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The COVID-19 pandemic has made adolescents´ technology use unavoidable for sustaining teaching and learning processes. In the present paper we conducted two studies using a person-centered latent profile analysis to examine adolescents' technology use before (Study 1

Leaderboards, a key topic in the gamification literature, are often used to enhance student engagement and motivation through social comparison. Previous research has examined the overall effects of leaderboard versus a no leaderboard condition but paid less attention to how positions on different types of leaderboard may affect students' learning performance, intrinsic motivation, and course engagement. In the two studies, we exposed 50 postgraduate students from two fully online courses to two types of leaderboard (absolute and relative) and measured their learning performance, course engagement, intrinsic motivation, and perceptions. Results suggest that the absolute leaderboard helps intensify students’ sense of comparison and competitiveness more than the relative leaderboard. In the absolute leaderboard class, students at different positions showed similar levels of learning performance and course engagement, but a higher position was associated with higher intrinsic motivation. Conversely, in the relative leaderboard class, students ranked in the top third tended to display better learning performance than their peers in the lower two thirds did. Students who ranked in different positions showed similar levels of course engagement and intrinsic motivation for learning. Qualitative analyses based on a survey suggested that the students ranked in the bottom third preferred anonymous (vs public) comparison on an absolute leaderboard but favoured public (vs anonymous) comparison on a relative leaderboard. Most students reported positive attitude toward the use of leaderboards for sustaining comparison and competitiveness.

We investigated how medical students' collaborative diagnostic reasoning, particularly evidence elicitation and sharing, can be facilitated effectively using agent-based simulations. Providing adaptive collaboration scripts has been suggested to increase effectiveness, but existing evidence is diverse and could be affected by unsystematic group constellations. Collaboration scripts have been criticized for undermining learners' agency. We investigate the effect of adaptive and static scripts on collaborative diagnostic reasoning and basic psychological needs. We randomly allocated 160 medical students to one of three groups: adaptive, static, or no collaboration script. We found that learning with adaptive collaboration scripts enhanced evidence sharing performance and transfer performance. Scripting did not affect learners’ perceived autonomy and social relatedness. Yet, compared to static scripts, adaptive scripts had positive effects on perceived competence. We conclude that for complex skills complementing agent-based simulations with adaptive scripts seems beneficial to help learners internalize collaboration scripts without negatively affecting basic psychological needs.

We propose a model of contextual facilitators for learning activities involving technology (in short: C♭-model) for both on-site and distance learning environments in higher education. The C♭-model aims at systematizing research on digital teaching and learning and offers a roadmap for future research to understand the complex dynamic of factors that lead to successful digital teaching and learning in higher education via suitable learning activities. First, we introduce students' learning outcomes as central benchmarks of teaching and learning with digital technologies in higher education. Second, we want to focus on a major proximal factor for students' learning outcomes and thus apply a learning activities perspective. Learning activities involving digital technologies reflect cognitive processes of students when using digital technologies and are causally connected with students' learning outcomes. Third, we highlight several contextual facilitators for learning activities involving technology in the C♭-model: learning opportunities that result from higher education teachers' instructional use of technology and students' self-arranged learning opportunities involving digital technologies. Apart from these proximal facilitators, we include more distal factors, namely, higher education teachers' knowledge, skills, and attitudes toward digital technology; higher education teachers' qualification; students' and teachers’ digital technology equipment; and institutional, organizational, and administrative factors.

We investigated how often teachers apply digital technology in their teaching and which student learning activities teachers initiate. Further, we analyzed factors relating to technology use. 410 teachers in our sample, representative for the state of Bavaria (Germany), reported that they spend a substantial amount of time using digital technologies in a typical lesson. Results indicated that rather teachers’ basic digital skills and technology-related teaching skills than digital technology resources are crucial. Even though a certain threshold level of digital technology is necessary in school, our results suggest shifting the focus from equipping schools to teachers’ skills using technologies effectively.

Background Memory impairment (MI) is a common symptom of MS. Previous studies were conflicting in respect to the possible existence of early MI and the role of hippocampal atrophy. The objective of this study was to investigate MI and structural MRI correlates in homogenous groups of early and late MS, controlling for a potential information-processing speed (IPS) deficit, and utilizing multiple memory test paradigms. Methods 152 individually matched subjects were recruited: early MS (EMS, N = 25, disease duration 1.0 ± 0.8 years), late MS (LMS, N = 52, 16.5 ± 5.2 years), and corresponding controls. Five memory tests were utilized to account for differences in learning material (verbal, visual), encoding (incidental, intentional), and retrieval (free recall, recognition, recurring recognition). Performance was related to IPS, memory-specific (hippocampal volumes), and unspecific MRI measures (T1/T2LL, brain volume, cortical thickness). Results Memory was impaired across all tests in LMS, but not in EMS. LMS-patients were also significantly impaired in IPS which was correlated with several memory scores. Regression analyses revealed IPS and cortical thickness as predictors for visual MI, and IPS, sex, and left hippocampal volume as predictors for verbal MI. Conclusion Additionally to direct destructions in memory specific tracts such as the hippocampus, memory decline in MS may also be related to a general factor comprising slowed information-processing and global tissue loss.

The main aim of gamification, i.e. the implementation of game design elements in real-world contexts for non-gaming purposes, is to foster human motivation and performance in regard to a given activity. Previous research, although not entirely conclusive, generally supports the hypothesis underlying this aim. However, previous studies have often treated gamification as a generic construct, neglecting the fact that there are many different game design elements which can result in very diverse applications. Based on a self-determination theory framework, we present the results of a randomized controlled study that used an online simulation environment. We deliberately varied different configurations of game design elements, and analysed them in regard to their effect on the fulfilment of basic psychological needs. Our results show that badges, leaderboards, and performance graphs positively affect competence need satisfaction, as well as perceived task meaningfulness, while avatars, meaningful stories, and teammates affect experiences of social relatedness. Perceived decision freedom, however, could not be affected as intended. We interpret these findings as general support for our main hypothesis that gamification is not effective per se, but that specific game design elements have specific psychological effects. Consequences for further research, in particular the importance of treatment checks, are discussed. Motivational effects of gamification are analysed from an educational psychology perspective.Gamification is not effective per se, but different game design elements can trigger different motivational outcomes.A self-determination theory framework was used to study the effects of different configurations of game design elements.Competence and autonomy regarding task meaningfulness was affected by badges, leaderboards, and performance graphs.Social relatedness was positively influenced by avatars, a meaningful story, and teammates.

This study investigated the initiation of digitally supported learning activities and personal and institutional factors associated with them in different higher education courses, based on the C♭-model. The C♭-model is a theoretical framework that systematizes contextual factors, which influence students‘ learning activities as the most important facilitator of students’ learning success. Using a self-assessment instrument with anchored scenarios in a sample of 1625 higher education teachers, we were able to identify three levels at which higher education teachers initiated digital learning activities: a low level (powerpointers), a moderate level (clickerers), and a high level (digital pros). The findings also support the relevance of the contextual factors specified in the C♭-model for initiating a high level of digital learning activities, namely digitalization policy and commitment of university administration, institutional equipment, technical and educational support, self-assessed basic digital skills, and self-assessed technology-related teaching skills. All of these factors explain a substantial amount of variance in the level of initiated digital learning activities. We conclude that a comprehensive approach rather than isolated measures might contribute to successful teaching and learning in higher education.

This is the introductory article for the special issue “Technology-related knowledge, skills, and attitudes of pre- and in-service teachers”. It (1) specifies the concept of technology-related knowledge, skills, and attitudes (KSA) of teachers, (2) presents how these KSA are currently assessed, and (3) outlines ways of fostering them among pre- and in-service teachers. The eight articles in the special issue are structured accordingly, and we demonstrate how they contribute to knowledge in these three areas. Moreover, we show how the afterword to the special issue widens the perspective on technology integration by taking into account systems and cultures of practice. Due to their quantitative empirical nature, the eight articles investigate technology at the current state of the art. However, the potential of artificial intelligence has not yet been fully exploited in education. We provide an outlook on potential developments and their implications on teachers’ technology-related KSA. To this end, we introduce the concept of augmentation strategies., Highlights • Review of teachers' technology related knowledge, skills, and attitudes (KSA). • Three areas: specification, assessment, and ways of fostering. • Explanation of contribution of the eight articles in the special issue. • Outlook on KSA changes due to technological developments: artificial intelligence.

Instruments that assess teachers' skills and attitudes on the basis of a broad range of specific standards and demands for teaching with digital technologies are lacking to date. Based on the K19 framework, we validated the scenario-based instrument IN.K19 that simultaneously assesses technology-related teaching skills and attitudes via self-assessment. In our study with N = 90 teachers and student teachers with teaching experience, we demonstrate that the instrument has satisfactory factorial validity in our confirmatory factor analyses. To investigate its predictive validity, we examined the instruments' relationships with teachers' frequency of technology use in class and teachers' initiation of different types of student learning activities involving technology. Results from structural equation modelling show relationships between self-assessed skills in different phases of teaching with technology and the self-reported initiation of student learning activities involving overt actions (active, constructive, and interactive learning activities), supporting the predictive validity of our instrument. Positive attitudes towards technology-related teaching also exhibit positive relationships with the initiation of learning activities involving digital technologies, but more specifically learning activities that do not include observable actions by learners (passive learning activities). Thus, teachers' self-assessed technology-related skills rather than attitudes might contribute to facilitating learning activities crucial for students’ learning.

Measurements of domain knowledge very often use and report Cronbach's alpha or similar indicators of internal consistency for test construction. In this short article, we argue that this approach is often at odds with the theoretical conception of knowledge underlying the measure. While domain knowledge is usually described as a formative construct (formed by the manifest observations) theoretically, the use of Cronbach's alpha to construct and evaluate an empirical measure implies a reflective model (the construct reflects in manifest behaviors). After illustrating the difference between reflective and formative models, we illustrate how this mismatch between theoretical conception and empirical operationalization can have substantial implications for the assessment and modeling of domain knowledge. Specifically, the construct may be operationalized too narrowly or even be misinterpreted by applying criteria for item selection that focus on homogeneity such as Cronbach's alpha. Rather than maximizing items internal consistency, researchers constructing measures of domain knowledge should, therefore, make strong arguments for the theoretical merit of their items even if they are not correlated to each other.

Occipital stroke often leads to visual field loss, for which no effective treatment exists. Little is known about the potential of non-invasive electric current stimulation to ameliorate visual functions in patients suffering from unilateral occipital stroke. One reason is the traditional thinking that visual field loss after brain lesions is permanent. Since evidence is available documenting vision restoration by means of vision training or non-invasive electric current stimulation future studies should also consider investigating recovery processes after visual cortical strokes. Here, protocols of repetitive transorbital alternating current stimulation (rtACS) and transcranial direct current stimulation (tDCS) are presented and the European consortium for restoration of vision (REVIS) is introduced. Within the consortium different stimulation approaches will be applied to patients with unilateral occipital strokes resulting in homonymous hemianopic visual field defects. The aim of the study is to evaluate effects of current stimulation of the brain on vision parameters, vision-related quality of life, and physiological parameters that allow concluding about the mechanisms of vision restoration. These include EEG-spectra and coherence measures, and visual evoked potentials. The design of stimulation protocols involves an appropriate sham-stimulation condition and sufficient follow-up periods to test whether the effects are stable. This is the first application of non-invasive current stimulation for vision rehabilitation in stroke-related visual field deficits. Positive results of the trials could have far-reaching implications for clinical practice. The ability of non-invasive electrical current brain stimulation to modulate the activity of neuronal networks may have implications for stroke rehabilitation also in the visual domain.

We studied two adult patients with myalgia and muscular fatigability during prolonged physical exercise. Serum creatine kinase was increased and muscle biopsy revealed a lipid storage myopathy affecting predominantly the type I fibres. Skeletal muscle carnitine content was reduced to 15% and 21% of the normal mean values, while serum carnitine levels were either normal or decreased. Four months of oral therapy with L-carnitine (3 g per day) resolved the clinical symptoms completely in both patients, and a subsequent muscle biopsy confirmed a marked reduction of lipid storage, along with increased muscle carnitine levels. The analysis of renal carnitine excretion and the exclusion of possible secondary carnitine deficiencies in both patients are compatible with mild defects of the carnitine transporter in one patient and of carnitine biosynthesis in the other. Since myalgia and muscular fatigue are frequent but unspecified complaints of otherwise clinically unremarkable adult patients, it is important to identify myopathies associated with primary carnitine deficiency because they may be amenable to treatment.

To assess whether TGF-beta isoforms are significantly increased after intravenous immunoglobulin (i.v.IG) infusion in the plasma of patients with multiple sclerosis (MS), 19 patients with clinically definite MS were enrolled in a double blind placebo controlled i.v.IG study. TGF-beta1, TGF-beta2, TGF-beta3 plasma concentrations were measured prior and directly after i.v.IG infusions by specific ELISA. Compared to the placebo group, we found a significant increase in the plasma levels of all three TGF-beta isoforms in patients treated with i.v.IG. The significantly increased TGF-beta plasma concentrations in treated patients suggest an additional, immediate mechanism of action that may accompany the molecular effects of i.v.IG therapy in MS. The variable amount of the potent anti-inflammatory TGF-beta isoforms within the i.v.IG preparations may exert a differentiated view regarding the manifold indications of i.v.IG therapy.

The differentiation of multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) from idiopathic Parkinson's disease (IPD) is difficult. Magnetization transfer imaging (MTI), a measure that correlates with myelination and axonal density, was employed in this study in the attempt to distinguish between these disorders. Measurements were carried out in 15 patients with IPD, 12 patients with MSA, 10 patients with PSP, and in 20 aged-matched healthy control subjects. The main finding was a change in the magnetization transfer ratio in the globus pallidus, putamen, caudate nucleus, substantia nigra, and white matter in IPD, MSA, and PSP patients, matching the pathological features of the underlying disorder. Furthermore, stepwise linear discriminant analysis provided a good classification of the individual patients into the different disease groups. All IPD patients and control subjects were correctly separated from the MSA and PSP cohort, and all PSP patients and 11 of 12 MSA patients were correctly separated from the IPD and control cohort. There was also a fairly good discrimination of IPD patients from control subjects and of MSA from PSP patients. In conclusion, MTI revealed degenerative changes in patients with different parkinsonian syndromes matching the underlying pathological features of the different diseases, underlining the high potential of this method in distinguishing MSA and PSP from IPD.

Mitochondrial pathology is an early observation in motor neurons and skeletal muscle of patients with amyotrophic lateral sclerosis (ALS). To clarify the relevance of this finding, we determined the effects of a 1-month oral administration of creatine on (1)H NMR-visible metabolites in the motor cortices of 15 controls and 15 patients with sporadic ALS, most of whom had mitochondrial pathology in skeletal muscle. In the motor cortex of the ALS group the N-acetylaspartate (NAA)/creatine (Cr(t)) metabolite ratio was lower than in our control group, indicating NAA loss. Upon creatine supplementation we observed in the controls a decline in the NAA/Cr(t), NAA/choline (Cho), glutamate + glutamine (Glx)/Cr(t), and Glx/Cho metabolite ratios. In contrast, in the ALS patient group the NAA/Cr(t) and the NAA/Cho metabolite ratios remained unchanged, while the Glx/Cr(t) and Glx/Cho metabolite ratios decreased. These data are compatible with the interpretation that creatine supplementation causes an increase in the diminished NAA levels in ALS motor cortex as well as an increase of choline levels in both ALS and control motor cortices. Because NAA is synthesized by mitochondria in an energy-dependent manner and the NAA/Cho metabolite ratios in the ALS motor cortices were found to be correlated to the degree of mitochondrial pathology in ALS skeletal muscle, our results can be explained by a deficiency of enzymes of mitochondrial respiratory chain in the ALS motor cortex which might affect motor neuron survival.

Neurodegeneration following inflammatory injury is considered to be a pathological correlate of irreversible disability in patients with multiple sclerosis. The availability of neurotrophins could influence the probability or rate of disease progression and the time of onset. The BDNF-Val66Met-polymorphism leads to altered intracellular transport and secretion of BDNF, and is thus a logical candidate for a gene that influences susceptibility and, more specifically, the clinical course of multiple sclerosis. In order to test this hypothesis we genotyped the polymorphism in 951 UK multiple sclerosis trio families, but found no evidence for association before (p=0.63) or after stratification for clinical course (p=0.73).