The emergence and global spread of COVID-19 has disrupted the traditional mechanisms of education throughout the world. Institutions of learning were caught unprepared and this jeopardised the face-to-face method of curriculum delivery and assessment. Teaching institutions have shifted to an asynchronous mode whilst attempting to preserve the principles of integrity, equity, inclusiveness, fairness, ethics, and safety. A framework of assessment that enables educators to utilise appropriate methods in measuring a student’s progress is crucial for the success of teaching and learning, especially in health education that demands high standards and comprises consistent scientific content. Within such a framework, this paper aims to present a narrative review of the currently utilised methods of assessment in health education and recommend selected modalities that could be administered in an asynchronous mode during the COVID-19 pandemic. Assessment methods such as open-ended short answer questions, problem-based questions, oral exams, and recorded objective structured clinical exams (OSCE) would be appropriate for use in an asynchronous environment to assess the knowledge and competence of health professional students during COVID-19. Fairness and integrity can be ensured by using technological tools such as video and audio recording surveillance.
Introduction This study explored the efficacy and safety of a serotonin‐6 receptor antagonist, masupirdine, as adjunct treatment in patients with moderate Alzheimer's disease (AD) concomitantly treated with donepezil and memantine. Methods The effects of masupirdine were evaluated in patients with moderate AD dementia on background treatment with donepezil and memantine. Five hundred thirty‐seven patients were expected to be randomized in a 1:1:1 ratio, using permuted blocked randomization. After a 2‐ to 4‐week screening period, the study consisted of a 26‐week double‐blind treatment period, and a 4‐week washout period. The primary efficacy measure was the 11‐item cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS‐Cog 11). Secondary efficacy measures were Clinical Dementia Rating Scale–Sum of Boxes, Mini‐Mental State Examination, 23‐item Alzheimer's Disease Co‐operative Study Activities of Daily Living, and 12‐item Neuropsychiatric Inventory. Changes from baseline were analyzed using a mixed effects model for repeated measures (MMRM). A total of 564 patients were randomized to receive either daily masupirdine 50 mg (190 patients), masupirdine 100 mg (185 patients), or placebo (189 patients). The study is registered at ClinicalTrials.gov (NCT02580305). Results The MMRM results showed statistically non‐significant treatment differences in change from baseline in ADAS‐Cog 11 scores at week 26, comparing each masupirdine dose arm to the placebo arm. No significant treatment effects were observed in the secondary evaluations. Discussion Masupirdine was generally safe and well tolerated. Possible reasons for the observed trial results are discussed. Highlights Masupirdine was evaluated in moderate Alzheimer's disease patients. First trial in class with background treatment of donepezil and memantine. Masupirdine was generally safe and well tolerated. Possible reasons for the observed trial results are discussed.
Peptides are distinctive biomacromolecules that demonstrate potential cytotoxicity and diversified bioactivities against a variety of microorganisms including bacteria, mycobacteria, and fungi via their unique mechanisms of action. Among broad-ranging pharmacologically active peptides, natural marine-originated thiazole-based oligopeptides possess peculiar structural features along with a wide spectrum of exceptional and potent bioproperties. Because of their complex nature and size divergence, thiazole-based peptides (TBPs) bestow a pivotal chemical platform in drug discovery processes to generate competent scaffolds for regulating allosteric binding sites and peptide–peptide interactions. The present study dissertates on the natural reservoirs and exclusive structural components of marine-originated TBPs, with a special focus on their most pertinent pharmacological profiles, which may impart vital resources for the development of novel peptide-based therapeutic agents.
Background: Recent findings suggest bacteria's ability to adapt to various classes of antibiotics through three distinct resistance mechanisms: lipopolysaccharide modification, increased drug efflux, and reduced porin pathway. These mechanisms involve the adaptive response by bacteria to specific signal due to antibacterial presence in its environment, leading to up-and down regulation of the efflux system (MexXY/OprM), and the porin pathway (OprD) respectively. Molecular encapsulation in niosomes could block signal generation and prevent bacteria from recognizing the presence of encapsulated drug molecules, enhance fusogenic properties and enable drug assimilation. Methods: Niosomes of select fluoroquinolones (i.e. ciprofloxacin, gatifloxacin, levofloxacin and norfloxacin) were prepared using thin film rehydration method and the parameters controlling niosomal drug loading were investigated including the speed of evaporation, temperature of rehydration, time of rehydration and volume of rehydration, using percent (%) drug loading as output variable. In vitro activity of noisome encapsulated fluoroquinolones against twenty ciprofloxacinresistant bacteria strains (each of Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus) was determined by broth microdilution technique. Paired sample t-test was performed for independent sample comparison while multi-group analysis was done with one-way analysis of variance (ANOVA) and significance determined at 95 % confidence level using MINITAB 16 statistical package. Results: Entrapment efficiencies for the fluoroquinolones were 71.11±1.39% (ciprofloxacin), 19.11±1.86% (gatifloxacin), 34.23±1.86% (levofloxacin) and 70.09±1.64% (norfloxacin) respectively. The formulations displayed temperature-dependent stability with the highest stability occurring at 5ºC and the lowest at 37ºC respectively. Drug diffusion across dialyzing membrane was slower from the vesicles and followed a more sustained profile compared with the non-encapsulated drug particles. Analysis of drug liberation kinetics suggests first-order (concentration-dependent) release from the vesicles. Conclusions: The niosomes of fluoroquinolones produced at least twofold reduction in MIC's against Pseudomonas aeruginosa and Escherichia coli, and at least four-fold reduction in MIC's against Staphylococcus aureus. Results therefore suggest the potential for enhancement of fluoroquinolones delivery to their target sites in the bacteria cytoplasm through formulation in niosomes.
Objective: To determine the infective dose of Staphylococcus aureus (ATCC 29213) and Pseudomonas aeruginosa (ATCC 27853) in Sprague Dawley rats, when the inoculum is injected via the intraperitoneal route. Design and Methods: In interest of animal welfare and to reduce the number of animals used, we utilized the "up-down procedure" for dose determination of Pseudomonas aeruginosa and Staphylococcus aureus. Animals were grouped in fours, injected IP with inoculums of known concentration of a single organism and observed for 10 days. Clinical signs such as lethargy, increased respiration, porphyrin staining was recorded. Gross necropsy was performed ten (10) days post infection. Only one infective dose was done at a time and depending on the outcome, the size of inoculum was adjusted for the next step in the experimental infectious process. Results: Doses of inoculum was carefully titrated and the highest tolerable dose for each organism was determined. These doses allowed for survival of the animals and gave clinical signs, which mimicked the scenario in a human population. Symptoms of infection included lethargy, ruffled fur, porphyrin staining, dehydration and hunched back. At necropsy at 10 days post infection, common indicators of infection observed were ascites, abscesses on the intestinal wall, kidneys, liver and spleen. There were also fibrin tags, rounded livers, enlarged spleen and increased pericardial effusion was prominent in the S. aureus infected group. Conclusions: The infective doses were determined based on clinical signs, survival and post mortem changes. The doses determined for Staphylococcus aureus (ATCC 29213) was 1.75 X 10 10 cfu/ml and Pseudomonas aeruginosa (ATCC 27853) was 3.0 X 10 8 cfu/ml. These doses would be useful in infective animal studies to determine the efficacy of antimicrobial agents.
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