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Interest in the study of computer technology in schools (often in the form of Computer Science subjects or coding initiatives) is seen to have undergone two waves of interest, one in the late 1970s/early 1980s and the other more recently since about 2010. Through a historical exploration of the rationales for the study of computer technology in schools in both the first wave and the second wave, this paper aimed to explore the various curriculum ideologies underpinning their justification. In doing so, the paper highlights the chameleon-like nature of this change agenda in aligning with contemporary trends to advance the study of computer technology on the curriculum. The paper argues that current manifestations of the study of computer technology in schools are at odds with broader curriculum reform goals and international policies and raises questions about students' access to such knowledge.

This paper presents a document analysis of the Norwegian qualification framework Professional Digital Competence Framework for Teachers (PDC) to explore the underlying assumptions within the policy. Employing a post-structural policy analysis, the paper analyses the representation of the 'problem' of PDC by asking what the document does in relation to teachers' professionalism. To do this, the analysis explores the underlying assumptions of the policy document and its construction of the problem. The paper argues that the policy document is constructing a particular image of a digital future and presenting the teacher as the 'problem' in realising this imagined future. The paper discusses the discursive effects of this policy and explores the implications for the teaching profession.

Major depressive disorder (MDD) is a leading cause of disability worldwide. One of the most efficacious treatments for treatment-resistant MDD is electroconvulsive therapy (ECT). Recently, magnetic seizure therapy (MST) was developed as an alternative to ECT due to its more favorable side effect profile. While these approaches have been very successful clinically, the neural mechanisms underlying their therapeutic effects are unknown. For example, clinical slowing of the electroencephalogram beginning in the postictal state and extending days to weeks post-treatment has been observed in both treatment modalities. However, a recent longitudinal study of a small cohort of ECT patients revealed that, rather than delta oscillations, clinical slowing was better explained by increases in aperiodic activity, an emerging EEG signal linked to neural inhibition. Here we investigate the role of aperiodic activity in a cohort of patients who received ECT and a cohort of patients who received MST treatment. We find that aperiodic neural activity increases significantly in patients receiving either ECT or MST. Although not directly related to clinical efficacy in this dataset, increased aperiodic activity is linked to greater amounts of neural inhibition, which is suggestive of a potential shared neural mechanism of action across ECT and MST.

BACKGROUND: There is a clinical need for therapeutics for COVID-19 patients with acute hypoxemic respiratory failure whose 60-day mortality remains at 30-50%. Aviptadil, a lung-protective neuropeptide, and remdesivir, a nucleotide prodrug of an adenosine analog, were compared with placebo among patients with COVID-19 acute hypoxaemic respiratory failure. METHODS: TESICO was a randomised trial of aviptadil and remdesivir versus placebo at 28 sites in the USA. Hospitalised adult patients were eligible for the study if they had acute hypoxaemic respiratory failure due to confirmed SARS-CoV-2 infection and were within 4 days of the onset of respiratory failure. Participants could be randomly assigned to both study treatments in a 2 × 2 factorial design or to just one of the agents. Participants were randomly assigned with a web-based application. For each site, randomisation was stratified by disease severity (high-flow nasal oxygen or non-invasive ventilation vs invasive mechanical ventilation or extracorporeal membrane oxygenation [ECMO]), and four strata were defined by remdesivir and aviptadil eligibility, as follows: (1) eligible for randomisation to aviptadil and remdesivir in the 2 × 2 factorial design; participants were equally randomly assigned (1:1:1:1) to intravenous aviptadil plus remdesivir, aviptadil plus remdesivir matched placebo, aviptadil matched placebo plus remdesvir, or aviptadil placebo plus remdesivir placebo; (2) eligible for randomisation to aviptadil only because remdesivir was started before randomisation; (3) eligible for randomisation to aviptadil only because remdesivir was contraindicated; and (4) eligible for randomisation to remdesivir only because aviptadil was contraindicated. For participants in strata 2-4, randomisation was 1:1 to the active agent or matched placebo. Aviptadil was administered as a daily 12-h infusion for 3 days, targeting 600 pmol/kg on infusion day 1, 1200 pmol/kg on day 2, and 1800 pmol/kg on day 3. Remdesivir was administered as a 200 mg loading dose, followed by 100 mg daily maintenance doses for up to a 10-day total course. For participants assigned to placebo for either agent, matched saline placebo was administered in identical volumes. For both treatment comparisons, the primary outcome, assessed at day 90, was a six-category ordinal outcome: (1) at home (defined as the type of residence before hospitalisation) and off oxygen (recovered) for at least 77 days, (2) at home and off oxygen for 49-76 days, (3) at home and off oxygen for 1-48 days, (4) not hospitalised but either on supplemental oxygen or not at home, (5) hospitalised or in hospice care, or (6) dead. Mortality up to day 90 was a key secondary outcome. The independent data and safety monitoring board recommended stopping the aviptadil trial on May 25, 2022, for futility. On June 9, 2022, the sponsor stopped the trial of remdesivir due to slow enrolment. The trial is registered with ClinicalTrials.gov, NCT04843761. FINDINGS: Between April 21, 2021, and May 24, 2022, we enrolled 473 participants in the study. For the aviptadil comparison, 471 participants were randomly assigned to aviptadil or matched placebo. The modified intention-to-treat population comprised 461 participants who received at least a partial infusion of aviptadil (231 participants) or aviptadil matched placebo (230 participants). For the remdesivir comparison, 87 participants were randomly assigned to remdesivir or matched placebo and all received some infusion of remdesivir (44 participants) or remdesivir matched placebo (43 participants). 85 participants were included in the modified intention-to-treat analyses for both agents (ie, those enrolled in the 2 x 2 factorial). For the aviptadil versus placebo comparison, the median age was 57 years (IQR 46-66), 178 (39%) of 461 participants were female, and 246 (53%) were Black, Hispanic, Asian or other (vs 215 [47%] White participants). 431 (94%) of 461 participants were in an intensive care unit at baseline, with 271 (59%) receiving high-flow nasal oxygen or non-invasive ventiliation, 185 (40%) receiving invasive mechanical ventilation, and five (1%) receiving ECMO. The odds ratio (OR) for being in a better category of the primary efficacy endpoint for aviptadil versus placebo at day 90, from a model stratified by baseline disease severity, was 1·11 (95% CI 0·80-1·55; p=0·54). Up to day 90, 86 participants in the aviptadil group and 83 in the placebo group died. The cumulative percentage who died up to day 90 was 38% in the aviptadil group and 36% in the placebo group (hazard ratio 1·04, 95% CI 0·77-1·41; p=0·78). The primary safety outcome of death, serious adverse events, organ failure, serious infection, or grade 3 or 4 adverse events up to day 5 occurred in 146 (63%) of 231 patients in the aviptadil group compared with 129 (56%) of 230 participants in the placebo group (OR 1·40, 95% CI 0·94-2·08; p=0·10). INTERPRETATION: Among patients with COVID-19-associated acute hypoxaemic respiratory failure, aviptadil did not significantly improve clinical outcomes up to day 90 when compared with placebo. The smaller than planned sample size for the remdesivir trial did not permit definitive conclusions regarding safety or efficacy. FUNDING: National Institutes of Health.

Purpose: The article unpacks potentials of and resistance towards facilitating meetings between refugee and non-refugee youth in global citizenship education. Design/methodology/approach: The analyses are based on participant observation in a school-based intervention in three locations, developed on the principles of design-based research [DBR]. Findings: The article exposes both how meetings between students could be deeply educational and how teachers prevent meaningful interaction between students out of concern for refugee students. Research limitations/implications: More research is needed on how students care for themselves and others in transformational learning contexts. Practical implications: Privileged teachers' concern for retraumatising students can veil unconscious protection of the privileged self against students' trauma and should therefore be subject to critical reflection.

BACKGROUND: Cryptococcal meningitis is a common cause of AIDS-related mortality. Although symptom recurrence after initial treatment is common, the etiology is often difficult to decipher. We sought to summarize characteristics, etiologies, and outcomes among persons with second-episode symptomatic recurrence. METHODS: We prospectively enrolled Ugandans with cryptococcal meningitis and obtained patient characteristics, antiretroviral therapy (ART) and cryptococcosis histories, clinical outcomes, and cerebrospinal fluid (CSF) analysis results. We independently adjudicated cases of second-episode meningitis to categorize patients as (1) microbiological relapse, (2) paradoxical immune reconstitution inflammatory syndrome (IRIS), (3) persistent elevated intracranial pressure (ICP) only, or (4) persistent symptoms only, along with controls of primary cryptococcal meningitis. We compared groups with chi-square or Kruskal-Wallis tests as appropriate. RESULTS: 724 participants were included (n = 607 primary episode, 81 relapse, 28 paradoxical IRIS, 2 persistently elevated ICP, 6 persistent symptoms). Participants with culture-positive relapse had lower CD4 (25 cells/μL; IQR: 9-76) and lower CSF white blood cell (WBC; 4 cells/μL; IQR: 4-85) counts than paradoxical IRIS (CD4: 78 cells/μL; IQR: 47-142; WBC: 45 cells/μL; IQR: 8-128). Among those with CSF WBC

BackgroundEnsovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection.ObjectiveTo investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone.DesignDouble-blind, randomized, placebo-controlled, clinical trial. (ClinicalTrials.gov: NCT04501978).SettingMultinational, multicenter trial.ParticipantsAdults hospitalized with COVID-19.InterventionIntravenous ensovibep, 600 mg, or placebo.MeasurementsEnsovibep was assessed for early futility on the basis of pulmonary ordinal scores at day 5. The primary outcome was time to sustained recovery through day 90, defined as 14 consecutive days at home or place of usual residence after hospital discharge. A composite safety outcome that included death, serious adverse events, end-organ disease, and serious infections was assessed through day 90.ResultsAn independent data and safety monitoring board recommended that enrollment be halted for early futility after 485 patients were randomly assigned and received an infusion of ensovibep (n = 247) or placebo (n = 238). The odds ratio (OR) for a more favorable pulmonary outcome in the ensovibep (vs. placebo) group at day 5 was 0.93 (95% CI, 0.67 to 1.30; P = 0.68; OR > 1 would favor ensovibep). The 90-day cumulative incidence of sustained recovery was 82% for ensovibep and 80% for placebo (subhazard ratio [sHR], 1.06 [CI, 0.88 to 1.28]; sHR > 1 would favor ensovibep). The primary composite safety outcome at day 90 occurred in 78 ensovibep participants (32%) and 70 placebo participants (29%) (HR, 1.07 [CI, 0.77 to 1.47]; HR

BackgroundWe aimed to assess the efficacy and safety of two neutralising monoclonal antibody therapies (sotrovimab [Vir Biotechnology and GlaxoSmithKline] and BRII-196 plus BRII-198 [Brii Biosciences]) for adults admitted to hospital for COVID-19 (hereafter referred to as hospitalised) with COVID-19.MethodsIn this multinational, double-blind, randomised, placebo-controlled, clinical trial (Therapeutics for Inpatients with COVID-19 [TICO]), adults (aged ≥18 years) hospitalised with COVID-19 at 43 hospitals in the USA, Denmark, Switzerland, and Poland were recruited. Patients were eligible if they had laboratory-confirmed SARS-CoV-2 infection and COVID-19 symptoms for up to 12 days. Using a web-based application, participants were randomly assigned (2:1:2:1), stratified by trial site pharmacy, to sotrovimab 500 mg, matching placebo for sotrovimab, BRII-196 1000 mg plus BRII-198 1000 mg, or matching placebo for BRII-196 plus BRII-198, in addition to standard of care. Each study product was administered as a single dose given intravenously over 60 min. The concurrent placebo groups were pooled for analyses. The primary outcome was time to sustained clinical recovery, defined as discharge from the hospital to home and remaining at home for 14 consecutive days, up to day 90 after randomisation. Interim futility analyses were based on two seven-category ordinal outcome scales on day 5 that measured pulmonary status and extrapulmonary complications of COVID-19. The safety outcome was a composite of death, serious adverse events, incident organ failure, and serious coinfection up to day 90 after randomisation. Efficacy and safety outcomes were assessed in the modified intention-to-treat population, defined as all patients randomly assigned to treatment who started the study infusion. This study is registered with ClinicalTrials.gov, NCT04501978.FindingsBetween Dec 16, 2020, and March 1, 2021, 546 patients were enrolled and randomly assigned to sotrovimab (n=184), BRII-196 plus BRII-198 (n=183), or placebo (n=179), of whom 536 received part or all of their assigned study drug (sotrovimab n=182, BRII-196 plus BRII-198 n=176, or placebo n=178; median age of 60 years [IQR 50-72], 228 [43%] patients were female and 308 [57%] were male). At this point, enrolment was halted on the basis of the interim futility analysis. At day 5, neither the sotrovimab group nor the BRII-196 plus BRII-198 group had significantly higher odds of more favourable outcomes than the placebo group on either the pulmonary scale (adjusted odds ratio sotrovimab 1·07 [95% CI 0·74-1·56]; BRII-196 plus BRII-198 0·98 [95% CI 0·67-1·43]) or the pulmonary-plus complications scale (sotrovimab 1·08 [0·74-1·58]; BRII-196 plus BRII-198 1·00 [0·68-1·46]). By day 90, sustained clinical recovery was seen in 151 (85%) patients in the placebo group compared with 160 (88%) in the sotrovimab group (adjusted rate ratio 1·12 [95% CI 0·91-1·37]) and 155 (88%) in the BRII-196 plus BRII-198 group (1·08 [0·88-1·32]). The composite safety outcome up to day 90 was met by 48 (27%) patients in the placebo group, 42 (23%) in the sotrovimab group, and 45 (26%) in the BRII-196 plus BRII-198 group. 13 (7%) patients in the placebo group, 14 (8%) in the sotrovimab group, and 15 (9%) in the BRII-196 plus BRII-198 group died up to day 90.InterpretationNeither sotrovimab nor BRII-196 plus BRII-198 showed efficacy for improving clinical outcomes among adults hospitalised with COVID-19.FundingUS National Institutes of Health and Operation Warp Speed.

The relative importance of environmental pathways that results in enteropathogen transmission may vary by context. However, measurement of contact events between individuals and the environment remains a challenge, especially for infants and young children who may use their mouth and hands to explore their environment. Using a mixed-method approach, we combined 1) semistructured observations to characterize key behaviors associated with enteric pathogen exposure and 2) structured observations using Livetrak, a customized software application, to quantify the frequency and duration of contacts events among infants in rural Ecuador. After developing and iteratively piloting the structured observation instrument, we loaded the final list of prompts onto a LiveTrak pallet to assess environmental exposures of 6-month infants (N = 19) enrolled in a prospective cohort study of diarrheal disease. Here we provide a detailed account of the lessons learned. For example, in our field site, 1) most mothers reported washing their hands after diaper changes (14/18, 77.8%); however only a third (4/11, 36.4%) were observed washing their hands; 2) the observers noted that animal ownership differed from observed animal exposure because animals owned by neighboring households were reported during the observation; and 3) using Livetrak, we found that infants frequently mouthed their hands (median = 1.9 episodes/hour, median duration: 1.6 min) and mouthed surroundings objects (1.8 episodes/hour, 1.9 min). Structured observations that track events in real time, can complement environmental sampling, quantitative survey data and qualitative interviews. Customizing these observations enabled us to quantify enteric exposures most relevant to our rural Ecuadorian context.

Dengue is recognized as a major health issue in large urban tropical cities but is also observed in rural areas. In these environments, physical characteristics of the landscape and sociodemographic factors may influence vector populations at small geographic scales, while prior immunity to the four dengue virus serotypes affects incidence. In 2019, a rural northwestern Ecuadorian community, only accessible by river, experienced a dengue outbreak. The village is 2-3 hours by boat away from the nearest population center and comprises both Afro-Ecuadorian and Indigenous Chachi households. We used multiple data streams to examine spatial risk factors associated with this outbreak, combining maps collected with an unmanned aerial vehicle (UAV), an entomological survey, a community census, and active surveillance of febrile cases. We mapped visible water containers seen in UAV images and calculated both the green-red vegetation index (GRVI) and household proximity to public spaces like schools and meeting areas. To identify risk factors for symptomatic dengue infection, we used mixed-effect logistic regression models to account for the clustering of symptomatic cases within households. We identified 55 dengue cases (9.5% of the population) from 37 households. Cases peaked in June and continued through October. Rural spatial organization helped to explain disease risk. Afro-Ecuadorian (versus Indigenous) households experience more symptomatic dengue (OR = 3.0, 95%CI: 1.3, 6.9). This association was explained by differences in vegetation (measured by GRVI) near the household (OR: 11.3 95% 0.38, 38.0) and proximity to the football field (OR: 13.9, 95% 4.0, 48.4). The integration of UAV mapping with other data streams adds to our understanding of these dynamics.

BACKGROUND: Eculizumab is approved for the treatment of atypical hemolytic uremic syndrome (aHUS). Its use off-label is frequently reported. The aim of this study was to describe the broader use and outcomes of a cohort of pediatric patients exposed to eculizumab. METHODS: A retrospective, cohort analysis was performed on the clinical and biomarker characteristics of eculizumab-exposed patients < 25 years of age seen across 21 centers of the Pediatric Nephrology Research Consortium. Patients were included if they received at least one dose of eculizumab between 2008 and 2015. Traditional summary statistics were applied to demographic and clinical data. RESULTS: A total of 152 patients were identified, mean age 9.1 (+/-6.8) years. Eculizumab was used off-label in 44% of cases. The most common diagnoses were aHUS (47.4%), Shiga toxin-producing Escherichia coli HUS (12%), unspecified thrombotic microangiopathies (9%), and glomerulonephritis (9%). Genetic testing was available for 60% of patients; 20% had gene variants. Dosing regimens were variable. Kidney outcomes tended to vary according to diagnosis. Infectious adverse events were the most common adverse event (33.5%). No cases of meningitis were reported. Nine patients died of noninfectious causes while on therapy. CONCLUSIONS: This multi-center retrospective cohort analysis indicates that a significant number of children and young adults are being exposed to C5 blockade for off-label indications. Dosing schedules were highly variable, limiting outcome conclusions. Attributable adverse events appeared to be low. Cohort mortality (6.6%) was not insignificant. Prospective studies in homogenous disease cohorts are needed to support the role of C5 blockade in kidney outcomes.

With a growing global population and increased environmental concerns around animal agriculture, it is essential to humanely maximize animal performance and reduce environmental emissions. This study aims to determine the efficacy of feeding ractopamine hydrochloride (RAC), an orally active, β 1-adrenergic agonist (β1AA), to feedlot steers in the last 42 d of finishing to reduce ammonia (NH3) emissions and improve animal performance. A randomized complete block design was used to allocate 112 Angus and crossbred Angus steers (initial body weight [BW] = 566.0 ± 10.4 kg) to 8 cattle pen enclosures. Pens (n = 4 per treatment, 14 steers per pen, and 56 steers per treatment) were randomly assigned to one of two treatments: 1) CON; finishing ration containing no RAC, 2) RAC; finishing ration containing 27.3 g/907 kg dry matter (DM) basis RAC. Steers were weighed on day -1 and 0 before treatment and day 14, 28, and 42 during treatment. Treatment rations were mixed and delivered daily by masked personnel. Measured emissions included NH3, nitrous oxide (N2O), methane (CH4), hydrogen sulfide (H2S), and carbon dioxide (CO2). The primary response variables assessed were emissions standardized by live weight (LW) and hot carcass weight (HCW). Steers were harvested on day 43 and carcass data were collected on day 43 and 44. Steers fed RAC reduced NH3 emissions by 17.21% from day 0 to 28 (P = 0.032) and tended to reduce NH3 from day 0 to 42 by 11.07% (P = 0.070) vs. CON. When standardized for LW, NH3 was reduced by 23.88% from day 0 to 14 (P = 0.018), 17.80% from day 0 to 28 (P = 0.006), and 12.50% for day 0 to 42 (P = 0.027) in steers fed RAC vs. CON. Steers fed RAC had 14.05% (P = 0.013) lower cumulative NH3 emissions when standardized by HCW vs. CON. Feeding RAC to Steers reduced H2S by 29.49% from day 0 to 14 (P = 0.009) and tended to reduce H2S over day 0 to 28 by 11.14% (P = 0.086) vs. CON. When H2S emissions were standardized for LW, RAC fed steers had a 28.81% reduction from day 0 to 14 (P = 0.008) vs. CON. From day 0 to 42 the RAC fed steers tended to have a 0.24 kg/d greater average daily gain (ADG) (P = 0.066) and tended to eat 4.27% less (P = 0.069) on a DM basis vs. CON. The RAC fed steers had a 19.95% greater gain to feed ratio (G:F) compared to CON (P = 0.012). Steers fed RAC had an average of 12.52 kg greater HCW (P = 0.006) and an increase of 1.93 percentage units in dressing percent (DP) (P = 0.004) vs. CON. Ractopamine is an effective medicated feed additive for reducing NH3 and improving end product performance through HCW yields.

Many European governments, including Norway, have ambitious educational policies regarding digitalisation. Many businesses and policymakers pay great attention to the use of digital technologies in education in order to meet the future demands for a competent and qualified workforce. Among researchers and policymakers, there is a general consensus that the professional teacher is a key figure for the successful implementation of digital technologies in schools. Many expectations have been placed upon professional teachers regarding the implementation and use of digital technologies. The professional teacher is, to a certain degree, supposed to independently decide how digital technologies should be used in the classroom. This paper discusses what the concept of a 'professional digitally competent teacher' may mean in the context of schools. It also argues the need for a greater understanding of professional digital competence, one which takes into consideration various social and cultural aspects with regard to technology, schools and the teaching profession. In unpacking the social and cultural conditions for implementing technology in a professional teaching context, I will draw on concepts from the constructivist understanding of technology, namely, the 'domestication of technology'.

This article investigates use of digital storytelling as a learning activity in education about migration. Based on a study in two Norwegian schools and two adult education centers for refugees and migrants, the article analyzes student's digital stories and observations of the process of production. Counter to research on the promise of digital storytelling to promote diverse perspectives, personal experience and creativity, our findings show that digital stories as a learning activity includes powerful standardization drivers. The standardization limits diversity in students' knowledge and experience from coming into view in the final product. The identified standardization drivers are: (1) discursive blueprints of refugee experience, including the narrative about the 'Good Refugee' and idealization of the destination country, (2) challenges with representing traumatic experiences through photographic imagery, and (3) material affordances in the production process such as google algorithms. In conclusion, we argue that critical engagement with the involved modalities and standardization drivers is a condition for using digital stories to foster critical thinking about migration.

This paper examines the online marketing of digital technologies in education from three multi-national technology corporations' websites focusing on both the language used in the text and the nature of the accompanying images. Through a content analysis, the paper shows the ways in which the need for technology investment is rationalised. It also highlights how the need for educational reform drives much of the discourse in relation to K-12 education whereas, within the higher education sites, alignment with existing practices is emphasised. The analysis of the sites highlights the veiled ways in which digital futures are presented and how the corporations and their products and services are positioned. The paper highlights how educational technology advertising capitalises on new public management practices in education to a target school and university management in the promotion and marketing of educational technology -- largely by-passing those working at the coalface of education.

This article details the creation of the Finding Your Place Podcast. Key features of the podcast are presented, including the way it features student producers documenting their college experiences. The theoretical underpinnings of the podcast are explored along with key features of sound-only storytelling, making it an effective way to reach college students in general and first-year, first-generation college students in particular. Results from a survey of 94 listeners are also presented and analyzed.

This article presents the main findings of an applied research project, which studied student experiences of the challenges and opportunities of Problem-Based Learning (PBL) in two master programmes (MPs) at Aalborg University (AAU) characterised by diverse student groups, who bring different educational backgrounds, skills and experiences to the table. Research shows that PBL holds a potential for integrating and promoting learning outcomes for diverse student population, but also that heterogeneity can have negative influence on group dynamics and collaboration central in PBL, but how students experience this is under-researched. The investigation shows that diversity in terms of age differences and varieties in educational backgrounds are experienced both as challenges in teaching situations, but also as an opportunity to increase student learning over time. The study concludes with recommendations for practical alterations of the introduction to and conditions for the PBL model.