A campus wide setup of Question Mark Perception (V2.5) at the Katholieke Universiteit Leuven (Belgium) – facing a large scale implementation

The first part of this paper outlines the drawbacks of a large scale implementation of Question Mark Perception’s assessment software (QMP). The default publishing procedures offered by QMP, i.e. ODBC or disk sharing, do not meet the needs of global Internet accessibility and security. Academic staff members had to upload their session files by completing a web form; publishing requests were handled manually by members of the Computing Center’s staff. As on the server side all question and session records were stored in one single database, and graphics and multimedia files reside in one directory on the server, a cumbersome system of naming conventions was necessary to prevent files and database records from being overwritten. While creating questions with QMP’s authoring application – Question Manager – authors wanting to refer to graphics or multimedia files had to insert in a non-intuitive way the pathname of the graphics directory on the server. Moreover QMP’s server software never commits a delete transaction in the question database. This caused major problems for authors reloading assessments to the central database after having deleted one or more questions. To cope with these problems the Computing Centre of Leuven University has developed an upload application for use by the academic staff members. This application, which is described in detail in the second part of this paper, meets the constraints of a campus wide setup of QMP’s assessment software

Human Paramyxovirus Infections Induce T Cells That Cross-React with Zoonotic Henipaviruses

Humans are infected with paramyxoviruses of different genera early in life, which induce cytotoxic T cells that may recognize conserved epitopes. This raises the question of whether cross-reactive T cells induced by antecedent paramyxovirus infections provide partial protection against highly lethal zoonotic Nipah virus infections. By characterizing a measles virus-specific but paramyxovirus cross-reactive human T cell clone, we discovered a highly conserved HLA-B*1501- restricted T cell epitope in the fusion protein. Using peptides, tetramers, and single cell sorting, we isolated a parainfluenza virus-specific T cell clone from a healthy adult and showed that both clones cleared Nipah virus-infected cells. We identified multiple conserved hot spots in paramyxovirus proteomes that contain other potentially cross-reactive epitopes. Our data suggest that, depending on HLA haplotype and history of paramyxovirus exposures, humans may have cross-reactive T cells that provide protection against Nipah virus. The effect of preferential boosting of these cross-reactive epitopes needs to be further studied in light of paramyxovirus vaccination studies

Fostering first-year student learning through research integration into teaching: Student perceptions, beliefs about the value of research and student achievement

Research should be explicated in undergraduate teaching in a way that stimulates student learning. Previous studies in higher education have shown that student perceptions of research integrated into teaching could promote student learning, but have also indicated that it can be difficult to confront first-year undergraduates with research during courses. In this study, we describe relationships between first-year medical student perceptions of research, learning outcomes and beliefs about the value of research. The Student Perception of Research Integration Questionnaire was filled out by 261 students. Answers were related to student achievement. The findings suggest that student motivation for research is strongly related to merging current research into teaching. Students rather recognised an emphasis on research methodologies than research engagement. Particularly student beliefs about research are related to achievement. It is suggested that to foster positive beliefs about research, teachers should familiarise students with current research and create enthusiasm for research.Teaching and Teacher Learning (ICLON

Haematopoietic stem cell transplantation in South Africa: Current limitations and future perspectives

The growing need for haematopoietic stem cell transplantation (HSCT) is reflected in the increasing number of transplants performed globally each year. HSCT provides life-changing and potentially curative therapy for a range of pathologies including haematological malignancies; other indications include certain congenital and acquired disorders of the haematopoietic system, autoimmune conditions and hereditary diseases. The primary goals of HSCT are either to replace haematopoietic stem and progenitor cells (HSPC) following myeloablative chemotherapy or to cure the original pathology with allogeneic HSPCs. Success depends on optimal outcomes at various stages of the procedure including mobilisation of marrow stem/progenitor cells for harvesting from the patient or donor, long-term and sustainable engraftment of these cells in the recipient, and prevention of graft-versus-host disease in the case of allogeneic HSCT. Challenges in South Africa include high cost, limited infrastructure and lack of appropriately trained staff, as well as limitations in securing suitable haematopoietic stem cell donors. This review aims to provide an overview of HSCT and some of the challenges that are faced in the South African context

The research-teaching nexus: A case study of students' awareness, experiences and perceptions of research

This paper presents a case study of students' awareness, experiences and perceptions of research in a 'new' university in the UK. The findings are based on a questionnaire of almost 200 students and five small group interviews. Many of the students participating in this research perceived clear benefits to their learning from staff research, including being taught by enthusiastic staff, enhanced staff credibility, and the reflected glory of being taught by well-known researchers. However, they also perceived disadvantages, particularly with regard to staff availability, and did not believe that staff research should take priority over their needs as learners. They recognised that their awareness of the nature of research and the development of research skills increased most when they were actively involved in undertaking research projects. Several students also perceived benefits for future employment from their participation in research activities. The questionnaire has been used by several other universities around the world to benchmark their practices. © 2010 Taylor & Francis

Clinical Practice Audit on the Management of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis in the Netherlands

Introduction: Managing complex and rare systemic autoimmune diseases such as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) can be challenging and is often accompanied by undesirable variations in clinical practice. Adequate understanding of clinical practice can help identify essential issues to improve the care for AAV patients. Therefore, we studied the real-life management and outcomes of AAV patients in the Netherlands. Methods: In this cohort study, we investigated clinical practice in university and nonuniversity teaching hospitals with respect to patients with a clinical diagnosis of AAV. We retrospectively collected clinical data encompassing clinical variables, medication details, and outcome parameters. Results: Data of 230 AAV patients were collected in 9 Dutch hospitals. Of these, 167 patients (73%) were diagnosed with granulomatosis with polyangiitis, 54 (24%) with microscopic polyangiitis and 9 (4%) with eosinophilic granulomatosis with polyangiitis. One hundred sixty-six patients (72%) had generalized disease. The median year of diagnosis was 2013 (range 1987–2018). Besides steroids, oral cyclophosphamide was the most used drug (50%) for induction therapy and azathioprine (68%) for maintenance therapy. Adverse outcomes were major infections in 35%, major relapses in 23%, malignancy in 10%, major cardiovascular events in 8%, and end-stage renal disease in 7%. Conclusion: Oral cyclophosphamide was the most frequently used induction therapy, azathioprine for maintenance therapy; over time, the use of rituximab is increasingly employed. Major infection and relapses are the most prevalent adverse outcomes. This audit resulted in important indicators for treatment of AAV patients that can be implemented for future, national audits to improve the outcomes of AAV patients

Identifying relevant determinants of in-hospital time to diagnosis for ANCA-associated vasculitis patients

OBJECTIVES: Diagnosing patients with ANCA-associated vasculitis (AAV) can be challenging owing to its rarity and complexity. Diagnostic delay can have severe consequences, such as chronic organ damage or even death. Given that few studies have addressed diagnostic pathways to identify opportunities to improve, we performed a clinical audit to evaluate the diagnostic phase. METHODS: This retrospective, observational study of electronic medical records data in hospitals focused on diagnostic procedures during the first assessment until diagnosis. RESULTS: We included 230 AAV patients from nine hospitals. First assessments were mainly performed by a specialist in internal medicine (52%), pulmonology (14%), ENT (13%) or rheumatology (10%). The overall median time to diagnosis was 13 [interquartile range: 2–49] days, and in patients primarily examined by a specialist in internal medicine it was 6 [1–25] days, rheumatology 14 [4–45] days, pulmonology 15 [5–70] days and ENT 57 [16–176] days (P = 0.004). Twenty-two of 31 (71%) patients primarily assessed by a specialist in ENT had non-generalized disease, of whom 14 (64%) had ENT-limited activity. Two hundred and nineteen biopsies were performed in 187 patients (81%). Histopathological support for AAV was observed in 86% of kidney biopsies, 64% of lung biopsies and 34% of ENT biopsies. CONCLUSION: In The Netherlands, AAV is diagnosed and managed predominantly by internal medicine specialists. Diagnostic delay was associated with non-generalized disease and ENT involvement at presentation. Additionally, ENT biopsies had a low diagnostic yield, in contrast to kidney and lung biopsies. Awareness of this should lead to more frequent consideration of AAV and early referral for a multidisciplinary approach when AAV is suspected

Delineating morbillivirus entry, dissemination and airborne transmission by studying in vivo competition of multicolor canine distemper viruses in ferrets

Identification of cellular receptors and characterization of viral tropism in animal models have vastly improved our understanding of morbillivirus pathogenesis. However, specific aspects of viral entry, dissemination and transmission remain difficult to recapitulate in animal models. Here, we used three virologically identical but phenotypically