reports of SARS-CoV-2 outbreaks in Belgian nursing homes, we found this strain caused moderately severe outcomes (8.7% case fatality ratio). A distinct nasopharyngeal immune response was observed in elderly patients, characterized by 80% unique signatures, higher B- and T-cell activation, increased type I IFN signaling, and reduced NK, Th17, and complement system activation, compared to similar outbreaks. This unique immune response may explain the variants epidemiological behavior and underscores the need for nasal vaccine strategies against emerging variants.

Abstract Background Breast cancer (BC) is the most common cancer in women in the developed world. In order to find developing cancers in an early stage, BC screening is commonly used. In Flanders, screening is performed in and outside an organized breast cancer screening program (BCSP). However, the determinants of BC screening coverage for both screening strategies are yet unknown. Objective To assess the determinants of BC screening coverage in Flanders. Methods Reimbursement data were used to attribute a screening status to each woman in the target population for the years 2008–2016. Yearly coverage data were categorized as screening inside or outside BCSP or no screening. Data were clustered by municipality level. A generalized linear equation model was used to assess the determinants of screening type. Results Over all years and municipalities, the median screening coverage rate inside and outside BCSP was 48.40% (IQR: 41.50–54.40%) and 14.10% (IQR: 9.80–19.80%) respectively. A higher coverage rate outside BSCP was statistically significantly (P

Abstract Background We examined 15 years of key performance indicators (KPIs) of the population-based mammography screening programme (PMSP) in Flanders, Belgium. Methods Individual screening data were linked to the national cancer registry to obtain oncological follow-up. We benchmarked crude KPI results against KPI-targets set by the European guidelines and KPI results of other national screening programmes. Temporal trends were examined by plotting age-standardised KPIs against the year of screening and estimating the Average Annual Percentage Change (AAPC). Results PMSP coverage increased significantly over the period of 15 years (+ 7.5% AAPC), but the increase fell to + 1.6% after invitation coverage was maximised. In 2016, PMSP coverage was at 50.0% and opportunistic coverage was at 14.1%, resulting in a total coverage by screening of 64.2%. The response to the invitations was 49.8% in 2016, without a trend. Recall rate decreased significantly (AAPC -1.5% & -5.0% in initial and subsequent regular screenings respectively) while cancer detection remained stable (AAPC 0.0%). The result was an increased positive predictive value (AAPC + 3.8%). Overall programme sensitivity was stable and was at 65.1% in 2014. In initial screens of 2015, the proportion of DCIS, tumours stage II+, and node negative invasive cancers was 18.2, 31.2, and 61.6% respectively. In subsequent regular screens of 2015, those proportions were 14.0, 24.8, and 65.4% respectively. Trends were not significant. Conclusion Besides a suboptimal attendance rate, most KPIs in the Flemish PMSP meet EU benchmark targets. Nonetheless, there are several priorities for further investigation such as a critical evaluation of strategies to increase screening participation, organising a biennial radiological review of interval cancers, analysing the effect that preceding opportunistic screening has on the KPI for initial screenings, and efforts to estimate the impact on breast cancer mortality.

We identified a cluster of mpox exposures among key populations in Kenya through retrospective serologic screening. We identified strong seropositivity among sex workers and gay, bisexual, and other men who have sex with men. These findings demonstrate the need for increased mpox surveillance among mpox-endemic and mpox-endemic-adjacent regions in Africa.

Abstract: Atmospheric rivers (ARs) deliver significant and essential precipitation to the western United States (US) with consequential interannual variability. The intensity and frequency of ARs strongly influence reservoir levels, mountain snowpack, and groundwater recharge, which are key drivers of water‐resource availability and natural hazards. Between October 2022 and April 2023, western states experienced exceptionally heavy precipitation from several families of powerful ARs. Using observations of surface‐loading deformation from Global Navigation Satellite Systems, we find that terrestrial water‐storage gains exceeded 100% of normal within vital California watersheds. Independent water‐storage solutions derived from different data‐analysis and inversion methods provide an important measure of precision. The sustained storage increases, which we show are closely associated with ARs at daily‐to‐weekly timescales, alleviated both meteorological and hydrological drought conditions in the region, with a lag in hydrological‐drought improvements. Quantifying water‐storage recovery associated with extreme precipitation after drought advances understanding of an increasingly variable hydrologic cycle.

Algorithmic systems such as Learning Analytics (LA) are driving the datafication and algorithmization of education. In this research, we focus on the appropriateness of LA systems from the perspective of parents and students in secondary education. Anchored in the contextual integrity framework (Nissenbaum, "Washington Law Review, 79," 41, 2004), we conducted two survey studies (N[subscript students]=277, N[subscript parents]=1013) in Flanders to investigate how they evaluate the appropriateness of the data flows in LA systems, and how both populations differ in their evaluations. The results show that the most-used student-centered LA are perceived less appropriate than the less-used teacher-centered LA by both students and parents. The usage of personal characteristics in LA is perceived as least appropriate, in contrast to coarser class characteristics. Sharing insights of LA with institutions that are part of the traditional educational context, such as the school, is seen as the most appropriate, and more appropriate than sharing it with learning platforms or third parties (e.g., Big Tech). Overall, we found that parents evaluated the different elements of the dataflows embedded in LA as less appropriate than students. In the discussion, we argue that educational institutions should include the evaluation of both parents and students to further manage expectations and construct shared norms and practices when implementing LA in education.informa

Intuitive conceptions based on cognitive biases (teleology, anthropomorphism, and essentialism) often prove helpful in everyday life while simultaneously being problematic in scientific contexts. Nonetheless, students often have intuitive conceptions of scientific topics such as evolution. As potential approaches to enable students to self-regulate their conceptions in the context of evolution, we investigated the effectiveness of two instructional approaches that are based on metacognition and self-regulated learning: (a) a formative criteria-referenced self-assessment of one's conceptions and (b) instruction on conditional metaconceptual knowledge (metacognitive knowledge about why and in which contexts specific conceptions are appropriate or not). We conducted an experimental intervention study using a 2 × 2 factorial (plus an additional control group), pre-post-follow-up-test design in German upper secondary level biology classes (N = 730). The groups that received one or both interventions had higher conceptual knowledge (i.e., used less intuitive conceptions and/or more scientific conceptions) afterward than those whose conceptions were not addressed: The self-assessment resulted in higher use of scientific conceptions; the instruction on conditional metaconceptual knowledge additionally resulted in lower use of intuitive conceptions based on cognitive biases, more reported thought processes relating to inhibition of cognitive biases, and a better ability to identify inappropriate phrasing based on cognitive biases. No effects were found on students' self-reported metaconceptual awareness and regulation. However, the fact that students inhibited their intuitive conceptions in the post-test indicates that they were indeed metaconceptually aware of and self-regulated their conceptions. The results suggest that students can be taught to become aware of the differences between intuitive and scientific conceptions and to regulate the use of their intuitive conceptions in a scientific context.

It remains poorly understood how SARS-CoV-2 infection influences the physiological host factors important for aerosol transmission. We assessed breathing pattern, exhaled droplets, and infectious virus after infection with Alpha and Delta variants of concern (VOC) in the Syrian hamster. Both VOCs displayed a confined window of detectable airborne virus (24-48 hr), shorter than compared to oropharyngeal swabs. The loss of airborne shedding was linked to airway constriction resulting in a decrease of fine aerosols (1-10 µm) produced, which are suspected to be the major driver of airborne transmission. Male sex was associated with increased viral replication and virus shedding in the air. Next, we compared the transmission efficiency of both variants and found no significant differences. Transmission efficiency varied mostly among donors, 0-100% (including a superspreading event), and aerosol transmission over multiple chain links was representative of natural heterogeneity of exposure dose and downstream viral kinetics. Co-infection with VOCs only occurred when both viruses were shed by the same donor during an increased exposure timeframe (24-48 hr). This highlights that assessment of host and virus factors resulting in a differential exhaled particle profile is critical for understanding airborne transmission.

Maternal educational attainment (MEA) shapes offspring health through multiple potential pathways. Differential DNA methylation may provide a mechanistic understanding of these long-term associations. We aimed to quantify the associations of MEA with offspring DNA methylation levels at birth, in childhood and in adolescence. Using 37 studies from high-income countries, we performed meta-analysis of epigenome-wide association studies (EWAS) to quantify the associations of completed years of MEA at the time of pregnancy with offspring DNA methylation levels at birth (n = 9 881), in childhood (n = 2 017), and adolescence (n = 2 740), adjusting for relevant covariates. MEA was found to be associated with DNA methylation at 473 cytosine-phosphate-guanine sites at birth, one in childhood, and four in adolescence. We observed enrichment for findings from previous EWAS on maternal folate, vitamin-B12 concentrations, maternal smoking, and pre-pregnancy BMI. The associations were directionally consistent with MEA being inversely associated with behaviours including smoking and BMI. Our findings form a bridge between socio-economic factors and biology and highlight potential pathways underlying effects of maternal education. The results broaden our understanding of bio-social associations linked to differential DNA methylation in multiple early stages of life. The data generated also offers an important resource to help a more precise understanding of the social determinants of health.

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its Minimal Information for Studies of Extracellular Vesicles, which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly.

Ammonia-oxidizing archaea (AOA) are among the most ubiquitous and abundant archaea on Earth, widely distributed in marine, terrestrial, and geothermal ecosystems. However, the genomic diversity, biogeography, and evolutionary process of AOA populations in subsurface environments are vastly understudied compared to those in marine and soil systems. Here, we report a novel AOA order Candidatus (Ca.) Nitrosomirales which forms a sister lineage to the thermophilic Ca. Nitrosocaldales. Metagenomic and 16S rRNA gene-read mapping demonstrates the abundant presence of Nitrosomirales AOA in various groundwater environments and their widespread distribution across a range of geothermal, terrestrial, and marine habitats. Terrestrial Nitrosomirales AOA show the genetic capacity of using formate as a source of reductant and using nitrate as an alternative electron acceptor. Nitrosomirales AOA appear to have acquired key metabolic genes and operons from other mesophilic populations via horizontal gene transfer, including genes encoding urease, nitrite reductase, and V-type ATPase. The additional metabolic versatility conferred by acquired functions may have facilitated their radiation into a variety of subsurface, marine, and soil environments. We also provide evidence that each of the four AOA orders spans both marine and terrestrial habitats, which suggests a more complex evolutionary history for major AOA lineages than previously proposed. Together, these findings establish a robust phylogenomic framework of AOA and provide new insights into the ecology and adaptation of this globally abundant functional guild.

The glycosylation of IgG plays a critical role during human severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, activating immune cells and inducing cytokine production. However, the role of IgM N-glycosylation has not been studied during human acute viral infection. The analysis of IgM N-glycosylation from healthy controls and hospitalized coronavirus disease 2019 (COVID-19) patients reveals increased high-mannose and sialylation that correlates with COVID-19 severity. These trends are confirmed within SARS-CoV-2-specific immunoglobulin N-glycan profiles. Moreover, the degree of total IgM mannosylation and sialylation correlate significantly with markers of disease severity. We link the changes of IgM N-glycosylation with the expression of Golgi glycosyltransferases. Lastly, we observe antigen-specific IgM antibody-dependent complement deposition is elevated in severe COVID-19 patients and modulated by exoglycosidase digestion. Taken together, this work links the IgM N-glycosylation with COVID-19 severity and highlights the need to understand IgM glycosylation and downstream immune function during human disease.

Post-acute sequelae of SARS-CoV-2 (PASC) is a significant public health concern. We describe Patient Reported Outcomes (PROs) on 590 participants prospectively assessed from hospital admission for COVID-19 through one year after discharge. Modeling identified 4 PRO clusters based on reported deficits (minimal, physical, mental/cognitive, and multidomain), supporting heterogenous clinical presentations in PASC, with sub-phenotypes associated with female sex and distinctive comorbidities. During the acute phase of disease, a higher respiratory SARS-CoV-2 viral burden and lower Receptor Binding Domain and Spike antibody titers were associated with both the physical predominant and the multidomain deficit clusters. A lower frequency of circulating B lymphocytes by mass cytometry (CyTOF) was observed in the multidomain deficit cluster. Circulating fibroblast growth factor 21 (FGF21) was significantly elevated in the mental/cognitive predominant and the multidomain clusters. Future efforts to link PASC to acute anti-viral host responses may help to better target treatment and prevention of PASC.