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Digital literacy competence (DL) is an important capacity for students' learning in a rapidly changing world. However, little is known about the empirical structure of DL. In this paper, we review major DL assessment frameworks and explore the dimensionality of DL from an empirical perspective using assessment data collected using authentic software applications, rather than simulated assessment environments. Secondary analysis on representative data collected from primary and secondary school students in Hong Kong using unidimensional and multidimensional item response theory reveals a general dimension of digital literacy performance and four specific, tool-dependent dimensions. These specific DL dimensions are defined by the software applications that students use and capture commonality among students' performance that is due to their familiarity with the assessment tools and contexts. The design of DL assessment is discussed in light of these findings, with particular emphasis on the influence of the nature of digital applications and environments used in assessment on the DL achievement scores measured. [ABSTRACT FROM AUTHOR]

Current guidelines for vaccination in allogeneic hematopoietic stem cell transplant (HCT) recipients recommend initiation of pneumococcal vaccination series three to six months post-HCT, with most data supporting initiation at six months due to a more robust immune response. This single-center, retrospective, observational chart review aimed to evaluate the impact of initiating the pneumococcal vaccine series at three months post-HCT compared to six months post-HCT. The primary endpoints were defined as a percentage of patients with a serologic response of >1 and >1.3 µg/mL for over 50% of the defined serotypes. Outcomes showed no difference in immunologic response between the two groups. [ABSTRACT FROM AUTHOR]

Background: Evaluating organ suitability for transplantation based on infection risk is a core competency in transplant infectious disease (TID). It is unclear if trainees have opportunities to practice during training. We created a simulation curriculum to develop and evaluate this skill among infectious disease (ID) trainees. Methods: We created six simulation questions about organ suitability for transplant based on infection risk. During trainees' TID rotations, faculty texted or paged the simulation cases posing as the transplant coordinator. Trainees had 15 min to ask questions before deciding the suitability of the organ and explained their clinical reasoning in a survey. Trainees completed a post‐simulation survey to evaluate its effectiveness. Results: ID trainees, including residents and fellows on rotation, from seven centers participated. Eighty‐seven percent (13/15) of trainees felt the simulation was effective in teaching them this concept, and 80% (12/15) felt prepared for clinical practice. The proportion of correct responses was generally high among the six different cases (43%–100%); correct responses increased for some cases in the post‐activity survey. Of the 100 clinical reasoning decisions made during the activity, 19% were discordant, where the trainee correctly identified suitable organs for incorrect reasons. Conclusion: Our simulation was effective in teaching when to accept or reject an organ for transplant and was a valuable educational tool. By evaluating clinical reasoning for decisions our simulation provides educators with nuanced insight and allows for targeted coaching. This study demonstrates a critical need for further educational tools in TID. [ABSTRACT FROM AUTHOR]

This article examines breakthrough COVID-19 infections in solid organ transplant recipients who received Tixagevimab/Cilgavimab (T/C) prophylaxis. The study found that there is limited data on the effect of T/C prophylaxis on breakthrough infections in this population during the omicron variant era. The analysis included 481 adult solid organ transplant recipients who received T/C at the University of California San Diego Health. The study found that breakthrough infections were associated with being further out from transplant and from the last vaccine dose, as well as cyclosporine use and lower prednisone doses. The study provides insights into the risk factors for breakthrough infections in solid organ transplant recipients receiving T/C prophylaxis, but further research is needed. [Extracted from the article]

Background: Pre-exposure prophylaxis for COVID-19 with tixagevimab/cilgavimab (T/C) received Emergency Use Authorization (EUA) based on results of a clinical trial conducted prior to the emergence of the Omicron variant. The clinical effectiveness of T/C has not been well described in the Omicron era. We examined the incidence of symptomatic illness and hospitalizations among T/C recipients when Omicron accounted for virtually all local cases. Methods: Through retrospective electronic medical record chart review, we identified patients who received T/C between January 1 –July 31, 2022 within our quaternary referral health system. We determined the incidence of symptomatic COVID-19 infections and hospitalizations due to or presumed to be caused by early Omicron variants before and after receiving T/C (pre-T/C and post-T/C). Chi square and Mann-Whitney Wilcoxon two-sample tests were used to examine differences between the characteristics of those who got COVID-19 before or after T/C prophylaxis, and rate ratios (RR) and 95% confidence intervals (CI) were calculated to assess differences in hospitalization rates for the two groups. Results: Of 1295 T/C recipients, 105 (8.1%) developed symptomatic COVID-19 infection before receiving T/C, and 102 (7.9%) developed symptomatic disease after receiving it. Of the 105 patients who developed symptomatic infection pre-T/C, 26 (24.8%) were hospitalized, compared with six of the 102 patients (5.9%) who were diagnosed with COVID-19 post-T/C (RR = 0.24; 95% CI = 0.10–0.55; p = 0.0002). Seven of the 105 (6.7%) patients infected pre-T/C, but none of the 102 infected post-T/C required ICU care. No COVID-related deaths occurred in either group. The majority of COVID-19 cases among those infected pre-T/C treatment occurred during the Omicron BA.1 surge, while the majority of post-T/C cases occurred when Omicron BA.5 was predominant. In both groups, having at least one dose of vaccine strongly protected against hospitalization (pre-T/C group RR = 0.31, 95% CI = 0.17–0.57, p = 0.02; post-T/C group RR = 0.15; 95% CI = 0.03–0.94; p = 0.04). Conclusion: We identified COVID-19 infections after T/C prophylaxis. Among patients who received T/C at our institution, COVID-19 Omicron cases occurring after T/C were one-fourth as likely to require hospitalization compared to those with Omicron prior to T/C. However, due to the presence of changing vaccine coverage, multiple therapies, and changing variants, the effectiveness of T/C in the Omicron era remains difficult to assess. [ABSTRACT FROM AUTHOR]

Bacteriophage therapy is the use of viruses to kill bacteria for the treatment of antibiotic-resistant infections. Little is known about the human immune response following phage therapy. We report the development of phage-specific CD4 T cells alongside rising phage-specific immunoglobulin G and neutralizing antibodies in response to adjunctive bacteriophage therapy used to treat a multidrug-resistant Pseudomonas aeruginosa pneumonia in a lung transplant recipient. Clinically, treatment was considered a success despite the development phage-specific immune responses. [ABSTRACT FROM AUTHOR]

Introduction: Patients with generalized myasthenia gravis (gMG) experience functional impairment due to MG symptoms. This study aimed to assess, from the patient perspective, the symptoms, impacts, and treatment goals of individuals diagnosed with gMG. Methods: Semi-structured, in-depth concept-elicitation interviews were conducted with 28 individuals diagnosed with gMG in the United States. Results: Participants reported gMG symptoms that affected many body regions and functions, with an average of 16 symptoms per participant. The most frequently reported symptoms were eyelid drooping (93%), physical fatigue (89%), symptoms affecting the legs (82%), difficulty breathing (82%), and difficulty holding head up (82%). Nearly all participants (96%) reported fluctuations in symptoms and severity. Participants' most bothersome symptoms were blurry/double vision (43%), breathing difficulties (36%), all-over fatigue (36%), and swallowing problems (29%). Impacts on physical functioning included an inability to participate in hobbies/sports, need for increased planning, and difficulties performing activities of daily living. All participants reported emotional impacts and impacts on their work and finances. Their treatment goals included reduced fatigue and weakness, improved symptom stability, and minimization of the impact of symptoms, in particular the emotional impact. Conclusions: The fluctuating and unpredictable nature of gMG symptoms was found to have a substantial impact on patients' emotional, social, and economic well-being. Participants' goals for symptom management suggest that greater focus is needed to help them quickly resume a normal lifestyle by achieving symptom stability. Impacts of fluctuating and unpredictable symptoms are difficult to measure, but it is important to consider symptom fluctuation as well as ongoing symptomatology when making treatment decisions, and to recognize the impact of uncontrolled symptoms on patients, their partners/caregivers, and family/friends. These factors are often not reflected in burden/cost-of-illness studies. Plain Language Summary: The aim of this study was to understand—from the patient's point of view—the range of generalized myasthenia gravis (gMG) symptoms that they experience, which symptoms bother them most, and which symptoms have the greatest impact on everyday life, as well as patients' treatment goals. Researchers asked these questions in one-on-one interviews with 28 people in the US who have gMG. Study participants reported living with symptoms that come and go, and are sometimes severe, making it difficult to lead a normal life. The most frequently reported symptoms were eyelid drooping (reported by 93% of study participants), physical fatigue (89%), symptoms affecting the legs (82%), difficulty breathing (82%), and difficulty holding head up (82%). The symptoms that bothered patients most were difficulties with vision (43%), problems breathing (36%), all-over fatigue (36%), and trouble swallowing (29%). Participants reported that gMG symptoms affected physical functioning, making it hard to participate in hobbies/sports, increasing the amount of planning needed to conduct their daily lives, and hindering their ability to do day-to-day activities (like driving, eating, and bathing). All participants reported that they were affected emotionally, and that the symptoms of gMG impacted their ability to work and their financial well-being. Participants' treatment goals included reducing fatigue and weakness, making symptoms more stable, and reducing the impact of symptoms, particularly emotional impacts. These responses reveal the extensive effects of gMG symptoms on patients' daily lives and highlight that symptom stability is especially important to people with gMG. [ABSTRACT FROM AUTHOR]

Swift digital advancements provide teenagers with ample online opportunities but also expose them to potential hazards that impact their wellbeing. The consequences of perceiving online risks vary among individuals, emphasizing the role of digital resilience as a protective mechanism. Digital resilience, rooted in the Digital Resilience Framework encompassing coping strategies, recovery, and learning from online risk experiences, goes beyond individual efforts. Instead, familial and educational factors play significant roles. This study investigates protective factors enhancing digital resilience from a socio-ecological perspective to boost adolescents' wellbeing. Data were collected from 1,882 parent-child pairs and 30 school ICT coordinators in 30 Hong Kong secondary schools between July and September 2022. Student and parent surveys assessed digital resilience, digital literacy, parental monitoring, and parent-child relationships, while the school ICT coordinator survey evaluated school-level digital literacy curriculum. Initially, no significant differences in adolescent wellbeing emerged regarding exposure to online risks. Employing structural equation modeling, this study suggests the protective role of digital resilience in enhancing adolescents' wellbeing. Results revealed that adolescents' digital resilience was positively associated with their digital literacy, positive parent-child relationships, and school-based digital literacy programs, particularly those focused on cyberbullying prevention. However, parental monitoring was only found to be significantly associated with adolescents' non-productive coping strategies, which were negatively associated with their wellbeing. These findings offer crucial insights for stakeholders such as educators, policymakers, and parents. These insights can empower adolescents to navigate the digital landscape effectively while safeguarding their wellbeing. • Digital resilience is a multifaceted concept that includes coping strategies, recovery, and learning from online hazards. • Digital resilience acts as a protective factor for adolescent wellbeing, shielding them from potential online risks. • Boost adolescent digital resilience via socio-ecological factors (e.g., individuals, family, and school). • Parental monitoring may not be efficacious in promoting adolescents' digital resilience. [ABSTRACT FROM AUTHOR]

Hong Kong was one of the first places hit with the COVID‐19 outbreak in January 2020 and has since responded with several periods of full or partial school suspension, during which teaching and learning often occurred remotely using digital means. During this time, collecting research data and testing students have become more difficult than before. In this article, we report on a large‐scale digital literacy (DL) performance assessment in Hong Kong that had to be conducted in a mix of modes—onsite, online supported, and online self‐directed—during the pandemic. We discuss the administrative and methodological challenges of assessing DL, and explore preliminary data on the associations between student performance and the assessment mode adopted. We further discuss potential implications, including for high‐stakes testing, and make recommendations for assessing DL remotely. [ABSTRACT FROM AUTHOR]

This study aims to investigate the mastery profiles of digital literacy skills of Hong Kong primary students using a general cognitive diagnosis model (CDM) framework. In particular, the relationship between the mastery of each digital skill and a number of students' background characteristics is explored using a three-step approach. The current study analyzes data collected from 642 Grade 3 students in Hong Kong using a newly developed digital literacy assessment (DLA). CDMs are fitted to the data to determine students' mastery profiles of five digital skills, as well as test properties; subsequently latent logistic regression analyses were implemented to determine the relationship between skill mastery and the covariates. Results indicate that CDM analysis is an appropriate method to analyze the DLA performance data, which exhibited measurement invariance across gender and socioeconomic status (SES). Despite low mastery proportions for all digital skills, students' skill mastery can be accurately classified. Finally, the latent logistic regression results indicate that children's background characteristics (i.e., gender, educational aspiration, home language, SES, and access to digital devices) are differentially related to their mastery of each digital skill. • Cognitive diagnosis model analysis provided a finer grain differentiation of students' digital literacy (DL) achievements. • Educational aspiration, SES, device access were significant predictors of Primary 3 students' DL skills mastery level. • Children's DL masteries were not significantly predicted by gender and home language. • Shared access to computers at home was positively related to DL mastery, but exclusive access was not. [ABSTRACT FROM AUTHOR]

Individuals who experience cyberbullying are at increased risk for future health and social difficulties. Despite this correlation, not all individuals who encountered cyberbullying experience exhibit poor subjective well-being, indicating the need for further investigation into potential protective factors. Cognitive emotional regulation strategy may help buffer or reinforce the negative emotions triggered by cyberbullying and prevent psychological problems, and there may be sex differences in emotion regulation resulting from the influence of social expectations and gender norms. Therefore, the present study examined sex differences in the moderating role of cognitive-emotional regulation strategies on the association between cyberbullying experiences and well-being outcomes in adolescents. We analyzed data from 5151 adolescents from 30 secondary schools (female = 53.9%, Mean grade level = 8.68, SD = 1.98) in Hong Kong. The results indicated that the experience of cyberbullying perpetration, victimization, and bystander was negatively associated with adolescent girls' well-being, whereas only the experience of cyberbullying perpetration was negatively associated with adolescent boys' well-being. Girls who reported blaming others more often had better well-being when they were victims of cyberbullying, and those who engaged in more cognitive reappraisal had better well-being when they were perpetrators of cyberbullying. Boys who reported blaming others more often had better well-being if they were cyberbullying perpetrators. These findings provide valuable insights for the development of gender-specific interventions aimed at reducing the negative impact of cyberbullying experience on adolescents' well-being. • Female adolescents were more vulnerable to cyberbullying experiences than male adolescents. • Victimization and bystander experiences in cyberbullying are negatively associated only with adolescent girls' well-being. • The protective role of emotion regulation strategy on mental health outcomes differed by gender. • Developing effective emotion regulation strategies may be vital in managing cyberbullying, especially for girls. [ABSTRACT FROM AUTHOR]

Background: Despite increased utilization of hepatitis C virus‐infected (HCV+) organs for transplantation into HCV‐uninfected recipients, there is lack of standardization in HCV‐related patient education/consent and limited data on financial and social impact on patients. Methods: We conducted a survey on patients with donor‐derived HCV infection at our center transplanted between 4/1/2017 and 11/1/2019 to assess: why patients chose to accept HCV+ organ(s), the adequacy of their pre‐transplant HCV education and informed consent process, financial issues related to copays after discharge, and social challenges they faced. Results: Among 49 patients surveyed, transplanted organs included heart (n = 19), lung (n = 9), kidney (n = 11), liver (n = 4), heart/kidney (n = 4), and liver/kidney (n = 2). Many recipients accepted an HCV‐viremic (HCV‐V) organ due to perceived reduction in waitlist time (n = 33) and/or trust in their physician's recommendation (n = 29). Almost all (n = 47) felt that pre‐transplant education and consent was appropriate. Thirty patients had no copay for direct‐acting antivirals (DAA) for HCV, including 21 with household income <$20 000; seven had copays of <$100 and one had a copay >$1000. Two patients reported feeling isolated due to HCV infection and eight reported higher than anticipated medication costs. Patients' biggest concern was potential HCV transmission to partners (n = 18) and family/friends (n = 15). Overall almost all (n = 47) patients reported a positive experience with HCV‐V organ transplantation. Conclusion: We demonstrate that real‐world patient experiences surrounding HCV‐V organ transplantation have been favorable. Almost all patients report comprehensive HCV‐related pre‐transplant consent and education. Additionally, medication costs and social isolation/exclusion were not barriers to the use of these organs. [ABSTRACT FROM AUTHOR]