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Recent literature underscores the need for teachers to develop AI competencies with a recognition of the current lack of well-defined competence frameworks. This critical review investigates teachers' Artificial Intelligence (AI) competence frameworks (AI CFTs), analysing their strengths, weaknesses and practical applications for researchers, educators and policymakers. It identifies five distinct types of AI CFTs within Competence Construct Claims (Child, S., & Shaw, S. 2023). A conceptual approach to validating competence frameworks. "Research Matters: A Cambridge University Press & Assessment publication," 35, 27-40.), each addressing the complexities of AI in its early stages. Notably, frameworks derived from empirical data offer detailed descriptions of competencies, while those based on conceptual models provide broader overviews. Highlighting the need for further empirical research, this review helps identify and understand existing approaches to teacher AI competence development and paves the way for integrating AI CFTs into teacher education, ultimately enhancing educators' preparedness to harness AI in their teaching practices.

Background: Prolonged packing of anorectal abscess cavities with internal dressings after incision and drainage is frequently used, but the efficacy of this practice remains controversial. Some studies highlight its use in hemostasis and preventing fistula and abscess recurrence, whereas others describe its economic burden and increase in pain. In this systematic review, we examine current evidence on the impact of packing after incision and drainage for anorectal abscesses. Methods: The medical librarian conducted a comprehensive literature search on January 5, 2023. We conducted the meta-analysis using RevMan 5.4.1 software with a Mantel-Haenszel random-effects model. Results: We identified 3 randomized controlled trials, comprising 490 patients. Of those, 241 patients (49%) received postoperative packing; most patients were male (n =158, 65.6%), with a median age of 40.5 years and a follow-up of 6 months. Meta-analysis showed that prolonged wound packing was associated with delayed wound healing and increased pain, but no difference in abscess recurrence or fistula formation. Conclusion: In this systematic review of current evidence highlighting the impact of packing after incision and drainage for anorectal abscesses, we found that the practice is not associated with significant differences in abscess recurrence and fistula formation, but is associated with increased postoperative pain and delayed wound healing. Contexte : On a souvent recours un m chage prolong des cavit s d'abc s anorectaux apr s l'incision et drainage, mais son efficacit n'a pas t tablie. Certaines tudes mentionnent son utilisation pour l'h mostase et la pr vention des fistules et des r currences d'abc s, tandis que d'autres soulignent son co t et un accroissement de la douleur. Dans cette revue syst matique, nous analysons les donn es r centes sur l'impact du m chage apr s l'incision et drainage des abc s anorectaux. M thodes : La biblioth que m dicale a t charg e de proc der une interrogation globale de la litt rature le 5 janvier 2023. Nous avons effectu une m ta-analyse l'aide du logiciel RevMan 5.4.1 et d'un mod le effets al atoires de Mantel-Haenszel. R sultats : Nous avons retenu 3 essais randomis s et contr l s regroupant 490 personnes, dont 241 (49%) chez qui une m che a t install e apr s l'intervention; la plupart des participants taient de sexe masculin (n = 158, 65,6%), l' ge moyen tait de 40,5 ans et le suivi a dur 6 mois. Selon la m ta-analyse, un m chage prolong de la cavit de l'abc s a t associ un ralentissement de la cicatrisation et une douleur plus marqu e, et n'a rien chang la r currence des abc s ou la formation de fistules. Conclusion : Lors de notre revue syst matique des donn es r centes sur l'impact du m chage apr s l'incision et drainage des abc s anorectaux, nous avons constat que cette pratique n'est pas associ e des diff rences significatives aux plans de la r currence des abc s et de la formation de fistules, mais qu'elle est plut t associ e une augmentation de la douleur postop ratoire et une cicatrisation plus lente de la plaie., Suppurative cryptoglandular anorectal disease refers to a spectrum of anorectal infections involving blockage of the base of the anal crypts of Morgagni responsible for drainage of secretory anal glands. (1-3) [...]

Abstract Introduction Chronic kidney disease (CKD) demonstrates a complex interaction with tobacco exposure and sex differences, where females and males may experience varying risks and outcomes. This study aims to investigate how sex differences mediate the relationship between tobacco exposure and CKD development, with a secondary focus on regional variability and social determinants of health. Study selection and criteria Comprehensive searches on MEDLINE, EMBASE, clinicaltrials.gov, and MedRxiv until October 6, 2022, were conducted. Eligibility criteria involved any study that reported primary data on the prevalence of CKD, with information pertaining to both sex and tobacco exposure. Data extraction Data retrieved include patient socio-demographic characteristics, general study information, diagnostic methods, social determinants of health, and the cause of CKD (e.g., tobacco-related or non-tobacco-related). Results Studies were selected through a comprehensive search using key terms such as "chronic kidney disease," "smoking," and "sex differences," which identified 3,025 articles, of which 28 were selected for full texts after screening titles, abstracts. Among the 28 included studies, smoking was consistently identified as a significant risk factor for CKD, with notable disparities related to sex, socioeconomic status, race, and urban versus rural settings. Significant geographical variability in CKD prevalence was observed, ranging from 2.5% to 68.1%, with the highest prevalence in Asia. However, due to high heterogeneity and methodological limitations, a meta-analysis of CKD prevalence stratified by sex and tobacco exposure was not feasible. Conclusions The findings emphasize the need for further research to comprehend the intricate relationship between, tobacco exposure, sex, and CKD management, as well as the consideration of cultural, geographical, socioeconomic, political, and structural factors when understanding the pathophysiology and management of CKD.

Background: This study assessed the effects of the "Jump-in" whole-school intervention in Amsterdam, the Netherlands, on children's weight development by comparing children exposed to the intervention and controls from 3 other large Dutch cities. Jump-in is a comprehensive intervention that aims to stimulate healthy nutrition and physical activity in children at primary schools in Amsterdam. In addition, the relationship between the intervention's implementation degree and its effectiveness was studied. Methods: Demographic and anthropometric data, collected by youth health care professionals via routine health checks at T0 (2014) and T1 (2019), were used to analyze possible intervention effects by comparing the weight development of children exposed to the Jump-in intervention versus unexposed controls. Implementation logs from health promotion professionals were used to determine intervention effects per implementation degree. Multilevel regression analyses were used for all analyses. Results: In total, 4299 children were included mean age ± 5.5 years (T0), 10.6 years (T1), and [approximately equal to] 50% boys/girls at both times. Receiving the fully implemented intervention resulted in a decline in standardized body-mass index (zBMI) compared to the controls (-0.23, confidence interval [CI] -0.33, -0.13). It also led to higher odds to move into a healthier weight category over time (odds ratio [OR] 1.36, CI 1.06, 1.74), yet no statistically significant shift towards a healthy weight was found. Conclusions: Relative to the controls, children exposed to the intervention showed positive zBMI developments, with stronger effects when the implementation degree was higher. Despite positive results, creating more impact might require the further integration of school-based programs into whole-systems approaches that include other energy-balance behaviors.

Abstract Intermediate-length repeat expansions in ATAXIN-2 (ATXN2) are the strongest genetic risk factor for amyotrophic lateral sclerosis (ALS). At the molecular level, ATXN2 intermediate expansions enhance TDP-43 toxicity and pathology. However, whether this triggers ALS pathogenesis at the cellular and functional level remains unknown. Here, we combine patient-derived and mouse models to dissect the effects of ATXN2 intermediate expansions in an ALS background. iPSC-derived motor neurons from ATXN2-ALS patients show altered stress granules, neurite damage and abnormal electrophysiological properties compared to healthy control and other familial ALS mutations. In TDP-43 Tg -ALS mice, ATXN2-Q33 causes reduced motor function, NMJ alterations, neuron degeneration and altered in vitro stress granule dynamics. Furthermore, gene expression changes related to mitochondrial function and inflammatory response are detected and confirmed at the cellular level in mice and human neuron and organoid models. Together, these results define pathogenic defects underlying ATXN2-ALS and provide a framework for future research into ATXN2-dependent pathogenesis and therapy.

Introduction:: Manual segmentation of medical images is labor intensive and especially challenging for images with poor contrast or resolution. The presence of disease exacerbates this further, increasing the need for an automated solution. To this extent, SynthSeg is a robust deep learning model designed for automatic brain segmentation across various contrasts and resolutions. This study validates the SynthSeg robust brain segmentation model on computed tomography (CT), using a multi-center dataset. Methods:: An open access dataset of 260 paired CT and magnetic resonance imaging (MRI) from radiotherapy patients treated in 5 centers was collected. Brain segmentations from CT and MRI were obtained with SynthSeg model, a component of the Freesurfer imaging suite. These segmentations were compared and evaluated using Dice scores and Hausdorff 95 distance (HD95), treating MRI-based segmentations as the ground truth. Brain regions that failed to meet performance criteria were excluded based on automated quality control (QC) scores. Results:: Dice scores indicate a median overlap of 0.76 (IQR: 0.65-0.83). The mean volume difference is 7.79% (CI: 6.41%–9.18%), with CT segmentations typically smaller than MRI-based. The median HD95 is 2.95 mm (IQR: 1.73-5.39). QC score based thresholding improves median dice by 0.1 and median HD95 by 0.05 mm. Morphological differences related to sex and age, as detected by MRI, were also replicated with CT, with an approximate 17% difference between the CT and MRI results for sex and 10% difference between the results for age. Conclusion:: SynthSeg can be utilized for CT-based automatic brain segmentation, but only in applications where precision is not essential. CT performance is lower than MRI based on the integrated QC scores, but low-quality segmentations can be excluded with QC-based thresholding. Additionally, performing CT-based neuroanatomical studies is encouraged, as the results show correlations in sex- and age-based analyses similar to those found with MRI.

Background/Purpose: Radiation-induced cardiac toxicity in lung cancer patients has received increased attention since RTOG 0617. However, large cohort studies with accurate cardiac substructure (CS) contours are lacking, limiting our understanding of the potential influence of individual CSs. Here, we analyse the correlation between CS dose and overall survival (OS) while accounting for deep learning (DL) contouring uncertainty, α/β uncertainty and different modelling approaches. Materials/Methods: This single institution, retrospective cohort study includes 730 patients (early-stage tumours (I or II). All treated: 2009–2019), who received stereotactic body radiotherapy (≥ 5 Gy per fraction). A DL model was trained on 70 manually contoured patients to create 12 cardio-vascular structures. Structures with median dice score above 0.8 and mean surface distance (MSD)

Introduction The early years are a critical period for establishing healthy 24-hour movement behaviours (physical activity, sedentary behaviour and sleep), yet studies examining prospective associations between all 24-hour movement behaviours and young children’s growth and development are lacking. The My Little Moves study aims to (1) examine the prospective association between 24-hour movement behaviours of young children (ie, 0–4 years) and their growth, motor and social–emotional development; and (2) explore potential determinants of young children’s 24-hour movement behaviours from an ecological perspective, to inform public health strategies aimed at promoting healthy behaviours and development.Methods and analysis My Little Moves is a longitudinal observational cohort study, with data collection at baseline, and after 9 and 18 months follow-up. Data are collected in three subcohorts. In all subcohorts, 24-hour movement behaviours are assessed by parent-report. Additionally in subcohort 1, data on potential determinants are collected by parental questionnaires, including child, parental and environmental factors. In subcohort 2, social–emotional development is assessed using the Dutch version of the Bayley Scales of Infant and Toddler Development-third edition (Bayley-III-NL) Social Emotional Scale. In subcohort 3, data on height and weight, gross motor development, using the Bayley-III-NL Gross Motor Scale, and 7 consecutive days of 24-hour accelerometer data are collected. Hybrid model analyses are used to assess the prospective associations of 24-hour movement behaviours with young children’s growth and development. Potential determinants of young children’s 24-hour movement behaviours are explored using regression analysis.Ethics and dissemination The Medical Ethics Committee of the VU University Medical Center approved the protocol for the My Little Moves study (2022.0020). The results of this study will be disseminated through the network of all authors, to inform public health strategies for promoting healthy 24-hour movement behaviours and contribute to the evidence-base of recommendations for ideal 24-hour movement behaviours in young children.

Abstract Introduction The standard treatment for patients with focal drug-resistant epilepsy (DRE) who are not eligible for open brain surgery is the continuation of anti-seizure medication (ASM) and neuromodulation. This treatment does not cure epilepsy but only decreases severity. The PRECISION trial offers a non-invasive, possibly curative intervention for these patients, which consist of a single stereotactic radiotherapy (SRT) treatment. Previous studies have shown promising results of SRT in this patient population. Nevertheless, this intervention is not yet available and reimbursed in the Netherlands. We hypothesize that: SRT is a superior treatment option compared to palliative standard of care, for patients with focal DRE, not eligible for open surgery, resulting in a higher reduction of seizure frequency (with 50% of the patients reaching a 75% seizure frequency reduction at 2 years follow-up). Methods In this waitlist-controlled phase 3 clinical trial, participants are randomly assigned in a 1:1 ratio to either receive SRT as the intervention, while the standard treatments consist of ASM continuation and neuromodulation. After 2-year follow-up, patients randomized for the standard treatment (waitlist-control group) are offered SRT. Patients aged ≥ 18 years with focal DRE and a pretreatment defined epileptogenic zone (EZ) not eligible for open surgery will be included. The intervention is a LINAC-based single fraction (24 Gy) SRT treatment. The target volume is defined as the epileptogenic zone (EZ) on all (non) invasive examinations. The seizure frequency will be monitored on a daily basis using an electronic diary and an automatic seizure detection system during the night. Potential side effects are evaluated using advanced MRI, cognitive evaluation, Common Toxicity Criteria, and patient-reported outcome questionnaires. In addition, the cost-effectiveness of the SRT treatment will be evaluated. Discussion This is the first randomized trial comparing SRT with standard of care in patients with DRE, non-eligible for open surgery. The primary objective is to determine whether SRT significantly reduces the seizure frequency 2 years after treatment. The results of this trial can influence the current clinical practice and medical cost reimbursement in the Netherlands for patients with focal DRE who are not eligible for open surgery, providing a non-invasive curative treatment option. Trial registration Clinicaltrials.gov Identifier: NCT05182437. Registered on September 27, 2021.

Opportunistic salpingectomy (OS) for the primary prevention of ovarian cancer is performed by gynecologists. Advocates have suggested expanding its use to other surgical specialties. General surgeons are the other group to routinely perform intraperitoneal operations in women and could play a role in ovarian cancer prevention. Herein, we review the current evidence and perioperative factors requiring consideration prior to OS implementation in select general surgery cases. A systematic search was conducted for English-language studies evaluating OS during general surgery. The primary outcomes of this study were the feasibility and safety of OS during general surgery procedures. Secondary outcomes included pre-operative considerations (patient selection and the consent process), operative factors (technique and surgical specialty involvement), and post-operative factors (follow-up and management of operative complications). We evaluated 3977 studies, with 9 meeting the eligibility criteria. Few studies exist but preliminary evidence suggests relative safety, with no complication attributable to OS among 140 patients. Feasibility was reported in one study, which showed the capacity to perform OS in 98 out of 105 cholecystectomies (93.3%), while another study reported quick visualization of the fallopian tubes in >80% of cases. All patients in the included studies were undergoing elective procedures, including cholecystectomy, interval appendectomy, colorectal resection, bariatric surgery, and laparoscopic hernia repair. Studies only included patients ≥ 45 years old, and the mean age ranged from 49 to 67.5 years. Gynecologists were frequently involved during the consent and surgical procedures. OS represents a potential intervention to reduce the risk of ovarian cancer. Ongoing studies evaluating the general surgeon’s understanding; the consent process; the feasibility, operative outcomes, and risks of OS; and surgeon training are required prior to consideration.

Abstract In cancer research there is much interest in building and validating outcome prediction models to support treatment decisions. However, because most outcome prediction models are developed and validated without regard to the causal aspects of treatment decision making, many published outcome prediction models may cause harm when used for decision making, despite being found accurate in validation studies. Guidelines on prediction model validation and the checklist for risk model endorsement by the American Joint Committee on Cancer do not protect against prediction models that are accurate during development and validation but harmful when used for decision making. We explain why this is the case and how to build and validate models that are useful for decision making.

Abstract Background Alzheimer’s disease (AD) is the most frequent cause of dementia. Recent evidence suggests the involvement of peripheral immune cells in the disease, but the underlying mechanisms remain unclear. Methods We comprehensively mapped peripheral immune changes in AD patients with mild cognitive impairment (MCI) or dementia compared to controls, using cytometry by time-of-flight (CyTOF). Results We found an adaptive immune signature in AD, and specifically highlight the accumulation of PD1+ CD57+ CD8+ T effector memory cells re-expressing CD45RA in the MCI stage of AD. In addition, several innate and adaptive immune cell subsets correlated to cerebrospinal fluid (CSF) biomarkers of AD neuropathology and measures for cognitive decline. Intriguingly, subsets of memory T and B cells were negatively associated with CSF biomarkers for tau pathology, neurodegeneration and neuroinflammation in AD patients. Lastly, we established the influence of the APOE ε4 allele on peripheral immunity. Conclusions Our findings illustrate significant peripheral immune alterations associated with both early and late clinical stages of AD, emphasizing the necessity for further investigation into how these changes influence underlying brain pathology.

Background. There are no high-quality data to guide long-term mycophenolate mofetil (MMF) dosing in kidney transplant recipients (KTRs) to balance the long-term risks of allograft rejection with that of infections and malignancy. At our center, KTRs are managed with either a “preemptive” dose reduction strategy, where the MMF dose is reduced after the first year before the development of adverse events, or with a “reactive” dosing strategy, where they are maintained on the same MMF dose and only reduced if they develop an adverse event. We hypothesized that a preemptive MMF dosing strategy after the first year of transplantation is associated with decreased infections without increasing alloimmune complications. Methods. We conducted a retrospective cohort study of all KTRs receiving MMF from January 1, 2015, to December 31, 2020. The primary outcome was the incidence of infections requiring hospitalization. Results. One hundred forty-two KTRs met the inclusion criteria, of whom 44 (31%) were in the preemptive group and 98 (69%) were in the reactive group. The median follow-up was 4 y (interquartile range, 3.8–4.0). Multivariable analysis showed that a preemptive MMF dose reduction strategy was associated with a lower risk of infections requiring hospitalization (adjusted hazard ratio = 0.39; 95% confidence interval, 0.16-0.92). There was no difference in graft loss, rejection, or estimated glomerular filtration rate slope. Conclusions. Preemptive MMF dose reduction in KTRs may be an effective strategy to prevent infections without increasing the risk of allograft rejection. Randomized clinical trials are needed to confirm these findings.

Background. In solid organ transplant recipients (SOTRs), studies investigating post–acute sequelae of SARS-CoV-2 infection (PASC) are limited, and risk factors for their development require further investigation. Methods. In this cross-sectional study, we evaluated PASC symptoms among SOTRs followed at our institutions who had COVID-19 during the Omicron period from December 28, 2021, to November 4, 2022. Participants were surveyed using a newly published PASC score containing 13 symptoms experienced for ≥30 d. PASC was defined as a score of ≥12. Results. Of 299 SOTRs invited, 93 completed the survey and were analyzed. The mean age was 58 y and 43% were women. Forty-six individuals (49%) reported experiencing ≥1 PASC symptom for ≥30 d, of whom 13 (14%) met the PASC definition. Multivariable analysis showed that female sex (adjusted odds ratio [aOR] = 0.32; 95% confidence interval [CI], 0.12-0.83), years from transplantation (aOR = 0.90 per additional year; 95% CI, 0.81-0.99), and tixagevimab-cilgavimab preexposure prophylaxis (aOR = 0.33; 95% CI, 0.12-0.84) were associated with significantly lower odds of developing ≥1 PASC symptom. Conclusions. PASC symptoms are common in SOTRs infected during the Omicron period. PASC symptoms are less frequent in those with a longer time since transplant and in those who received tixagevimab-cilgavimab. New SARS-CoV-2 prevention and treatment strategies should also evaluate PASC symptoms as outcomes.

IntroductionWith the advent of anti-β-amyloid therapies, clinical distinction between Aβ + and Aβ− in cognitive impairment is becoming increasingly important for stratifying referral and better utilization of biomarker assays.MethodsCognitive profile, rate of decline, neuropsychiatric inventory questionnaire (NPI-Q), and imaging characteristics were collected from 52 subjects with possible/probable AD.ResultsParticipants with Aβ+ status had lower baseline MMSE scores (24.50 vs. 26.85, p = 0.009) and higher total NPI-Q scores (2.73 vs. 1.18, p

BackgroundThe occurrence of peritoneal metastasis (PM) in patients with colorectal cancer (CRC) has a dismal prognosis. There is often limited response to systemic- and immunotherapy, even in microsatellite unstable (MSI) CRC. To overcome therapy resistance, it is critical to understand local immune environment in the peritoneal cavity, and to develop models to study anti-tumor immune responses. Here, we defined the peritoneal immune system (PerIS) in PM-CRC patients and evaluate the pre-clinical potential of a humanized immune system (HIS) mouse model for PM-CRC.MethodsWe studied the human PerIS in PM-CRC patients (n=20; MSS 19/20; 95%) and in healthy controls (n=3). HIS mice (NODscid gamma background; n=18) were generated, followed by intraperitoneal injection of either saline (HIS control; n=3) or human MSS/MSI CRC cell lines HUTU80, MDST8 and HCT116 (HIS-PM, n=15). Immune cells in peritoneal fluid and peritoneal tumors were analyzed using cytometry by time of flight (CyTOF).ResultsThe human and HIS mouse homeostatic PerIS was equally populated by NK cells and CD4+- and CD8+ T cells, however differences were observed in macrophage and B cell abundance. In HIS mice, successful peritoneal engraftment of both MSI and MSS tumors was observed (15/15; 100%). Both in human PM-CRC and in the HIS mouse PM-CRC model, we observed that MSS PM-CRC triggered a CD4+ Treg response in the PerIS, while MSI PM-CRC drives CD8+ TEMs responses.ConclusionIn conclusion, T cell responses in PM-CRC in HIS mice mirror those in human PM-CRC, making this model suitable to study antitumor T cell responses in PM-CRC.

Background. Limited information is available regarding outcomes of islet cell isolation (ICI) and transplantation (ITx) using medical assistance in dying (MAiD) donors. We aimed to assess the feasibility and outcomes of ICI and ITx in MAiD donors. Methods. ICI and ITx from MAiD were compared with donation after circulatory death (DCD) type III between 2016 and 2023. Differences of isolated islet equivalents (IEQs), numeric viability and other quantitative in vitro metabolic measures were assessed. Results. Overall, 81 ICIs were available of whom 34 (42%) and 47 (58%) from MAiD and DCD-III, respectively. There were no differences of pancreas and digested tissue weight and islets viability among the 2 groups; however, cold ischemic time was longer in MAiD (11.5 versus 9.1 h; P = 0.021). The IEQ (P