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Introduction Dry mouth is a subjective symptom of the feeling of dehydration inside of the mouth and is closely linked to reduced salivary secretion. The occurrence of dry mouth and GI disorders due to antidepressants greatly affects the course of the mental disorder and medication compliance, but it has barely ever been studied. Objectives The purpose of this study was to identify the characteristics of dry mouth and gastrointestinal (GI) disorders in antidepressant patients. Methods The study included 103 antidepressant-taking patients. Antidepressants were classified according to their mode of action. The GI disorders were investigated using the medical records of the patients. The Patient Health Questionnaire-15 and a questionnaire for assessing dry mouth symptoms were used in this study. The questionnaire for the evaluation of dry mouth symptoms, a visual analog scale (VAS)–based instrument, developed and evaluated for reliability by Lee et al. was used to assess dry mouth. In the questionnaire, 6 VAS items were assessed for the extent of dry mouth (0-100 points) : 1) dry mouth at night or when waking up in the morning, 2) dry mouth during the day, 3) dry mouth when eating, 4) difficulty in swallowing, 5) subjective evaluation of the volume of saliva in the mouth, and 6) overall discomfort in daily life. Additionally, four items examined behaviors due to dry mouth (1-5points) : 1) frequency of waking up from sleep due to dry mouth, 2) frequency of preparing drinking water before going to bed, 3) frequency of drinking water when eating solid foods, and 4) frequency of eating hard candies or chewing gums to help dry mouth. Results The score for “overall discomfort due to dry mouth in daily life” (31.72±33.82), “dry mouth at night or in the morning” (47.86±35.87), and “dry mouth during the day” (39.83±31.67) were slightly higher than “discomfort in chewing or swallowing foods”. According to somatization severity, the mean values were 116.36±113.34 in the mild, 213.18±136.98 in the moderate, and 277.59±201.44 in the severe, the between-group difference was significant (F=10.294, p

This study provides an overview of the fundamental statistics and features of the El Niño–Southern Oscillation (ENSO) in the historical simulations of the Taiwan Earth System Model version 1 (TaiESM1). Compared with observations, TaiESM1 can reproduce the fundamental features of observed ENSO signals, including seasonal phasing, thermocline coupling with winds, and atmospheric teleconnection during El Niño events. However, its ENSO response is approximately 2 times stronger than observed in the spectrum, resulting in powerful teleconnection signals. The composite of El Niño events shows a strong westerly anomaly extending fast to the eastern Pacific in the initial stage in March, April, and May, initiating a warm sea surface temperature anomaly (SSTA) there. This warm SSTA is maintained through September, October, and November (SON) and gradually diminishes after peaking in December. Analysis of wind stress–SST and heat flux–SST coupling indicates that biased positive SST–shortwave feedback significantly contributes to the strong warm anomaly over the eastern Pacific, especially in SON. Our analysis demonstrates TaiESM1's capability to simulate ENSO – a significant tropical climate variation on interannual scales with strong global impacts – and provides insights into mechanisms in TaiESM1 related to ENSO biases, laying the foundation for future model development to reduce uncertainties in TaiESM1 and climate models in general.

Introduction According to the psychodynamic hypothesis in FGIDs, as well, UGIDs such as functional heartburn (FH) and functional dyspepsia (FD) are often a consequence of receiving inadequate nutrition from one’s mother during childhood, which leads to a failure to adapt to eating. Meanwhile, lower GI disorders such as IBS and functional constipation are generally accompanied by avoidant defense mechanisms and obsessive compulsive disorder. Objectives This study aimed to identify the differences in the psychological characteristics of the anatomical location of functional gastrointestinal disorders (FGIDs) and the factors that influence the quality of life (QOL). Methods Altogether, 233 patients who were diagnosed with FGIDs were classified into the upper gastrointestinal disorder (UGID; n=175) group and the lower gastrointestinal disorder group (LGID; n=58). Psychological characteristics were identified using the Korean version of the Beck Depression Inventory 2nd ed.; Korean version of the Beck Anxiety Inventory; Korean version of Childhood Trauma Questionnaire; Multi-dimensional Scale of Perceived Social Support; Korean version of Type-D Personality Scale-14; and Korean version of the Connor–Davidson Resilience Scale. QOL was evaluated using the World Health Organization Quality of Life - Brief Version. Results The UGID group demonstrated higher scores in ‘emotional’ than the LGID group. (t=-3.031, p

This paper presents a study of haze in Singapore caused by biomass burning in Southeast Asia over the 6-year period from 2010 to 2015, using the Numerical Atmospheric-dispersion Modelling Environment (NAME), which is a Lagrangian dispersion model. The major contributing source regions to the haze are identified using forwards and backwards model simulations of particulate matter.The coincidence of relatively strong southeast monsoonal winds with increased biomass burning activities in the Maritime Continent create the main Singapore haze season from August to October (ASO), which brings particulate matter from varying source regions to Singapore. Five regions are identified as the dominating sources of pollution during recent haze seasons: Riau, Peninsular Malaysia, South Sumatra, and Central and West Kalimantan. In contrast, off-season haze episodes in Singapore are characterised by unusual weather conditions, ideal for biomass burning, and contributions dominated by a single source region (different for each event). The two most recent off-season haze events in mid-2013 and early 2014 have different source regions, which differ from the major contributing source regions for the haze season. These results challenge the current popular assumption that haze in Singapore is dominated by emissions/burning from only Indonesia. For example, it is shown that Peninsular Malaysia is a large source for the Maritime Continent off-season biomass burning impact on Singapore.The results demonstrate that haze in Singapore varies across year, season, and location and is influenced by local and regional weather, climate, and regional burning. Differences in haze concentrations and variation in the relative contributions from the various source regions are seen between monitoring stations across Singapore, on a seasonal as well as on an inter-annual timescale. This study shows that even across small scales, such as in Singapore, variation in local meteorology can impact concentrations of particulate matter significantly, and it emphasises the importance of the scale of modelling both spatially and temporally.

Teachers' well-being and self-efficacy are two important factors linked to quality education. Recent research examining their bidirectionality has revealed inconsistent findings, while those examining the relationships among pre-service and in-service teachers are scarce. This study investigates the reciprocal relationships between teachers' well-being and self-efficacy in a sample of Hong Kong early childhood education teachers. Participants were 155 pre-service (n = 77) and in-service (n = 78) teachers (M[subscript age] = 23.97, SD = 4.46, female = 92.9%). Participants reported their teachers' well-being (PERMA model including positive emotion, engagement, relationship, meaning, and accomplishment) and teachers' self-efficacy at two-time points. The results from the cross-lagged panel model revealed that teachers' self-efficacy at baseline significantly predicted all aspects of prospective well-being except for engagement. In contrast, none of the teachers' well-being components significantly predicted later teachers' self-efficacy, except for accomplishment. The associations between teachers' self-efficacy and well-being were invariant across pre-service and in-service teachers. The results underscored the importance of teachers' self-efficacy in facilitating teachers' well-being. The findings also highlight the utility of intervention efforts targeting teachers' self-efficacy and well-being, especially in promoting teachers' accomplishment, at an early stage of their careers.

The impact of global ENSO on the regional monsoon onset over the Maritime Continent is examined, using satellite-derived scatterometer surface winds over the sea channel from the South China Sea, through the Karimata Strait into the Java Sea. An index of monsoon onset, fracsign, is defined based on a positive dot-product between the monthly wind at each gridpoint and the "basis-wind" or climatological wind at the peak of the relevant monsoon season.Rather than being delayed throughout the Maritime Continent during El Niño years, the monsoon is seen to arrive faster at and remain longer over the western Maritime Continent, and therefore delayed for the eastern Maritime Continent. The wind-based diagnostic can be further decomposed into two components that reflect the monsoon wind strength and the location of the wind convergence zone, respectively. During El Niño years, the monsoon strength post-onset is weaker than normal over the eastern maritime continent. However, there is no ENSO-related differentiation in monsoon strength post-onset over the western Maritime Continent.

A text recommendation system helps language learners find suitable reading materials. Similar to graded readers, most systems assign difficulty levels or school grades to the documents in their database, and then identify the documents that best match the language proficiency of the learner. This graded approach has two main limitations. First, the common grade scale assumes that all learners find the same words difficult, ignoring different orders in vocabulary acquisition. Second, it cannot cater to the incremental vocabulary expansion typical of language learners, since discrete grades do not facilitate fine-grained adaptation in text recommendation. This article evaluates a personalized and adaptive method for text recommendation that aims to mitigate these limitations. This method recommends documents according to the new-word density preferred by the user. It estimates a document's new-word density with an open learner model that predicts the user's vocabulary knowledge. Users can dynamically update the learner model as they acquire new vocabulary. We conducted a user study involving ten learners of Chinese as a foreign language. Results shows that this method can estimate the learner model at 77.6% accuracy, outperforming the graded approach. Further, a user simulation demonstrates that it can recommend documents within 0.22% of the target new-word density, satisfying user preferences more accurately than the graded approach.

This study investigated the cross-sectional relationships between reading-related affective and cognitive factors and reading skills among adolescents with and without dyslexia. Participants were 120 Chinese-speaking eighth graders, including 60 adolescents with dyslexia and 60 typically developing adolescents from Hong Kong, China. Adolescents completed questionnaires on general anxiety, reading anxiety, and reading self-concept. They were also assessed on measures of rapid digit naming, verbal working memory, word reading, reading fluency, and reading comprehension. The results showed that readers with dyslexia reported higher levels of general anxiety and reading anxiety and lower levels of reading self-concept than typical readers. They also showed difficulties in rapid digit naming and verbal working memory. Importantly, controlling for rapid digit naming and verbal working memory, reading self-concept was uniquely associated with word reading and reading fluency for readers with and without dyslexia. Furthermore, reading anxiety and reading self-concept were uniquely associated with reading comprehension for the two groups of readers. The findings point to the importance of considering affective factors when examining the reading skills of Chinese readers and the utility of targeting these factors when supporting the learning of adolescents with and without dyslexia.

To develop an in-depth understanding of the natural dynamics of the Indo-Pacific Warm Pool (IPWP) during the last deglaciation, stacked north- (N-) and south-IPWP (S-IPWP) thermal and hydrological records over the past 23–10.5 ka were built using planktonic foraminiferal geochemistry data from a new core, MD05-2925 (9.3° S, 151.5° E water depth 1661 m) in the Solomon Sea and eleven previous sites. Ice-volume-corrected seawater δ18O (δ18OSW-IVC) stacks show that S-IPWP δ18OSW-IVC values are indistinguishable from their northern counterparts through glacial time. The N-IPWP SST (sea surface temperature) stacked record features an increasing trend of 0.5 °C ka−1 since 18 ka. Its S-IPWP counterpart shows an earlier onset of temperature increase at 19 ka and a strong teleconnection to high-latitude climate in the Southern Hemisphere. Meridional SST gradients between the N- and S-IPWP were 1–1.5 °C during the Bølling/Allerød period and 1 °C during both Heinrich event 1 and the Younger Dryas, due to a warmer S-IPWP. A warm S-IPWP during the cold events could weaken the southern hemispheric branch of the Hadley cell and reduce precipitation in the Asian monsoon region.

The orbital-timescale dynamics of the Quaternary Asian summer monsoons (ASM) are frequently attributed to precession-dominated northern hemispheric summer insolation. However, this long-term continuous ASM variability is inferred primarily from oxygen isotope records of stalagmites, mainly from Sanbao cave in mainland China, and may not provide a comprehensive picture of ASM evolution. A new spliced stalagmite oxygen isotope record from Yangkou cave tracks summer monsoon precipitation variation from 124 to 206 thousand years ago in Chongqing, southwest China. Our Yangkou record supports that the evolution of ASM was dominated by the North Hemisphere solar insolation on orbital timescales. When superimposed on the Sanbao record, the precipitation time series referred from Yangkou cave stalagmites supports the strong ASM periods at marine isotope stages (MIS) 6.3, 6.5, and 7.1 and weak ASM intervals at MIS 6.2, 6.4, and 7.0. This consistency confirms that ASM events affected most of mainland China. Except for the solar insolation forcing, the large amplitude of minimum δ18O values in Yangkou record during glacial period, such as MIS 6.5, could stem from the enhanced prevailing Pacific trade wind and/or continental shelf exposure in the Indo–Pacific warm pool.

Background: Thoracoscopic surgery has become very popular in recent years. Conventional thoracoscopic surgery requires three or more port wounds for manipulations of endoscopic instruments. For complicated cancer surgery, more port wounds and a larger thoracotomy wound may be required due to technical reasons. We want to investigate the effectiveness of single-port thoracoscopic approach in elective thoracoscopic surgery for thoracic disease. Materials and methods: From July 1st, 2010 to March 31, 2011, 90 consecutive patients underwent general thoracoscopic surgery performed by the same thoracic surgeon. Two patients with severe trauma and massive bleeding were excluded from the study. All patients included had thoracoscopic surgery with a single-port approach. The surgical outcomes, complications, mortality and conversion rates were recorded and analyzed. Results: A total of 88 patients were included in this study. All these patients were operated on by the same surgeon. For sixty-eight patients, the single-port thoracoscopic approach was used. Nineteen patients were changed to a two-port thoracoscopic approach and one patient's was changed to mini-thoracotomy. Two patients died from terminal lung cancer and severe mitral regurgitation. Complications occurred in six cases. Eighty-seven patients (98.8%) were effectively managed with either single-port or a two-port approach. Only one patient was managed by mini-thoracotomy. Conclusion: Elective thoracoscopic surgery performed through a single-port wound is feasible. Single-incisional thoracoscopic surgery can be safely applied as a first-line approach in most cases of elective thoracoscopic procedures. Resumo: Introdução: A cirurgia toracoscópica tornou-se muito popular nos últimos anos. A cirurgia toracoscópica convencional requer três ou mais incisões para manipulação dos instrumentos endoscópicos. Para cirurgias de cancro complicadas, podem ser requeridas mais incisões e uma incisão toracotomia maior, por razões técnicas. Pretendemos investigar a eficácia da abordagem toracoscópica de incisão única em cirurgias toracoscópica eletivas. Materiais e métodos: Desde 1 de julho de 2010 até 31 de março de 2011, 90 pacientes consecutivos foram submetidos a cirurgia toracoscópica geral realizada pelo mesmo cirurgião torácico. Dois pacientes com trauma grave e hemorragia massiva foram excluídos do estudo. Todos os pacientes incluídos foram submetidos a cirurgia toracoscópica com uma abordagem de incisão única. Os resultados cirúrgicos, complicações, mortalidade e taxas de conversão foram registados e analisados. Resultados: Um total de 88 pacientes foram incluídos neste estudo. Todos estes pacientes foram operados pelo mesmo cirurgião. Para sessenta e oito pacientes, foi usada a abordagem de incisão única torácica. Dezanove pacientes foram convertidos para uma abordagem dupla porta e um paciente convertido em mini-toracotomia. Dois pacientes morreram de cancro do pulmão terminal e regurgitação mitral grave. Ocorreram complicações em seis casos. Oitenta e sete pacientes (98,8%) foram tratados eficazmente com uma abordagem de incisão única ou de incisão dupla. Apenas um paciente foi tratado por mini-toracotomia. Conclusão: A cirurgia toracoscópica eletiva realizada através de incisão única é viável. A cirurgia toracoscópica de incisão única pode ser aplicada em segurança como uma abordagem de primeira linha na maioria dos casos de procedimentos toracoscópicos eletivos. Keywords: Thoracoscopy, Video-assisted thoracic surgery, Single-incisional endoscopic Surgery, Palavras-chave: Torascopia, Cirurgia toracoscópica video-assistida, Cirurgia Endoscópica de incisão única

The pattern of evaporative sources and the direction of the large-scale circulation over the Indian Ocean during the boreal summer raises the question of whether atmospheric conditions in Australia could influence conditions over the Indian subcontinent, despite the long passage of air over the Indian Ocean. The authors propose that such an influence is sometimes possible when there is unusually low temperature over inland Australia during the austral winter, through the mechanism where such a temperature extreme enhances evaporation rate over the eastern tropical Indian Ocean and hence enhances rainfall over two regions in western India after 13–19 days. Results from trajectory calculations indicate that such an influence is mechanistically feasible, with air of Australian origin contributing 0.5–1.5% of the climatological net precipitation for monsoon seasonal rainfall over western India. Statistics performed on reanalysis, satellite and in situ data are consistent with such a mechanism. Since extreme winter temperature in Australia is often associated with cold-air outbreaks, the described mechanism may be an example of how southern hemispheric mid-latitude weather can influence northern hemispheric monsoon rainfall. Further study is recommended through modelling and comparison with various known causes of atmospheric variability to confirm the existence of such a mechanism and determine the extent of its influence during specific low temperature episodes.

Pleistocene benthic δ18O records exhibit strong spectral power at ~41 kyr, indicating that global ice volume has been modulated by Earth's axial tilt. This feature, and weak spectral power in the precessional band, has been attributed to the influence of obliquity on mean annual and seasonal insolation gradients at high latitudes. In this study, we use a coupled ocean-atmosphere general circulation model to quantify changes in continental snowfall associated with mean annual and seasonal insolation forcing due to a change in obliquity. Our model results indicate that insolation changes associated with a decrease in obliquity amplify continental snowfall in three ways: (1) Local reductions in air temperature enhance precipitation as snowfall. (2) An intensification of the winter meridional insolation gradient strengthens zonal circulation (e.g. the Aleutian low), promoting greater vapor transport from ocean to land and snow precipitation. (3) An increase in the summer meridional insolation gradient enhances summer eddy activity, increasing vapor transport to high-latitude regions. In our experiments, a decrease in obliquity leads to an annual snowfall increase of 25.0 cm; just over one-half of this response (14.1 cm) is attributed to seasonal changes in insolation. Our results indicate that the role of insolation gradients is important in amplifying the relatively weak insolation forcing due to a change in obliquity. Nonetheless, the total snowfall response to obliquity is similar to that due to a shift in Earth's precession, suggesting that obliquity forcing alone can not account for the spectral characteristics of the ice-volume record.

We report the photometric properties in BVR bands for the resolved bright supergiant stars in the dwarf galaxy Holmberg II. The color-magnitude diagrams and color-color diagram of 374 resolved stars indicate that the majority of the member stars are supergiant stars with a wide range of spectral type between B-K. A comparison with theoretical evolutionary tracks indicates that the supergiant stars in the observed field have progenitor masses between ~10M_⨀ and 20M_⨀. The exponent of luminosity function in V is in good agreement with those of the Small and Large Magellanic Clouds.

Abstract While hypertension is widely recognized as a risk factor for dementia, few observational studies and clinical trials fully accounted for the effect of age on blood pressure (BP) changes prior to dementia onset. In this territory-wide population-based longitudinal study of 16,591 community-living dementia-free older adults, we followed their BP and cognitive status and tested if loss of longitudinal increase in BP in late life was associated with higher dementia risk in 6 years, with consideration of the confounding effects of hypertension, hypotension, BP variability, and other health problems and behaviours and, in the data analysis, exclusion of individuals who developed dementia within 3 years after baseline to minimize risk of reverse causality. Over 72,997 person-years of follow-up, 1429 participants developed dementia. We found that loss of longitudinal increase in systolic BP (defined as SBP increased by either

Abstract Like other soft-bodied organisms, ctenophores (comb jellies) produce fossils only under exceptional taphonomic conditions. Here, we present the first record of a Late Devonian ctenophore from the Escuminac Formation from Miguasha in eastern Canada. Based on the 18-fold symmetry of this disc-shaped fossil, we assign it to the total-group Ctenophora. Our phylogenetic analyses suggest that the new taxon Daihuoides jakobvintheri gen. et sp. nov. falls near Cambrian stem ctenophores such as ‘dinomischids’ and 'scleroctenophorans'. Accordingly, Daihuoides is a Lazarus-taxon, which post-dates its older relatives by over 140 million years, and overlaps temporally with modern ctenophores, whose oldest representatives are known from the Early Devonian. Our analyses also indicate that the fossil record of ctenophores does not provide strong evidence for or against the phylogenomic hypothesis that ctenophores are sister to all other metazoans.

Abstract Background Although existing studies have described patterns of social media use in healthcare, most are focused on health professionals in one discipline. Population health requires a multi-disciplinary approach to ensure diversity and to include diverse stakeholders. To date, what is known about using social media in population health is focused on its potential as a communication tool. This study aims to investigate patterns of use and perceived value of social media usage among stakeholders in population health practice, policy, or research. Methods We conducted a web-based survey of delegates attending the Singapore Population Health Conversations and Workshop. We designed a 24-item questionnaire to assess 1) social media use in terms of type of platform and frequency of use; 2) perceptions of social media relevance and impact on population health; and 3) top three areas in population health that would benefit from social media. We used descriptive and logistic regression analyses to assess the relationships between variables. Results Of the 308 survey respondents, 97.7% reported that they use social media in some form. Messaging (96.8%) was the most dominant activity when using social media. Challenges in implementing social media for population health were time investment by health care professionals (56.2%) and patient adoption (52.9%). The top three population health areas that would benefit most from using social media were the promotion of healthy behaviors (60.7%), community engagement (47.7%), and preventive care (40.6%). Older respondents (> = 40 years) were less likely to view social media as useful for the promotion of healthy behaviors (OR = 0.34; 95% CI: 0.19–0.60). Non-social/healthcare professionals were more likely to consider social media to be useful for community engagement (OR = 1.74; 95% CI: 1.10–2.76). For preventive care, older respondents (OR = 0.51; 95% CI: 0.32–0.82) and non-social/healthcare professionals were less likely to view social media as useful (OR = 0.61; 95% CI: 0.38–0.97). Conclusions Our findings suggest that it may be important to select the specific care areas that would benefit most from using social media. The time investment needed by population health professionals should be fully addressed in planning to maximize the application and potential value of social media.

Abstract Background The relative influence of diet and phylogeny on snake venom activity is a poorly understood aspect of snake venom evolution. We measured the activity of two enzyme toxin groups – phospholipase A2 (PLA2), and L-amino acid oxidase (LAAO) – in the venom of 39 species of Australian elapids (40% of terrestrial species diversity) and used linear parsimony and BayesTraits to investigate any correlation between enzyme activity and phylogeny or diet. Results PLA2 activity ranged from 0 to 481 nmol/min/mg of venom, and LAAO activity ranged from 0 to 351 nmol/min/mg. Phylogenetic comparative methods, implemented in BayesTraits showed that enzyme activity was strongly correlated with phylogeny, more so for LAAO activity. For example, LAAO activity was absent in both the Vermicella and Pseudonaja/Oxyuranus clade, supporting previously proposed relationships among these disparate taxa. There was no association between broad dietary categories and either enzyme activity. There was strong evidence for faster initial rates of change over evolutionary time for LAAO (delta parameter mean 0.2), but no such pattern in PLA2 (delta parameter mean 0.64). There were some exceptions to the phylogenetic patterns of enzyme activity: different PLA2 activity in the ecologically similar sister-species Denisonia devisi and D. maculata; large inter-specific differences in PLA2 activity in Hoplocephalus and Austrelaps. Conclusions We have shown that phylogeny is a stronger influence on venom enzyme activity than diet for two of the four major enzyme families present in snake venoms. PLA2 and LAAO activities had contrasting evolutionary dynamics with the higher delta value for PLA2 Some species/individuals lacked activity in one protein family suggesting that the loss of single protein family may not incur a significant fitness cost.

Abstract Stacking fault energies (SFE) were determined in additively manufactured (AM) stainless steel (SS 316 L) and equiatomic CrCoNi medium-entropy alloys. AM specimens were fabricated via directed energy deposition and tensile loaded at room temperature. In situ neutron diffraction was performed to obtain a number of faulting-embedded diffraction peaks simultaneously from a set of (hkl) grains during deformation. The peak profiles diffracted from imperfect crystal structures were analyzed to correlate stacking fault probabilities and mean-square lattice strains to the SFE. The result shows that averaged SFEs are 32.8 mJ/m2 for the AM SS 316 L and 15.1 mJ/m2 for the AM CrCoNi alloys. Meanwhile, during deformation, the SFE varies from 46 to 21 mJ/m2 (AM SS 316 L) and 24 to 11 mJ/m2 (AM CrCoNi) from initial to stabilized stages, respectively. The transient SFEs are attributed to the deformation activity changes from dislocation slip to twinning as straining. The twinning deformation substructure and atomic stacking faults were confirmed by electron backscatter diffraction (EBSD) and transmission electron microscopy (TEM). The significant variance of the SFE suggests the critical twinning stress as 830 ± 25 MPa for the AM SS 316 L and 790 ± 40 MPa for AM CrCoNi, respectively.

Objective Abrupt changes in ophthalmology education caused by the COVID-19 pandemic have resulted in novel online curriculum development. The aims of this study were to identify (1) the scope of online curricula implemented both prior to and during the COVID-19 pandemic; (2) perception of educators on these online modalities; and (3) early lessons from online implementation that may guide future curricular planning. Methods Implementation of online curricula was evaluated by using a national online survey of Ophthalmology Directors of Medical Student Education (DMSE) via Qualtrics software. Participants Medical Student Educators of the Association of University Professors of Ophthalmology (AUPO) were surveyed. Results Fifty responses were collected, representing a 64.9% response rate. Prior to the COVID-19 pandemic, 44% of institutions had no online components in their courses, but 78.3% of institutions reported increasing online components in response to the pandemic. Required courses were significantly associated both with having implemented online components before the pandemic and implementing online-only versions of these courses in response to the pandemic. The three most popular modalities used for online teaching were lectures, interactive cases, and problem-based learning, with a median satisfaction of 4.0, 4.32, and 4.35, (out of five) respectively. The least popular modalities used were online teaching of physical exam skills and telemedicine, both with a median satisfaction of 2.5. Median overall educator satisfaction with online teaching was four (out of five). The most common weakness related to online teaching was the lack of effective physical exam skills training. Conclusion Our data demonstrate that most institutions successfully shifted their ophthalmology curriculum to a virtual and online version in response to the COVID-19 pandemic. DMSEs adapted quickly, transitioning in-person clinical courses, and extracurricular activities to online formats. Overall, educator satisfaction with online curricula was high. Integration of online curricula provides the opportunity to enrich institutional curriculums and overcome limitations imposed by decreasing curriculum time. This study reveals an early window into the utilization, strengths, and weaknesses of online ophthalmology education, which can serve as a guiding point to enhance ophthalmology curriculum development.

Abstract Background Palaeognathae is a basal clade within Aves and include the large and flightless ratites and the smaller, volant tinamous. Although much research has been conducted on various aspects of palaeognath morphology, ecology, and evolutionary history, there are still areas which require investigation. This study aimed to fill gaps in our knowledge of the Southern Cassowary, Casuarius casuarius, for which information on the skeletal systems of the syrinx, hyoid and larynx is lacking - despite these structures having been recognised as performing key functional roles associated with vocalisation, respiration and feeding. Previous research into the syrinx and hyoid have also indicated these structures to be valuable for determining evolutionary relationships among neognath taxa, and thus suggest they would also be informative for palaeognath phylogenetic analyses, which still exhibits strong conflict between morphological and molecular trees. Results The morphology of the syrinx, hyoid and larynx of C. casuarius is described from CT scans. The syrinx is of the simple tracheo-bronchial syrinx type, lacking specialised elements such as the pessulus; the hyoid is relatively short with longer ceratobranchials compared to epibranchials; and the larynx is comprised of entirely cartilaginous, standard avian anatomical elements including a concave, basin-like cricoid and fused cricoid wings. As in the larynx, both the syrinx and hyoid lack ossification and all three structures were most similar to Dromaius. We documented substantial variation across palaeognaths in the skeletal character states of the syrinx, hyoid, and larynx, using both the literature and novel observations (e.g. of C. casuarius). Notably, new synapomorphies linking Dinornithiformes and Tinamidae are identified, consistent with the molecular evidence for this clade. These shared morphological character traits include the ossification of the cricoid and arytenoid cartilages, and an additional cranial character, the articulation between the maxillary process of the nasal and the maxilla. Conclusion Syrinx, hyoid and larynx characters of palaeognaths display greater concordance with molecular trees than do other morphological traits. These structures might therefore be less prone to homoplasy related to flightlessness and gigantism, compared to typical morphological traits emphasised in previous phylogenetic studies.

The diverse living Australian lizard fauna contrasts greatly with their limited Oligo-Miocene fossil record. New Oligo-Miocene fossil vertebrates from the Namba Formation (south of Lake Frome, South Australia) were uncovered from multiple expeditions from 2007 to 2018. Abundant disarticulated material of small vertebrates was concentrated in shallow lenses along the palaeolake edges, now exposed on the western of Lake Pinpa also known from Billeroo Creek 2 km northeast. The fossiliferous lens within the Namba Formation hosting the abundant aquatic (such as fish, platypus Obdurodon and waterfowl) and diverse terrestrial (such as possums, dasyuromorphs and scincids) vertebrates and is hereafter recognized as the Fish Lens. The stratigraphic provenance of these deposits in relation to prior finds in the area is also established. A new egerniine scincid taxon Proegernia mikebulli sp. nov. described herein, is based on a near-complete reconstructed mandible, maxilla, premaxilla and pterygoid. Postcranial scincid elements were also recovered with this material, but could not yet be confidently associated with P. mikebulli. This new taxon is recovered as the sister species to P. palankarinnensis, in a tip-dated total-evidence phylogenetic analysis, where both are recovered as stem Australian egerniines. These taxa also help pinpoint the timing of the arrival of scincids to Australia, with egerniines the first radiation to reach the continent.

OBJECTIVE:To investigate junior secondary school students' experiences and perspectives of in-school and out-of-school sport-safety, with a particular focus on the meaning and content that they applied to the motivational and social cognitive factors of sport injury prevention. DESIGN:Focus-group interview. METHOD:Participants were 128 junior secondary school students (Form 1 to Form 3) aged between 12 and 16 years from two secondary schools. We organised focus-group interviews by class (group size = six to nine students). Seventeen groups completed semi-structured interviews regarding their experience, beliefs, and motives for injury prevention in-school and out-of-school. We analysed data by thematic content analysis using a typological approach. RESULTS:Higher order themes (N = 7) including in-school and out-of-school motives and social cognitive factors and associated lower-order themes (N = 16), emerged from the analysis corresponding to constructs from trans-contextual model tenets. CONCLUSIONS:The current study is the first qualitative study to explore junior secondary school students' experience and perspectives on sport injury prevention, using trans-contextual model as a framework for investigation. The findings contribute to a better understanding on their motivational and social cognitive factors in adopting sport injury prevention. The content of the theme behavior also indicated the inadequacy of students' knowledge of effective sport injury prevention techniques, and underscored the importance of sport safety education.