Transitional approaches to teaching in the superlab environment

PROBLEM With the completion of Building 15 in 2020, for the first time at Edith Cowan University (ECU), undergraduate students had the opportunity to learn hands-on practical skills in a SuperLab environment.  Moving from smaller classes into more open-plan learning environments requires a shift in thinking on behalf of both the student and the teacher.  Teaching styles and training techniques will need to be modified in order to encourage skill development and present novel opportunities for student engagement. PLAN This project set out to capture the student experience, via questionnaires and focus groups, across a diverse range of student cohorts transitioning into the SuperLabs in 2020.  Five ECU Academics (Balmer, Berry, Wajrak, Gough and Phillips) commenced teaching in the SuperLabs with a diverse cohort of students from a variety of units across chemistry, genetics and biomedical sciences. The plan for this project was to seek and probe students’ perceptions and experiences of learning in the SuperLabs. ACTION Students’ experiences in the SuperLabs were captured, via an online questionnaire deployed using Qualtrics, across a diverse range of student cohorts, for both students commencing studies and those with previous experience of the smaller laboratory environment, to understand how the two lab environments compared, with regard to their learning experience.  35 survey questions were designed using Likert scale, multiple-choice, emojis to convey emotions and extended comments. The dominant finding of this project was that the results obtained were highly dependent on students’ previous laboratory experience, i.e., whether they were students whose first laboratory environment was the SuperLab or students who had previously studied in other smaller lab classes (24 student capacity). Overwhelmingly, the data showed that students value and prefer the new SuperLab environment and had mostly positive experiences, however, when we drilled down to individual responses, students identified some important issues which were detrimental to their learning, such as: not being able to hear instructions, could not see the demonstrator, uncomfortable chairs, not enough demonstrators to assist, significantly harder to concentrate with so many students around and a lot more noise. REFLECTION These findings are important and need to be considered when designing teaching plans for the SuperLab environment. It is crucial that teaching staff are aware of issues which have a negative impact on students’ learning in the SuperLab environment and think about how to best overcome those problems

INTRODUCING AUTHENTIC RESEARCH EXPERIENCE AT THE UNDERGRADUATE LEVEL

One of the challenges facing new graduates is that they don’t necessarily know what lies out there for them once they have finished their degrees. Not all students are aware of the jobs they are qualified for, or the post-graduate opportunities that may be available to them. In an attempt to engage with undergraduate students and give them a glimpse into life after graduation, we ran a pilot Cancer Research Summer Project (CRSP). In this pilot program we took four high-achieving second-year biomedical science students through a three-week research project, which exposed them to a real-life laboratory experience, and also provided them with additional skills training in areas such as scientific journal article writing and database mining. Students were given a fully immersive laboratory experience, receiving the type of instruction and supervision they could expect in either post-graduate study or out in the workforce, with some autonomy, and successes and failures driven by their own hands. Students reported that the CRSP provided a fantastic opportunity and made them aware of a new world of possibilities after graduation. At the end of the project the students were provided with a supporting letter to include in their curriculum vitae, showing evidence of the industry-relevant training they undertook. Work experience is often required of new employees, especially in the field of biomedical research. This project had the additional benefit of providing students with vitally important first-hand experience. It also provided a vehicle to demonstrate to the students that the skills and theories they learn in their undergraduate courses can be directly transferred to the workplace or in their further studies. With the continuation of this project into the future, the hope is that students can gain a broader understanding of the opportunities available to them and that more students will be encouraged to take up post-graduate study

Determinants of variation in radical local treatment for men with high-risk localised or locally advanced prostate cancer in England.

BACKGROUND: Many factors are implicated in the potential 'under-treatment' of prostate cancer but little is known about the between-hospital variation. METHODS: The National Prostate Cancer Audit (NPCA) database was used to identify high-risk localised or locally advanced prostate cancer patients in England, between January 2014 and December 2017, and the treatments received. Hospital-level variation in radical local treatment was explored visually using funnel plots. The intra-class correlation coefficient (ICC) quantified the between-hospital variation in a random-intercept multivariable logistic regression model. RESULTS: 53,888 men, from 128 hospitals, were included and 35,034 (65.0%) received radical local treatment. The likelihood of receiving radical local treatment was increased in men who were younger (the strongest predictor), more affluent, those with fewer comorbidities, and in those with a non-Black ethnic background. There was more between-hospital variation (P < 0.001) for patients aged ≥80 years (ICC: 0.235) compared to patients aged 75-79 years (ICC: 0.070), 70-74 years (ICC: 0.041), and <70 years (ICC: 0.048). Comorbidity and socioeconomic deprivation did not influence the between-hospital variation. CONCLUSIONS: Radical local treatment of high-risk localised or locally advanced prostate cancer depended strongly on age and comorbidity, but also on socioeconomic deprivation and ethnicity, with the between-hospital variation being highest in older patients

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

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

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

The clinical presentation of autoimmune thyroid disease in men is associated with IL12B genotype

Background Common variants in the interleukin 12B (IL12B) gene are associated with predominantly inflammatory (Th1) or antibody-mediated (Th2) immune responses. As Hashimoto’s disease and Graves’ disease are thought to arise from mainly Th1 and Th2 immune responses respectively, we hypothesized that IL12B genotype may influence the clinical presentation of autoimmune thyroid disease. Objective We tested for differences in IL12B genotype between Graves’ disease and Hashimoto’s disease. Patients We studied a discovery cohort of 203 Australian women and 37 men with autoimmune thyroid disease, a replication cohort of 100 European men and a cohort of 146 Chinese men. Intervention We analysed three IL12B variants: rs41292470, in the promoter; rs3212227, in the 3¢ untranslated region and rs6887695, located 60 kilobases upstream from the coding region. Results In the discovery cohort, rs41292470 and rs3212227 genotypes did not differ significantly between Hashimoto’s disease and Graves’ disease. In Australian men (but not women), rs6887695 genotype differed between Hashimoto’s disease and Graves’ disease, with a minor allele frequency (MAF) of 14% and 41%, respectively (P = 0Æ034). This result was confirmed in the European men (MAF 24% and 41%; P = 0Æ013). On combined analysis of Australian, European and Chinese men (N = 285), the difference was highly significant (MAF 23% and 45%; P = 3 · 10)5). In 233 men without thyroid disease, the MAF was 34%, significantly different from Graves’ disease (P = 0Æ005) and Hashimoto’s disease (P = 0Æ029). Conclusion In men with autoimmune thyroid disease, a common variant located upstream of the IL12B coding region may influence whet

Silicon Isotopic Composition of Dry and Wet-Based Glaciers in Antarctica

Glaciers and ice sheets export significant amounts of silicon (Si) to downstream ecosystems, impacting local and potentially global biogeochemical cycles. Recent studies have shown Si in Arctic glacial meltwaters to have an isotopically distinct signature when compared to non-glacial rivers. This is likely linked to subglacial weathering processes and mechanochemical reactions. However, there are currently no silicon isotope (d30Si) data available from meltwater streams in Antarctica, limiting the current inferences on global glacial silicon isotopic composition and its drivers. To address this gap, we present dissolved silicon (DSi), d30SiDSi, and major ion data from meltwater streams draining a polythermal glacier in the region of the West Antarctic Peninsula (WAP; King George Island) and a cold-based glacier in East Antarctica [Commonwealth Stream, McMurdo Dry Valleys (MDV)]. These data, alongside other global datasets, improve our understanding of how contrasting glacier thermal regime can impact upon Si cycling and therefore the d30SiDSi composition. We find a similar d30SiDSi composition between the two sites, with the streams on King George Island varying between -0.23 and C1.23h and the Commonwealth stream varying from - 0.40 to C1.14h. However, meltwater streams in King George Island have higher DSi concentrations, and the two glacial systems exhibit opposite DSi – d30SiDSi trends. These contrasts likely result from differences in weathering processes, specifically the role of subglacial processes (King George Island) and, supraglacial processes followed by in-stream weathering in hyporheic zones (Commonwealth Stream). These findings are important when considering likely changes in nutrient fluxes from Antarctic glaciers under climatic warming scenarios and consequent shifts in glacial thermal regimes

Enhanced trace element mobilization by Earth’s ice sheets

Trace elements sustain biological productivity, yet the significance of trace element mobilization and export in subglacial runoff from ice sheets is poorly constrained at present. Here, we present size-fractionated (0.02, 0.22, and 0.45 µm) concentrations of trace elements in subglacial waters from the Greenland Ice Sheet (GrIS) and the Antarctic Ice Sheet (AIS). Concentrations of immobile trace elements (e.g., Al, Fe, Ti) far exceed global riverine and open ocean mean values and highlight the importance of subglacial aluminosilicate mineral weathering and lack of retention of these species in sediments. Concentrations are higher from the AIS than the GrIS, highlighting the geochemical consequences of prolonged water residence times and hydrological isolation that characterize the former. The enrichment of trace elements (e.g., Co, Fe, Mn, and Zn) in subglacial meltwaters compared with seawater and typical riverine systems, together with the likely sensitivity to future ice sheet melting, suggests that their export in glacial runoff is likely to be important for biological productivity. For example, our dissolved Fe concentration (20,900 nM) and associated flux values (1.4 Gmol y−1) from AIS to the Fe-deplete Southern Ocean exceed most previous estimates by an order of magnitude. The ultimate fate of these micronutrients will depend on the reactivity of the dominant colloidal size fraction (likely controlled by nanoparticulate Al and Fe oxyhydroxide minerals) and estuarine processing. We contend that ice sheets create highly geochemically reactive particulates in subglacial environments, which play a key role in trace elemental cycles, with potentially important consequences for global carbon cycling