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Predictive student models are increasingly used in learning environments due to their ability to enhance educational outcomes and support stakeholders in making informed decisions. However, predictive models can be biased and produce unfair outcomes, leading to potential discrimination against certain individuals and harmful long-term implications. This has prompted research on fairness metrics meant to capture and quantify such biases. Nonetheless, current metrics primarily focus on predictive performance comparisons between groups, without considering the behavior of the models or the severity of the biases in the outcomes. To address this gap, we proposed a novel metric in a previous work (Verger et al., 2023) named "Model Absolute Density Distance" (MADD), measuring algorithmic unfairness as the difference of the probability distributions of the model's outcomes. In this paper, we extended our previous work with two major additions. Firstly, we provided theoretical and practical considerations on a hyperparameter of MADD, named "bandwidth," useful for optimal measurement of fairness with this metric. Secondly, we demonstrated how MADD can be used not only to measure unfairness but also to mitigate it through postprocessing of the model's outcomes while preserving its accuracy. We experimented with our approach on the same task of predicting student success in online courses as our previous work, and obtained successful results. To facilitate replication and future usages of MADD in different contexts, we developed an open-source Python package called maddlib (https://pypi.org/project/maddlib/). Altogether, our work contributes to advancing the research on fair student models in education.

Federal and highly decentralized political systems open different spaces to interpret, adapt, and enact international policy trends and ideas within the same territory. Spain, a country with a highly decentralized educational system and contentious territorial politics, is a very suitable case to analyze these dynamics. Spain and its different regions have not been immune to the influence of global policy ideas that gear around promoting private provision, school choice, and New Public Management (NPM) in education. However, the consolidation of the decentralization project, together with the fact that many regional governments have aimed to construct, for a variety of reasons, singular political profiles, have resulted in markedly different policy trajectories. To show this, this article pays particular attention to recent changes in the educational governance arrangements of two important Spanish regions, Madrid and Catalonia, as they have gone through differentiated processes of educational reform. Albeit the two regional education systems share important features (such as a historical and wide-scale public-private partnership for school provision), they have engaged with, combined, and mobilized exogenous and endogenous privatization policy ideas in remarkably different ways. The article delves into the political drivers behind this policy differentiation process by paying special attention to the relations of coordination, conflict, and competition that prevail within an incomplete federal system, such as the Spanish one.

Thomas Briot,1,2 Emilie Roger,1 Nolwenn Lautram,1 Alexis Verger,1 Anne Clavreul,3,4 Frederic Lagarce1,2 1Micro & Nanomédecines Translationelles – MINT, UNIV Angers, INSERM 1066, CNRS 6021, Université Bretagne Loire, MINT IBS-CHU, 2Pharmacy Department, University Hospital of Angers, 3Neurosurgery Department, University Hospital of Angers, 4CRCINA, INSERM, Université de Nantes, Université d’Angers, Angers, France Abstract: Decitabine is a hydrophilic drug that acts by hypomethylating DNA. Decitabine is used in Europe for the treatment of acute myeloid leukemia (AML) in patients aged ≥65 years. However, it can only be administered intravenously due to very low oral bioavailability and a large distribution volume. Oral administration would allow outpatient treatment, improving quality of life and reducing treatment costs. The present study proposes to develop lipid nanocapsules (LNCs), originally designed for lipophilic drugs, to encapsulate decitabine. Two different formulations of LNCs were designed: LNCs based on a high proportion of Transcutol® HP (THP-LNCs) and LNCs associated with a mixture of Transcutol® HP and Tween® 80 (THP-T80-LNCs). The second formulation had a diameter of 26.5±0.5 nm, high encapsulation efficiency (>85%), and a drug payload of 472±64 µg/mL. Decitabine-loaded THP-T80-LNC cytotoxicity was evaluated on two AML cell lines depending on their decitabine resistance: HEL (not resistant) and HL-60 (resistant). The permeability of decitabine-loaded THP-T80-LNCs was also evaluated on Caco-2 cell monolayers. Decitabine cytotoxicity against HEL and HL-60 was higher when decitabine was loaded in THP-T80-LNCs than when free. Apparent permeability on Caco-2 cell monolayers was also increased, suggesting a potentially useful formulation to increase the oral bioavailability of decitabine. Keywords: lipid nanocapsules, acute myeloid leukemia, decitabine, nanomedicine, nanoparticles, oral administration, Caco2 cells

Contemporary educational reforms emphasise school autonomy, performance-based management, and accountability as necessary policies for attaining improvement goals. Despite their widespread adoption, the configuration and enactment of these policies are discretionary and contingent, deeply influenced by the interaction of local contexts, organisational features, and teachers' beliefs about policy and pedagogy. Apart from these challenges, schools serving disadvantaged students, often targeted for educational improvement, also struggle with significant organisational constraints and policy overload. This study explores how disadvantaged urban schools make sense of their policy environment and engage with the school improvement mandate through different logics and practices. The analytical framework stresses the policy filtering and adaptation processes that school actors undergo when tasked with multiple implementation demands, and how these interact with school contexts to produce diverse responses. This research is conducted in Catalonia, Spain, and adopts a sequential mixed-methods strategy, relying on interviews with principals and teachers, as well as survey and administrative data. The findings are organised in four ideal types of school responses to the improvement mandate, showing the diverging ways schools engage with policy. Disadvantaged schools exhibit diverse improvement approaches despite sharing structural characteristics, explained by the interaction of contextual factors and organisational characteristics. Each ideal type prioritises different aspects, such as performance, innovation, or inclusive practices. The heterogeneity of school responses highlights the necessity for targeted, context-sensitive support to ensure equitable educational practices.

Under test-based accountability, side-effects--including practices to inflate test results, often seen as cheating--are usually associated to so-called high-stakes policies. However, the influence of different types of stakes in the generation of this type of practices has been overlooked in education research. Based on a survey experiment, our results indicate that the type and level of stakes of accountability systems (e.g., high- vs. low-stakes, material vs. symbolic) do not differ in triggering side-effects. Counterintuitively, individual symbolic consequences trigger similar reactions among teachers than material incentives. In-depth interviews give insights into the social mechanisms that lead to symbolic effects having such an influence in understanding teachers' reactivity to accountability.

Creativity researchers are increasingly interested in understanding when, how, and for whom creativity can be beneficial. Previous reviews have demonstrated that creativity research largely ignores the study of its impact on factors that promote health, and well-being among populations of adults. It is unclear, in fact, whether this gap in research also extends to creativity research among young children. This paper addresses this issue. Early childhood is a crucial stage for the cognitive development of young children who remain highly sensitive to stress, and adversity. It is therefore essential to identify and promote factors that are beneficial to early childhood resilience, thereby contributing to documenting more of the effects of creative activities on positive outcomes. This paper presents a review with a bibliometric analysis of 1000 randomly selected articles from the Web of Science, without bias towards any specific peer-reviewed journal. The analysis of 454 included articles shows that approximately 80% of the included studies focus on creativity as an outcome (replicating previous findings with a larger sample), with only 3.78% investigating creative activities as predictors among young children. In this small percentage, most of the studies addressed creative activities in young children related to resilience outcomes.

Abstract Background Healthcare professionals (HCPs) can play an important role in encouraging patients and their caregivers to be vaccinated. The objective of this qualitative study was to investigate HCPs’ perspectives on challenges in vaccine communication and unmet training needs in this domain. Methods Semi-structured interviews were conducted with 41 HCPs (mainly nurses and physicians) with vaccination roles (23 in England; 18 in France), gathering information on: (1) HCPs’ approach to vaccine conversations with patients; (2) Challenges of communicating about vaccines; (3) Vaccine-related training and learning resources available to HCPs, and; (4) HCPs’ training needs around vaccine communication. Results HCPs described a range of communication experiences that indicated insufficient time, information, and skills to confidently navigate difficult conversations with vaccine-hesitant patients. Communication skills were especially important to avoid conflict that could potentially damage the patient-provider relationship. Some HCPs interviewed had received communication training, but for most, this training was not specific to vaccination. Although general communication skills were transferable to vaccine conversations, most HCPs welcomed specific training and informational resources to support countering patients’ misconceptions or misinformation about vaccines. Conclusions HCPs would benefit from training tailored to address vaccine communication with patients, and this should be part of a systemic approach that also provides time and space to have effective vaccine conversations.

In recent decades, the governance of educational systems has experienced dramatic changes in many countries. Schools have been given more autonomy whilst being held increasingly accountable at the central level through standardized testing and other forms of external evaluation. The mechanisms of performance-based accountability (PBA) and the consequences attached to test results vary. In high-stakes systems, teachers' careers are more directly connected to students' performance, and low performing schools might risk closure, whereas in lower-stakes systems, the official administrative consequences of accountability for school actors are more symbolic than material. The main aim of this paper is to understand the impact of different forms of PBA on teachers' work from a comparative perspective. Most research on this topic is based on single-context case studies, which makes it difficult to understand the impact of policy factors and professional contexts in teachers' decisions and autonomy. To address this challenge, we review recent investigations (2017-2020) on the topic and compare their findings in different teachers' regulatory contexts. The review includes 101 articles from the SCOPUS and Web of Science databases. We find that evidence on the impact of PBA on teachers' perceptions and beliefs are variegated, and that the implications of PBA on teachers' autonomy does not only depend on the level of accountability stakes, but on teachers' professional regulation.

Children with disabilities and their families have the right to access Early Childhood Intervention (ECI). Family members should act as active agents of the intervention. In this sense, service professionals should offer support and intervention to improve family well-being and child development. We analyzed the experiences of parents of children with disabilities users of ECI services and the professional coordinators in the Balearic Islands (Spain) from a phenomenological-hermeneutic approach. Data collection was through semi-structured interviews and focus groups. A total of 5 coordinators and 30 family members participated in the study. The results indicate five categories: making ECI visible, reception phase, family well-being, intervention, and current barriers. The findings project the need to make ECI visible in policies and administrations, as well as plans to raise social awareness of child disability. Protocols must be found to facilitate access to services for children and families. Implications for the improvement of ECI are proposed.

Abstract The ketogenic diet (KD) has been shown to be effective in refractory epilepsy after long-term administration. However, its interference with short-term brain metabolism and its involvement in the early process leading to epilepsy remain poorly understood. This study aimed to assess the effect of a short-term ketogenic diet on cerebral glucose metabolic changes, before and after status epilepticus (SE) in rats, by using [18F]-FDG PET. Thirty-nine rats were subjected to a one-week KD (KD-rats, n = 24) or to a standard diet (SD-rats, n = 15) before the induction of a status epilepticus (SE) by lithium-pilocarpine administrations. Brain [18F]-FDG PET scans were performed before and 4 h after this induction. Morphological MRIs were acquired and used to spatially normalize the PET images which were then analyzed voxel-wisely using a statistical parametric-based method. Twenty-six rats were analyzed (KD-rats, n = 15; SD-rats, n = 11). The 7 days of the KD were associated with significant increases in the plasma β-hydroxybutyrate level, but with an unchanged glycemia. The PET images, recorded after the KD and before SE induction, showed an increased metabolism within sites involved in the appetitive behaviors: hypothalamic areas and periaqueductal gray, whereas no area of decreased metabolism was observed. At the 4th hour following the SE induction, large metabolism increases were observed in the KD- and SD-rats in areas known to be involved in the epileptogenesis process late—i.e., the hippocampus, parahippocampic, thalamic and hypothalamic areas, the periaqueductal gray, and the limbic structures (and in the motor cortex for the KD-rats only). However, no statistically significant difference was observed when comparing SD and KD groups at the 4th hour following the SE induction. A one-week ketogenic diet does not prevent the status epilepticus (SE) and associated metabolic brain abnormalities in the lithium-pilocarpine rat model. Further explorations are needed to determine whether a significant prevention could be achieved by more prolonged ketogenic diets and by testing this diet in less severe experimental models, and moreover, to analyze the diet effects on the later and chronic stages leading to epileptogenesis.

Abstract This study assesses the feasibility of using a sample-efficient model to investigate radiomics changes over time for predicting progression-free survival in rare diseases. Eighteen high-grade glioma patients underwent two L-3,4-dihydroxy-6-[18F]-fluoro-phenylalanine positron emission tomography (PET) dynamic scans: the first during treatment and the second at temozolomide chemotherapy discontinuation. Radiomics features from static/dynamic parametric images, alongside conventional features, were extracted. After excluding highly correlated features, 16 different models were trained by combining various feature selection methods and time-to-event survival algorithms. Performance was assessed using cross-validation. To evaluate model robustness, an additional dataset including 35 patients with a single PET scan at therapy discontinuation was used. Model performance was compared with a strategy extracting informative features from the set of 35 patients and applying them to the 18 patients with 2 PET scans. Delta-absolute radiomics achieved the highest performance when the pipeline was directly applied to the 18-patient subset (support vector machine (SVM) and recursive feature elimination (RFE): C-index = 0.783 [0.744–0.818]). This result remained consistent when transferring informative features from 35 patients (SVM + RFE: C-index = 0.751 [0.716–0.784], p = 0.06). In addition, it significantly outperformed delta-absolute conventional (C-index = 0.584 [0.548–0.620], p

The pandemic dramatically accelerated research on vaccine attitudes and uptake, a field which mobilizes researchers from the social sciences and humanities as well as biomedical and public health disciplines. The field has the potential to contribute much more, but the growth in research and the deeper connections between disciplines brings challenges as well as opportunities. This perspective article assesses the recent development of the field, exploring progress whilst emphasizing that not enough attention has been paid to national and local contexts. This lack of contextual attention limits the progress of research and hinders our capacity to learn from the COVID-19 crisis. We suggest three concrete responses: building and recognizing new publishing formats for reporting and synthesizing studies at a country level; establishing country-level interdisciplinary networks to connect research and praxis; and strengthening international comparative survey work by enhancing the focus on local contextual factors.