Synchronous Components Research Articles

Clinical Effects of Asynchronous Provider-Guided Practice Sessions During Blended Care Therapy for Anxiety and Depression: Pragmatic Retrospective Cohort Study.

Blended care therapy models are intended to increase the efficiency and effectiveness of evidence-based psychotherapy by combining synchronous and asynchronous components of care. This retrospective cohort study evaluated the clinical effects of synchronous video therapy sessions and asynchronous guided practice session elements on anxiety and depression in a blended care therapy program, with a novel focus on asynchronous provider feedback messages. Participants were adults (N=33,492) with clinical symptoms of anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7] score of ≥8) and depression (Patient Health Questionnaire 9-item scale [PHQ-9] score of ≥10) at intake. Symptom trajectories were evaluated via individual growth curve models. Time-varying covariates evaluated effects of synchronous video session attendance and the presence or absence of each asynchronous guided practice session element occurring within 7 days and 8-14 days prior to each clinical outcome assessment. Guided practice session elements included client digital lesson completion, client digital exercise completion, and feedback messages sent by providers. Approximately 86.6% (29,012/33,492) of clients met criteria for clinical improvement by end of care (median 6, IQR 4-8 synchronous sessions). Synchronous video session attendance and client digital lesson completion in the past 7 days and in the past 8-14 days were each uniquely and significantly associated with lower GAD-7 scores (video session effects: bsession7=-0.82, bsession8-14=-0.58, P values<.001; digital lesson effects: blesson7=-0.18, blesson8-14=-0.26, P values <.001) and PHQ-9 scores (video session effects: bsession7=-0.89, bsession8-14=-0.67, P values <.001; digital lesson effects: blesson7=-0.12, blesson8-14=-0.30, P values <.001). Client digital exercise completion in the past 8-14 days was significantly associated with lower GAD-7 scores (bexercise8-14=-0.10; P<.001) but exercise completion in the 7 days prior to clinical outcome assessment was not (bexercise7=0.00; P=.89). Exercise completion in the past 7 days was significantly associated with lower PHQ-9 scores (bexercise7=-0.16; P<.001) but exercise completion in the past 8-14 days was not (bexercise8-14=-0.05; P=.09). Provider feedback messaging in the past 7 days and in the past 8-14 days was significantly associated with lower GAD-7 and PHQ-9 scores, respectively (GAD-7: bfeedback7=-0.12, P<.001; bfeedback8-14=-0.07, P=.004; PHQ-9: bfeedback7=-0.15, P<.001; bfeedback8-14=-0.08, P=.01). Provider feedback between synchronous therapy sessions provided significant benefit for symptom reduction, beyond the effects of client digital engagement and synchronous video sessions. When guided practice sessions are well integrated into care, blended care therapy provides meaningful improvements upon the traditional, synchronous session-only therapy model. Provider guidance and feedback for clients between synchronous sessions support more efficient and effective mental health care overall.

The impact of a microaggressions-themed interprofessional education curriculum on attitudes, confidence, and collaboration competencies: A curricular resource for health professions learners

While attention has been paid to microaggressions (MAs) and interprofessional (IP) education independently, little attention has been paid to how training IP learners in MA can impact confidence and willingness to respond to MAs. We developed an online IPE activity, for six health professions, with asynchronous and synchronous components utilizing standardized patients (SPs) aiming to educate on MAs, their impacts, and how to appropriately respond as recipient, bystander, and source. Students from senior undergraduate nursing (BSN), second-year medical (MD), third-year pharmacy (PharmD), physician assistant/associate (PA) students, athletic training (BS), and graduate nursing (DNP) health professions programs participated.Objectives included: define MA; respond to a MA as the source, bystander, and recipient using Ackerman-Barger's Microaggressions Triangle model; respond to a MA when the source is lateral, in a position of authority, and a patient; and identify the ability of the activity to allow interprofessional collaboration across the six Interprofessional Collaborative Competencies Attainment Scale (ICCAS) domains. The synchronous virtual session began with a large group didactic mini lecture and transitioned to IP small group activities. Within groups, students completed SP simulations where students role played responding to MAs as the recipient, bystander, and source. The session concluded with a faculty-led large group debrief. Students were pleased with the learning experience and demonstrated improvements in attitudes/confidence responding to MAs and ICCAS domains. The curriculum can be customized to meet the needs of a variety of health profession learners and is available for use from the authors.

Learning to support self-regulation: empowering preschool teachers through understanding by design and blended learning

ABSTRACT In this study, preschool teachers’ self-regulation knowledge and practices were improved through a professional development program. The program was crafted using the Understanding by Design framework to facilitate the transfer of learned concepts into the classroom. A blended learning approach with synchronous and asynchronous components was used to accommodate time and location constraints. The program covered executive functions, metacognition, emotion regulation, and motivation regulation in five modules. Program effectiveness was assessed using a nested mixed-method design. The study included 68 preschool teachers from 26 Turkish cities. Pre- and post-tests were used to collect quantitative data, while electronic survey forms and focus group interviews were used to collect qualitative data. The program significantly increased teachers’ use of metacognition and emotional-motivational regulation practices. Teachers’ belief in children’s control potential improved, resulting in significant shifts in their understanding and application of self-regulation.

High-speed magnetically levitated centrifugal hydrogen recirculation pump in proton exchange membrane fuel cells

This paper presents a novel magnetically levitated centrifugal hydrogen recirculation pump (MLCHRP) designed for proton exchange membrane fuel cells (PEMFCs). Compared to traditional hydrogen recirculation pump, the MLCHRP offers significant advantages, including no lubrication, no mechanical friction, and active vibration suppression. However, the compact design of the pump imposes constraints on the load capacity of the active magnetic bearings (AMBs). As a result, the rotor is more susceptible to instability when subjected to unbalanced disturbance forces. This paper details the structure of the MLCHRP and provides an analysis of the basic model for unbalanced disturbance forces. A method for suppressing these unbalanced disturbances is proposed, utilizing a Linear Extended State Observer (LESO) combined with Parallel Peak Filters (PPF). The impact of this approach on system stability is thoroughly examined, and the effectiveness of the proposed method for unbalanced disturbance suppression is experimentally validated. The experimental results show that the peak-to-peak displacement of the rotor decreased by 80%. Additionally, the synchronous component in the rotor's displacement FFT was reduced by 6 dB (from -19.2 dB), and the second harmonic component decreased by 23.8 dB (from -23.7 dB). Finally, aerodynamic performance tests confirm that the MLCHRP meets the application requirements of actual PEMFCs system.

Subband Independent Component Analysis for Coherence Enhancement.

Cortico-muscular coherence (CMC) is becoming a common technique for detection and characterization of functional coupling between the motor cortex and muscle activity. It is typically evaluated between surface electromyogram (sEMG) and electroencephalogram (EEG) signals collected synchronously during controlled movement tasks. However, the presence of noise and activities unrelated to observed motor tasks in sEMG and EEG results in low CMC levels, which often makes functional coupling difficult to detect. In this paper, we introduce Coherent Subband Independent Component Analysis (CoSICA) to enhance synchronous cortico-muscular components in mixtures captured by sEMG and EEG. The methodology relies on filter bank processing to decompose sEMG and EEG signals into frequency bands. Then, it applies independent component analysis along with a component selection algorithm for re-synthesis of sEMG and EEG designed to maximize CMC levels. We demonstrate the effectiveness of the proposed method in increasing CMC levels across different signal-to-noise ratios first using simulated data. Using neurophysiological data, we then illustrate that CoSICA processing achieves a pronounced enhancement of original CMC. Our findings suggest that the proposed technique provides an effective framework for improving coherence detection. The proposed methodologies will eventually contribute to understanding of movement control and has high potential for translation into clinical practice.

Advancing interprofessional workplace learning: Successful implementation of the ‘WILD Series©’ hybrid professional development model

BackgroundThe 2021 NCICLE Pathways to Excellence framework highlights the need for professional development opportunities promoting interprofessional learning to optimize healthcare provider and learner teaming in the clinical learning environment. Despite this priority, research shows some clinicians are not developing their collaborative practice skills. PurposeThis article describes the hybrid Workplace Interprofessional Learning and Development (WILD) Series, which was developed to promote interprofessional preceptor development through workplace learning. MethodThe WILD Series© includes four unique six-week offerings, each dedicated to one Interprofessional Education Collaborative (IPEC) competency area. Each six-week session includes five weeks of one topical, actionable independent email engagement and concludes with a structured, facilitated synchronous debriefing session. DiscussionThe WILD Series© is the first IPE program designed for independently practicing clinicians and preceptors that includes synchronous and asynchronous components. Initial feedback was positive regarding the series format, content, and outcomes. ConclusionThe WILD Series© demonstrates that workplace learning can be an effective strategy for addressing gaps in interprofessional preceptor development.

Unleashing leadership potential in unprecedented times: Lessons learned from an evaluation of a virtual cohort-based adaptive leadership program for public health executives

ObjectivesThis paper presents the evaluation results from the Adaptive Leadership Academy (ALA), a pilot program aimed at developing executive-level leaders in public and community health. Study designMixed methods study. MethodsThe evaluation followed the Kirkpatrick Model to assess program participants’ satisfaction with the training, knowledge and skill gain, and behavior change. Data were collected beginning in December 2021 through August 2022 from 20 program participants via online surveys and key informant interviews. ResultsThe findings indicated that ALA helped participants improve their leadership knowledge, skills, and capabilities. In particular, the study highlighted the effectiveness of cohort-based leadership development programs using adaptive leadership as the foundation for the curriculum. Participants found the cohort-based model and synchronous components particularly useful in creating a supportive environment in which to be vulnerable and grow. ConclusionsOverall, the evaluation provided evidence that the ALA pilot enhanced leadership knowledge, skills, and capabilities. The findings support the use of adaptive leadership as a framework for leadership development programs in the public health sector.

Reduced precision of motor and perceptual rhythmic timing in autistic adults

Recent results suggest that autistic individuals exhibit reduced accuracy compared to non-autistic peers in temporally coordinating their actions with predictable external cues, e.g., synchronizing finger taps to an auditory metronome. However, it is not yet clear whether these difficulties are driven primarily by motor differences or extend into perceptual rhythmic timing tasks. We recruited autistic and non-autistic participants for an online study testing both finger tapping synchronization and continuation as well as rhythmic time perception (anisochrony detection). We fractionated each participant's synchronization results into parameters representing error correction, motor noise, and internal time-keeper noise, and also investigated error-correcting responses to small metronome timing perturbations. Contrary to previous work, we did not find strong evidence for reduced synchronization error correction. However, we found compelling evidence for noisier internal rhythmic timekeeping in the synchronization, continuation, and perceptual components of the experiment. These results suggest that noisier internal rhythmic timing processes underlie some sensorimotor coordination challenges in autism.

From Needs Analysis to Programme Design: Online Speaking Skills Upskilling Programme for ESL Teachers

This study observed that many teacher professional development programmes are designed without considering teacher’s voice. The present study addresses this gap by designing an online speaking skills upskilling programme that is based on a group of ESL teachers’ needs. The study employed the mixed methods research approach. Using the convenience sampling, 104 ESL teachers answered an online needs analysis survey. In the qualitative phase, an online interview was carried out with seven teachers who took part in the upskilling programme. Based on the findings, two conclusions can be made. First, for an upskilling programme that focuses on the enhancement of the speaking skills to be successful, psychological constructs such as self-esteem and anxiety need to be considered at the design stage. Second, as the programme was conducted fully online, having synchronous sessions is an important design feature. There are two implications. Firstly, it underscores the importance of integrating psychological considerations into the design of online speaking skills programs for ESL teachers. Secondly, it emphasizes the value of striking a balance between online and synchronous components While the study contributes valuable insights, it is important to acknowledge its limitations. Specifically, it does not explore the impact of improved speaking skills on teachers' classroom practices, and it solely focuses on speaking skills development. Future research could delve into the relationship between teachers' speaking proficiency and their instructional practices. Additionally, exploring the broader benefits of such online upskilling programs on other language skills would be a promising avenue for further investigation.

Bichronous Online Learning: Perspectives, Best Practices, Benefits, and Challenges from Award-Winning Online Instructors

Bichronous online learning is the intentional blending of asynchronous and synchronous online learning experiences. Twelve award-winning online instructors participated in interviews to discuss best practices they use, and benefits and challenges in bichronous online courses. When sharing best practices for bichronous online courses, award-winning online instructors explained how they combined best practices in asynchronous and synchronous online learning. Asynchronous online best practices included course design and structure, resources, and instructor presence; and synchronous online best practices focused on formats, activities, and content of synchronous sessions, and community-building. The best practices, benefits and challenges discussed in this paper have implications for instructors who currently teach in a bichronous online format or may be considering it in the future, and for instructional designers and administrators who work with faculty on offering courses in this modality. Based on the data, the intentional blending of synchronous and asynchronous components has a lot of potential to enhance students’ online learning experiences.

Student perceptions of weekly synchronous team quizzes in an online statistics course

In a fully online college introductory statistics class, we incorporated a flexible synchronous course component to provide instructor immediacy and support students who are lacking sufficient prior knowledge when a new topic is introduced. We describe a learning cycle with weekly team quizzes inspired by the readiness assurance process of team-based learning; we interviewed eight students for their perceptions of the course structure. Team quizzes are designed to provide regular formative assessment and feedback in real-time with the goal of improving student satisfaction and success in the course. Overall, students reported that the weekly synchronous sessions contributed to a strong sense of belonging to peers and the instructor, were helpful for their learning and helped them successfully complete the course. Implications for practice or policy: Instructors can use regular synchronous team quizzes in a fully online course to improve student engagement, connectedness, persistence and learning. Instructors can use team quizzes for regular formative assessment and feedback and to facilitate just-in-time intervention.

Optimization design of an innovative francis draft tube: Insight into improving operational flexibility

Hydropower has transitioned from base-load generation into an energy regulator in the hydro-wind-solar integrated systems, resulting in prolonged turbine operation under off-design conditions. Inspired by the new requirements of operation mode, an innovative Francis draft tube with inclined conical diffuser is presented to mitigate the pressure fluctuations and fatigue damage induced by flow instabilities. The design is optimized and comprehensively investigated to improve the operational flexibility. Computational fluid dynamics combined with design of experiments, artificial neural network and multi-objective optimization process lead to two optimal designs denoted as Opt-1 and Opt-2 from the Pareto fronts. Corresponding maximum pressure fluctuation amplitude is reduced by 15 % and 20 % compared to the traditional, respectively. An 81 % decrease of the fluctuating pressure recovery for the modified draft tube is obtained, leading to a steadier runner torque and consequently lower power swing. The asymmetric design of inclined daft tube is mainly targeted at the mitigation of the synchronous component as well as the attenuation of interaction between the swirling flow and elbow, accompanied with the mitigated energy of first-order vortex structure. The proposed innovative draft tube and optimization technique are found useful to broaden the operating range of hydraulic turbine in a computationally affordable way.

Dynamically driven correlations in elastic net models reveal sequence of events and causality in proteins.

An explicit analytic solution is given for the Langevin equation applied to the Gaussian Network Model of a protein subjected to both a random and a deterministic periodic force. Synchronous and asynchronous components of time correlation functions are derived and an expression for phase differences in the time correlations of residue pairs is obtained. The synchronous component enables the determination of dynamic communities within the protein structure. The asynchronous component reveals causality, where the time correlation function between residues i and j differs depending on whether i is observed before j or vice versa, resulting in directional information flow. Driver and driven residues in the allosteric process of cyclophilin A and human NAD-dependent isocitrate dehydrogenase are determined by a perturbation-scanning technique. Factors affecting phase differences between fluctuations of residues, such as network topology, connectivity, and residue centrality, are identified. Within the constraints of the isotropic Gaussian Network Model, our results show that asynchronicity increases with viscosity and distance between residues, decreases with increasing connectivity, and decreases with increasing levels of eigenvector centrality.

ENHANCING FLIPPED LEARNING: A COMPREHENSIVE METHODOLOGY FOR INTERGRATING ASYNCHRONOUS AND SYNCHRONOUS INTERACTION

This article delves into effective flipped learning strategies for the training of future foreign language teachers, with a focus on developing their professionally oriented communicative competence. A methodological approach integrating asynchronous and synchronous interactions is proposed, highlighting the importance of independent learning activities, which are complemented by synchronous support to enhance engagement. This approach, underpinned by scientific literature, suggests that the evolution of asynchronous learning should strengthen the flipped learning methodology. It projects asynchronous -synchronous interaction as a special type of asynchronous mode. In this mode, the independent (asynchronous) component is primary, and the collaborative (synchronous) component is secondary. This structure emphasizes students’ independent learning activities. Synchronous interactions provide additional support in cooperation. The article advocates for a balanced use of both delayed (asynchronous) and quasi-instant (synchronous) communication, the latter being quicker than traditional delayed methods but not as immediate as real-time interactions.The study maintains that integrating and incorporating synchronous aspects into asynchronous learning activities enhances the core essence of flipped learning. It outlines four specific principles for the effective application of asynchronous-synchronous techniques. They are: consistent integration, making the best use of technology tools, feedback loop, combining communication methods. Drawing on previous research and the author’s personal teaching experience at the Faculty of Philology of Educational Technologies, Kyiv National Linguistic University, Ukraine, the impact of these methods on the education of students studying at the second (master’s) level has been examined. Survey results have indicated a significant positive effect (70% to 90%) of blended learning and the flipped learning model on students’ professional growth and overall satisfaction with their education. Additionally, the article presents examples of exercises (preparatory stage of flipped learning) designed to develop English-language professionally oriented speech competence in master’s students, along with online resources for their implementation in a blended learning format.

Constant sign and nodal solutions for singular Gierer–Meinhardt-type system

We establish the existence of three solutions for singular semilinear elliptic system, two of which are of opposite constant sign. Under a strong singularity effect, the third solution is nodal with synchronous sign components. The approach combines sub-supersolutions method and Leray–Schauder topological degree involving perturbation argument.

Auditory-motor synchronization and perception suggest partially distinct time scales in speech and music

Speech and music might involve specific cognitive rhythmic timing mechanisms related to differences in the dominant rhythmic structure. We investigate the influence of different motor effectors on rate-specific processing in both domains. A perception and a synchronization task involving syllable and piano tone sequences and motor effectors typically associated with speech (whispering) and music (finger-tapping) were tested at slow (~2 Hz) and fast rates (~4.5 Hz). Although synchronization performance was generally better at slow rates, the motor effectors exhibited specific rate preferences. Finger-tapping was advantaged compared to whispering at slow but not at faster rates, with synchronization being effector-dependent at slow, but highly correlated at faster rates. Perception of speech and music was better at different rates and predicted by a fast general and a slow finger-tapping synchronization component. Our data suggests partially independent rhythmic timing mechanisms for speech and music, possibly related to a differential recruitment of cortical motor circuitry.

Redesigning a faculty development program for clinical teachers in Indonesia: a before-and-after study.

Faculty development (FD) is important to support teaching, including for clinical teachers. Faculty of Medicine Universitas Indonesia (FMUI) has conducted a clinical teacher training program developed by the medical education department since 2008, both for FMUI teachers and for those at other centers in Indonesia. However, participation is often challenging due to clinical, administrative, and research obligations. The COVID-19 pandemic amplified the urge to transform this program. This study aimed to redesign and evaluate an FD program for clinical teachers that focuses on their needs and current situation. A five-step design thinking framework (empathizing, defining, ideating, prototyping, and testing) was used with a pre/post-test design. Design thinking made it possible to develop a participant-focused program, while the pre/post-test design enabled an assessment of the program's effectiveness. Seven medical educationalists and four senior and four junior clinical teachers participated in a group discussion in the empathize phase of design thinking. The research team formed a prototype of a 3-day blended learning course, with an asynchronous component using the Moodle learning management system and a synchronous component using the Zoom platform. Pre-post-testing was done in two rounds, with 107 and 330 participants, respectively. Evaluations of the first round provided feedback for improving the prototype for the second round. Design thinking enabled an innovative-creative process of redesigning FD that emphasized participants' needs. The pre/post-testing showed that the program was effective. Combining asynchronous and synchronous learning expands access and increases flexibility. This approach could also apply to other FD programs.

Nine Tips for Humanizing Online Learning

Creating a meaningful and engaging online learning environment requires the deliberate fostering of social relationships, tapping into the inherent social nature of learning. Nine key strategies include sharing professional experience and expertise, demonstrating empathy and compassion, maintaining a visible online presence, integrating personalized videos, offering warm welcomes and farewells, providing one-on-one support, establishing rapport, and incorporating synchronous components to facilitate real-time interaction, all aimed at humanizing the online learning experience and effectively supporting learner engagement.

A Design Method to Eliminate Sub Synchronous Response in Automotive Turbochargers utilizing Nonlinear Dynamics of Time Periodic Systems

The present work introduces a methodology for the dynamic design evaluation of high-speed rotors, applying nonlinear dynamics of time periodic systems. The paper focuses on the definition of design variables so as the system to avoid sub synchronous components in the response. The response of an unbalanced turbocharger rotor mounted on oil bearings with wire mesh dampers (WMDs) is evaluated with an efficient collocation method coupled to the pseudo arc length continuation to evaluate response limit cycles in the entire range of the rotating speed, which acts as bifurcation parameter. The specific system is used to demonstrate the method without loss of generality. The analytical model of the WMD component is implemented directly from the literature, while rigid rotor model and short bearing approximations are used for the rest components. Floquet theory is applied in the non-autonomous dynamic system and the stability characteristics of the response limit cycles are evaluated through Floquet multipliers, the magnitude of which act in the algorithm as stability index. A sensitivity analysis is performed at first to evaluate the correlation between WMD key design parameters and the time response of the system.A multi objective optimization method is embedded to set Floquet multipliers at specific values; in this way the response limit cycles retain stability and periodicity, avoiding any type of bifurcation which would render sub-synchronous component. Acceptable sets for design variables of journal bearings and WMDs are defined by multi-objective optimization and these are verified in efficiency by evaluating the response of the system by time integration, as a virtual experiment, for several operating conditions. The method requires severely lower computational time and capacity to render an acceptable design compared to the conventional design of experiment DoE procedure, and it is not limited on the analytical models of rotor, bearing, or other component.

Incorporating principal component analysis into Hotelling [formula omitted] control chart for compositional data monitoring

In the manufacturing industry, compositional data (CoDa) is a vital quality characteristic to be monitored. The proposed study has introduced a Hotelling T2 control chart using principal component analysis to monitor CoDa explicitly. The proposed method overcomes the limitations of previous approaches by utilizing isometric log-ratio transformation to map the CoDa into unrestricted real space. A Monte Carlo simulation procedure is employed to evaluate the performance of the proposed multivariate control chart. The simulation involves varying combinations of the number of variables (p) and subgroup sizes to obtain metrics such as the average run length when the process is out-of-control (OOC) and the upper control limit. The article presents a comprehensive analysis of the proposed control chart’s statistical performance. These visual aids facilitate a deeper understanding of the method’s effectiveness in detecting OOC conditions in CoDa. Furthermore, two illustrative examples using synchronous machines and components of electronic scrap are provided to illustrate the practical implementation and effectiveness of the Hotelling T2-based principal component control chart for p=5-part and p=12-part CoDa in real-world scenarios.