Rapid Test Can Identify a Key Driver of Severe Asthma by Tracking Protein Signatures

A rapid sputum-based test can accurately identify the presence of white blood cells by tracking their protein signatures.

Researchers have developed a new rapid sputum-based test that can identify the presence of a key driver of severe asthma, white blood cells. A simple, rapid testing device has the potential to detect key drivers of respiratory diseases, including asthma, and would Excellerate accessibility and efficiency in identifying patients with asthma.

The full experimental study is published in Angewandte Chemie International Edition.1

In this study, researchers aimed to develop a new sputum-based lateral flow device (LFD), similar to that of a rapid COVID-19 test, that can quickly and accurately identify eosinophils in complex biological samples, such as sputum, by tracking their protein signatures.

“This is what their collaboration set out to achieve,” said John Brennan, PhD, director of McMaster University’s Biointerfaces Institute and senior study author, in a statement.2 “This test and others like it can have the kind of lasting, meaningful impact that will Excellerate or even save many lives.”

White blood cells, otherwise known as eosinophils, are known to play a role in many airways diseases, including chronic cough, chronic obstructive pulmonary disease (COPD), and certain forms of vasculitis and bronchiectasis. Measurements of eosinophil peroxidase (EPX) are the most abundant and specific of eosinophil cationic proteins and a reliable identifier of eosinophil number and activity.

The researchers developed a protein-targeting element known as a DNAzyme and modified it into the rapid test. Although DNAzymes have primarily been used for detecting metals or bacterial targets, the researchers believed the new platform could be adapted to identify any material of biological origin by detecting its protein signature.

A modified version of the test acted as a bridging strand to allow capture of complimentary DNA (cDNA) modified gold nanoparticles (GNPs) onto a DNA-modified test line to identify measurements of EPX.

Thirty-eight sputum samples from patients or healthy donors were obtained using saline-induction or spontaneous expectorant. Healthy donors included nonsmokers with no known respiratory disease, infection, or symptoms who had not received any vaccination in the prior 8 weeks.

To compare the rapid test results to gold standard sputum cytometry results, the sputum plugs were collected and processed to created 2 sputum samples. One of the samples was centrifuged to remove cellular debris and the other for use with the LFD.

The DNAzyme-based LFD and fluorescence assay for detection of EPX showed good resistance to mammalian nucleases and high sensitivity and selectivity against other eosinophil proteins, including eosinophil cationic protein and eosinophil-derived neurotoxin, and neutrophil proteins, including myeloperoxidase. Furthermore, these assays were validated with patient sputum levels, reaching 100% clinical sensitivity and 96% specificity within 45 minutes.

However, the researchers acknowledge that further work needs to be done to evaluate the rapid test in a clinical setting.

Parameswaran Nair, MD, PhD

“A rapid test to detect eosinophilia would help clinicians make decisions about using drugs, such as steroids or new biologics for patients with severe asthma, and other lung diseases associated with eosinophilia, such as severe cough, and COPD,” said Parameswaran Nair, MD, PhD, professor of medicine at McMaster University and co-author of the study, in a statement.2 “It would also help to limit the unnecessary use of antibiotics.”

References

1. Ali MM, Mukherjee M, Radford K, et al. A rapid sputum‐based lateral flow assay for airway eosinophilia using an RNA‐cleaving DNAzyme selected for Eosinophil peroxidase. Angew Chem Int Ed Engl. Published online July 21, 2023. doi:10.1002/anie.202307451

2. While resolving a key asthma challenge, Hamilton researchers also create a new method to detect proteins in body fluids and other materials. News release. EurekAlert! August 1, 2023. Accessed August 23, 2023. https://www.eurekalert.org/news-releases/997344

How To Pass The ASWB exam To Become A Licensed Social Worker

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Social work licensing practices vary widely by state. Some states require entry-level and generalist social workers to pass an exam and earn licensure. In other states, you only need a license to become a licensed clinical social worker (LCSW) and provide psychotherapy services.

In many states, social work licensure at any level requires you to pass an exam administered by the Association of Social Work Boards (ASWB). The ASWB exam is a nationally recognized exam that evaluates your comprehension of human behavior and development.

If you’re a social work major or considering pivoting into the human services field, read on to discover how to prepare for, take and pass the ASWB licensure exam—with or without a social work degree.

ASWB is a nonprofit organization comprising all of the state social work regulatory boards in the United States and Canada. This body regulates the social work profession and administers the licensure exam that evaluates prospective social workers’ ethics and expertise. Passing the ASWB exam is the final step to earning a social work license in many states.

ASWB offers five exam categories—associate, bachelor’s, master’s, advanced generalist and clinical—each tailored to a specific education and experience level. A candidate’s exam category determines their title and scope of practice post-licensure.

Within a four-hour window, ASWB exam-takers must answer questions concerning:

All ASWB exam categories contain 170 questions on human development and behavior, but question types may vary among categories. For example, the associate and bachelor’s exams lean more heavily on recall questions than other exam categories, which feature larger proportions of reasoning questions.

Each exam category may lead to a different level of social work licensure depending on your state’s licensing processes. Not all states offer all five categories of the ASWB exam.

This category offers a licensure pathway for applicants who want to practice social work without earning a four-year degree in the field. In most cases, associate-level social workers can only practice under supervision.

A handful of states offer this licensing pathway: South Dakota, Michigan, Ohio, New Hampshire and Massachusetts. Only South Dakota, New Hampshire and Massachusetts require associate-level social workers to pass the associate ASWB exam.

Registration for the associate ASWB exam category costs $230.

The ASWB bachelor’s exam, which also costs $230, evaluates your generalist understanding of social work practices and ethics. You must hold a bachelor’s degree in social work from an accredited college to sit for this exam category.

The bachelor’s category features the same questions as the associate category.

Passing the bachelor’s exam qualifies you to become a non-clinical baccalaureate social worker. Exact titles vary among states; in Oregon, these professionals are called registered baccalaureate social workers, while North Carolina calls them certified social workers.

In most cases, social workers at this level interview clients, manage cases, conduct research and advocate for social justice. Depending on the state, they may only be able to practice autonomously after gaining supervised work experience post-licensure.

The ASWB master’s category requires a master of social work (MSW) and usually qualifies applicants for the licensed master social worker (LMSW) credential. Again, the exact title may vary by state—Indiana calls these professionals licensed social workers, for example.

The master’s-level exam tests your foundational understanding of the social work field and evaluates your application of specialized skills gained during their MSW program. Licensees know how to apply advanced practice skills and specialized knowledge in their roles.

LMSWs can drive social change and justice for various communities. In some states, they can provide clinical therapy with oversight from an LCSW. The registration fee for this ASWB exam category is $230.

The advanced generalist category is tailored to prospective LMSWs who aspire to work in macro-level roles. This means working with large populations, such as entire states and countries. The advanced generalist ASWB exam indicates a desire to work with public policy, state or national campaigns, or other government initiatives.

To sit for the advanced generalist ASWB exam, you must hold a master’s degree in social work plus two years of nonclinical professional experience.

With a fee of $260, test takers can prove their expertise in social justice, public policy and administration, and public welfare to their state licensing boards.

The minimum requirements for this ASWB category include an MSW and two years of clinical experience. The clinical ASWB test serves prospective social workers who want to provide mental health services in clinical settings.

LCSWs (who may work under different titles, depending on where they practice) provide psychotherapy services to prevent, diagnose and treat mental illnesses. Through individual or group therapy, these professionals help people struggling with emotional distress.

Clinical social workers practice independently in various settings, including hospitals, schools, psychiatric facilities and social service agencies. Registering for the clinical ASWB exam category costs $260.

First, you must get your state board’s approval to register for the ASWB exam. Approval processes differ depending on the state where you want to practice.

Typical requirements vary by state and license level but may include college transcripts, a license application fee and proof of supervised experience, which you can send to the board via email or fax. Some states may also require you to provide fingerprints and undergo a background check.

Once you receive approval from your state social work board, you must register for the appropriate ASWB licensure exam, either online, via mail or by fax. Registration costs between $230 and $260, depending on your exam category.

If your registration is successful, you’ll receive an “authorization to test” email from ASWB.

Pearson VUE provides testing centers for licensure applicants nationwide. You can schedule, cancel and reschedule exam appointments with Pearson VUE through the testing authorization email.

The ASWB exam is a four-hour, computer-based test comprising 170 multiple-choice questions that test your expertise and decision-making skills as a social worker.

Exam questions cover various content areas and competencies you should have covered during your degree program. You may also find knowledge, skills and abilities statements resembling real-life situations that require critical thinking. To pass the licensure exam, you must answer about 100 out of the 150 questions correctly.

Although self-study is necessary to pass professional exams, practice exams can help you prepare better. By taking a mock test, you can identify loopholes in your study plan, learn the testing software, understand your strengths and areas for improvement, and prepare for complex questions.

After you register for your exam, ASWB offers a 30-day window to take a practice questions for an additional $85. Practice exams exist for all categories except the advanced generalist exam.

Other test prep resources offer free practice tests, but ASWB warns against those resources because their content may be misleading.

ASWB enforces several security measures on test day to ensure a reliable exam process. Prepare to present two photo IDs and sign a confidentiality agreement.

Pearson VUE test centers are fitted with surveillance tools to detect exam malpractice. Exam Center personnel may also walk through the room at intervals.

You cannot enter the testing center with personal items, but you will receive erasable note boards, markers and other necessary materials from the Exam Center personnel. You must return the items after the exam or risk invalidating your score.

The testing equipment should look like a typical computer setup. Test administrators may provide a short on-screen tutorial to help you navigate the software.

Upon completing the licensure exam, you’ll receive an unofficial score report at the Exam Center indicating your performance. ASWB will then send the official score report to your state’s social work board two weeks after the exam.

Note that your scores cannot be altered at any point, so all you can do is wait for your state board to contact you or go ahead with other state-specific requirements. This may take anywhere from two weeks to a month.

If you fail the licensure exam, you can retake it after 90 days.

The ASWB exam stands for the Association of Social Work Boards examination. This test determines whether a candidate is fit to practice social work at their desired licensure level.

A exact ASWB report showed that 75.8% of first-time test takers passed the clinical exam category in 2021. The master’s and bachelor’s categories had pass rates of 73% and 68.7%, respectively.

Specific passing score thresholds on the ASWB exam may vary with each passing year. ASWB recommends that testers correctly answer 90 to 107 of the graded questions to pass the licensure exam.