Mountain Lakes High School

Abstract Background Risankizumab, a human monoclonal antibody directed against IL-23, is a drug widely used for the treatment of inflammatory diseases (e.g., plaque psoriasis, Crohn*s disease, ulcerative colitis). Therapeutic drug monitoring is currently proposed to provide useful information to clinicians to improve the efficacy of the treatment. Biosynex has just developed the innovative i-Tracker kits: fast quantification of Risankizumab and Anti-Risankizumab antibodies fully automated on the random-access IDS-i10 chemiluminescent analyzer. Methods The analytical performance was studied using two types of samples: human serum samples spiked with Risankizumab or anti-Risankizumab antibodies, and human serum samples from patients with inflammatory diseases treated with Risankizumab. For drug assay, Risankizumab was captured using IL-23-coupled magnetic microparticles and detected using an acridinium ester-conjugated anti-Risankizumab polyclonal antibody. For the assay of anti-Risankizumab antibodies, microparticles coupled to Risankizumab were used. The anti-Risankizumab antibodies thus captured were detected by Risankizumab conjugated to the acridinium ester. Light emission from acridinium ester conjugates is directly related to the amount of Risankizumab or anti-Risankizumab antibodies present in the sample. Results The quantification of Risankizumab by the i-Tracker Risankizumab kit shows very good accuracy (the percentages of recovery are between 80% and 100%). The intra-test and inter-test reproducibility is very good (CV <7.3% for the Risankizumab assay and CV <8.0% for the anti-Risankizumab antibody assay). No interference from biological agents (bilirubin, hemoglobin, triglycerides, rheumatoid factors) was detected. The assay measurement ranges are 1 µg/mL to 80 µg/mL for Risankizumab and 10 ng/mL to 2000 ng/mL for anti-Risankizumab antibodies. Conclusion The i-Tracker Risankizumab and anti-Risankizumab kits are rapid tests (results obtained in less than 40 minutes) and highly accurate. Monitoring Risankizumab plasma levels could provide clinicians with relevant information to improve treatment efficacy.

Abstract The world is on the edge of a transformative era of energy generation in which emerging technologies have the power to address local and global challenges. But getting there requires an educated citizenry empowered to create and utilize sustainable energy solutions. The QESST Engineering Research Center is focused on furthering the use of solar energy by advancing photovoltaics (PV) science and technology. We are also committed to promoting solar energy education by: developing an extensive set of K-12 curriculum materials to support solar energy and PV engineering education, supporting teachers and outreach coordinators to implement lessons and modules on PV science and engineering, and fostering teacher’s confidence in developing PV engineering curriculum. To achieve these aims, the QESST program designed a summer research experience to provide K-12 classroom teachers opportunities to develop connections between PV engineering research labs and the classroom. Participants conduct use-inspired PV research, and design solar energy lessons. Resulting lessons integrate STEM instruction to support 4th-12th grade students’ understanding of how solar cells are made and how engineering research is improving the capacity of PV to address the most pressing energy challenges of the 21st century. Our eventual aim is to develop a sequenced learning progression of solar energy engineering concepts and skills. Here, we present example lessons designed for students from 3rd to 12th grade, integrating NGSS curriculum standards, disciplinary concepts, practices, and cross-cutting ideas.

Background: Injectable somatostatin receptor ligands (SRLs) are currently the most widely used medical therapy for acromegaly worldwide. Oral octreotide capsules (OOC) have been formulated as a potential therapy for this disorder and the safety and efficacy were evaluated in the CHIASMA OPTIMAL pivotal study (Samson et al. ENDO 2020). As reported, mean IGF-I levels of the OOC treatment group were maintained within normal range at the end of treatment in all patients. However, some patients may not respond to OOC treatment (25% of OOC group and 68% of placebo groups required rescue, P=0.003). This analysis describes the degree and rapidity with which patients achieve biochemical control (IGF-I ≤1.0 x ULN) when reverted to their prior injectable SRL treatment. Methods: Patients with confirmed acromegaly and receiving a stable dose of injectable SRL (≥3 months) were randomized to OOC (40mg/day; N=28) or placebo (N=28) for 36 weeks. Patients were dose titrated to 60 or 80mg of OOC (or placebo) through week 24 at investigator discretion based on increased IGF-I levels and/or worsening acromegaly signs/symptoms. Patients could be rescued via reversion to prior injectable SRL therapy if they met the predefined withdrawal criteria (i.e., IGF-I ≥1.3 x upper limit of normal [ULN] for 2 consecutive visits on the highest dose, and exacerbation of clinical signs/symptoms) or discontinued treatment early for any other reason. In the study, 7 patients in the OOC group and 19 in the placebo group required rescue. The change in IGF-I from Baseline was compared to the end of the Double-blind Placebo Controlled period. Results: In patients rescued up to week 32 and in whom there were at least 4 weeks of follow up, baseline IGF-I levels (mean of Screening Visit 2 and Baseline) were 0.80 and 0.87 x ULN in the OOC and placebo groups, respectively. In patients receiving rescue therapy, the end of study IGF-I levels (mean of week 34 and 36) were 0.80 and 0.89 x ULN in the OOC and placebo groups, respectively, virtually unchanged. The median time to return to normal baseline IGF-I values following loss of response was 4.0 weeks after discontinuing OOC and 4.0 weeks after discontinuing placebo treatment. Therefore, most patients who required rescue following a short trial of therapy with OOC returned to their baseline values following a single SRL injection. Conclusion: Most treatment failures in the CHIASMA OPTIMAL trial (on either OOC or placebo) rescued with injectable SRL re-established their baseline response levels after a single injectable SRL administration (at pre-study dose). Based on this data, patients may potentially be treated with OOC and for those not responding, either not biochemically controlled or who have adverse effects, they may be able to return to injectable SRLs with immediate IGF-I control after one SRL injection.

The Dynamic Gait Index (DGI) has emerged as a valid indicator of functional gait abilities for people with balance and vestibular disorders. Recent Rasch-based analyses have indicated possible concerns for multidimensionality and a ceiling effect within the DGI. The aim of this study was to evaluate the DGI in a sample of patients from a dizziness and balance clinic to determine whether patient features such as dizziness or fall history influence the measurement characteristics of the DGI. This study used a retrospective design. A sample of 117 patients' charts was reviewed, and patients were grouped according to a primary impairment of dizziness only or imbalance and were categorized based on a history of falls. A one-parameter Rasch-Andrich rating scale model was used with thorough analyses, including rating scale analysis, item-difficulty hierarchy, scale unidimensionality, and differential item functioning (DIF). The DGI demonstrated an effective rating scale design and was found to be a unidimensional measurement of dynamic gait. The DGI displayed a modest ceiling effect, primarily with patients with higher functional levels displaying symptoms of dizziness. Three items ("vertical head nods," "gait on level surface," and "stepping over obstacles") demonstrated DIF based on categories of patient characteristics, although the effects on measurement were negligible. Functional categories were based on impairments and not underlying medical diagnoses derived from a retrospective chart review, whereas the limited sample size may have underestimated statistically significant DIF. Results from this study offer additional evidence supporting the validity of the DGI as a measure of gait ability. The present findings also are in agreement with prior research that has shown a ceiling effect for the DGI in people with balance or vestibular disorders. Effects of DIF were found to be negligible, yet the presence of DIF within the present sample helped to explain some differences in DGI item-difficulty hierarchies from prior studies. Continued research is needed to determine how population differences may affect performance on the DGI and to develop and test assessments capable of measuring a broader range of gait abilities.

I discuss notations for some styles of mathematical reasoning that include analogy. These notations extend the conventions of the mathematical package mathscape that I reported recently in the Journal of Symbolic Computation. The paper introduces the reasoning objects that I call "precursors" and "consequences lists".

Candace Simar, RN,C, resides in Pequot Lakes, MN. Editor’s Note:In this new time of home care delivery and an aging population, we are serving more patients in a unique home situation—assisted living. These short tips will help home care nurses better care for patients in this environment as more of these facilities are launched. Address for correspondence: 28718 Co. Road 107, Pequot Lakes, MN 56472 (e-mail: [email protected]).