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As cognitively gifted students may be at risk for motivational problems and underachievement, it is critical to find effective ways to motivate them. Grounded in self-determination theory (SDT) and the literature on teacher beliefs and mindsets, the present study examined whether teachers adapt their motivational teaching style as a function of the cognitive ability of students and which factors can explain the variability in teachers' use of (de)motivating styles among gifted versus typical students. Results of linear mixed modeling among 122 teachers in secondary education (73% female; M[subscript age] = 39.52 years) indicated that teachers made more use of autonomy-supportive and chaotic and less use of controlling and structuring practices towards cognitively gifted, relative to typical, students, with differences in the perceived effectiveness of teaching styles by type of student explaining this variability. Regardless of students' giftedness status, teachers' fixed mindset related positively to the use of a controlling and chaotic style and experience in giftedness education related positively to the use of autonomy support. Misconceptions regarding giftedness did not relate to teachers' motivating style. These results inform prevention efforts aimed at improving teachers' motivating styles, to the benefit of the motivation of both cognitively gifted and typical students.

This study examined the unique and interactive role of students' quality of motivation, as defined in self-determination theory, and their mindsets about intelligence, as conceptualized in Dweck's framework, in predicting a variety of learning outcomes (engagement, learning strategies, persistence, procrastination, and test anxiety) and achievement. Moving beyond past work, this study examined their effects both at the level of between-student differences and at the level of semester-to-semester fluctuations within students' own functioning, thereby controlling for students' cognitive ability. The study had a four-wave longitudinal design, following 3,415 seventh-grade students across a 2-year period with 6-month intervals (49.8% female; M[subscript age] = 12.65 years). Multilevel analyses demonstrated that autonomous motivation and effort beliefs had independent and favorable associations with most outcomes and that controlled motivation and a fixed mindset related more uniquely to maladaptive outcomes, findings that emerged at both levels of analysis. This pattern of associations was held after controlling for students' cognitive ability and applied to both students with high and low cognitive ability. The number of interactions between motivation and mindsets was quite limited. It can be concluded that the quality of motivation and mindsets about intelligence represent compatible resources for learning that help to explain between-student and within-student differences in learning and achievement.

Abstract Sarcopenia has been associated with adverse health outcomes, including cognitive dysfunction. However, its specific interrelationship with neurocognitive disorders such as mild cognitive impairment (MCI), Alzheimer's disease (AD) or other types of dementia has not been thoroughly explored. This meta‐analysis aims to summarize the existing evidence on this interrelationship. This systematic review was pre‐registered on PROSPERO (CRD42022366309) and reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 2020 guidelines. Databases, including PubMed, Embase, CINAHL, Scopus, Web of Science, PEDro, SPORTDiscus and the Cochrane Central Register of Controlled Trials, and the data registry ClinicalTrials.gov were searched from inception to 8 June 2023. Observational studies (cross‐sectional and cohort) and interventional studies reporting on the association and prevalence of sarcopenia in MCI, AD or other types of dementia in adults ≥50 years were included. For the meta‐analysis, pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association of sarcopenia with the neurocognitive disorders using random‐effects/fixed‐effects models. Subgroup analyses were performed to identify potential sources of heterogeneity. A total of 77 studies consisting of 92 058 subjects were finally included in the qualitative analysis (71 cross‐sectional, 4 cohort and 2 interventional studies). Studies were heterogeneous, using different diagnostic criteria to define both sarcopenia and cognitive status. The majority of studies (n = 38) included Asian community‐dwelling older adults. Most studies investigated the association of sarcopenia with AD (33/77) and MCI (32/77). For studies focusing on other forms of dementia, two studies included Lewy body dementia and one study included Parkinson's dementia, whereas the remaining studies did not specify dementia aetiology (n = 21). Three cohort studies explored the association between sarcopenia and incident MCI, whereas only one cohort study explored the association between dementia and incident sarcopenia. Two interventional studies investigated whether an exercise programme could prevent the progression of sarcopenia in older adults with dementia or AD. The information for the meta‐analysis was extracted from 26 studies. Sarcopenia was significantly associated with MCI (pooled OR = 1.58, 95% CI 1.42–1.76) (n = 14), AD (pooled OR = 2.97, 95% CI 2.15–4.08) (n = 3) and non‐AD dementia (pooled OR = 1.68, 95% CI 1.09–2.58) (n = 9). The significance and magnitude of the associations differed in subgroup analyses by study design, population, definition of sarcopenia or used tool to measure cognitive status. This meta‐analysis showed that sarcopenia is significantly associated with MCI, AD and other types of dementia. These findings suggest the importance of early screening and prevention of sarcopenia in older people with cognitive dysfunction, although further longitudinal research is needed to clarify the causal relationship.

Abstract Background The maternal mortality ratio (MMR) in Indonesia is among the highest in Southeast Asia. We aim to describe trends in the MMR and causes of maternal deaths in Indonesia over the past decades, regionally and nationally. Methods We performed a systematic review and conducted a search using PubMed, Embase, Global Health, CINAHL, Cochrane, Portal Garuda, and Google Scholar from the inception of the database to April 2023. We included all studies on the incidence and/or the causes of maternal deaths in Indonesia. The MMR was defined as the number of maternal deaths per 100,000 live births. Maternal death causes were assessed and reclassified according to the WHO International Classification of Disease Maternal Mortality (ICD-MM). Results We included 63 studies that reported the MMR (54 studies) and/or the causes of maternal deaths (44 studies) in Indonesia from 1970 to 2022, with a total of 254,796 maternal deaths. The national MMR declined from 450 to 249 (45%) between 1990 and 2020. Great differences in MMR exist across the country, with the lowest in Java-Bali and the highest (more than twice the national MMR) in Sulawesi and Eastern Indonesia. Between 1990 and 2022, the proportion of deaths due to hemorrhage and sepsis decreased, respectively from 48 to 18% and 15–5%, while the share of deaths due to hypertensive disorders and non-obstetric causes increased, respectively from 8 to 19% and 10–49%. Conclusion Despite the steady decline of maternal deaths in Indonesia, it remains one of the highest in Southeast Asia, with enormous disparities within the country. Hypertensive disorders and non-communicable diseases make up a growing share of maternal deaths, making maternal death reduction strategies increasingly challenging. National Maternal Death Surveillance and Response needs to be prioritized to eliminate preventable maternal deaths in Indonesia. Registration of systematic reviews PROSPERO, CRD42022320213.

Abstract Leukemias with ambiguous lineage comprise several loosely defined entities, often without a clear mechanistic basis. Here, we extensively profile the epigenome and transcriptome of a subgroup of such leukemias with CpG Island Methylator Phenotype. These leukemias exhibit comparable hybrid myeloid/lymphoid epigenetic landscapes, yet heterogeneous genetic alterations, suggesting they are defined by their shared epigenetic profile rather than common genetic lesions. Gene expression enrichment reveals similarity with early T-cell precursor acute lymphoblastic leukemia and a lymphoid progenitor cell of origin. In line with this, integration of differential DNA methylation and gene expression shows widespread silencing of myeloid transcription factors. Moreover, binding sites for hematopoietic transcription factors, including CEBPA, SPI1 and LEF1, are uniquely inaccessible in these leukemias. Hypermethylation also results in loss of CTCF binding, accompanied by changes in chromatin interactions involving key transcription factors. In conclusion, epigenetic dysregulation, and not genetic lesions, explains the mixed phenotype of this group of leukemias with ambiguous lineage. The data collected here constitute a useful and comprehensive epigenomic reference for subsequent studies of acute myeloid leukemias, T-cell acute lymphoblastic leukemias and mixed-phenotype leukemias.

This study aims to better understand differences in the decision-making process behind study choices for higher education by investigating the presence of exploration profiles and then explore the explanatory base. To achieve this, we first identified different exploration profiles of students transitioning to higher education (n = 5660), and then investigated whether they were predicted by different student variables (i.e., learning strategies, gender, and educational track) and linked with different outcomes of the decision-making process (i.e., the amount of information acquired regarding higher education, decisional status, and commitment). A latent profile analysis identified three exploration profiles based on the decisional tasks of orientation, self-, broad, and in-depth exploration: passive (35%), moderately active (52%), and highly active explorers (13%). Students' learning strategies (regulation and processing strategies) were associated with these profiles. Students with more effective regulation and processing strategies were more likely to be highly active than passive or moderately active explorers. Female students and students from the technical track were more likely to be found in the highly active profile compared to the moderately active and the passive or moderately active profile, respectively. Finally, highly active explorers had the most favorable outcomes, measured by decisional status, commitment, and amount of information. Based on a substantial dataset, our findings contribute to a more comprehensive understanding of the explanatory base of important differences in the study choice making process of students opting for higher education. This may ultimately lead to more fitting support for students in less beneficial profiles.

This study used a longitudinal person-oriented approach to examine whether two distinct developmental pathways of maladaptive motivation could be distinguished among high-ability students (intelligence quotient [IQ] [greater than or equal to] 120, N = 403, M[subscript age] = 12.2 years, 60.5% males), as proposed by the Pathways to Underachievement Model. Latent class growth analysis provided evidence for a three-class solution, including an adaptive class and two maladaptive classes, largely corresponding with the predictions of the Pathways to Underachievement Model. Furthermore, the classes related to the outcome variables in the expected ways, with the maladaptive classes showing higher disengagement and underachievement. These findings substantiate the Pathways to Underachievement Model and provide developmental insight into the multiple motivational pathways underlying disengagement and underachievement among high-ability students.

Objectives To investigate if patients with early rheumatoid arthritis responding insufficiently to initial methotrexate (MTX) and bridging glucocorticoids (GCs) could benefit from early but temporary etanercept introduction as a second remission-induction attempt.Methods CareRA2020 (NCT03649061) was a 2-year, open-label, multicentre, pragmatic randomised controlled trial. Treatment-naïve patients started MTX and GC bridging (COBRA-Slim: CS). Within a time window from week (W) 8 until W32, early insufficient responders (28-joint Disease Activity Score – C-reactive Protein (DAS28-CRP) >3.2 between W8 and W32 or ≥2.6 at W32) were randomised to a Standard-CS strategy (adding leflunomide first) or Bio-induction-CS strategy (adding etanercept for 24 weeks). Additional treatment adaptations followed the treat-to-target principle. Longitudinal disease activity (DAS28-CRP) over 104 weeks (primary outcome), achievement of DAS28-CRP

Background: Teachers may play a key role in reducing bullying by responding to incidents among students. Inspired by the theory of planned behaviour, several studies have investigated teachers' bullying-related cognitions as predictors of their responses to bullying. Aims: This study investigated whether six teachers' bullying-related cognitions (i.e., perceived seriousness, empathy, attitudes, self-efficacy and attribution of the bullying) predicted five student-perceived teachers' responses (i.e., Non-Intervention, Disciplinary Methods, Victim Support, Mediation and Group Discussion) over time. By examining this objective, more insight into student perceptions of teachers' responses to bullying could also be provided. Sample: In total, 999 upper elementary school students (M[subscript age] = 10.61 at Wave 1, SD[subscript age] = 0.90; 53.6% girls) and their 59 teachers (M[subscript age] = 39.61 at W1, SD[subscript age] = 11.60; 79.7% female) participated. Methods: A bullying questionnaire was administered in three waves to assess students' perceptions of the teachers' responses. Teachers reported bullying-related cognitions in the first wave. Multilevel analyses were used to investigate the relative contribution of the predictors on the teachers' responses over time. Results: None of the teachers' bullying-related cognitions significantly predicted the teachers' specific responses. Conclusions: The findings suggest that teachers' bullying-related cognitions are not reflected in their responses to bullying as perceived by students. Moreover, the findings indicate that students' perceptions of teachers' responses vary widely within classrooms and over time. Student- and teacher-reported teachers' responses might differ, and these possible differences should be taken into account.

Abstract Background Interferon-γ-inducible protein of 10 kDa (IP-10/CXCL10) is a dual-function CXC chemokine that coordinates chemotaxis of activated T cells and natural killer (NK) cells via interaction with its G protein-coupled receptor (GPCR), CXC chemokine receptor 3 (CXCR3). As a consequence of natural posttranslational modifications, human CXCL10 exhibits a high degree of structural and functional heterogeneity. However, the biological effect of natural posttranslational processing of CXCL10 at the carboxy (C)-terminus has remained partially elusive. We studied CXCL10(1–73), lacking the four endmost C-terminal amino acids, which was previously identified in supernatant of cultured human fibroblasts and keratinocytes. Methods Relative levels of CXCL10(1–73) and intact CXCL10(1–77) were determined in synovial fluids of patients with rheumatoid arthritis (RA) through tandem mass spectrometry. The production of CXCL10(1–73) was optimized through Fmoc-based solid phase peptide synthesis (SPPS) and a strategy to efficiently generate human CXCL10 proteoforms was introduced. CXCL10(1–73) was compared to intact CXCL10(1–77) using surface plasmon resonance for glycosaminoglycan (GAG) binding affinity, assays for cell migration, second messenger signaling downstream of CXCR3, and flow cytometry of CHO cells and primary human T lymphocytes and endothelial cells. Leukocyte recruitment in vivo upon intraperitoneal injection of CXCL10(1–73) was also evaluated. Results Natural CXCL10(1–73) was more abundantly present compared to intact CXCL10(1–77) in synovial fluids of patients with RA. CXCL10(1–73) had diminished affinity for GAG including heparin, heparan sulfate and chondroitin sulfate A. Moreover, CXCL10(1–73) exhibited an attenuated capacity to induce CXCR3A-mediated signaling, as evidenced in calcium mobilization assays and through quantification of phosphorylated extracellular signal-regulated kinase-1/2 (ERK1/2) and protein kinase B/Akt. Furthermore, CXCL10(1–73) incited significantly less primary human T lymphocyte chemotaxis in vitro and peritoneal ingress of CXCR3+ T lymphocytes in mice. In contrast, loss of the four endmost C-terminal residues did not affect the inhibitory properties of CXCL10 on migration, proliferation, wound closure, phosphorylation of ERK1/2, and sprouting of human microvascular endothelial cells. Conclusion Our study shows that the C-terminal residues Lys74-Pro77 of CXCL10 are important for GAG binding, signaling through CXCR3A, T lymphocyte chemotaxis, but dispensable for angiostasis. Graphical Abstract

Otago Exercise Program (OEP) is a rehabilitation program for older adults to improve frailty, sarcopenia, and balance. Accurate monitoring of patient involvement in OEP is challenging, as self-reports (diaries) are often unreliable. The development of wearable sensors and their use in Human Activity Recognition (HAR) systems has lead to a revolution in healthcare. However, the use of such HAR systems for OEP still shows limited performance. The objective of this study is to build an unobtrusive and accurate system to monitor OEP for older adults. Data was collected from 18 older adults wearing a single waist-mounted Inertial Measurement Unit (IMU). Two datasets were recorded, one in a laboratory setting, and one at the homes of the patients. A hierarchical system is proposed with two stages: 1) using a deep learning model to recognize whether the patients are performing OEP or activities of daily life (ADLs) using a 10-minute sliding window; 2) based on stage 1, using a 6-second sliding window to recognize the OEP sub-classes. Results showed that in stage 1, OEP could be recognized with window-wise f1-scores over 0.95 and Intersection-over-Union (IoU) f1-scores over 0.85 for both datasets. In stage 2, for the home scenario, four activities could be recognized with f1-scores over 0.8: ankle plantarflexors, abdominal muscles, knee bends, and sit-to-stand. These results showed the potential of monitoring the compliance of OEP using a single IMU in daily life. Also, some OEP sub-classes are possible to be recognized for further analysis.

The potential of FinTech algorithms to decrease gender bias in credit decisions is limited by the impartiality of the data used to train them. If the data is partial or biased, the algorithmic decision-making process may also be discriminatory, exacerbating existing inequalities. In this study, the effect of FinTech Firms on reducing gender inequality in bank loans in the USA is examined using a loan application from 60 U.S. banks from 2012 to 2022. We use a two-step system GMM approach to estimate the effect of FinTech algorithms on gender bias in credit decisions, focusing on female loan approval rates. Our results show that by controlling the other factor, banks with credit algorithms significantly increased the loan approval rates and thus reduced gender inequality in bank loans. Specifically, the female loan approval rates increased by 8% after banks adopted FinTech algorithms. We also find that the effect is more substantial for banks with higher baseline gender bias in credit decisions. We also performed the Difference in Difference analysis to analyse the policy shocks and FinTech adoption on bank loans’ gender inequality. Results of the study show that FinTech adoption and policy implications have significantly increased the loans for female borrowers. Our findings suggest that FinTech algorithms can potentially mitigate gender bias in credit decisions and promote gender equality in financial services.

Since there has been no clear overview of educational practices that benefit high-ability students in mixed-ability classrooms in grades one to six, this review aims to provide insight into the effects of educational practices on the cognitive and affective-motivational learning outcomes of high-ability students. In order to identify these educational practices, we conducted a review of the existing literature, comprising a systematic search of the Education Resources Information Center and Web of Science databases for studies from the last 25 years. Only empirical studies that investigated the impact of interventions were included. Applying these criteria resulted in the inclusion of seventeen studies. Four different educational practices were shown to have a positive impact on cognitive learning outcomes: providing dynamic feedback, enhancing self-regulated learning, adjusting the curriculum and providing differentiated instruction. The impact of educational practices on affective-motivational learning outcomes was inconclusive. Based on this review, we conclude that teachers can help high-ability students in mixed-ability classrooms in grades one to six across various educational contexts using the educational practices reported in this study.

The move to include students with special educational needs (SEN) in mainstream education is one of the priorities of educational reform agendas in many countries. Also in Flanders (Belgium) the government's aim is to implement a more inclusive school system, but this faces some resistance from practitioners. This study examines the way in which professional development initiatives (PDIs) supporting inclusive education can reduce this resistance. PDIs are defined by nine key features, which are subdivided in four core (referring to the content): (1) content focus, (2) pedagogical knowledge, (3) coherent and evidence-based, and (4) ownership; and five structural features (referring to the design of a PDI): (1) duration, (2) collective or collaborative participation, (3) school- or site-based, (4) active learning, and (5) trainer quality. The results indicate that school team members' positive experiences with students with special educational needs (SEN) have more impact on the willingness to include them than the core or structural features of PDIs. Furthermore, indications were found that PDIs focussing on a specific SEN can create more willingness to include these students.

This meta-analysis synthesizes evidence about the associations of affective teacher--student relationships with bullying perpetration and peer victimization. A systematic database search resulted in 65 primary studies (k) that met the inclusion criteria. The final sample included 185,881 students from preschool to high school. Separate multilevel analyses were conducted for bullying perpetration (k = 25, N = 97,627) and peer victimization (k = 57, N = 151,653). Results showed small to medium, negative overall correlations between teacher-student relationship quality and both bullying perpetration (r = -0.17, 95% CI [-0.21, -0.14]) and peer victimization (r = -0.14, 95% CI [-0.17, -0.11]). Teacher-student relationship quality was also related to less subsequent peer victimization (b = -0.05, 95% CI [-0.08, -0.02]). Associations between teacher-student relationship quality and bullying were stronger for ethnic minority students and when the same informant reported about both variables. Associations with peer victimization were stronger for negative (e.g., conflict) than for positive (e.g., closeness) relationship indicators and when the same informant was used for both variables. Generally, findings demonstrate that higher-quality teacher-student relationships are related to less bullying perpetration and less peer victimization. Hence, promoting positive and minimizing negative teacher-student relationships may help to tackle school-based bullying and peer victimization.

Teachers are key guidance figures in the lives of high-ability students. By building and maintaining close relationships with their students, teachers may heavily affect the socioemotional development of high-ability students. This study investigated how the teacher-student relationship quality affected the development of high-ability students' academic engagement. Additionally, we examined if the teacher-student relationship quality was more important for the engagement of at-risk high-ability students (i.e. students with a low SES background or students with a diagnosed learning disability or developmental disorder). A sample of 403 Flemish high-ability students (IQ [greater than or equal to] 120) reported on their behavioral and emotional (dis)engagement using scales developed by Skinner and colleagues (2009) and their relationship with their teachers using the People in My Life questionnaire (Cook et al. 1995). Multilevel growth curve analyses showed that positive and negative teacher-student relationships both contributed to the development of high-ability students' behavioral and emotional (dis)engagement. Analyses also revealed that negative relationships had a stronger effect on the behavioral disengagement of low SES students. The emotional (dis)engagement of students with a diagnosed learning disability or developmental disorder was less affected by a negative teacher-student relationship. Results highlight the key position of the teacher in creating an engaging environment for high-ability students.

Classification criteria have been developed for rheumatoid arthritis (RA) and other rheumatic diseases in order to gather a homogeneous patient population for clinical studies and facilitate the timely implementation of therapeutic measures. Although classification criteria are not intended to be used for diagnosis, they are frequently used to support the diagnostic process in clinical practice, including clinical decision-making. The 2010 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria for RA are capable of identifying the majority of symptomatic patients with RA already in the earliest stages of the disease who are not yet showing radiographic changes. These patients will also profit from the early implementation of therapy with disease-modifying antirheumatic drugs (DMARDs). However, the risk of misclassification is higher as compared with the former 1987 ACR criteria, which were considerably less sensitive to the recognition of patients with early RA. Of note, the presence of rheumatoid factors (RFs) and anticitrullinated protein antibodies (ACPAs) has been attributed equal weight in the 2010 ACR/EULAR criteria and may contribute up to 50% of the score needed for being classified as RA. However, while ACPAs have been proven to be the most specific serological markers of RA, the specificity of RF is moderate, especially at lower titres. This may lead to the misclassification of RF-positive patients and, consequently, the unjustified implementation of DMARD therapy. Therefore, issues arise on how comprehensive the criteria should be and whether they should be updated and adapted to findings from the past two decades that might increase both their specificity and sensitivity.