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Schools' sex composition and gender role attitudes are often overlooked in teachers' self-efficacy studies, while research suggests that gender role attitudes may color teachers' perceptions of students. This study investigates the association of schools' sex composition and teachers' gender role attitudes with teachers' self-efficacy in instructional strategies, classroom management and student engagement, and how this latter association might differ between schools with more boys or girls. A multilevel analysis was carried out on data of 1247 teachers in 59 schools (2012-2013). Teachers feel more efficacious in classroom management in schools with more boys, especially male teachers with traditional gender role attitudes. Male teachers with traditional gender role attitudes feel less efficacious in classroom management in mixed schools. Female teachers feel less efficacious in all dimensions when holding traditional gender role attitudes, regardless of schools' sex composition. The results highlight the importance of addressing gender bias in teacher training in order to improve teachers' self-efficacy across all dimensions.

Grade retention is often perceived as an academic failure and a negative response from the educational system. Hence, based on the social cognitive theory, being retained might decrease self-efficacy. This way, we expect that retainees are less likely to pursue a degree in higher education. Retainees that do enroll in higher education, are expected to opt for a college of applied sciences instead of university. We assume that self-efficacy mediates the association between grade retention and post-secondary schooling choices of retained students. In addition, based on comparative reference group taking, we expect the impact of being retained to be more detrimental in schools with a low percentage of retainees. If true, this would signal a school retention composition effect. Longitudinal, multilevel analyses were carried out on the International Study of City Youth (ISCY) dataset (1252 respondents, 30 schools in Ghent, Flanders). Results show that being retained significantly decreases the likelihood of higher education enrollment, while those students who do enroll, are less likely to opt for university. There was a mediation effect of self-efficacy with regard to program choice, but not for higher education enrollment. We did not find a moderation effect of school retention composition. Implications are discussed.

Teachability perceptions reflect teachers' perceptions of students' cognitive-motivational behaviors, personal social behaviors, and school-appropriate behaviors. Teachers in schools with more students with a low socioeconomic status (SES) or in schools with more boys have been shown to perceive students as less teachable. It remains to be seen whether teacher characteristics, specifically efficacy or trust, buffer against lower teachability perceptions in challenging school contexts. A multilevel analysis was carried out on data of 1247 teachers in 59 Flemish schools (2012-2013). Lower teachability perceptions were found in low-SES schools and schools with more boys. Efficacious teachers perceived their students as teachable, but teacher efficacy did not buffer against lower teachability perceptions in low-SES schools or in schools with more boys. Teacher trust, on the other hand, does buffer lower teachability perceptions in schools with more boys. This finding demonstrates that trusting teacher-student relationships might be a key factor to overcome between-school differences in teacher perceptions.

Teachers play a crucial role in the diagnostic process of Attention-Deficit/Hyperactivity Disorder (ADHD) in students: They are often the first to identify ADHD-related behaviors in children and to signal them to parents. Research has demonstrated that the recognition and labeling of certain behaviors as evidential for ADHD by teachers vary with respect to student characteristics. This study examines if and how the association between teacher perception of students' ADHD-related behaviors and teacher suspicion of ADHD in students is moderated by teacher perception of students' cognitive capacities. Multilevel analysis was carried out on data collected in 2017 and 2018 from 939 students and 108 teachers in 15 Flemish (Belgium) and 16 Québec (Canada) schools in the context of a collaborative research project on ADHD-prevalence and identification. Results show that, when teachers perceive ADHD-related behaviors in students, they more readily suspect ADHD when students are cognitively stronger. This study suggests that teachers are more inclined to free cognitively stronger students from the blame of ADHD-related behaviors by administering them an ADHD-label.

Teacher turnover negatively impacts educational quality. This study investigates whether schools' socioeconomic composition (SES), teachers' teachability perceptions, emotional exhaustion and teacher efficacy impact teachers' intention to quit and transfer schools. Through multilevel analysis on data of 1247 teachers in 59 Flemish schools, our results indicate that teachers are more emotionally exhausted in low-SES schools, resulting in stronger intentions to transfer schools. This association is explained through the lower teachability levels that teachers ascribe to students in low-SES schools. Intentions to quit teaching do not vary across schools. Efficacious teachers show less intent to quit teaching partly due to less emotional exhaustion.

While considerable research in education has established objective and subjective status differences between tracks and focused on the outcomes of ability grouping on students' educational and broader outcomes, there is virtually no research that explains students' variability in track valuation. This study relies on theoretical insights from social psychology, ethnic studies and school effects research to develop hypotheses about the influence of individual and school level features on students' track valuation. Data from The School, Identity and Society survey, involving 4,540 adolescents from 64 Belgian schools is utilised, using multilevel modelling. The findings show the relevance of social identity theory and social norms in students judging all tracks; and track chauvinism, patriotism and cross-track friendships in explaining variability in students' prejudice towards other tracks. However, these relationships vary according to the track position of the student. The conclusions discuss the implications of this study for future research and social policy.

Across the world, numerous students are being bullied at school. Bullying is often caused by a power imbalance between students. Therefore, identifying potential sources of such a power imbalance can prevent school bullying from happening. Based on the labelling theory, we expect that grade retention can lead to such a power imbalance and, therefore, increase the likelihood of being bullied at school. Hence, this study examines the association between grade retention and self-reported victimisation. We also expect that retainees will be less likely to become a victim of school bullying in schools and countries with a high number of other retainees. If true, this would signal a moderating effect of both school- and country retention composition on the association between grade retention and victimisation. The contextualised impact of grade retention upon victimisation is assessed by cross-national multilevel analyses on PISA2018 data (25 countries; 8,039 schools; 159,412 students). Overall, our findings indicate that being retained in primary and/or secondary education is associated with higher levels of victimisation, while retainees suffer from more victimisation in countries with a low number of other retainees. In contrast to our expectations, however, we did not find such a moderation effect of school retention composition.

Starting from observed gender differences in educational effort and because research considers motivation to be a personal student feature, this study had two aims. First, it examined whether autonomous and controlled motivation are shared by students within a school and whether such a motivation culture is associated with the school's student composition. Second, the study examined whether students', and specifically boys', class engagement and disruptive behaviour are associated with the motivation culture in their school. The main findings of analyses of data from 5162 eighth-grade students (average age 14) in 57 Flemish secondary schools are that (1) schools are characterized by an autonomous and controlled motivated culture that is related to schools' sex and migrant composition and schools' socioeconomic composition, respectively, and (2) boys' disruptive behaviour is related to the autonomous motivation culture, showing boys are more susceptible to their peers' motivation culture. Implications for research and practice are discussed.

In explaining why girls outperform boys in school, some studies focus on individual gender-identity. Others stress the interactional dimension of students exerting pressure to act in a more masculine/feminine way. Still other research examines the development of student cultures in specific school contexts. Considering the gender structure, this study aims to understand gender differences in educational engagement by looking at the three dimensions of gender -- individual, interactional and institutional -- simultaneously. Stepwise multilevel analyses of data of 5162 students in 57 Flemish secondary schools, show that girls are more engaged in class activities than boys. The gender gap gets significantly larger with higher levels of traditional gender-role-attitudes (considered here a reflection of the institutional dimension) -- making boys less engaged. Second, boys display significantly more disruptive behaviour. This gender gap gets larger with higher levels of gender pressure (interactional dimension) and, above all, traditional gender-role-attitudes -- both making boys misbehaving more.

Recent research has increasingly been studying the long-lasting effects of secondary education structures and processes on higher education (HE) outcomes. While the influence of socioeconomic composition on higher education enrolment is established, the underlying mechanisms remain unclear. We posit that the composition effect partially runs through the educational expectations of the students' peers at school. By considering shared post-secondary expectations among students within a school -- or, peer expectation culture -- we transcend the dominant individual approach to expectations. Additionally, we go beyond the supposed positive (i.e. normative) effects of peers on HE enrolment, by considering the negative effects of having ambitious peers on HE enrolment resulting from comparative group processes. Logistic multilevel analyses of longitudinal data (2013-2019) from 1250 students across 30 Flemish high schools showed that socio-economic status (SES) composition effects on HE outcomes were mediated by expectation culture. Students attending schools with high expectation cultures were more likely to attend HE in general, and to attend university over other HE institutes compared to students in schools with low expectation cultures. The results suggest normative effects of peers on both outcomes, while comparative processes were only found for the choice of institution. This study underscores the long-term consequences of both individual and school-level expectations in secondary education and calls for including comparative reference group effects in studies on educational decision-making.

Having a low sense of belonging in secondary education is associated with feelings of social alienation, lower school performance, and dropping out early. Based on person-environment fit theory, we expect retained students to experience a misfit with their academic environment. This experience could intensify when there are fewer other retained students around. The contextual impact of grade retention on sense of belonging is assessed by cross-national multilevel analyses on PISA 2015 data (25 countries; 7,979 schools; 194,195 students). Overall, results suggest retained students have a significantly lower sense of belonging. The negative association between grade retention and sense of belonging increases in schools and countries with a low number of retained students. This indicates that in schools and countries with a low retention composition, retained students suffer from a lower sense of belonging, because of both their status as a retained student and the absence of other retained students. Implications are discussed.

Trichuriosis is a disease in mammals caused by the whipworms of the genus Trichuris. These worms are known for the high disease burden they cause in humans and domestic animals, especially in sub-Saharan Africa. In this study, we investigated the prevalence and seasonal variations of Trichuris worms in multimammate rats (Mastomys natalensis). The study was conducted between January and November 2021 in Tanzania, in two regions (Morogoro and Iringa) that differ in their eco-climatic conditions. Removal trapping was conducted using Sherman® live traps during the rainy and dry seasons. The gastrointestinal tracts of captured rodents were screened for the presence of Trichuris worms, which were identified using morphological keys. A total of 200 M. natalensis rats were collected from each of the regions, with 100 animals in each season. For Morogoro, the overall prevalence of Trichuris worms in M. natalensis was 36% (n = 72), of which 42% (n = 42) and 30% (n = 30) were for the rainy and dry seasons, respectively. For Iringa, the overall prevalence was 65% (n = 130), of which there were 80% (n = 80) and 50% (n = 50) for the rainy and dry seasons, respectively. Trichuris worm infections were significantly higher during the rainy season in Iringa than in Morogoro; however, no significant difference in infections between males and females was noted in either region or season. Other helminths detected were Strongyloides spp., Capillaria spp., Hymenolepis spp. and eggs of a helminth that has yet to be confirmed, possibly an Anoplocephalid species. Since M. natalensis is the most important pest species in sub-Saharan Africa, and is a carrier of several zoonotic helminths, there is a need for improved surveillance of helminths infections in the studied regions, in order to establish strategic control programs to reduce their adverse impacts on health.

School discipline research has demonstrated that the labeling of student behaviors as requiring disciplinary action is a selective process in which school staff take into account other factors than the characteristics of the behaviors. We argue that school staff react in a disciplinary way to students with negative attitudes toward the educational system. Concretely, we examined if feelings of futility caused students to suffer disciplinary consequences more often. Multilevel analysis was carried out on data of 2,358 students in 28 Ghentian (Belgium) schools that participated in the International Study of City Youth (ISCY). Results indicate that school staff do not react to students' sense of futility directly by means of disciplinary actions; however, they impose disciplinary actions following disruptive behaviors on students displaying higher feelings of futility more often.

Abstract Purpose / objective This study compares the dosimetric plans of three distinct boost modalities in cervical cancer (CC): intracavitary (IC) with tandem/ovoids brachytherapy (BT), IC + interstitial (IS) BT, and Stereotactic-Body-Radiotherapy (SBRT). The aim is to determine the dosimetric impact in terms of target coverage and organ at risk (OAR) doses. Materials and methods 24 consecutive IC + IS BT boost treatment plans were retrospectively identified. For each plan included, two additional plans were created: IC-BT and SBRT. Importantly, no planning target volume (PTV) or planning (organ at) risk volume (PRV) margins were generated, therefore all structures were identical for any boost modality. Two different normalizations were performed: (1) Normalization to the target: prescription of 7.1 Gy to the D90% (defined as the minimum dose covering 90%) of the high-risk clinical target volume (HR-CTV); (2) Normalization to the OARs. HR-CTV coverage and OARs sparing were compared. The equivalent doses in 2 Gy fractions (EQD2) of EBRT and BT for CTV-HR and OARs were calculated using the linear-quadratic model with α/β of 10 (EQD210) and 3 (EQD23), respectively Results A total of 72 plans were investigated. In the first normalization, the mean EQD23−D2cc (defined as the minimal dose of the 2 cc) of OAR was significantly higher in the IC-BT plans, and the bladder D2cc hard constraint could not be reached. IC + IS BT leads to a 1 Gy mean absolute decrease of bladder EQD23-D2cc (relative dose: -19%), allowing to reach the hard constraint. SBRT (without PTV) delivers the lowest EQD23-D2cc to the OAR. In the second normalization, IC-BT provides a significantly lower dose to the EQD210-D90% (6.62 Gy) and cannot achieve the coverage goal. SBRT (without PTV) yields the highest dose to the D90% of HR-CTV and a significantly lower EQD210-D50% and D30%. Conclusion The key dosimetric benefit of BT over SBRT without PTV is a significantly higher D50% and D30% in the HR-CTV, which increases the local and conformal dose to the target. IC + IS BT vs. IC-BT provides significantly better target coverage and a lower dose to the OARs, making it the preferred boost modality in CC.

While female students are more successful and show more behavioural engagement at school than male students, they also report lower levels of subjective well-being. This study examines how motivational regulation interacts with school engagement in predicting subjective well-being of male and female students. In questionnaire data from a representative sample of Flemish students in the academic track (N = 3452, age 13-14) female students reported lower subjective well-being, more engagement, and more autonomous than controlled motivation compared to male students. Multilevel-analyses, carried out separately for female and male students, revealed that for both genders, subjective well-being was positively associated with engagement and negatively associated with a more controlled than autonomous motivation. For female students only, motivational regulation significantly interacted with engagement in predicting their well-being. The negative association between having more controlled than autonomous motivation and subjective well-being was less strong for female students showing higher school engagement.

Considerable research concerning determinants of teacher efficacy focuses on teachers' individual characteristics. School characteristics, such as the socioeconomic and gender composition of the school, are largely overlooked. The scant research including schools' student composition suggests that teachers feel less efficacious when teaching boys with a low socioeconomic status (SES). A multilevel analysis, using data from 1247 teachers in 59 Flemish secondary schools, shows that teachers' feelings of efficacy do not appear to differ very much between schools, although many studies assumed that the greater part of variance in teacher efficacy could be found between schools. The socioeconomic composition of the school does not affect teacher efficacy. Gender composition, however, does influence teacher efficacy, as teachers display more efficacy in classroom management and experience more general efficacy when teaching mostly boys. The unexpected finding that teachers seem to feel more efficacious in classroom management when teaching mostly boys is discussed.

At-risk students are overrepresented in disadvantaged segregated primary schools. Often, these students begin with an educational delay and have less parental support, which makes them more dependent on the quality of their education. Since quality of education depends in great measure upon mechanisms at the class level, it is crucial to gain insight into the interrelations between class input, teacher process variables and student outcomes. A multilevel path analysis was conducted to explore the relationship between socioeconomic and ethnic class composition, teacher trust in students, teaching learning strategies, and reading comprehension in socially and ethnically disadvantaged segregated primary classes. A reading comprehension test, teacher questionnaire and video observations of language lessons were administered (September-October 2013) to a sample of 7- and 8-year-old students (n = 271) and their 22 teachers. The socioeconomic and ethnic class situation had a significant impact on teaching learning strategies, which in turn was positively related to students' reading comprehension. Our findings underline the key role of teaching learning strategies, which mediates the relationship between the socioeconomic and ethnic class composition and reading comprehension in disadvantaged, segregated primary classes. Policy implications, limitations and directions for future research are discussed.

A mixed-methods study was conducted to investigate the relationship between four aspects of quality of teaching (safe and stimulating learning climate, efficient classroom management, adaptation of teaching, teaching learning strategies) and reading comprehension in segregated, low SES classes in Flanders. Second-grade students (n = 312) were tested for reading comprehension, and their teachers' language lessons (n = 22) were observed. A two-level analysis and qualitative video analysis were conducted. The results show that managing the class efficiently and teaching learning strategies are positively related to reading comprehension, while adaptation of teaching is negatively related to students' reading comprehension. The qualitative results deepen the quantitative findings. They offer insights into the difference in teaching quality of the highest and lowest performing teachers for efficient classroom management, adaptation of teaching and teaching learning strategies. The results and directions for future research are discussed.

Ethnic discrimination is a serious problem in education. Previous quantitative research is predominately focused on the consequences of ethnic discrimination. Very little is known, however, about the characteristics of the school context that influence the initial experience of ethnic discrimination. This knowledge is essential to support schools in how to organize in a way that diminishes the likelihood of adolescents being discriminated against. This study examines the relationship between multicultural education and perceived ethnic discrimination, and the moderating role of the ethnic composition of the student population. Multicultural education is a broad concept. The focus lies on the three main actors: multicultural policy from the perspective of the principal, multicultural teaching from the perception of the teacher and students' perception of multicultural teaching. The results of a multilevel analysis on a large-scale dataset (N = 2715 students, 38 schools) collected in secondary education in Belgium show that students of ethnic Belgian descent are more likely to report ethnic discrimination by peers if the school applies a more multicultural policy or if the school has a high concentration of students with an other-than-Belgian background. Students with an other-than-Belgian background are more likely to report ethnic discrimination by teachers if the school applies a more multicultural policy. If students perceive that their teachers pay attention to multicultural education, they are less likely to report ethnic discrimination by teachers, but more by peers. The ethnic composition is not directly related to perceived ethnic discrimination, nor does it play a moderating role.

Previous studies on the impact of grade retention on academic self-concept suffer from inconclusive findings. There is no consensus if retention yields long-term benefits that could offset its opportunity costs and, if so, under what conditions. Therefore, this article examines whether grade retention decreases academic self-concept and whether this relationship is mediated by sense of belonging. Moreover, we aim to contextualise retention research by accounting for schools' retention composition. Based on reference group theory, the effect of grade retention composition on academic self-concept is expected to be twofold. Normative reference grouping leads to the assumption that students in high retention composition schools will exhibit lower levels of academic self-concept, because retainees' values are more likely to spread across all students within the same school. Comparative reference grouping might lead to a moderation effect of retention composition on the relationship between grade retention and academic self-concept. Multilevel analyses on International Study of City Youth data, consisting of 2,354 students in 30 secondary schools in Ghent (Flanders), revealed a negative association between grade retention and academic self-concept, which was mediated by sense of belonging. Students in high retention composition schools had a significantly lower academic self-concept. The impact of being retained on academic self-concept is not affected by the number of retainees within a given context. Implications are discussed.

In 2016, Uruguay started gathering longitudinal student data to improve educational trajectories by putting in place an 'early alert' system. Underlying the system is the understanding that prior schooling predicts likelihood of grade repetition and grade repetition predicts later school dropout, while close follow-up can help prevent both repetition and dropout. We used a database of administrative registries from a national public primary school graduating cohort on their last year in primary and first year in secondary education (2015-2016, n = 36,754). We conducted two-level cross-classified logistic regression analyses to assess the suitability of using features of Uruguayan students' primary school trajectories, individual, family and primary school characteristics to predict their success or failure in their first year of secondary school. All considered prior schooling factors (previous repetition experiences, achievement, behaviour and absenteeism), the student's family socio-economic status (SES) and primary school's SES composition, as well as the location of the school in an urban or rural setting, help explain differences in chances of first-year success or failure (grade repetition) in secondary school. While these results support the 'early alert' system's approach, predictive performance analyses are needed when using explanatory models for planning interventions with scarce resources and making decisions affecting individual students' trajectories. The importance of testing resulting models' sensitivity, as well as their false positive rates, is highlighted.

Given the importance of relatedness for study motivation, motivation might be associated with faculty trust in students and, as such, with schools' student composition. Representative Flemish data of 5162 students and 1247 teachers in 57 Flemish secondary schools, gathered at the end of the 2013/2014 school year (April--May 2014), reveal that the association between faculty trust in students and students' autonomous motivation goes through students' trust in teachers. In schools with a higher socioeconomic student composition, students are less autonomously motivated, but this does not show because faculty trust is high, which generates more autonomous motivation--via students' trust in teachers.

This study assesses the effect of secondary schools' sex-composition on boys' and girls' felt pressure for gender-conformity. Whereas gender-conformity pressure affects adolescents' well-being, little large-scale research examines school features' influence. Multilevel-analyses are conducted on representative Flemish data of first grade students, 2688 boys and 2430 girls, in 57 secondary schools, gathered at the beginning of school-year 2012/13 and the end of 2013/14. When estimating the effects on gender-conformity pressure at time 2, the gender-conformity pressure at time 1 is accounted for. For girls, no effects of the school's sex-composition are found. Boys in schools with more girls display lower levels of felt pressure at the start of secondary education. The felt pressure at time 2 increases with the proportion of girls, indicating that boys forming a numerical minority at school, report more growth in gender-conformity pressure. This effect is stronger for boys holding more traditional gender-role attitudes.

Throughout their life cycle, viruses interact with cellular host factors, thereby influencing propagation, host range, cell tropism and pathogenesis. The hepatitis E virus (HEV) is an underestimated RNA virus in which knowledge of the virus–host interaction network to date is limited. Here, two related high-throughput mammalian two-hybrid approaches (MAPPIT and KISS) were used to screen for HEV-interacting host proteins. Promising hits were examined on protein function, involved pathway(s), and their relation to other viruses. We identified 37 ORF2 hits, 187 for ORF3 and 91 for ORF4. Several hits had functions in the life cycle of distinct viruses. We focused on SHARPIN and RNF5 as candidate hits for ORF3, as they are involved in the RLR-MAVS pathway and interferon (IFN) induction during viral infections. Knocking out (KO) SHARPIN and RNF5 resulted in a different IFN response upon ORF3 transfection, compared to wild-type cells. Moreover, infection was increased in SHARPIN KO cells and decreased in RNF5 KO cells. In conclusion, MAPPIT and KISS are valuable tools to study virus–host interactions, providing insights into the poorly understood HEV life cycle. We further provide evidence for two identified hits as new host factors in the HEV life cycle.

The assumption that (early) attendance of universal pre-school enhances the future academic performance of pupils with lower socio-economic and/or immigrant backgrounds underlies many education policies in Europe. The purpose of this study is to assess this assumption for Flanders -- a case characterised by near-general enrolment and a 'schoolified' approach to pre-school education. We investigated general and equity benefits of pre-school duration regarding academic outcomes in fourth grade, analysing quantitative data from a survey of 1761 pupils. First, multilevel regression analysis showed that pre-school duration was significantly yet weakly related to standardised test scores in science but not in reading. Second, pre-school duration moderately mitigated the relation between parental socio-economic status (SES) and reading outcomes. Third, the relation between pre-school duration and science/reading achievement did not vary significantly across immigrant and linguistic backgrounds. Altogether, these findings indicate a relationship between pre-school participation and short-term academic achievement that is mixed in terms of cognitive task and pupil backgrounds. The result that attending pre-school seems to counter the disparity in reading outcomes between low-SES and high-SES pupils is consistent with existing evidence.

There is no question that teachers nowadays are challenged to adapt their teaching practices to the needs that arise from increasing diversity in the current classroom. Since effective teaching asks for alignment between teaching and assessment practices, the increasing diversity challenges teachers' assessment practices and schools' assessment policies as well. This study will explore these practices and policies in schools with a diverse student population. To this end, data was collected in 2017 through case studies in six primary schools, three of which are characterized by a heterogeneous pupil composition and three of which have a homogeneous composition. The data collection includes interviews with six school principals and 24 teachers in primary education, six of whom are employed in pre-primary education. Although the results show a variety in reported assessment practices, there is no evidence for differences linked to schools' pupil composition. This study emphasizes the crucial role of an assessment policy at the school level, as it serves as a condition for high-quality assessment practices that support effective teaching, while also responding to the challenges of diversity.

This study examines whether the gender difference in sense of academic futility is related to the proportion of girls attending a school. We argue that the more progressive gender role culture in schools with a higher proportion of girls might influence especially boys' sense of futility. Multilevel analyses of data gathered in 2014 from 5,162 second-grade students in 57 secondary schools in Flanders confirm a small but significant gender difference in sense of futility. The more girls at school, the less feelings of futility boys manifest. This impact can be explained by boys' traditional gender role attitudes. For girls, the impact of gender composition, higher feelings of futility in schools with more girls, is buffered by girls' progressive gender role attitudes. In schools with more girls, boys display lower levels of futility than girls. Finally, this impact of gender composition can be ascribed to the students' educational track.

Transferring to another school or leaving the educational system altogether has considerable consequences not only for the student who makes the decision to leave, but also for the students who stay behind. This paper aims to investigate the effects of secondary schools' mobility and dropout rates on the levels of school engagement in the persistent student population, drawing on peer effect research in engagement and dropout literature. Multilevel analysis was carried out on data collected in 2015 from 1577 non-mobile students in 25 Ghentian (Belgium) schools, who participated in the International Study of City Youth-project (ISCY). The findings suggest that schools get caught up in a vicious circle, in which higher in-mobility rates bring about lower levels of behavioral engagement in non-mobile students, making those students in turn more vulnerable for negative educational decisions like dropping out or changing schools.

Introduction New Zealand general practice and primary care is currently facing significant challenges and opportunities following the impact of the coronavirus disease 2019 (COVID-19) pandemic and the introduction of health sector reform. For future sustainability, it is important to understand the workload associated with differing levels of patient case mix seen in general practice. Aim To assess levels of morbidity and concomitant levels of socio-economic deprivation among primary care practices within a large primary health organisation (PHO) and associated Māori provider network. Methods Routinely collected practice data from a PHO of 57 practices and a Māori provider (PHO) of five medical practices in the same geographical area were used to compare a number of population health indicators between practices that had a high proportion of high needs patients (HPHN) and practices with a low proportion of high needs patients (Non-HPHN). Results When practices in these PHOs are grouped in terms of ethnicity distribution and deprivation scores between the HPHN and Non-HPHN groups, there is significantly increased clustering of both long-term conditions and health outcome risk factors in the HPHN practices. Discussion In this study, population adverse health determinants and established co-morbidities are concentrated into the defined health provider grouping of HPHN practices. This ‘concentration of complexity’ raises questions about models of care and adequate resourcing for quality primary care in these settings. The findings also highlight the need to develop equitable and appropriate resourcing for all patients in primary care.

Introduction Risk stratification tools in primary care may help practices better identify high-risk patients and plan for their treatment. Patients of all ages can be at high risk of acute hospital admissions. Aim We aim to improve existing risk stratification tools by using larger datasets, and accounting for practice-level variations in hospitalisation rates and read-code quality. Methods This work has derived an acute admission risk stratification tool in the Wellington, Kāpiti Coast and Wairarapa regions of New Zealand. An open cohort, starting 1 March 2017 and finishing 1 November 2021, contains 319 943 patients. An accelerated failure time survival regression model is used to model acute admission risk. Candidate models are tested on holdout data using six different test metrics. Results Patient risk is most affected by demographic, and the frequency of recent healthcare system usage. Morbidity categories have less predictive capability, but may still be useful from a practical perspective. The preferred model has an area under the receiver operating characteristic curve (AUROC) of 0.75 for a 6-month forecast period. Discussion The model is straightforward to apply to other datasets. Although most of the highest-risk patients will be well-known to their primary care practices already, the model helps to identify the patients who are high risk but not regularly attendees of the practice, and may benefit from proactive care planning.

Background & Aims: Elimination of chronic HBV/HDV infection remains a major global health challenge. Targeting excessive hepatitis B surface antigen (HBsAg) release may provide an interesting window of opportunity to break immune tolerance and to achieve a functional cure using additional antivirals. Methods: We evaluated a HBsAg-specific human monoclonal antibody, as part of either a prophylactic or therapeutic strategy, against HBV/HDV infection in cell culture models and in human-liver chimeric mice. To assess prophylactic efficacy, mice were passively immunized prior to infection with HBV or HBV/HDV (coinfection and superinfection setting). Therapeutic efficacy was assessed in HBV and HBV/HDV-coinfected mice receiving 4 weeks of treatment. Viral parameters (HBV DNA, HDV RNA and HBsAg) were assessed in mouse plasma. Results: The antibody could effectively prevent HBV/HDV infection in a dose-dependent manner with IC50 values of ∼3.5 ng/ml. Passive immunization showed complete protection of mice from both HBV and HBV/HDV coinfection. Moreover, HDV superinfection was either completely prevented or at least attenuated in HBV-infected mice. Finally, antibody treatment in mice with established HBV/HDV infection resulted in a significant decline in viremia and a concomitant drop in on-treatment HBsAg, with a moderate viral rebound following treatment cessation. Conclusion: We present data on a valuable antibody candidate that could complement other antivirals in strategies aimed at achieving functional cure of chronic HBV and HDV infection. Impact and implications: Patients chronically infected with HBV may eventually develop liver cancer and are at great risk of being superinfected with HDV, which worsens and accelerates disease progression. Unfortunately, current treatments can rarely eliminate both viruses from chronically infected patients. In this study, we present data on a novel antibody that is able to prevent chronic HBV/HDV infection in a mouse model with a humanized liver. Moreover, antibody treatment of HBV/HDV-infected mice strongly diminishes viral loads during therapy. This antibody is a valuable candidate for further clinical development.

Leptospirosis is a neglected zoonotic disease and one of the leading causes of zoonotic morbidity and mortality, particularly in resource-poor settings. Sri Lanka has one of the highest disease burdens worldwide, with occasional endemic leptospirosis outbreaks (2008, 2011). Rodents are considered the main wildlife reservoir, but due to a scarcity of studies it is unclear which particular species contributes to bacterial transmission and reservoir maintenance in this multi-host multi-parasite system. Several rodent species act as agricultural pests both in rice fields and in food storage facilities. To unravel the interactions among the small mammal communities, pathogenic Leptospira spp. and human transmission pathways, we collected animals from smallholder food storage facilities, where contact between humans and small mammals is most likely, and screened kidney tissue samples for Leptospira spp. using PCR. Samples were collected in three climatic zones along a rainfall gradient. Pathogenic Leptospira spp. were detected in small mammal communities in 37 (74%) out of 50 sampled farms and 61 (12%) out of 500 collected individuals were infected. The small mammal community was comprised of Rattus rattus (87.6%), Suncus shrews (8.8%), Bandicota spp. (2.8%) and Mus booduga (0.8%). Three pathogenic Leptospira spp. were identified, L. borgpetersenii (n = 34), L. interrogans (n = 15), and L. kirschneri (n = 1). Suncus shrews were commonly infected (32%), followed by B. indica (23%) and R. rattus (10%). L. borgpetersenii strains similar to strains previously extracted from human clinal samples in Sri Lanka were detected in R. rattus and Suncus shrews. L. interrogans was observed in R. rattus only. A single L. kirschneri infection was found in M. booduga. The presence of human pathogenic Leptospira species in an agricultural pest rodent (R. rattus) and in commensal shrews (Suncus) calls for management of these species in commensal settings. Further investigation of the interplay between pathogen and reservoir population dynamics, overlap in geographic range and the extent of spill-over to humans in and around rural settlements is required to identify optimal management approaches.

The 3D musculoskeletal motion of animals is of interest for various biological studies and can be derived from X-ray fluoroscopy acquisitions by means of image matching or manual landmark annotation and mapping. While the image matching method requires a robust similarity measure (intensity-based) or an expensive computation (tomographic reconstruction-based), the manual annotation method depends on the experience of operators. In this paper, we tackle these challenges by a strategic approach that consists of two building blocks: an automated 3D landmark extraction technique and a deep neural network for 2D landmarks detection. For 3D landmark extraction, we propose a technique based on the shortest voxel coordinate variance to extract the 3D landmarks from the 3D tomographic reconstruction of an object. For 2D landmark detection, we propose a customized ResNet18-based neural network, BoneNet, to automatically detect geometrical landmarks on X-ray fluoroscopy images. With a deeper network architecture in comparison to the original ResNet18 model, BoneNet can extract and propagate feature vectors for accurate 2D landmark inference. The 3D poses of the animal are then reconstructed by aligning the extracted 2D landmarks from X-ray radiographs and the corresponding 3D landmarks in a 3D object reference model. Our proposed method is validated on X-ray images, simulated from a real piglet hindlimb 3D computed tomography scan and does not require manual annotation of landmark positions. The simulation results show that BoneNet is able to accurately detect the 2D landmarks in simulated, noisy 2D X-ray images, resulting in promising rigid and articulated parameter estimations.

Strain theories expect socio-economically disadvantaged students to be overrepresented among perpetrators of school-deviant behavior. Empirical research, however, is inconclusive about the SES-deviance relationship. Recently, strain theorists argued that economic deprivation, rather than a socio-economic status (SES) index is related to delinquency. This study is unique in investigating these claims in an educational context. Specifically, we investigate the association between SES and economic deprivation, and school misconduct. We also aim to shed light on why and under which conditions SES and deprivation are associated with misconduct. Starting from strain theory and social cognitive theory, we hypothesize academic self-efficacy to mediate and/or to moderate discovered associations. Following previous findings that socioeconomic status effects on deviance differ across national contexts, we apply a cross-national design, investigating the hypotheses in four European cities, namely Barcelona (Spain), Bergen (Norway), Ghent (Belgium), and Wroclaw (Poland). Analyses on data of 9174 students across 111 schools (2013-2014) confirmed that deprivation is more important for rule-breaking than SES, but self-efficacy did not mediate, nor moderate deprivation effects. Importantly, self-efficacy did moderate SES effects. Students from lower SES-families are prone to be deviant at school, but this association may be buffered by increasing students' academic self-efficacy. Implications for theory and practice are discussed.

This study examines whether secondary schools' gender composition and levels of laddish attitudes influence the degree of ethnic prejudice among Flemish pupils. We hypothesize that in addition to pupil-level predictors of prejudice, the school's gender composition and its laddish culture play roles in pupils' attitudes toward ethnic minorities. We use multilevel analysis with data obtained in 2014-2015 from 2250 Flemish pupils in 48 secondary schools in Flanders. Both girls' and boys' ethnic prejudice is related to their laddish attitudes. Boys' levels of ethnic prejudice are associated with the gender composition and the laddish culture of their school, while girls' ethnic prejudice is more likely to be influenced by the laddish culture of the school when the proportion of male pupils in the school increases. The findings suggest that in order to reduce ethnic prejudice it might be fruitful to focus on macro-level factors, such as tackling laddish cultures at school.

Abstract Background Ethiopia is affected by human leishmaniasis caused by several Leishmania species and transmitted by a variety of sand fly vectors of the genus Phlebotomus. The sand fly fauna in Ethiopia is highly diverse and some species are closely related and similar in morphology, resulting in difficulties with species identification that requires deployment of molecular techniques. DNA barcoding entails high costs, requires time and lacks reference sequences for many Ethiopian species. Yet, proper species identification is pivotal for epidemiological surveillance as species differ in their actual involvement in transmission cycles. Recently, protein profiling using MALDI-TOF mass spectrometry has been introduced as a promising technique for sand fly identification. Methods In our study, we used an integrative taxonomic approach to identify most of the important sand fly vectors of leishmaniasis in Ethiopia, applying three complementary methods: morphological assessment, sequencing analysis of two genetic markers, and MALDI-TOF MS protein profiling. Results Although morphological assessment resulted in some inconclusive identifications, both DNA- and protein-based techniques performed well, providing a similar hierarchical clustering pattern for the analyzed species. Both methods generated species-specific sequences or protein patterns for all species except for Phlebotomus pedifer and P. longipes, the two presumed vectors of Leishmania aethiopica, suggesting that they may represent a single species, P. longipes Parrot & Martin. All three approaches also revealed that the collected specimens of Adlerius sp. differ from P. (Adlerius) arabicus, the only species of Adlerius currently reported in Ethiopia, and molecular comparisons indicate that it may represent a yet undescribed new species. Conclusions Our study uses three complementary taxonomical methods for species identification of taxonomically challenging and yet medically import Ethiopian sand flies. The generated MALDI-TOF MS protein profiles resulted in unambiguous identifications, hence showing suitability of this technique for sand fly species identification. Furthermore, our results contribute to the still inadequate knowledge of the sand fly fauna of Ethiopia, a country severely burdened with human leishmaniasis.

Abstract Background In eco-epidemiological studies, Leishmania detection in vectors and reservoirs is frequently accomplished by high-throughput and sensitive molecular methods that target minicircle kinetoplast DNA (kDNA). A pan-Leishmania SYBR green quantitative PCR (qPCR) assay which detects the conserved spliced-leader RNA (SL RNA) sequence was developed recently. This study assessed the SL RNA assay performance combined with a crude extraction method for the detection of Leishmania in field-collected and laboratory-reared sand flies and in tissue samples from hyraxes as reservoir hosts. Methods Field-collected and laboratory-infected sand fly and hyrax extracts were subjected to three different qPCR approaches to assess the suitability of the SL RNA target for Leishmania detection. Nucleic acids of experimentally infected sand flies were isolated with a crude extraction buffer with ethanol precipitation and a commercial kit and tested for downstream DNA and RNA detection. Promastigotes were isolated from culture and sand fly midguts to assess whether there was difference in SL RNA and kDNA copy numbers. Naive sand flies were spiked with a serial dilution of promastigotes to make a standard curve. Results The qPCR targeting SL RNA performed well on infected sand fly samples, despite preservation and extraction under presumed unfavorable conditions for downstream RNA detection. Nucleic acid extraction by a crude extraction buffer combined with a precipitation step was highly compatible with downstream SL RNA and kDNA detection. Copy numbers of kDNA were found to be identical in culture-derived parasites and promastigotes isolated from sand fly midguts. SL RNA levels were slightly lower in sand fly promastigotes (ΔCq 1.7). The theoretical limit of detection and quantification of the SL RNA qPCR respectively reached down to 10−3 and 10 parasite equivalents. SL RNA detection in stored hyrax samples was less efficient with some false-negative assay results, most likely due to the long-term tissue storage in absence of RNA stabilizing reagents. Conclusions This study shows that a crude extraction method in combination with the SL RNA qPCR assay is suitable for the detection and quantification of Leishmania in sand flies. The assay is inexpensive, sensitive and pan-Leishmania specific, and accordingly an excellent assay for high-throughput screening in entomological research.

Synthetic aperture radar systems perform signal acquisition under varying incidence angles and register an implicit intensity decay from near to far range. Owing to the geometrical interaction between microwaves and the imaged targets, the rates at which intensities decay depend on the nature of the targets, thus rendering single-rate image correction approaches only partially successful. The decay, also known as the incidence angle effect, impacts the segmentation of wide-swath images performed on absolute intensity values. We propose to integrate the target-specific intensity decay rates into a nonstationary statistical model, for use in a fully automatic and unsupervised segmentation algorithm. We demonstrate this concept by assuming Gaussian distributed log-intensities and linear decay rates, a fitting approximation for the smooth systematic decay observed for extended flat targets. The segmentation is performed on Sentinel-1, Radarsat-2, and UAVSAR wide-swath scenes containing open water, sea ice, and oil slicks. As a result, we obtain segments connected throughout the entire incidence angle range, thus overcoming the limitations of modeling that does not account for different per-target decays. The model simplicity also allows for short execution times and presents the segmentation approach as a potential operational algorithm. In addition, we estimate the log-linear decay rates and examine their potential for a physical interpretation of the segments.