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Nielsen A, Soerensen S, Skaarup K, Djernaes K, Estepar R, Hansen M, Worck R, Johannesen A, Hansen J, Biering-Soerensen T. Left atrial function assessed by speckle tracking echocardiography predicts atrial fibrillation burden after catheter ablation independently of reconduction: a RACE-AF echocardiographic sub-study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Left atrial (LA) function assessed by 2D speckle tracking echocardiography (STE) has demonstrated to be a useful predictor of recurrence of atrial fibrillation (AF) following catheter ablation (CA). Pulmonary vein reconduction (PVR) is one of the most important causes of recurrent paroxysmal AF (PAF) after ablation. The purpose of this study was to evaluate the association between AF burden (% of time in AF) following CA and LA strain measurements independently of PVR.
Methods
This prospective study included 66 patients with PAF who underwent CA (mean age 60 ± 8 years, 65% male). STE was performed during sinus rhythm prior to CA. AF burden was recorded by continuous rhythm monitoring using implantable loop recorders during a follow-up period of 4-6 months, excluding a blanking period of 3 months. After follow-up, all patients underwent an invasive assessment of pulmonary vein isolation to test for PVR. Multivariable linear regression analysis was used to assess the association between AF burden and peak atrial longitudinal reservoir strain (PALS), peak atrial contraction strain (PACS) and peak atrial conduit strain (PCS).
Results
Prior to CA, median AF burden was 3.8% (IQR: 0.5, 17). During follow-up, 37 patients (56%) were free of AF while median AF burden was 0.7% (IQR: 0.2, 1.6) in patients with an AF burden of more than 0%. A total of 35 patients (54%) were found to have PVR after ablation. Patients with AF recurrence had significantly lower PACS compared to patients with no AF during follow-up (10% ± 6% vs. 14% ± 5%, p = 0.004). No differences in PALS and PCS were observed. Increased PACS remained independently associated with low AF burden following CA after multivariable adjustments for clinical characteristics, comorbidities, and PVR (β=-0.262, p = 0.049) (Figure 1). PALS and PCS did not remain significantly associated with AF burden.
Conclusion
Increased PACS is strongly associated with low AF burden after CA even after adjusting for PVR. This suggests that an analysis of LA function could be useful to stratify patients prior to CA and improve treatment strategies.
Abstract Figure.
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Hoy RF, Hansen J, Glass DC, Dimitriadis C, Hore-Lacy F, Sim MR. Serum angiotensin converting enzyme elevation in association with artificial stone silicosis. Respir Med 2021; 177:106289. [PMID: 33421941 DOI: 10.1016/j.rmed.2020.106289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Silicosis is a rapidly emerging major health concern for workers in the artificial stone benchtop industry. The association between serum angiotensin converting enzyme (sACE) levels and artificial stone silicosis is unknown. METHODS We investigated 179 male workers (median age 40 years, interquartile range (IQR) 33-48 years) from the stone benchtop industry in Victoria, Australia. All had worked in an environment where dry processing of artificial stone had occurred and were registered with the Victorian Silica-associated Disease Registry between June 2019 and August 2020. Workers had undergone protocolised assessments including respiratory function testing, high resolution CT chest and blood tests panel, including sACE. FINDINGS Sixty workers with artificial stone silicosis were identified and they had a higher median sACE level (64.1 U/L, IQR 51.5, 87.5), compared to 119 without silicosis (35.0 U/L, IQR 25.0, 47.0). Compared to those with a normal assessment, regression modelling noted significantly higher average differences in sACE levels for workers with lymphadenopathy alone (12.1 U/L, 95% confidence interval (CI): 1.3, 22.9), simple silicosis (28.7 U/L, 95% CI: 21.3, 36.0) and complicated silicosis (36.0 U/L, 95% CI 25.2, 46.9). There was a small negative association with gas transfer, but no associations with exposure duration or spirometry. CONCLUSION sACE levels were noted to be higher in artificial stone workers with silicosis compared to those without disease and was highest in those with complicated silicosis. Longitudinal follow up is required to evaluate sACE as a prognostic biomarker for workers with this rapidly emerging occupational lung disease.
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Andreasen L, Ahlberg G, Hartmann J, Paludan-Mueller C, Jensen H, Riahi S, Hansen J, Sandgaard N, Haunsoe S, Kanters J, Ellervik C, Bundgaard H, Svendsen J, Olesen M. Genome-wide association study of patients with atrioventricular nodal reentry tachycardia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Supraventricular tachycardias (SVTs) originate from the atria or the area close to the AV node. AV nodal reentry tachycardia (AVNRT) is one of the tachyarrhytmias comprising the group of SVTs. The typical patient is female, young at disease onset, with a structurally normal heart. At present we do not know the etiology of AVNRT. We therefore hypothesized that AVNRT might be caused by changes in the DNA.
Methods
DNA from purified blood was obtained from patients with AVNRT verified by an invasive electrophysiological study. Patients were recruited from five ablation centers in Denmark and individuals from the general population of Denmark (the BEFUS cohort) served as controls. DNA was subjected to chip genotyping, imputation and analyses in a genome-wide association study (GWAS) setup.
Results
A GWAS on 1,143 AVNRT patients and 3,004 controls revealed one locus close to the gene MYH6 to reach genome-wide significance for association with AVNRT (P=4.8x10–8). MYH6 encodes the α-isoform of the protein myosin heavy chain important for the contractile units of the heart, the sarcomeres. The gene is predominantly expressed in the atria. Additional subthreshold loci located close to other plausible arrhythmia genes were identified.
Conclusion
We report the first genetic locus to be associated with AVNRT close to the sarcomere gene MYH6. This is, to our knowledge, the first gene ever associated with AVNRT.
Manhattan plot
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Rigshospitalets Forskningspulje - 3 years PhD salary
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Dixon B, Hoffman E, Feng B, Davidson E, Hays R, Worrall A, Hansen J, Fei T, Hiruta H, Peterson-Droogh J, Ganda F, Betzler B, Kim T, Taiwo T. Reassessing methods to close the nuclear fuel cycle. ANN NUCL ENERGY 2020. [DOI: 10.1016/j.anucene.2020.107652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Olsen F, Darkner S, Chen X, Pehrson S, Johannessen A, Hansen J, Gislason G, Svendsen J, Biering-Sorensen T. Relationship between cardiac structure and function and atrial fibrillation related hospitalizations following catheter ablation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Even though catheter ablation (CA) is an effective treatment for atrial fibrillation (AF), AF-related hospitalizations and cardioversions are common following this procedure.
Purpose
To investigate whether echocardiographic measures of left atrial (LA) function could predict AF-related hospitalizations and cardioversions.
Methods
This was a substudy of a trial that randomized patients to amiodarone vs place to reduce AF recurrence following CA. Transthoracic echocardiography was performed prior to CA and included assessment of: end-systolic and end-diastolic LA volumes, emptying fraction (LAEF), atrial strain, and global longitudinal strain (GLS). Poisson regression was used to assess predictive value for AF-related hospitalizations and cardioversions. Multivariable adjustments were made for: age, gender, ejection fraction, AF burden, AF subtype, dyspnea, and class 1c antiarrhythmics.
Results
Of the 212 patients, 80 were hospitalized for AF (206 times), and 77 were cardioverted (192 times) within the 6 months follow-up period. Mean age was 60 years, 83% were men, and mean LVEF was 50%. In univariable analyses, LA volumes, LAEF and GLS were predictors of the outcomes but did not remain significant predictors after multivariable adjustments. During echocardiography 162 patients were in sinus rhythm and 50 had AF rhythm. Rhythm during the echocardiogram modified the association between GLS and outcomes (p for interaction <0.05 for both endpoints), such that GLS predicted both AF-related hospitalizations and cardioversions in patients with sinus rhythm but not AF during the echocardiogram (figure).
Conclusion
Global longitudinal strain predicts AF-related hospitalizations and cardioversions after CA, but only in patients presenting in sinus rhythm during the echocardiogram. Patients presenting with impaired global longitudinal strain should be considered high-risk patients following CA who may benefit from close follow-up.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Danish Heart Foundation
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Esmonde N, Rodan W, Haisley KR, Joslyn N, Carboy J, Hunter JG, Schipper PH, Tieu BH, Hansen J, Dolan JP. Treatment protocol for secondary esophageal reconstruction using 'supercharged' colon interposition flaps. Dis Esophagus 2020; 33:5810256. [PMID: 32193534 DOI: 10.1093/dote/doaa008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/06/2020] [Accepted: 01/28/2020] [Indexed: 12/11/2022]
Abstract
Locoregional esophageal cancer is currently treated with induction chemoradiotherapy, followed by esophagectomy with reconstruction, using a gastric conduit. In cases of conduit failure, patients are temporized with a cervical esophagostomy and enteral nutrition until gastrointestinal continuity can be established. At our institution, we favor reconstruction, using a colon interposition with a 'supercharged' accessory vascular pedicle. Consequently, we sought to examine our technique and outcomes for esophageal reconstruction, using this approach. We performed a retrospective review of all patients who underwent esophagectomy at our center between 2008 and 2018. We identified those patients who had a failed gastric conduit and underwent secondary reconstruction. Patient demographics, perioperative details, and clinical outcomes were analyzed after our clinical care pathway was used to manage and prepare patients for a second major reconstructive surgery. Three hundred and eighty eight patients underwent esophagectomy and reconstruction with a gastric conduit. Seven patients (1.8%) suffered gastric conduit loss and underwent a secondary reconstruction using a colon interposition with a 'supercharged' vascular pedicle. Mean age was 70.1 (±7.3) years, and six patients were male. The transverse colon was used in four cases (57.1%), left colon in two cases (28.6%), and right colon in one case (14.3%). There were no deaths or loss of the colon interposition at follow-up. Three patients (42.9%) developed an anastomotic leak, which resolved with conservative management. All patients had resumption of oral intake within 30 days. Utilizing a 'supercharging' technique for colon interposition may improve the perfusion to the organ and may decrease morbidity. Secondary reconstruction should occur when the patient's oncologic, physiologic, and psychosocial condition is optimized. Our outcomes and preoperative strategies may provide guidance for those centers treating this complicated patient population.
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Gerenday SP, Clark JF, Hansen J, Fischer I, Koreny J. Sulfur Hexafluoride and Potassium Bromide as Groundwater Tracers for Managed Aquifer Recharge. GROUND WATER 2020; 58:777-787. [PMID: 32020587 DOI: 10.1111/gwat.12983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/21/2020] [Accepted: 01/26/2020] [Indexed: 06/10/2023]
Abstract
Sulfur hexafluoride (SF6 ) is an established tracer for use in managed aquifer recharge projects. SF6 exsolves from groundwater when it encounters trapped air according to Henry's law. This results in its retardation relative to groundwater flow, which can help determine porous media saturation and flow dynamics. SF6 and the conservative, nonpartitioning tracer, bromide (Br- added as KBr), were introduced to recharge water infiltrated into stacked glacial aquifers in Thurston County, Washington, providing the opportunity to observe SF6 partitioning. Br- , which is assumed to travel at the same velocity as the groundwater, precedes SF6 at most monitoring wells (MWs). Average groundwater velocity in the unconfined aquifer in the study area ranges from 3.9 to 40 m/d, except in the southwestern corner where it is slower. SF6 in the shallow aquifer exhibits an average retardation factor of 2.5 ± 3.8, suggesting an air-to-water ratio on the order of 10-3 to 10-2 in the pore space. Notable differences in tracer arrival times at adjacent wells indicate very heterogeneous conductivity. One MW exhibits double peaks in concentrations of both tracers with different degrees of retardation for the first and second peaks. This suggests multiple flowpaths to the well with variable saturation. The confining layer between the upper two aquifers appears to allow intermittent connection between aquifers but serves as an aquitard in most areas. This study demonstrates the utility of SF6 partitioning for evaluating hydrologic conditions at prospective recharge sites.
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Khatri S, Hansen J, Clausen MH, Kragstrup TW, Hung SC, Mellins E, Astakhova K. LB0002 A FIRST IN CLASS THERAPEUTIC NANOPARTICLE FOR SPECIFIC TARGETING OF ANTI-CITRULLINATED PROTEIN ANTIBODY AMELIORATES SERUM TRANSFER AND COLLAGEN INDUCED ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is an immune mediated inflammatory disease with autoimmune features, including antibodies to citrullinated proteins and peptides (ACPAs). Several in vitro studies have suggested a pathogenic role of ACPAs in RA. However, in vivo proof of this concept has been hampered by the lack of therapeutic strategies to reduce or deplete ACPA in serum and synovial fluid. Previously, we constructed a chitosan-hyaluronic acid nanoparticle formulation with the ability to use neutrophil recruitment as a delivery mechanism to inflamed joints. Specifically, nanoparticles got phagocytosed and then released to synovial fluid upon death of the short-lived neutrophilsObjectives:We hypothesized that reducing ACPA levels would have a therapeutic effect by blocking cytokine production. In this study, we prepared and tested a series of therapeutic nanoparticles for specific targeting of ACPA in synovial fluid.Methods:Nanoparticles were prepared by the microdroplet method and then decorated with synthetic cyclic citrullinated peptide aptamer PEP2, PEG/hexanoic acid and fluorophore (Cy5.5). Nanoparticles were characterized by dynamic light scattering (DLS), scanning electron microscopy (SEM) and high-performance liquid chromatography (HPLC). Nanoparticles were then used in a series of in vitro assays, including cell uptake with flow cytometry (FACS) detection, and in vivo studies including disease activity scores, cytokine measurements and near-infrared imaging.Results:We screened a series of citrullinated peptide epitopes and identified a fibrinogen-derived 21-amino-acid-long citrullinated peptide showing high selectivity toward autoantibodies in RA samples. We incorporated this aptamer in the chitosan-hyaluronic acid nanoparticle formulation previously described. Average nanoparticle size was 230 nm ± 10 nm by DLS and SEM; z potential was -0.0012. Purity by HPLC was over 95%. Attachment efficiency of the aptamer was 92% by HPLC. FACS study showed selective uptake of Cy5.5 labelled aptamer-nanoparticle conjugates by neutrophils in the concentration range 0.5-4 nM. Similar to previous studies,1there was no apparent immunogenicity for this nanoparticle formulation measured by cytokine secretion from human peripheral blood leukocytes. In vivo, over 50% reduction of disease activity was achieved in three weeks treatment using as little as 1 nM drug candidate (dosed every 48 hours) in the collagen-induced (CIA) mouse model of RA (N=30; p<0.001 for treated vs placebo). Same was observed in the serum transfer model (N=10). The aptamer-nanoparticle conjugate significantly reduced IL-6 and TNFα levels in the mouse sera (p<0.01). The effects were not inferior to tocilizumab treated controls (N=30). To confirm mode of action, we applied Cy5.5-labelled aptamer-nanoparticles in the collagen-induced mouse model (N=10) and analyzed the resulting uptake by near-infrared imaging. We confirmed over 6-fold higher signal accumulation in inflamed vs healthy joints (p<0.01), which strongly supports the fact that the aptamer is highly specific to the inflammatory process.Conclusion:Overall, we have designed a first-in-class therapeutic nanoparticle drug for specific targeting of anti-citrullinated protein antibodies. The marked effect of this nanoparticle observed in vivo holds promise for targeting ACPAs as a therapeutic option in RA.References:[1]Khatri S, Hansen J, Mendes AC, Chronakis IS, Hung S-C, Mellins ED, Astakhova K. Bioconjug Chem. 2019 Oct 16;30(10):2584–259Disclosure of Interests:Sangita Khatri: None declared, Jonas Hansen: None declared, Mads Hartvig Clausen Shareholder of: iBio Tech ApS, Tue Wenzel Kragstrup Shareholder of: iBio Tech ApS, Consultant of: Bristol-Myers Squibb, Speakers bureau: TWK has engaged in educational activities talking about immunology in rheumatic diseases receiving speaking fees from Pfizer, Bristol-Myers Squibb, Eli Lilly, Novartis, and UCB., Shu-Chen Hung: None declared, Elisabeth Mellins: None declared, Kira Astakhova: None declared
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Janssen JK, Cammack KM, Grubbs JK, Underwood KR, Hansen J, Kruse C, Blair AD. Influence of Postmortem Aging and Storage Conditions on Tenderness of Grain and Grass Finished Bison Striploin Steaks. MEAT AND MUSCLE BIOLOGY 2019. [DOI: 10.22175/mmb.10687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesThe objectives of this study were to: 1) compare the influence of postmortem aging on tenderness of striploin steaks from grain- and grass-finished bison, and 2) compare the influence of freezing on tenderness of striploin steaks from grain- and grass-finished bison.Materials and MethodsBison heifers were randomly assigned to finishing treatments: Grain-finished (n = 30, backgrounded on pasture and finished for 130 d with ad libitum access to grass hay, alfalfa and a corn and dry distiller’s grain concentrate prior to slaughter) or Grass-finished (n = 30, remained on pasture until slaughter). Heifers were slaughtered at approximately 28 mo of age, and striploins were removed from both sides of the carcass posterior to the 12th rib separation and fabricated into 2.54-cm steaks. One steak was removed from each striploin (n = 60), vacuum packaged and stored fresh for 14 d at 4°C. Four additional steaks were fabricated from each striploin, aged for 4,7,14, or 21 d, vacuum packaged, and frozen for approximately 3 mo. Warner-Bratzler Shear Force (WBSF) was utilized to determine objective tenderness. Frozen steaks were thawed at 4°C for 24 h before cooking. All steaks were weighed prior to cooking to an internal temperature of 71°C. Internal temperature was monitored using a digital thermometer placed near the geometric center of each steak. After cooking, all steaks were reweighed to determine cook loss and cooled to room temperature (20°C). Five to six 1.27-cm cores were removed from each steak and sheared once perpendicular to the muscle fiber orientation and peak force was recorded. A texture analyzer with a Warner-Bratzler attachment was used to assess instrumental tenderness. An average shear force value was then calculated for each steak. For Objective 1, cook loss and shear force data were analyzed as repeated measures using the ante-dependence covariance structure in the MIXED procedure of SAS (SAS Inst. Inc., Cary, NC) for effects of finishing treatment, aging, and their interaction; peak temperature was included as a covariate. For Objective 2, shear force data were analyzed for the effects of finishing treatment, storage treatment and their interaction using the GLM procedure of SAS. For both objectives, the interaction was not significant and omitted from the final model. Separation of least-squares main effect means was performed using LSD with a Tukey’s adjustment and assuming a level of 0.05.ResultsSteaks from grain finished bison heifers had tendency to be more tender (P = 0.0552) and had less cook loss (P < 0.0001) than steaks from grass finished heifers. Tenderness of all steaks improved (P < 0.0001) with postmortem aging. Aging time also influenced cook loss (P = 0.0199). Cook loss was greater (P = 0.0133) at Day 4 than Day 7 and tended to be greater (P = 0.0561) at Day 4 than Day 21. Frozen storage improved tenderness (P < 0.0001) and increased cook loss (P < 0.0001) of bison steaks compared to fresh storage.ConclusionCollectively this data indicates postmortem aging, storage conditions, and finishing systems influence meat tenderness of bison striploin steaks. Grain-finishing resulted in reduced cook loss and tended to improved tenderness of bison steaks compared to grass-finishing. Additionally, holding bison steaks in frozen storage improved tenderness, but also increased cook loss.
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Hansen J, Janssen J, Morgenstern M, Hanewinkel R. [E-Cigarette Use and Later Use of Conventional Cigarettes - Results of a Prospective Observational Study over 2 Years]. Pneumologie 2019; 74:39-45. [PMID: 31756736 DOI: 10.1055/a-1041-9970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM The aim was to investigate whether e-cigarette use predicts later experimentation with conventional cigarettes. METHODS During the 2016/2017 school year, 2,388 children and adolescents from Baden-Württemberg, Mecklenburg-Western Pomerania, North Rhine-Westphalia, Rhineland-Palatinate, Schleswig-Holstein and Saxony who had never smoked conventional cigarettes before took part in a survey over a 2-year period (mean age 11.8 years, SD = 1.21; 49.6 % female). RESULTS At baseline, 85 pupils (3.6 %) reported that they had already tried e-cigarettes at least once. By the end of the observational period, 430 of the sample had tried conventional cigarettes (18.0 %). After statistical control for age, sex, migration background, type of school, socioeconomic status, sensation-seeking, alcohol use, and school performance, the adjusted relative risk of experimentation with conventional cigarettes was 85 % higher (adjusted relative risk = 1.85, 95 % CI [1.34 - 2.56]) for pupils who had used e-cigarettes at baseline. Further analyses revealed that the risk was higher among adolescents with low sensation-seeking scores. CONCLUSION Among young never-smokers, experimentation with conventional cigarettes is more common in those who used e-cigarettes before than among those who have not tried e-cigarettes before. This effect seems to be stronger among adolescents who, in general, have a lower risk of starting to smoke.
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de Jong J, Hansen J, Groenewegen P. Why do we need for timeliness of research in decision-making? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Compared to the policy process, the research process is slow. As a result, research evidence is not always available when needed in the policy process. These differences in timelines between research and policy hinder the use of research evidence in the policy process. In order to support evidence-based policy making, timeliness of research is important.
Methods
Examples are provided, e.g. where research was on time to be included in the policy process and where research was too late to be included in it. These examples are described and analysed to provide for recommendations on how to better align both processes.
Results
It is shown that in order to create timeliness of research, policy makers and researchers should talk on a regular basis. This increases the chance that results from the research are included in policy making.
Conclusions
Timeliness of research is important for evidence-based policy making. In order to create timeliness of research, interaction between researchers and policy makers is important.
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Hansen J, Batenburg R, Vis E, Van der Velden L. Regional shortages in a small country: how to provide the right care in the right place? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The Netherlands, though being a relatively small and densely populated country, is faced with a similar challenge as other countries in terms of regional differences in access to care and attractiveness for care workers to build their careers. Both in primary care and hospital care new solutions are being sought which should help resolve these growing difficulties.
Methods
We conducted a literature review, survey and registry analysis, and held interviews with key stakeholders.
Results
Substantial differences exist between regions in the supply of both primary care and hospital care doctors. Particular and less populated regions appear to be hit in multiple ways, both with an extra ageing population requiring more care as well as by limited attractiveness for both primary care and hospital care workers. Solutions being used so far are mostly initiated by individual health care settings, such as strategic personnel management, redistribution of tasks and campaigns to increase the inflow of staff. Increasingly, solutions are also being explored at regional level, including a growing emphasis on regional collaboration, both in providing the right care in the right place as well as in terms of joint recruitment strategies. Still, such approaches only have a limited effect as a result of which new approaches are needed.
Conclusions
Strategies to improve the attractiveness of particular regions are now often fragmented, both between types of professions and sectors and different regions. In addition, innovative and new solutions appear to be hampered by vested interests of stakeholders. If new solutions are to be developed it is key that stakeholders are willing to compromise, be it when it comes to the autonomy of health care professionals and their associations and to the financial commitments required from government and insurer side.
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Liu X, D'Cruz AA, Hansen J, Croker BA, Lawlor KE, Sims NA, Wicks IP. Deleting Suppressor of Cytokine Signaling-3 in chondrocytes reduces bone growth by disrupting mitogen-activated protein kinase signaling. Osteoarthritis Cartilage 2019; 27:1557-1563. [PMID: 31176017 DOI: 10.1016/j.joca.2019.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/01/2019] [Accepted: 05/29/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the impact of deleting Suppressor of Cytokine Signaling (SOCS)-3 (SOCS3) in chondrocytes during murine skeletal development. METHOD Mice with a conditional Socs3 allele (Socs3fl/fl) were crossed with a transgenic mouse expressing Cre recombinase under the control of the type II collagen promoter (Col2a1) to generate Socs3Δ/Δcol2 mice. Skeletal growth was analyzed over the lifespan of Socs3Δ/Δcol2 mice and controls by detailed histomorphology. Bone size and cortical bone development was evaluated by micro-computed tomography (micro-CT). Growth plate (GP) zone width, chondrocyte proliferation and apoptosis were assessed by immunofluorescence staining for Ki67 and TUNEL. Fibroblast growth factor receptor-3 (FGFR3) signaling in the GP was assessed by immunohistochemistry, while the effect of SOCS3 overexpression on FGFR3-driven pMAPK signaling in HEK293T cells was evaluated by Western blot. RESULTS Socs3Δ/Δcol2 mice of both sexes were consistently smaller compared to littermate controls throughout life. This phenotype was due to reduced long bone size, poor cortical bone development, reduced Ki67+ proliferative chondrocytes and decreased proliferative zone (PZ) width in the GP. Expression of pMAPK, but not pSTAT3, was increased in the GPs of Socs3Δ/Δcol2 mice relative to littermate controls. Overexpression of FGFR3 in HEK293T cells increased Fibroblast Growth Factor 18 (FGF18)-dependent Mitogen-activated protein kinase (MAPK) phosphorylation, while concomitant expression of SOCS3 reduced FGFR3 expression and abrogated MAPK signaling. CONCLUSION Our results suggest a potential role for SOCS3 in GP chondrocyte proliferation by regulating FGFR3-dependent MAPK signaling in response to FGF18.
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Platonov PG, Carlson J, Castrini I, Svensson A, Christiansen MK, Gilljam T, Madsen T, Hansen J, Astrom MA, Haagua K, Jensen HK, Edvardsen T, Svendsen JH. P2247Pregnancies and childbirth in women with arrhythmogenic right ventricular cardiomyopathy are associated with low risk of ventricular arrhythmias. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with a risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD). Even though female patients with ARVC are considered to be at lower risk of VA, the impact of pregnancy and child birth on the arrhythmic risk and development of arrhythmic substrate in the context of ARVC remains insufficiently studied.
Objective
To assess the risk of VA in relation to childbirth in women with ARVC and the impact of multiple pregnancies on progression of arrhythmic manifestations of the disease.
Methods
The study included 186 females with definite ARVC (n=107, 70 probands) or unaffected mutation-carriers (n=79) with median age at the end of follow up of 48 (IQR 34–60) years. Seventeen women had 1, 59 had 2 and 29 had ≥3 child births by the age of 40 years. VA was defined as ventricular tachycardia, appropriate ICD therapy, aborted cardiac arrest or SCD. Proportions of patients who experienced VA by the age of 40 years were compared between nulliparous women (n=81) and those with reported child births (n=105). VA-free survival after accomplished pregnancies was assessed for women ≥40 years of age (n=119). Cumulative probability of VA for each pregnancy (n=230) was assessed from conception through 2 years after child birth and compared between those that occurred before ARVC diagnosis (Pre-Ds, n=164), after it (Post-Ds, n=11) and in unaffected mutation carriers (No-Ds, n=55).
Results
The nulliparous women had lower age at ARVC diagnosis (37 vs 44, p=0.023) and more often had VA before the age of 40 (31% vs 13%, p=0.003) while the number of child births was not related to the prevalence of VA (18% among women with 1 childbirth, 12% in those with 2 and 14% in those with 3 or more, ns). Three women suffered SCD before the age of 40. VA-free survival after 40 years did not differ between nulliparous and those who gave birth (Figure A). Only four pregnancy-related events were documented (Figure B): 1 in the Post-Ds group and three in the Pre-Ds group. No pregnancy-related events were reported in the unaffected mutation carriers.
Conclusion
In this Scandinavian cohort of women with ARVC we observed no indication of an increased VA risk either associated with pregnancies or during long-term follow up after the last child birth.
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Christiansen MK, Haugaa K, Svensson A, Gilljam T, Madsen T, Hansen J, Holst A, Bundgaard H, Edvardsen T, Svendsen JH, Platonov P, Jensen HK. P992Incidence, predictors, and success of ventricular tachycardia catheter ablation in arrhythmogenic right ventricular cardiomyopathy (ARVC): A long-term cohort study from the Nordic ARVC registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Catheter ablation may reduce ventricular tachycardia (VT) burden in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. However, little is known about factors predicting need for ablation and various outcomes have been reported.
Purpose
We sought to investigate predictors and use of VT ablation and to evaluate the post-procedural outcome in ARVC patients.
Methods
We studied 435 patients from the Nordic ARVC registry including 220 probands with definite ARVC according to the 2010 task force criteria and 215 mutation-carrying relatives identified through cascade screening. Patients were followed until first-time VT ablation, death, heart transplantation, or January 1st 2018. Additionally, patients undergoing VT ablation were further followed from the time of ablation for recurrent ventricular arrhythmias.
Results
Cumulative use of VT ablation was 4% (95% CI 3%-6%) and 11% (95% CI 8%-15%) after 1 and 10 years. All procedures were performed in probands in whom the cumulative use was 8% (95% CI 5%-12%) and 20% (95% CI 15%-26%). In adjusted analyses restricted to probands, only young age predicted need for ablation. In patients undergoing ablation, risk of recurrent arrhythmias was 59% (95% CI 44%-71%) and 74% (95% CI 59%-84%) 1 and 5 years after the procedure. Despite high recurrence rates, the burden of ventricular arrhythmias was reduced after ablation (p=0.0042). Young age, use of several antiarrhythmic drugs and inducibility to VT immediately after ablation were associated with an unfavorable outcome.
Conclusions
Twenty percent of ARVC probands developed a clinical indication for VT ablation within 10 years after diagnosis whereas mutation-carrying relatives were without such need. Although the burden of ventricular arrhythmias decreased after ablation, risk of recurrence was substantial.
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Gallé T, Koehler C, Plattes M, Pittois D, Bayerle M, Carafa R, Christen A, Hansen J. Large-scale determination of micropollutant elimination from municipal wastewater by passive sampling gives new insights in governing parameters and degradation patterns. WATER RESEARCH 2019; 160:380-393. [PMID: 31158619 DOI: 10.1016/j.watres.2019.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/30/2019] [Accepted: 05/04/2019] [Indexed: 06/09/2023]
Abstract
A simple balancing method using passive samplers over a week's period has been developed and tested successfully to determine elimination rates of 22 common micropollutants of household and industrial sources in 18 full-scale wastewater treatment plants of different design and performance. Independent reactor tests to delineate elimination rates with native sludge of the treatment plants correlated very well with the full-scale elimination rate determinations. As opposed to common assumptions, this large dataset indicated that shorter sludge retention times - read: higher active biomass - showed higher micropollutant elimination rates in many cases. Multivariate statistical analysis of the elimination rates over the 18 treatment plants was able to group compounds according to common degradation pathways and showed that sensitivity to SRT drove the grouping. The dataset also allowed to determine population equivalent normalized loads of the investigated micropollutants. The application of WWTP balancing with passive sampling makes it relatively easy to gather elimination rates and inlet loads on a much broader basis than before and gives orientation for more in-depth analysis of degradation pathways.
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Møller DS, Schmidt M, Ravkilde T, Poulsen P, Hansen J, Worm E, Schmidt H, Knap M, Safwat A, Rose H, Hoffmann L. PO-0974 Intra-fractional stability of Deep Inspiration Breath Hold during RT for lung and lymphoma cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31394-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Adli E, Ahuja A, Apsimon O, Apsimon R, Bachmann AM, Barrientos D, Barros MM, Batkiewicz J, Batsch F, Bauche J, Berglyd Olsen VK, Bernardini M, Biskup B, Boccardi A, Bogey T, Bohl T, Bracco C, Braunmüller F, Burger S, Burt G, Bustamante S, Buttenschön B, Caldwell A, Cascella M, Chappell J, Chevallay E, Chung M, Cooke D, Damerau H, Deacon L, Deubner LH, Dexter A, Doebert S, Farmer J, Fedosseev VN, Fior G, Fiorito R, Fonseca RA, Friebel F, Garolfi L, Gessner S, Gorgisyan I, Gorn AA, Granados E, Grulke O, Gschwendtner E, Guerrero A, Hansen J, Helm A, Henderson JR, Hessler C, Hofle W, Hüther M, Ibison M, Jensen L, Jolly S, Keeble F, Kim SY, Kraus F, Lefevre T, LeGodec G, Li Y, Liu S, Lopes N, Lotov KV, Maricalva Brun L, Martyanov M, Mazzoni S, Medina Godoy D, Minakov VA, Mitchell J, Molendijk JC, Mompo R, Moody JT, Moreira M, Muggli P, Mutin C, Öz E, Ozturk E, Pasquino C, Pardons A, Peña Asmus F, Pepitone K, Perera A, Petrenko A, Pitman S, Plyushchev G, Pukhov A, Rey S, Rieger K, Ruhl H, Schmidt JS, Shalimova IA, Shaposhnikova E, Sherwood P, Silva LO, Soby L, Sosedkin AP, Speroni R, Spitsyn RI, Tuev PV, Turner M, Velotti F, Verra L, Verzilov VA, Vieira J, Vincke H, Welsch CP, Williamson B, Wing M, Woolley B, Xia G. Experimental Observation of Proton Bunch Modulation in a Plasma at Varying Plasma Densities. PHYSICAL REVIEW LETTERS 2019; 122:054802. [PMID: 30822008 DOI: 10.1103/physrevlett.122.054802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Indexed: 06/09/2023]
Abstract
We give direct experimental evidence for the observation of the full transverse self-modulation of a long, relativistic proton bunch propagating through a dense plasma. The bunch exits the plasma with a periodic density modulation resulting from radial wakefield effects. We show that the modulation is seeded by a relativistic ionization front created using an intense laser pulse copropagating with the proton bunch. The modulation extends over the length of the proton bunch following the seed point. By varying the plasma density over one order of magnitude, we show that the modulation frequency scales with the expected dependence on the plasma density, i.e., it is equal to the plasma frequency, as expected from theory.
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Turner M, Adli E, Ahuja A, Apsimon O, Apsimon R, Bachmann AM, Barros Marin M, Barrientos D, Batsch F, Batkiewicz J, Bauche J, Berglyd Olsen VK, Bernardini M, Biskup B, Boccardi A, Bogey T, Bohl T, Bracco C, Braunmüller F, Burger S, Burt G, Bustamante S, Buttenschön B, Caldwell A, Cascella M, Chappell J, Chevallay E, Chung M, Cooke D, Damerau H, Deacon L, Deubner LH, Dexter A, Doebert S, Farmer J, Fedosseev VN, Fior G, Fiorito R, Fonseca RA, Friebel F, Garolfi L, Gessner S, Gorgisyan I, Gorn AA, Granados E, Grulke O, Gschwendtner E, Guerrero A, Hansen J, Helm A, Henderson JR, Hessler C, Hofle W, Hüther M, Ibison M, Jensen L, Jolly S, Keeble F, Kim SY, Kraus F, Lefevre T, LeGodec G, Li Y, Liu S, Lopes N, Lotov KV, Maricalva Brun L, Martyanov M, Mazzoni S, Medina Godoy D, Minakov VA, Mitchell J, Molendijk JC, Mompo R, Moody JT, Moreira M, Muggli P, Öz E, Ozturk E, Mutin C, Pasquino C, Pardons A, Peña Asmus F, Pepitone K, Perera A, Petrenko A, Pitman S, Plyushchev G, Pukhov A, Rey S, Rieger K, Ruhl H, Schmidt JS, Shalimova IA, Shaposhnikova E, Sherwood P, Silva LO, Soby L, Sosedkin AP, Speroni R, Spitsyn RI, Tuev PV, Velotti F, Verra L, Verzilov VA, Vieira J, Vincke H, Welsch CP, Williamson B, Wing M, Woolley B, Xia G. Experimental Observation of Plasma Wakefield Growth Driven by the Seeded Self-Modulation of a Proton Bunch. PHYSICAL REVIEW LETTERS 2019; 122:054801. [PMID: 30822039 DOI: 10.1103/physrevlett.122.054801] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Indexed: 06/09/2023]
Abstract
We measure the effects of transverse wakefields driven by a relativistic proton bunch in plasma with densities of 2.1×10^{14} and 7.7×10^{14} electrons/cm^{3}. We show that these wakefields periodically defocus the proton bunch itself, consistently with the development of the seeded self-modulation process. We show that the defocusing increases both along the bunch and along the plasma by using time resolved and time-integrated measurements of the proton bunch transverse distribution. We evaluate the transverse wakefield amplitudes and show that they exceed their seed value (<15 MV/m) and reach over 300 MV/m. All these results confirm the development of the seeded self-modulation process, a necessary condition for external injection of low energy and acceleration of electrons to multi-GeV energy levels.
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Janssen JK, Cammack KM, Grubbs JK, Underwood KR, Hansen J, Kruse C, Blair AD. Influence of Postmortem Aging and Storage Conditions on Tenderness of Grain and Grass Finished Bison Striploin Steaks. MEAT AND MUSCLE BIOLOGY 2019. [DOI: 10.22175/mmb2019.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kroezen M, Schäfer W, Sermeus W, Hansen J, Batenburg R. Healthcare assistants in EU Member States: an overview. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hansen J, Groenewegen P, Nolte E, Vella S, Ricciardi W. Prioritization for transferring health technology and health service innovations between health systems. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hansen J, Nolte E. A conceptual framework and overview of medium and long term challenges and policy priorities. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Colley H, Said Z, Santocildes-Romero M, Baker S, D'Apice K, Hansen J, Madsen LS, Thornhill M, Hatton P, Murdoch C. Pre-clinical evaluation of novel mucoadhesive bilayer patches for local delivery of clobetasol-17-propionate to the oral mucosa. Biomaterials 2018; 178:134-146. [DOI: 10.1016/j.biomaterials.2018.06.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/29/2018] [Accepted: 06/06/2018] [Indexed: 12/24/2022]
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Adli E, Ahuja A, Apsimon O, Apsimon R, Bachmann AM, Barrientos D, Batsch F, Bauche J, Berglyd Olsen VK, Bernardini M, Bohl T, Bracco C, Braunmüller F, Burt G, Buttenschön B, Caldwell A, Cascella M, Chappell J, Chevallay E, Chung M, Cooke D, Damerau H, Deacon L, Deubner LH, Dexter A, Doebert S, Farmer J, Fedosseev VN, Fiorito R, Fonseca RA, Friebel F, Garolfi L, Gessner S, Gorgisyan I, Gorn AA, Granados E, Grulke O, Gschwendtner E, Hansen J, Helm A, Henderson JR, Hüther M, Ibison M, Jensen L, Jolly S, Keeble F, Kim SY, Kraus F, Li Y, Liu S, Lopes N, Lotov KV, Maricalva Brun L, Martyanov M, Mazzoni S, Medina Godoy D, Minakov VA, Mitchell J, Molendijk JC, Moody JT, Moreira M, Muggli P, Öz E, Pasquino C, Pardons A, Peña Asmus F, Pepitone K, Perera A, Petrenko A, Pitman S, Pukhov A, Rey S, Rieger K, Ruhl H, Schmidt JS, Shalimova IA, Sherwood P, Silva LO, Soby L, Sosedkin AP, Speroni R, Spitsyn RI, Tuev PV, Turner M, Velotti F, Verra L, Verzilov VA, Vieira J, Welsch CP, Williamson B, Wing M, Woolley B, Xia G. Acceleration of electrons in the plasma wakefield of a proton bunch. Nature 2018; 561:363-367. [PMID: 30188496 PMCID: PMC6786972 DOI: 10.1038/s41586-018-0485-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/14/2018] [Indexed: 12/03/2022]
Abstract
High-energy particle accelerators have been crucial in providing a deeper understanding of fundamental particles and the forces that govern their interactions. To increase the energy of the particles or to reduce the size of the accelerator, new acceleration schemes need to be developed. Plasma wakefield acceleration1–5, in which the electrons in a plasma are excited, leading to strong electric fields (so called ‘wakefields’), is one such promising acceleration technique. Experiments have shown that an intense laser pulse6–9 or electron bunch10,11 traversing a plasma can drive electric fields of tens of gigavolts per metre and above—well beyond those achieved in conventional radio-frequency accelerators (about 0.1 gigavolt per metre). However, the low stored energy of laser pulses and electron bunches means that multiple acceleration stages are needed to reach very high particle energies5,12. The use of proton bunches is compelling because they have the potential to drive wakefields and to accelerate electrons to high energy in a single acceleration stage13. Long, thin proton bunches can be used because they undergo a process called self-modulation14–16, a particle–plasma interaction that splits the bunch longitudinally into a series of high-density microbunches, which then act resonantly to create large wakefields. The Advanced Wakefield (AWAKE) experiment at CERN17–19 uses high-intensity proton bunches—in which each proton has an energy of 400 gigaelectronvolts, resulting in a total bunch energy of 19 kilojoules—to drive a wakefield in a ten-metre-long plasma. Electron bunches are then injected into this wakefield. Here we present measurements of electrons accelerated up to two gigaelectronvolts at the AWAKE experiment, in a demonstration of proton-driven plasma wakefield acceleration. Measurements were conducted under various plasma conditions and the acceleration was found to be consistent and reliable. The potential for this scheme to produce very high-energy electron bunches in a single accelerating stage20 means that our results are an important step towards the development of future high-energy particle accelerators21,22. Electron acceleration to very high energies is achieved in a single step by injecting electrons into a ‘wake’ of charge created in a 10-metre-long plasma by speeding long proton bunches.
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