The Impact of Feedback Interactions on Online Learner Satisfaction and Achievement

Thesis (Ed.D.) - Indiana University, Department of Instructional Systems Technology, 2019The design of an online course--taught by different faculty members and accessed by groups of adult, online learners--has the potential to produce or prevent learner satisfaction and achievement. Feedback interactions between online learners and the instructor are central to successful learning; nevertheless, there are gaps in what is known about the frequency, distribution, timeliness, and content of feedback that can impact student achievement and satisfaction. This study uses analytics from a learning management system (LMS) along with analyses of the feedback instructors provide to students in comments on written assignments. It compares those data with achievement exam scores and learners’ responses on an institutional end-of-course (EOC) survey. The intent is to determine whether there are relationships between easily accessible learning analytics data sources and student achievement or satisfaction. Findings indicate that while LMS data were not predictors of student achievement or satisfaction, there was evidence that individualized and content-specific comments from instructors to students had an impact on student achievement and satisfaction. As a result, instructional designers could target course improvements that facilitate the instructor’s ability to provide meaningful, individualized feedback to students

Absorption Coefficient (ABSCO) Tables for the Orbiting Carbon Observatories: Version 5.1

The accuracy of atmospheric trace gas retrievals depends directly on the accuracy of the molecular absorption model used within the retrieval algorithm. For remote sensing of well-mixed gases, such as carbon dioxide (CO₂), where the atmospheric variability is small compared to the background, the quality of the molecular absorption model is key. Recent updates to oxygen (O₂) absorption coefficients (ABSCO) for the 0.76 μm A-band and the water vapor (H₂O) continuum model within the 1.6 μm and 2.06 μm CO₂ bands used within the Orbiting Carbon Observatory (OCO-2 and OCO-3) algorithm are described here. Updates in the O₂ A-band involve the inclusion of new laboratory measurements within multispectrum fits to improve relative consistency between O₂ line shapes and collision-induced absorption (CIA). The H₂O continuum model has been updated to MTCKD v3.2, which has benefited from information from a range of laboratory studies relative to the model utilized in the previous ABSCO version. Impacts of these spectroscopy updates have been evaluated against ground-based atmospheric spectra from the Total Carbon Column Observing Network (TCCON) and within the framework of the OCO-2 algorithm, using OCO-2 soundings covering a range of atmospheric and surface conditions. The updated absorption coefficients (ABSCO version 5.1) are found to offer improved fitting residuals and reduced biases in retrieved surface pressure relative to the previous version (ABSCO v5.0) used within B8 and B9 of the OCO-2 retrieval algorithm and have been adopted for the OCO B10 Level 2 algorithm

Absorption Coefficient (ABSCO) Tables for the Orbiting Carbon Observatories: Version 5.1

The accuracy of atmospheric trace gas retrievals depends directly on the accuracy of the molecular absorption model used within the retrieval algorithm. For remote sensing of well-mixed gases, such as carbon dioxide (CO₂), where the atmospheric variability is small compared to the background, the quality of the molecular absorption model is key. Recent updates to oxygen (O₂) absorption coefficients (ABSCO) for the 0.76 μm A-band and the water vapor (H₂O) continuum model within the 1.6 μm and 2.06 μm CO₂ bands used within the Orbiting Carbon Observatory (OCO-2 and OCO-3) algorithm are described here. Updates in the O₂ A-band involve the inclusion of new laboratory measurements within multispectrum fits to improve relative consistency between O₂ line shapes and collision-induced absorption (CIA). The H₂O continuum model has been updated to MTCKD v3.2, which has benefited from information from a range of laboratory studies relative to the model utilized in the previous ABSCO version. Impacts of these spectroscopy updates have been evaluated against ground-based atmospheric spectra from the Total Carbon Column Observing Network (TCCON) and within the framework of the OCO-2 algorithm, using OCO-2 soundings covering a range of atmospheric and surface conditions. The updated absorption coefficients (ABSCO version 5.1) are found to offer improved fitting residuals and reduced biases in retrieved surface pressure relative to the previous version (ABSCO v5.0) used within B8 and B9 of the OCO-2 retrieval algorithm and have been adopted for the OCO B10 Level 2 algorithm

Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial

OBJECTIVE: To determine the feasibility, efficacy, and safety of early cold stored platelet transfusion compared with standard care resuscitation in patients with hemorrhagic shock. BACKGROUND: Data demonstrating the safety and efficacy of early cold stored platelet transfusion are lacking following severe injury. METHODS: A phase 2, multicenter, randomized, open label, clinical trial was performed at 5 US trauma centers. Injured patients at risk of large volume blood transfusion and the need for hemorrhage control procedures were enrolled and randomized. The intervention was the early transfusion of a single apheresis cold stored platelet unit, stored for up to 14 days versus standard care resuscitation. The primary outcome was feasibility and the principal clinical outcome for efficacy and safety was 24-hour mortality. RESULTS: Mortality at 24 hours was 5.9% in patients who were randomized to early cold stored platelet transfusion compared with 10.2% in the standard care arm (difference, -4.3%; 95% CI, -12.8% to 3.5%; P =0.26). No significant differences were found for any of the prespecified ancillary outcomes. Rates of arterial and/or venous thromboembolism and adverse events did not differ across treatment groups. CONCLUSIONS AND RELEVANCE: In severely injured patients, early cold stored platelet transfusion is feasible, safe and did not result in a significant lower rate of 24-hour mortality. Early cold stored platelet transfusion did not result in a higher incidence of arterial and/or venous thrombotic complications or adverse events. The storage age of the cold stored platelet product was not associated with significant outcome differences

The SUN protein UNC-84 is required only in force-bearing cells to maintain nuclear envelope architecture

The nuclear envelope (NE) consists of two evenly spaced bilayers, the inner and outer nuclear membranes. The Sad1p and UNC-84 (SUN) proteins and Klarsicht, ANC-1, and Syne homology (KASH) proteins that interact to form LINC (linker of nucleoskeleton and cytoskeleton) complexes connecting the nucleoskeleton to the cytoskeleton have been implicated in maintaining NE spacing. Surprisingly, the NE morphology of most Caenorhabditis elegans nuclei was normal in the absence of functional SUN proteins. Distortions of the perinuclear space observed in unc-84 mutant muscle nuclei resembled those previously observed in HeLa cells, suggesting that SUN proteins are required to maintain NE architecture in cells under high mechanical strain. The UNC-84 protein with large deletions in its luminal domain was able to form functional NE bridges but had no observable effect on NE architecture. Therefore, SUN-KASH bridges are only required to maintain NE spacing in cells subjected to increased mechanical forces. Furthermore, SUN proteins do not dictate the width of the NE

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Bringing life

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