Thomas Aechtner- School of Historical and Philosophical Inquiry, Faculty of Humanities, Arts and Social Sciences, University of Queensland, Brisbane, QLD, Australia
Vaccine hesitancy remains a significant global health challenge, yet accessible, systematic courses addressing this issue have been scarce. To fill this gap, the University of Queensland developed and launched “AVAXX101x: Antivaccination and Vaccine Hesitancy” on the edX platform in 2021. This was the world’s first edX MOOC focused on countering antivaccination claims and addressing vaccine hesitancy. The course aimed to educate healthcare workers, public health professionals, and the general public, offering evidence-based strategies to address vaccination doubts. This paper discusses the course’s objectives, content, design, and descriptively examines student demographics and survey responses, along with learner feedback. Findings reveal that AVAXX101x attracted a diverse cohort from 144 countries, including significant representation from UN-identified developing economies and a higher-than-average proportion of female learners. The course achieved respectable completion rates and garnered overwhelmingly positive feedback. Cumulatively, AVAXX101x successfully met its objectives by enhancing students’ understanding of vaccines, vaccine safety, and vaccine hesitancy. It further demonstrates how open online courses can be effective tools to equip learners with strategies for addressing vaccine hesitancy, as well as an educational means to sway vaccine hesitant participants.
1 Introduction
In 2019, before SARS-CoV-2 spread internationally, the World Health Organization listed vaccine hesitancy as one of the top ten threats to global health (WHO, 2019). Vaccine hesitancy is the reluctance or refusal to vaccinate, and while its significance was underscored during the pandemic, its implications remain an ongoing concern. Connectedly, researchers have identified the need to educate healthcare workers and public health professionals on vaccine hesitancy, recognizing the benefits of training practitioners with research-informed strategies for addressing it (Attwell et al., 2021; Vyas et al., 2018). Yet easily accessible, comprehensive training on science-skepticism, antivaccination and vaccine hesitancy has not always been freely available (Gille et al., 2015; Ozawa et al., 2016). Correspondingly, at the start of the pandemic there was no massive open online course (MOOC) explicitly addressing vaccine hesitancy available on prominent web-based learning platforms such as edX or Coursera. To fill this gap, a MOOC titled “AVAXX101x: Antivaccination and Vaccine Hesitancy” was made available in 2021 by members of the University of Queensland (UQ). MOOCs can be effective tools for delivering large scale training on a variety of topics, while offering free or inexpensive education to people throughout the world. This paper details AVAXX101x’s course content and design, its educational goals, and descriptively assesses student demographics, survey results and learner feedback.
Massive open online courses are freely accessible, web-based educational resources that emerged in the late 2000s (Romero and Ventura, 2017). Since their inception, MOOCs have been praised for democratizing education while also criticized as being overhyped (Ega et al., 2022; Wildavsky, 2015; Finkle and Masters, 2014). Although designed to be universally accessible, their reach is constrained by technical, cultural, and linguistic barriers, particularly for learners in low-to-middle-income countries. Nonetheless, MOOCs remain widely recognized for their capacity to deliver high-quality instruction on globally relevant subjects, including public health training (Liyanagunawardena and Williams, 2014; Patru and Balaji, 2016).
With the prospective benefits of MOOCs in mind, a massive open online course hosted on the edX platform dedicated to addressing antivaccination and vaccine hesitancy was developed at the University of Queensland (UQ) in 2020. It was launched on 9 February 2021, becoming the world’s first edX MOOC dedicated to responding to antivaccination claims and vaccine hesitancy. Developed with support from UQ’s Institute for Teaching and Learning Innovation (ItaLI) and led by Thomas Aechtner, AVAXX101x was designed as a specialized, smaller-scale MOOC, directed toward healthcare professionals, public health officials, and interested members of the general public. Its goal was to untangle vaccine hesitancy and antivaccination claims, while also mapping out optimal ways of responding to immunization concerns. Additional objectives included achieving gender parity among learners and expanding access to students in UN-designated developing economies, where MOOC participation remains disproportionately low.
1.1 Course content and design
The course was chiefly designed to teach participants about the psychological tendencies lying behind why people have vaccine worries. It also focused on the sociocultural factors influencing vaccine decision-making, while covering the science and safety of vaccines. This included exploring many of the most widespread antivaccine myths and persuasion strategies. In doing so, it was intended to not only provide genuine vaccination facts, but to also uncover the striking ways that counter-vaccine narratives continue to influence audiences around the world. Altogether, the MOOC was designed to meet the following five teaching objectives:
1. Analyze the science of vaccines, including their safety and effectiveness.
2. Identify twelve vaccine myths and seven antivaccination persuasion strategies.
3. Understand the psychological factors driving vaccine hesitancy.
4. Recognize ineffective approaches to dispelling vaccine myths.
5. Explore evidence-based strategies for engaging with vaccine-hesitant individuals.
AVAXX101x was constructed around six central modules, which outlined the most effective, academically informed strategies for addressing vaccine doubts expressed by hesitant patients, friends, or relatives. This included five general principles for improving pro-vaccine communications, and tips for more effectively debunking misinformation. Altogether, it offered a suite of practical advice about vaccine refusal, and research-based methods that can be implemented to improve vaccine advocacy.
Each module featured 3–5 short videos, which were approximately 6–9 min in length apiece, including title screens and concluding attribution slides. These videos featured Thomas Aechtner, the course lecturer, discussing topics linked to module themes. Lecture videos were interspersed with images, infographics, diagrams, and animations that complemented presentation topics. The modules were also punctuated by sections of text for students to read, situated before and after the instructor videos, wherein these were further comingled with diagrams, infographics and related images. Additionally, modules contained numerous interactive activities. Such activities included word cloud tasks that sought participant responses to questions, student polls to such queries as, “Are vaccines safe?” and “What percentage of the world’s children are vaccinated?,” plus personality profile tests and interactive pictures. The course also offered eight optional video interviews with leading researchers and healthcare practitioners, including Ian Frazer, the co-inventor of the technology used to develop HPV vaccines, as well as experts on vaccine hesitancy and science skepticism, such as Holly Seale and John Cook. Along with optional interview videos, weblinks to relevant but nonmandatory external sites and online activities were also distributed throughout the MOOC’s modules. These included links to podcasts, such as an episode of the BBC’s program, The Anti-Vax Files, and the online game, Bad News, designed to teach players how to detect the hallmarks of fake news and misinformation (Roozenbeek and van der Linden, 2018; Wendling and Spring, 2021).
Modules concluded with an online discussion forum, a curated list of core readings and additional resources, plus a module quiz. A UQ PhD candidate moderated the forums, guiding discussions and addressing student inquiries. Instructor-provided discussion questions encouraged engagement and peer interaction. The readings and resources compiled academic research supporting module content, alongside relevant news articles and online tools such as UNICEF’s Vaccine Misinformation Management Field Guide (Thomson and Finnegan, 2020). Each module ended with a 15-question quiz, comprising multiple-choice and true/false questions to assess student comprehension. The course also featured a regularly updated frequently asked questions (FAQ) page, which provided detailed, evidence-based responses to common discussion forum queries. These responses, curated by the moderator and addressed by the instructor, covered topics such as the fairness of compulsory vaccination, vaccine safety testing against control groups, and monitoring of vaccine side effects.
2 Methods
AVAXX101x featured pre- and post-course surveys, which students were invited to complete voluntarily. The surveys featured informed consent pages, and students opted-in to participate by selecting a consent checkbox required to proceed to each survey. Additionally, to join the course itself, learners must have agreed to edX’s terms of service conditions (edX, 2024). These indicate that edX collects deidentified information, which may be used for research purposes by edX members, including course enrollment data, engagement activity on the platform, and usage patterns. No personally identifying information was gathered for survey responses. As surveys involved voluntary responses and self-reporting, reporting limitations include possible selection and nonresponse bias, social-desirability bias, while limiting the overall generalizability.
The pre-course survey was presented at the point of course onboarding, and it solicited learners about how they had heard about the course, asking about their prior experiences with MOOCs, and reasons why they signed up for AVAXX101x. The post-course survey subsequently gauged students’ assessments of course, and whether the MOOC successfully met its five key learning objectives (above). The post-course survey included a concluding textbox, in which learners could provide written feedback on the course. Of the students who enrolled in AVAXX101x, 867 (25.0%) participated in the MOOC’s pre-course survey. 4.5% (n = 155) of AVAXX101x students completed the course’s post-course survey, with 2.5% (n = 86) of these participants opting to provide written feedback. The sample provided key assessments of the MOOC, including opinions about its content and design, while commenting on potential areas for improvement. Further learner data was collected via edX’s Insights data utility tool, which provided information about learner demographics, including student gender, countries from which participants have enrolled, education levels, and course engagement statistics. This data was collated into Excel spreadsheets for descriptive statistical analysis and subsequent comparison with extant data on MOOCs. Additionally, post-course statistics were calculated using Wilson 95% confidence intervals. Finally, NVivo was used to qualitatively code post-course written feedback.
3 Results
3.1 Learner overview: gender, country, and education levels
AVAXX101x ran from February 2021 to February, 2024, after which it was discontinued following UQ’s withdrawal from the edX platform. Over this period, the MOOC attracted 3,463 learners from 144 countries, including 140 verified enrolments. Verified enrolment required a $99 USD fee, granting students an edX and UQ certificate upon successful course completion, graded assessments, and unlimited course access. In contrast, unverified (audit) enrolment provided 6 weeks of limited access, with no graded assessments or certification.
In many ways, AVAXX101x’s enrolment statistics deviated from learner trends reported in other MOOCs. Accordingly, research has identified that less than 3% of MOOC participants tend to be from United Nations-designated Least Developed Countries, while the majority are likely to be young, highly educated males (Patru and Balaji, 2016; Emanuel, 2013). These figures were of concern during AVAXX101x production, because as the COVID-19 pandemic highlighted, studies have found that females are more likely to delay or reject vaccines in different national contexts (Yasmin et al., 2021; Okubo et al., 2021; Robertson et al., 2021; Toshkov, 2023). Additionally, research suggests that in some regions of the world, women often play more significant roles in family health decision-making (Matoff-Stepp et al., 2014; O'Brien et al., 2014). To gain female enrolments, course content focused on counter-vaccine arguments and concerns sometimes expressed by women more than men. This includes unease about vaccine safety for infants and unborn children, fertility-related anxieties, gender-based trends in distrust of healthcare systems and government institutions, and the influence of social media and peer networks on vaccine perceptions (Harris, 2023; Slatton et al., 2025; Li et al., 2022; Kroese et al., 2024; Truong et al., 2021). Furthermore, female academic specialists and medical practitioners were selected as interviewees. Ultimately, AVAXX101x succeeded in attracting female learners, with 66.0% (n = 2,286) of participants identifying as female, 32.0% (n = 1,108) as male, and 2.0% (n = 69) as other. Consequently, unlike many other MOOCs, most students were not male, and the course met its target of reaching female participants.
The MOOC also aimed to attract participants from UN-designated developing economies by incorporating international data on vaccine hesitancy and uptake, including case studies from low- and middle-income nations (UN, 2014). This focus was added, despite recent scholarship identifying a relative scarcity of vaccine hesitancy research conducted in non-Western, developing countries (Acharya et al., 2025; Acharya et al., 2024). While students in developed countries still constituted the majority of course participants, India, Brazil, and Pakistan featured in the top ten list of country enrolments (Table 1). Collectively, these three nations accounted for 13.8% (n = 478) of participants, surpassing representation from developing economies typically observed in other MOOCs.
Table 1. Top ten countries of enrolment.
Though the course successfully engaged learners from developing economies, the majority of participants were still highly educated. Among respondents, 42.9% (n = 1,489) held undergraduate degrees, 38.0% (n = 1,316) had postgraduate qualifications, and only 19.0% (n = 658) had completed high school or less. As with other MOOCs, the student demographic skewed toward an already well-educated cohort.
Although employment data was not formally collected by edX, written responses frequently indicated that participants worked in healthcare, while pre-course survey responses (below) indicated that numerous learners were health professionals or healthcare-related students. Thus, the high educational attainment among learners may also reflect engagement from medical professionals seeking to maintain or expand their credentials.
3.2 Why did they enroll?
Research of MOOCs has highlighted several motivations for why learners enroll into courses, such as enhancing workplace skills, curiosity about taught subjects, and a desire for intellectual stimulation. Of the 867 participants (25.0%) who completed the pre-course survey for AVAXX101x, 34.0% (n = 295) cited gaining knowledge and skills in a new area as their primary reason for enrolment. 25.0% (n = 217) selected “personal challenge,” 17.0% (n = 147) chose “curiosity about the topic,” and 9.0% (n = 78) indicated “reviewing concepts in a previously studied field.” 5% (n = 43) were motivated by employment opportunities, and 3.0% (n = 26) by the availability of unique learning opportunities. The remaining 7.0% (n = 61) selected “other.” Overall, most respondents reported being ostensibly new to the area of vaccine hesitancy, as they took the course to seek new skills, a novel educational challenge, to quench their curiosity, or to pursue career advancement as well as learning not otherwise available.
The pre-course survey also inquired about how participants had learned about AVAXX101x and their prior MOOC experiences. Of the 704 respondents, 43.0% (n = 303) reported discovering the course through the edX website itself. Other sources included word-of-mouth (19.0%, n = 134), edX promotional emails (14.1%, n = 99), Google search (10.9%, n = 77), University of Queensland communications (8.0%, n = 56), and social media (5.0%, n = 35). Thus, the edX platform itself was the most common source of awareness. Regarding prior MOOC experience, 32.1% of respondents (n = 153) reported completing fewer than five MOOCs, while 30.1% (n = 144) indicated that AVAXX101x was their first MOOC. 18.0% (n = 86) had started but not completed any MOOCs, and 11.9% (n = 57) had completed more than five. The remaining 8.0% (n = 38) were unsure of their previous MOOC engagement. Thus, while nearly one-third of students had no prior MOOC experience, 62.0% had engaged with MOOCs to some extent, though not always to completion. This aligns with the fact that many students discovered the course through the edX website, suggesting previous engagement with MOOCs, particularly on the edX platform.
The pre-course survey further asked participants the following: “People register for edX courses for different reasons. Which of the following best describes you?” Of those who responded (N = 697), 32.3% (n = 225) indicated, “I am just curious about this topic.” Notably, 44.3% (n = 309) of survey respondents identified as either health professionals or health-related students. In fact, 20.5% (n = 143) specified that they were health professionals outside of Australia, 11.2% (n = 78) were health professionals working in Australia, while 9.9% (n = 69) identified as health-related students outside of Australia, and 2.7% (n = 19) indicated being health-related students within Australia. The remaining survey participants included 11.6% (n = 81) who self-identified as non-health-related students interested in the course topics, 9.6% (n = 67) researchers wanting to learn more about AVAXX101x topics, and finally, 2.2% (n = 15) who indicated they were teachers seeking new materials for their own courses. According to this data, therefore, a sizeable cohort of students were health practitioners, or those training for health professions, wherein the majority of these individuals were participants from outside of Australia. This indicates that the course met its goal of educating medical professionals.
3.3 Engagement, design, and completion rates
Though MOOCs have made headlines for garnering enormous student numbers, research consistently reveals that open online courses experience far worse completion rates than do traditional university offerings. Hence, only 5–15% of those who sign on to MOOCs tend to finish them (Daniel, 2012; Patru and Balaji, 2016). Key factors influencing engagement and completion include course design, interactivity, and support mechanisms. Concerning design, AVAXX101x was shaped with interactivity in mind, such that every module featured the interactive components described previously. Support included the engagement of the discussion forum moderator and the instructor’s participation in these forums and via direct email responses to student queries. However, support was limited by the part-time availability of the moderator and the instructor’s other full-time teaching and research commitments. The moderator conducted three checks per week and forwarded learner queries to the instructor when necessary. Ultimately, AVAXX101x achieved a completion rate of 15.0% (n = 519), aligning with the uppermost average rates reported in MOOCs hosted across various open online course providers.
3.4 Post-course survey and student feedback
4.5% (n = 155) of AVAXX101x students completed the post-course survey. Perceived learning was high, and respondents indicated that the course successfully met its teaching goals. For instance, 83.2% (129/155; 95% CI 76.6–88.3) of participants agreed that completing the course improved learners’ understanding of how to engage with vaccine hesitancy. Additionally, 94.8% (147/155; 90.1–97.4) of participants reported that the course effectively met its objective of helping students to examine the science of vaccines, while 95.5% (148/155; 91.0–97.8) indicated that the course helped them to recognize vaccine misinformation and rhetorical tactics. Similarly, 92.9% (144/155; 95% CI 87.7–96.0) felt it met the objective of identifying twelve vaccine myths and seven antivaccination persuasion strategies. Regarding vaccine hesitancy, 94.8% (147/155; 95% CI 90.1–97.4) indicated the course helped them understand why some people are hesitant about vaccines, while 92.9% (144/155; 95% CI 87.7–96.0) felt it provided insight into what not to do when addressing vaccine myths. 92.3% (143/155; 95% CI 87.0–95.5) agreed that the course equipped them with strategies to effectively respond to vaccine-hesitant individuals. Therefore, according to respondents, the course successfully enabled them to not only to understand vaccines and vaccine hesitancy, but it provided the means to respond effectively to vaccine hesitant individuals.
Students further provided positive feedback regarding the course design, with 92.3% (143/155; 95% CI 87.0–95.5) agreeing that AVAXX101x effectively integrated text, videos, and interactive elements. Similarly, 92.3% (143/155; 95% CI 87.0–95.5) found the videos both informative and easy to follow, and 89.0% (138/155; 95% CI 83.1–93.0) felt the course length was appropriate. When asked about the best aspects of the course, its usefulness, and suggestions for improvement, participants praised the clear, concise videos presented by the course lecturer. They also highlighted the course’s relevance for those aiming to enhance health communications, noting that it provided relevant and accessible overviews of vaccine hesitancy and its underlying causes.
Regarding design, numerous comments praised the quality of the instructor’s videos and expertise. One learner remarked, “Videos with the Prof were excellent and well-constructed. He was also a good interviewer.” Another student appreciated the instructor’s engagement, stating: “Engaging and expert professor, passionate about the material. I valued the relevance to health communications in vaccination advocacy and other fields where misinformation and stigma hinder access to lifesaving interventions.” Respondents also expressed approval of the course’s blend of videos, written content, core and supplementary readings, and interactive features. As one student noted, “I liked the mix of videos, texts, and interviews. The Bad News game was also interesting,” while another commented, “Clear, concise videos and great reading materials, including supplemental readings at the end of each section.”
Feedback was also received from learners who identified as being vaccine hesitant. These participants relayed that AVAXX101x was the single most effective resource that they had yet encountered for assuaging their own uncertainties, along with the hesitancy of others. As one student explained: “I’ve watched webinars, read books and participated in different trainings. This class was able to pull everything I’ve learned together and fill in the gaps.” Another learner with vaccination qualms asserted, “I took this course BECAUSE for some strange unknown reason, I had doubts about getting the Covid vaccine (whatever the brand or company). I sort of expected a pitch to sell me the vaccine (like a used car salesperson). But that was not what I got. Instead, I got a well-researched, well published course… I got my first shot in June and will have the second in August.” Similarly, a vaccine hesitant student who described themselves as an accountant admitted knowing “next to nothing about medicine in general.” This learner went on to affirm, “Thanks to this course, I now have a better understanding of how vaccines work and how safe they are… After taking this course, I’ve made my final decision to get vaccinated against Covid-19.”
While feedback was overwhelmingly positive, several learners also suggested areas for improvement. Recommendations included shortening interviews, streamlining video and textual content, and offering more practical examples on addressing vaccine hesitancy and refuting antivaccine conspiracy theories. One student noted, “Some of the interviews were too long,” and another suggested, “The course content could have been shorter. A dot-point overview and examples of conspiracy theories with counterarguments would provide practical strategies.” Others recommended reducing complex academic language, with one commenting, “The theoretical jargon was difficult to retain.” Additionally, some learners proposed reducing or waiving fees for verified enrolment for students from low-to-middle-income countries. This suggestion aligns with the fact that AVAXX101x attracted higher-than-average engagement from such nations, where MOOCs typically see lower participation. As one learner expressed, “Please consider fee waivers for middle-income country students.”
Responses to student feedback were limited by resource constraints and the feasibility of altering course materials post-production. For example, refilming or editing videos to reduce jargon or shortening their length was not possible. However, modifications to written content were feasible, allowing for improved readability, reduced jargon, and ongoing updates to the MOOC’s FAQs based on student queries. In response to requests for concise overviews, the instructor and UQ’s Institute for Teaching and Learning Innovation design team created the AVAXX101 Advocacy Guide (Supplementary material S1). This 1-page document, featuring key recommendations from modules 5 and 6, was added to module 6 and made available to all learners. Student feedback was also incorporated into Antivaccination and Vaccine Hesitancy: A Professional Guide to Foster Trust and Tackle Misinformation (Aechtner, 2024). This book translates AVAXX101x and learner recommendations into book form, following the MOOC’s discontinuation. Finally, in response to fee waiver requests from students in low-to-middle-income nations, learners were informed about edX’s financial assistance program, which offers discounted verified enrolment for those facing economic hardship.
4 Discussion
AVAXX101x was the world’s first edX MOOC dedicated to addressing antivaccination claims and vaccine hesitancy. Developed at the University of Queensland, the course was designed to meet the need for accessible, systematic training on vaccine hesitancy. Targeting healthcare professionals, public health officials, and other interested learners, AVAXX101x aimed to unpack the complexities of vaccine hesitancy and deconstruct antivaccination claims. The MOOC attracted a diverse cohort of learners from 144 countries. Crucially, AVAXX101x met its aims, including garnering participation from UN-identified developing economies, with a notable cohort participating from India, Brazil, and Pakistan. The course also succeeded in educating medical professionals, having reached healthcare workers or practitioners in training from across the globe. This is of particular significance, because training healthcare workers with the strategies for engaging with vaccine-hesitant individuals featured in AVAXX101x can be pivotal for influencing vaccination decision-making (Dube and Gagnon, 2025). Furthermore, contrary to typical MOOC trends, AVAXX101x had a higher proportion of female learners, surpassing its goal of gender parity. Post-course survey respondents affirmed that the course met its educational objectives, stating that it successfully enhanced their understanding of vaccination, vaccine safety, and hesitancy, while equipping them with effective strategies to address vaccine reluctance. Consequently, while being relatively small, this online course demonstrates that MOOCs can be effective tools for teaching about vaccine safety and how to confront vaccine hesitancy, while they can also serve as learning mechanisms to sway hesitant individuals to get vaccinated themselves. With that in mind, it is suggested that future online courses addressing vaccine hesitancy target female learners to improve student gender parity. Video and textual content should be as concise as possible, while providing abundant practical examples and avoiding technical jargon. Finally, future online courses should endeavor to have fee-free certification for students in low-to-middle-income nations.
Data availability statement
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Ethics statement
The studies involving humans were approved by UQ’s Faculty of Humanities and Social Sciences Low and Negligible Risk subcommittee. Written informed consent to participate in this study was provided by participants, who opted-in to participate in the research by selecting a checkbox indicating that they would voluntarily like to participate. Additionally, to join the course learners must have agreed to edX’s policies and guidelines for enrollees, which indicates to learners at the time of creating an edX account that edX collects information which can be used for research purposes, such as course enrollment data, engagement activity on the platform, and usage patterns, which can be used for research purposes by edX Members. The studies were conducted in accordance with the local legislation and institutional requirements.
Author contributions
TA: Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by the Westpac Scholars Trust via a Westpac Research Fellowship, Grant Number RF1600007.
Acknowledgments
I acknowledge the following members of the University of Queensland’s Institute for Teaching and Learning Innovation’s MOOC design team who helped to develop AVAXX101x, and who provided access to course data: Samantha Briggs, Shannon O’Brien, Anne-Maree Jaggs, Catherine Coogan West, Neville Smith, and Kristopher Yates.
Conflict of interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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The author declares that no Gen AI was used in the creation of this manuscript.
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Supplementary material
The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/feduc.2025.1583695/full#supplementary-material
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Keywords: MOOC, vaccine hesitancy, antivaccination, edX, healthcare, public health
Citation: Aechtner T (2025) AVAXX101x: assessing the first edX course on antivaccination and vaccine hesitancy. Front. Educ. 10:1583695. doi: 10.3389/feduc.2025.1583695
Edited by:
Mohammed Saqr, University of Eastern Finland, FinlandReviewed by:
Erma Manoncourt, Sciences Po, FranceMateus Dias Antunes, University of São Paulo, Brazil
Copyright © 2025 Aechtner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Thomas Aechtner, dC5hZWNodG5lckB1cS5lZHUuYXU=