Search

Coccidioidomycosis is an important fungal disease that is found in many desert regions of the western hemisphere. The inhaled organisms are highly pathogenic, but only half of infected, immunologically intact people develop symptomatic pneumonia; most symptomatic infections resolve spontaneously, although some resolve very slowly. Furthermore, second infections are very rare and natural immunity after infection is robust. Therefore, the host response to this organism is very effective at resolving the infection in most cases and immunizing to prevent second infections. People who are immunocompromised are much more likely to develop disseminated infection. This is a comprehensive review of the innate and acquired immune responses to Coccidioides spp., the genetics of resistance to severe infection, and the search for an effective vaccine.

Background: Previous research has examined the use of augmented reality (AR) and virtual reality (VR) in English language teaching. However, to the best of our knowledge, none of the earlier studies that investigated integrating AR and VR "wearables" into teaching and learning English based on the attention, relevance, confidence, and satisfaction (ARCS) motivation model compared the differences in learning motivation and performance between traditional teaching methods and those using AR- and VR-based using wearables. Objectives: To create a thematic learning environment based on learners' lived experiences and provide them with an immersive English course that extends textbook knowledge using a technology-assisted real-life learning context. Method: This study used a quasi-experimental research design. A total of 119 participants were spilt into three learning groups based on teaching tools: traditional methods and AR- and VR-based wearable devices. The performance of each group was evaluated through three stages using appropriate educational tools for traditional, AR-, and VR-based classrooms, followed by semistructured interviews. Multiple regression analysis was conducted to investigate the inference learning performance (remembering and analysing) of the four ARCS dimensions with the three teaching methods. Results: The results showed that confidence and relevance were positively correlated with learning performance in the VR-based wearable group. In the context of the ARCS model, learners' confidence predicted learning performance and the remembering subdimension when VR-based learning materials were used. Implications: These results suggest that, compared to traditional teaching methods, VR-based wearables make it easier to create a highly immersive learning environment and are more likely to help learners find the correct words, improve their accuracy, and increase their confidence and sense of accomplishment in the entire learning process.

Studies have highlighted the possible advantages of tangible user interfaces (TUIs) over multitouch interfaces (MTIs) in preschool education; however, more objective evidence is required to establish the superiority of TUIs. In this article, we design a mathematical application called THE NUMBERS to compare preschool children's learning potential and employed the eye-tracking method to assess the cognitive differences between the TUI and MTI versions. The results demonstrate that the TUI version participants made more attempts in the task, which was a significant predictor of learning outcomes. Furthermore, using TUIs leads to lower cognitive load, increases attention on key areas, and provides higher entertainment value, which has long-term effects on promoting preschool children's learning. The results of the perception questionnaire show that the TUI version is easier to use, more interesting, and more motivating for them to learn mathematics than the MTI version is. On the other hand, the interview results show that 62.5% of students prefer to use the TUI version to learn mathematics. The results can provide educators with a deeper understanding of the mental characteristics involved in MTIs and TUIs to enable them to design educational applications that are more suitable for preschool children.

BackgroundHealth care avoidance in the COVID-19 pandemic has been widely reported. Yet few studies have investigated the dynamics of hospital avoidance behavior during pandemic waves and inferred its impact on excess non–COVID-19 deaths. ObjectiveThis study aimed to measure the impact of hospital avoidance on excess non–COVID-19 deaths in public hospitals in Hong Kong. MethodsThis was a retrospective cohort study involving 11,966,786 patients examined between January 1, 2016, and December 31, 2021, in Hong Kong. All data were linked to service, treatment, and outcomes. To estimate excess mortality, the 2-stage least squares method was used with daily tallies of emergency department (ED) visits and 28-day mortality. Records for older people were categorized by long-term care (LTC) home status, and comorbidities were used to explain the demographic and clinical attributes of excess 28-day mortality. The primary outcome was actual excess death in 2020 and 2021. The 2-stage least squares method was used to estimate the daily excess 28-day mortality by daily reduced visits. ResultsCompared with the prepandemic (2016-2019) average, there was a reduction in total ED visits in 2020 of 25.4% (548,116/2,142,609). During the same period, the 28-day mortality of non–COVID-19 ED deaths increased by 7.82% (2689/34,370) compared with 2016-2019. The actual excess deaths in 2020 and 2021 were 3143 and 4013, respectively. The estimated total excess non–COVID-19 28-day deaths among older people in 2020 to 2021 were 1958 (95% CI 1100-2820; no time lag). Deaths on arrival (DOAs) or deaths before arrival (DBAs) increased by 33.6% (1457/4336) in 2020, while non–DOA/DBAs increased only by a moderate 4.97% (1202/24,204). In both types of deaths, the increases were higher during wave periods than in nonwave periods. Moreover, non-LTC patients saw a greater reduction in ED visits than LTC patients across all waves, by more than 10% (non-LTC: 93,896/363,879, 25.8%; LTC: 7,956/67,090, 11.9%). Most of the comorbidity subsets demonstrated an annualized reduction in visits in 2020. Renal diseases and severe liver diseases saw notable increases in deaths. ConclusionsWe demonstrated a statistical method to estimate hospital avoidance behavior during a pandemic and quantified the consequent excess 28-day mortality with a focus on older people, who had high frequencies of ED visits and deaths. This study serves as an informed alert and possible investigational guideline for health care professionals for hospital avoidance behavior and its consequences.

Coccidioides immitis and posadasii are closely related fungal species that cause coccidioidomycosis. These dimorphic organisms cause disease in immunocompetent as well as immunocompromised individuals and as much as 40% of the population is infected in the endemic area. Although most infections resolve spontaneously, the infection can be prolonged and, in some instances, fatal. Coccidioides has been studied for more than 100 years and many aspects of the organism and the disease it causes have been investigated. There are over 500 manuscripts concerning Coccidioides (excluding clinical articles) referenced in PubMed over the past 50 years, so there is a large body of evidence to review. We reviewed the most accurate and informative basic research studies of these fungi including some seminal older studies as well as an extensive review of current research. This is an attempt to gather the most important basic research studies about this fungus into one publication. To focus this review, we will discuss the mycology of the organism exclusively rather than the studies of the host response or clinical studies. We hope that this review will be a useful resource to those interested in Coccidioides and coccidioidomycosis.

Existing computational thinking (CT) research focuses on programming in K-12 education; however, there are challenges in introducing it into the formal disciplines. Therefore, we propose the introduction of non-programming plugged learning in mathematics to develop students' CT. The research and teaching teams collaborated to develop an instructional design for primary school students. The participants were 112 third- and fourth-grade students (aged 9-10) who took part in three rounds of experiments. In this paper, we present an iterative problem-solving process in design-based implementation research, focusing on the implementation issues that lead to the design principles in the mathematics classroom. The computational tasks, environment, tools, and practices were iteratively improved over three rounds to incorporate CT effectively into mathematics. Results from the CT questionnaire demonstrated that the new program could significantly improve students' CT abilities and compound thinking. The results of the post-test revealed that CT, including the sub-dimensions of decomposition, algorithmic thinking, and problem-solving improved threefold compared to the pre-test between the three rounds, indicating that strengthened CT design enhanced CT perceptions. Similarly, the students' and teacher' interviews confirmed their positive experiences with CT. Based on empirical research, we summarize design characteristics from computational tasks, computational environment and tools, and computational practices and propose design principles. We demonstrate the potential of non-programming plugged learning for developing primary school students' CT in mathematics.

The citizenship curriculum used in Taiwan during the authoritarian period from 1949 to 1987 sacrificed the individual for the national interest as a tool for political socialisation. In the wake of democratisation since 1987, the curriculum has gradually been stripped of its nationalist overtones which were designed to foster 'informed citizens' to facilitate those in power. The increased stress on the reflective and critical capabilities of the individual reminds pupils to examine their positions and roles in society instead of mechanistically accepting the existing social structure. This article sheds light on the intricate internal-external power relationships and differing views on critical pedagogy among curriculum designers. Interviewed curriculum designers hold that pluralistic ideologies should be presented in the curriculum and then room should be left for students to deliberate or judge for themselves. As the gatekeepers tasked with deciding which information to include and being faced with the intervention of numerous internal and external forces, the Curriculum Committee sided with the critical theory and aimed to break the unreflective social reproduction.

Engaging students as pedagogical partners aspires to reposition students with more agency within universities as egalitarian learning communities. The growing literature reports numerous beneficial outcomes of such positioning, yet many partnership opportunities are limited to small numbers of selected students in extra-curricular, quality-assurance efforts. Understanding how partnership can reach into the classroom space affords opportunities to expand both practices to more students and theorisations of partnership beyond the extra-curricular realm. Our study investigates how final-year undergraduate students experienced the shift toward partnership in the classroom. Thematic analysis of focus group conversations surfaced four interrelated themes that shared many similarities with existing literature, yet diverged in regards to the central place of conflict students navigated as power dynamics shifted. Conflict manifested as both internal (within individual students) and interpersonal (among students and between students and the teacher). We argue for deeper attention to conflict, including its generative potential, in partnership practices.

The new Taiwanese citizenship curriculum has converted its traditional bullet-point guidelines to hundreds of open-ended questions. Each question acts to initiate collective inquiry, to stimulate the sharing of lived experiences and to trigger within-class conversations. The previous pre-determined educational objectives and learning outcomes, in line with the Tyler Rationale, have been replaced by the process model. This Taiwanese case aims to prove that the process model, which emerged in the 1970s, remains relevant and applicable to current curriculum construction and this revived version may bring new perspectives to the scholarship on curriculum development. Based on interviews with fifteen curriculum developers, this article reveals the thinking behind the curriculum transformation and shows how the creation of such new guidelines is more attentive to students' personal experiences and diverse views, and facilitates mutual understanding, conversations and the possible reaching of consensus. This approach also attracts less controversy or opposition while still managing to touch upon sensitive social topics in the curriculum. Meanwhile, the 'Social Inquiry Method' has also been integrated into Taiwan's new curriculum to ensure question-based guidelines can bring about reforms to actual classroom practice, despite concerns regarding the required re-training of teachers and the ingrained exam-driven culture.

Training needs reassessment at times requires extra time and effort in asking questions, doing surveys, or doing interviews. By extracting themes and key concepts from trainees' online narrative feedback after training, this research explored a mixed way of human and computational analysis on trainees' perception of training deficiencies to weave individual narrative feedback as supplementary features into a semantic knowledge map of training needs. The case study was conducted in an international company with over 100000 employees at dispersed locations. This research provides a method for any specific companies with unique characteristics to construct a dynamic knowledge map, leading to a possible automatic improvement of the training program.