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Purpose Stridor during emergence from anesthesia is not rare in children managed with supraglottic airway (SGA). However, we know little about the mechanisms of stridor and behavior of the vocal cords (VC). This study aimed to clarify patterns of VC movement and laryngeal airway maintenance function during recovery from anesthesia in children with SGA. Methods This is a secondary analysis of data collected from an observational study involving 27 anesthetized children. Using a multi-panel recording system, endoscopic VC image, vital sign monitor, multi-channel tracings of respiratory variables and respiratory sound and patient's view were simultaneously captured in one monitor. Inspiratory and expiratory VC angles formed by lines connecting anterior and posterior commissures were measured at the first spontaneous breath and the breath one minute after the first breath. VC narrowing and dilation were assessed by differences of VC angles. Results Inspiratory VC narrowing (median (IQR): 5.3 (2.7, 9.1) degree at the first breath) and dilation (- 2.7 (- 3.8, - 1.7) degree at the first breath) were observed in 15 and 12 out of 27 children, respectively. The former group achieved greater tidal volume compared to the latter in one minute. Five children (19%) temporarily developed stridor-like sound from outside with inspiratory VC narrowing. The stridor-like sound was captured by microphones attached to the neck and anesthesia circuit, but was not evident from the chest. Conclusion Laryngeal narrowing occurs in half of the children with SGA during emergence from anesthesia, and temporal stridor-like sound is relatively common. Clinical trial registration UMIN (University Hospital Information Network) Clinical Registry: UMIN000025058 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000028697)., Author(s): Katsuhiko Ishibashi [sup.1], Yuji Kitamura [sup.1] [sup.4], Shinichiro Kato [sup.1] [sup.5], Miri Sugano [sup.1] [sup.6], Yuichi Sakaguchi [sup.1] [sup.7], Yasunori Sato [sup.2], Shiroh Isono [sup.3] Author Affiliations: (1) https://ror.org/0126xah18, [...]

Background: 5-alpha reductase inhibitors (5-ARIs) change hormonal pathways and reduce prostate size. We evaluated the effects of 5-ARIs on prostatic multiparametric magnetic resonance imaging (mpMRI) suspicious findings and in the identification of prostate cancer using targeted biopsies. Methods: We conducted a retrospective study including 600 consecutive patients who, between 2017 and 2021, underwent combined transperineal fusion biopsies. Primary outcomes were Prostate Imaging Reporting and Data System version 2 (PIRADS v2) scores and the identification of clinically significant prostate cancer from suspicious lesions (targeted CSPC). Outcomes were compared between patients treated with 5-ARIs for a minimum of 6 months and the other patients. Results: Patients treated with 5-ARIs were older (p < 0.001) with higher rates of previous prostate biopsies (p = 0.004). PIRADS scores were 3, 4, and 5 in 15 (29%), 28 (54%), and 9 (17%) patients among the 5-ARI group and 130 (24%), 308 (56%), and 110 (20%) patients among the others, and the scores were not different between the groups (p = 0.69). The targeted CSPC identification rate among 5-ARI patients was 31%, not different compared to the non-5-ARI group (p = 1). Rates of targeted CSPC for each PIRADS score were not affected by 5-ARI treatment. The 5-ARI was not associated with neither PIRADS ≥ 4 score nor targeted CSPC on logistic regression analyses (OR = 0.76, 95% CI 0.4–1.4 and OR = 1.02, 95% CI 0.5–1.9, respectively). Conclusions: 5-ARI treatment is not associated with PIRADS score alterations or targeted biopsy results. Patients treated by 5-ARIs with suspicious lesions should not be addressed differently during the mpMRI-related diagnostic process.

A fundamental principle of biological motor control is that the neural commands driving movement must conform to the response properties of the motor plants they control. In the oculomotor system, characterizations of oculomotor plant dynamics traditionally supported models in which the plant responds to neural drive to extraocular muscles on exclusively short, subsecond timescales. These models predict that the stabilization of gaze during fixations between saccades requires neural drive that approximates eye position on longer timescales and is generated through the temporal integration of brief eye velocity-encoding signals that cause saccades. However, recent measurements of oculomotor plant behaviour have revealed responses on longer timescales. Furthermore, measurements of firing patterns in the oculomotor integrator have revealed a more complex encoding of eye movement dynamics. Yet, the link between these observations has remained unclear. Here we use measurements from the larval zebrafish to link dynamics in the oculomotor plant to dynamics in the neural integrator. The oculomotor plant in both anaesthetized and awake larval zebrafish was characterized by a broad distribution of response timescales, including those much longer than 1 s. Analysis of the firing patterns of oculomotor integrator neurons, which exhibited a broadly distributed range of decay time constants, demonstrates the sufficiency of this activity for stabilizing gaze given an oculomotor plant with distributed response timescales. This work suggests that leaky integration on multiple, distributed timescales by the oculomotor integrator reflects an inverse model for generating oculomotor commands, and that multi-timescale dynamics may be a general feature of motor circuitry. KEY POINTS: Recent observations of oculomotor plant response properties and neural activity across the oculomotor system have called into question classical formulations of both the oculomotor plant and the oculomotor integrator. Here we use measurements from new and published experiments in the larval zebrafish together with modelling to reconcile recent oculomotor plant observations with oculomotor integrator function. We developed computational techniques to characterize oculomotor plant responses over several seconds in awake animals, demonstrating that long timescale responses seen in anaesthetized animals extend to the awake state. Analysis of firing patterns of oculomotor integrator neurons demonstrates the sufficiency of this activity for stabilizing gaze given an oculomotor plant with multiple, distributed response timescales. Our results support a formulation of gaze stabilization by the oculomotor system in which commands for stabilizing gaze are generated through integration on multiple, distributed timescales.

The number of students with disabilities attending higher education has been soaring. Support centres in the institutions provide assistance in the form of assistive technologies, private tutoring, meetings with counsellors, and workshops. Still, many students express lack of confidence and low self-esteem that extend beyond the academic sphere into their personal and social life. Using qualitative methods, this study examines a peer mentoring program in which the mentors are students with special needs, who, based on their strengths, provide assistance and mentoring to other students. Semi-structured interviews were conducted with these mentors. The analysis of the interviews sheds light on the participants' narratives about the effect of mentoring on their academic success and their emotional and psychological well-being. Three central themes emerged from the interviews that describe the students' transformation and improvement: (1) self-esteem; (2) self-efficacy; and (3) empowerment. These themes correspond with the significance and impact that students attribute to peer-mentoring. Thus, the study indicates that mentoring could be used as an additional therapeutic tool when working with students with special needs.

Education policies claiming to promote 'excellence' aim to improve outcomes in various quantitative measures of specific standards. However, excellence can also mean individual self-improvement. We analyse Israeli policies at the national, local, and school levels. We structure our argument based on sensemaking theory by applying qualitative content analysis to the texts of Director General Circulars of the Ministry of Education, local educational authority regulations, and local school-based programmes and procedures. We also conduct inductive and thematic analyses of interviews with senior actors at the three levels. We show that national policies mainly support outcomes-based forms of excellence, while local authorities and school principals play a prominent role in sensemaking and interpretation of these national policies by determining which of the outcomes-based or self-improvement notions of 'excellence' their schools will promote. This is specifically important in schools serving low socio-economic populations, where customisation of excellence promoting policies is vital.

This paper explores the factors that predict children's willingness to have contact with those from cultures in conflict, using data collected in 2014-2015 from the TEC4Schools program which begins online and eventually includes face-to-face contact. Hierarchical regression analysis was conducted on the results of the questionnaire from 577 students. The predictors were entered in four steps: (1) personal details (gender and religion), (2) equity and satisfaction (3) collaboration (the use of collaborative learning in the course), and (4) intercultural attitudes. Both intercultural attitudes and positive experiences are associated with collaboration and predict the dependent variable: the willingness of the children to interact with those from other cultures. Satisfaction and equity do not directly predict willingness to interact with other children but do so via collaboration. In addition, the variable 'intercultural attitudes' is a mediator for collaboration, meaning that collaboration does predict willingness to interact with other cultures via intercultural attitudes. Although the findings show that gender and religion do not predict willingness to interact, there are significant differences in gender and/or religion in satisfaction, equity, intercultural attitudes, and collaboration.

This study aimed to explore the strengths and weaknesses of e-learning during the COVID-19 pandemic from the perspective of its primary stakeholders, namely professors and students, and to provide practical solutions. Design is a qualitative study. We enrolled 22 faculty members and 58 students purposively. Research data were collected through a data collection checklist and via email and continued until the data were saturated. The qualitative content analyses were the basis of analysis in this study. Strengths were presented in 6 themes and 26 subthemes, weaknesses in 5 themes and 23 subthemes, and solutions were presented in 5 themes and 20 subthemes. Save money, time and energy; use modern software and educational technologies; and the ability to individualize education were among the strengths of e-learning. The most important weaknesses related to e-learning include infrastructure difficulties, problems related to the ability of professors and students to use educational systems. The most beneficial solutions offered included improving and upgrading the e-learning infrastructure, empowering professors and students to use educational systems. We concluded that using online teaching has many strengths as well as some weaknesses. Identifying these strengths and weaknesses can help policymakers plan better.

The limited capabilities of teaching laboratories, combined with an increasing number of students enrolled in university, require constant augmentation of instructional approaches. By enhancing laboratory demonstrations with digital technology, these structural issues can be addressed while at the same time enhancing student understanding and learning. Our case study focuses on the fermentation lab part of the Reaction Equilibria and Thermodynamics (RET) module, a first-year chemical engineering course at the University of Birmingham. Video demonstrations were used to introduce students to the laboratory set-ups and walk them through each step and technique. The video demonstrations allowed the students to attend the in-person lab sessions having established knowledge and understanding of the processes involved and the outcomes desired, which decreased the burden on the facilities and the staff. A knowledge-based quiz and a student survey conducted at the end of the module showed that the pre-lab videos encouraged more active participation in the laboratory sessions and reinforced learning. Approximately 70% of the students polled in the first survey conducted within this project felt more confident going into the laboratory sessions after watching the pre-lab videos and attempting the knowledge quiz, while 92% of the students polled in the second survey judged the pre-lab video sessions as beneficial to them. Overall, the teaching method has the potential to improve student participation and access, boost confidence and learning, and provided a more structured and flexible approach to laboratory learning outcomes.

In this paper, we reveal and describe the context in which education policy networks in Israel have expanded recently, given the evolving interdependent relationships among the actors involved. We draw upon resource dependence theory, which assumes that actors' power relations within a network depends on their own and others' perceptions of the dependency relations among the different actors in the network. Policy documents and committee reports were identified and analyzed qualitatively, alongside transcripts of semi-structured, in-depth interviews conducted with stakeholders in Israeli education policy. We identified significant changes regarding which stakeholders take initiative for policy-making and implementation processes in Israeli education. We related these changes to the dynamics of resource dependence relationships among actors. In addition, we revealed a new stage in the evolution of educational governance in Israel -- a transition from intersectoral collaboration within a top-down policy process defined and led by the Ministry of Education to a situation in which policy networks including non-governmental stakeholders initiate and subsequently lead many education policy processes. At this new stage, certain non-state actors increased their power, presence, and influence over Israeli education policy and can thus shape existing policies by leveraging their perceived control over a range of resources.

Israelis consistently secure European Research Council (ERC) grant funding at higher success rates compared to peers from most participating countries. Israeli scores in the ERC metric within the Adjusted Research Excellence Index (AREI) have been significantly above average and double those of the next highest (Switzerland) -- yet on other AREI indicators, including publication and mobility measures, Israel has scored only modestly. Since governmental funding mechanisms in Israeli higher education are heavily weighted to reward institutions for securing external funding, competition between Israeli institutions is intense. This study seeks to understand how various actors in the Israeli system position themselves within their field, and how they navigate and negotiate their positions framed by various disciplinary, institutional, and national pressures. To explore this question, this study uses 43 interviews with stakeholders within the higher education system (including policy makers, senior administrators, and grant winning academics) and documents' analysis to present the perceptions and strategies of actors at all levels of the Israeli academic research system, using Bourdieu's field theory. We show that the national academic habitus regards grantsmanship as cultural capital and grant attainment as symbolic capital. We highlight differences between the humanities, social, life, and physical/engineering sciences in their perceptions and strategies around external funding.

We examined perceptions of precarity in higher education by conducting interviews with a cohort of academics in Israel. The participants were 1.5 generation immigrants who were born in the former Soviet Union (FSU) and then moved to Israel as children or teenagers with their family, typically in the 1990s. Using a narrative research approach, we examined the personal perceptions of 43 academics employed at colleges and universities in Israel. Despite differences in their employment status and contract conditions, our findings made clear that all the academics in our cohort had experienced employment precarity. Using a Bourdieusian framework, we attribute Israeli academic precarity to a deficiency in the cultural and social capital necessary for establishing relevance. Although they had been relatively successful in integrating into Israeli society, and had decades of living within it, our interviewees from all types of academic institutions reported feelings and experiences of extreme precarity. This precarity was ascribed by interviewees to the structure of the Israeli higher education market, which is characterized by an unstable, hyper-competitive, and neoliberal environment, leaving minority groups employed within it particularly vulnerable.

Students' perceptions of assessment in higher education (HE) are critical, since such perceptions can enhance or diminish student motivation for learning. Despite this, research on students' perceptions of assessment in HE is scarce. To initiate a new agenda in this area, the present study explored Iranian doctoral students' (N = 16) perceptions of assessment and their emotional/behavioral reactions towards assessment. Qualitative data were collected and analyzed using a phenomenological approach. The overall findings indicated that students' perceptions of assessment: (a) predominantly centered on unethical issues, (b) evoked some negative emotional but not behavioral reactions towards such perceived unethical assessment, and (c) were mostly summative-oriented. Specifically, based on the findings, a tripartite, local model of assessment was generated highlighting that unethical assessment is relevant to assessment, instructional, and micro-political (power) issues. In the light of these findings, this study may add a new conceptualization of assessment ethics to the literature and highlights the inclusion of training courses on ethics principles across HE professional development programs in Iran and elsewhere.