Can virtual reality improve dyslexic English students’ reading fluency and their emotional valence towards reading?

Abstract. The purpose of this master’s thesis is to compare whether a text read in a virtual environment improves the reading of English students with dyslexia in terms of fluency compared with a text laid and read on a piece of paper. Furthermore, another interest of this study is to identify how the participants’ emotional valence was aroused while reading. This master’s thesis is done with the help of Lyfta Oy, an EdTech learning company focused on 360º photos and VR learning environment. Moreover, the thesis design is based on a Lyfta’s workshops, were one the participants read an entire passage in VR without difficulties being dyslexic. Two research questions are aimed to be answered during this research: (1) Is there a difference in fluency between reading in virtual reality (VR) and on a piece of paper? And (2) How positive and negative emotions were empathized while reading? The study was carried out in the UK, were 23 Year 7, 8 and 9 students took part of the data collection. During this face, the participants were asked to read two short passages, one in VR and the other on a piece of paper, being video recorded and, they were asked to fill in two questionnaires about their emotions while reading both texts. Afterwards, the number of errors, words read per minute and prosody were quantified based on the videos, to analyze the participants’ fluency (which comprises three elements: (1) accuracy, (2) rate and (3) prosody) and to answer the first research question. The results suggested that there is not enough data to draw statistical difference between VR and paper. To answer the second research question, the questionnaires’ answers were analyzed. The results suggested that there is a statistical difference in terms of prosody and emotional valence between VR and paper. This study could have some implications in school children having dyslexia, since it might boost positive emotional valence and hence boost their motivation to practice their reading skills. Moreover, educational companies might find a motivation to research more in depth in some aspects of this research and create educational products that can beneficiate dyslexic students’ academic achievement. Also, this research could not only have an impact in dyslexic students, but in general education and other students, since the current master’s thesis continues investigating and analyzing issues that are important in the school days and everyday life of students, such as the role of emotions in the classroom and how VR can affect their emotional valence

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030