Engaging university students in online learning: a regional comparative study from the perspective of social presence theory

This study investigates the factors influencing university students' online learning engagement from three distinct aspects, namely, behavioural, cognitive and emotional engagement. A comparison is drawn from university students in Asia who embraced online learning during the COVID-19 pandemic. An online survey was conducted on 495 university students in Mainland China, Hong Kong and Malaysia during the surge of the COVID-19 Omicron variant, which was considered more infectious but less deadly than previous variants. A consistent positive relationship between Satisfaction and Academic Performance is found in all the regions. Malaysia presents a unique situation as compared to Mainland China and Hong Kong whereby no association was found between Social Context and Online communication towards Student Engagement. The novelty of this study is attributed to the integration of Social Presence Theory in Student Engagement through the nature of online learning as a coping strategy to halt the spread of COVID-19 during the Omicron variant surge. © 2023, Beijing Normal University.

Virtual Reality in Festivals: A Systematic Literature Review and Implications for Consumer Research

Technological advancements in virtual reality have influenced festivalgoers, performers, and festival organizers. Due to the COVID-19 pandemic, organizers of cultural and tourism festivals have sought to deliver festivals online using virtual reality to provide an immersive experience from home. However, despite growing interest in virtual reality for festivals, there is no current systematic review to synthesize knowledge from academic papers within the festival context. This paper aims to provide a structured understanding of extant virtual reality research regarding festivals by using a systematic literature review. After a comprehensive review of extant literature from major databases, 19 relevant articles were extracted and synthesized according to the types, venues, roles, and objectives of the virtual reality applications. This study is the first systematic literature review to examine the current landscape of consumer research on virtual reality in festivals. Our results show that the limited numbers of extant literature concerning virtual reality in festivals indicates that this is an important yet significantly under-researched topic for future research. Current literature on virtual reality in festival contexts also lacks an in-depth understanding of consumer engagement and experiences. This paper recommends incorporating the application of theory and robust consumer research methods into future virtual festival research. © 2022 by the authors. Licensee ESJ, Italy.

USE OF NEW MOBILITY SCORE AND A TRANS-DISCIPLINARY APPROACH TO REDUCE HOSPITAL LOS, RETURN TO ORIGINAL RESIDENCE, AND MORTALITY

Introduction: The National Hip Fracture Database indicated Guy's and St Thomas' Trust ranked in the fourth quartile nationally with reference to hospital length of stay (LOS), ∗Note 1 and 2 co lead authors return to original residence (ROR), and mortality in hip fracture patients in 2018. This quality improvement project aimed to improve and maintain these key factors via a twostage process. Methods: Stage one involved implementation of four key interventions through a transdisciplinary focus group, comprising ortho-geriatricians, orthopaedic surgeons, physiotherapists (PT), occupational therapists (OT), nursing staff, and a transfer of care navigator (TCN). Firstly, the New Mobility Score (NMS) was employed as a tool to guide estimated length of stay. Secondly, use of preoperative OT assessment allowed early evaluation of patient expectations concerning discharge planning. Third, facilitation of the discharge process was optimised by the recruitment of a TCN. Lastly, attendance of a senior orthogeriatrician during the daily board round was established. Stage two involved education of new members of the trans-disciplinary team to ensure that the key interventions listed above were maintained on hip fracture patients. Results: Following stage one, average acute hospital LOS and overall LOS decreased from 20.1 to 15.1 days and 22.4 to 18.3 days, respectively. Rate of ROR within 120 days of discharge improved from 72.4% to 86.9%, while mortality rates fell from 7.1 to 3.4. Following stage two, overall LOS improved to 17.1 days, while acute LOS and mortality were maintained at 15.6 and 3.9 days, respectively. While ROR fell to 82.8%, this remained higher than the national average at 69.9%. Conclusions: Utilisation of NMS and multi-disciplinary input effectively improved ROR, while reducing length of hospital stay and mortality rates in hip fracture patients. Education of new members of the trans-disciplinary team allowed sustained improvement despite challenges faced during the COVID-19 pandemic.

Epidemic Exposure Tracking With Wearables: A Machine Learning Approach to Contact Tracing

The recent pandemic revealed weaknesses in several areas, including the limited capacity of public health systems for efficient case tracking and reporting. In the post-pandemic era, it is essential to be ready and provide not only preventive measures, but also effective digital strategies and solutions to protect our population from future outbreaks. This work presents a contact tracing solution based on wearable devices to track epidemic exposure. Our proximity-based privacy-preserving contact tracing (P3CT) integrates: 1) the Bluetooth Low Energy (BLE) technology for reliable proximity sensing, 2) a machine-learning approach to classify the exposure risk of a user, and 3) an ambient signature protocol for preserving the user's identity. Proximity sensing exploits the signals emitted from a smartwatch to estimate users' interaction, in terms of distance and duration. Supervised learning is then used to train four classification models to identify the exposure risk of a user with respect to a patient diagnosed with an infectious disease. Finally, our proposed P3CT protocol uses ambient signatures to anonymize the infected patient's identity. Extensive experiments demonstrate the feasibility of our proposed solution for real-world contact tracing problems. The large-scale dataset consisting of the signal information collected from the smartwatch is available online. According to experimental results, wearable devices along with machine learning models are a promising approach for epidemic exposure notification and tracking. © 2013 IEEE.

An appraisal of respiratory system compliance in mechanically ventilated COVID-19 patients

Rationale Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous smallcase series or studies conducted at a national level.Methods We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe the impact of CRS on the ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide.Results We enrolled 318 COVID-19 patients enrolled into the study from January 14th through September 31th, 2020 in 19 countries and stratified into two CRS groups. CRS was calculated as: tidal volume/[airway plateau pressure-positive endexpiratory pressure (PEEP)] and available within 48h from commencement of MV in 318 patients. Patients were mean±SD of 58.0±12.2, predominantly from Europe (54%) and males (68%). Median CRS (IQR) was 34.1 mL/cmH2O (26.5-45.5) and PaO2/FiO2 was 119 mmHg (87.1-164) and was not correlated with CRS. Female sex presented lower CRS than in males (95% CI:-13.8 to-8.5 P<0.001) and higher body mass index (34.7±10.9 vs 29.1±6.0, p<0.001). Median (IQR) PEEP was 12 cmH2O (10-15), throughout the range of CRS, while median (IQR) driving pressure was 12.3 (10-15) cmH2O and significantly decreased as CRS improved (p<0.001). No differences were found in comorbidities and clinical management between CRS strata. In addition, 28-day ICU mortality and hospital mortality did not differ between CRSgroups.Conclusions This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV-predominantly males or overweight females, in their late 50s-admitted to ICU during the first international outbreaks. Phenotypes associated with different CRS upon commencement of MV could not be identified.

Factors associated with mortality in patients with COVID-19 requiring mechanical ventilation: An international cohort study from 139 intensive care unit across 6 continents

Rationale: Patients with COVID-19 commonly develop severe hypoxemic respiratory failure and require invasive mechanical ventilation (MV). The disease burden and predictors of mortality in this population remain uncertain. Methods: Prospective observational cohort study from 139 intensive care units of the international COVID-19 Critical Care Consortium. Patients enrolled from January 14th through November 31st 2020 were included in the analysis. Patient's characteristics and clinical data were assessed. Multivariable Cox proportional hazards analysis was conducted to identify indipendent predictors of mortality within 28 days from commencement of MV. Results: 1578 patients on MV were included into the analysis. Mean±SD age was 59 years±13 and patients were predominantly males (66%). 542 Patients (34.4%) died within 28 days from commencement of MV. Nonsurvivors were slightly older (mean age±SD 62±13 vs. 59±13) and presented more frequently hypertension, chronic cardiac disease and diabetes. Median (IQR) PaO2/FiO2 upon commencement of MV was 96 (68-135) and 111 (81-173) in patients who did not survive vs. survivors, respectively (p=0.04). ECMO (13% vs 25%, p<0.01), inhaled nitric oxide (11% vs 15%, p=0.02) and recruitment manoeauvres (26% vs 31%, p<0.01) were used less frequently in patients who did not survive. Independent risk factors associated with 28-day mortality included age older than 70 years (hazard ratio [HR], 2.83;95% CI, 1.32-6.07), higher creatinine levels upon ICU admission (HR, 1.20;95% CI, 1.03-1.40), and lower pH within 24h from commencement of MV (HR, 0.12;95% CI, 0.02-0.62), while a shorter period (day) from early symptoms to hospitalisation reduced mortality risks (HR, 0.96;95% CI, 0.93-0.99). Conclusions: Our findings from a large international cohort of critically-ill COVID-19 patients on mechanical ventilation emphasises that elderly patients, not promptly admitted to the hospital, and who present higher creatinine levels and acidosis are at higher risk of mortality.

Characteristics and outcomes of patients with COVID-19 admitted to intensive care units-a report from the global COVID-19 critical care consortium

Objective: SARS-CoV-2 has been reported in almost all countries around the world, and a significant proportion of critically ill patients with COVID-19 require care in the intensive care unit (ICU). There have been few observational cohorts including patients in ICU across different countries. We present summary data from a global critical care consortium. Methods: The COVID-19 Critical Care Consortium/ ECMOCARD (COVID-19 CCC/ECMOCARD) is an ongoing international multicenter observational study including more than 377 hospitals in 53 countries. Clinical and treatment characteristics are collected for patients with COVID-19 requiring ICU admission. Results: Data from 2,670 patients with COVID-19 admitted between January 28 and December 19, 2020 were summarized - 182 from Africa, 516 from Asia, 72 from Oceania, 710 from Europe, 343 from Latin America, and 847 from North America. The median (IQR) age was 59 (49 to 68) years, and 909 (34%) were female. 1,283 (49%) patients had hypertension and 830 (32%) had diabetes mellitus. The time from symptom onset to hospital admission was 7 (3 to 10) days, and 1,360 (51%) patients were admitted to ICU on the same day as hospital admission. Upon ICU admission, the heart rate was 95 (80 to 110) beats/min, respiratory rate was 26 (20 to 33) breaths/ min, and oxygen saturation was 93 (89 to 96) %. Details of arterial blood gases and ICU interventions are tabulated. Amongst survivors, ICU length of stay (LOS) was 13 (7 to 25) days, and hospital LOS was 24 (14 to 39) days. As of 31 December 2020, 1,358 (51%) patients were discharged from ICU, and 1,219 (46%) patients survived to hospital discharge. Among 963 (36%) patients who died in hospital, 837 (87%) died within 28 days of ICU admission. Conclusions: The COVID-19 CCC/ECMO offers a unique global perspective of characteristics and outcomes of patients with COVID-19 requiring admission to the ICU.

Timely change and timeless constants: COVID-19 and educational change in Singapore

The COVID-19 pandemic has caused great disruption in schooling around the world. This has triggered me to reflect on educational change in Singapore and some related issues the pandemic has raised. Using “Timely Change, Timeless Constants” as an organizing framework, this paper examines the educational changes that are happening in Singapore and amidst such changes, the timeless constants that should be affirmed. In particular, the move towards a blended learning approach needs to help students develop the capacity for independent learning, not just replicate classroom teaching in the virtual medium. Also, despite needing to adapt very quickly to the pandemic, Singapore should continue to build its education system in a balanced and steady manner, reaffirming the important roles that school leaders, teachers and schools play in the society. Some of these points are applicable to other parts of the world. © 2020, Springer Nature Singapore Pte Ltd.