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The relationship between self-concept and academic achievement that is commonly cited has primarily been found in studies of students from Western countries with individualistic societies. Thus, this relationship may not be evident among students from non-Western countries, which are thought to largely adopt collectivist cultural values and behaviors that are inconsistent with the way that students from individualist nations perceive and evaluate their academic functioning. This lack of clarity motivates the present scoping review about the relationship between self-concept and academic achievement among students from collectivist countries who study in elementary, secondary, and post-secondary schools. A final review of 27 empirical articles involving student populations across educational levels and from several collectivist countries provided support for the same general relationship between self-concept and academic achievement that has been found in Western countries. Accordingly, the development of a favorable self-concept was associated with greater academic achievement. In some cases, this relationship was dependent on self-concept and academic achievement being measured in the context of a school-related discipline and on the time interval between the examination of both variables. Our findings provide insight into pathways to academic success that are effective across cultures, and we offer considerations for successful academic self-concept interventions for collectivist students.

Abstract Background Undifferentiated arthritis (UA) is a term used to describe patients with inflammatory arthritis that has not differentiated into a specific rheumatic disease. UA may be a pre-stage of rheumatoid arthritis (RA) or another inflammatory disease or remain undifferentiated, but a substantial proportion of patients may also achieve spontaneous remission. As UA may be an early presentation of RA, rheumatologists often start methotrexate (or another csDMARD) as early as possible. There are however very little data on the potential benefits of early DMARD treatment, and longitudinal data suggests that long-term outcomes such as physical functioning hardly improved in these patients in the past decades. In the I CEA trial, we investigate if it is beneficial to start early treatment with MTX or baricitinib, a more rapidly acting drug with a broader mechanism of action, compared to waiting for spontaneous remission with symptomatic therapy in patients with UA. Methods The I CEA is a multicenter single-blind (independent assessor) randomized clinical trial with a 3-month interventional and 9-month observational follow-up period. The study includes patients with early (

Choosing a course of study is one of the most consequential decisions a university student will make. While there is considerable literature investigating how personality influences students' choice of discipline, there is currently no evidence about how students cluster in disciplines relative to their civic-mindedness. This is an important gap in knowledge for faculty and staff who are increasingly implementing programmes and curricula aimed at developing civic-mindedness. Using data from a survey conducted at a single Dutch university (N = 1514) conducted prior to the start of first-year students' undergraduate studies, we estimated a confirmatory factor analysis model to measure two constructs related to civic-mindedness, Service Motivation and Civic Efficacy, and personality traits included in the five-factor model. We present distributions of these traits across disciplines of study and show large differences between disciplines in both measures of civic-mindedness. We also found that a model including personality, Service Motivation and Civic Efficacy explained a small, but non-trivial (six percent) amount of the variation in discipline selection. A better understanding of the distribution of civic-mindedness across disciplines will help educators and policy makers develop types of civic education that are better suited to the heterogeneity of today's student population.

Executive function (EF) is critical to students' academic behaviors and well-being. Environmental influences, particularly teacher-student interaction (TSI), play a key role in enhancing EF development. Previous studies have linked TSI quality to children's EF, yet the relationships between subdimensions of TSI--such as closeness, conflict, dependency, emotional support, classroom management, and instructional support--and EF outcomes remain unclear. Moreover, it is unclear whether these relations hold true across different cultural contexts. From an initial pool of 14,915 articles, in this meta-analysis, we considered 84 empirical studies across 18 cultural regions, revealing that TSI subdimensions are consistently related to EF with small-to-medium effect sizes. The analysis also identified statistically significant moderating factors, such as individualism, power distance, EF type, EF instrument, and socioeconomic status. Notably, stronger TSI-EF correlations were found among children from cultures with low-individualism and high-power-distance, as well as among children from higher socioeconomic backgrounds. These patterns were particularly pronounced in studies measuring hot EF through adult-reported data. This comprehensive meta-analysis bridges knowledge gaps in TSI-EF dynamics, and supporting theories, such as attachment theory, social learning theory, and socio-cultural theory within educational settings. Crucially, it provides cross-cultural perspectives showing how cultural and contextual factors may intertwine with TSI-EF interactions.

Objective Combination therapy with rituximab and belimumab is a novel treatment strategy for severe SLE and lupus nephritis. Phase II studies have shown promising results, although long-term data are currently lacking. To address this, we analysed outcomes of patients with severe treatment-refractory SLE who previously participated in the phase II Synbiose Study, with a particular focus on immunological parameters.Methods Eight patients continued belimumab treatment beyond the 2-year duration of the original trial. We conducted a descriptive study to evaluate the course of treatment and immunological parameters over an extended follow-up. Our analyses include blood cell counts, immunoglobulins, autoantibodies, complement markers and clinical disease activity parameters. Additionally, we examined long-term effects on the B cell compartment employing high-sensitivity flow cytometry.Results Over a median follow-up period of 6.8 years, six out of eight previously treatment-refractory patients maintained long-term clinical remission, while two experienced a major flare. Among those in remission, two patients achieved immunosuppression-free remission, and four continued belimumab. Long-term effects on humoral (auto-)immunity were a persistent decrease in IgM levels, while IgG normalised. Most patients maintained low autoantibody titres, and complement markers remained normal. On the cellular level, belimumab treatment after rituximab prevented B cell repopulation. Notably, patients exhibited a stable reduction of double-negative (DN) B cells, irrespective of continuing or stopping belimumab.Conclusions Long-lasting remission was observed in patients with SLE following combination treatment with rituximab and belimumab. We observed no significant hypogammaglobulinaemia and, notably, persistent reduction of DN B cells.

Objectives To evaluate the potential of clinical factors, ultrasound findings, serum autoantibodies, and serum cytokine and chemokine profiles as predictors of clinical outcomes in rheumatoid arthritis (RA).Patients and methods We included 200 patients with RA treated with biological and targeted synthetic disease-modifying antirheumatic drugs in a prospective multicentre ultrasound cohort study. Their serum levels of multiple cytokines and chemokines, rheumatoid factors, and serum autoantibodies (anti-cyclic citrullinated peptide-2 (anti-CCP2) and anti-carbamylated protein antibodies) were measured at baseline, 3 months and 12 months.Results Dimensionality reduction using 38 cytokines and chemokines demonstrated four distinct clusters that differed significantly regarding the frequencies of remission defined by clinical composite measures and ultrasound evaluations. Prominent differences in IL-1β, IL-5, IL-7, IL-10, IFNγ, GRO, IP-10, MCP-1 and MIP-1β characterised the between-cluster differences. Two distinct groups made of four clusters showed a significant difference in IgM-anti-CCP2 positivity. The least absolute shrinkage and selection operator regression of 38 cytokines and chemokines for Clinical Disease Activity Index (CDAI) remission at 12 months resulted in the selection of MIP-1β. Logistic regression using baseline levels of anti-citrullinated protein antibody, IgM-anti-CCP2 positivity, the CDAI, the total power Doppler score, the cluster by cytokines and chemokines, MIP-1β, methotrexate dose and mechanisms of action revealed that cluster by cytokines and chemokines was the sole significant factor for CDAI remission at 12 months.Conclusions Specific patterns of cytokines and chemokines—no other clinical factors and autoantibody profiles—were important to distinguish patients with RA achieving remission at 12 months.Trial registration number UMIN000012524.

Objectives: Parenteral drug products manufactured under GMP conditions should be visually inspected for defects and particulate contamination by trained and qualified personnel. Although personnel qualification is required, no practical protocols or formal guidelines are available for the development of qualification test sets (QTSs) used for qualification procedures. The current practice is to either procure a standardized QTS from a commercial supplier or amass sufficient manufacturing rejects during visual inspection procedures to compile in-house QTSs. However, both strategies inherently possess disadvantages and limitations. The objective of this study was to develop a manufacturing protocol for an optimal and adaptable QTS for training and qualification procedures. Methods: We combined the results of a literature search, survey of five Dutch hospital pharmacy compounding facilities, semi-structured personnel interviews, and extensive pre-GMP formulation studies to develop an optimal and adaptable QTS manufacturing protocol. Results: The literature search did not identify a manufacturing protocol for an optimal and adaptable QTS, but did identify specifications and requirements for optimal QTSs. The survey among hospital pharmacy compounding facilities revealed considerable variability in the qualification procedures and used QTSs. Semi-structured personnel interviews and pre-GMP formulation studies demonstrated that defects encountered during routine productions could be realistically simulated with pharmaceutical-grade excipients. As a proof-of-concept, we manufactured two different QTSs under GMP conditions and assessed these for formal GMP training and qualification purposes, which were considered a significant improvement compared to using manufacturing rejects. Conclusions: To the best of our knowledge, this is the first study presenting these data and our adaptable protocol, which is provided in the Supplemental Materials, may aid compounding facilities in the standardization, training, and qualification of personnel involved in visual inspection procedures.

The affordances of Open Educational Resources (OER) have resulted in various initiatives around the world, but most of them cease to exist once the initial project funding stops. Communities might be a means to create sustainable practices, yet, such communities can only function if their members perceive these communities as valuable. We applied the value creation framework of Wenger, Trayner, and De Laat to examine the value teachers ascribe to their engagement with an inter-institutional community on OER. In this community, 15 universities of applied sciences collaborated on sharing knowledge and resources across their institutional barriers. We collected data through user statistics, an online questionnaire, and semi-structured interviews. Major value creation occurred from teachers' personal needs, with dominant immediate and potential values. Findings on applied and realized values denote that it became easier for teachers to connect with peers, and to initiate collaboration projects across institutes. The framework we used is helpful to inform actions to further promote value creation in communities on OER. Recommendations relating to communities' aspirations, its relations with the wider organization, and adoption of OER are formulated to inform sustainable practices of inter-institutional communities.

Brokers are individuals who facilitate transfer of knowledge and resources, and coordinate efforts across boundaries of organizations. They are defined by their role rather than their organizational position. Brokers might be imperative for the formation and maintenance of inter-institutional relationship as they have the responsibility and the necessary structural position to connect otherwise separate groups. In the context of this study, brokers had the role to cultivate an inter-institutional community around open educational resources (OER) by connecting groups of teachers across higher education institutes. OER provide higher education institutes with an aid to face the challenges of improving teaching and learning. Yet most OER users encounter challenges that relate to finding resources that are relevant, up-to-date, and of good quality. Communities could minimize this issue, but many OER initiatives fizzle out as expanding their impact is an arduous task. This qualitative descriptive study draws upon cultural-historical activity theory to understand the complexities associated with the role of brokers in creating sustainable collaboration on OER across 15 higher education institutes in the Netherlands. Data was collected from project documents, process reports, reflections reports, and a retrospective focus group. The findings show that brokers engaged in a wide variety of actions but that a small-scale, personal, and content-oriented approach to encourage teachers to engage with the OER repository and the online community was perceived as the most valuable. Brokers also experienced conflicts due to the demanding context they were operating in, the ambiguity of their role, and the organizational constraints they were confronted with. Practical implications refer to supporting higher education institutes that wish to initiate sustainable collaboration across institutes.

Objective Gut-residing bacteria, such as Escherichia coli, can acetylate their proteome under conditions of amine starvation. It is postulated that the (gut) microbiome is involved in the breach of immune tolerance to modified self-proteins leading to the anti-modified protein antibodies (AMPAs), hallmarking seropositive rheumatoid arthritis (RA). Our aim was to determine whether acetylated bacterial proteins can induce AMPA responses cross-reactive to modified self-proteins and be recognised by human AMPA (hAMPA).Methods E. coli bacteria were grown under amine starvation to generate endogenously acetylated bacterial proteins. Furthermore, E. coli proteins were acetylated chemically. Recognition of these proteins by hAMPA was analysed by western blotting and ELISA; recognition by B cells carrying a modified protein-reactive B cell receptor (BCR) was analysed by pSyk (Syk phosphorylation) activation assay. C57BL/6 mice were immunised with (modified) bacterial protein fractions, and sera were analysed by ELISA.Results Chemically modified bacterial protein fractions contained high levels of acetylated proteins and were readily recognised by hAMPA and able to activate B cells carrying modified protein-reactive BCRs. Likely due to substantially lower levels of acetylation, endogenously acetylated protein fractions were not recognised by hAMPA or hAMPA-expressing B cells. Immunising mice with chemically modified protein fractions induced a strong cross-reactive AMPA response, targeting various modified antigens including citrullinated proteins.Conclusions Acetylated bacterial proteins are recognisable by hAMPA and are capable of inducing cross-reactive AMPA in mice. These observations provide the first conceptual evidence for a novel mechanism involving the (endogenous) acetylation of the bacterial proteome, allowing a breach of tolerance to modified proteins and the formation of cross-reactive AMPA.

Cognitive abilities, such as learning and flexibility, are hypothesized to aid behavioral adaptation to urbanization. Although growing evidence suggests that cognition may indeed facilitate persistence in urban environments, we currently lack knowledge of the cognitive abilities of many urban taxa. Recent methodological advances, including radio frequency identification (RFID), have extended automated cognitive testing into the field but have yet to be applied to a diversity of taxa. Here, we used an RFID-enabled operant conditioning device to assess the habituation, learning and cognitive flexibility of a wild population of raccoons (Procyon lotor). We examined how several biological and behavioral traits influenced participation and performance in testing. We then compared the cognitive performance of wild raccoons tested in natural conditions with that of wild-caught raccoons tested in captivity from a previous study. In natural conditions, juvenile raccoons were more likely to habituate to the testing device, but performed worse in serial reversal learning, compared with adults. We also found that docile raccoons were more likely to learn how to operate the device in natural conditions, which suggests a relationship between emotional reactivity and cognitive ability in raccoons. Although raccoons in both captive and natural conditions demonstrated rapid associative learning and flexibility, raccoons in captive conditions generally performed better, likely owing to the heightened vigilance and social interference experienced by raccoons in natural conditions. Our results have important implications for future research on urban carnivores and cognition in field settings, as well as our understanding of behavioral adaptation to urbanization and coexistence with urban wildlife.

Deep learning has become the preferred method for automated object detection, but the accurate detection of small objects remains a challenge due to the lack of distinctive appearance features. Most deep learning-based detectors do not exploit the temporal information that is available in video, even though this context is often essential when the signal-to-noise ratio is low. In addition, model development choices, such as the loss function, are typically designed around medium-sized objects. Moreover, most datasets that are acquired for the development of small object detectors are task-specific and lack diversity, and the smallest objects are often not well annotated. In this study, we address the aforementioned challenges and create a deep learning-based pipeline for versatile small object detection. With an in-house dataset consisting of civilian and military objects, we achieve a substantial improvement in YOLOv8 (baseline mAP = 0.465) by leveraging the temporal context in video and data augmentations specifically tailored to small objects (mAP = 0.839). We also show the benefit of having a carefully curated dataset in comparison with public datasets and find that a model trained on a diverse dataset outperforms environment-specific models. Our findings indicate that small objects can be detected accurately in a wide range of environments while leveraging the speed of the YOLO architecture.

Author(s): Vanessa K. Weva [sup.1] , Jenilee-Sarah Napoleon [sup.1] , Eva Malkus [sup.2] , Michael Hoover [sup.1] , Lydia Krabbendam [sup.3] [sup.4] , Jacob A. Burack [sup.1] , Mariëtte Huizinga [...], Academic motivation represents a psychoeducational construct that is associated with the academic success of youth. For some immigrant youth, however, their academic motivation may be affected by the various challenges that they face during their settlement in a culturally diverse school that promotes different self-construal values and practices. The main goal of this study is to investigate the cultural match or mismatch between non-Western immigrant youth and the self-construal orientation typically promoted in Western schools, as well as how specific challenges associated with migration contribute to the development of different levels of academic motivation during their recent settlement. We hypothesize that non-Western immigrant youth experience cultural mismatch in a Western school, and that greater reports of migration challenges are associated with increases in levels of external motivation and decreases in levels of intrinsic motivation. To test these hypotheses, the present study was conducted among non-Western immigrant youth between 12 and 19 years old in their first year of attending a Dutch academic integration program in The Netherlands. Our findings highlight that non-Western immigrant youth are mismatched with the self-construal orientations typically promoted in Dutch schools, and that there is specificity in the way that migration challenges relate to different levels of academic motivation. These findings should be considered by Western educational stakeholders who aim to foster academic success for immigrant youth early on in their resettlement.

Abstract. The BRIEF-2 (Gioia et al., 2015) is a widely used questionnaire to measure daily behavior related to executive function behaviors in the home and school environment of children between 5 and 18 years old. The current study was conducted to investigate the psychometric properties of the Dutch version of the BRIEF-2 in a representative Dutch-speaking norm sample. Using methods from classical test theory and network theory, we examined the reliability and validity of the BRIEF-2. The results indicated that the BRIEF-2 can be considered as a valid and reliable questionnaire that provides information on the role of executive function in the child’s and adolescent’s functioning in the home and school environment.

Objectives To assess whether prednisone use and/or disease activity score (DAS) are associated with the development of hyperglycaemia and diabetes in rheumatoid arthritis (RA).Methods We included 504 non-diabetic early RA patients from the BeSt study (Dutch acronym for treatment strategies). Patients were randomised to four DAS-steered treatment arms and followed for 10 years. The associations between DAS and prednisone use with glucose levels and the occurrence of hyperglycaemia over time were assessed with linear and logistic mixed effects regression models. Development of diabetes was analysed with Cox regression. Sensitivity analyses were performed in patients who had a first episode of hyperglycaemia.Results 31 of 504 patients (6.2%) with a mean age of 54 years developed diabetes during follow-up; 11 of these (35%) had received prior treatment with prednisone. Prednisone use was not associated with development of hyperglycaemia or diabetes after correction for multiple testing in main or sensitivity analyses. In the main analyses, DAS was significantly associated with development of diabetes (HR 1.802 per 1 point DAS increase, 95% CI 1.284 to 2.529) but not with glucose levels nor hyperglycaemia. In patients with previous hyperglycaemia, DAS was associated with glucose levels, recurrence of hyperglycaemia and diabetes.Conclusions In non-diabetic early RA patients, the use of prednisone was not associated with developing hyperglycaemia or diabetes. However, high DAS increased the risk of diabetes. Potential risks associated with prednisone use may have been mitigated by its effect on DAS.

Objectives To untangle the association between smoking and systemic sclerosis (SSc).Methods In the European Scleroderma Trials and Research cohort, the autoantibody status was compared between ever-smokers and never-smokers. Time until disease progression was assessed using Kaplan-Meier curves. Cox models were built to investigate the influence of smoking over 15 years of follow-up. All analyses were performed for the total cohort and stratified for sex and for positivity of anti-centromere (ACA) and anti-topoisomerase antibodies (ATA).Results Overall, 12 314 patients were included in the study. Of these, 10 393 were women (84%), 4637 were ACA-positive (38%), 3919 were ATA-positive (32%) and 4271 (35%) were ever-smokers. In men, but not in women, smoking was associated with mortality (HR 1.63, 95% CI 1.23 to 2.16, p=0.001). Ever-smoking women were at higher risk for skin progression (HR 1.10, 95% CI 1.00 to 1.22, p=0.046) and for ‘any organ progression’ (HR 1.07, 95% CI 1.00 to 1.13, p=0.036). In women, 34% of never-smokers were ATA-positive compared with 21% of ever-smokers (p

Objectives To investigate the efficacy, safety, pharmacokinetics and pharmacodynamics of nipocalimab in participants with moderate to severe active rheumatoid arthritis (RA) and inadequate response or intolerance to ≥1 antitumour necrosis factor agent.Methods In this phase 2a study, participants with RA seropositive for anticitrullinated protein antibodies (ACPA) or rheumatoid factors were randomised 3:2 to nipocalimab (15 mg/kg intravenously every 2 weeks) or placebo from Weeks 0 to 10. Efficacy endpoints (primary endpoint: change from baseline in Disease Activity Score 28 using C reactive protein (DAS28-CRP) at Week 12) and patient-reported outcomes (PROs) were assessed through Week 12. Safety, pharmacokinetics and pharmacodynamics were assessed through Week 18.Results 53 participants were enrolled (nipocalimab/placebo, n=33/20). Although the primary endpoint did not reach statistical significance for nipocalimab versus placebo, a numerically higher change from baseline in DAS28-CRP at Week 12 was observed (least squares mean (95% CI): –1.03 (–1.66 to –0.40) vs –0.58 (–1.24 to 0.07)), with numerically higher improvements in all secondary efficacy outcomes and PROs. Serious adverse events were reported in three participants (burn infection, infusion-related reaction and deep vein thrombosis). Nipocalimab significantly and reversibly reduced serum immunoglobulin G, ACPA and circulating immune complex levels but not serum inflammatory markers, including CRP. ACPA reduction was associated with DAS28-CRP remission and 50% response rate in American College of Rheumatology (ACR) criteria; participants with a higher baseline ACPA had greater clinical improvement.Conclusions Despite not achieving statistical significance in the primary endpoint, nipocalimab showed consistent, numerical efficacy benefits in participants with moderate to severe active RA, with greater benefit observed for participants with a higher baseline ACPA.Trial registration number NCT04991753.