Continuous Assessment Research Articles

Quality of education in migration hotspot areas in Ethiopia: Input‐process‐outcome‐context approach

AbstractWhile the lack of educational opportunities limits the future of most people in Ethiopia, they pose dire consequences to young people in migration hotspot areas. Using input‐process‐outcome‐context‐education quality framework, this study investigated the quality of education in eight migration hotspot areas of Ethiopia and its association with migration. A random sample of 1,187 participants (793 students, 262 teachers and 132 parents) completed a survey. Data were analysed using descriptive and inferential statistics. Results indicated that participants’ overall rating of education quality was low. Over a third of participants perceived that input, process and outcome components of education in migration hotspot areas have a quality problem. Over 80% of the participants believed that poor quality of education could be a cause for migration. More specifically, a significant portion of the participants (37%) reported that there was no pedagogical centre in their respective schools; continuous assessment was practiced rarely (36%); and creativity and discovery among students was almost non‐existent (40%). The participants' ratings indicated that the top five factors that contribute to the poor quality of education are low level of teacher competence, poor student motivation, poverty, value attached to education and large class size.

National Institutes of Health Stroke Scale Reporting in Medicare Claims Data: Reporting in the First 3 Years.

Since 2016, hospitals have been able to document International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for the National Institutes of Health Stroke Scale (NIHSS). As of 2023, the Centers for Medicare & Medicaid Services uses NIHSS as a risk adjustment variable. We assessed associations between patient- and hospital-level variables and contemporary NIHSS reporting. We performed a retrospective cross-sectional analysis of 2019 acute ischemic stroke admissions using deidentified, national 100% inpatient Medicare Fee-For-Service data sets. We identified index acute ischemic stroke admissions using the ICD-10-CM code I63.x and abstracted demographic information, medical comorbidities, hospital characteristics, and NIHSS. We linked Medicare and Mount Sinai Health System (New York, NY) registry data from 2016 to 2019. We calculated NIHSS documentation at the patient and hospital levels, predictors of documentation, change over time, and concordance with local data. There were 231 383 index acute ischemic stroke admissions in 2019. NIHSS was documented in 44.4% of admissions and by 66.5% of hospitals. Hospitals that documented ≥1 NIHSS were more commonly teaching hospitals (39.0% versus 5.5%; standardized mean difference score, 0.88), stroke certified (37.2% versus 8.0%; standardized mean difference score, 0.75), higher volume (mean, 80.8 [SD, 92.6] versus 6.33 [SD, 14.1]; standardized mean difference score, 1.12), and had intensive care unit availability (84.9% versus 23.2%; standardized mean difference score, 1.57). Adjusted odds of documentation were lower for patients with inpatient mortality (odds ratio, 0.64 [95% CI, 0.61-0.68]; P<0.0001), in nonmetropolitan areas (odds ratio, 0.49 [95% CI, 0.40-0.61]; P<0.0001), and male sex (odds ratio, 0.95 [95% CI, 0.93-0.97]; P<0.0001). NIHSS was documented for 52.9% of Medicare cases versus 93.1% of registry cases, and 74.7% of Medicare NIHSS scores equaled registry admission NIHSS. Missing ICD-10-CM NIHSS data remain widespread 3 years after the introduction of the ICD-10-CM NIHSS code, and there are systematic differences in reporting at the patient and hospital levels. These findings support continued assessment of NIHSS reporting and caution in its application to risk adjustment models.

Assessing the influence of seasonal precipitation patterns on groundwater quality in the coal rich environment of Enugu, Nigeria

As the impacts of climate change continue to be felt around the world, understanding the effects on groundwater quality and quantity has become an important area of investigation. As a global source of water that contributes to preserving the environment, a better understanding of the effect of precipitation seasonal pattern on these systems is crucial; though studies connected to groundwater quality in this era of environmental crisis are at infancy. This study aims to evaluate the effect of precipitation seasonal pattern on groundwater quality in a coal enriched environment of developing city of west African sub-region with particular reference to Enugu, a coal city in Nigeria. Three residential areas (Abakpa, Achara, and Independence Layout) were randomly selected from high, medium, and low neighbourhood densities in the metropolis. Within the period spanning from April 2018 to March 2019, a physiochemical analysis was conducted on twelve deep wells utilizing weighted arithmetic index method. This technique was implemented in order to facilitate the assessment of the degree of water quality by translating a number of variables to just one metric value. The results of the investigation showed that the groundwater resources in the study region are mildly acidic, presumably as a result of the presence of pyrite, which is a byproduct of coal weathering, and chloride-ion-charged rains. Additionally, noticeable distinctions in the properties of water samples were observed between the dry and rainy seasons. Specifically, just 1% of the sampled water had excellent ratings, while 58.3% were considered good, 29.1% were deemed poor, and 8.3% of samples were categorized as very poor. The study concluded that coupled with climate crisis, seasonal precipitation patterns affect groundwater resources by reducing recharge, discharge, and the overall quality of water. These results have important implications for the management of groundwater resources in the region and highlight the need for continued monitoring and assessment of water quality in the face of ongoing environmental changes.

Assessing and Improving the Care of Patients With Heart Failure in Ghana: Protocol for a Prospective Observational Study and the Ghana Heart Initiative-Heart Failure Registry.

Heart failure (HF) is a leading cause of morbidity and mortality globally, with a high disease burden. The prevalence of HF in Ghana is increasing rapidly, but epidemiological profiles, treatment patterns, and survival data are scarce. The national capacity to diagnose and manage HF appropriately is also limited. To address the growing epidemic of HF, it is crucial to recognize the epidemiological characteristics and medium-term outcomes of HF in Ghana and improve the capability to identify and manage HF promptly and effectively at all levels of care. This study aims to determine the epidemiological characteristics and medium-term HF outcomes in Ghana. We conducted a prospective, multicenter, multilevel cross-sectional observational study of patients with HF from January to December 2023. Approximately 5000 patients presenting with HF to 9 hospitals, including teaching, regional, and municipal hospitals, will be recruited and evaluated according to a standardized protocol, including the use of an echocardiogram and an N-terminal pro-brain natriuretic peptide (NT-proBNP) test. Guideline-directed medical treatment of HF will be initiated for 6 months, and the medium-term outcomes of interventions, including rehospitalization and mortality, will be assessed. Patient data will be collated into a HF registry for continuous assessment and monitoring. This intervention will generate the necessary information on the etiology of HF, clinical presentations, the diagnostic yield of various tools, and management outcomes. In addition, it will build the necessary capacity and support for HF management in Ghana. As of July 30, 2023, the training and onboarding of all 9 centers had been completed. Preliminary analyses will be conducted by the end of the second quarter of 2024, and results are expected to be publicly available by the middle of 2024. This study will provide the necessary data on HF, which will inform decisions on the prevention and management of HF and form the basis for future research. ISRCTN Registry (United Kingdom) ISRCTN18216214; https:www.isrctn.com/ISRCTN18216214. DERR1-10.2196/52616.

Wearable device for continuous sweat lactate monitoring in sports: a narrative review

In sports science, the use of wearable technology has facilitated the development of new approaches for tracking and assessing athletes’ performance. This narrative review rigorously explores the evolution and contemporary state of wearable devices specifically engineered for continuously monitoring lactate levels in sweat, an essential biomarker for appraising endurance performance. Lactate threshold tests have traditionally been integral in tailoring training intensity for athletes, but these tests have relied on invasive blood tests that are impractical outside a laboratory setting. The transition to noninvasive, real-time monitoring through wearable technology introduces an innovative approach, facilitating continuous assessment without the constraints inherent in traditional methodologies. We selected 34 products from a pool of 246 articles found through a meticulous search of articles published up to January 2024 in renowned databases: PubMed, Web of Science, and ScienceDirect. We used keywords such as “sweat lactate monitoring,” “continuous lactate monitoring,” and “wearable devices.” The findings underscore the capabilities of noninvasive sweat lactate monitoring technologies to conduct long-term assessments over a broad range of 0–100 mM, providing a safer alternative with minimal infection risks. By enabling real-time evaluations of the lactate threshold (LT) and maximal lactate steady state (MLSS), these technologies offer athletes various device options tailored to their specific sports and preferences. This review explores the mechanisms of currently available lactate monitoring technologies, focusing on electrochemical sensors that have undergone extensive research and show promise for commercialization. These sensors employ amperometric reactions to quantify lactate levels and detect changes resulting from enzymatic activities. In contrast, colorimetric sensors offer a more straightforward and user-friendly approach by displaying lactate concentrations through color alterations. Despite significant advancements, the relationship between sweat lactate and blood lactate levels remains intricate owing to various factors such as environmental conditions and the lag between exercise initiation and sweating. Furthermore, there is a marked gap in research on sweat lactate compared to blood lactate across various sports disciplines. This review highlights the need for further research to address these shortcomings and substantiate the performance of lactate sweat monitoring technologies in a broader spectrum of sports environments. The tremendous potential of these technologies to supplant invasive blood lactate tests and pioneer new avenues for athlete management and performance optimization in real-world settings heralds a promising future for integrating sports science and wearable technology.

From a final exam to continuous assessment on a large Bachelor level engineering course

ABSTRACT A typical practice of assessment in engineering studies, especially on large Bachelor level courses, is a final exam at the end of the course. This practice is problematic both in terms of learning and teaching, as it does not provide feedback on learning experience or student progress before the course is completed. This study examines the gradual process of moving from a final exam towards continuous assessment that integrates the practices of summative and formative assessment. The aim is to understand how the changes affect student performance on the course over a period of four years. The changes were implemented on a large Bachelor level engineering course. The impact of adding practices of continuous assessment was analyzed in relation to the course pass rate, grade distribution, and student feedback. The results show that replacing the final exam with weekly homework improved student performance. Some of the identified differences are statistically significant. Student feedback implies that moving towards continuous assessment had a positive impact on the learning experience. The results support increased use of continuous assessment in the assessment of student learning on large Bachelor level engineering courses.

Neuromonitoring in neurocritical care for traumatic brain injury in the Thai context

The purposes of this review were to identify the incidence and types of traumatic brain injury (TBI) in Thailand, and recommend neuro-monitoring for limited resources in Thai patients. The monitoring methods focus on the targeted and personalized management in severe TBI such as intracranial pressure (ICP), pressure reactivity index (PRx), regional cerebral saturation (rSO2), cerebral autoregulation (CA), as well as noninvasive methods for example near-infrared spectroscopy (NIRS) and optic nerve sheath diameter (ONSD). These monitors are aimed to optimize brain oxygen delivery and prevent further neurologic deterioration in terms of increased ICP and decreased cerebral perfusion pressure (CPP). Some of these were implemented in neurological monitoring protocol and clinical practice guidelines for severe TBI. However, cost - effectiveness is concerned. Even though considering CA and the advance monitoring methods in continuous assessment are widely used, current therapeutic interventions which appear entirely to bedside approach for correct dysregulated CA are limited. In addition, understanding of basic molecular and cellular pathways involved in cerebral homeostasis ( brain oxygen delivery, cerebral blood flow, CA and cerebral vascular reactivity to oxygen and carbon dioxide) as well as secondary brain injury prevention are still necessary for improving TBI outcomes. In summary, further study in Thailand is required to determine optimal cerebral physiologic-based technology, monitoring parameters, and individualized thresholds to optimize CA and potentially improve neurologic outcomes across a spectrum of TBI patients, which focus in Thai rural areas where invasive monitoring is not routinely performed due to resources limitation. Encourage and training of non invasive methods might solve these issues.

Impact of vessel volume on thermodilution measurements in patients with coronary microvascular dysfunction.

Two invasive methods are available to estimate microvascular resistance: bolus and continuous thermodilution. Comparative studies have revealed a lack of concordance between measurements of microvascular resistance obtained through these techniques. This study aimed to examine the influence of vessel volume on bolus thermodilution measurements. We prospectively included patients with angina with non-obstructive coronary arteries (ANOCA) undergoing bolus and continuous thermodilution assessments. All patients underwent coronary CT angiographyto extract vessel volume. Coronary microvascular dysfunction was defined as coronary flow reserve (CFR) < 2.0. Measurements of absolute microvascular resistance (in Woods units) and index of microvascular resistance (IMR) were compared before and after volumetric adjustment. Overall, 94 patients with ANOCA were included in this study. The mean age was 64.7 ± 10.8 years, 48% were female, and 19% had diabetes. The prevalence of CMD was 16% based on bolus thermodilution, while continuous thermodilution yielded a prevalence of 27% (Cohen's Kappa 0.44, 95% CI 0.23-0.65). There was no correlation in microvascular resistance between techniques (r = 0.17, 95% CI -0.04 to 0.36, p = 0.104). The adjustment of IMR by vessel volume significantly increased the agreement with absolute microvascular resistance derived from continuous thermodilution (r = 0.48, 95% CI 0.31-0.63, p < 0.001). In patients with ANOCA, invasive methods based on coronary thermodilution yielded conflicting results for the assessment of CMD. Adjusting IMR with vessel volume improved the agreement with continuous thermodilution for the assessment of microvascular resistance. These findings strongly suggest the importance of considering vessel volume when interpreting bolus thermodilution assessment.

Continuous Long-Term Assessment of Heart Rate Variability in Adults with Cyanotic Congenital Heart Disease after Surgical Repair.

Background: Heart rate variability (HRV) is an established, non-invasive parameter for the assessment of cardiac autonomic nervous activity and the health status in general cardiology. However, there are few studies on HRV in adults with congenital heart defects (CHDs). The aim of the present study was to evaluate the use of long-term continuous HRV measurement for the assessment of global health status in adults with cyanotic CHD. Methods: This prospective study included 45 adults (40% female, mean age = 35.2 ± 9.2 [range: 19-58] years) after cardiac surgical repair. HRV parameters were calculated from continuous 24 h measurements using a Bittium Faros 180 sensor (Bittium Corp., Oulu, Finland). Results: Postoperative patients with transposition of the great arteries (TGA) (n = 18) achieved significantly higher values of standard deviation of NN intervals (SDNN) (175.4 ± 59.9 ms vs. 133.5 ± 40.6 ms; p = 0.013) compared with patients with other conotruncal anomalies (n = 22). Comparing patients with TGA after a Senning-Brom or Mustard operation (n = 13) with all other heart surgery patients (n = 32), significantly higher HRV parameters were found after atrial switch (root mean square of successive RR interval differences: 53.6 ± 20.7 ms vs. 38.4 ± 18.3 ms; p = 0.019; SDNN: 183.5 ± 58.4 ms vs. 136.3 ± 45.3 ms; p = 0.006). A higher SDNN was also measured after Senning-Brom or Mustard operations than after a Rastelli operations (n = 2) (SDNN: 183.5 ± 58.4 ms vs. 84.5 ± 5.2 ms; p = 0.037). When comparing atrial switch operations (n = 3) with Rastelli operations, the SDNN value was significantly shorter in the Rastelli group (p = 0.004). Conclusions: Our results suggest that continuous HRV monitoring may serve as a marker of cardiac autonomic dysfunction in adults with cyanotic CHD after surgical repair. Impaired cardiac autonomic nervous activity may be associated with an increased risk of adverse reactions in patients with repaired CHD. Therefore, a longitudinal assessment of HRV patterns and trends may provide a deeper insight into dynamic changes in their autonomic regulation and disease progression, lifestyle changes, or treatments. As each person has individual variability in heart rate, HRV may be useful in assessing intra-individual disease progression and may help to improve personalized medicine. Further studies are needed to better understand the underlying mechanisms and to explore the full potential of HRV analysis to optimize medical care for ACHDs.

Integration of Real-Time Monitoring and Data Analytics to Mitigate Sand Screenouts During Fracturing Operations

Summary Sand screenout, the most frequent incident during hydraulic fracturing, is one of the major threats to operational safety and efficiency. Screenout occurs when advancing hydraulic fractures are blocked by injected proppant-slurry, stall, and develop fluid overpressure. Because massive wells are still being hydraulically fractured every year, operational safety has become a critical and urgent issue that has always been overshadowed by the whether-or-not controversy. However, the suddenness and unheralded surprise of screenout make it extremely difficult to predict and handle. Previous efforts attempt to predict screenout as discrete events by interpreting injection pressure directly. We propose and then demonstrate a self-updating (via data and experience augmentation) and customizable (numerical models and algorithms) data-driven strategy of real-time monitoring and management for screenout based on records of shale gas fracturing. Two new indicators—proppant filling index (PFI) and safest fracturing pump rate (SFPR)—are improved and then integrated into the strategy. The PFI reveals the mismatch between injected proppant and hydraulic fractures and provides a continuous time-historical risk assessment of screenout. A pretrained ensemble learning model is applied to process the geological and hydraulic measurements in real time for the PFI evolution curve during fracturing operations. Integrated with the SFPR, a stepwise pump rate regulation strategy is deployed successfully to mitigate sand screenout for field applications. Four field trials are elaborated, which are representative cases exhibiting the data-driven approach to monitor and manage sand screenout during hydraulic fracturing.

Precision Education: The Future of Lifelong Learning in Medicine.

The goal of medical education is to produce a physician workforce capable of delivering high-quality equitable care to diverse patient populations and communities. To achieve this aim amidst explosive growth in medical knowledge and increasingly complex medical care, a system of personalized and continuous learning, assessment, and feedback for trainees and practicing physicians is urgently needed. In this perspective, the authors build on prior work to advance a conceptual framework for such a system: precision education (PE).PE is a system that uses data and technology to transform lifelong learning by improving personalization, efficiency, and agency at the individual, program, and organization levels. PE "cycles" start with data inputs proactively gathered from new and existing sources, including assessments, educational activities, electronic medical records, patient care outcomes, and clinical practice patterns. Through technology-enabled analytics , insights are generated to drive precision interventions . At the individual level, such interventions include personalized just-in-time educational programming. Coaching is essential to provide feedback and increase learner participation and personalization. Outcomes are measured using assessment and evaluation of interventions at the individual, program, and organizational levels, with ongoing adjustment for repeated cycles of improvement. PE is rooted in patient, health system, and population data; promotes value-based care and health equity; and generates an adaptive learning culture.The authors suggest fundamental principles for PE, including promoting equity in structures and processes, learner agency, and integration with workflow (harmonization). Finally, the authors explore the immediate need to develop consensus-driven standards: rules of engagement between people, products, and entities that interact in these systems to ensure interoperability, data sharing, replicability, and scale of PE innovations.

Effects of Hypoxia Severity on Muscle Oxygenation Kinetics Using Statistical Parametric Mapping During Repeated Treadmill Sprints.

We examined the effects of increasing hypoxia severity on oxygenation kinetics in the vastus lateralis muscle during repeated treadmill sprints, using statistical parametric mapping (SPM). Ten physically active males completed 8 sprints of 5seconds each(recovery = 25s) on a motorized sprint treadmill in normoxia (sea level; inspired oxygen fraction = 0.21), moderate hypoxia (inspired oxygen fraction = 0.17), and severe hypoxia (SH; inspired oxygen fraction = 0.13). Continuous assessment of tissue saturation index (TSI) in the vastus lateralis muscle was conducted using near-infrared spectroscopy. Subsequently, TSI data were averaged for the sprint-recovery cycle of all sprints and compared between conditions. The SPM analysis revealed no discernible difference in TSI signal amplitude between conditions during the actual 5-second sprint phase. However, during the latter portion of the 25-second recovery phase, TSI values were lower in SH compared with both sea level (from 22 to 30s; P = .003) and moderate hypoxia (from 16 to 30s; P = .001). The mean distance covered at sea level (22.9 [1.0]m) was greater than for both moderate hypoxia (22.5 [1.2]m; P = .045) and SH (22.3 [1.4]m; P = .043). The application of SPM demonstrated that only SH reduced muscle oxygenation levels during the late portion of the passive (recovery) phase and not the active (sprint) phase during repeated treadmill sprints. These findings underscore the usefulness of SPM for assessing muscle oxygenation differences due to hypoxic exposure and the importance of the duration of the between-sprints recovery period.

Is there scope to do better? Clinical communication with adolescents and young adults with cancer-A scoping review.

How to communicate effectively with adolescent and young adults with cancer (AYACs) is a research priority. In a UK-wide survey of young people with cancer's research priorities, communication was a striking cross-cutting theme. It is increasingly recognised that AYACs have experiences and communication needs that differ significantly from those of younger children and older adults. The purpose of this review is to explore the features of effective clinical communication with AYACs. A literature search was undertaken to identify and map the available evidence using a broad scope to get an overview of the pertinent literature, identify knowledge gaps and clarify concepts. The searches yielded 5825 records, generating 4040 unique articles. These were screened and 71 full articles were read by four researchers with disagreements resolved by discussion leaving 29 included articles. Narrative synthesis was undertaken in relation to each of the research questions. Three key themes were identified: being an adolescent/young adult, supporters, and healthcare professionals (HCPs). AYACs need to feel that HCPs understand their unique perspective. They want to be involved, this changes over time and in different contexts. Supporters are a central tenet, are most often parents and undertake several roles which are not always universally supportive. HCPs enable involvement of AYACs, and this needs to be actively promoted. AYACs preference for their level of involvement requires continual assessment. The three themes are interlinked and exist within the wider scope of the triadic encounter and cancer experience. Supporters, most often parents were a key feature across the data and were seemingly paradoxical in nature. Triadic communication, the presence of a third person, is a central tenet of communication with AYACs and we propose a conceptual model to represent the nuances, components, and facets of this complex communication.

Cybersecurity risks in online banking: A detailed review and preventive strategies applicatio

In an era where the digital transformation of the banking sector intersects with the escalating complexity of cyber threats, this paper endeavors to dissect the multifaceted realm of cybersecurity within the banking industry. With a backdrop of increasing online banking adoption and the concomitant rise in cybercrime, the study aims to illuminate the current cybersecurity landscape, evaluate the efficacy of existing frameworks and propose strategic enhancements to fortify digital defenses. Employing a methodological amalgam of literature review and analysis of recent cybersecurity incidents, this investigation delves into the intricacies of cyber threats, the financial repercussions of breaches and the robustness of current cybersecurity measures in banking. The scope of this paper encompasses a comprehensive examination of recent cyber incidents, an assessment of the financial impact of cyber-attacks, an evaluation of the effectiveness of existing cybersecurity frameworks and the formulation of strategic recommendations for bolstering cybersecurity measures. Through this scholarly inquiry, key findings emerge, highlighting the critical need for dynamic cybersecurity strategies that integrate advanced technologies, promote regulatory compliance and foster a culture of cybersecurity awareness. Conclusively, the study posits that the banking sector must embrace a holistic and adaptive approach to cybersecurity, underscored by strategic investments in technology, education, and collaboration. Recommendations advocate for the integration of Big Data analytics, artificial intelligence and continuous risk assessment methodologies to navigate the evolving cyber threat landscape effectively. This paper serves as a clarion call to banking institutions, urging a reinvigorated commitment to cybersecurity resilience in safeguarding financial assets and customer trust against the backdrop of digital transformation.

Hereditary or acquired? Comprehensive genetic testing assists in stratifying angioedema patients

Hereditary angioedema (HAE) poses diagnostic challenges due to its episodic, non-specific symptoms and overlapping conditions. This study focuses on the genetic basis of HAE, particularly focusing on unresolved cases and those with normal C1-inhibitor levels (nC1-INH HAE). This study reveals that conventional testing identified pathogenic variants in only 10 patients (n = 32), emphasizing the necessity for an integrative approach using genome, exome, and transcriptome sequencing. Despite extensive genetic analyses, the diagnostic yield for nC1-INH HAE remains low in our study, the pathogenic variant for nC1-INH HAE was identified in only 1 patient (n = 21). Investigation into candidate genes yielded no pathogenic variants, prompting a re-evaluation of patients’ diagnoses. This study advocates for a nuanced approach to genetic testing, recognizing its limitations and emphasizing the need for continuous clinical assessment. The complex genetic landscape of nC1-INH HAE necessitates further research for a more comprehensive understanding. In conclusion, this study contributes valuable insights into the genetic intricacies of HAE, highlighting the challenges in diagnosis and the evolving nature of the disease. The findings underscore the importance of advanced sequencing techniques and an integrated diagnostic strategy in unravelling the complexities of HAE, particularly in nС1-INH HAE cases.

TEACHERS’ BELIEFS ABOUT CLASSROOM LANGUAGE ASSESSMENT: COLLABORATIVE DISCUSSION AS A MEDIATIONAL SPACE

In recent years, numerous studies have been conducted on language teachers’ beliefs about language assessment; however, teachers’ collaborative discussion as a mediational tool has received scant attention. The present study aimed to investigate non-native language teachers’ beliefs about classroom language assessment regarding features of effective assessment, assessment of learners by teachers, peers, and themselves, benefits of assessment, informal assessment vs. formal assessment, and continuous assessment. Participants of the study were positioned in two collaborative discussion groups of novice and experienced teachers. Analysis of the data indicated that the teachers in each focus group held similar beliefs about most of the issues on classroom language assessment. The findings also demonstrated that the participants believed in the important role of classroom language assessment for different purposes, the utilization of both informal and formal assessment, and the utilization of continuous assessment as a fair mode of assessment. Furthermore, they believed that classroom language assessment should accurately assess what is taught in the course while focusing on all four language skills and sub-skills. Although they had positive attitudes toward teacher assessment and self-assessment, they were not in favor of peer assessment. The results of this study have implications for teacher education as adequate attention should be paid to teachers’ assessment beliefs due to their vital role in classroom assessment. Collaborative discussions can be enacted in teacher education to shape and reshape teachers' assessment beliefs.

Characteristics of SARS-CoV-2 Omicron BA.5 variants in Shanghai after ending the zero-COVID policy in December 2022: a clinical and genomic analysis.

An unprecedented surge of Omicron infections appeared nationwide in China in December 2022 after the adjustment of the COVID-19 response policy. Here, we report the clinical and genomic characteristics of SARS-CoV-2 infections among children in Shanghai during this outbreak. A total of 64 children with symptomatic COVID-19 were enrolled. SARS-CoV-2 whole genome sequences were obtained using next-generation sequencing (NGS) technology. Patient demographics and clinical characteristics were compared between variants. Phylogenetic tree, mutation spectrum, and the impact of unique mutations on SARS-CoV-2 proteins were analysed in silico. The genomic monitoring revealed that the emerging BA.5.2.48 and BF.7.14 were the dominant variants. The BA.5.2.48 infections were more frequently observed to experience vomiting/diarrhea and less frequently present cough compared to the BF.7.14 infections among patients without comorbidities in the study. The high-frequency unique non-synonymous mutations were present in BA.5.2.48 (N:Q241K) and BF.7.14 (nsp2:V94L, nsp12:L247F, S:C1243F, ORF7a:H47Y) with respect to their parental lineages. Of these mutations, S:C1243F, nsp12:L247F, and ORF7a:H47Y protein were predicted to have a deleterious effect on the protein function. Besides, nsp2:V94L and nsp12:L247F were predicted to destabilize the proteins. Further in vitro to in vivo studies are needed to verify the role of these specific mutations in viral fitness. In addition, continuous genomic monitoring and clinical manifestation assessments of the emerging variants will still be crucial for the effective responses to the ongoing COVID-19 pandemic.

Towards Trustworthy AI-based Military Cyber Operations

Within the dynamic realm of contemporary warfare, Artificial Intelligence (AI) emerges as a transformative force that reshapes the ways and means used to strategize, execute, and assess military operations. In this journey, the use of AI spans functions and capabilities like intelligence analysis, target engagement decision-making support, weapon autonomy, and effects analytics. Concurrently, AI enhances, e.g., the effectiveness of military plans and capabilities having the potential to reducing risks to civilians, civilian objects, and military personnel. In this rapidly evolving arena, military Cyber Operations gained unprecedented prominence due to their intrinsic digital and cross-domain nature, speed, and became a clear option to achieving military goals, and a mature set of alternatives to conventional ones. Nonetheless, they need continuous assessment, deal with different uncertainty types produced by characteristics like anonymity and can imply psychological impact. Hence, such military operations demand meticulous planning, sophisticated execution, and a deep understanding of technical, military-legal, ethical, and strategic implications and consequences. This represents a direct call for building solutions that align the potential of AI with the responsible and safe conduct of military operations in the military cyber domain: building trustworthy AI-based military Cyber Operations. While incipient efforts to tackle important dimensions of such an approach exist in this domain, a direct and unified approach that unifies them as a commitment and artefact lacks. To tackle this knowledge gap, this research aims to build a bridge between the above-mentioned dimensions by proposing a working definition and framework for building trustworthy AI-based military Cyber Operations using the Design Science Research methodology.

An implementation of integrated performance assessment model in vocational English for communication learning

This research implemented the Integrated Performance Assessment (IPA) model within the context of vocational English for communication learning. The IPA model, proposed by the American Council on the Teaching of Foreign Languages (ACTFL), serves as a comprehensive framework aimed at unifying teaching and assessment methodologies to enhance students' speaking abilities. The primary objective of this research is to evaluate the efficacy of the IPA model in improving students' communication skills within a vocational English setting. First-semester students at AKN Blitar serve as the subjects of this research. A mixed-method approach is employed, encompassing both quantitative and qualitative analyses. Pre-test and post-test stages are conducted, with student scores calculated using the Shapiro-Wilk test to ensure the validity of the findings. The results of this research demonstrate a significant improvement in students' communication skills following the implementation of the IPA model. Despite the observed increase in scores between the pre-test and post-test stages, further investigation reveals that the significance value (p) remains above 0.05 (sig. &gt; 0.05), underscoring the need for continued assessment and refinement of the IPA model in vocational English education.

Patient perspectives on primary care providers role in long-term opioid therapy.

Over the past decade, long-term use of prescription opioids for chronic non-cancer pain (CNCP) has risen globally despite the associated risks. The majority of opioid users receive their first prescription in primary care. To investigate the perspective of long-term opioid users in primary care regarding the role of healthcare providers (HCP) in their prolonged opioid use. Semi-structured interviews in Dutch primary care Methods: We recruited long-term opioid users for CNCP from seven community pharmacies in the Netherlands. In-depth, semi-structured interviews focussed on experiences with long term opioid use, access to opioids, and the guidance of their HCPs. A directed content analysis was conducted on the transcribed interviews using NVivo. Participants (n=25) mentioned ways HCPs impacted their long-term use of opioids. These encompassed: 1) the initiation of treatment, 2) chronic use of opioids, 3) discontinuation of treatment. Participants stressed the need for risk counselling during initial prescriptions, ongoing medication evaluations including tapering conversations, and more support from their HCP during a tapering attempt. Patients' perspective illustrates the important role of HCPs across the spectrum of opioid usage - from initiation to tapering. It underscores the importance of clear risk counselling starting at the initial prescription, continuous medication assessments throughout treatment, addressing tapering at regular intervals and strong support during tapering. These insights carry significant implications for clinical practice, emphasising the importance of informed and patient-centred care when it comes to opioid use for chronic non-cancer pain management.