Effectiveness of a proficiency-based progression e-learning approach to training in communication in the context of clinically deteriorating patients: a multi-arm randomised controlled trial.

OBJECTIVE: To determine the effectiveness of proficiency-based progression (PBP) e-learning in training in communication concerning clinically deteriorating patients. DESIGN: Single-centre multi-arm randomised double-blind controlled trial with three parallel arms. RANDOMISATION, SETTING AND PARTICIPANTS: A computer-generated program randomised and allocated 120 final year medical students in an Irish University into three trial groups. INTERVENTION: Each group completed the standard Identification, Situation, Background, Assessment, Recommendation communication e-learning; group 1 Heath Service Executive course group (HSE) performed this alone; group 2 (PBP) performed additional e-learning using PBP scenarios with expert-determined proficiency benchmarks composed of weighted marking schemes of steps, errors and critical errors cut-offs; group 3 (S) (self-directed, no PBP) performed additional e-learning with identical scenarios to (PBP) without PBP. MAIN OUTCOME MEASURES: Primary analysis was based on 114 students, comparing ability to reach expert-determined predefined proficiency benchmark in standardised low-fidelity simulation assessment, before and after completion of each group's e-learning requirements. Performance was recorded and scored by two independent blinded assessors. RESULTS: Post-intervention, proficiency in each group in the low-fidelity simulation environment improved with statistically significant difference in proficiency between groups (p<0.001). Proficiency was highest in (PBP) (81.1%, 30/37). Post hoc pairwise comparisons revealed statistically significant differences between (PBP) and self-directed (S) (p<0.001) and (HSE) (p<0.001). No statistically significant difference existed between (S) and (HSE) (p=0.479). Changes in proficiency from pre-intervention to post-intervention were significantly different between the three groups (p=0.001). Post-intervention, an extra 67.6% (25/37) in (PBP) achieved proficiency in the low-fidelity simulation. Post hoc pairwise comparisons revealed statistically significant differences between (PBP) and both (S) (p=0.020) and (HSE) (p<0.001). No statistically significant difference was found between (S) and (HSE) (p=0.156). CONCLUSIONS: PBP e-learning is a more effective way to train in communication concerning clinically deteriorating patients than standard e-learning or e-learning without PBP. TRIAL REGISTRATION NUMBER: NCT02937597.

The potentials for incidental vocabulary acquisition from listening to computer science academic lectures: a higher education corpus-based case study from Macau.

Introduction: Universities in non-Anglophone countries are increasingly implementing English as the medium of instruction (EMI) lectures. There seems to be an assumption that students' performance on standardized English examinations can be equated with the lexical knowledge needed to comprehend EMI lectures regardless of discipline. For unknown words students encounter, it is assumed that they can be picked up through listening to these lectures. This potential for students to acquire unknown words incidentally while listening to these lectures has yet to be fully explored. Methods: This study addresses the potential of students incidentally acquiring vocabulary from listening to EMI lectures through corpus analyses of computer science lectures at one public university in Macau. Taking into consideration frequency, range, and lecturer explanation, corpus analyses of the transcripts of 28 computer science lectures (40 h 36 min) were conducted to determine the lexical knowledge needed for students to comprehend the lectures. The potential number of words these students could acquire through listening to the lectures was also uncovered through further analyses. Results: Results showed that L2 students need to have receptive knowledge of the most frequent 3,000 word families plus proper nouns and marginal words to reach beyond 95% lexical coverage. To reach 98% lexical coverage, 5,000 word families are needed. Considering frequency, range, and teacher explanation, we concluded that 30 new words could reasonably be incidentally acquired after listening to the 28 lectures. Discussion: These results indicate a need for EMI lecturers to consider the lexical knowledge of students and whether additional pedagogical techniques (i.e., vocabulary explanation) should be employed in content classrooms when lectures are delivered in English, especially for specialized fields such as computer science. Our results also draw attention to the importance of field specific vocabulary and the potential pitfalls of using blanket English language admissions criteria when admitting students to different academic programs.

A Mixed-Methods Investigation of the Effectiveness and Perceptions of Learning English Collocations Using the Keyword Method and the Rote Learning Method.

This study investigated the effectiveness, as well as EFL learners' perceptions, of the keyword method (KWM) in comparison to the rote learning method (RLM) for the learning of English collocations. A controlled laboratory-like setting was adopted for randomly assigning participants to the KWM group (n = 15) or the RLM group (n = 15). After receiving training on the use of the respective strategy, the two participant groups applied the respective strategy to the learning of collocations. Collocations were assessed at three different time periods, and additional data regarding perceptions of the two strategies were elicited through one-on-one post hoc interviews. The quantitative data revealed that the KWM was superior to the RLM in terms of the long-term retention of productive collocation knowledge; knowledge of adjective-noun collocations was retained better than verb-noun collocations. The qualitative data revealed that participants deemed that the KWM was unfamiliar but effective. Additionally, participants claimed that the RLM was facile but may result in a high rate of forgetting. The pedagogical implications are that foreign language teachers should encourage language learners to use the KWM for learning English collocations. Although the KWM has been recommend by many researchers, it is still rarely advocated for by foreign language instructors. Therefore, it is important that both EFL learners and teachers should be aware of the KWM's long-term retention effects on the learning of English collocations and apply this vocabulary learning strategy (VLS) in their actual learning and teaching context.

Cyanostilbene-based fluorescent paper array for monitoring fish and meat freshness via amino content detection.

The detection of biogenic amines released from degraded meats is an effective method for evaluating meat freshness. However, existing traditional methods like titration are deemed tedious, while the use of sophisticated analytical instruments is not amenable to field testing. Herein, a cyanostilbene-based fluorescent array was rapidly fabricated using macroarray synthesis on a cellulose paper surface to detect amines liberated from spoiled beef, fish, and chicken. The fluorescence changes of immobilized molecules from the interaction with gaseous amines were used to monitor changes in freshness levels. Thanks to the high-throughput nature of macroarray synthesis, a set of highly responsive molecules such as pyridinium and dicyanovinyl moieties were quickly revealed. Importantly, this method offers flexibility in sensing applications including (1) sensing by individual sensor molecules, where the fluorescence response correlated well with established titration methods, and (2) collective sensing whereby chemometric analysis was used to provide a cutoff of freshness with 73-100% accuracy depending on meat types. Overall, this study paves the way for a robust and cost-effective tool for monitoring meat freshness.

Empirical Support for the Involvement Load Hypothesis (ILH): A Systematic Review.

The Involvement Load Hypothesis (ILH) has become a widely used framework for predicting second language (L2) vocabulary learning from task completion. The purpose of this systematic review was to analyze the predictive ability of the ILH in the acquisition of aspects of knowing a word, its application in different target populations, the effective vocabulary learning task types designed based on the ILH, and the occurrence rate of the ILH components in vocabulary learning tasks. We searched IEEE, ERIC, WOS, Scopus, and ProQuest databases for empirical studies published between 2001 and 2021, using a vocabulary-focused keyword string combined with an ILH-focused keyword string. A total of 78 studies were selected using a set of inclusion and exclusion criteria. The content analysis of these studies showed that researchers have used the ILH to investigate the acquisition of six aspects of knowing a word. Four types of tasks (i.e., fill-in-the-blanks, reading, composition writing, and meaning-inferring) provided more positive evidence for the validation of the ILH. The search component was least present in the vocabulary learning tasks. Researchers have supported the use of the ILH to predict the vocabulary learning potential of tasks completed mainly by adult learners. This systematic review provides direction for future reviews and empirical studies in L2 vocabulary teaching and learning framed by the ILH.

Learning English vocabulary from word cards: A research synthesis.

Researchers' interest in the learning of vocabulary from word cards has grown alongside the increasing number of studies published on this topic. While meta-analyses or systematic reviews have been previously performed, the types of word cards investigated, and the number of word card studies analyzed were limited. To address these issues, a research synthesis was conducted to provide an inclusive and comprehensive picture of how the use of word cards by learners results in vocabulary learning. A search of the Web of Science and Scopus databases resulted in 803 potential studies, of which 32 aligned with the inclusion criteria. Coding of these studies based on an extensive coding scheme found most studies assessed receptive vocabulary knowledge more often than productive vocabulary knowledge, and knowledge of vocabulary form and meaning were assessed more often than knowledge of vocabulary use. Results of effect size plots showed that more of the reviewed studies showed larger effects for the use of paper word cards than digital word cards, and for the use of ready-made word cards than self-constructed word cards. Results also indicated more studies showed larger effects for using word cards in an intentional learning condition compared with an incidental learning condition, and for using word cards in a massed learning condition compared with a spaced learning condition. Although a correlation was found between time spent using word cards and vocabulary learning outcomes, this correlation was not statistically significant. Learners that were more proficient in English learned more words from using word cards than those less proficient. These results suggest that future researchers should report learner proficiency, adopt reliable tests to assess vocabulary learning outcomes, compare the effectiveness of ready-made word cards and self-constructed word cards, and investigate the learning of different aspects of word knowledge. Teachers should provide learners guidance in how to use word cards and target word selection for self-construction of word cards. In addition, teachers should encourage learners to create word cards for incidentally encountered unknown words and use massed learning when initially working with these new words before using spaced learning for later retrieval practice.

Incidental vocabulary acquisition from listening to English teacher education lectures: A case study from Macau higher education.

Some proponents of higher education English as a medium of instruction (EMI) have suggested listening to English lectures provides students the opportunity to incidentally acquire unknown words. A case study was designed to examine this assumption. First, the lexical profiles of 27 Introduction to English Language Teaching first-year undergraduate course lectures were computed to determine how many words students need to know for comprehension. Then an incoming year-1 undergraduate student with an English vocabulary size of 7,500 word families and mastery of the most frequent 3,000 word families listened to these lectures across 13.5 weeks with the purpose of measuring incidental acquisition gains of three aspects of word knowledge for ten targeted words. Lastly, the student's perceptions about listening to EMI lectures and potentials for this listening inducing incidental acquisition of word knowledge were gathered through a semi-structured interview. The lexical profiling of the entire corpus showed students need knowledge of the most frequent 4,000 English word families plus proper nouns and marginal words for 98% lexical coverage; however, some lectures present students with a more substantial lexical burden than the lectures overall. The student made the most gains in receptive meaning, followed by receptive form, and finally productive meaning. Content analysis of the interview transcript found seven themes representing the student's perception about listening to EMI lectures and their potential for inducing incidental vocabulary acquisition. While the student found listening to the EMI lectures challenging, he perceived the process as useful in preparing for university studies and a career as a secondary English teacher. The student perceived attention, topic, existing vocabulary knowledge, lecturer's native language, and lack of interaction with the lecturer to have moderated incidental learning of vocabulary through listening to English lectures. These results indicate a need to confirm whether incoming students' vocabulary knowledge meet the lexical demands of the EMI lectures given in the Macau context. Furthermore, pedagogical training on teacher talk strategies and orientation training for incoming students should both be provided to ensure students are receiving high quality instruction.

Pre-Service Teachers Learning to Teach English to Very Young Learners in Macau: Do Beliefs Trump Practice?

The global importance of English and therefore the teaching of the English language has made the English language curriculum an integral part of all levels of teacher education, including early childhood education. The purpose of this study was to first explore the beliefs about the teaching of English to very young learners held by pre-service pre-primary teachers in Macau and then to see whether these beliefs were reflected in their microteaching. Qualitative content analysis performed on the written reflections and transcriptions of the microteaching videos of 75 pre-service pre-primary teachers found that their beliefs about classroom practices, lesson planning, and English as a foreign language (EFL) learners and learning were the most predominant beliefs exhibited in their reflections and were evidenced in their microteaching. Less predominant, but still salient, were their beliefs about the goals of language learning, assessment, teaching, pedagogical knowledge, and content. No observable practices were found regarding the pre-service teachers' beliefs about the role of teaching, learning to teach, microteaching, the self, the subject, hearsay, self-assessment, and schooling. The current study found that with only limited exposure to EFL teaching methodology from a single course, the pre-service pre-primary teachers were able to implement some of their beliefs about several important aspects of teaching English to very young learners.

Medical School Students' Preferences for and Perceptions of Teacher Written Corrective Feedback on English as a Second Language Academic Writing: An Intrinsic Case Study.

This intrinsic case study investigated English as a foreign language (EFL) medical students' preferences for and perceptions of teacher written corrective feedback (WCF) on their academic writing. Chinese-speaking second-year first-semester undergraduate medicine majors (n = 71) enrolled in an academic EFL "reading to write" course at a university in northern Taiwan were recruited as participants. Qualitative content analysis, as well as some descriptive statistics, was used to investigate data gathered from participants' responses to an open- and closed-ended questionnaire. The questionnaire enquired about their preferences for and perceptions of teacher WCF relating to writing structure, writing content, and writing mechanics. Qualitative content analysis of two in-depth semi-structured interviews with the English teacher uncovered why the participants preferred certain WCF types and perceived them as helpful. Questionnaire data revealed that students showed a preference for WCF relating to writing structure over content and mechanics, and direct feedback over indirect feedback for both writing content and structure. Compared to writing structure and writing content, the examples given by students of the most (n = 25) and least helpful (n = 14) feedback were predominantly related to writing mechanics. The interview transcript data underscored the influencing factors of EFL medical students' preferences and the perceived benefits and challenges related to feedback. These findings suggest that writing teachers should consider the specialized preferences of particular learner groups (e.g., EFL medical school students) prior to administering feedback.

Pre-service Teachers Learning to Teach English as a Foreign Language to Preschool Learners in Macau: A Longitudinal Study.

Language teacher beliefs have received increasing research attention for the past few decades. However, little is known about the beliefs of pre-service teachers in the pre-primary English as a foreign language (EFL) education context. This qualitative case study extends this line of inquiry by investigating the trajectory of student teachers' beliefs about teaching English to pre-primary learners in Macau within a teacher education course. The participants included 60 pre-service teachers taking an English Language Activities course in their third year of a 4-year Bachelor of pre-primary education program. The data comprised written reflections collected at three points in time during the 16-week course: at the beginning of the course, mid-way through the course, and at the end of the course. The findings showed five broad themes, constituted from 15 subthemes, regarding (1) learners and learning, (2) teaching, (3) subject, (4) self, and (5) learning to teach. The major themes have been documented in the literature, but several subthemes were identified for the first time in the context of pre-primary EFL teacher education. More importantly, the findings revealed that some of the subthemes were newly shaped and several subthemes were reshaped as a consequence of taking the course. The findings were interpreted in relation to the content of the course, the experiential learning opportunities, the pre-service teachers' prior experiences of language learning and teaching, and the local language teaching and learning context. Implications for pre-service teacher education programs are discussed.

Effects of individual and group metacognitive prompts on EFL reading comprehension and incidental vocabulary learning.

Recent research has highlighted the value of providing metacognitive guidance for learning English in a small group setting. This study investigated the effects that the presence or absence of metacognitive prompts for group or individual learning could have on reading comprehension and the incidental learning of vocabulary through reading. A total of 171 university students were randomly assigned to four treatment conditions: collaborative learning with metacognitive prompts, collaborative learning without metacognitive prompts, individual learning with metacognitive prompts, and individual learning without metacognitive prompts. Results indicated that after the treatment, learners in the collaborative learning with metacognitive prompts group outperformed the other groups on both reading comprehension and incidental vocabulary learning assessments. In addition, the vocabulary knowledge acquired by students in the collaborative learning with metacognitive prompts group was highest for meaning recognition, followed by form recognition, meaning recall, and finally form recall. These findings highlight the importance of training students' self-regulated learning and suggest that the use of metacognitive prompts in a group setting is an effective means to boost EFL reading comprehension and the incidental vocabulary learning for Chinese university students. Pedagogical implications of these and other nuanced findings are discussed.

Hypoxia Associated Proteolytic Processing of OS-9 by the Metalloproteinase Meprin ß.

Meprin metalloproteases play a role in the pathology of ischemia/reperfusion- (IR-) induced renal injury. The endoplasmic reticulum-associated protein, osteosarcoma-9 (OS-9), has been shown to interact with the carboxyl-terminal tail of meprin ß. More importantly, OS-9 interacts with the hypoxia inducible factor-1α (HIF-1α) and the prolyl-hydroxylase, proteins which mediate the cell's response to hypoxia. To determine if OS-9 is a meprin substrate, kidney proteins from meprin αß knockout mice (αßKO) (which lack endogenous meprins) and purified human OS-9 were incubated with activated forms of meprin A and meprin B, and Western blot analysis was used to evaluate proteolytic processing of OS-9. Fragmentation of OS-9 was observed in reactions with meprin B, but not meprin A. To determine whether meprin B cleaves OS-9 in vivo, wild-type (WT) and meprin αßKO mice were subjected to IR-induced renal injury. Fragmentation of OS-9 was observed in kidney proteins from WT mice subjected to IR, but not in meprin αßKO counterparts. Transfection of kidney cells (MDCK and HEK293) with meprin ß cDNA prevented accumulation of OS-9 following exposure to the hypoxia mimic, CoCl2. These data suggest that meprin ß interaction with OS-9 plays a role in the hypoxia response associated with IR-induced renal injury.

Rational endodontics must pass the commonsense test.

By applying the principles of common sense, we can arrive at a rational approach to endodontics that eliminates concerns we have in using the rotary NiTi. We can use this same approach to improve our choices of what to use to create the original glide path. By switching from the poorly designed K-file to the more rationally designed and utilized relieved reamers, we not only create a more usable glide path, we quickly learn that an extension of this approach can eliminate the use of rotary NiTi and the various compromises it makes us incorporate in an attempt to use it safely.

Radiopacity of endodontic materials on film and a digital sensor.

The purpose of this study was to compare the radiographic appearance of 12 endodontic materials as visualized on either Kodak Ultra-speed D speed film (Eastman Kodak Company, Rochester, NY) or a Gendex eHD digital sensor (Gendex Dental Systems, Milan, Italy). Ten discs of each material were radiographed alongside an aluminum alloy 1100 (Alcoa, Pittsburgh, PA) stepwedge that was used for reference. For every radiograph, the average grayscale value of the material was converted into absorbance notation and compared with that of the reference stepwedge in order to determine the equivalent radiopacity in terms of millimeters of Al 1100 per millimeter of material. Two-way repeated-measures analysis of variance testing detected significant differences with respect to imaging system, material, and the interaction of the two factors (p < 0.001). The difference in a material's radiopacity as measured on the digital sensor compared with film was greater than 10% for 4 of the 12 materials and over 40% for InnoEndo (Heraus Kulzer, Armonk, NY). It was speculated that barium fillers cause this effect.

Characterization of the early events in dengue virus cell entry by biochemical assays and single-virus tracking.

In this study, we investigated the cell entry characteristics of dengue virus (DENV) type 2 strain S1 on mosquito, BHK-15, and BS-C-1 cells. The concentration of virus particles measured by biochemical assays was found to be substantially higher than the number of infectious particles determined by infectivity assays, leading to an infectious unit-to-particle ratio of approximately 1:2,600 to 1:72,000, depending on the specific assays used. In order to explain this high ratio, we investigated the receptor binding and membrane fusion characteristics of single DENV particles in living cells using real-time fluorescence microscopy. For this purpose, DENV was labeled with the lipophilic fluorescent probe DiD (1,1'-dioctadecyl-3,3,3',3'-tetramethylindodicarbocyanine, 4-chlorobenzenesulfonate salt). The surface density of the DiD dye in the viral membrane was sufficiently high to largely quench the fluorescence intensity but still allowed clear detection of single virus particles. Fusion of the viral membrane with the cell membrane was evident as fluorescence dequenching. It was observed that DENV binds very inefficiently to the cells used, explaining at least in part the high infectious unit-to-particle ratio. The particles that did bind to the cells showed different types of transport behavior leading to membrane fusion in both the periphery and perinuclear regions of the cell. Membrane fusion was observed in 1 out of 6 bound virus particles, indicating that a substantial fraction of the virus has the capacity to fuse. DiD dequenching was completely inhibited by ammonium chloride, demonstrating that fusion occurs exclusively from within acidic endosomes.

Measuring the radiopacity of luting cements, dowels, and core build-up materials with a digital radiography system using a CCD sensor.

PURPOSE: This study assessed the radiopacity of five luting cements, five dowels, and five core build-up materials using two target distances. MATERIALS AND METHODS: Materials were analyzed using a modified version of ISO protocol 4049. samples 1 mm thick were digitally radiographed alongside a stepwedge of aluminum alloy 1100 using a Trophy RVG-4 CCD sensor and 70 kVp X-ray generator. The gray-scale values of the stepwedge and sample were converted to X-ray absorbencies. The relationship between X-ray absorbance and aluminum thickness was linear for thicknesses less than 10 mm and followed a power-law relationship above 10 mm. These relations were used to convert the absorbencies of the samples into aluminum thicknesses. The radiopacity data was subjected to ANOVA/Student-Newman-Keuls testing. RESULTS: All materials were more radiopaque than equivalent thicknesses of aluminum. Each product category contained a wide range of radiopacities. Syringe-dispensed materials tended to be less radiopaque than materials dispensed by mechanically assisted syringe or mixed by hand (p < 0.01). Target distance did not affect the measured radiopacity so long as the exposure time was suitably adjusted (p= 0.86). CONCLUSIONS: All luting cements and core materials met or exceeded the ISO minimums. The tested metal-reinforced glass ionomer core build-up materials were extremely radiopaque. Some publications suggest that excessively radiopaque core materials can hinder a clinician's ability to spot voids or marginal defects.