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Abstract Objective This study identified biomarkers of neurological outcome in Sturge‐Weber syndrome (SWS) via urine angiogenic factors and captured longitudinally derived natural history data within an SWS cohort. Methods This longitudinal, prospective, multicentered study of 61 people with SWS aged 0.4–55 years reports port‐wine birthmark score, Neuroscore, Neuro‐Quality of Life, and urine angiogenic factors over a two‐year period. Results Cognitive Neuroscore worsened over time for children aged 0–2 years. Male sex was associated with worsening Cognitive Function Neuroscore during the study. Age of seizure onset before 2 years was strongly associated with worse Neuroscore. Children with SWS had low Neuro‐Quality of Life related to cognitive function. Seizure severity, male sex, and earlier age of seizure onset were associated with worse Neuro‐Quality of Life in school‐aged children. Children with SWS have elevated basic fibroblast growth factor in their urine compared with controls, whereas higher vascular endothelial growth factor was associated with better Neuroscore. Interpretation This study is the first multicenter, prospective, and longitudinal study of people with SWS. It identifies significant clinical prognostic factors such as age of seizure onset and male sex, informs symptom progression over time by age group, and suggests that further study of angiogenic mechanisms and potential biomarkers are needed.

Climate change has emerged across many regions. Some observed regional climate changes, such as amplified Arctic warming and land-sea warming contrasts have been predicted by climate models. However, many other observed regional changes, such as changes in tropical sea surface temperature and monsoon rainfall are not well simulated by climate model ensembles even when taking into account natural internal variability and structural uncertainties in the response of models to anthropogenic radiative forcing. This suggests climate model predictions may not fully reflect what our future will look like. The discrepancies between models and observations are not well understood due to several real and apparent puzzles and limitations such as the “signal-to-noise paradox” and real-world record-shattering extremes falling outside of the possible range predicted by models. Addressing these discrepancies, puzzles and limitations is essential, because understanding and reliably predicting regional climate change is necessary in order to communicate effectively about the underlying drivers of change, provide reliable information to stakeholders, enable societies to adapt, and increase resilience and reduce vulnerability. The challenges of achieving this are greater in the Global South, especially because of the lack of observational data over long time periods and a lack of scientific focus on Global South climate change. To address discrepancies between observations and models, it is important to prioritize resources for understanding regional climate predictions and analyzing where and why models and observations disagree via testing hypotheses of drivers of biases using observations and models. Gaps in understanding can be discovered and filled by exploiting new tools, such as artificial intelligence/machine learning, high-resolution models, new modeling experiments in the model hierarchy, better quantification of forcing, and new observations. Conscious efforts are needed toward creating opportunities that allow regional experts, particularly those from the Global South, to take the lead in regional climate research. This includes co-learning in technical aspects of analyzing simulations and in the physics and dynamics of regional climate change. Finally, improved methods of regional climate communication are needed, which account for the underlying uncertainties, in order to provide reliable and actionable information to stakeholders and the media.

There are few pharmacologic options for the treatment of cognitive deficits associated with traumatic brain injury in pediatric patients. Acetylcholinesterase inhibitors such as donepezil have been evaluated in adult patients after traumatic brain injury, but relatively less is known about the effect in pediatric populations. The goal of this review is to identify knowledge gaps in the efficacy and safety of acetylcholinesterase inhibitors as a potential adjuvant treatment for neurocognitive decline in pediatric patients with traumatic brain injury. Investigators queried PubMed to identify literature published from database inception through June 2023 describing the use of donepezil in young adult traumatic brain injury and pediatric patients with predefined conditions. Based on preselected search criteria, 340 unique papers were selected for title and abstract screening. Thirty-two records were reviewed in full after eliminating preclinical studies and papers outside the scope of the project. In adult traumatic brain injury, we review results from 14 papers detailing 227 subjects where evidence suggests donepezil is well tolerated and shows both objective and patient-reported efficacy for reducing cognitive impairment. In children, 3 papers report on 5 children recovering from traumatic brain injury, showing limited efficacy. An additional 15 pediatric studies conducted in populations at risk for cognitive dysfunction provide a broader look at safety and efficacy in 210 patients in the pediatric age group. Given its promise for efficacy in adults with traumatic brain injury and tolerability in pediatric patients, we believe further study of donepezil for children and adolescents with traumatic brain injury is warranted.

Abstract Real‐world data derived from electronic health records often exhibit high levels of missingness in variables, such as laboratory results, presenting a challenge for statistical analyses. We developed a systematic workflow for gathering evidence of different missingness mechanisms and performing subsequent statistical analyses. We quantify evidence for missing completely at random (MCAR) or missing at random (MAR), mechanisms using Hotelling's multivariate t‐test, and random forest classifiers, respectively. We further illustrate how to apply sensitivity analyses using the not at random fully conditional specification procedure to examine changes in parameter estimates under missing not at random (MNAR) mechanisms. In simulation studies, we validated these diagnostics and compared analytic bias under different mechanisms. To demonstrate the application of this workflow, we applied it to two exemplary case studies with an advanced non‐small cell lung cancer and a multiple myeloma cohort derived from a real‐world oncology database. Here, we found strong evidence against MCAR, and some evidence of MAR, implying that imputation approaches that attempt to predict missing values by fitting a model to observed data may be suitable for use. Sensitivity analyses did not suggest meaningful departures of our analytic results under potential MNAR mechanisms; these results were also in line with results reported in clinical trials.

Paroxysmal sympathetic hyperactivity (PSH) syndrome is a potentially life-threatening complication after traumatic brain injuries that results from a massive release of catecholamines in the brain. Fat embolism syndrome (FES) is a complication of long bone fractures that results in cerebral or pulmonary fat emboli. We describe PSH in the setting of cerebral FES in an adolescent female following polytrauma secondary to a motor vehicle collision to highlight the importance of rapid diagnosis and treatment of this rare complication.

A canonical genealogy of artificial intelligence must include technologies and data being built with, for and from animals. Animal identification using forms of electronic monitoring and digital management began in the 1970s. Early data innovations comprised RFID tags and transponders that were followed by digital imaging and computer vision. Initially applied in the 1980s for agribusiness to identify meat products and to classify biosecurity data for animal health, yet computer vision is interlaced in subtler ways with commercial pattern recognition systems to monitor and track people in public spaces. As such this paper explores a set of managerial projects in Australian agriculture connected to computer vision and machine learning tools that contribute to dual-use. Herein, ‘the cattle crush’ is positioned as a pivotal space for animal bodies to be interrogated by AI imaging, digitization and data transformation with forms of computational and statistical analysis. By disentangling the kludge of numbering, imaging and classifying within precision agriculture the paper highlights a computational transference of techniques between species, institutional settings and domains that is relevant to regulatory considerations for AI development. The paper posits how a significant sector of data innovation – concerning uses on animals – may tend to evade some level of regulatory and ethical scrutiny afforded to human spaces and settings, and as such afford optimisation of these systems beyond our recognition.

Background: Traumatic rib fractures are associated with increased morbidity and mortality, with complications including pneumothorax, difficult to control pain, and pneumonia. Use of a bundled, multi-disciplinary approach to the care of patients with multiple rib fractures has been shown to reduce morbidity and mortality. In this study, we investigate the implementation of a checklist for the multidisciplinary management of patients with multiple rib fractures who present to an urban, level 1 trauma center and safety-net hospital. Study design: This was a single-institution, retrospective cohort study to assess changes in treatment characteristics and patient outcomes before and after implementation of a comprehensive checklist for the management of high-risk patients with three or more traumatic rib fractures at a level-one trauma center. The primary outcome was pneumonia rates with secondary outcomes of mechanical ventilation rates and mechanical ventilation days, ICU length of stay, mortality, and non-opioid and opioid consumption (morphine milligram equivalents). Results: A total of 104 patients met study eligibility, including 51 patients who presented during the pre-protocol period and 53 patients who received care after implementation. We observed that the checklist was utilized and reviewed in 83% of patients during the post-protocol period. Pneumonia rates were significantly lower in the post-protocol group (35.3% vs 15.1%, p = 0.017). There was no difference in the number of patients who required mechanical ventilation or the duration of mechanical ventilation. On unadjusted analysis, median overall length of stay (11.5 days vs 13 days, p = 0.71), median ICU stay (4 days vs 5 days, p = 0.18), and rate of in-hospital mortality (11.8% vs 7.6%, p = 0.47) was not different between the two time periods. Conclusion: In patients with chest wall trauma and associated rib fractures, implementation of a standardized, multidisciplinary checklist to ensure utilization of multimodal analgesia and non-pharmacological interventions was associated with decreased pneumonia rates at our institution.

Abstract Cardiovascular magnetic resonance (CMR) has been utilized in the management and care of pediatric patients for nearly 40 years. It has evolved to become an invaluable tool in the assessment of the littlest of hearts for diagnosis, pre-interventional management and follow-up care. Although mentioned in a number of consensus and guidelines documents, an up-to-date, large, stand-alone guidance work for the use of CMR in pediatric congenital 36 and acquired 35 heart disease endorsed by numerous Societies involved in the care of these children is lacking. This guidelines document outlines the use of CMR in this patient population for a significant number of heart lesions in this age group and although admittedly, is not an exhaustive treatment, it does deal with an expansive list of many common clinical issues encountered in daily practice.

New Zealand is a remote country in the South Pacific Ocean. The isolation and relatively late arrival of humans into New Zealand has meant there is a recorded history of the introduction of domestic species. Honey bees (Apis mellifera) were introduced to New Zealand in 1839, and the disease American foulbrood was subsequently found in the 1870s. Paenibacillus larvae, the causative agent of American foulbrood, has been genome sequenced in other countries. We sequenced the genomes of P. larvae obtained from 164 New Zealand apiaries where American foulbrood was identified in symptomatic hives during visual inspection. Multi-locus sequencing typing (MLST) revealed the dominant sequence type to be ST18, with this clonal cluster accounting for 90.2% of isolates. Only two other sequence types (with variants) were identified, ST5 and ST23. ST23 was only observed in the Otago area, whereas ST5 was limited to two geographically non-contiguous areas. The sequence types are all from the enterobacterial repetitive intergenic consensus I (ERIC I) genogroup. The ST18 and ST5 from New Zealand and international P. larvae all clustered by sequence type. Based on core genome MLST and SNP analysis, localized regional clusters were observed within New Zealand, but some closely related genomes were also geographically dispersed, presumably due to hive movements by beekeepers.

Abstract Cholera toxin (CT) and Escherichia coli heat-labile enterotoxin (LT) are structurally similar AB5-type protein toxins. They move from the cell surface to the endoplasmic reticulum where the A1 catalytic subunit is separated from its holotoxin by protein disulfide isomerase (PDI), thus allowing the dissociated A1 subunit to enter the cytosol for a toxic effect. Despite similar mechanisms of toxicity, CT is more potent than LT. The difference has been attributed to a more stable domain assembly for CT as compared to LT, but this explanation has not been directly tested and is arguable as toxin disassembly is an indispensable step in the cellular action of these toxins. We show here that PDI disassembles CT more efficiently than LT, which provides a possible explanation for the greater potency of the former toxin. Furthermore, direct examination of CT and LT domain assemblies found no difference in toxin stability. Using novel analytic geometry approaches, we provide a detailed characterization of the positioning of the A subunit with respect to the B pentamer and demonstrate significant differences in the interdomain architecture of CT and LT. Protein docking analysis further suggests that these global structural differences result in distinct modes of PDI-toxin interactions. Our results highlight previously overlooked structural differences between CT and LT that provide a new model for the PDI-assisted disassembly and differential potency of these toxins.

Abstract Background Higher education is responsible for providing education that meets international benchmarks relevant to the needs of the international community. Due to the increase of digital tools in higher education, the possibility of sharing learning resources across nations has expanded. In the current project, a Norwegian university invited universities in Spain and the United Kingdom to adapt and translate e-learning resources originally developed for Norwegian nursing students for use within their respective Bachelor in Nursing programmes. Aim The aim of the current study was to gain insights into the usability and value for learning of e-compendiums shared and implemented across three European universities. Methods The study adopted a descriptive cross-sectional design and included nursing students from the University of Nottingham, Valencia Catholic University, and the University of Stavanger. Data were collected in Autumn 2017 through a questionnaire adapted from the validated “Centre for Excellence in Teaching and Learning Reusable Learning Object evaluation questionnaire” The questionnaire consisted of 19 items that included two aspects: e-compendiums’ value for learning and e-compendiums’ usability. The different study sites were compared using a binary logistic regression analysis. Subgroups of students were compared based on their gender and age. Results A total of 480 nursing students participated in the study. The e -compendiums were overall positively rated, especially for reinforcing and retaining knowledge. Compared to the students from the University of Stavanger, students from Valencia Catholic University rated the e-compendiums more positively in most aspects of learning. Students from University of Nottingham found the e-compendiums to be more important for learning engagement compared to students at the Norwegian study site, and no differences were found in any other aspects of learning. Younger students rated the interactivity and visual components as more important compared to older students. Conclusions Students from the University of Nottingham and Valencia Catholic University seem to accept the e-compendiums despite the fact that they were originally developed for use in another country. We argue that, when sharing e-learning resources across countries, an adaptation and translation process that includes a multicultural and multidisciplinary perspective should be carried out.

Regional patterns of fish diversity, abundance, distribution, and assemblage composition are driven by a combination of biotic and abiotic conditions in the marine environment, but these conditions can be altered through anthropogenic activities, such as those associated with oil and gas extraction. The present study utilises data on fish relative abundance and diversity obtained from 1546 baited remote underwater video deployments conducted between 2004 – 2019 in depths of 9 – 170 m across 2000 km of coastline in north-west Australia on natural habitats and subsea pipelines to understand the influence of oil and gas infrastructure on fish assemblages. A total of 450 fish taxa from 56 families was observed, with populations dominated by generalist and invertebrate carnivore taxa. At the regional scale, subsea pipelines had lower diversity (lower taxonomic richness) than natural environments, but possessed a higher abundance of piscivorous and herbivorous fish taxa. Clear patterns in fish assemblage composition were observed in multivariate analyses, reflecting the proximity of oceanic shoals and banks, depth, and to a lesser extent, oil and gas infrastructure. Shallow-water and close to shoals assemblages were characterised by a diversity of site-attached (e.g., wrasses, tuskfish), reef-associated taxa (e.g., emperors). Mesophotic fish assemblages were characterised by commercially important (e.g., goldband snapper), wide-ranging (e.g., sharks) and sand-affiliated (e.g., toadfish, threadfin bream) taxa. Proximity to pipelines and platforms ranked low as predictors in the multivariate analyses suggesting a negligible regional influence of these structures on fish communities in comparison to depth and shoal habitats. Local-scale influences of subsea infrastructure, however, may be important for some fish species (infrastructure vs. immediate surrounds). Our study highlights the influence of abiotic factors on regional-scale patterns in fish assemblage structure across north-west Australia.

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Purpose – The purpose of this paper is to provide an experiential learning exercise that develops student understanding of social networks within organizations. Understanding these networks can foster complete access to information and inclusive decision-making that translates into career success. Design/methodology/approach – This experiential learning classroom exercise supports all student learning styles using a puzzle to teach students to apply social network theory toward real-world decision-making. This exercise is best used in small and medium-sized classrooms with ideally 15–40 students. This simulation could be used during 50 up through 120-min class sessions. Findings – The game-like environment created by this exercise helps extend real-world understanding that may traditionally be lost with a lecture. Components within this simulation provide balanced consideration for many different learning styles. This exercise has been used successfully within a graduate-level leadership and decision-making course in at least ten sessions over 5 years. Practical implications – This is a real-time theory to practice application exercise where an experiential activity is deployed for students to understand the practical implications and application of a theoretical concept. Social implications – Organizations have internal social networks connecting employees. These connections are how information is dispersed and knowledge is shared. When these networks are understood and effectively used, it can result in more comprehensive problem-solving, valuable collaboration and the maximization of subject matter expertise within the organization. Originality/value – This is a “how-to” teaching and pedagogical exercise. It is original with the benefit of its flexibility and adaptability in the classroom.

Previous reports of paraneoplastic encephalitis occurring in primary fallopian tube carcinoma have been exclusively classified as paraneoplastic cerebellar degeneration, with MR imaging either unremarkable or demonstrating cerebellar atrophy. We report a case of paraneoplastic encephalitis in a 64-year-old female with primary fallopian tube carcinoma, reminiscent of N-methyl d-aspartate receptor encephalitis, with MR imaging demonstrating bilateral subcortical and deep white matter T2-FLAIR hyperintensities sparing cerebellar and brainstem structures. To our knowledge, this represents the first reported case of noncerebellar paraneoplastic encephalitis related to primary fallopian tube carcinoma.

Abstract Purpose The European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) identified the need to develop a competency-based core curriculum for ESSKA specialists, against which all their educational activities, resources and priorities for development could be mapped. The aim of this study was to take a research-based approach to developing a competency-based core curriculum for ESSKA specialists. Methods A Core Curriculum Working Group, with experts representing the ESSKA Board, Sections and Committees, reviewed existing curricula and literature in their own specialist areas and developed a draft list of 285 core competencies for ESSKA specialists. All ESSKA members were asked to comment and rate the importance of these competencies, and the Working Group used these results to refine the curriculum. Results Four hundred-forty responses to the online survey contained meaningful data. Almost all were ESSKA members, with broad representation of the countries, ages and backgrounds of the membership. All 285 core competencies were considered at least ‘Important’ for ESSKA specialists so are retained in the final curriculum, and no new competencies were added. 82 (29%) were considered ‘Essential’, constituting between 19% and 37% of the competencies within each specialist area. 96 (33.5%) were considered ‘Very Important’, and 107 (37.5%) ‘Important’. Conclusions A competency-based core curriculum for ESSKA specialists was achieved through a systematic and scholarly approach, involving both expert opinion and engagement of the wider ESSKA membership. The core curriculum addresses the identified need in terms of educational development for ESSKA and should also be of interest to the wider orthopaedic and sports medicine communities.

Objective: Endovascular chemical angioplasty has been in practice in patients with symptomatic cerebral vasospasm secondary to aneurysmal subarachnoid haemorrhage in many neurosurgical centres. However, the evidence base is derived from clinical case series and expert consensus. The aim of this retrospective cohort study is to evaluate the immediate and functional outcomes of endovascular intervention in aneurysmal subarachnoid haemorrhage cerebral vasospasm treated with a combination of vasodilators. Methods: A cohort of 25 patients was identified. Each patient underwent surgical clipping, and endovascular treatment for vasospasm. A combination of Verapamil and Nimodipine was intra-arterially administered. Statistical analysis was performed to determine the rate of response. The angiographic response and functional outcome on discharge (modified Rankin score - MRS) were used as markers of outcome. Results: The study cohort consisted of 25 patients with a mean age of 50.3 (SD 11.2). A total of 135 therapeutic DSA’s were performed. There was an associated between MRS outcomes and number of vasodilation’s each patient received. For each additional vasodilation episode, the odds of a poor outcome increased by 1.190. An angiographic response was demonstrated in 88% of patients, a clinical response in 27%. A good functional outcome was achieved in 17/25, 71% at discharge. Conclusion: The combination therapy of Intra-arterial nimodipine and verapamil in patients with aneurysmal subarachnoid haemorrhage vasospasm appears to have a synergistic, if not comparable, outcome to from solitary vasodilatory treatment results and potentially promote future studies with prospective designs to measure the outcomes.

Nuclear power plants collect and store large volumes of heterogeneous data from various components and systems. With recent advances in machine learning (ML) techniques, these data can be leveraged to develop diagnostic and short-term forecasting models to better predict future equipment condition. Maintenance operations can then be planned in advance whenever degraded performance is predicted, thus resulting in fewer unplanned outages and the optimization of maintenance activities. This enables lower maintenance costs and improves the overall economics of nuclear power. This paper focuses on developing a short-term forecasting process that leverages a feature selection process to distill large volumes of heterogeneous data and predict specific equipment parameters. A variety of feature selection methods, including Shapley Additive Explanations (SHAP) and variance inflation factor (VIF), were used to select the optimal features as inputs for three ML methods: long short-term memory (LSTM) networks, support vector regression (SVR), and random forest (RF). Each combination of model and input features was used to predict a pump bearing temperature both 1 and 24 hours in advance, based on actual plant system data. The optimal inputs for the LSTM and SVR were selected using the SHAP values, while the optimal input for the RF consisted solely of the response variable itself. Each model produced similar 1-hour-ahead predictions, with root mean square errors (RMSEs) of roughly 0.006. For the 24-hour-ahead predictions, differences could be seen between LSTM, SVR, and RF, as reflected by model performances of 0.036 +- 0.014, 0.0026 +- 0, and 0.063 +- 0.004 RMSE, respectively. As big data and continuous online monitoring become more widely available, the proposed feature selection process can be used for many applications beyond the prediction of process parameters within nuclear infrastructure.

BackgroundEffective knowledge transfer of eLearning objects can hasten the adoption and dissemination of technology in teaching and learning. However, challenges exist which hinder inter-organisational knowledge transfer, particularly across continents. The ACoRD project aimed to transfer knowledge on digital learning development from UK/EU (provider) to Malaysian (receiver) higher education institutions (HEIs). This study explores the challenges encountered during the knowledge transfer process and lessons learned.MethodsThis is a qualitative study involving both the knowledge providers and receivers in focus group discussions (n = 25). Four focus group discussions were conducted in the early (n = 2) and mid-phase (n = 2) of the project by trained qualitative researchers using a topic guide designed to explore experiences and activities representing knowledge transfer in multi-institutional and multi-cultural settings. The interviews were audio-recorded, transcribed verbatim, and checked. The transcripts were analysed using thematic analysis.ResultsFive main themes emerged from this qualitative study: mismatched expectations between providers and receivers; acquiring new knowledge beyond the professional "comfort zone"; challenges in cascading newly acquired knowledge to colleagues and management; individual and organisational cultural differences; and disruption of knowledge transfer during the COVID-19 pandemic.ConclusionThis study highlights the need to create a conducive platform to facilitate continuous, timely and bi-directional needs assessment and feedback; this should be done in the early phase of the knowledge transfer process. The challenges and strategies identified in this study could guide more effective knowledge transfer between organisations and countries.

From its earliest inception, FOLIO was conceived not as an ILS (Integrated Library System), but as a true Services Platform, composed of many independent but interdependent modules, and forming a foundation on which an ILS or other library software could be built out of relevant modules. This vision of modularity is crucial to FOLIO’s appeal to the library community, because it lowers the bar to participation: individual libraries may create modules that meet their needs, or hire developers to do so, or contribute to funding modules that will be of use to a broader community — all without needing “permission” from a central authority. The technical design of FOLIO is deeply influenced by the requirements of modularity, with the establishment of standard specifications and an emphasis on machine-readable API descriptions. While FOLIO’s modular design has proved advantageous, it also introduces difficulties, including cross-module searching and data consistency. Some conventions have been established to address these difficulties, and others are in the process of crystallizing. As the ILS built on FOLIO’s platform grows and matures, and as other application suites are built on it, it remains crucial to resist the shortcuts that monolithic systems can benefit from, and retain the vision of modularity that has so successfully brought FOLIO this far.

Mucopolysaccharidosis (MPS) type I is a rare lysosomal storage disorder caused by an accumulation of glycosaminoglycans (GAGs) resulting in multisystem disease. Neurological morbidity includes hydrocephalus, spinal cord compression, and cognitive decline. While many neurological symptoms have been described, stroke is not a widely-recognized manifestation of MPS I. Accordingly, patients with MPS I are not routinely evaluated for stroke, and there are no guidelines for managing stroke in patients with this disease. We report the case of a child diagnosed with MPS I who presented with overt stroke and repeated neurological symptoms with imaging findings for severe ventriculomegaly, infarction, and bilateral terminal carotid artery stenosis. Direct intracranial pressure evaluation proved negative for hydrocephalus. The patient was subsequently treated with cerebral revascularization and at a 3-year follow-up, the patient reported no further neurological events or new ischemia on cerebral imaging. Cerebral arteriopathy in patients with MPS I may be associated with GAG accumulation within the cerebrovascular system and may predispose patients to recurrent strokes. However, further studies are required to elucidate the etiology of cerebrovascular arteriopathy in the setting of MPS I. Although the natural history of steno-occlusive arteriopathy in patients with MPS I remains unclear, our findings suggest that cerebral revascularization is a safe treatment option that may mitigate the risk of future strokes and should be strongly considered within the overall management guidelines for patients with MPS I.

BackgroundEngaging students in the e-learning development process enhances the effective implementation of e-learning, however, students' priority on the topics for e-learning may differ from that of the educators. This study aims to compare the differences between the students and their educators in prioritising the topics in three healthcare curricula for reusable e-learning object (RLO) development.MethodA modified Delphi study was conducted among students and educators from University Malaya (UM), Universiti Putra Malaysia (UPM) and Taylor's University (TU) on three undergraduate programmes. In Round 1, participants were asked to select the topics from the respective syllabi to be developed into RLOs. Priority ranking was determined by using frequencies and proportions. The first quartile of the prioritised topics was included in Round 2 survey, which the participants were asked to rate the level of priority of each topic using a 5-point Likert scale. The mean score of the topics was compared between students and educators.ResultA total of 43 educators and 377 students participated in this study. For UM and TU Pharmacy, there was a mismatch in the prioritised topics between the students and educators. For UPM, both the educators and students have prioritised the same topics in both rounds. To harmonise the prioritisation of topics between students and educators for UM and TU Pharmacy, the topics with a higher mean score by both the students and educators were prioritised.ConclusionThe mismatch in prioritised topics between students and educators uncovered factors that might influence the prioritisation process. This study highlighted the importance of conducting needs assessment at the beginning of eLearning resources development.