Multiple Courses Research Articles

Web-Based Health Information Seeking by People Living With Multiple Sclerosis: Qualitative Investigation of the Multiple Sclerosis Online Course.

Digital technologies have afforded people living with multiple sclerosis (MS) access to telehealth consultations, diagnostic tools, and monitoring. Although health care professionals remain the most trusted source of information, the internet has emerged as a valuable resource for providing MS-related information, particularly during the COVID-19 pandemic. Notably, people living with MS are increasingly seeking educational content for a range of topics related to the self-management of MS; however, web-based information seeking remains largely underevaluated. To address this gap and ensure that web-based health-related information is accessible and engaging, this study used qualitative methods to analyze the reflections from participants of web-based educational programs for people living with MS. This study aimed to explore the motivations, behaviors, and expectations of web-based health information seeking for people living with MS. We conducted semistructured interviews for 38 people living with MS 1 month after they completed the novel MS Online Course, which provided information on modifiable lifestyle-related risk factors for people living with MS. Of the 38 participants, 22 (58%) completed the intervention course and 16 (42%) completed the standard care course. Inductive thematic analysis was used within a qualitative paradigm, and 2 authors coded each interview separately and arrived at themes with consensus. We identified 2 themes: motivation to learn and MS information on the web. The diagnosis of MS was described as a pivotal moment for precipitating web-based information seeking. People living with MS sought lifestyle-related information to facilitate self-management and increase control of their MS. Although social media sites and MS websites were considered useful for providing both support and information, discretion was needed to critically appraise information. Recognizable institutions were frequently accessed because of their trustworthiness. This study provided novel insights into the motivations of people living with MS for seeking web-based health information. Furthermore, their preferences for the content and format of the web-based information accessed and their experiences and reactions to this information were explored. These findings may guide educators, researchers, and clinicians involved in MS care to optimize the engagement and processing of web-based health information seeking by people living with MS.

Prenatal maternal glucocorticoid exposure modifies sperm miRNA profiles across multiple generations in the guinea-pig.

Maternal stress and glucocorticoid exposure during pregnancy have multigenerational effects on neuroendocrine function and behaviours in offspring. Importantly, effects are transmitted through the paternal lineage. Altered phenotypes are associated with profound differences in transcription and DNA methylation in the brain. In the present study, we hypothesized that maternal prenatal synthetic glucocorticoid (sGC) exposure in the F0 pregnancy will result in differences in miRNA levels in testes germ cells and sperm across multiple generations, and that these changes will associate with modified microRNA (miRNA) profiles and gene expression in the prefrontal cortex (PFC) of subsequent generations. Pregnant guinea-pigs (F0) were treated with multiple courses of the sGC betamethasone (Beta) (1mgkg-1; gestational days 40, 41, 50, 51, 60 and 61) in late gestation. miRNA levels were assessed in testes germ cells and in F2 PFC using the GeneChip miRNA 4.0 Array and candidate miRNA measured in epididymal sperm by quantitative real-time PCR. Maternal Beta exposure did not alter miRNA levels in germ cells derived from the testes of adult male offspring. However, there were significant differences in the levels of four candidate miRNAs in the sperm of F1 and F2 adult males. There were no changes in miRNA levels in the PFC of juvenile F2 female offspring. The present study has identified that maternal Beta exposure leads to altered miRNA levels in sperm that are apparent for at least two generations. The fact that differences were confined to epididymal sperm suggests that the intergenerational effects of Beta may target the epididymis. KEY POINTS: Paternal glucocorticoid exposure prior to conception leads to profound epigenetic changes in the brain and somatic tissues in offspring, and microRNAs (miRNAs) in sperm may mediate these changes. We show that there were significant differences in the miRNA profile of epididymal sperm in two generations following prenatal glucocorticoid exposure that were not observed in germ cells derived from the testes. The epididymis is a probable target for intergenerational programming. The effects of prenatal glucocorticoid treatment may span multiple generations.

Incorporating vertical collaboration to address sustainable development goals: the Monarch Route Project

Higher Education Institutions in their societal transformative role need to effectively integrate the UN‘s Sustainable Development Goals (SDGs) and the 2030 Agenda into their curricula. Our goal is to inspire and trigger the discussion in the academic community on learning environments for education for sustainable development. We report The Monarch Route (MRP), a project conducted at Tecnologico de Monterrey and awarded with the 2018 Premios Latinoamerica Verde. Engaging all the students enrolled in the different semesters of the Sustainable Development Engineering (SDE) program, it adopted a research-based learning methodology, which is highly flexible at setting the final deliverables and due dates. It also implemented horizontal (intraclass), vertical (interclass), and interdisciplinary (multiple courses) student collaboration. In partnership with a non-governmental organization, the MRP aimed to reverse the extinction threat to the monarch butterfly while benefiting rural communities along the butterfly’s migratory route. With an exploratory action research approach, we analyzed the data gathered 2 months after the end of the courses: A survey on the perceived learning outcomes (87% confidence level) and a letter for future classes sharing their experience on the MRP, both optional. The analysis included a mixed methodology, i.e., quantitative and qualitative, including text mining, which evidenced that the participants strengthened both, transverse competences (collaboration, citizenship, communication, and critical thinking) and disciplinary competences (subject matter). The MRP is innovative for its dynamic structure that resembles the interconnectedness of real professional practice, scientific research, and environmental conservation efforts. In addition to the disciplinary application and societal relevance, the instructional design of MRP reflects that contributing to 2030 Agenda requires a multi-faceted approach, involving educational institutions, community partnerships, and interdisciplinary collaboration. Traditional education no longer fulfills our needs to face environmental challenges; academics, institutions, and governments are encouraged to implement policies and strategies to educate for a sustainable and better future for humanity and the planet.

P591 Treatment of microscopic colitis: retrospective analysis of consecutive single centre patients

Abstract Background Microscopic colitis (MC) is a chronic autoimmune inflammatory condition of the colon that causes watery diarrhoea along with other symptoms like bowel incontinence. MC is a benign condition with no increase in cancer risk or impact on survival but it usually requires treatment due to significantly impaired quality of life. Even though MC therapy is symptom oriented, recent studies have shown that almost half the patients require long-term medical treatment. Methods A retrospective analysis of consecutive MC patients treated in Lithuanian University of Health Sciences Hospital Kauno Klinikos over the last 6 years was performed. Patient characteristics and clinical information was obtained from electronic records. Results 94 MC patients were treated in our centre since 2017, 46 (49 %) with collagenous colitis (CC), 39 (41.5 %) with lymphocytic colitis (LC), 2 (2.1 %) with incomplete CC and 7 (7.4 %) with incomplete LC. 77 patients were female (82 %). Median age was 59 years [44.8-70.3]. There was a tendency for men to be younger (median 42 [37-68]) than women (median 60 [50-70.5]) but not significantly (p>0.05). During the 6-year period 67 patients (71.3 %) were treated with budesonide, 33 (35.1 %) received only one course and went into clinical remission while 34 (36.2 %) needed either multiple courses or continuous treatment for relapsing or chronic active disease respectively. Primary non-response to budesonide wasn’t documented in any patient. 8 patients (8.5 %) were treated with azathioprine due to budesonide dependency or intolerance but it was discontinued in all but 1 patient due to lack of response or adverse events. 3 patients (3.2 %) were treated with biological therapy. 1 patient was treated with adalimumab which was discontinued due to adverse events, 1 was treated with infliximab which was switched to vedolizumab due to loss of response, and 1 was treated with vedolizumab which was switched to adalimumab due to primary non-response. At the time of analysis 61 patients (64.9 %) were receiving no active treatment, 21 (22.3 %) were receiving intermittent courses of budesonide, 6 (6.4 %) had been prescribed budesonide on demand, 3 (3.2 %) were taking budesonide continuously, 1 (1.1 %) was taking azathioprine and 2 (2.1 %) were on biological therapy. There was no difference between CC and LC patients.Conclusion A little less than half of the patients needed long-term medical treatment. While budesonide was widely used and usually effective, we observed a need for advanced therapies as well.

P554 Assessment of corticosteroid prescribing trends and appropriateness for management of Inflammatory Bowel Disease in a secondary care centre in New Zealand

Abstract Background Corticosteroids are commonly used for inducing remission in Inflammatory Bowel Disease (IBD) but are considered ineffective for long-term maintenance1. Evaluating the appropriateness of corticosteroid usage is crucial in optimising IBD management given their common adverse effects. Methods This study aimed to assess the appropriateness of corticosteroid usage for patients with IBD in a secondary centre in New Zealand, using international standards2,3. A retrospective records’ audit was conducted in 2020, encompassing all IBD patients encountered in Nelson Hospital from 2005 to 2020. Ethical approval was obtained beforehand. The primary outcome measure evaluated was the appropriateness of corticosteroid prescriptions, in accordance with established international standards (UK2 and ECCO3). Key criteria included dosage (strength and/or duration), patient counselling on side effects and alternatives. Results We studied a group of 613 IBD patients with an average age of 55, comprising 311 males and 302 females. Crohn's Disease was the predominant diagnosis (297 cases), followed by Ulcerative Colitis (252 cases) and Indeterminate Colitis (64 cases). Of the patients included in the audit, 51.4% (315 out of 613) were prescribed steroids during the 15-year study period. Of the 315 total prescriptions, 52.1% (163) were considered inappropriate. Among these, 28.6% (90) were excessively long courses, 23.5% (74) were due to under-dosing or multiple short courses, and 6.3% (20) were because of corticosteroid dependence. Out of a total of 315 prescriptions, Gastroenterologists issued 36.5% (115), while General Practitioners were responsible for 24.1% (76). The remaining prescriptions were divided among General Surgery (9%), General Medicine (6%), and the Emergency Department (5%). Conclusion Corticosteroid prescribing for IBD patients in this secondary centre in New Zealand deviated from international guidelines, primarily in terms of dose and duration. It’s vital to adopt accessible, customized guidelines and enhance quality measures to ensure IBD patients receive evidence-based corticosteroid treatment when needed. References 1-Ford AC, Bernstein CN, Khan KJ, et al. Glucocorticosteroid therapy in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol 2011;106:590-599; quiz 600. 2- Mowat C, Cole A, Windsor A, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011;60:571-607. 3-Gomollon F, Dignass A, Annese V, et al. 3rd European evidencebased consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J CrohnsColitis. 2017;11:3-25

Liver toxicity following reirradiation and multiple-target SBRT for primary hepatocellular carcinoma.

514 Background: Stereotactic body radiation therapy (SBRT) is increasingly used to treat hepatocellular carcinoma (HCC), but its safety in the treatment of multiple synchronous or recurrent lesions is underreported. We aim to better characterize SBRT-related hepatic toxicity in this population. Methods: We conducted a retrospective analysis of patients with primary HCC who underwent SBRT for 2 or more synchronous or recurrent liver lesions. We collected patient characteristics and dosimetric data (mean liver dose, cumulative effective volume [Veff], cumulative volume of liver receiving 15Gy [V15Gy], and cumulative planning target volume [PTV]) along with liver-related toxicity (measured by albumin-bilirubin [ALBI] and Child-Pugh [CP] scores). We employed a linear mixed-effects model to assess the effect of multi-target SBRT on changes in ALBI. Results: There were 25 patients and 56 lesions with median follow-up of 29 months. Eleven patients had synchronous lesions and 14 had recurrent lesions treated with separate SBRT courses. Eight local failures occurred at a median of 8 months (range: 4 – 25 months) after SBRT. Among those receiving multiple SBRT courses, there were 7 lesions with overlap of V15Gy (median V15Gy overlap: 35mL, range: 0.5 – 388mL). There was no association between cumulative Veff, V15Gy, or PTV and change in ALBI. Four of 25 patients an increase of Child-Pugh (CP) score by ≥ 2 points, within 3 to 6 months after SBRT. Neither increase in CP nor ALBI were associated with cumulative Veff, V15Gy, and PTV. Comparing the groups that received SBRT in a single course versus multiple courses revealed no statistically significant differences in liver toxicity. Conclusions: LiverSBRT for multiple lesions in a single or in separate courses results in worsening of CP scores or ALBI in a small percentage of patients, suggesting a low risk of RILD. Prospective studies with a larger cohort are needed to better characterize safety in this population.

High Levels of Perivascular Inflammation and Active Demyelinating Lesions at Time of Death Associated with Rapidly Progressive Multiple Sclerosis Disease Course: A Retrospective Postmortem Cohort Study.

Analysis of postmortem multiple sclerosis (MS) tissues combined with in vivo disease milestones suggests that whereas perivascular white matter infiltrates are associated with demyelinating activity in the initial stages, leptomeningeal immune cell infiltration, enriched in B cells, and associated cortical lesions contribute to disease progression. We systematically examine the association of inflammatory features and white matter demyelination at postmortem with clinical milestones. In 269 MS brains, 20 sites were examined using immunohistochemistry for active lesions (ALs) and perivenular inflammation (PVI). In a subset of 22, a detailed count of CD20+ B cells and CD3+ T cells in PVIs was performed. ALs were detected in 22%, whereas high levels of PVI were detected in 52% of cases. ALs were present in 35% of cases with high levels of PVI. Shorter time from onset of progression to death was associated with increased prevalence and higher levels of PVI (both p < 0.0001). Shorter time from onset of progression to wheelchair use was associated with higher prevalence of ALs (odds ratio [OR] = 0.921, 95% confidence interval [CI] = 0.858-0.989, p = 0.0230) and higher level of PVI (OR = 0.932, 95% CI = 0.886-0.981, p = 0.0071). High levels of PVI were associated with meningeal inflammation and increased cortical demyelination and significantly higher levels of B lymphocytes within the PVI. ALs, a feature of early disease stage, persist up to death in a subgroup with high levels of PVI. These features link to a rapid progressive phase and higher levels of meningeal inflammation and B-cell infiltrates, supporting the hypothesis that chronic inflammation drives progression in MS. ANN NEUROL 2024;95:706-719.

Students’ Perception towards Online Learning across Multiple Disciplinary Courses in India—A Qualitative Analysis

Online learning has become essential to the teaching and learning approach during the pandemic. Due to its enormous benefits, online or e-learning can be sustained. The acceptability of online or e-learning depends on the student’s perception and the availability of infrastructure. Data from various streams and age groups has been collected from students in different institutions. After collecting the data, this research incorporates descriptive statistics for a thorough analysis and utilizes the Chi-square test to provide scientific evidence. This study finds that the majority of final-year undergraduate and postgraduate students support online education. The student’s economic status affects their preference for online or e-learning. Having a smart device and internet access also influence the decision to pursue online or e-learning. Gender is positively associated with access to Internet facilities and has a cascading effect on preferences for online or e-learning. Female students prefer online classes but require additional internet resources. Higher education institutions could enhance their online course offerings by targeting specific groups, such as female students for postgraduate programs, if they could better understand their preferences. Even though some existing studies in the literature have examined the Indian scenario to understand the factors influencing the adoption of online education, none of these studies have considered the fundamental need for online or e-learning. Moreover, the preferences were not studied based on different demographics. This research work has collected and utilized data from various educational disciplines across multiple institutes, marking the first endeavor of its kind in the literature.

Refractory Osteomyelitis in a Military Service Member Resolved With Adjunctive Hyperbaric Oxygen Therapy.

Refractory osteomyelitis is typically defined as a chronic infection that persists or recurs despite definitive surgical management and antibiotic therapy. Cases often involve complex wounds or fractures and can be challenging to treat, resulting in multiple courses of broad-spectrum antibiotic therapy and numerous surgeries over periods of months to years. Adjuncts to improve resolution of these complicated infections are sorely needed. Here, we describe the case of a 47-year-old active duty military member who sustained an open right ankle fracture during a skydiving accident that was subsequently complicated by refractory osteomyelitis. The patient failed more than three courses of combined medical and surgical management over a 9-month period before undergoing adjunctive hyperbaric oxygen therapy (HBOT), ultimately resulting in resolution of the infection. Adjunctive HBOT for treatment of conditions such as refractory osteomyelitis may be an underutilized resource in part because of a general paucity of high-quality data in the literature supporting its use, as well as a relative lack of availability of this resource. Nonetheless, the overall accumulating body of evidence indicates that the use of adjunctive HBOT in select patients with refractory osteomyelitis is safe and effective and further research may be warranted given its relevance and potential impact to military populations.

P04 A Complex Case of Urticaria

Abstract An 11 year old female, with Type 1 diabetes and no previous atopy or allergy , presented with a 6 week history of facial swelling and a generalised urticaria on the trunk and limbs. She had been seen privately by “Allergy” clinic and diagnosed with chronic spontaneous urticaria with angioedema. Blood tests for common allergens were negative, with a total IgE &amp;lt;20 kU/L. Treatment with Loratadine, Cetirizine 10mg, Fexofenadine 120mg QDS, Acrivastine 8mg BD, Montelukast 10mg OD and prednisolone 20mg OD had only a limited effect. Skin biopsy confirmed urticaria with no evidence of vasculitis. Immunology bloods were negative. Despite reporting compliance, she continued to experience debilitating symptoms with raised UAS scores. Desloratadine 2.5mg BD and multiple intermittent short courses of prednisolone were needed. Omalizumab was started at 300mg monthly for 6 months with partial improvement. However symptoms flared on cessation and following tertiary advice, a 2nd course of Omalizumab was commenced at 300 mg s/c monthly for 3 months &amp; 300mg s/c fortnightly for 3 months with the addition of 100mg BD Ciclosporin and Famotidine 10mg BD. Ciclosporin was discontinued after 1 month due to side effects and substituted with Methotrexate 15mg OW. If control is not obtained, management plans include Mycophenolate Mofetil, or trialing omalizumab 450mg S/C monthly. This is a case of extremely difficult to control urticaria in a child highlighting available systemic treatment options1.

Biochemical Safety of SBRT to Multiple Intrahepatic Lesions for Hepatocellular Carcinoma.

We aim to better characterize stereotactic body radiation therapy (SBRT)-related hepatic biochemical toxicity in patients with multiple intrahepatic lesions from hepatocellular carcinoma (HCC). We conducted a retrospective analysis of patients with HCC who underwent SBRT for 2 or more synchronous or metachronous liver lesions. We collected patient characteristics and dosimetric data (mean liver dose [MLD], cumulative effective volume [Veff], cumulative volume of liver receiving 15 Gy [V15Gy], and cumulative planning target volume [PTV]) along with liver-related toxicity (measured by albumin-bilirubin [ALBI] and Child-Pugh [CP] scores). A linear mixed-effects model was used to assess the effect of multi-target SBRT on changes in ALBI. There were 25 patients and 56 lesions with median follow-up of 29 months. Eleven patients had synchronous lesions, and 14 had recurrent lesions treated with separate SBRT courses. Among those receiving multiple SBRT courses, there were 7 lesions with overlap of V15Gy (median V15Gy overlap: 35 mL, range: 0.5-388 mL). There was no association between cumulative MLD, Veff, V15Gy, or PTV and change in ALBI. Four of 25 patients experienced non-classic radiation-induced liver disease (RILD), due to an increase of CP score by ≥2 points 3 to 6 months after SBRT. Sixteen of 25 patients experienced an increase in ALBI grade by 1 or more points 3 to 6 months after SBRT. Comparing the groups that received SBRT in a single course versus multiple courses revealed no statistically significant differences in liver toxicity. Liver SBRT for multiple lesions in a single or in separate courses is feasible and with acceptable risk of hepatotoxicity. Prospective studies with a larger cohort are needed to better characterize safety in this population.

Navigating Mathematical Basics: A Primer for Deep Learning in Science.

We present a gentle introduction to elementary mathematical notation with the focus of communicating deep learning principles. This is a "math crash course" aimed at quickly enabling scientists with understanding of the building blocks used in many equations, formulas, and algorithms that describe deep learning. While this short presentation cannot replace solid mathematical knowledge that needs multiple courses and years to solidify, our aim is to allow nonmathematical readers to overcome hurdles of reading texts that also use such mathematical notation. We describe a few basic deep learning models using mathematical notation before we unpack the meaning of the notation. In particular, this text includes an informal introduction to summations, sets, functions, vectors, matrices, gradients, and a few more objects that are often used to describe deep learning. While this is a mathematical crash course, our presentation is kept in the context of deep learning and machine learning models including the sigmoid model, the softmax model, and fully connected feedforward deep neural networks. We also hint at basic mathematical objects appearing in neural networks for images and text data.

A comparative study of electroconvulsive therapy among the elderly and adult patients with depressive disorder

ABSTRACT Aim: The present study aimed to compare the clinical profile, indications for electroconvulsive therapy (ECT), effectiveness of ECT, and complications associated with the use of ECT among elderly and adult patients. Methodology: Using a retrospective study design, data from patients with a diagnosis of unipolar depression, who received ECT between January 2013 and March 2023 was extracted. Based on the age at the time of receiving ECT, the study sample was divided into adult (age &lt;60 years) and elderly (≥60 years) groups and compared. Results: The study included data from 1144 patients with depression. Of them, 371 (32.4%) patients were aged 60 years or above. Compared to the adult group, a significantly higher number of patients in the elderly group were diagnosed with recurrent depressive disorder (P &lt; 0.001), had psychotic symptoms (P &lt; 0.001), and had at least one medical comorbidity. Compared to adult patients, elderly depressed patients had longer total lifetime duration of illness (P &lt; 0.001) and longer duration of current symptoms (P = 0.012). In terms of indications for ECT, the elderly patients had a higher frequency of poor response to the pharmacological treatment (P = 0.003) and a lower frequency of suicidality and attempts at self-harm (P &lt; 0.001). Compared to adults, elderly patients received a higher number of effective ECTs (P = 0.04). There were no differences between the two groups in terms of the reason for stopping ECT and the extent of improvement. However, a higher proportion of the elderly experienced complications related to ECT and received repeat ECT courses (P = 0.003) and continuation ECT (P &lt; 0.001). Conclusion: The present study shows that there are some differences between the elderly and adult patients with depression in terms of indications for ECT, side effects related to ECT, need for multiple courses of ECT, and continuation ECT. However, the efficacy of ECT does not differ between the two groups.

The impact of COVID-19 infection on multiple sclerosis disease course across 12 countries: a propensity-score-matched cohort study.

The relationship between coronavirus disease 2019 (COVID-19) infection and multiple sclerosis (MS) relapse and disease progression remains unclear. Previous studies are limited by small sample sizes and most lack a propensity-matched control cohort. To evaluate the effect of COVID-19 infection on MS disease course with a large propensity-matched cohort. This multi-centre cohort study analysed relapse and disability outcomes post-COVID-19 infection after balancing covariates using a propensity score matching method. The study period was from the 11th of September 2019 to the 16th of February 2023. The mean follow-up period was 1.7 years. Data were retrieved from the MSBase Registry. Propensity scores were obtained based on age, sex, disease duration, baseline Expanded Disability Status Scale (EDSS), MS course, relapses pre-baseline, disease-modifying therapy (DMT) class and country. Primary outcomes were time to first relapse, annualised relapse rate (ARR) and time to confirm EDSS progression. Secondary outcomes were time to EDSS of 3, 4 or 6. Sensitivity analyses with baseline DMT classes were performed. The study included 2253 cases and 6441 controls. After matching, there were 2161 cases and an equal number of matched controls. Cases had a significantly higher ARR (ARR = 0.10 [95% CI 0.09-0.11]) compared to controls (ARR = 0.07 [95% CI 0.06-0.08]). Cases had a significantly greater hazard of time to first relapse compared to controls (hazard ratio (HR) = 1.54 [95% CI 1.29-1.84]). There was no association between COVID-19 infection and 24-week EDSS progression (HR = 1.18 [95% CI 0.92-1.52]), or time to EDSS of 3, 4 or 6. For patients on interferons and glatiramer acetate (BRACE), COVID-19 infection was associated with a greater hazard of time to first relapse (HR = 1.83 [95% CI 1.25-2.68]) and greater hazard of time to EDSS of 3 (HR = 2.04 [95% CI 1.06-3.90]) compared to patients on BRACE therapy without COVID-19 infection. COVID-19 infection was associated with a significantly increased MS relapse rate and a shorter time to first relapse. There was no effect on confirmed EDSS progression over the short term. These results support ongoing COVID-19 risk minimisation strategies to protect patients with MS.

A comparative study of readiness and confidence in online teaching among faculty members in health and non-health colleges within the United Arab Emirates.

This study explores and compares the levels of readiness and confidence among faculty members in health and non-health colleges regarding online teaching in the United Arab Emirates (UAE). The study adopted a cross-sectional research design and utilized a comprehensive survey instrument. A convenience sampling method was employed to enlist 412 faculty members from varied academic disciplines, comprising 278 from non-health programs and 134 from health programs. These participants offered valuable insights into their levels of preparedness and confidence for engaging in online teaching. The study uncovered nuanced differences in readiness and confidence levels between health and non-health colleges regarding online teaching preparedness. Significant gender-based variations were found, with female participants in health colleges reporting lower readiness (mean = 4.13) and confidence (mean = 4.11) compared to their counterparts in non-health colleges (mean = 4.43; mean = 4.52) (out of 5) (P < 0.05). Male participants in non-health colleges demonstrated higher readiness and confidence (P < 0.05). Academic rank and teaching experience (>5 years) positively influenced readiness and confidence (P < 0.05). Marital status, spouse working status, and years teaching online showed no significant differences. Teaching multiple online courses before and during the coronavirus disease 2019 (COVID-19) pandemic significantly enhanced readiness and confidence (P < 0.05). Professional development before and during the COVID-19 pandemic did not yield significant differences. The study contributes to the existing literature on online education, offering valuable insights into the specific challenges and opportunities faced by faculty in health and non-health colleges. The results inform decision-making processes for educational institutions and policymakers in the UAE, emphasizing the evolving global landscape of online teaching.

Maintaining Course Quality and Integrity Across Multiple Modalities

To effectively educate the future public health workforce, it is essential for public health faculty to engage in purposeful and thoughtful pedagogical practices in their teaching. In the post-COVID higher education environment, instructors teaching course sections offered both in-person and online concurrently must ensure that curricular continuity is maintained, while respecting modality-driven differences. Developing multiple course sections, parallel in outcomes and rigor, but bespoke in instructional approach requires both additional development time and faculty support structures. While time is always in short supply, it is troubling to note that there is a paucity of information directed toward faculty that provides guidance on how faculty engage in course design work that requires them to plan in two modalities simultaneously. In the absence of available best practices for course design in multiple modalities, this paper provides a description of a pedagogical curriculum reflection exercise created to ensure that course sections delivered across different modalities are comparable and meet course competencies, such as those of the Council on Education for Public Health, in equitable ways.

Self-Localization Using Trajectory Attractors in Outdoor Environments

Self-localization in probabilistic robotics requires detailed, geographically consistent environmental maps, which increases the computational cost. In this study, we propose a simple self-localization method that does not require such maps. In the proposed method, the order structure, such as the mobile robot’s navigation route, is embedded as trajectory attractors in the state space of a nonmonotone neural network, and self-position estimation is performed by processing based on the autonomous dynamics of the network. From experiments, we demonstrated the basic performance of the proposed method, including robust self-localization in complex outdoor environments. Furthermore, self-localization is possible on multiple courses with overlapping paths by suitably varying the network dynamics based on environmental information. While issues remain, this study points to the great potential of neurodynamics-based robotic self-localization.

Classroom Connections: A Social Network Analysis of STEM Students at a Regional University

Previous research has established that peer relationships are important for student success, yet little research has examined connections made in the classroom, as opposed to residence life or extracurricular activities. This project utilized social network analysis in two cohorts of science and mathematics majors to investigate the degree to which students take multiple courses with the same peers. Results showed (1) wide variability in student networks, (2) course selection by students included more repeated connections than random course selection, (3) networks did not vary much by demographic variables (gender, race, first-generation status, and income), and (4) student networks significantly predicted graduation and grades. This correlational research provides a foundation for future experimental research testing the causal impact of classroom-based student networks. This research also serves as a model for how other institutions may analyze institutional data to understand patterns of peer connections and course enrollment at their institution.

An Actor-Critic Hierarchical Reinforcement Learning Model for Course Recommendation

Online learning platforms provide diverse course resources, but this often results in the issue of information overload. Learners always want to learn courses that are appropriate for their knowledge level and preferences quickly and accurately. Effective course recommendation plays a key role in helping learners select appropriate courses and improving the efficiency of online learning. However, when a user is enrolled in multiple courses, existing course recommendation methods face the challenge of accurately recommending the target course that is most relevant to the user because of the noise courses. In this paper, we propose a novel reinforcement learning model named Actor-Critic Hierarchical Reinforcement Learning (ACHRL). The model incorporates the actor-critic method to construct the profile reviser. This can remove noise courses and make personalized course recommendations effectively. Furthermore, we propose a policy gradient based on the temporal difference error to reduce the variance in the training process, to speed up the convergence of the model, and to improve the accuracy of the recommendation. We evaluate the proposed model using two real datasets, and the experimental results show that the proposed model significantly outperforms the existing recommendation models (improving 3.77% to 13.66% in terms of HR@5).

Schedules and Waitlists and Integer Programs, Oh My!

Summary Student class schedules often involve significant scheduling conflicts and can be challenging to resolve. Three scheduling problems common to students, advisors, and deans at universities include building a schedule, changing schedules for multiple students due to a course cancelation, and finding seats for students on waitlists for multiple courses. This paper presents binary integer programs to solve each, building in complexity.