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It is important that educators understand how to adapt their health education lessons to ensure they are inclusive of all students. This article provides six strategies for teaching health education to students with intellectual disabilities, both in the classroom and in physical education class, to improve their health literacy.

Authors examine the impact of honors education on four early career scholars who each spent two years in a postdoctoral position (2017-2023), highlighting how initial in-depth exposure to honors curricula and culture positively influences professional identity and teaching practice. Fellowships in a Teaching, Research, and Mentoring (TRM) Program offer nascent scholars from a range of disciplines the opportunity to work with students, extend curricular offerings, and launch career trajectories in a variety of ways. Accounts of these experiences should encourage honors program administrators to look to the ranks of early career scholars as desirable instructors.

Abstract Allergen-specific immunotherapy (AIT) induces immune tolerance, showing the highest success rate (>95%) for insect venom while a much lower chance for pollen allergy. However, the molecular switches leading to successful durable tolerance restoration remain elusive. The primary outcome of this observational study is the comprehensive immunological cellular characterization during the AIT initiation phase, whereas the secondary outcomes are the serological and Th2-cell-type-specific transcriptomic analyses. Here we apply a multilayer-omics approach to reveal dynamic peripheral immune landscapes during the AIT-initiation phase in venom allergy patients (VAP) versus pollen-allergic and healthy controls. Already at baseline, VAP exhibit altered abundances of several cell types, including classical monocytes (cMono), CD4+ hybrid type 1-type 17 cells (Th1-Th17 or Th1/17) and CD8+ counterparts (Tc1-Tc17 or Tc1/17). At 8-24 h following AIT launch in VAP, we identify a uniform AIT-elicited pulse of late-transitional/IL-10-producing B cells, IL-6 signaling within Th2 cells and non-inflammatory serum-IL-6 levels. Sequential induction of activation and survival protein markers also immediately occur. A disequilibrium between serum IL-6 and cMono in VAP baseline is restored at day seven following AIT launch. Our longitudinal analysis discovers molecular switches during initiation-phase insect-venom AIT that secure long-term outcomes. Trial number: NCT02931955.

Abstract Testicular germ cell tumours (TGCT), which comprise seminoma and non-seminoma subtypes, are the most common cancers in young men. In this study, we present a comprehensive whole genome sequencing analysis of adult TGCTs. Leveraging samples from participants recruited via the UK National Health Service and data from the Genomics England 100,000 Genomes Project, our results provide an extended description of genomic elements underlying TGCT pathogenesis. This catalogue offers a comprehensive, high-resolution map of copy number alterations, structural variation, and key global genome features, including mutational signatures and analysis of extrachromosomal DNA amplification. This study establishes correlations between genomic alterations and histological diversification, revealing divergent evolutionary trajectories among TGCT subtypes. By reconstructing the chronological order of driver events, we identify a subgroup of adult TGCTs undergoing relatively late whole genome duplication. Additionally, we present evidence that human leukocyte antigen loss is a more prevalent mechanism of immune disruption in seminomas. Collectively, our findings provide valuable insights into the developmental and immune modulatory processes implicated in TGCT pathogenesis and progression.

Fostering productive engagement within teams has been found to improve student learning outcomes. Consequently, characterizing productive and unproductive time during teamwork sessions is a critical preliminary step to increase engagement in teamwork meetings. However, research from the cognitive sciences has mainly focused on characterizing levels of productive engagement. Thus, the theoretical contribution of this study focuses on characterizing active and passive forms of engagement, as well as negative and positive forms of engagement. In tandem, researchers have used computer-based methods to supplement quantitative and qualitative analyses to investigate teamwork engagement. Yet, these studies have been limited to information extracted primarily from one data stream. For instance, text data from discussion forums or video data from recordings. We developed an artificial intelligence (AI)-based automatic system that detects productive and unproductive engagement during live teamwork sessions. The technical contribution of this study focuses on the use of three data streams from an interactive session: audio, video, and text. We automatically analyze them and determine each team's level of engagement, such as productive engagement, unproductive engagement, disengagement, and idle. The AI-based system was validated based on hand-coded data. We used the system to characterize productive and unproductive engagement patterns in teams using deep learning methods. Results showed that there were > 91% prediction accuracy and < 7% mismatches between predictions for the three engagement detectors. Moreover, Pearson's r values between the predictions of the three detectors were > 0.844. On a scale of -1 (unproductive engagement) to 1 (productive engagement), the scores for all teams were 0.94 ± 0.04, suggesting high productive engagement. In addition, teams tended to mostly be in productive engagement before transitioning to disengagement (> 90.34% of the time) and to idle (> 93.69% of the time). Before transitioning to productive engagement, we noticed almost equal fractions of teams being in idle and disengagement modes. These results show that the system effectively detects engagement and can be a viable tool for characterizing productive and unproductive engagement patterns in teamwork sessions.

Universities have renewed interest in blended learning in preparation for post-COVID education. However, unsatisfactory social interactions hinder the quality of blended learning, despite its potential for flexible and personalized learning. In this situation, a sense of community would provide essential academic and social benefits. To develop a sense of community among students, we need to further understand students' and teachers' perceptions concerning this subject by exploring their experiences in blended learning. Therefore, we investigated this for three blended courses using a qualitative case study approach. We conducted: (1) classroom observation; (2) document analysis of course content, assignments, and assessments; and (3) individual interviews with teachers (n = 3) and group interviews with students (n = 18). The results showed the main factors that appeared to contribute to sense of community: group learning activities within courses, non-academic and extracurricular activities across courses, and the campus as a physical place integrating academic and social life after COVID. Further, we identified two obstacles: students valued group learning but struggled to manage group dynamics, and despite teachers' efforts to encourage learning autonomy, students viewed teachers as the ultimate authority in the learning process, which strained the student-teacher relationship. Additionally, this study revealed the limitations that digital tools have for promoting sense of community, as students questioned whether these tools have added value for supporting intricate and in-depth conversations. Finally, based on these findings, we provided practical recommendations for the future development of sense of community in blended learning.

Abstract Human development relies on the correct replication, maintenance and segregation of our genetic blueprints. How these processes are monitored across embryonic lineages, and why genomic mosaicism varies during development remain unknown. Using pluripotent stem cells, we identify that several patterning signals—including WNT, BMP, and FGF—converge into the modulation of DNA replication stress and damage during S-phase, which in turn controls chromosome segregation fidelity in mitosis. We show that the WNT and BMP signals protect from excessive origin firing, DNA damage and chromosome missegregation derived from stalled forks in pluripotency. Cell signalling control of chromosome segregation declines during lineage specification into the three germ layers, but re-emerges in neural progenitors. In particular, we find that the neurogenic factor FGF2 induces DNA replication stress-mediated chromosome missegregation during the onset of neurogenesis, which could provide a rationale for the elevated chromosomal mosaicism of the developing brain. Our results highlight roles for morphogens and cellular identity in genome maintenance that contribute to somatic mosaicism during mammalian development.

Abstract The study presented focuses on material research of La Tène rivets and represents the very first study conducted into this class of archaeological finds from the Bohemian region. The rivets examined come from two significant archaeological sites situated in this geographical area—a hillfort Kolo near Týnec nad Labem and an oppidum in Stradonice. The sets of the rivets selected for the study were dated to the Late La Tène period (second–first century BC)—in the context of Western Europe, the term Celtic period can also be found. Thorough material research of the objects utilised a range of methods such as scanning electron microscopy with energy dispersive analyser, atomic absorption spectrometry, X-ray micro-tomography scanning, laser ablation-inductively coupled plasma-mass spectrometry, and Raman spectrometry. As a result, the research has identified and described three different technologies used to produce the rivets. The rivets uncovered there were mostly produced by casting from a bronze alloy or by putting wrought iron pins into the bronze melt of rivet heads. In addition, a minority of the rivets were produced using forged wrought iron with their heads plated with a very thin bronze plate. The results of the elemental analysis showed that several of the rivets and most of the rivet heads were made of bronze alloys with a tin content of 2–10 wt.%. The lead content of bronze alloy rivets from both sites varies from 0.2 to 10.1 wt.%. It can be assumed, that lead was intentionally added to the bronze melt used to produce the majority of the artefacts examined. Also, several bronze rivet heads were found to be decorated with enamel, which is a type of soda-lime-silica high lead glass coloured with crystals of Cu2O (the Colour of the enamel was predominantly red). In conclusion, two different groups of enamels were distinguished: (a) enamels with PbO up to 20% and (b) enamels with a higher content of PbO reaching up to 40%.

Learning in science, technology, engineering, and mathematics (STEM) is often challenging due to the abstract and counterintuitive nature of some concepts. Computer-based learning has emerged as an alternative method to help improve students' comprehension of these complex topics, even though technological tools must be supported with pedagogical strategies, technology affordances, sound design, and structured activities to teach scientific concepts properly. In that sense, we propose the design of an immersive virtual reality (IVR) experience, including visual and haptic cues to facilitate learning about electric fields (EFs) and charged particles (CPs) concepts. We scaffolded our design tool based on embodied design principles and cognition. The IVR experience allows learners to manipulate the components of point charges (e.g., particles, distance between particles, and charges) to learn electricity concepts. We conducted a qualitative study (N = 8) to assess the designed application. The sample included undergraduate students (five male and three female) from technology-related fields with some or no prior knowledge of high school or higher education physics. We assessed study participants' conceptual understanding through a pretest-posttest and conducted a brief interview to identify their expected interaction with the designed affordances. Screen recording and the System Usability Scale (SUS) are the other metrics of interest in defining study participants’ performance and experience. The collected data and thematic analysis suggested that participants recognized the included affordances based on the embodied design principles and used them to interact, link previous knowledge, and identify the different factors to explain the physics phenomenon. Additionally, we provided insights for designing IVR experiences to promote conceptual understanding of complex STEM topics based on embodied learning principles.

ABSTRACTCOVID-19 vaccine uptake varied across countries, in part due to vaccine hesitancy fueled by a lack of trustworthy information. To help health workers provide evidence-based answers to common questions about COVID-19 vaccines and vaccination, and thereby, assist individuals´ decisions on vaccine acceptance, COVID-19 InfoVaccines, a joint WHO-EU project, was launched in February 2021 to support COVID-19 vaccine rollout in 6 Eastern European countries. COVID-19 InfoVaccines was made available in seven languages and shared on social media networks. A total of 262,592 users accessed COVID-19 InfoVaccines.com between February 11, 2021, and January 31st, 2023. The users were most interested in: general questions; vaccine efficacy and duration of protection; vaccine safety; vaccine co-administration, and dose-interval and interchangeability; though the interest in a specific theme varied in function of the epidemiological situation. A total of 118,510 (45.1%) and 46,644 (17.7%) users scrolled up to 35% and 75% of the COVID-19 InfoVaccines webpage, respectively. The average engagement rate was 71.61%. The users accessed COVID-19 InfoVaccines from 231 countries and territories, but the majority were in Ukraine (N = 38,404; 14.6%), Spain (N = 23,327; 8.9%), and Argentina (N = 21,167; 8.1%). Older Facebook users were more interested in COVID-19 information than younger individuals (X2 p-value < .0001). Two hundred twenty-eight videos were shared on YouTube. The average Click-Through-Rate on Facebook was 7.82%, and that on YouTube was 4.4%, with 60 videos having a Click-Through-Rate >5%, falling in the range of average YouTube video Click-Through-Rate (2% – 10%). As misinformation about vaccines and vaccination spreads easily and can negatively impact health-related decisions, initiatives like COVID-19 InfoVaccines are crucial to facilitate access to reliable information.

Abstract Within the thymus, thymic epithelial cells (TECs) create dedicated microenvironments for T cell development and selection. Considering that TECs are sensitive to distinct pathophysiological conditions, uncovering the molecular elements that coordinate their thymopoietic role has important fundamental and clinical implications. Particularly, medullary thymic epithelial cells (mTECs) play a crucial role in central tolerance. Our previous studies, along with others, suggest that mTECs depend on molecular factors linked to genome-protecting pathways, but the precise mechanisms underlying their function remain unknown. These observations led us to examine the role of Foxo3, as it is expressed in TECs and involved in DNA damage response. Our findings show that mice with TEC-specific deletion of Foxo3 (Foxo3cKO) displayed a disrupted mTEC compartment, with a more profound impact on the numbers of CCL21+ and thymic tuft mTEClo subsets. At the molecular level, Foxo3 controls distinct functional modules in the transcriptome of cTECs and mTECs under normal conditions, which includes the regulation of ribosomal biogenesis and DNA damage response, respectively. These changes in the TEC compartment resulted in a reduced total thymocyte cellularity and specific changes in regulatory T cell and iNKT cell development in the Foxo3cKO thymus. Lastly, the thymic defects observed in adulthood correlated with mild signs of altered peripheral immunotolerance in aged Foxo3cKO mice. Moreover, the deficiency in Foxo3 moderately aggravated the autoimmune predisposition observed in Aire-deficient mice. Our findings highlight the importance of Foxo3 in preserving the homeostasis of TECs and in supporting their role in T cell development and tolerance.

Abstract Objectives The use of hemoadsorption (HA) has become popular in the treatment of vasoplegic states associated with massive cytokine release, including septic shock. However, this approach does not seem to be based on robust evidence, and it does not follow international guidelines. To understand the pathophysiological rationale and timing of HA, we conducted a large animal septic shock experiment. Design Prospective randomized large-animal peritoneal septic shock experiment. Setting Laboratory investigation. Subjects Twenty-six anesthetized, mechanically ventilated, and instrumented pigs randomly assigned into (1) sham-operated group with HA (SHAM, n = 5); (2) sepsis animals without HA (SEPSIS, n = 5); (3) sepsis group with HA at norepinephrine initiation (EARLY, n = 8); and (4) sepsis group with HA initiated at norepinephrine rate reaching 0.5 μg/kg/min (LATE, n = 8). Interventions Peritoneal sepsis was induced by cultivated autologous feces inoculation. A CytoSorb cartridge (200 g) with a blood flow rate of 200 mL/min and heparin anticoagulation was used to perform HA. The animals received sedation and intensive organ support up to 48 h or until they experienced cardiovascular collapse. Measurements and main results Systemic hemodynamics, multiple-organ functions, and immune-inflammatory response were measured at predefined periods. The HA treatment was not associated with any measurable benefit in terms of systemic hemodynamics and organ support. The systemic inflammatory markers were unaffected by any of the treatment timings. In contrast, the HA resulted in higher vasopressor load and decreased 36-h survival (5 animals in SHAM (100%), 4 (80%) in SEPSIS, 4 (57%) in EARLY, and 2 (25%) in LATE; p = 0.041). The HA exposure in healthy animals was associated with hemodynamic deterioration, systemic inflammatory response, and cytopenia. Conclusions In this large-animal-controlled fulminant sepsis study, the HA was unable to counteract the disease progression in the early or advanced septic shock phase. However, findings from the HA-exposed sham animals suggest potential safety concerns.

Abstract Aims The determinants and relevance of right ventricular (RV) mechanical dyssynchrony in heart failure with reduced ejection fraction (HFrEF) are poorly understood. We hypothesized that increased afterload may adversely affect the synchrony of RV contraction. Methods and results A total of 148 patients with HFrEF and 36 controls underwent echocardiography, right heart catheterization, and gated single‐photon emission computed tomography to measure RV chamber volumes and mechanical dyssynchrony (phase standard deviation of systolic displacement timing). Exams were repeated after preload (N = 135) and afterload (N = 15) modulation. Patients with HFrEF showed higher RV dyssynchrony compared with controls (40.6 ± 17.5° vs. 27.8 ± 9.1°, P

Growth is an important marker of child health and development. It is related to aspects such as social-economic conditions, being affected by social inequalities. Race is a social construct that functions as an essential tool of racism. It creates social hierarchy, resulting in segregation, different quality and access to health care, and unequal distributions of social determinants on health. Understanding the effects of ethno-racial inequalities on growth trajectories is essential to improve children development and well-being. In the study we investigated child growth according to maternal ethno-racial group using a nationwide Brazilian database. Data were obtained via linkage of the CIDACS Birth Cohort and the Brazilian Food the Nutrition Surveillance System. It included 4,090,271 children under 5 years old, born at term, followed-up between 2008 and 2017. We used mixed-effects model to estimate both original and standardized forms of length/height and weight trajectories. Results pointed out to growth differences among the racial groups, concerning both markers. Children born to Indigenous mothers presented the most critical situation, followed by those born to Parda, Asian-descent, and Black mothers. The strengthening of policies aimed at protecting Indigenous children should be urgently undertaken to address systematic ethno-racial health inequalities. Additionally, these findings may help policymakers to achieve the United Nation’s 2030 Sustainable Development Goals (eradication of hunger and all forms of malnutrition).

In January 2021, Germany commenced surveillance of SARS-CoV-2 variants under the Corona Surveillance Act, which ceased in July 2023. The objective was to bolster pandemic control, as specific alterations in amino acids, particularly within the spike protein, were linked to heightened transmission and decreased vaccine effectiveness.Consequently, our team conducted whole genome sequencing using the commercially accessible ARTIC protocol on Illumina's NextSeq500 platform and MiSeq for SARS-CoV-2 positive samples obtained from patients at Heidelberg University Hospital, affiliated hospitals, and the public health office in the Rhine-Neckar/Heidelberg region. Throughout the pandemic, we refined the existing ARTIC V4 protocol as well as our bioinformatics pipeline, the details of which are outlined in this report. This report reflects the protocol for the MiSeq analysis, the protocol for the NextSeq500 can be found in our previous publication.

Introduction: This study aimed to develop, implement, and test a visuo-haptic simulator designed to explore the buoyancy phenomenon for freshman engineering students enrolled in physics courses. The primary goal was to enhance students’ understanding of physical concepts through an immersive learning tool.Methods: The visuo-haptic simulator was created using the VIS-HAPT methodology, which provides high-quality visualization and reduces development time. A total of 182 undergraduate students were randomly assigned to either an experimental group that used the simulator or a control group that received an equivalent learning experience in terms of duration and content. Data were collected through pre- and post-tests and an exit-perception questionnaire.Results: Data analysis revealed that the experimental group achieved higher learning gains than the control group (p = 0.079). Additionally, students in the experimental group expressed strong enthusiasm for the simulator, noting its positive impact on their understanding of physical concepts. The VIS-HAPT methodology also reduced the average development time compared to similar visuo-haptic simulators.Discussion: The results demonstrate the efficacy of the buoyancy visuo-haptic simulator in improving students’ learning experiences and validate the utility of the VIS-HAPT method for creating immersive educational tools in physics.

Teaching interdisciplinary research methods to honors students across disciplines is complex. A pre-capstone seminar, The Art of Inquiry, centers ethical considerations within and beyond individual research interests, helping junior and senior students of all majors prepare for ethical, scholarly projects.

Abstract In this study, we provide a comprehensive clinical and molecular biological characterization of radiation-induced gliomas (RIG), including a risk assessment for developing gliomas. A cohort of 12 patients who developed RIG 9.5 years (3–31 years) after previous cranial radiotherapy for brain tumors or T-cell acute lymphoblastic leukemia was established. The derived risk of RIG development based on our consecutive cohort of 371 irradiated patients was 1.6% at 10 years and 3.02% at 15 years. Patients with RIG glioma had a dismal prognosis with a median survival of 7.3 months. We described radiology features that might indicate the suspicion of RIG rather than the primary tumor recurrence. Typical molecular features identified by molecular biology examination included the absence of Histon3 mutation, methylation profile of pedHGG-RTK1 and the presence of recurrent PDGFRA amplification and CDKN2A/B deletion. Of the two long-term surviving patients, one had gliomatosis cerebri, and the other had pleomorphic xanthoastrocytoma with BRAF V600E mutation. In summary, our experience highlights the need for tissue diagnostics to allow detailed molecular biological characterization of the tumor, differentiation of the secondary tumor from the recurrence of the primary disease and potentially finding a therapeutic target.

During food quality control, NIR technology enables the rapid and non-destructive determination of the typical quality characteristics of food categories, their origin, and the detection of potential counterfeits. Over the past 20 years, the NIR results for a variety of food groups—including meat and meat products, milk and milk products, baked goods, pasta, honey, vegetables, fruits, and luxury items like coffee, tea, and chocolate—have been compiled. This review aims to give a broad overview of the NIRS processes that have been used thus far to assist researchers employing non-destructive techniques in comparing their findings with earlier data and determining new research directions.

Background: As health coaching is becoming more popular as a health promotion intervention tool, there is a lack of empirical evidence to understand the clients' experience in the peer health coaching program among college students. Purpose: This qualitative study explored the experiences and perceptions of the health coaching clients following an 8-week peer health coaching intervention in college. Method: A total of 14 student clients (female, n = 9, 57% White) from the health coaching program participated in the focus group, following an 8-week peer health coaching program. The semistructured focus group guide was developed to understand their experience. Results: Clients' positive experience in the health coaching program contributed to transformative outcomes, including behavioral outcomes and goal achievement, well-being and personal growth, and self-empowerment, with the coaching relationship mediating the relationship and the coaching modality moderating the relationship. Discussion: The health coaching experience facilitated lifestyle changes, helped clients gain self-efficacy and confidence to manage their health and wellbeing and provided an overall caring, enjoyable, supportive experience. The bonding with the peer health coaches provided important social support for the student clients. Translation to Health Education Practice: A peer health coaching program can be a cost-effective option for health promotion on college campuses.

Aims & Objectives The purpose of this study was to identify patient characteristics associated with engagement and completion of physical therapy (PT) following total knee arthroplasty (TKA) and examine the relationship between number of PT sessions attended and outcomes during the first 12 weeks after surgery. Methods Patients underwent unilateral primary TKA by a single surgeon and were advised to complete 17 PT sessions over 6 weeks at a hospital-affiliated facility. Analyses examined predictors of PT engagement (attendance of ≥2 sessions) and completion (attendance of 17 ± 1 sessions) within 6 weeks and associations between number of PT sessions attended and changes in range of motion (ROM) and Knee Injury and Osteoarthritis Outcome Score (KOOS) values. Results Patients living

Abstract The impacts of global change—from shifts in climate to overfishing to land use change—can depend heavily on local abiotic context. Building an understanding of how to downscale global change scenarios to local impacts is often difficult, however, and requires historical data across large gradients of variability. Such data are often not available—particularly in peer reviewed or gray literature. However, these data can sometimes be gleaned from casual records of natural history—field notebooks, data sheet marginalia, course notes, and more. Here, we provide an example of one such approach for the Gulf of Maine, as we seek to understand how environmental context can influence local outcomes of region‐wide shifts in subtidal community structure. We explore a decade of hand‐drawn algal cover maps around Appledore Island made by Dr. Art Borror while teaching at the Shoals Marine Lab. Appledore's steep wave exposure gradient—from exposed to the open ocean to fully protected—provides a living laboratory to test interactions between global change and local conditions. We then recreate Borror's methods two and a half decades later. We show that overfishing‐driven urchin outbreaks in the 1980s were slowed or stopped by wave exposure and benthic topography. Similarly, local variation appears to have curtailed current invasions by filamentous red algae. Last, some formerly dominant kelps have disappeared over the past 40 years—an observation verified by subtidal surveys. Global change is altering life in the seas around us. While underutilized, solid natural history observations stand as a key resource for us to begin to understand how global change will translate to the heterogeneous mosaic of life in a future Gulf of Maine and other ecosystems around the world.

Purpose: To determine the rate of and risk factors for failure of tibial spine fracture (TSF) repair. Methods: This was a retrospective review of patients aged 18 years or younger with TSF who underwent arthroscopic repair performed by a single orthopaedic surgeon at a large tertiary academic hospital between 2015 and 2022. Demographic, clinical, injury, fracture, and surgical characteristics were collected. Coronal length and sagittal length and height of the fracture fragment were measured on preoperative plain radiographs and magnetic resonance imaging of the knee. Results: Of 25 patients who underwent arthroscopic reduction with internal fixation of TSFs, 2 (8%) experienced fixation failure. In 16 (64%), internal fixation was performed with suture anchors, whereas 8 (32%) underwent internal fixation with screws. There were 19 male patients (76%). There were no differences in demographic factors (age, race, sex, and body mass index), injury characteristics (laterality, mechanism of injury, and activity causing injury), modified Meyers-McKeever fracture classification, or method of internal fixation between the group with fixation failure and the group without failure. Coronal length (14.2 mm vs 18 mm, P = .17) and sagittal length (13.9 mm vs 18.7 mm, P = .17) of the fracture fragment also did not differ significantly between groups. Sagittal height of the fracture fragment was thinner in patients with failure of fixation (4.3 mm) than in those without failure (8 mm) (P = .02). Conclusions: Decreased bone thickness of the displaced fragment was associated with an increased likelihood of fixation failure. Level of Evidence: Level III, retrospective cohort study.

The application of extended reality (XR) technology in education has been growing for the last two decades. XR offers immersive and interactive visualization experiences that can enhance learning by making it engaging. Recent technological advances have led to the availability of high-quality and affordable XR headsets. These advancements have spurred a wave of research focused on designing, implementing, and validating XR educational interventions. Limited literature focuses on the recent trends of XR within science, technology, engineering, and mathematics (STEM) education. Thus, this paper presents an umbrella review that explores the exploding field of XR and its transformative potential in STEM education. Using six online databases, the review zoomed in on 17 out of 1972 papers on XR for STEM education, published between 2020 and 2023, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The results highlighted the types of XR technology applied (i.e., virtual reality and augmented reality), the specific STEM disciplines involved, the focus of each study reviewed, and the major findings from recent reviews. Overall, the educational benefits of using XR technology in STEM education are apparent: XR boosts student motivation, facilitates learning engagement, and improves skills, for example. However, using XR in education still has challenges that must be addressed, such as the physical discomfort of the learner wearing the XR headset and technical glitches. Besides revealing trends of using XR in STEM education, this umbrella review encourages reflection on current practices and suggests ways to apply XR to STEM education effectively.

Background: Little is known about trends in implementing skills-based instruction in US schools, specifically for sexual and reproductive health (SRH). We examined state-level trends in the percentage of US secondary schools teaching SRH skills in a required course in grades 6 to 8 and 9 to 12. Methods: Representative data from 35 states participating across 6 cycles of School Health Profiles (2008-2018) was analyzed. The prevalence of teaching four SRH skills was assessed through lead health education teacher self-administered questionnaires. Logistic regression models examined linear trends in the percentages of schools teaching SRH skills in grades 6 to 8 and 9 to 12. Trends were calculated for states with weighted data (response rates [greater than or equal to] 70%) for at least 3 cycles, including 2018. Results: During 2008 to 2018, the median percentage of schools addressing each SRH skill ranged from 63.5% to 69.7% (grades 6-8) and 88.2% to 92.0% (grades 9-12). Linear decreases in SRH skills instruction were more common for grades 6 to 8 than grades 9 to 12; linear increases were comparable for both groups. Most states demonstrated no change in the percentage of schools teaching SRH skills in grades 6 to 8 and 9 to 12. Conclusions: Limited changes and decreases in SRH skills instruction in US secondary schools suggest efforts to strengthen SRH education are needed.

The purpose of this study was to use a grounded theory, qualitative approach to gain a deeper understanding of students' self-regulated learning processes in a required first-year gateway Anatomy and Physiology (A&P) course that is critical for success in health care-related academic programs and professions. At the end of a two-semester sequence in A&P, students were recruited to participate in individual 30-minute semi-structured interviews based on questions related to their metacognitive beliefs and behaviors. Investigators reviewed verbatim transcripts from 25 primarily first-year students and identified four major themes: 1) career orientation, 2) relevance of Anatomy and Physiology, 3) success as the ability to earn good grades, as well as retention and ability to apply materials, and 4) student behaviors referring to the learning and metacognitive strategies reported by students. Within the theme of student behaviors, four sub-themes emerged: collaborative work with peers, self-responsibility, self-awareness, and evolution as learners. The results of this study will help investigators to design and implement strategies to improve success in this course for pre-health professional students.