Objective monitoring tools for improved management of childhood asthma.

Asthma is a common chronic disease amongst children. Epidemiological studies showed that the mortality rate of asthma in children is still high worldwide. Asthma control is therefore essential to minimize asthma exacerbations, which can be fatal if the condition is poorly controlled. Frequent monitoring could help to detect asthma progression and ensure treatment effectiveness. Although subjective asthma monitoring tools are available, the results vary as they rely on patients' self-perception. Emerging evidence suggests several objective tools could have the potential for monitoring purposes. However, there is no consensus to standardise the use of objective monitoring tools. In this review, we start with the prevalence and severity of childhood asthma worldwide. Then, we detail the latest available objective monitoring tools, focusing on their effectiveness in paediatric asthma management. Publications of spirometry, fractional exhaled nitric oxide (FeNO), hyperresponsiveness tests and electronic monitoring devices (EMDs) between 2016 and 2023 were included. The potential advantages and limitations of each tool were also discussed. Overall, this review provides a summary for researchers dedicated to further improving objective paediatric asthma monitoring and provides insights for clinicians to incorporate different objective monitoring tools in clinical practices.

The magnitude of the testing effect is independent of retrieval practice performance.

Practicing retrieval is a potent learning enhancer. Theoretical accounts of the testing effect generally suggest that the magnitude of the testing effect is dependent on retrieval practice performance, such that conditions that promote better retrieval practice performance should result in a greater testing effect. Empirical evidence, however, has been mixed. Although some studies showed a positive association between retrieval practice performance and the testing effect, others have shown either no relation or the reverse. In the present study, we experimentally manipulated retrieval practice performance using a retrieval-based response deadline manipulation and an encoding-based study trial manipulation. Across six experiments, the magnitude of the testing effect was independent of retrieval practice performance. However, when we aggregated the data across the experiments, participants with superior retrieval practice performance showed a greater testing effect-an individual difference. This dissociation between experimental and correlational outcomes suggests that the positive relation between retrieval practice performance and the testing effect is not causal, and indeed, simulation data showed that the correlation between retrieval practice performance and testing effect was an artifact. We discuss the challenges these findings present to existing accounts of the testing effect. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Does testing potentiate new learning because it enables learners to use better strategies?

Testing can potentiate new learning, which is often called the forward testing effect. One potential explanation for this benefit is that testing might enable participants to use more effective learning strategies subsequently. We investigated this possibility by asking participants to report their encoding strategies in a multi-list foreign language learning paradigm with four preregistered experiments and one non-preregistered pilot experiment. In Experiments 1-3, participants learned three lists of Chinese-English pairs; one group took a test after every list (i.e., test condition) and the other group took a test only for the criterial List 3 (i.e., restudy condition). In addition, participants completed a transfer test and a study strategy survey. Although we found a forward testing effect in all experiments, participants in the test and restudy conditions did not report differences in strategies. In Experiments 4 and 5, we used a within-subject design so that we could correlate changes in strategy use with the magnitude of the forward testing effect on an individual level. Interestingly, individual differences in strategy change were moderately associated with the magnitude of the forward testing effect, but even here, strategy change did not mediate the effect of testing on performance. Overall, our data showed that, at least for foreign language learning of Chinese characters, interim testing did not enhance new learning by altering participants' subsequent encoding strategies. Moreover, our data showed that interim testing did not promote the transfer of Chinese language learning to novel characters. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Experimental and meta-analytic evidence that source variability of misinformation does not increase eyewitness suggestibility independently of repetition of misinformation.

Considerable evidence has shown that repeating the same misinformation increases its influence (i.e., repetition effects). However, very little research has examined whether having multiple witnesses present misinformation relative to one witness (i.e., source variability) increases the influence of misinformation. In two experiments, we orthogonally manipulated repetition and source variability. Experiment 1 used written interview transcripts to deliver misinformation and showed that repetition increased eyewitness suggestibility, but source variability did not. In Experiment 2, we increased source saliency by delivering the misinformation to participants via videos instead of written interviews, such that each witness was visibly and audibly distinct. Despite this stronger manipulation, there was no effect of source variability in Experiment 2. In addition, we reported a meta-analysis (k = 19) for the repeated misinformation effect and a small-scale meta-analysis (k = 8) for the source variability effect. Results from these meta-analyses were consistent with the results of our individual experiments. Altogether, our results suggest that participants respond based on retrieval fluency rather than source-specifying information.

Guessing as a learning intervention: A meta-analytic review of the prequestion effect.

Giving students test questions before they have learned the correct answers (i.e., prequestions) enhances learning. However, existing research has provided conflicting evidence on whether the benefits of prequestions are specific to the initially tested material or if they generalize to new, nontested material. In this review, we summarize the literature on the prequestion effect, describe the attention-based account underlying this effect, report a meta-analysis of the magnitude of the specific and general effects, and explore theoretically and empirically relevant moderator variables that influence the size and direction of the prequestion effect. This preregistered meta-analysis demonstrated a moderate specific effect (g = 0.54, k = 97) but a virtually nonexistent general effect (g = 0.04, k = 91). Overall, the attention-based account received support from some theoretically relevant moderator analyses. Future researchers are encouraged to conduct theoretically motivated studies to help clarify the mechanisms that underlie the attention-enhancing effects of prequestions and to explore the benefits of prequestions in educational domains to establish the extent to which these effects translate into the classroom.

Unproctored online exams provide meaningful assessment of student learning.

In the United States, the onset of COVID-19 triggered a nationwide lockdown, which forced many universities to move their primary assessments from invigilated in-person exams to unproctored online exams. This abrupt change occurred midway through the Spring 2020 semester, providing an unprecedented opportunity to investigate whether online exams can provide meaningful assessments of learning relative to in-person exams on a per-student basis. Here, we present data from nearly 2,000 students across 18 courses at a large Midwestern University. Using a meta-analytic approach in which we treated each course as a separate study, we showed that online exams produced scores that highly resembled those from in-person exams at an individual level despite the online exams being unproctored-as demonstrated by a robust correlation between online and in-person exam scores. Moreover, our data showed that cheating was either not widespread or ineffective at boosting scores, and the strong assessment value of online exams was observed regardless of the type of questions asked on the exam, the course level, academic discipline, or class size. We conclude that online exams, even when unproctored, are a viable assessment tool.

Improving face identification of mask-wearing individuals.

Research has consistently shown that concealing facial features can hinder subsequent identification. The widespread adoption of face masks due to the COVID-19 pandemic has highlighted the critical and urgent need to discover techniques to improve identification of people wearing face coverings. Despite years of research on face recognition and eyewitness identifications, there are currently no evidence-based recommendations for lineup construction for cases involving masked individuals. The purpose of this study was to examine identification accuracy of a masked perpetrator as a function of lineup type (i.e., unmasked or masked lineups) and perpetrator presence (i.e., absent or present). In both experiments, discriminability was superior for masked lineups, a result that was due almost exclusively to higher hits rates in target-present conditions. These data suggest that presenting a masked lineup can enhance identification of masked faces, and they have important implications for both eyewitness identification and everyday face recognition of people with face coverings.

Does testing enhance new learning because it insulates against proactive interference?

Taking a test on previously learned material can enhance new learning. One explanation for this forward testing effect is that retrieval inoculates learners from proactive interference (PI). Although this release-from-PI account has received considerable empirical support, most extant evidence is correlational rather than causal. We tested this account by manipulating the level of PI that participants experience as they studied several lists while receiving interpolated tests or not. In Experiments 1 and 2, we found that testing benefited new learning similarly regardless of PI level. These results contradict those from Nunes and Weinstein (Memory, 20(2), 138-154, 2012), who found no forward testing effect when encoding conditions minimized PI. In Experiments 3 and 4, we failed to replicate their results. Together, our data indicate that reduced PI might be a byproduct, rather than a causal factor, of the forward testing effect.

Warning weakens retrieval-enhanced suggestibility only when it is given shortly after misinformation: The critical importance of timing.

Recalling details from an experienced event can sometimes exacerbate eyewitnesses' susceptibility to subsequent misinformation. This finding, known as retrieval-enhanced suggestibility (RES), can be eliminated when participants are warned about possible inaccuracies in the misinformation source (Thomas et al., 2010). In three experiments, we investigated whether this warning benefit persists across delays. When the warning was issued shortly after participants were exposed to misinformation, it inoculated participant witnesses against RES, regardless of whether the final memory test occurred immediately or 48 hr after the warning. However, the warning lost its effectiveness when it was delivered 48 hr after participants were exposed to misinformation. These results applied to both recognition memory and the confidence-accuracy relationship. We considered these data from the perspective of temporal distinctiveness, and we argue that a warning serves a similar function to a forget cue in the directed forgetting paradigm. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Does expressive writing or an instructional intervention reduce the impacts of test anxiety in a college classroom?

Test anxiety is a major concern in education because it causes uncomfortable feelings in test-anxious students and may reduce the validity of exam scores as a measure of learning. As such, brief and cost-effective interventions are necessary to minimize the negative impact of test anxiety on students' academic performance. In the present experiment, we examine two such interventions: expressive writing (Experiment 1) and an instructional intervention (Experiment 2), with the latter developed from a similar intervention for stereotype threat. Across four authentic exams in a psychology class, students alternated between completing the intervention and a control task immediately before completing the exams. Neither intervention was effective at reducing test anxiety or improving exam performance. The present results suggest that these interventions may not be successful in addressing the impacts of test anxiety in all classroom settings.

Polyploidy but Not Range Size Is Associated With Seed and Seedling Traits That Affect Performance of Pomaderris Species.

Ploidy and species range size or threat status have been linked to variation in phenotypic and phenological seed and seedling traits, including seed size, germination rate (speed) and seedling stature. There is surprisingly little known about the ecological outcomes of relationships between ploidy, key plant traits and the drivers of range size. Here we determined whether ploidy and range size in Pomaderris, a genus of shrubs that includes many threatened species, are associated with variation in seed and seedling traits that might limit the regeneration performance of obligate seeders in fire-prone systems. We experimentally quantified seed dormancy and germination processes using fire-related heat treatments and evaluated seedling performance under drought stress. We also examined the association of seed size with other seed and seedling traits. Polyploids had bigger seeds, a faster germination rate and larger and taller seedlings than diploids. There was a lack of any clear relationship between range size and seed or seedling traits. The ploidy effects observed for many traits are likely to be indirect and associated with the underlying seed size differences. These findings indicate that there is a higher potential competitive advantage in polyploid than diploid Pomaderris during regeneration, a critical stage in the post-fire environment. This insight to the regeneration phase may need to be considered when planning and prioritising management of threatened species.

Assessment of retinal neurodegeneration with spectral-domain optical coherence tomography: a systematic review and meta-analysis.

OBJECTIVES: To comprehensively assess diabetic retinopathy neurodegeneration (DRN) as quantified by retinal neuronal and axonal layers measured with spectral-domain optical coherence tomography (SD-OCT) in subjects with diabetes mellitus (DM). METHODS: Articles on the topic of examining macular ganglion cell-inner plexiform layer (m-GCIPL), macular retinal nerve fibre layer (m-RNFL), macular ganglion cell complex (m-GCC), and peripapillary RNFL (p-RNFL) measured with SD-OCT in DM subjects without DR (NDR) or with non-proliferative DR (NPDR) were searched in PubMed and Embase up to November 31, 2019. Standardized mean difference (SMD) as effect size were pooled using random-effects model. RESULTS: Thirty-six studies searched from online databases and the CUHK DM cohort were included in the meta-analysis. In the comparison between NDR and control, macular measures including mean m-GCIPL (SMD = -0.26, p = 0.003), m-RNFL (SMD = -0.26, p = 0.046), and m-GCC (SMD = -0.28; p = 0.009) were significantly thinner in the NDR group. In the comparison between NPDR and NDR, only mean p-RNFL was significantly thinner in the NPDR group (SMD = -0.27; p = 0.03), but not other macular measures. CONCLUSIONS: Thinning of retinal neuronal and axonal layers at macula as measured by SD-OCT are presented in eyes with NDR, supporting DRN may be the early pathogenesis in the DM patients without the presence of clinical signs of DR. In the future, these SD-OCT measures may be used as surrogates of DRN to stratify DM patients with a high risk of DR, and may be used as a therapeutic target if neuroprotection treatment for DR is available.

Ophthalmology in the time of COVID-19: experience from Hong Kong Eye Hospital.

AIM: To review international guidelines and to share our infection control experience during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary eye centre in Hong Kong. METHODS: Infection control guidelines and recommendations from international ophthalmological bodies are reviewed and discussed. The measures at our hospital were drawn up as per international and local health authorities' guidelines and implemented with the collaboration of doctors, nurses and administrative staff. RESULTS: The aims of our infection control measures are to 1) minimize cross-infection within the hospital; 2) protect and support hospital staff; 3) ensure environmental control. To minimize the risk of cross-infection, outpatient attendance and elective surgery have been reduced by 40%, and general anesthesia procedures were reduced by 90%. Patients entering the hospital are screened for fever, travel history, contact and cluster history, and COVID-19 related symptoms. To protect and support hospital staff, we ensure provision of adequate personal protective equipment (PPE) and provide clear guidelines on the level of PPE needed, depending on the clinical situation. Other protective measures include provision of work uniforms, easy access to alcohol-based hand rub, opening new lunch areas, implementation of self-monitoring and self-reporting systems, and communication via online education and updates. Finally, environmental control is achieved by ensuring regular disinfection of the hospital premise, enhancing ventilation, and usage of disposable ophthalmic instruments. CONCLUSION: Our multi-pronged approach to infection control is, so far, successful in minimizing infection risks, while allowing the maintenance of essential ophthalmic services.

Transient corneal ectasia after phacoemulsification in an eye with femtosecond intrastromal presbyopic treatment.

We report a case of transient corneal ectasia developed after phacoemulsification in an eye previously treated with INTRACOR. There was a myopic refractive surprise after cataract surgery. Corneal tomography showed an increase in keratometry and elevation profile compared with preoperative examination. Soft contact lenses and intraocular pressure-lowering medications were prescribed as interim treatment. Clinical improvement was seen gradually, and the resolution of myopia and ectasia was achieved at 3 months. We believe that high intraocular pressure during phacoemulsification and the weakening effect of femtosecond intrastromal presbyopic treatment can be the culprits.

Clinically relevant factors associated with quantitative optical coherence tomography angiography metrics in deep capillary plexus in patients with diabetes.

BACKGROUND: To test clinically relevant factors associated with quantitative artifact-free deep capillary plexus (DCP) metrics in patients with diabetes mellitus (DM). METHODS: 563 eligible eyes (221 with no diabetic retinopathy [DR], 135 with mild DR, 130 with moderate DR, and 77 with severe DR) from 334 subjects underwent optical coherence tomography-angiography (OCT-A) with a swept-source OCT (Triton DRI-OCT, Topcon, Inc., Tokyo, Japan). Strict criteria were applied to exclude from analysis those DCP images with artifacts and of poor quality, including projection artifacts, motion artifacts, blurriness, signal loss, B-scan segmentation error, or low-quality score. A customized MATLAB program was then used to quantify DCP morphology from the artifact-free DCP images by calculating three metrics: foveal avascular zone (FAZ), vessel density (VD), and fractal dimension (FD). RESULTS: 166 (29.5%) eyes were excluded after quality control, leaving in the analysis 397 eyes (170 with no DR, 101 with mild DR, 90 with moderate DR, 36 with severe DR) from 250 subjects. In the multiple regression models, larger FAZ area was associated with more severe DR (ß = 0.687; p = 0.037), shorter axial length (AL) (ß = - 0.171; p = 0.003), thinner subfoveal choroid thickness (ß = - 0.122; p = 0.031), and lower body mass index (BMI) (ß = - 0.090; p = 0.047). Lower VD was associated with more severe DR (ß = - 0.842; p = 0.001), shorter AL (ß = 0.107; p = 0.039), and poorer visual acuity (VA) (ß = - 0.133; p = 0.021). Lower FD was associated with more severe DR (ß = - 0.891; p < 0.001) and with older age (ß = - 0.142; p = 0.004). CONCLUSIONS: Quantitative artifact-free DCP metrics are associated with VA, DR severity, AL, subfoveal choroidal thickness, age, and BMI in diabetic patients. The effects of ocular and systemic factors should be considered for meaningful interpretations of DCP changes in DM patients.

OCT Angiography Metrics Predict Progression of Diabetic Retinopathy and Development of Diabetic Macular Edema: A Prospective Study.

PURPOSE: To prospectively determine the relationship of OCT angiography (OCTA) metrics to diabetic retinopathy (DR) progression and development of diabetic macular edema (DME). DESIGN: Prospective, observational study. PARTICIPANTS: A total of 205 eyes from 129 patients with diabetes mellitus followed up for at least 2 years. METHODS: All participants underwent OCTA with a swept-source OCT device (DRI-OCT Triton, Topcon, Inc, Tokyo, Japan). Individual OCTA images of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were generated by IMAGEnet6 (Basic License 10). After a quality check, automated measurements of foveal avascular zone (FAZ) area, FAZ circularity, vessel density (VD), and fractal dimension (FD) of both SCP and DCP were then obtained. MAIN OUTCOME MEASURES: Progression of DR and development of DME. RESULTS: Over a median follow-up of 27.14 months (interquartile range, 24.16-30.41 months), 28 of the 205 eyes (13.66%) developed DR progression. Of the 194 eyes without DME at baseline, 17 (8.76%) developed DME. Larger FAZ area (hazard ratio [HR], 1.829 per SD increase; 95% confidence interval [CI], 1.332-2.512), lower VD (HR, 1.908 per SD decrease; 95% CI, 1.303-2.793), and lower FD (HR, 4.464 per SD decrease; 95% CI, 1.337-14.903) of DCP were significantly associated with DR progression after adjusting for established risk factors (DR severity, glycated hemoglobin, duration of diabetes, age, and mean arterial blood pressure at baseline). Lower VD of SCP (HR, 1.789 per SD decrease; 95% CI, 1.027-4.512) was associated with DME development. Compared with the model with established risk factors alone, the addition of OCTA metrics improved the predictive discrimination of DR progression (FAZ area of DCP, C-statistics 0.723 vs. 0.677, P < 0.001; VD of DCP, C-statistics 0.727 vs. 0.677, P = 0.001; FD of DCP, C-statistics 0.738 vs. 0.677, P < 0.001) and DME development (VD of SCP, C-statistics 0.904 vs. 0.875, P = 0.036). CONCLUSIONS: The FAZ area, VD, and FD of DCP predict DR progression, whereas VD of SCP predicts DME development. Our findings provide evidence to support that OCTA metrics improve the evaluation of risk of DR progression and DME development beyond traditional risk factors.

Telling a good story: The effects of memory retrieval and context processing on eyewitness suggestibility.

Witnesses are likely to describe a crime many times before testifying or encountering misinformation about that crime. Research examining the effect of retrieval on later suggestibility has yielded mixed results. LaPaglia and Chan manipulated whether misinformation was presented in a narrative or misleading questions, and they found that retrieval increased suggestibility when misinformation was presented in a narrative, but reduced suggestibility when the same misinformation was presented in questions. In the current study, we aimed to address why these differences occurred. Specifically, we examined whether contextual detail and narrative coherence during misinformation exposure influenced the relation between retrieval and suggestibility. Participants watched a robbery video and some were questioned about the event afterwards. They were then exposed to misinformation presented in a narrative (Experiment 1) or questions (Experiment 2) before taking a final memory test. Testing enhanced suggestibility when the misinformation phase reinstated contextual information of the event, but not when the misinformation phase included few contextual details-regardless of whether the misinformation was in a narrative or questions. In Experiment 3, disrupting narrative coherence by randomizing the order of contextual information eliminated retrieval-enhanced suggestibility. Therefore, context processing during the post-event information phase influences whether retrieval enhances or reduces eyewitness suggestibility.

Do masked-face lineups facilitate eyewitness identification of a masked individual?

Perpetrators often wear disguises like ski masks to hinder subsequent identification by witnesses or law enforcement officials. In criminal cases involving a masked perpetrator, the decision of whether and how to administer a lineup often rests on the investigating officer. To date, no evidence-based recommendations are available for eyewitness identifications of a masked perpetrator. In 4 experiments, we examined lineup identification performance depending on variations in both encoding (studying a full face vs. a partial/masked face) and retrieval conditions (identifying a target from a full-face lineup vs. a partial/masked-face lineup). In addition, we manipulated whether the target was present or absent in the lineup in Experiments 3 and 4. Across all experiments, when participants had encoded a masked face, the masked-face lineup increased identification accuracy relative to the full-face lineup. These data provide preliminary evidence that matching lineup construction to how witnesses originally encoded the perpetrator may enhance the accuracy of eyewitness identifications. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Retrieval potentiates new learning: A theoretical and meta-analytic review.

A growing body of research has shown that retrieval can enhance future learning of new materials. In the present report, we provide a comprehensive review of the literature on this finding, which we term test-potentiated new learning. Our primary objectives were to (a) produce an integrative review of the existing theoretical explanations, (b) summarize the extant empirical data with a meta-analysis, (c) evaluate the existing accounts with the meta-analytic results, and (d) highlight areas that deserve further investigations. Here, we identified four nonexclusive classes of theoretical accounts, including resource accounts, metacognitive accounts, context accounts, and integration accounts. Our quantitative review of the literature showed that testing reliably potentiates the future learning of new materials by increasing correct recall or by reducing erroneous intrusions, and several factors have a powerful impact on whether testing potentiates or impairs new learning. Results of a metaregression analysis provide considerable support for the integration account. Lastly, we discuss areas of under-investigation and possible directions for future research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).