High throughput screening for drugs that inhibit 3C-like protease in SARS-CoV-2

The SARS coronavirus 2 (SARS-CoV-2) pandemic remains a major problem in many parts of the world and infection rates remain at extremely high levels. This high prevalence drives the continued emergence of new variants, and possibly ones that are more vaccine-resistant and that can drive infections even in highly vaccinated populations. The high rate of variant evolution makes clear the need for new therapeutics that can be clinically applied to minimize or eliminate the effects of COVID-19. With a hurdle of 10 years, on average, for first in class small molecule therapeutics to achieve FDA approval, the fastest way to identify therapeutics is by drug repurposing. To this end, we developed a high throughput cell-based screen that incorporates the essential viral 3C-like protease and its peptide cleavage site into a luciferase complementation assay to evaluate the efficacy of known drugs encompassing approximately 15,000 clinical-stage or FDA-approved small molecules. Confirmed inhibitors were also tested to determine their cytotoxic properties. Medicinal chemistry efforts to optimize the hits identified Tranilast as a potential lead. Here, we report the rapid screening and identification of potentially relevant drugs that exhibit selective inhibition of the SARS-CoV-2 viral 3C-like protease.

Importance of cross reaction covariance data for user applications

The characterization of the uncertainty in radiation damage metrics presents many challenges. This paper examines the current approaches to characterizing radiation damage metrics such as hydrogen and helium gas production, material heating, trapped charge in microelectronics, and lattice displacement damage. Critical uncertainty aspects go beyond just the material cross sections and involve the consideration of energy-dependent cross reaction correlations, the recoil ion energy spectrum, and models used for the partitioning of the recoil ion energy into various forms of energy deposition. This paper starts with a review of terminology and then examines the current approaches in the characterization of uncertainty in radiation damage metrics for several applications. The major deficiencies in the uncertainty of the damage metric characterization are also identified.

Understanding Online Registry Facilitators and Barriers Experienced by Black Brain Health Registry Participants: The Community Engaged Digital Alzheimer's Research (CEDAR) Study

BACKGROUND

Failure of Alzheimer's disease and related diseases (ADRD) research studies to include and engage Black participants is a major issue, which limits the impact and generalizability of research findings. Little is known about participation of Black adults in online ADRD-related research registries.

OBJECTIVES

As part of the Community Engaged Digital Alzheimer's Research (CEDAR) Study, this study aims to increase our understanding of facilitators and barriers of Black adults to participating in ADRD-related online registries, as well as to understand their preferences for communication channels.

DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS

We invited all Black participants enrolled in the Brain Health Registry (BHR) to complete a cross-sectional online survey. The survey consisted of rating scales and open-text questions asking about their attitudes towards brain health research, reasons for joining and continuing to participate in BHR, difficulties with participating, and preferences for modes of contact and website usage.

RESULTS

Of all invited Black BHR participants (N=3,636), 198 (5.5%) completed the survey. The mean age was 58.4 (SD=11.3), mean years of education were 16.3 (SD=2.4), and 85.5% identified as female. Reported facilitators for joining and continuing to participate in BHR were personal interest (e.g., learning more about own brain health) and altruism (e.g., helping research). Among additional registry features which could encourage return, receiving feedback or scores about BHR tasks was rated the highest. Of those who found BHR participation difficult (21%), the most frequent reason was time burden. The most preferred way of receiving study information was via email. Participants reported that the websites that they used the most were YouTube and Facebook.

DISCUSSION

The results of our study can inform the development of culturally-responsive registry features and engagement efforts to improve inclusion and participation of Black adults in online ADRD research. Providing participants with feedback about their registry performance and reducing the number of registry tasks are among the recommended strategies.

The Community Engaged Digital Alzheimer's Research (CEDAR) Study: A Digital Intervention to Increase Research Participation of Black American Participants in the Brain Health Registry

BACKGROUND

Although Black/African American older adults bear significant inequities in prevalence, incidence, and outcomes of Alzheimer's disease and related dementias, they are profoundly under-included in Alzheimer's Disease research. Community-Engaged Research (e.g., equitable community/science partnerships) is an evidence-based approach for improving engagement of underrepresented populations into Alzheimer's Disease research, but has lacked scalability to the national level. As internet use among older adults from underrepresented populations continues to grow, internet-based research shows promise as a feasible, valid approach to engagement and longitudinal assessment. The Community Engaged Digital Alzheimer's Research (CEDAR) study utilizes a community-engaged research approach to increase the engagement and research participation of Black/African American adults in the Brain Health Registry (BHR) and Alzheimer Disease clinical research.

OBJECTIVES

To describe the methods and evaluate the feasibility of the CEDAR culturally-informed digital platform within BHR.

DESIGN

All Black/African American participants in BHR were invited to enroll in CEDAR and to consider serving on a newly convened Community-Scientific Partnership Board to guide the study. The community board guided the development a culturally-informed cadre of engagement materials and strategies to increase research participation. Engagement strategies included incentives for study task completion, culturally-informed communications (e.g., landing page, emails and social media), resources about brain health, and video and written testimonials by CEDAR participants.

SETTING

BHR, an Internet-based registry and cohort.

PARTICIPANTS

BHR participants self-identifying as Black/African American were invited to enroll. All participants who signed an online informed consent document were enrolled.

MEASUREMENTS

We report the number of participants invited, enrolled, completed tasks, and volunteered to join the community board. We compared the demographics, cognitive profile, and baseline BHR task completion rates between CEDAR participants and all those invited to join the study.

RESULTS

Of 3738 invited, 349 (9.34%) enrolled in CEDAR. 134 (37% of CEDAR participants) volunteered to join the community board, of which 19 were selected for the community board. Compared to those invited, the CEDAR cohort had a higher percentage of female participants (84.5%) and a lower percentage of participants who identify as belonging to more than one ethnocultural group (21.8%). Compared to those did not enroll in CEDAR, those enrolled in CEDAR had a higher percentage of participants completing all BHR tasks (22%) and a higher percentage of participants completing at least one cognitive test (76%). Those enrolled in CEDAR also had a higher percentage of participants having an enrolled study partner (18%).

CONCLUSIONS

A culturally-informed Community-Engaged Research approach, including a remotely-convened community board, to engagement of Black/African American participants in an online research registry is feasible. This approach can be adapted for use in various clinical studies and other settings. Future studies will evaluate the effectiveness of the engagement strategies.

INVESTIGATION OF BIOLOGICAL DETERMINANTS OF FRAILTY IN MALE AND FEMALE MICE

Frailty is quantified as the accumulation of health deficits over an organism’s lifetime and gives a measure of the overall health of an organism. Preliminary studies have found an association between frailty and some of the hallmarks of aging including inflammation and senescence. However, the molecular underpinnings of frailty, and whether the mechanisms of frailty are distinct from or overlap those of aging is unknown. Previously we developed clocks based on frailty assessments that accurately predict age and lifespan in older male mice. Here, we expand these clocks to predict age, lifespan and frailty itself in younger, and also female mice. Additionally, we incorporate molecular measures including blood cell composition, plasma metabolomics, PBMC DNA methylation and stool microbial diversity measures into the clocks. These clocks provide important tools for the field, and also provide an indication of the molecular underpinnings of frailty and sex differences in these.

A comparison of emotion-focused therapy and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: Results of a feasibility randomized controlled trial

Generalized anxiety disorder (GAD) is a chronic mental health difficulty typically present in primary care settings. Cognitive-behavioral therapy (CBT) is the psychological intervention with the best evidence for its efficacy for GAD. The development of other psychological interventions can increase client choice. This feasibility trial examined an initial assessment of the efficacy of EFT in comparison to CBT in the treatment of GAD in the context of an Irish public health service. The trial provided information on recruitment, therapist training/adherence, and client retention relevant for a potential noninferiority trial. A randomized controlled trial compared the efficacy of EFT versus CBT for GAD. Both therapies were offered in a 16-20 sessions format. Therapists (n = 8) were trained in both conditions and offered both therapies. Clients were randomly assigned to the two therapies EFT (n = 29) and CBT (n = 29). Outcomes were assessed using several measures, with the Generalized Anxiety Disorder-7 (GAD-7) being the primary outcome. Clients were assessed at baseline, week 16, end of therapy, and at 6-month follow-up. Therapists were able to learn the two models after a short training and showed moderate levels of adherence. Although not statistically significant, the drop out from treatment was 10% for EFT and 27% for CBT. The two therapies showed large pre-post change and similar outcomes across all measures, with these benefits retained at 6-month follow-up. Results suggest that EFT is a potentially promising treatment for GAD. Further investigation is indicated to establish its potential to expand the available psychological therapies for GAD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Disorder-to-Order Transition Activates an ATP-Independent Membrane Protein Chaperone

The 43 kDa subunit of the chloroplast signal recognition particle, cpSRP43, is an ATP-independent chaperone essential for the biogenesis of the light harvesting chlorophyll-binding proteins (LHCP), the most abundant membrane protein family on earth. cpSRP43 is activated by a stromal factor, cpSRP54, to more effectively capture and solubilize LHCPs. The molecular mechanism underlying this chaperone activation is unclear. Here, a combination of hydrogen-deuterium exchange, electron paramagnetic resonance, and NMR spectroscopy experiments reveal that a disorder-to-order transition of the ankyrin repeat motifs in the substrate binding domain of cpSRP43 drives its activation. An analogous coil-to-helix transition in the bridging helix, which connects the ankyrin repeat motifs to the cpSRP54 binding site in the second chromodomain, mediates long-range allosteric communication of cpSRP43 with its activating binding partner. Our results provide a molecular model to explain how the conformational dynamics of cpSRP43 enables regulation of its chaperone activity and suggest a general mechanism by which ATP-independent chaperones with cooperatively folding domains can be regulated.

Association between minimum inhibitory concentration, beta-lactamase genes and mortality for patients treated with piperacillin/tazobactam or meropenem from the MERINO study

INTRODUCTION

This study aims to assess the association of piperacillin/tazobactam and meropenem minimum inhibitory concentration (MIC) and beta-lactam resistance genes with mortality in the MERINO trial.

METHODS

Blood culture isolates from enrolled patients were tested by broth microdilution and whole genome sequencing at a central laboratory. Multivariate logistic regression was performed to account for confounders. Absolute risk increase for 30-day mortality between treatment groups was calculated for the primary analysis (PA) and the microbiologic assessable (MA) populations.

RESULTS

320 isolates from 379 enrolled patients were available with susceptibility to piperacillin/tazobactam 94% and meropenem 100%. The piperacillin/tazobactam non-susceptible breakpoint (MIC > 16 mg/L) best predicted 30-day mortality after accounting for confounders (odds ratio 14.9, 95% CI 2.8 - 87.2). The absolute risk increase for 30-day mortality for patients treated with piperacillin/tazobactam compared with meropenem was 9% (95% CI 3% - 15%) and 8% (95% CI 2% - 15%) for the original PA population and the post-hoc MA populations, which reduced to 5% (95% CI -1% - 10%) after excluding strains with piperacillin/tazobactam MIC values > 16 mg/L. Isolates co-harboring ESBL and OXA-1 genes were associated with elevated piperacillin/tazobactam MICs and the highest risk increase in 30-mortality of 14% (95% CI 2% - 28%).

CONCLUSION

After excluding non-susceptible strains, the 30-day mortality difference was from the MERINO trial was less pronounced for piperacillin/tazobactam. Poor reliability in susceptibility testing performance for piperacillin/tazobactam and the high prevalence of OXA co-harboring ESBLs suggests meropenem remains the preferred choice for definitive treatment of ceftriaxone non-susceptible E. coli and Klebsiella.

Using Rasch Analyses To Inform the Revision of a Scale Measuring Students' Process-Oriented Writing Competence in Portfolios

Thanks to the wide range of benefits it provides to teaching and learning, portfolio assessment has maintained widespread popularity in language education over the last few decades. However, the practical use of this assessment method is still subject to debates, particularly about the lack of clear definitions and empirical validations of the constructs underlying the assessment. This problem can be addressed by research into portfolio scale development and examination and this article reports on the process of investigating the psychometric properties of a scale assessing the portfolio-based writing competence of Vietnamese students who speak English as a foreign language (EFL). The psychometric validation in this investigation involved applying different Rasch models, including multidimensional, partial credit and many-facet models, to examine the characteristics of the scale items. The findings support the use of the scale with mostly good item functioning and acceptable raters' consistency in using the scale. Finally, only one item addressing the length of writing is removed from the developed scale and the items assessing the planning stage of writing in writing portfolios are flagged for further inspection in a larger scale study. Implications for using the scale to improve the quality of teaching and assessment of writing via portfolios can be drawn.

A comparison of emotion-focused therapy and cognitive-behavioural therapy in the treatment of generalised anxiety disorder: study protocol for a randomised controlled trial

Background

Generalised anxiety disorder (GAD) is a chronic and debilitating condition characterised by high co-morbidity. Alongside pharmacological treatment, cognitive behavioural therapy (CBT) is an established psychological therapy for GAD. Its effectiveness is limited, however, with only an estimated 50% of clients presenting in the non-clinical range after a course of treatment. Furthermore, not all clients prefer CBT as a psychological therapy. Recently, emotion-focused therapy (EFT) was developed for GAD and was tested in an open trial with promising results.

Methods/design

The present research project is a feasibility testing randomised controlled trial (RCT) that compares the efficacy of EFT with an established treatment for GAD, CBT. Sixty clients presenting in a primary care psychology/counselling service will be randomly assigned to one of two conditions: EFT or CBT. Outcomes will be assessed using several measures (Generalised Anxiety Disorder-7, Generalised Anxiety Disorder Severity Scale, Patient Health Questionnaire-9, and Clinical Outcome in Routine Evaluation – Outcome Measure). Clients will be assessed prior to and at the end of therapy, as well as at 6-month follow-up. On the basis of findings from the initial open EFT trial with regard to the optimal length of therapy, it is proposed that therapy last between 16 and 20 sessions.

Discussion

This study aims to test the feasibility of a full comparison RCT. It will test subject recruitment, therapist adherence to manualised treatment, and client retention rates. It will also provide estimates of comparative outcomes that can inform power calculations for a definitive trial.

Trial registration

ISRCTN Registry, ISRCTN52689081. Registered on 24 October 2017.

Electronic supplementary material

The online version of this article (10.1186/s13063-018-2892-0) contains supplementary material, which is available to authorized users.

Graphical Item Maps: providing clearer feedback on professional exam performance

This article was migrated. The article was marked as recommended. Background: Structured feedback is an important component of learning and assessment and is highly valued by candidates. Unfortunately, item specific feedback is generally not feasible for high stakes professional assessments due to the high cost of item development and the need to maintain stable assessment performance characteristics. In a high stakes assessment of fetal surveillance knowledge, we sought to use graphical item mapping to allow informative candidate feedback without compromising the item bank. Methods: We developed Graphical Item Maps (GIMs) to display individual candidate performance in the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Fetal Surveillance Education Program (FSEP) multiple-choice question assessment. GIMs use item and person parameter estimates from Item Response Theory (IRT) models to map the interaction between a test taker and assessment tasks of varying difficulty. Results: It is both feasible and relatively simple to provide GIMs for individual candidate feedback. Operational examples are presented from the RANZCOG FSEP assessment. This paper demonstrates how test takers and educators might use GIMs as a form of assessment feedback. Conclusions: Graphical Item Maps are a useful and insightful assessment feedback tool for clinical practitioners partaking in a high stakes professional education and assessment program. They might be usefully employed in similar healthcare professional assessments to inform directed learning.

Safety and tolerability of plecanatide in patients with chronic idiopathic constipation: long-term evidence from an open-label study

OBJECTIVE

This multi-center, fixed-dose, open-label study evaluated the long-term safety and tolerability of once-daily oral plecanatide for the treatment of adults with chronic idiopathic constipation (CIC).

METHODS

Eligible patients completed a phase 2b or phase 3 double-blind study of plecanatide, or had not previously been treated with plecanatide. Enrolled patients received plecanatide (3 or 6 mg) for up to 72 weeks. Safety and tolerability were assessed by the incidence, nature, and severity of spontaneously reported treatment-emergent adverse events (TEAEs). Patients also completed Patient Global Assessment questionnaires, which included measures of treatment satisfaction and the desire to continue treatment.

RESULTS

There were 2370 patient exposures in this study, with the vast majority (90.5%) receiving treatment with plecanatide 6 mg. At the time of study closure, 1932 (81.5%) had completed or were still receiving study drug. TEAEs were qualitatively and quantitatively similar to those observed in prior double-blind studies. The most common TEAEs were diarrhea (7.1%) and urinary tract infection (2.2%). TEAEs leading to discontinuation occurred in 5.3% of patients, with diarrhea leading to discontinuation in 3.1%. Most TEAEs were mild/moderate in severity and were generally considered not related to plecanatide treatment. At the end of treatment, the median score for treatment satisfaction was 4.0 (quite satisfied), and the median score for treatment continuation was 4.0 (quite likely).

CONCLUSIONS

Long-term treatment of adults with CIC demonstrated that plecanatide was safe and well tolerated, with low TEAE and discontinuation rates. Patients indicated satisfaction and a desire to continue with plecanatide treatment.

Randomized clinical trial: efficacy and safety of plecanatide in the treatment of chronic idiopathic constipation

BACKGROUND

Plecanatide, with the exception of a single amino acid replacement, is identical to human uroguanylin and is approved in the United States for adults with chronic idiopathic constipation (CIC). This double-blind, placebo-controlled, phase III study evaluated the efficacy and safety of plecanatide versus placebo in CIC.

METHODS

Adults meeting modified Rome III CIC criteria were randomized to plecanatide 3 mg (n = 443), 6 mg (n = 449), or placebo (n = 445). Patients recorded bowel movement (BM) characteristics [including spontaneous BMs (SBMs) and complete SBMs (CSBMs)] and rated CIC symptoms in daily electronic diaries. The primary endpoint was the percentage of durable overall CSBM responders (weekly responders for ⩾9 of 12 treatment weeks, including ⩾3 of the last 4 weeks). Weekly responders had ⩾3 CSBMs/week and an increase of ⩾1 CSBM from baseline for the same week.

RESULTS

A significantly greater percentage of durable overall CSBM responders resulted with each plecanatide dose compared with placebo (3 mg = 20.1%; 6 mg = 20.0%; placebo = 12.8%; p = 0.004 each dose). Over the 12 weeks, plecanatide significantly improved stool consistency and stool frequency. Significant increases in mean weekly SBMs and CSBMs began in week 1 and were maintained through week 12 in plecanatide-treated patients. Adverse events were mostly mild/moderate, with diarrhea being the most common (3 mg = 3.2%; 6 mg = 4.5%; placebo = 1.3%).

CONCLUSIONS

Plecanatide resulted in a significantly greater percentage of durable overall CSBM responders and improved stool frequency and secondary endpoints. Plecanatide was well tolerated; the most common AE, diarrhea, occurred in a small number of patients.[ClinicalTrials.gov identifier: NCT02122471].

Health and Safety Adoption from Use of a Risk Assessment Document on Irish Farms

OBJECTIVES

This article describes levels of implementation of occupational health and safety (OHS) controls on a sample of Irish farms following completion of a risk assessment document (RAD) made available as part of a statutory code of practice (COP) for the agriculture sector. The article describes the legislation mandating the COP and the operation of a prevention initiative (PI) among key stakeholders to develop and promote farmer use of the COP and RAD.

METHODS

RADs were collected for farmers (N = 475) and the number and type of OHS controls listed for action were tabulated. A farm audit of OHS standards and of implementation of controls listed for action in the RAD was undertaken among a randomly selected sample of farms (N = 94) where the RAD was completed.

RESULTS

The study data indicates that farmers used the RAD to a limited extent, and that their focus in its use was on identifying physical rather than organizational controls. An association was found between farmers who actively implemented controls and positive OHS standards. Farm OHS standards were also associated with farmer attitude to OHS, farm enterprise, farmer age category, and work time needed to operate the farm.

CONCLUSIONS

Overall, the study data suggests that standards of farm management are a crucial determinant of OHS standards. The study data also indicates that having knowledge of required OHS controls does not ensure implementation. Development of social learning in groups is considered as a significant means of increasing OHS farm adoption.

Molecular assembly of rhodopsin with G protein-coupled receptor kinases

G protein-coupled receptor kinases (GRKs) play pivotal roles in desensitizing GPCR signaling but little is known about how GRKs recognize and phosphorylate GPCRs due to the technical difficulties in detecting the highly dynamic GPCR/GRK interaction. By combining a genetic approach with multiple biochemical assays, we identified the key determinants for the assembly of the prototypical GPCR rhodopsin with its kinase GRK1. Our work reveals that the regulatory G-protein signaling homology (RH) domain of GRKs is the primary binding site to GPCRs and an active conformation of the GRK1 kinase domain is required for efficient interaction with rhodopsin. In addition, we provide a mechanistic solution for the longstanding puzzle about the gain-of-function Q41L mutation in GRK5. This mutation is in the RH domain and increases the capacity of the GRK mutant to interact with and to desensitize GPCRs. Finally we present the principal architecture of a rhodopsin/GRK complex through negative stain electron microscopy reconstruction. Together, these data define the key components for the rhodopsin/GRK1 interaction and provide a framework for understanding GRK-mediated desensitization of GPCRs.

Abstract 4854: Bazedoxifene inhibits ESR1 somatic mutants with improved potency compared to tamoxifene and raloxifene

Despite continued administration of antiestrogen therapies, approximately 50% of all estrogen receptor alpha (ERalpha) positive breast cancers will present new metastatic lesions. The acquisition of secondary hormone-resistant metastatic breast cancers represents a significant clinical barrier towards life-long disease free survival for the patient. Somatic mutations to the ERalpha gene (ESR1) Y537S and D538G represent a novel mechanism of acquired antiestrogen resistance because they confer hormone-free transcriptional activity and reduced selective estrogen receptor modulator (SERM) and selective estrogen receptor degrader (SERD) potency. Fulvestrant, a SERD, was the only molecule that could completely ablate mutant ERalpha activity. Unfortunately, fulvestrant possesses poor pharmacologic profiles that limit its therapeutic utility. Bazedoxifene (BZA) is a potent mixed SERM/SERD and has improved pharmacokinetics and oral bioavailability compared to fulvestrant. We show that BZA inhibits Y537S and D538G ESR1 somatic mutation transcriptional activity with a greater potency than the SERMs 4-hydroxytamoxifen (TOT) and raloxifene (RAL). Further investigations into the biophysical and structural basis for BZA action suggest that BZA increases the conformational dynamics of helix 12, a key molecular switch that governs ERalpha action resulting in SERD-like properties and improved potency against the somatic mutations compared to TOT and RAL.

Citation Format: Sean W. Fanning, Venkat Dharmarajan, Christopher G. Mayne, Weiyi Toy, Kathryn E. Carlson, Teresa A. Martin, Jason Nowak, Jerome Nwachukwu, David J. Hosfield, Emad Tajkhorshid, Sarat Chandarlapaty, Patrick Griffin, Yang Shen, John A. Katzenellenbogen, Geoffrey L. Greene. Bazedoxifene inhibits ESR1 somatic mutants with improved potency compared to tamoxifene and raloxifene. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4854.

Primary ciliary dyskinesia in two English Cocker Spaniels

BACKGROUND

Primary ciliary dyskinesia (PCD) is an inherited condition characterised by structural and functional defects of ciliated cells. Ciliated cells are present in several different anatomic locations and PCD can thus cause a variety of clinical signs; however, the predominant clinical signs in dogs are respiratory in nature, most commonly chronic nasal discharge and recurrent lower respiratory tract infections commencing in the neonatal period.

CASE REPORT AND CONCLUSION

This report describes two cases of PCD in English Cocker Spaniel puppies presenting with chronic nasal discharge and bronchopneumonia. We describe the use of a minimally invasive technique to collect samples suitable for cilial studies for its diagnosis.

Development of the school entrant health questionnaire for assessing primary school children aged 5–7

This article describes the development and pilot testing of the School Entrant Health Questionnaire (SEHQ) for the School Nursing Program in Victoria, Australia to provide a health profile of primary school children. Items likely to discriminate between healthy children and children having health concerns were generated. Domains included were: general health, medications, immunizations, dental health, speech/language, hearing, vision, disabilities, general development, behavior and emotional wellbeing, and family stress. Testing to determine reliability, validity and discriminability was conducted in four phases. The SEHQ was found to have sound reliability and good discriminability between students who had problems and those who did not. Analysis of the SEHQ data leads directly to clinical nursing actions for children identfied as having problems in any of the 11 domains. SEHQ is used to reach almost an Australian state population of 5-7year olds annually, generating a significant data base on this age group.

Performance assessment of higher order thinking

This article describes a study investigating the effect of intervention on student problem solving and higher order competency development using a series of complex numeracy performance tasks (Airasian and Russell, 2008). The tasks were sequenced to promote and monitor student development towards hypothetico-deductive reasoning. Using Rasch partial credit analysis (Wright and Masters, 1982) to calibrate the tasks and analysis of residual gain scores to examine the effect of class and school membership, the study illustrates how directed intervention can improve students' higher order competency skills. This paper demonstrates how the segmentation defined by Wright and Masters can offer a basis for interpreting the construct underlying a test and how segment definitions can deliver targeted interventions. Implications for teacher intervention and teaching mentor schemes are considered. The article also discusses multilevel regression models that differentiate class and school effects, and describes a process for generating, testing and using value added models.

Measuring nursing competencies in the operating theatre: instrument development and psychometric analysis using Item Response Theory

BACKGROUND

Concern about the process of identifying underlying competencies that contribute to effective nursing performance has been debated with a lack of consensus surrounding an approved measurement instrument for assessing clinical performance. Although a number of methodologies are noted in the development of competency-based assessment measures, these studies are not without criticism.

RESEARCH AIM

The primary aim of the study was to develop and validate a Performance Based Scoring Rubric, which included both analytical and holistic scales. The aim included examining the validity and reliability of the rubric, which was designed to measure clinical competencies in the operating theatre.

RESEARCH METHOD

The fieldwork observations of 32 nurse educators and preceptors assessing the performance of 95 instrument nurses in the operating theatre were used in the calibration of the rubric. The Rasch model, a particular model among Item Response Models, was used in the calibration of each item in the rubric in an attempt at improving the measurement properties of the scale. This is done by establishing the 'fit' of the data to the conditions demanded by the Rasch model.

RESULTS

Acceptable reliability estimates, specifically a high Cronbach's alpha reliability coefficient (0.940), as well as empirical support for construct and criterion validity for the rubric were achieved. Calibration of the Performance Based Scoring Rubric using Rasch model revealed that the fit statistics for most items were acceptable.

CONCLUSION

The use of the Rasch model offers a number of features in developing and refining healthcare competency-based assessments, improving confidence in measuring clinical performance. The Rasch model was shown to be useful in developing and validating a competency-based assessment for measuring the competence of the instrument nurse in the operating theatre with implications for use in other areas of nursing practice.

Pharmacological repression of RORγ is therapeutic in the collagen-induced arthritis experimental model (P5214)

The nuclear receptor RORγ has been shown to play an essential role in the development of Th17 cells. Previously, it was reported that the potent and selective RORγ inverse agonist SR2211 was effective at modulating RORγ activity in cell culture. More recently we demonstrated that the RORγ inverse agonist SR2211 can repress expression and production inflammatory cytokines in Th17 cells and LPS stimulated RAW264.7 cells. Here we present in vivo efficacy of SR2211 in an experimental model of arthritis, the murine collagen induced arthritis or CIA model. Significantly reduced Joint CIA scores were observed in SR2211 treated mice as compared with vehicle in the acute phase of the model. CIA represents an autoimmune environment characterized by the accumulation of inflammatory cells into the synovium leading to the destruction of joints. In this model cytokines have been shown to be important regulators of synovial inflammation. Administration of SR2211 in CIA mice led to an increase in IFNγ in ex vivo stimulated draining lymph nodes. As IFNγ has been shown to be beneficial for the treatment of rheumatoid arthritis. In previous work, patients treated with IFNγ showed significant therapeutic potential of RA the data presented suggest the potential of targeting RORγ to repress inflammatory T cell function and macrophage activation in arthritis. Thus, SR2211 has potential utility in the treatment of inflammatory disease.

Fixed or mixed: a comparison of three, four and mixed-option multiple-choice tests in a Fetal Surveillance Education Program

BACKGROUND

Despite the widespread use of multiple-choice assessments in medical education assessment, current practice and published advice concerning the number of response options remains equivocal. This article describes an empirical study contrasting the quality of three 60 item multiple-choice test forms within the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Fetal Surveillance Education Program (FSEP). The three forms are described below.

METHODS

The first form featured four response options per item. The second form featured three response options, having removed the least functioning option from each item in the four-option counterpart. The third test form was constructed by retaining the best performing version of each item from the first two test forms. It contained both three and four option items.

RESULTS

Psychometric and educational factors were taken into account in formulating an approach to test construction for the FSEP. The four-option test performed better than the three-option test overall, but some items were improved by the removal of options. The mixed-option test demonstrated better measurement properties than the fixed-option tests, and has become the preferred test format in the FSEP program. The criteria used were reliability, errors of measurement and fit to the item response model.

CONCLUSIONS

The position taken is that decisions about the number of response options be made at the item level, with plausible options being added to complete each item on both psychometric and educational grounds rather than complying with a uniform policy. The point is to construct the better performing item in providing the best psychometric and educational information.

Developing of two instruments to measure attitudes of Vietnamese parents and students toward schooling

The attitudes of parents and students towards schooling are often considered to be important factors associated with students' educational outcomes. This article presents the process of constructing and calibrating two scales to measure the attitudes of students and parents in Vietnam, and then linking these two scales to compare the two groups. A set of items that covered both development and opportunity aspects of education was designed. After the items were trialled, a final version of 13 items was compiled. The two scales yielded scores that were shown to have logical, face, content and construct validity.

MLN4924: a novel first-in-class inhibitor of NEDD8-activating enzyme for cancer therapy

INTRODUCTION

The small ubiquitin-like molecule NEDD8 has been identified as an essential regulator of the activity of the cullin-RING E3 ubiquitin ligases (CRLs), which control the turnover of multiple proteins with fundamental roles in cancer biology. The aberrant function of the NEDD8 cascade within the context of malignancy makes it an attractive target for the development of novel anticancer agents. MLN4924 is a first-in-class inhibitor of the proximal regulator of the NEDD8 system (NEDD8-activating enzyme, NAE) that has entered Phase-I trials for cancer therapy and has established that significant therapeutic benefit can be achieved by antagonizing NEDD8-mediated protein degradation.

AREAS COVERED

This review provides a detailed overview of the NEDD8 system and discusses the mechanisms of action of MLN4924, a novel small molecule NAE inhibitor. Key findings from preclinical investigations of MLN4924 in a broad range of cancer models and preliminary findings from ongoing Phase-I clinical trials with MLN4924 are also discussed.

EXPERT OPINION

Targeting protein NEDDylation represents an exciting new anticancer strategy with demonstrable therapeutic benefit. Ongoing and future studies focused on dissecting the functional status/regulation of the NEDD8 system in individual tumor types will facilitate the design of novel approaches that yield optimal therapeutic benefit.

Bespoke latex allergen testing improves assessment of respiratory symptoms in textile-braiding workers

BACKGROUND

Latex allergy is poorly understood in latex-exposed textile workers.

METHODS

A cross-sectional study was carried out to better characterize respiratory symptoms, using personal breathing zone latex allergen measurement and specific IgE to latex allergens.

RESULTS

Forty-four of the 86 (51% participation rate) participated. Ten of 39 workers who gave a blood sample (25.6%) were found to have IgE to at least one workplace allergen (5/39 positive to either latex braiding coated with silica or talc, 4/39 were positive to the dyed cotton extract, and 1/39 to latex braiding coated with silica or talc and dyed cotton extract), whilst only 2 of these 10 had specific IgE to the commercial latex extract.

CONCLUSIONS

The presence of symptoms with evidence of sensitization was strongly dictated by current latex exposure. Bespoke workplace allergen IgE testing identified cases of WR respiratory symptoms with sensitization that otherwise would not have been identified.

The partial replacement of soyabean meal and rapeseed meal with feed grade urea or a slow-release urea and its effect on the performance, metabolism and digestibility in dairy cows

The objectives of the study were to determine the effect of the partial replacement of soyabean meal and rapeseed meal with feed grade urea or a slow-release urea on the performance, metabolism and whole-tract digestibility in mid-lactation dairy cows. Forty-two Holstein-Friesian dairy cows were allocated to one of three dietary treatments in each of three periods of 5 weeks duration in a Latin square design. Control (C) cows were offered a total mixed ration based on grass and maize silages and straight feeds that included 93 g/kg dry matter (DM) soyabean meal and 61 g/kg DM rapeseed meal. Cows that received either of the other two treatments were offered the same basal ration with the replacement of 28 g/kg DM soyabean and 19 g/kg DM rapeseed meal with either 5 g/kg DM feed grade urea (U) or 5.5 g/kg DM of the slow-release urea (S; Optigen®; Alltech Inc., Kentucky, USA), with the content of maize silage increasing. There was no effect (P > 0.05) of dietary treatment on DM intake, which averaged 22.5 kg/day. Similarly, there was no effect (P > 0.05) of treatment on daily milk or milk fat yield but there was a trend (P = 0.09) for cows offered either of the diets containing urea to have a higher milk fat content (average of 40.1 g/kg for U and S v. 38.9 g/kg for C). Milk true protein concentration and yield were not affected by treatment (P > 0.05). Milk yield from forage and N efficiency (g milk N output/g N intake) were highest (P < 0.01) in cows when offered S and lowest in C, with cows receiving U having intermediate values. Cows offered S also tended to have the highest live weight gain (0.38 kg/day) followed by U (0.23 kg/day) and C (0.01 kg/day; P = 0.07). Plasma urea concentrations were higher (P < 0.05) at 2 and 4 h post feeding in cows when offered U and lowest in C, with animals receiving S having intermediate values. There was no effect (P > 0.05) of treatment on whole-tract digestibility. In conclusion, the partial replacement of soyabean meal and rapeseed meal with feed grade urea or a slow-release urea can be achieved without affecting milk performance or diet digestibility, with the efficiency of conversion of dietary N into milk being improved when the slow-release urea was fed.

Testing a multi-stage screening system: Predicting performance on Australia’s national achievement test using teachers’ ratings of academic and social behaviors

This study addresses the predictive validity of results from a screening system of academic enablers, with a sample of Australian elementary school students, when the criterion variable is end-of-year achievement. The investigation included (a) comparing the predictive validity of a brief criterion-referenced nomination system with more comprehensive behavior ratings, and (b) determining the optimal combination of scores to gather from this system for identifying academic difficulties. Students ( n = 360) were rated using both the Performance Screening Guides (PSGs; Elliott & Gresham, 2007) and the Rating Scales (Gresham & Elliott, 2008) of the Social Skills Improvement System. The PSGs were highly sensitive (0.95) predictors of below minimum standard performance on the national test. The Rating Scales, including the brief academic competence scale in particular, added predictive value in most domains. The discussion addresses implications of these findings for school psychologists and other educators interested in the role of social behaviors as academic enablers and predictors of academic achievement.

Line-orientation generalization following signalled-reinforcer training

Three naive and three nonnaive pigeons key pecked for food on a multiple variable-interval 1-minute variable-interval 1-minute schedule with a black zero-degree vertical line on a white surround associated with one component and a black line shifted 30 degrees to the right (+30 degree) associated with the other component. Subsequently, a signalled-reinforcer procedure was introduced in the +30 degree component, i.e., whenever the reinforcer was available for the next response, the key changed to blank white. Following this training, the original unsignalled-reinforcer condition was re-instated. Line orientation generalization tests were given at the end of signalled-reinforcer training and after the second unsignalled-reinforcer condition. The signalled-reinforcer procedure reduced response rate in the +30-degree component in all subjects but facilitated responding during the zero-degree component (behavioral contrast) for two of the naive subjects only. However, average generalization gradients following signalled-reinforcer training indicated peak shift in two subjects and area shift in all five subjects that completed the experiment. There was no apparent relation between contrast and peak shift or degree of area shift. The data were interpreted as supporting the notion that the signalled-reinforcer procedure segments a variable-interval schedule into extinction and fixed ratio 1 segments.

Complementary methods to investigate the development of clogging within a horizontal sub-surface flow tertiary treatment wetland

A combination of experimental methods was applied at a clogged, horizontal subsurface flow (HSSF) municipal wastewater tertiary treatment wetland (TW) in the UK, to quantify the extent of surface and subsurface clogging which had resulted in undesirable surface flow. The three dimensional hydraulic conductivity profile was determined, using a purpose made device which recreates the constant head permeameter test in-situ. The hydrodynamic pathways were investigated by performing dye tracing tests with Rhodamine WT and a novel multi-channel, data-logging, flow through Fluorimeter which allows synchronous measurements to be taken from a matrix of sampling points. Hydraulic conductivity varied in all planes, with the lowest measurement of 0.1md(-1) corresponding to the surface layer at the inlet, and the maximum measurement of 1550md(-1) located at a 0.4m depth at the outlet. According to dye tracing results, the region where the overland flow ceased received five times the average flow, which then vertically short-circuited below the rhizosphere. The tracer break-through curve obtained from the outlet showed that this preferential flow-path accounted for approximately 80% of the flow overall and arrived 8h before a distinctly separate secondary flow-path. The overall volumetric efficiency of the clogged system was 71% and the hydrology was simulated using a dual-path, dead-zone storage model. It is concluded that uneven inlet distribution, continuous surface loading and high rhizosphere resistance is responsible for the clog formation observed in this system. The average inlet hydraulic conductivity was 2md(-1), suggesting that current European design guidelines, which predict that the system will reach an equilibrium hydraulic conductivity of 86md(-1), do not adequately describe the hydrology of mature systems.

Rasch scaling procedures for informing development of a valid Fetal Surveillance Education Program multiple-choice assessment

BACKGROUND

It is widely recognised that deficiencies in fetal surveillance practice continue to contribute significantly to the burden of adverse outcomes. This has prompted the development of evidence-based clinical practice guidelines by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and an associated Fetal Surveillance Education Program to deliver the associated learning. This article describes initial steps in the validation of a corresponding multiple-choice assessment of the relevant educational outcomes through a combination of item response modelling and expert judgement.

METHODS

The Rasch item response model was employed for item and test analysis and to empirically derive the substantive interpretation of the assessment variable. This interpretation was then compared to the hierarchy of competencies specified a priori by a team of eight subject-matter experts. Classical Test Theory analyses were also conducted.

RESULTS

A high level of agreement between the hypothesised and derived variable provided evidence of construct validity. Item and test indices from Rasch analysis and Classical Test Theory analysis suggested that the current test form was of moderate quality. However, the analyses made clear the required steps for establishing a valid assessment of sufficient psychometric quality. These steps included: increasing the number of items from 40 to 50 in the first instance, reviewing ineffective items, targeting new items to specific content and difficulty gaps, and formalising the assessment blueprint in light of empirical information relating item structure to item difficulty.

CONCLUSION

The application of the Rasch model for criterion-referenced assessment validation with an expert stakeholder group is herein described. Recommendations for subsequent item and test construction are also outlined in this article.

Plant systems biology comes of age

'Omics' research approaches have produced copious data for living systems, which have necessitated the development of systems biology to integrate multidimensional biological information into networks and models. Applications of systems biology to plant science have been rapid, and have increased our knowledge about circadian rhythms, multigenic traits, stress responses and plant defenses, and have advanced the virtual plant project.