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Abstract The persistence of SARS-CoV-2 despite the development of vaccines and a degree of herd immunity is partly due to viral evolution reducing vaccine and treatment efficacy. Serial infections of wild-type (WT) SARS-CoV-2 in Balb/c mice yield mouse-adapted strains with greater infectivity and mortality. We investigate if passaging unmodified B.1.351 (Beta) and B.1.617.2 (Delta) 20 times in K18-ACE2 mice, expressing the human ACE2 receptor, in a BSL-3 laboratory without selective pressures, drives human health-relevant evolution and if evolution is lineage-dependent. Late-passage virus causes more severe disease, at organism and lung tissue scales, with late-passage Delta demonstrating antibody resistance and interferon suppression. This resistance co-occurs with a de novo spike S371F mutation, linked with both traits. S371F, an Omicron-characteristic mutation, is co-inherited at times with spike E1182G per Nanopore sequencing, existing in different within-sample viral variants at others. Both S371F and E1182G are linked to mammalian GOLGA7 and ZDHHC5 interactions, which mediate viral-cell entry and antiviral response. This study demonstrates SARS-CoV-2’s tendency to evolve with phenotypic consequences, its evolution varying by lineage, and suggests non-dominant quasi-species contribution.

Art therapy is an emerging allied health profession in Singapore, although attitudes toward the role of the service remain unclear. This study surveyed 80 healthcare professionals from two tertiary care hospitals, exploring three areas: (a) perceptions of art therapy, (b) the referral process, and (c) suggestions to increase art therapy utilization. Findings suggest that healthcare professionals perceive art therapy as a form of psychotherapy, but need for clearer referral processes. Additional research in art therapy is necessary to support its implementation in acute healthcare in Singapore.

ObjectiveThis study aims to analyze the serotype distribution and drug resistance of Streptococcus pneumoniae isolated from children aged 8 days to 7 years in Urumqi, China, between 2014 to 2021, during which PCV13 was introduced in the private sector’s immunization program and COVID-19 control was administrated in the last 2 years.MethodsSerotypes of S. pneumoniae isolates were determined by Quellung reaction, and their susceptibility against 14 antimicrobials were tested. According to the start year of PCV13 administration (2017) and COVID-19 control (2020), the study period was divided into three stages: 2014–2015, 2018–2019, and 2020–2021.ResultsA total of 317 isolates were involved in this study. The most common serotypes were type 19F (34.4%), followed by 19A (15.8%), 23F (11.7%), 6B (11.4%), and 6A(5.0%). The coverage rate of both PCV13 and PCV15 was 83.0%. The coverage of PCV20 was a little higher at 85.2%. The resistance rate against penicillin was 28.6% according to the breakpoints of oral penicillin, which would reach up to 91.8% based on the breakpoints of parenteral penicillin for meningitis. The resistance rates to erythromycin, clindamycin, tetracycline, and sulfamethoxazole-trimethoprim were 95.9%, 90.2%, 88.9%, and 78.8%, respectively. The PCV13 isolate was more resistant to penicillin than the non-PCV13 ones. There was not any significant change found in the serotype distribution since the PCV13 introduction and the COVID-19 control. The resistance rate against oral penicillin slightly elevated to 34.5% in 2018–2019 from 30.7% in 2014–2015 and then decreased significantly to 18.1% in 2020–2021 (χ2 = 7.716, P < 0.05), while the resistance rate to ceftriaxone (non-meningitis) continuously declined from 16.0% in 2014–2015 to 1.4% in 2018–2019 and 0% in 2020–2021 (Fisher = 24.463, P < 0.01).ConclusionThe common serotypes of S. pneumoniae isolated from children in Urumqi were types 19F, 19A, 23F, 6B, and 6A, which we found to have no marked change since the PCV13 introduction and the COVID-19 control However, the resistance rate to oral penicillin and ceftriaxone significantly declined in the COVID-19 control stage.

The interest-driven creator (IDC) theory is being developed as a group endeavor by Asian researchers to articulate a holistic learning design theory for future education in Asia. The theory hypothesizes that students, driven by "interest", can be engaged in the "creation" of knowledge (generating ideas and artifacts). By repeating this creation process in their daily learning routines, they will excel in learning performance, develop twenty-first-century competencies, and form creation "habits". We hope that with such practices in education, our future generations will ultimately become lifelong interest-driven creators. In IDC Theory, there are three "anchored" concepts, namely, interest, creation, and habit. Each anchored concept comprises three "component" concepts which form a "concept loop". For example, the creation loop consists of three component concepts--"imitating", "combining", and "staging". Imitating is concerned with taking in (or inputting) an abundant amount of existing knowledge from the outside world to form one's background knowledge. Combining refers to delivering (or outputting) new ideas or artifacts prolifically by synthesizing existing information encountered in the world and thoughts arising from the students' background knowledge. Staging relates to frequently demonstrating the generated ideas or artifacts to the relevant communities and receiving feedback from these communities to improve the novelty and value of the demonstrated outcomes while gaining social recognition and nurturing positive social emotions. This paper focuses on describing the three components of the creation loop. We provide three case studies to illustrate the creation loop at work, as well as how it intertwines with both the interest and habit loops in supporting students to develop their creation capabilities. In presenting this iteration of the creation concept, an anchored concept in IDC theory, we acknowledge the roles played of imitation, combination, and staging in different learning and education contexts--indeed, there are multiple theories that inform and intersect with it.

Children of parents with traumatic brain injury (TBI) are more likely to develop psychiatric disorders. This association is usually attributed to TBI-induced changes in parents' personality and families' social environment. We tested the hypothesis that offspring of young adult male rats with TBI develop neurodevelopmental abnormalities in the absence of direct social contact with sires. Male Sprague-Dawley rats (F0 generation) in the TBI group underwent moderate TBI via a midline fluid percussion injury that involved craniectomy under sevoflurane (SEVO) anesthesia for 40 min on post-natal Day 60 (P60), while F0 rats in the control group were placed in a new cage, one per cage, for the equivalent time duration. A subset of F0 rats was sacrificed on P66 to assess acute changes in hypothalamic-pituitary-adrenal (HPA) axis and inflammation markers. The remaining F0 males were mated with naive females on P90 to generate offspring (F1 generation). The F0 males and F1 males and females were sequentially evaluated in the elevated plus maze, for pre-pulse inhibition of acoustic startle, in the Morris water maze, and for resting and stress levels of serum corticosterone starting on ∼P105 (F0) and ∼P60 (F1), followed by tissue collection for further analyses. Acutely, the F0 TBI males had messenger RNA (mRNA) transcripts altered to support an increased hypothalamic and hippocampal Na+-K+-Cl- (Slc12a2) Cl- importer / K+-2Cl- (Slc12a5) Cl- exporter ratio and decreased hippocampal glucocorticoid receptors (Nr3c1), as well as increased serum levels of corticosterone, interleukin-1β (IL-1β), and biomarkers of activated hippocampal microglia and astrocytes. Long-term, F0 TBI rats exhibited increased corticosterone concentrations at rest and under stress, anxiety-like behavior, impaired sensory-motor gating, and impaired spatial memory. These abnormalities were underpinned by reduced mRNA levels of hypothalamic and hippocampal mineralocorticoid receptors (Nr3c2), hippocampal Nr3c1, and hypothalamic brain-derived neurotrophic factor (Bdnf), as well as elevated serum levels of IL-1β, and biomarkers of activated hippocampal microglia and astrocytes. F1 male offspring of TBI sires exhibited abnormalities in all behavioral tests, while their F1 female counterparts had abnormal pre-pulse inhibition responses only. F1 male offspring of TBI sires also had reduced mRNA levels of hippocampal Nr3c1 and Nr3c2, as well as hypothalamic and hippocampal Bdnf, whereas increases in inflammatory markers were more profound in F1 females. These findings suggest that offspring of sires with a history of a moderate TBI that involved craniectomy under SEVO anesthesia for 40 min, develop sex-dependent neurobehavioral abnormalities in the absence of direct social interaction between the sire and the offspring. [ABSTRACT FROM AUTHOR]

Background: The use of games and technology for educational purposes can be an appropriate method of enhancing learning performance. Therefore, this study presents a technology-mediated board game and its related course to engage young learners in Indonesia for learning English vocabulary. The study investigated young learners' vocabulary learning performance and learning motivation as the effects of using technology-mediated board game in the course. Methodology: This study employed a quasi-experimental design involving 67 students of one urban and one rural primary school. The vocabularies of fruits and vegetables were implemented online in the game by using QR codes. The instructional practices are to improve students' learning achievement and to find out students' learning motivation. The pre-test, post-test, and Keller's ARCS motivation model were conducted to analyze the effectiveness of technology-mediated board game for learning English vocabulary. Findings: The main finding indicated that technology-mediated board games could improve students' English vocabulary learning achievement. Moreover, the use of technology-mediated board games encouraged young learners to have strong learning motivation. On the other hand, the game could promote students to have a concept in gardening that can be encounter in their daily life. Conclusion: These findings imply that technology-mediated board game becomes an effective way of teaching English vocabulary to young learners in Indonesia.

本研究以12名中學國語文教師為研究對象，就教師認知、教學資源與教學實踐三個面向，進行結構化深度訪談，將所得資料轉譯為口語報告，再進行編碼與歸類分析。期透過教育理想與教育現場兩方對話，對語文教育政策之落實現況更深入理解，並據此提出國語文教育的政策建議。本研究結果顯示：一、教師最關注教師專業，具備高省思與評鑑能力，期待專業成長，盼望將所學轉化運用於課室。不過，教育單位提供的精進課程未能符合需求，在進行時也欠缺適當配套措施，且未能有足夠時間讓教師轉化所學，影響落實的成效。二、國語文課綱揭示的素養有關概念已內化為教師認知，但高層次概念較少被提及。三、各校硬體資源分配不平均，教學運用上仍可再精進。教學文本趨精美多元，但選文未符整體性、脈絡化與多元化，且教師對教材有較大依賴性，少數自編教材亦較少納入核心素養。四、現場教學活動多元，趨向學習者中心。但學生能力、評量與家長期待等因素，影響新式教學的落實。綜上，本研究對國語文教育建議如下：一、植基於教師專業知能與專業成長期待，規劃精進課程，提供課務協助有關配套措施，並培養轉化能力。二、將教師教學想像與更高層次的課綱目標連結，以有效落實課綱精神。三、善用教師的專業與教學經驗，改善教科書選文，同時鼓勵教師教材編撰，使其更系統、多元，符合學生經驗與課綱精神。四、將課綱揭示的高層次能力與評量結合，使教學朝向政策目標，同時增加素養教學意義之社會宣導，以協助教師更順利達成素養教學的目標。 Structured in-depth interviews were conducted with 12 junior-high school Mandarin teachers to explore their opinions regarding three dimensions of Mandarin Education Policy － teacher acknowledgment, resources, and practices. The obtained data were first transcribed into verbal protocol, and classification and analysis were subsequently conducted according to a coding schema. Through discussion of the concepts and situation of Mandarin education, in-depth insight was obtained about the policy’s implementation. Based on the obtained insights, recommendations are proposed for the future Mandarin Education Policy. The study results revealed the following: First, teachers were most concerned about their professional development, demonstrating their strong abilities of reflection and evaluation, anticipation of professional growth, and goal of translating theory into practice. However, according to teachers, the in-service training provided by existing educational institutes is unsatisfactory, involves inadequate follow-up evaluations, and provides insufficient time for practice. These factors influence the policy’s effectiveness. Second, the concepts related to literacy presented in the Mandarin curricula were internalized within teachers’ schema, but high-level literacy concepts were rarely mentioned in their reports. Third, the distribution of hardware among schools was reported to be unequal and thus can be improved. Teachers reported that the curriculum textbooks are refined and diverse but fail to form a systematic framework. Finally, teachers claimed that teaching activities are diverse and oriented toward a learner-centered teaching method. However, differences in the abilities of students, assessments, expectations of parents influence their teaching. Based on the above observations, suggestions are presented for framing future policies pertaining to Mandarin education: First, in-service training courses should be based on the professional knowledge and growth expectations of teachers. Moreover, a habit of implementing theory into practical scenarios should be cultivated. Second, teachers should be encouraged to be more creative and undertake courses more closely related to the high level objectives of the curricula. Third, the Mandarin literature expertise and teaching experience of teachers should be utilized to improve textbook selection and compiling. Thus, the texts could be more relevant, diverse, and appropriate for students’ experiences. Finally, the high-level literacy abilities that are aims of the curricula should be incorporated into teaching materials and assessment, and promoted among parents to gain more support.

Abstract The interest-driven creator (IDC) theory is being developed as a group endeavor by Asian researchers to articulate a holistic learning design theory for future education in Asia. The theory hypothesizes that students, driven by interest, can be engaged in the creation of knowledge (generating ideas and artifacts). By repeating this creation process in their daily learning routines, they will excel in learning performance, develop twenty-first-century competencies, and form creation habits. We hope that with such practices in education, our future generations will ultimately become lifelong interest-driven creators. In IDC Theory, there are three anchored concepts, namely, interest, creation, and habit. Each anchored concept comprises three component concepts which form a concept loop. For example, the creation loop consists of three component concepts—imitating, combining, and staging. Imitating is concerned with taking in (or inputting) an abundant amount of existing knowledge from the outside world to form one’s background knowledge. Combining refers to delivering (or outputting) new ideas or artifacts prolifically by synthesizing existing information encountered in the world and thoughts arising from the students’ background knowledge. Staging relates to frequently demonstrating the generated ideas or artifacts to the relevant communities and receiving feedback from these communities to improve the novelty and value of the demonstrated outcomes while gaining social recognition and nurturing positive social emotions. This paper focuses on describing the three components of the creation loop. We provide three case studies to illustrate the creation loop at work, as well as how it intertwines with both the interest and habit loops in supporting students to develop their creation capabilities. In presenting this iteration of the creation concept, an anchored concept in IDC theory, we acknowledge the roles played of imitation, combination, and staging in different learning and education contexts—indeed, there are multiple theories that inform and intersect with it.

BackgroundElectronic medical records (EMRs) are integrated information sources generated by health care professionals (HCPs) from various health care information systems. EMRs play crucial roles in improving the quality of care and medical decision-making and in facilitating cross-hospital health information exchange. Although many hospitals have invested considerable resources and efforts to develop EMRs for several years, the factors affecting the long-term success of EMRs, particularly in the EMR infusion stage, remain unclear. ObjectiveThe aim of this study was to investigate the effects of technology, user, and task characteristics on EMR infusion to determine the factors that largely affect EMR infusion. In addition, we examined the effect of EMR infusion on individual HCP performance. MethodsA questionnaire survey was used to collect data from HCPs with >6 months experience in using EMRs in a Taiwanese teaching hospital. A total of 316 questionnaires were distributed and 211 complete copies were returned, yielding a valid response rate of 66.8%. The collected data were further analyzed using WarpPLS 5.0. ResultsEMR infusion (R2=0.771) was mainly affected by user habits (β=.411), portability (β=.217), personal innovativeness (β=.198), technostress (β=.169), and time criticality (β=.168), and individual performance (R2=0.541) was affected by EMR infusion (β=.735). This finding indicated that user (habit, personal innovativeness, and technostress), technology (portability), and task (mobility and time criticality) characteristics have major effects on EMR infusion. Furthermore, the results indicated that EMR infusion positively affects individual performance. ConclusionsThe factors identified in this study can extend information systems infusion theory and provide useful insights for the further improvement of EMR development in hospitals and by the government, specifically in its infusion stage. In addition, the developed instrument can be used as an assessment tool to identify the key factors for EMR infusion, and to evaluate the extent of EMR infusion and the individual performance of hospitals that have implemented EMR systems. Moreover, the results can help governments to understand the urgent needs of hospitals in implementing EMR systems, provide sufficient resources and support to improve the incentives of EMR development, and develop adequate EMR policies for the meaningful use of electronic health records among hospitals and clinics.

This study reported the group development training results using a digital game-based adventure education course. In the research, six traditional adventure education activities were developed into six digital games that are assembled and practiced in the face-to-face course. The course was designed based on Tuckman's team development model in which students are trained to have positive human interactions and work as a team. With Hill Interaction Matrix (HIM) and focus group, the processes of students' oral interactions in the course were documented and analysed to see each groups' group dynamics and group development conditions. The results showed that groups of all kinds can be developed into effective groups and had positive human interactions after the course.

BackgroundMindfulness-based interventions may benefit healthcare professionals with burnout symptoms. Virtual reality (VR) may reduce initial difficulty of engaging in mindfulness exercises and increase participants’ engagement through immersion and presence.AimThe aim was to investigate how VR affects participants’ experience of engagement with mindfulness practice, and its impact on quality of practice and negative mood states.MethodsFifty-one healthcare professionals were randomized to receive either a visualization or non-visualization mindfulness practice, to compare the quality of practice through the use of audio only vs. with a virtual reality interface. Selected self-reported measures were collected during the session (immersion, quality and difficulty of practice, mood states and likelihood for future practice).ResultsResults showed that order instead of type of modality administered made a difference in quality of mindfulness practice. A greater sense of presence was reported with VR if administered after audio (F = 4.810, p = 0.033, Partial η2 = 0.093). Further, participants described difficulty practicing with audio if administered after VR (F = 4.136, p = 0.048, Partial η2 = 0.081). Additionally, lower mood disturbance was reported with VR if administered after audio (F = 8.116, p = 0.006, Partial η2 = 0.147). Qualitative responses echoed a preference for VR to engage better, in addition to improved mood states after practice.ConclusionFindings suggest that VR has the potential to provide healthcare professionals with an alternative or a supplement to conventional mindfulness practice.

This study reported the group development training results using a digital game-based adventure education course. In the research, six traditional adventure education activities were developed into six digital games that are assembled and practiced in the face-to-face course. The course was designed based on Tuckman’s team development model in which students are trained to have positive human interactions and work as a team. With Hill Interaction Matrix (HIM) and focus group, the processes of students’ oral interactions in the course were documented and analysed to see each groups’ group dynamics and group development conditions. The results showed that groups of all kinds can be developed into effective groups and had positive human interactions after the course.