Impact of Face-to-Face Interactions and Digital Learning Platforms on Learning Motivation, Learning Achievements and Peer Interaction in After-School Activities

With modern technological advancements, the rise of digital learning has helped teachers and students in many ways;for example, learning is becoming increasingly learner centric. In recent years, learning has been compromised because of school suspensions due to the COVID-19 pandemic. Digital learning has helped to reduce the negative impacts on students' learning, and most students have shown a positive attitude toward digital learning. A learning management system provides a platform for learners to learn and interact with teachers or peers without time and space constraints. Moodle is one of the most popular and widely-used learning management systems. It is open source, offers different functional modules, and is available free of charge. However, according to recent literature, Moodle has several disadvantages. First, the topics discussed by students in the Moodle platform are not focused enough and not easy to be discussed in depth. Second, the interaction is not immediate because of a lack of instant notifications. Third, the interface is not user friendly and is thus difficult to operate. These drawbacks can hinder students' learning. Office 365 is another digital system that assists students' learning. Various functions of Office 365, such as Teams's real-time notifications and OneNote's recording function, complement Moodle. This study investigated the effects of after-school activities conducted through different media on students' motivation, learning achievement, and peer interaction. In present study, after-school activities were conducted face-to-face or via two learning platforms, Moodle and Office 365;the learning platform was considered the independent variables. In total, 143 middle school students were recruited as participants for an after-school activity and distributed into the face-to-face, Moodle, or Office 365 group. The quantitative data of three scales concerning with learning motivation, learning achievement and peer interaction were collected to represent their learning performance. Qualitative data were collected through textual analysis based on student responses to open-ended questions. The quantitative and qualitative data were then statistically analyzed with SPSS Statistics 23. The results of the quantitative analysis revealed the following results: (1) No significant difference was observed in learning motivation among the different groups. The reasons for the result may be that students were not familiar with learning management systems, the interface and function of the learning systems were complex, or student motivation to learn English was low. (2) The learning achievement of the face-to-face group was significantly higher than that of the Office 365 group. Office 365 has many functions, but it also increases the cognitive load on students. Additionally, middle school students in Taiwan are inexperienced with using learning management systems because of the lack of opportunities to do so. Furthermore, the focus of this research was not the formal school curriculum but after-school activities;therefore, gauging learning effectiveness was challenging. Finally, students are more familiar with face-to-face discussions, and this comfort increases the effectiveness of this mode of learning. (3) Students in the Office 365 group had a higher tendency to interact with peers than those in the face-to-face group. Interacting through Office 365 (as it provides voice and text input for discussions) removes the stress of public speaking, such as that experienced in face-to-face classes, thus increasing participation. However, the peer interaction in the Office 365 group was not significantly higher than that in the Moodle group because the students using Office 365 mainly used text input, which decreased the efficiency of their discussion. (4) Some groups of students using the learning management system (no matter Moodle group or Office 365 group) posted the answers to assignments in the chat room even before much group discussion, or they divided the work among themselves, and not discussing the assignment at all. The students seemed to be unfamiliar with the way in which group discussions are conducted through digital learning platforms. This inexperience was reflected in their lack of teamwork. (5) The ratio of discussions students posted on the Moodle platform (Moodle group) was positively correlated with their learning achievement and interaction with peers. The ratio of discussions students posted on the Office 365 platform (Office 365 group) was positively correlated with their learning achievement and learning motivation. The results have several implications. First, teachers should consider the most appropriate form of discussion for middle school students when planning group discussion activities during and after lessons. Second, although middle school students are better at learning through face-to-face discussion, the demand for distance learning and the use of digital platforms are increasing. Teachers should encourage the use of digital platforms by planning more exercises to implement through these platforms, thus improving students' learning performance as well as their efficiency in using these platforms. Third, the students in the Office 365 group had a higher tendency to interact with peers than did those in the face-to-face group. Thus, teacher may use Office 365 initially to make students willing to use digital platforms and for them to get familiar with its usage. Once students are comfortable using the platform, teachers can shift the focus to enhancing the effectiveness of learning. Fourth, when students are engaged in group discussions in after-school activities, only a limited number of students may participate, or students may directly provide answers without discussing them with their peers. Providing students with instructions and training on conducting group discussions may help them make more effective use of learning management systems. Finally, regarding the design of learning management systems, the registration and login procedures should be simplified, and the platform interface and operating functions should be more effectively integrated to make them user friendly. Doing so may enable novices to start and consistently use these systems more easily and reduce the time required by users to familiarize themselves with such systems.

A case series of chronic spontaneous urticaria after COVID-19 vaccination

Case report Introduction: Various immediate or delayed types of cutaneous adverse reactions such as local site reaction, urticaria, mobilliform rash, elayed large local reactions, etc. have been noted after COVID-19 vaccination, which were usually treatable with times. Here we report 13 patients with chronic spontaneous urticaria (CSU) developed after COVID-19 vaccination. Cases: Of the 13 CSU patients, four were male and mean age was 42+/-9 years (range: 28-56). Twelve patients were vaccinated with Pfizer-BioNTech COVID-19 vaccine, and one was with Oxford/ AstraZeneca vaccine. 7 patients (53.8%) were developed CSU after their first vaccination, 5 patients (38.5%) were after 2nd booster shot, and one (7.7%) were after third booster shot. Mean latent period was 7+/-6 days (range: 1-20). Mean duration of CSU were 22+/-8 weeks. Nine patients (69.2%) who refractory to 3-or 4-fold increase of H1-antihistamines took omalizumab treatment, all of whom reached well-or completely controlled status. Five of them (55.6%) achieved well-controlled status within 1 month, while 4 of them achieved well-controlled after 3 months. 1 of them took cyclosporine in addition to 300mg/4 weeks to reach well-controlled status. Conclusion(s): COVID-19 vaccination can be a cause of CSU. CSU after COVID-19 vaccination can be intractable to treatment with 4-fold increase of H1-antihistamines. Omalizumab works well to control CSU after COVID-19 vaccination.

Impact of Face-to-Face Interactions and Digital Learning Platforms on Learning Motivation, Learning Achievements and Peer Interaction in After-School Activities

With modern technological advancements, the rise of digital learning has helped teachers and students in many ways;for example, learning is becoming increasingly learner centric. In recent years, learning has been compromised because of school suspensions due to the COVID-19 pandemic. Digital learning has helped to reduce the negative impacts on students' learning, and most students have shown a positive attitude toward digital learning. A learning management system provides a platform for learners to learn and interact with teachers or peers without time and space constraints. Moodle is one of the most popular and widely-used learning management systems. It is open source, offers different functional modules, and is available free of charge. However, according to recent literature, Moodle has several disadvantages. First, the topics discussed by students in the Moodle platform are not focused enough and not easy to be discussed in depth. Second, the interaction is not immediate because of a lack of instant notifications. Third, the interface is not user friendly and is thus difficult to operate. These drawbacks can hinder students' learning. Office 365 is another digital system that assists students' learning. Various functions of Office 365, such as Teams's real-time notifications and OneNote's recording function, complement Moodle. This study investigated the effects of after-school activities conducted through different media on students' motivation, learning achievement, and peer interaction. In present study, after-school activities were conducted face-to-face or via two learning platforms, Moodle and Office 365;the learning platform was considered the independent variables. In total, 143 middle school students were recruited as participants for an after-school activity and distributed into the face-to-face, Moodle, or Office 365 group. The quantitative data of three scales concerning with learning motivation, learning achievement and peer interaction were collected to represent their learning performance. Qualitative data were collected through textual analysis based on student responses to open-ended questions. The quantitative and qualitative data were then statistically analyzed with SPSS Statistics 23. The results of the quantitative analysis revealed the following results: (1) No significant difference was observed in learning motivation among the different groups. The reasons for the result may be that students were not familiar with learning management systems, the interface and function of the learning systems were complex, or student motivation to learn English was low. (2) The learning achievement of the face-to-face group was significantly higher than that of the Office 365 group. Office 365 has many functions, but it also increases the cognitive load on students. Additionally, middle school students in Taiwan are inexperienced with using learning management systems because of the lack of opportunities to do so. Furthermore, the focus of this research was not the formal school curriculum but after-school activities;therefore, gauging learning effectiveness was challenging. Finally, students are more familiar with face-to-face discussions, and this comfort increases the effectiveness of this mode of learning. (3) Students in the Office 365 group had a higher tendency to interact with peers than those in the face-to-face group. Interacting through Office 365 (as it provides voice and text input for discussions) removes the stress of public speaking, such as that experienced in face-to-face classes, thus increasing participation. However, the peer interaction in the Office 365 group was not significantly higher than that in the Moodle group because the students using Office 365 mainly used text input, which decreased the efficiency of their discussion. (4) Some groups of students using the learning management system (no matter Moodle group or Office 365 group) posted the answers to assignments in the chat room even before much group discussion, or they divided the work among themselves and not discussing the assignment at all. The students seemed to be unfamiliar with the way in which group discussions are conducted through digital learning platforms. This inexperience was reflected in their lack of teamwork. (5) The ratio of discussions students posted on the Moodle platform (Moodle group) was positively correlated with their learning achievement and interaction with peers. The ratio of discussions students posted on the Office 365 platform (Office 365 group) was positively correlated with their learning achievement and learning motivation. The results have several implications. First, teachers should consider the most appropriate form of discussion for middle school students when planning group discussion activities during and after lessons. Second, although middle school students are better at learning through face-to-face discussion, the demand for distance learning and the use of digital platforms are increasing. Teachers should encourage the use of digital platforms by planning more exercises to implement through these platforms, thus improving students' learning performance as well as their efficiency in using these platforms. Third, the students in the Office 365 group had a higher tendency to interact with peers than did those in the face-to-face group. Thus, teacher may use Office 365 initially to make students willing to use digital platforms and for them to get familiar with its usage. Once students are comfortable using the platform, teachers can shift the focus to enhancing the effectiveness of learning. Fourth, when students are engaged in group discussions in after-school activities, only a limited number of students may participate, or students may directly provide answers without discussing them with their peers. Providing students with instructions and training on conducting group discussions may help them make more effective use of learning management systems. Finally, regarding the design of learning management systems, the registration and login procedures should be simplified, and the platform interface and operating functions should be more effectively integrated to make them user friendly. Doing so may enable novices to start and consistently use these systems more easily and reduce the time required by users to familiarize themselves with such systems. © 2022, National Taiwan Normal University. All rights reserved.

Stemming the Rise in Antibiotic Prescription for Community Acquired Respiratory Infections (ARI) during COVID-19 Pandemic in Singapore General Hospital (SGH)

Background. In early months of COVID-19 pandemic, SGH recorded a year-on-year increase in antibiotic (ABx) use for community acquired acute respiratory infection (CA ARI) from Feb-Apr 2019 (48.7 defined daily doses (DDD)/100 bed-days) to 2020 (50.8 DDD/100 bed-days). To address concerns of misuse, the antibiotic stewardship unit (ASU) expanded prospective audit feedback (PAF) to CA ARI patients admitted to ARI wards, with low procalcitonin (PCT). PAF was conducted on day 2-3 of ABx, on weekdays. Doctors received feedback to stop/ modify when ABx was deemed inappropriate. Here, we describe the impact of ASU's adaptive approach to curb rising ABx use in patients admitted for ARI during COVID-19 pandemic. Methods. A Pre- & Post-intervention study was conducted. All patients started on ABx (ceftriaxone/co-amoxiclav/piptazo/carbapenems/levofloxacin) for CA ARI & PCT < 0.5μg/L were analysed. Those who died ≤48h of admission;admitted to intensive care;required ABx escalation;>1 infective sites;complex lung infection were excluded. Primary objective was to compare the proportion of ABx stopped ≤4 days (time to final infection diagnosis) Pre (22/3-18/4/20) & Post (21/4-13/7/20). Results. 184 (Pre) & 528 (Post) ABx courses were analysed. ASU audited 51 (Pre) & 380 (Post) courses with the rest discontinued/discharged before review. Patients were largely similar in both periods;a third had low likelihood of bacterial infection (C reactive protein < 30mg/L). In Post, 73 feedback was given to stop ABx (often because symptoms suggested viral/fluid overload) & 18 to switch to oral ABx. 82 (90%) feedback was accepted. No ABx was restarted ≤48h or deaths ≤30 days due to ARI. 1 patient had C. difficile diarrhoea a day after ABx cessation as per ASU feedback. Proportion of all ABx stopped ≤4 days was higher in Post than Pre [27/184 (15%) vs 152/528 (29%), p< 0.01]. Median duration of therapy of IV ABx was reduced (6.5 vs 3 days, p< 0.01), with corresponding shorter median length of stay (10.5 vs 6 days, p< 0.01). Conclusion. PAF directly and indirectly reduced ABx duration in patients treated for CA ARI as prescribers become more conscious about stopping ABx when investigations show low likelihood of bacterial infection. ASU must remain agile during pandemics to detect emerging problems and adapt processes to counter early.

An Earth-mass planet in a time of COVID-19: KMT-2020-BLG-0414Lb

We report the discovery of KMT-2020-BLG-0414Lb, with a planet-to-host mass ratio q (2) = 0.9-1.2 x 10(-5) = 3-4 circle plus at 1 sigma, which is the lowest mass-ratio microlensing planet to date. Together with two other recent discoveries (4 less than or similar to q/q (circle plus) less than or similar to 6), it fills out the previous empty sector at the bottom of the triangular (log s, log q) diagram, where s is the planet-host separation in units of the angular Einstein radius theta E. Hence, these discoveries call into question the existence, or at least the strength, of the break in the mass-ratio function that was previously suggested to account for the paucity of very low-q planets. Due to the extreme magnification of the event, A (max) similar to 1450 for the underlying single-lens event, its light curve revealed a second companion with q (3) similar to 0.05 and ;log s (3);similar to 1, i.e., a factor similar to 10 closer to or farther from the host in projection. The measurements of the microlens parallax pi (E) and the angular Einstein radius theta E allow estimates of the host, planet and second companion masses, (M (1), M (2), M (3)) similar to (0.3 M (circle dot), 1.0 M (circle plus), 17 M-J ), the planet and second companion projected separations, (a (perpendicular to,2), a (perpendicular to,3)) similar to (1.5, 0.15 or 15) au, and system distance D (L) similar to 1 kpc. The lens could account for most or all of the blended light (I similar to 19.3) and so can be studied immediately with high-resolution photometric and spectroscopic observations that can further clarify the nature of the system. The planet was found as part of a new program of high-cadence follow-up observations of high-magnification events. The detection of this planet, despite the considerable difficulties imposed by COVID-19 (two KMT sites and OGLE were shut down), illustrates the potential utility of this program.

Impact of COVID-19 on TB epidemiology in South Korea.

SETTING: Five referral hospitals, South Korea.OBJECTIVE: To assess epidemiological changes in TB before and during the COVID-19 pandemic.DESIGN: This was a multicentre cohort study of 3,969 patients diagnosed with TB.RESULTS: We analysed 3,453 patients diagnosed with TB prior to the COVID-19 pandemic (January 2016-February 2020) and 516 during the pandemic (March-November 2020). During the pandemic, the number of patients visits declined by 15% from the previous 4-year average, and the number of patients diagnosed with TB decreased by 17%. Patients diagnosed during the pandemic were older than those diagnosed before the pandemic (mean age, 60.2 vs. 56.6 years, P < 0.001). The proportion of patients to have primary TB at a younger age (births after 1980) among those diagnosed with TB was significantly lower during the pandemic than before (17.8% in 2020 vs. 23.5% in 2016, 24.0% in 2017, 22.5% in 2018, 23.5% in 2019; P = 0.005).CONCLUSIONS: The COVID-19 pandemic resulted in a reduction in the number of visits to respiratory departments, leading to fewer patients being diagnosed with TB. However, our results suggest that universal personal preventive measures help to suppress TB transmission in regions with intermediate TB burden.