1
|
Ali AS, Wu D, Bannach-Brown A, Dhamrait D, Berg J, Tolksdorf B, Lichtenstein D, Dressler C, Braeuning A, Kurreck J, Hülsemann M. 3D bioprinting of liver models: A systematic scoping review of methods, bioinks, and reporting quality. Mater Today Bio 2024; 26:100991. [PMID: 38558773 PMCID: PMC10978534 DOI: 10.1016/j.mtbio.2024.100991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/19/2024] [Accepted: 02/03/2024] [Indexed: 04/04/2024] Open
Abstract
Background Effective communication is crucial for broad acceptance and applicability of alternative methods in 3R biomedical research and preclinical testing. 3D bioprinting is used to construct intricate biological structures towards functional liver models, specifically engineered for deployment as alternative models in drug screening, toxicological investigations, and tissue engineering. Despite a growing number of reviews in this emerging field, a comprehensive study, systematically assessing practices and reporting quality for bioprinted liver models is missing. Methods In this systematic scoping review we systematically searched MEDLINE (Ovid), EMBASE (Ovid) and BioRxiv for studies published prior to June 2nd, 2022. We extracted data on methodological conduct, applied bioinks, the composition of the printed model, performed experiments and model applications. Records were screened for eligibility and data were extracted from included articles by two independent reviewers from a panel of seven domain experts specializing in bioprinting and liver biology. We used RAYYAN for the screening process and SyRF for data extraction. We used R for data analysis, and R and Graphpad PRISM for visualization. Results Through our systematic database search we identified 1042 records, from which 63 met the eligibility criteria for inclusion in this systematic scoping review. Our findings revealed that extrusion-based printing, in conjunction with bioinks composed of natural components, emerged as the predominant printing technique in the bioprinting of liver models. Notably, the HepG2 hepatoma cell line was the most frequently employed liver cell type, despite acknowledged limitations. Furthermore, 51% of the printed models featured co-cultures with non-parenchymal cells to enhance their complexity. The included studies offered a variety of techniques for characterizing these liver models, with their primary application predominantly focused on toxicity testing. Among the frequently analyzed liver markers, albumin and urea stood out. Additionally, Cytochrome P450 (CYP) isoforms, primarily CYP3A and CYP1A, were assessed, and select studies employed nuclear receptor agonists to induce CYP activity. Conclusion Our systematic scoping review offers an evidence-based overview and evaluation of the current state of research on bioprinted liver models, representing a promising and innovative technology for creating alternative organ models. We conducted a thorough examination of both the methodological and technical facets of model development and scrutinized the reporting quality within the realm of bioprinted liver models. This systematic scoping review can serve as a valuable template for systematically evaluating the progress of organ model development in various other domains. The transparently derived evidence presented here can provide essential support to the research community, facilitating the adaptation of technological advancements, the establishment of standards, and the enhancement of model robustness. This is particularly crucial as we work toward the long-term objective of establishing new approach methods as reliable alternatives to animal testing, with extensive and versatile applications.
Collapse
Affiliation(s)
- Ahmed S.M. Ali
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Germany
| | - Dongwei Wu
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Germany
| | - Alexandra Bannach-Brown
- Berlin Institute of Health (BIH) @Charité, QUEST Center for Responsible Research, Berlin, Germany
| | - Diyal Dhamrait
- Berlin Institute of Health (BIH) @Charité, QUEST Center for Responsible Research, Berlin, Germany
| | - Johanna Berg
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Germany
| | - Beatrice Tolksdorf
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Germany
| | - Dajana Lichtenstein
- German Federal Institute for Risk Assessment (BfR), Department Food Safety, Berlin, Germany
| | - Corinna Dressler
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Medical Library, Germany
| | - Albert Braeuning
- German Federal Institute for Risk Assessment (BfR), Department Food Safety, Berlin, Germany
| | - Jens Kurreck
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Germany
| | - Maren Hülsemann
- Berlin Institute of Health (BIH) @Charité, QUEST Center for Responsible Research, Berlin, Germany
| |
Collapse
|
2
|
Tolksdorf B, Heinze J, Niemeyer D, Röhrs V, Berg J, Drosten C, Kurreck J. Development of a highly stable, active small interfering RNA with broad activity against SARS-CoV viruses. Antiviral Res 2024; 226:105879. [PMID: 38599550 DOI: 10.1016/j.antiviral.2024.105879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
Treatment options for COVID-19 remain limited. Here, we report the optimization of an siRNA targeting the highly conserved leader region of SARS-CoV-2. The siRNA was rendered nuclease resistant by the introduction of modified nucleotides without loss of activity. Importantly, the siRNA also retained its inhibitory activity against the emerged omicron sublineage variant BA.2, which occurred after the siRNA was designed and is resistant to other antiviral agents such as antibodies. In addition, we show that a second highly active siRNA designed against the viral 5'-UTR can be applied as a rescue molecule, to minimize the spread of escape mutations. We therefore consider our siRNA-based molecules to be promising broadly active candidates for the treatment of current and future SARS-CoV-2 variants.
Collapse
Affiliation(s)
- Beatrice Tolksdorf
- Chair of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Berlin, 10623, Germany
| | - Julian Heinze
- German Center for Infection Research (DZIF), Charitéplatz 1, 10117, Berlin, Germany; Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Germany
| | - Daniela Niemeyer
- German Center for Infection Research (DZIF), Charitéplatz 1, 10117, Berlin, Germany; Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Germany
| | - Viola Röhrs
- Chair of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Berlin, 10623, Germany
| | - Johanna Berg
- Chair of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Berlin, 10623, Germany
| | - Christian Drosten
- German Center for Infection Research (DZIF), Charitéplatz 1, 10117, Berlin, Germany; Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Germany
| | - Jens Kurreck
- Chair of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Berlin, 10623, Germany.
| |
Collapse
|
3
|
Ali ASM, Berg J, Roehrs V, Wu D, Hackethal J, Braeuning A, Woelken L, Rauh C, Kurreck J. Xeno-Free 3D Bioprinted Liver Model for Hepatotoxicity Assessment. Int J Mol Sci 2024; 25:1811. [PMID: 38339088 PMCID: PMC10855587 DOI: 10.3390/ijms25031811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Three-dimensional (3D) bioprinting is one of the most promising methodologies that are currently in development for the replacement of animal experiments. Bioprinting and most alternative technologies rely on animal-derived materials, which compromises the intent of animal welfare and results in the generation of chimeric systems of limited value. The current study therefore presents the first bioprinted liver model that is entirely void of animal-derived constituents. Initially, HuH-7 cells underwent adaptation to a chemically defined medium (CDM). The adapted cells exhibited high survival rates (85-92%) after cryopreservation in chemically defined freezing media, comparable to those preserved in standard medium (86-92%). Xeno-free bioink for 3D bioprinting yielded liver models with high relative cell viability (97-101%), akin to a Matrigel-based liver model (83-102%) after 15 days of culture. The established xeno-free model was used for toxicity testing of a marine biotoxin, okadaic acid (OA). In 2D culture, OA toxicity was virtually identical for cells cultured under standard conditions and in CDM. In the xeno-free bioprinted liver model, 3-fold higher concentrations of OA than in the respective monolayer culture were needed to induce cytotoxicity. In conclusion, this study describes for the first time the development of a xeno-free 3D bioprinted liver model and its applicability for research purposes.
Collapse
Affiliation(s)
- Ahmed S. M. Ali
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Johanna Berg
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Viola Roehrs
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Dongwei Wu
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | | | - Albert Braeuning
- Department Food Safety, German Federal Institute for Risk Assessment (BfR), 10589 Berlin, Germany;
| | - Lisa Woelken
- Department of Food Biotechnology and Food Process Engineering, Technische Universität Berlin, 14195 Berlin, Germany (C.R.)
| | - Cornelia Rauh
- Department of Food Biotechnology and Food Process Engineering, Technische Universität Berlin, 14195 Berlin, Germany (C.R.)
| | - Jens Kurreck
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| |
Collapse
|
4
|
Williams S, Hebblewhite M, Martin H, Meyer C, Whittington J, Killeen J, Berg J, MacAulay K, Smolko P, Merrill EH. Predation risk drives long-term shifts in migratory behaviour and demography in a large herbivore population. J Anim Ecol 2024; 93:21-35. [PMID: 37982331 DOI: 10.1111/1365-2656.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/27/2023] [Indexed: 11/21/2023]
Abstract
Migration is an adaptive life-history strategy across taxa that helps individuals maximise fitness by obtaining forage and avoiding predation risk. The mechanisms driving migratory changes are poorly understood, and links between migratory behaviour, space use, and demographic consequences are rare. Here, we use a nearly 20-year record of individual-based monitoring of a large herbivore, elk (Cervus canadensis) to test hypotheses for changing patterns of migration in and adjacent to a large protected area in Banff National Park (BNP), Canada. We test whether bottom-up (forage quality) or top-down (predation risk) factors explained trends in (i) the proportion of individuals using 5 different migratory tactics, (ii) differences in survival rates of migratory tactics during migration and whilst on summer ranges, (iii) cause-specific mortality by wolves and grizzly bears, and (iv) population abundance. We found dramatic shifts in migration consistent with behavioural plasticity in individual choice of annual migratory routes. Shifts were inconsistent with exposure to the bottom-up benefits of migration. Instead, exposure to landscape gradients in predation risk caused by exploitation outside the protected area drove migratory shifts. Carnivore exploitation outside the protected area led to higher survival rates for female elk remaining resident or migrating outside the protected area. Cause-specific mortality aligned with exposure to predation risk along migratory routes and summer ranges. Wolf predation risk was higher on migratory routes than summer ranges of montane-migrant tactics, but wolf predation risk traded-off with heightened risk from grizzly bears on summer ranges. A novel eastern migrant tactic emerged following a large forest fire that enhanced forage in an area with lower predation risk outside of the protected area. The changes in migratory behaviour translated to population abundance, where abundance of the montane-migratory tactics declined over time. The presence of diverse migratory life histories maintained a higher total population abundance than would have been the case with only one migratory tactic in the population. Our study demonstrates the complex ways in which migratory populations change over time through behavioural plasticity and associated demographic consequences because of individuals balancing predation risk and forage trade-offs.
Collapse
Affiliation(s)
- S Williams
- Wildlife Biology Program, Department of Ecosystem and Conservation Sciences, Franke College of Forestry and Conservation, University of Montana, Missoula, Montana, USA
| | - M Hebblewhite
- Wildlife Biology Program, Department of Ecosystem and Conservation Sciences, Franke College of Forestry and Conservation, University of Montana, Missoula, Montana, USA
| | - H Martin
- Wildlife Biology Program, Department of Ecosystem and Conservation Sciences, Franke College of Forestry and Conservation, University of Montana, Missoula, Montana, USA
| | - C Meyer
- Wildlife Biology Program, Department of Ecosystem and Conservation Sciences, Franke College of Forestry and Conservation, University of Montana, Missoula, Montana, USA
| | - J Whittington
- Banff National Park, Parks Canada, Banff, Alberta, Canada
| | - J Killeen
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - J Berg
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - K MacAulay
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - P Smolko
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
- Department of Applied Zoology and Wildlife Management, Technical University in Zvolen, Zvolen, Slovakia
| | - E H Merrill
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
5
|
Eriksson P, Berg J, Bernardo C, Bobjer J, Brändstedt J, Löfgren A, Simoulis A, Sjödahl G, Sundén F, Wokander M, Zackrisson S, Liedberg F. Urodrill - a novel MRI-guided endoscopic biopsy technique to sample and molecularly classify muscle-invasive bladder cancer without fractionating the specimen during transurethral resection. EUR UROL SUPPL 2023; 53:78-82. [PMID: 37304229 PMCID: PMC10248785 DOI: 10.1016/j.euros.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
The current diagnostic pathway for patients with muscle-invasive bladder cancer (MIBC), which involves with computed tomography urography, cystoscopy, and transurethral resection of the bladder (TURB) to histologically confirm MIBC, delays definitive treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) has been suggested for MIBC identification using magnetic resonance imaging (MRI), but a recent randomized trial reported misclassification in one-third of patients. We investigated a new endoscopic biopsy device (Urodrill) for histological confirmation of MIBC and assessment of molecular subtype by gene expression in patients with VI-RADS 4 and 5 lesions on MRI. In ten patients, Urodrill biopsies were guided by MR images to the muscle-invasive portion of the tumor via a flexible cystoscope under general anesthesia. During the same session, conventional TURB was subsequently performed. A Urodrill sample was successfully obtained in nine of ten patients. MIBC was verified in six of nine patients, and seven of nine samples contained detrusor muscle. In seven of eight patients for whom a Urodrill biopsy sample was subjected to RNA sequencing, single-sample molecular classification according to the Lund taxonomy was feasible. No complications related to the biopsy device occurred. A randomized trial comparing this new diagnostic pathway for patients with VI-RADS 4 and 5 lesions and the current standard (TURB) is warranted. Patient summary We report on a novel biopsy device for patients with muscle-invasive bladder cancer that facilitates histology analysis and molecular characterization of tumor samples.
Collapse
Affiliation(s)
- Pontus Eriksson
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Johanna Berg
- Department of Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
| | - Carina Bernardo
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Johannes Bobjer
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Johan Brändstedt
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Annica Löfgren
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Athanasios Simoulis
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Pathology, Skåne University Hospital, Malmö, Sweden
| | - Gottfrid Sjödahl
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Fredrik Sundén
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Mats Wokander
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Sophia Zackrisson
- Department of Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Fredrik Liedberg
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
6
|
Gamlin CR, Schneider-Mizell CM, Mallory M, Elabbady L, Gouwens N, Williams G, Mukora A, Dalley R, Bodor A, Brittain D, Buchanan J, Bumbarger D, Kapner D, Kinn S, Mahalingam G, Seshamani S, Takeno M, Torres R, Yin W, Nicovich PR, Bae JA, Castro MA, Dorkenwald S, Halageri A, Jia Z, Jordan C, Kemnitz N, Lee K, Li K, Lu R, Macrina T, Mitchell E, Mondal SS, Mu S, Nehoran B, Popovych S, Silversmith W, Turner NL, Wong W, Wu J, Yu S, Berg J, Jarsky T, Lee B, Seung HS, Zeng H, Reid RC, Collman F, da Costa NM, Sorensen SA. Integrating EM and Patch-seq data: Synaptic connectivity and target specificity of predicted Sst transcriptomic types. bioRxiv 2023:2023.03.22.533857. [PMID: 36993629 PMCID: PMC10055412 DOI: 10.1101/2023.03.22.533857] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Neural circuit function is shaped both by the cell types that comprise the circuit and the connections between those cell types 1 . Neural cell types have previously been defined by morphology 2, 3 , electrophysiology 4, 5 , transcriptomic expression 6-8 , connectivity 9-13 , or even a combination of such modalities 14-16 . More recently, the Patch-seq technique has enabled the characterization of morphology (M), electrophysiology (E), and transcriptomic (T) properties from individual cells 17-20 . Using this technique, these properties were integrated to define 28, inhibitory multimodal, MET-types in mouse primary visual cortex 21 . It is unknown how these MET-types connect within the broader cortical circuitry however. Here we show that we can predict the MET-type identity of inhibitory cells within a large-scale electron microscopy (EM) dataset and these MET-types have distinct ultrastructural features and synapse connectivity patterns. We found that EM Martinotti cells, a well defined morphological cell type 22, 23 known to be Somatostatin positive (Sst+) 24, 25 , were successfully predicted to belong to Sst+ MET-types. Each identified MET-type had distinct axon myelination patterns and synapsed onto specific excitatory targets. Our results demonstrate that morphological features can be used to link cell type identities across imaging modalities, which enables further comparison of connectivity in relation to transcriptomic or electrophysiological properties. Furthermore, our results show that MET-types have distinct connectivity patterns, supporting the use of MET-types and connectivity to meaningfully define cell types.
Collapse
|
7
|
Mei Y, Wu D, Berg J, Tolksdorf B, Roehrs V, Kurreck A, Hiller T, Kurreck J. Generation of a Perfusable 3D Lung Cancer Model by Digital Light Processing. Int J Mol Sci 2023; 24:ijms24076071. [PMID: 37047045 PMCID: PMC10094257 DOI: 10.3390/ijms24076071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/10/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Lung cancer still has one of the highest morbidity and mortality rates among all types of cancer. Its incidence continues to increase, especially in developing countries. Although the medical field has witnessed the development of targeted therapies, new treatment options need to be developed urgently. For the discovery of new drugs, human cancer models are required to study drug efficiency in a relevant setting. Here, we report the generation of a non-small cell lung cancer model with a perfusion system. The bioprinted model was produced by digital light processing (DLP). This technique has the advantage of including simulated human blood vessels, and its simple assembly and maintenance allow for easy testing of drug candidates. In a proof-of-concept study, we applied gemcitabine and determined the IC50 values in the 3D models and 2D monolayer cultures and compared the response of the model under static and dynamic cultivation by perfusion. As the drug must penetrate the hydrogel to reach the cells, the IC50 value was three orders of magnitude higher for bioprinted constructs than for 2D cell cultures. Compared to static cultivation, the viability of cells in the bioprinted 3D model was significantly increased by approximately 60% in the perfusion system. Dynamic cultivation also enhanced the cytotoxicity of the tested drug, and the drug-mediated apoptosis was increased with a fourfold higher fraction of cells with a signal for the apoptosis marker caspase-3 and a sixfold higher fraction of cells positive for PARP-1. Altogether, this easily reproducible cancer model can be used for initial testing of the cytotoxicity of new anticancer substances. For subsequent in-depth characterization of candidate drugs, further improvements will be necessary, such as the generation of a multi-cell type lung cancer model and the lining of vascular structures with endothelial cells.
Collapse
Affiliation(s)
- Yikun Mei
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Dongwei Wu
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Johanna Berg
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Beatrice Tolksdorf
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Viola Roehrs
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Anke Kurreck
- BioNukleo GmbH, Ackerstr. 76, 13355 Berlin, Germany
| | - Thomas Hiller
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
- PRAMOMOLECULAR GmbH, Robert-Rössle-Strasse 10, 13125 Berlin, Germany
| | - Jens Kurreck
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, TIB 4/3-2, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| |
Collapse
|
8
|
Kapanadze G, Berg J, Sun Y, Gerdin Wärnberg M. Facilitators and barriers impacting in-hospital Trauma Quality Improvement Program (TQIP) implementation across country income levels: a scoping review. BMJ Open 2023; 13:e068219. [PMID: 36806064 PMCID: PMC9944272 DOI: 10.1136/bmjopen-2022-068219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVE Trauma is a leading cause of mortality and morbidity globally, disproportionately affecting low/middle-income countries (LMICs). Understanding the factors determining implementation success for in-hospital Trauma Quality Improvement Programs (TQIPs) is critical to reducing the global trauma burden. We synthesised topical literature to identify key facilitators and barriers to in-hospital TQIP implementation across country income levels. DESIGN Scoping review. DATA SOURCES PubMed, Web of Science and Global Index Medicus databases were searched from June 2009 to January 2022. ELIGIBILITY CRITERIA Published literature involving any study design, written in English and evaluating any implemented in-hospital quality improvement programme in trauma populations worldwide. Literature that was non-English, unpublished and involved non-hospital TQIPs was excluded. DATA EXTRACTION AND SYNTHESIS Two reviewers completed a three-stage screening process using Covidence, with any discrepancies resolved through a third reviewer. Content analysis using the Consolidated Framework for Implementation Research identified facilitator and barrier themes for in-hospital TQIP implementation. RESULTS Twenty-eight studies met the eligibility criteria from 3923 studies identified. The most discussed in-hospital TQIPs in included literature were trauma registries. Facilitators and barriers were similar across all country income levels. The main facilitator themes identified were the prioritisation of staff education and training, strengthening stakeholder dialogue and providing standardised best-practice guidelines. The key barrier theme identified in LMICs was poor data quality, while high-income countries (HICs) had reduced communication across professional hierarchies. CONCLUSIONS Stakeholder prioritisation of in-hospital TQIPs, along with increased knowledge and consensus of trauma care best practices, are essential efforts to reduce the global trauma burden. The primary focus of future studies on in-hospital TQIPs in LMICs should target improving registry data quality, while interventions in HICs should target strengthening communication channels between healthcare professionals.
Collapse
Affiliation(s)
- George Kapanadze
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Johanna Berg
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Emergency and Internal Medicine, Skånes universitetssjukhus Malmö, Malmo, Sweden
| | - Yue Sun
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Martin Gerdin Wärnberg
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
9
|
Berg J, Lipponen E, Sailas E, Soininen P, Varpula J, Välimäki M, Lahti M. Nurses' perceptions of nurse-patient communication in seclusion rooms in psychiatric inpatient care: A focus group study. J Psychiatr Ment Health Nurs 2023. [PMID: 36718606 DOI: 10.1111/jpm.12907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/16/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Communication between nurses and patients is essential in mental health nursing. In coercive situations (e.g. seclusion), the importance of nurse-patient communication is highlighted. However, research related to nurses' perceptions of nurse-patient communication during seclusion is scant. AIM The aim of this study was to describe nurses' perceptions of nurse-patient communication during patient seclusion and the ways nurse-patient communication can be improved. METHOD A qualitative study design using focus group interviews was adopted. Thirty-two nurses working in psychiatric wards were recruited to participate. The data were analysed using inductive qualitative content analysis. RESULTS Nurses aimed to communicate in a patient-centred way in seclusion events, and various issues affected the quality of communication. Nurses recognized several ways to improve communication during seclusion. DISCUSSION Treating patients in seclusion rooms presents highly demanding care situations for nurses. Seclusion events require nurses to have good communication skills to provide ethically sound care. CONCLUSION Improved nurse-patient communication may contribute to shorter seclusion times and a higher quality of care. Improving nurses' communication skills may help support the dignity of the secluded patients. Safewards practices, such as respectful communication and recognizing the effect of non-verbal behaviour, could be considered when developing nurse-patient communication in seclusion events. RELEVANCE STATEMENT This study deepens the understanding of nurse-patient communication during seclusion events from the perspective of nurses. Caring for patients in seclusion presents challenging situations for nurses and demands that they have good communication skills. To enhance their communication skills in seclusion events, nurses require opportunities to take part in further training after education related to communication skills for demanding care situations. Knowing the appropriate ways to interact with individual patients during seclusion can help nurses create and maintain communication with patients. For mental health nursing, nurses' enhanced communication may promote increased use of noncoercive practices in psychiatric settings. For patients, improving nurses' communication skills may help support dignity and autonomy during seclusion and shorten the time spent in seclusion, resulting in a better quality of care and more positive patient experiences related to care offered in seclusion. In this, the perspectives of people with lived experience of mental health problems should be acknowledged. Components of Safewards practices, such as using respectful and individual communication and paying attention to one's non-verbal communication (Soft Words), could be useful when developing nurse-patient communication in seclusion events.
Collapse
Affiliation(s)
- Johanna Berg
- Turku University of Applied Sciences, Turku, Finland
| | | | - Eila Sailas
- Helsinki University Hospital, Kellokoski Hospital, Kellokoski, Finland
| | - Päivi Soininen
- Helsinki University Hospital, Kellokoski Hospital, Kellokoski, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Xiangya Nursing School, Central South University, Changsha, China
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
| |
Collapse
|
10
|
Jablonowski R, Nordlund D, Xanthis C, Bidhult S, Kopic S, Berg J, Engblom H, Aletras AH, Arheden H. Longitudinal assessment of myocardial edema following experimental acute myocardial infarction using a comprehensive CMR protocol. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Preclinical and clinical data following acute myocardial infarction (MI) and reperfusion have shown a bimodal pattern of edematous myocardium at risk (MaR) on cardiovascular magnetic resonance (CMR) imaging during the first week [1,2]. In contrary, there have also been data demonstrating that MaR is stable during the first week in patients using contrast-enhanced steady-state free precession (CE-SSFP) imaging [3].
Purpose
To use a comprehensive CMR protocol to assess the dynamics of edematous MaR during the first week following acute experimental MI.
Methods
Acute myocardial ischemia was induced in seven pigs by endovascular balloon occlusion in the left anterior descending artery with reperfusion after 40 minutes. CMR was performed at baseline, at 120 minutes, 24 hours and seven days post-reperfusion on a 1.5T scanner. The CMR protocol comprised of a prototype T2-SSFP sequence where two experiments with 16 echo times (T2 mapping16) and with 10 echo times (T2 mapping10) [1] were performed. After contrast administration, a short-axis CE-SSFP stack and late gadolinium enhancement (LGE) images were acquired. T2-maps were acquired in a mid-apical ventricular short-axis slice corresponding to the same anatomical level at all time points. All image analysis was performed using designated software. Severity of MaR was measured by placing a region of interest in the ischemic area on T2 maps and extent of MaR was assessed by delineating hyperintense areas in CE-SSFP short-axis stacks. Data is presented as mean ± SD and one-way ANOVA was used followed by Tukey's multiple comparison test.
Results
An example of all acquired CMR sequences is shown in Figure 1, with red arrows depicting the extent of edematous MaR. Figure 2 shows the severity of MaR by T2 values from T2 mapping16 where T2 values were significantly lower at 24 hours compared to 120 minutes post-reperfusion (P<0.05). However, no significant difference was seen at 120 minutes or at 24 hours compared to T2 values at seven days (P=0.46 and P=0.35). No difference at baseline (47±3 ms vs 49±3 ms, P=0.10) was observed when comparing T2 mapping16 against T2 mapping10 but a significant difference between the time points 120 min (80±8 ms vs 69±7 ms, P=0.02), 24 h, (69±9 ms vs 54±4 ms, P=0.03), and seven days (76±10 ms vs 67±5 ms, P=0.04) post-reperfusion. There was no statistically significant difference between T2 values post-reperfusion using T2 mapping10 (P=ns). The extent of myocardium at risk assessed by CE-SSFP did not show a bimodal pattern of edema, but rather a significantly lower extent at seven days compared to the extent at 120 minutes and 24 hours (P<0.05).
Conclusion
The severity and extent of edematous myocardium at risk does not follow a bimodal pattern over the course of one week. However, absolute T2 values differ between T2 mapping sequences and therefore a standardization of a CMR protocol for the assessment of MaR is of importance.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Swedish Heart-Lung Foundation and The Medical Faculty of Lund University (ALF)
Collapse
Affiliation(s)
- R Jablonowski
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| | - D Nordlund
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| | - C Xanthis
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| | - S Bidhult
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| | - S Kopic
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| | - J Berg
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| | - H Engblom
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| | - A H Aletras
- Aristotle University of Thessaloniki, Laboratory of Biomedical-Imaging Technologies, Aristotle University of Thessaloniki, Greece , Thessaloniki , Greece
| | - H Arheden
- Lund University, Skane University Hospital, Department of Clinical Physiology, Lund, Sweden , Lund , Sweden
| |
Collapse
|
11
|
Berg J, Villatore A, Sivilotti F, Pili G, Sala S, Della Bella P, Peretto G. Diagnostic value of electroanatomical mapping in patients with suspected arrhythmogenic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Case series suggested that low voltage areas (LVA) on invasive electroanatomical mapping (EAM) could identify arrhythmogenic cardiomyopathy (ACM) at an earlier stage as compared to late gadolinium enhancement (LGE) and fatty infiltration on cardiac magnetic resonance (CMR). Data comparing LVA with structural abnormalities on CMR are lacking.
Purpose
To report the prevalence of substrate abnormalities identified by EAM vs. CMR in a cohort of patients with suspected ACM.
Methods
We retrospectively identified 66 consecutive patients with suspected ACM, who underwent EAM following clinical onset with ventricular arrhythmias. The cutoff value for EAM-defined LVA was <0.5 mV bipolar, <8 mV unipolar. Data from a prior CMR, performed no more than 12 months before, were used for comparison.
Results
The study cohort (mean age 47 years, range 21–76; 83% males; mean left ventricular ejection fraction 53%, range 28–70%) was composed of patients with suspected ACM involving either the right (n=62) or the left ventricle (n=4) following presentation with sustained monomorphic ventricular tachycardia. EAM was obtained by isolated endocardial, epicardial, or combined approach, respectively, in 11 (17%), 15 (23%) and 40 (61%) patients. Overall, 61 patients (92%) had documented LVA, of whom 89% showed an epicardial localization. In the same population, CMR identified a lower prevalence of substrate abnormalities (LGE 65%; fatty infiltration 50%). In particular, there were 27 patients (41%) with EAM-defined LVA and absent substrate abnormalities on CMR. Based on the 2010 Task Force Criteria and the 2021 Padua Criteria, a definite diagnosis of ACM was missing for a total of 19 patients (29%): due to the uniform identification of LVA in the absence of CMR abnormalities, EAM helped to establish the most likely diagnosis of ACM in all of them (19/19).
Conclusions
Our data suggest that EAM is capable of identifying substrate abnormalities in a consistent proportion of patients with suspected ACM and absent abnormalities on CMR. In this setting, the implementation of LVA to the current diagnostic criteria could improve the diagnostic yield for ACM.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- J Berg
- San Raffaele Hospital, Department of arrhythmology , Milan , Italy
| | - A Villatore
- San Raffaele Hospital, Department of arrhythmology , Milan , Italy
| | - F Sivilotti
- San Raffaele Hospital, Department of arrhythmology , Milan , Italy
| | - G Pili
- San Raffaele Hospital, Department of arrhythmology , Milan , Italy
| | - S Sala
- San Raffaele Hospital, Department of arrhythmology , Milan , Italy
| | - P Della Bella
- San Raffaele Hospital, Department of arrhythmology , Milan , Italy
| | - G Peretto
- San Raffaele Hospital, Department of arrhythmology , Milan , Italy
| |
Collapse
|
12
|
Sivilotti F, Villatore A, Berg J, Romano SC, Parciante A, Pili G, Fioravanti F, El Sawaf B, Sala S, Della Bella P, Peretto G. High prevalence of malignant ventricular arrhythmias in patients with early-stage left ventricular noncompaction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Early-stage left ventricular non compaction (LVNC) is a nonischemic cardiomyopathy characterized with nondilated phenotype and unpredictable risk of malignant ventricular arrhythmias (MVA).
Purpose
To report the occurrence of MVA in patients with early-stage LVNC.
Methods
Consecutive patients (n=63) diagnosed with LVNC according to recognized criteria either on transthoracic echocardiogram or cardiac magnetic resonance were retrospectively enrolled. Patients with late-stage LVNC, defined by a coexistent dilated cardiomyopathy phenotype, were excluded (n=49). Patient-tailored medical treatment, as well as ICD implantation strategies, were based on the updated ESC guidelines integrated by the experience of a referral center for arrhythmia management. The study endpoint was the occurrence of MVA (defined as sustained VT, VF, or appropriate ICD therapy) by 5-year follow-up.
Results
The study cohort consisted of 14 patients (mean age 37±17 y, 64% males), presenting with palpitation (n=4), syncope (n=4), or dyspnea on effort (n=6). LVNC was diagnosed by echocardiogram and cardiac magnetic resonance in 13 and 1 patients, respectively. Because of nonmalignant VA, seven patients (50%) underwent ICD implant before discharge. By 5-year follow-up, 5 patients (36%) experienced MVA, including VF or appropriate ICD shocks for fast VT. Left ventricular ejection fraction (LVEF) ≥45% was the only factor associated with the occurrence of MVA (5/11 event in cases with LVEF ≥45% vs. 0/3 events in controls with LVEF <45%; p=0.145). Baseline features, including age, gender, NC/C ratio, and clinical presentation were comparable between cases with LVEF ≥45% and controls, all p>0.05. Drug treatment, including RAAS inhibitors, betablockers and antiarrhythmics was also comparable.
Conclusions
Our preliminary data show that in early-stage LVNC the occurrence of MVA is higher for patients with LVEF ≥45%. Efforts are needed to identify earlier predictors of arrhythmic risk, to improve patient selection for ICD implant.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- F Sivilotti
- University Vita-Salute San Raffaele , Milan , Italy
| | - A Villatore
- University Vita-Salute San Raffaele , Milan , Italy
| | - J Berg
- San Raffaele Hospital , Milan , Italy
| | - S C Romano
- University Vita-Salute San Raffaele , Milan , Italy
| | - A Parciante
- University Vita-Salute San Raffaele , Milan , Italy
| | - G Pili
- University Vita-Salute San Raffaele , Milan , Italy
| | | | | | - S Sala
- San Raffaele Hospital , Milan , Italy
| | | | - G Peretto
- San Raffaele Hospital , Milan , Italy
| |
Collapse
|
13
|
Berg J, Jablonowski R, Nordlund D, Ryd D, Heiberg E, Carlsson M, Arheden H. Hypothermia yields favourable cardiac energetics in experimental ischemia/reperfusion – insights from non-invasive pressure-volume loops by CMR. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
In experimental studies, mild hypothermia (<35°C) has reduced infarct size [1], potentially through reduced reperfusion injury [2], but human trials have been ambiguous [3]. Furthermore, a pressure-volume (PV) loop framework is the gold standard for assessing cardiac performance, but the invasive approach limits its clinical use. Therefore, we used a porcine model of ischemia/reperfusion with cardiovascular magnetic resonance (CMR) imaging throughout one week to acquire non-invasive PV loops.
Purpose
To quantify the cardioprotective effects of hypothermia at reperfusion by serial CMR imaging in a perspective of cardiac energy and mechanics.
Methods
Normothermia and Hypothermia groups (n=7+7 pigs) were imaged with CMR at baseline and subjected to 40 minutes of normothermic ischemia by catheter intervention. Thereafter, the Hypothermia group was rapidly cooled (<35°C) for 5 minutes before reperfusion. Additional imaging at two hours, 24 hours, and seven days were used to assess ventricular volumes and ischemic injuries. Infarct size was determined by high-resolution ex-vivo T1-weighted images.
Results
Figure 1 shows that stroke volume (SV: p=0.029; Friedmans test) and ejection fraction (EF: p=0.068) were notably reduced post-reperfusion in the Normothermia group. In contrast, the decreases were ameliorated in the Hypothermia group (SV: p=0.77; EF: p=0.13). Mean arterial pressure (MAP) was stable in the Normothermia group (p=0.77) but dropped two hours post-reperfusion in hypothermic animals (p=0.007). Over one week, both groups experienced the same decrease and partial recovery pattern for stroke work, external power, and ventricular-arterial coupling. Still, the adverse effects from ischemia were generally attenuated in the Hypothermia group. Although not significant, ischemia/reperfusion caused smaller infarcts in the Hypothermia group (10±8% vs 15±8%; p=0.32). The change in PV loop variables from baseline to 24 hours was compared with infarct size for each group. Though statistical power was limited, the general trend in analyses of covariance indicated that hypothermia has cardioprotective properties incremental to reducing infarct sizes (Figure 2), such as higher external power (p=0.061) and lower arterial elastance (p=0.015).
Conclusion
Using non-invasive PV loops by CMR, we observed that mild hypothermia before reperfusion results in favourable cardiac energetics that alleviates the heart's work after an ischemia/reperfusion injury during the first week. This study suggests that hypothermia has cardioprotective properties, incremental to reducing infarct size. The primary cardioprotective mechanism was likely an afterload reduction unloading the injured left ventricle.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Swedish Heart-Lung FoundationThe Medical Faculty of Lund University (ALF)
Collapse
Affiliation(s)
- J Berg
- Lund University, Department of Clinical Sciences Lund, Clinical Physiology , Lund , Sweden
| | - R Jablonowski
- Lund University, Department of Clinical Sciences Lund, Clinical Physiology , Lund , Sweden
| | - D Nordlund
- Lund University, Department of Clinical Sciences Lund, Clinical Physiology , Lund , Sweden
| | - D Ryd
- Lund University, Department of Clinical Sciences Lund, Clinical Physiology , Lund , Sweden
| | - E Heiberg
- Lund University, Department of Clinical Sciences Lund, Clinical Physiology , Lund , Sweden
| | - M Carlsson
- National Institute of Health (Home), Laboratory of Clinical Physiology, National Heart Lung and Blood Institute, Washington , DC , United States of America
| | - H Arheden
- Lund University, Department of Clinical Sciences Lund, Clinical Physiology , Lund , Sweden
| |
Collapse
|
14
|
Roth M, Lahti M, Gustafsson N, Berg J, Kaitala E, Kuosmanen L. Non-European immigrants' self-described strategies for mental health promotion and perceptions of Finnish mental health services: A qualitative descriptive analysis. Perspect Psychiatr Care 2022; 58:3016-3023. [PMID: 35445746 PMCID: PMC9790472 DOI: 10.1111/ppc.13096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/08/2022] [Accepted: 04/08/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE This study aims to describe non-European immigrants' perceptions toward mental health care in Finland and the factors that support their mental health. DESIGN AND METHODS Participants (N = 17) were interviewed through semistructured interviews, after which interview transcripts were analyzed using a six-phase thematic analysis process. FINDINGS The participants reported that developing self-help strategies benefitted their mental health. The participants primarily preferred unprofessional help over professional mental health care. Several structural and cultural barriers to help-seeking were identified. PRACTICAL IMPLICATION Health care staff working with immigrants need proper education and knowledge to provide sufficient, holistic care; for this reason, information about the cultural differences among immigrants and cultural sensitivity should be included in basic as well as post-graduate nursing education.
Collapse
Affiliation(s)
- Minni Roth
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mari Lahti
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Noora Gustafsson
- Department of Nursing, Turku University of Applied Sciences, Turku, Finland
| | - Johanna Berg
- Department of Nursing, Turku University of Applied Sciences, Turku, Finland
| | - Elina Kaitala
- Department of Nursing, Turku University of Applied Sciences, Turku, Finland
| | - Lauri Kuosmanen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
15
|
Loveday C, Garrett A, Law P, Hanks S, Poyastro-Pearson E, Adlard JW, Barwell J, Berg J, Brady AF, Brewer C, Chapman C, Cook J, Davidson R, Donaldson A, Douglas F, Greenhalgh L, Henderson A, Izatt L, Kumar A, Lalloo F, Miedzybrodzka Z, Morrison PJ, Paterson J, Porteous M, Rogers MT, Walker L, Eccles D, Evans DG, Snape K, Hanson H, Houlston RS, Turnbull C. Analysis of rare disruptive germline mutations in 2,135 enriched BRCA-negative breast cancers excludes additional high-impact susceptibility genes. Ann Oncol 2022; 33:1318-1327. [PMID: 36122798 DOI: 10.1016/j.annonc.2022.09.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/15/2022] [Accepted: 09/01/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Breast cancer has a significant heritable basis, of which approximately 60% remains unexplained. Testing for BRCA1/BRCA2 offers useful discrimination of breast cancer risk within families, and identification of additional breast cancer susceptibility genes could offer clinical utility. PATIENTS AND METHODS We included 2,135 invasive breast cancer cases recruited via the BOCS study, a retrospective UK study of familial breast cancer. ELIGIBILITY CRITERIA female, BRCA-negative, white European ethnicity, and one of: i) breast cancer family history, ii) bilateral disease, iii) young age of onset (<30 years), iv) concomitant ovarian cancer. We undertook exome sequencing of cases and performed gene-level burden testing of rare damaging variants against those from 51,377 ethnicity-matched population controls from gnomAD. RESULTS 159/2135 (7.4%) cases had a qualifying variant in an established breast cancer susceptibility gene, with minimal evidence of signal in other cancer susceptibility genes. Known breast cancer susceptibility genes PALB2, CHEK2 and ATM were the only genes to retain statistical significance after correcting for multiple testing. Due to the enrichment of hereditary cases in the series, we had good power (>80%) to detect a gene of BRCA1-like risk (odds ratio = 10.6) down to a population minor allele frequency of 4.6 x 10-5 (1 in 10,799, less than one tenth that of BRCA1)and of PALB2-like risk (odds ratio = 5.0) down to a population minor allele frequency of 2.8 x 10-4 (1 in 1,779, less than half that of PALB2). Power was lower for identification of novel moderate penetrance genes (odds ratio = 2-3) like CHEK2 and ATM. CONCLUSIONS This is the largest case-control whole-exome analysis of enriched breast cancer published to date. Whilst additional breast cancer susceptibility genes likely exist, those of high penetrance are likely to be of very low mutational frequency. Contention exists regarding the clinical utility of such genes.
Collapse
Affiliation(s)
- C Loveday
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - A Garrett
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - P Law
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - S Hanks
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - E Poyastro-Pearson
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - J W Adlard
- Yorkshire Regional Genetics Service, St James's University Hospital, Leeds, UK
| | - J Barwell
- Leicestershire Genetics Centre, University Hospitals of Leicester National Health Service (NHS) Trust, Leicester, UK
| | - J Berg
- Division of Medical Sciences, Human Genetics, University of Dundee, Dundee, UK
| | - A F Brady
- North West Thames Regional Genetics Service, Kennedy Galton Centre, London, UK
| | - C Brewer
- Peninsula Regional Genetics Service, Royal Devon & Exeter Hospital, Exeter, UK
| | - C Chapman
- West Midlands Regional Genetics Service, Birmingham Women's Hospital, Birmingham, UK
| | - J Cook
- Sheffield Regional Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - R Davidson
- West of Scotland Regional Genetics Service, Ferguson Smith Centre for Clinical Genetics, Glasgow, UK
| | - A Donaldson
- South Western Regional Genetics Service, University Hospitals of Bristol NHS Foundation Trust, Bristol, UK
| | - F Douglas
- Northern Genetics Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - L Greenhalgh
- Cheshire and Merseyside Clinical Genetics Service, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - A Henderson
- Northern Genetics Service (Cumbria), Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - L Izatt
- South East Thames Regional Genetics Service, Guy's and St. Thomas NHS Foundation Trust, London, UK
| | - A Kumar
- North East Thames Regional Genetics Service, Great Ormond St. Hospital, London, UK
| | - F Lalloo
- University Department of Medical Genetics & Regional Genetics Service, St. Mary's Hospital, Manchester, UK
| | - Z Miedzybrodzka
- University of Aberdeen and North of Scotland Clinical Genetics Service, Aberdeen Royal Infirmary, Aberdeen, UK
| | - P J Morrison
- Belfast Health and Social Care (HSC) Trust & Department of Medical Genetics, Northern Ireland Regional Genetics Service, Queen's University Belfast, Belfast, UK
| | - J Paterson
- East Anglian Regional Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - M Porteous
- South East of Scotland Clinical Genetics Service, Western General Hospital, Edinburgh, UK
| | - M T Rogers
- All Wales Medical Genetics Service, University Hospital of Wales, Cardiff, UK
| | - L Walker
- Oxford Regional Genetics Service, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
| | -
- Individual collaborators and their affiliations are listed in the Appendix
| | - D Eccles
- Faculty of Medicine, University of Southampton, Southampton University Hospitals NHS Trust, Southampton, UK
| | - D G Evans
- University Department of Medical Genetics & Regional Genetics Service, St. Mary's Hospital, Manchester, UK
| | - K Snape
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.; South West Thames Regional Genetics Service, St. George's Hospital, London, UK
| | - H Hanson
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.; South West Thames Regional Genetics Service, St. George's Hospital, London, UK
| | - R S Houlston
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - C Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.; Royal Marsden NHS Foundation Hospital, London, UK.
| |
Collapse
|
16
|
Al-Zeer MA, Prehn F, Fiedler S, Lienert U, Krisch M, Berg J, Kurreck J, Hildebrandt G, Schültke E. Evaluating the Suitability of 3D Bioprinted Samples for Experimental Radiotherapy: A Pilot Study. Int J Mol Sci 2022; 23:ijms23179951. [PMID: 36077349 PMCID: PMC9456381 DOI: 10.3390/ijms23179951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 12/22/2022] Open
Abstract
Radiotherapy is an important component in the treatment of lung cancer, one of the most common cancers worldwide, frequently resulting in death within only a few years of diagnosis. In order to evaluate new therapeutic approaches and compare their efficiency with regard to tumour control at a pre-clinical stage, it is important to develop standardized samples which can serve as inter-institutional outcome controls, independent of differences in local technical parameters or specific techniques. Recent developments in 3D bioprinting techniques could provide a sophisticated solution to this challenge. We have conducted a pilot project to evaluate the suitability of standardized samples generated from 3D printed human lung cancer cells in radiotherapy studies. The samples were irradiated at high dose rates using both broad beam and microbeam techniques. We found the 3D printed constructs to be sufficiently mechanically stable for use in microbeam studies with peak doses up to 400 Gy to test for cytotoxicity, DNA damage, and cancer cell death in vitro. The results of this study show how 3D structures generated from human lung cancer cells in an additive printing process can be used to study the effects of radiotherapy in a standardized manner.
Collapse
Affiliation(s)
- Munir A. Al-Zeer
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 13355 Berlin, Germany
- Correspondence: or (M.A.A.-Z.); (E.S.)
| | - Franziska Prehn
- Department of Radiooncology, Rostock University Medical Center, 18059 Rostock, Germany
| | - Stefan Fiedler
- European Molecular Biology Laboratory (EMBL), Hamburg Outstation/DESY, 22607 Hamburg, Germany
| | | | - Michael Krisch
- European Synchrotron Radiation Facility (ESRF), 38043 Grenoble, France
| | - Johanna Berg
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 13355 Berlin, Germany
| | - Jens Kurreck
- Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 13355 Berlin, Germany
| | - Guido Hildebrandt
- Department of Radiooncology, Rostock University Medical Center, 18059 Rostock, Germany
| | - Elisabeth Schültke
- Department of Radiooncology, Rostock University Medical Center, 18059 Rostock, Germany
- Correspondence: or (M.A.A.-Z.); (E.S.)
| |
Collapse
|
17
|
Berg J, Alvesson HM, Roy N, Ekelund U, Bains L, Chatterjee S, Bhattacharjee PK, David S, Gupta S, Kamble J, Khajanchi M, Lal P, Malhotra V, Meher R, Mishra A, Mohan LN, Petzold M, Saxena R, Shrivastava P, Singh R, Soni KD, Sural S, Gerdin Wärnberg M. Perceived usefulness of trauma audit filters in urban India: a mixed-methods multicentre Delphi study comparing filters from the WHO and low and middle-income countries. BMJ Open 2022; 12:e059948. [PMID: 35680271 PMCID: PMC9185581 DOI: 10.1136/bmjopen-2021-059948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare experts' perceived usefulness of audit filters from Ghana, Cameroon, WHO and those locally developed; generate context-appropriate audit filters for trauma care in selected hospitals in urban India; and explore characteristics of audit filters that correlate to perceived usefulness. DESIGN A mixed-methods approach using a multicentre online Delphi technique. SETTING Two large tertiary hospitals in urban India. METHODS Filters were rated on a scale from 1 to 10 in terms of perceived usefulness, with the option to add new filters and comments. The filters were categorised into three groups depending on their origin: low and middle-income countries (LMIC), WHO and New (locally developed), and their scores compared. Significance was determined using Kruskal-Wallis test followed by Wilcoxon rank-sum test. We performed a content analysis of the comments. RESULTS 26 predefined and 15 new filter suggestions were evaluated. The filters had high usefulness scores (mean overall score 9.01 of 10), with the LMIC filters having significantly higher scores compared with those from WHO and those newly added. Three themes were identified in the content analysis relating to medical relevance, feasibility and specificity. CONCLUSIONS Audit filters from other LMICs were deemed highly useful in the urban India context. This may indicate that the transferability of defined trauma audit filters between similar contexts is high and that these can provide a starting point when implemented as part of trauma quality improvement programmes in low-resource settings.
Collapse
Affiliation(s)
- Johanna Berg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Emergency and Internal Medicine, Skane University Hospital, Malmo, Sweden
| | | | - Nobhojit Roy
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The George Institute for Global Health India, New Delhi, Delhi, India
| | - Ulf Ekelund
- Emergency Medicine, Department of Clinical Sciences, Lund University Faculty of Medicine, Lund, Sweden
| | - Lovenish Bains
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
- WHO Collaboration Centre for Research in Surgical Care Delivery In Low and Middle-Income Countries, Mumbai, Maharashtra, India
| | - Shamita Chatterjee
- Department of Surgery, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | | | - Siddarth David
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Doctors For You, Mumbai, Maharashtra, India
| | - Swati Gupta
- Department of Radiodiagnosis and Imaging, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Jyoti Kamble
- Doctors For You, Mumbai, Maharashtra, India
- School of Public health, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Monty Khajanchi
- WHO Collaboration Centre for Research in Surgical Care Delivery In Low and Middle-Income Countries, Mumbai, Maharashtra, India
- Department of Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Pawanindra Lal
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Vikas Malhotra
- Department of ENT and Head & Neck Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Ravi Meher
- Department of ENT and Head & Neck Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Anurag Mishra
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | | | - Max Petzold
- School Public Health and Community Medicine, Institute of Medicine, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Ritu Saxena
- Department of Accident and Emergency, Lok Nayak Hospital, New Delhi, India
| | - Prabhat Shrivastava
- Department of Burns and Plastic Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Rajdeep Singh
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Kapil Dev Soni
- Department of Critical and Intensive Care, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Sumit Sural
- Department of Orthopaedic Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Martin Gerdin Wärnberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
18
|
Varpula J, Välimäki M, Lantta T, Berg J, Soininen P, Lahti M. Safety hazards in clinical practice of seclusion in psychiatric care. Eur Psychiatry 2022. [PMCID: PMC9566598 DOI: 10.1192/j.eurpsy.2022.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Seclusion is part of the clinical practice in European psychiatric hospital care with the aim to maintain the safety of patients and staff. Adverse events and harm have been reported for patients and staff resulting from seclusion. Safety hazards, which are the prerequisite of adverse events, can be identified using video observation methods. Identifying safety hazards can be used to prevent adverse events and improve the quality of psychiatric care. Objectives To identify safety hazards during seclusion in psychiatric hospital care. Methods Descriptive design with non-participant video-observation of seclusion care practice. Data consisted of video recordings (n = 36) from six wards of one psychiatric hospital in Finland. The data were analysed with inductive thematic analysis. Results Clinical practice of seclusion included safety hazards stemming from the actions of patients and staff. Patients’ actions were as follows: aggressive behaviour, attempting to escape, precarious movements, preventing the visibility of staff, exposing themselves to contamination, and falls during seclusion. Staff actions included: leaving dangerous items to seclusion, issues in the administration of medication, performing physical and mechanical restraints in unsecure way, and precarious movements and postures. Conclusions According to our results, the use of seclusion has safety hazards that can result in harm for patients and staff. To improve the quality and safety of seclusion in clinical practice, the guidelines, practices, and staff training need to consider the various safety hazards. While the work in Europe to abolish the use of seclusion is still in progress, this topic requires attention in clinical practice, education, and policymaking. Disclosure No significant relationships.
Collapse
|
19
|
Gerdin Wärnberg M, Berg J, Bhandarkar P, Chatterjee A, Chatterjee S, Chintamani C, Felländer-Tsai L, Gadgil A, Ghag G, Hasselberg M, Juillard C, Khajanchi M, Kizhakke Veetil D, Kumar V, Kundu D, Mishra A, Patil P, Roy N, Roy A, David S, Singh R, Solomon H, Soni KD, Strömmer L, Tandon M. A pilot multicentre cluster randomised trial to compare the effect of trauma life support training programmes on patient and provider outcomes. BMJ Open 2022; 12:e057504. [PMID: 35437251 PMCID: PMC9016405 DOI: 10.1136/bmjopen-2021-057504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Trauma accounts for nearly 10% of the global burden of disease. Several trauma life support programmes aim to improve trauma outcomes. There is no evidence from controlled trials to show the effect of these programmes on patient outcomes. We describe the protocol of a pilot study that aims to assess the feasibility of conducting a cluster randomised controlled trial comparing advanced trauma life support (ATLS) and primary trauma care (PTC) with standard care. METHODS AND ANALYSIS We will pilot a pragmatic three-armed parallel, cluster randomised controlled trial in India, where neither of these programmes are routinely taught. We will recruit tertiary hospitals and include trauma patients and residents managing these patients. Two hospitals will be randomised to ATLS, two to PTC and two to standard care. The primary outcome will be all-cause mortality at 30 days from the time of arrival to the emergency department. Our secondary outcomes will include patient, provider and process measures. All outcomes except time-to-event outcomes will be measured both as final values as well as change from baseline. We will compare outcomes in three combinations of trial arms: ATLS versus PTC, ATLS versus standard care and PTC versus standard care using absolute and relative differences along with associated CIs. We will conduct subgroup analyses across the clinical subgroups men, women, blunt multisystem trauma, penetrating trauma, shock, severe traumatic brain injury and elderly. In parallel to the pilot study, we will conduct community consultations to inform the planning of the full-scale trial. ETHICS AND DISSEMINATION We will apply for ethics approvals to the local institutional review board in each hospital. The protocol will be published to Clinical Trials Registry-India and ClinicalTrials.gov. The results will be published and the anonymised data and code for analysis will be released publicly.
Collapse
Affiliation(s)
- Martin Gerdin Wärnberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Johanna Berg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Emergency Medicine, Department of Internal and Emergency Medicine, Skåne University Hospital, Malmö, Sweden
| | - Prashant Bhandarkar
- Tata Institute of Social Sciences School of Health Systems Studies, Deonar, Maharashtra, India
- World Health Organization Collaborating Center for Research in Surgical Care Delivery in Low-and-Middle Income Countries, Mumbai, India
| | - Anirban Chatterjee
- Department of Orthopaedic Sciences, Medica Superspecialty Hospital, Kolkata, India
| | - Shamita Chatterjee
- Department of Surgery, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Chintamani Chintamani
- Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India
| | - Li Felländer-Tsai
- Division of Orthopaedics and Biotechnology, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Reconstructive Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Anita Gadgil
- World Health Organization Collaborating Center for Research in Surgical Care Delivery in Low-and-Middle Income Countries, Mumbai, India
| | - Geeta Ghag
- Department of Surgery, HBT Medical College and Dr R N Cooper Municipal General Hospital, Mumbai, India
| | - Marie Hasselberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Catherine Juillard
- Division of General Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, UK
| | - Monty Khajanchi
- Department of Surgery, Seth Gowardhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, India
| | | | - Vineet Kumar
- Department of Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Debabrata Kundu
- Department of Surgery, Medical College Kolkata, Kolkata, India
| | - Anurag Mishra
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Priti Patil
- World Health Organization Collaborating Center for Research in Surgical Care Delivery in Low-and-Middle Income Countries, Mumbai, India
- Department of Statistics, Bhabha Atomic Research Centre Medical Division, Mumbai, Maharashtra, India
| | - Nobhojit Roy
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- World Health Organization Collaborating Center for Research in Surgical Care Delivery in Low-and-Middle Income Countries, Mumbai, India
| | - Amit Roy
- Department of Surgery, Sir Nil Ratan Sircar Medical College & Hospital, Kolkata, India
| | - Siddarth David
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Doctors For You, Mumbai, India
| | - Rajdeep Singh
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Harris Solomon
- Department of Cultural Anthropology and the Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Kapil Dev Soni
- Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Lovisa Strömmer
- Department of Surgery, Capio S:t Görans Hospital, Stockholm, Sweden
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Megha Tandon
- Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India
| |
Collapse
|
20
|
Varpula J, Välimäki M, Lantta T, Berg J, Soininen P, Lahti M. Safety hazards in patient seclusion events in psychiatric care: A video observation study. J Psychiatr Ment Health Nurs 2022; 29:359-373. [PMID: 34536315 DOI: 10.1111/jpm.12799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 08/25/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Coercive measures such as seclusion are used to maintain the safety of patients and others in psychiatric care. The use of coercive measures can lead to harm among patients and staff. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study is the first of its kind to rely on video observation to expose safety hazards in seclusion events that have not been reported previously in the literature. The actions that both patients and staff take during seclusion events can result in various safety hazards. IMPLICATIONS FOR PRACTICE?: Constant monitoring of patients during seclusion is important for identifying safety hazards and intervening to prevent harm. Nursing staff who use seclusion need to be aware of how their actions can contribute to safety hazards and how they can minimize their potential for harm ABSTRACT: Introduction Seclusion is used to maintain safety in psychiatric care. There is still a lack of knowledge on potential safety hazards related to seclusion practices. Aim To identify safety hazards that might jeopardize the safety of patients and staff in seclusion events in psychiatric hospital care. Method A descriptive design with non-participant video observation was used. The data consisted of 36 video recordings, analysed with inductive thematic analysis. Results Safety hazards were related to patient and staff actions. Patient actions included aggressive behaviour, precarious movements, escaping, falling, contamination and preventing visibility. Staff actions included leaving hazardous items in a seclusion room, unsafe administration of medication, unsecured use of restraints and precarious movements and postures. Discussion This is the first observational study to identify safety hazards in seclusion, which may jeopardize the safety of patients and staff. These hazards were related to the actions of patients and staff. Implications for Practice Being better aware of possible safety hazards could help prevent adverse events during patient seclusion events. It is therefore necessary that nursing staff are aware of how their actions might impact their safety and the safety of the patients. Video observation is a useful method for identifying safety hazards. However, its use requires effort to safeguard the privacy and confidentiality of those included in the videos.
Collapse
Affiliation(s)
- Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Xiangya School of Nursing, Central South University, Hunan, China
| | - Tella Lantta
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Johanna Berg
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University of Applied Sciences, Turku, Finland
| | | | - Mari Lahti
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University of Applied Sciences, Turku, Finland
| |
Collapse
|
21
|
Rabie AM, Ali ASM, Al-Zeer MA, Barhoum A, EL-Hallouty S, Shousha WG, Berg J, Kurreck J, Khalil ASG. Spontaneous Formation of 3D Breast Cancer Tissues on Electrospun Chitosan/Poly(ethylene oxide) Nanofibrous Scaffolds. ACS Omega 2022; 7:2114-2126. [PMID: 35071900 PMCID: PMC8771982 DOI: 10.1021/acsomega.1c05646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/22/2021] [Indexed: 05/06/2023]
Abstract
Three-dimensional (3D) tissue culture has attracted a great deal of attention as a result of the need to replace the conventional two-dimensional cell cultures with more meaningful methods, especially for understanding the sophisticated nature of native tumor microenvironments. However, most techniques for 3D tissue culture are laborious, expensive, and limited to spheroid formation. In this study, a low-cost and highly effective nanofibrous scaffold is presented for spontaneous formation of reproducible 3D breast cancer microtissues. Experimentally, aligned and non-aligned chitosan/poly(ethylene oxide) nanofibrous scaffolds were prepared at one of two chitosan concentrations (2 and 4 wt %) and various electrospinning parameters. The resulting fabricated scaffolds (C2P1 and C4P1) were structurally and morphologically characterized, as well as analyzed in silico. The obtained data suggest that the fiber diameter, surface roughness, and scaffold wettability are tunable and can be influenced based on the chitosan concentration, electrospinning conditions, and alignment mode. To test the usefulness of the fabricated scaffolds for 3D cell culture, a breast cancer cell line (MCF-7) was cultured on their surfaces and evaluated morphologically and biochemically. The obtained data showed a higher proliferation rate for cells grown on scaffolds compared to cells grown on two-dimensional adherent plates (tissue culture plate). The MTT assay revealed that the rate of cell proliferation on nanofibrous scaffolds is statistically significantly higher compared to tissue culture plate (P ≤ 0.001) after 14 days of culture. The formation of spheroids within the first few days of culture shows that the scaffolds effectively support 3D tissue culture from the outset of the experiment. Furthermore, 3D breast cancer tissues were spontaneously formed within 10 days of culture on aligned and non-aligned nanofibrous scaffolds, which suggests that the scaffolds imitate the in vivo extracellular matrix in the tumor microenvironment. Detailed mechanisms for the spontaneous formation of the 3D microtissues have been proposed. Our results suggest that scaffold surface topography significantly influences tissue formation and behavior of the cells.
Collapse
Affiliation(s)
- Amna M.
I. Rabie
- Environmental
and Smart Technology Group (ESTG), Faculty of Science, Fayoum University, 63514 Fayoum, Egypt
- Chemistry
Department, Faculty of Science, Helwan University, Ain Helwan, 11795 Cairo, Egypt
| | - Ahmed S. M. Ali
- Department
of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 13355 Berlin, Germany
- Nanotechnology
Research Center (NTRC), The British University
in Egypt (BUE), El-Sherouk City, 11837 Cairo, Egypt
| | - Munir A. Al-Zeer
- Department
of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 13355 Berlin, Germany
| | - Ahmed Barhoum
- Chemistry
Department, Faculty of Science, Helwan University, Ain Helwan, 11795 Cairo, Egypt
| | - Salwa EL-Hallouty
- Department
of Medicinal Drugs, National Research Center, 12622 Giza, Egypt
| | - Wafaa G. Shousha
- Chemistry
Department, Faculty of Science, Helwan University, Ain Helwan, 11795 Cairo, Egypt
| | - Johanna Berg
- Department
of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 13355 Berlin, Germany
| | - Jens Kurreck
- Department
of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 13355 Berlin, Germany
| | - Ahmed S. G. Khalil
- Environmental
and Smart Technology Group (ESTG), Faculty of Science, Fayoum University, 63514 Fayoum, Egypt
- Materials
Science & Engineering Department, School of Innovative Design
Engineering, Egypt-Japan University of Science
and Technology (E-JUST), 21934 Alexandria, Egypt
| |
Collapse
|
22
|
Wu D, Berg J, Arlt B, Röhrs V, Al-Zeer MA, Deubzer HE, Kurreck J. Bioprinted Cancer Model of Neuroblastoma in a Renal Microenvironment as an Efficiently Applicable Drug Testing Platform. Int J Mol Sci 2021; 23:ijms23010122. [PMID: 35008547 PMCID: PMC8745467 DOI: 10.3390/ijms23010122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Development of new anticancer drugs with currently available animal models is hampered by the fact that human cancer cells are embedded in an animal-derived environment. Neuroblastoma is the most common extracranial solid malignancy of childhood. Major obstacles include managing chemotherapy-resistant relapses and resistance to induction therapy, leading to early death in very-high-risk patients. Here, we present a three-dimensional (3D) model for neuroblastoma composed of IMR-32 cells with amplified genes of the myelocytomatosis viral related oncogene MYCN and the anaplastic lymphoma kinase (ALK) in a renal environment of exclusively human origin, made of human embryonic kidney 293 cells and primary human kidney fibroblasts. The model was produced with two pneumatic extrusion printheads using a commercially available bioprinter. Two drugs were exemplarily tested in this model: While the histone deacetylase inhibitor panobinostat selectively killed the cancer cells by apoptosis induction but did not affect renal cells in the therapeutically effective concentration range, the peptidyl nucleoside antibiotic blasticidin induced cell death in both cell types. Importantly, differences in sensitivity between two-dimensional (2D) and 3D cultures were cell-type specific, making the therapeutic window broader in the bioprinted model and demonstrating the value of studying anticancer drugs in human 3D models. Altogether, this cancer model allows testing cytotoxicity and tumor selectivity of new anticancer drugs, and the open scaffold design enables the free exchange of tumor and microenvironment by any cell type.
Collapse
Affiliation(s)
- Dongwei Wu
- Institute of Biotechnology, Chair of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany; (D.W.); (J.B.); (V.R.); (M.A.A.-Z.)
| | - Johanna Berg
- Institute of Biotechnology, Chair of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany; (D.W.); (J.B.); (V.R.); (M.A.A.-Z.)
| | - Birte Arlt
- Department of Pediatric Hematology and Oncology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (B.A.); (H.E.D.)
| | - Viola Röhrs
- Institute of Biotechnology, Chair of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany; (D.W.); (J.B.); (V.R.); (M.A.A.-Z.)
| | - Munir A. Al-Zeer
- Institute of Biotechnology, Chair of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany; (D.W.); (J.B.); (V.R.); (M.A.A.-Z.)
| | - Hedwig E. Deubzer
- Department of Pediatric Hematology and Oncology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (B.A.); (H.E.D.)
- Neuroblastoma Research Group, Experimental and Clinical Research Center (ECRC) of the Charité and the Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- German Cancer Consortium (Deutsches Konsortium für Translationale Krebsforschung, DKTK), Partner Site Berlin, 10115 Berlin, Germany
- Berliner Institut für Gesundheitsforschung (BIH), 10178 Berlin, Germany
| | - Jens Kurreck
- Institute of Biotechnology, Chair of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany; (D.W.); (J.B.); (V.R.); (M.A.A.-Z.)
- Correspondence: ; Tel.: +49-30-314-27-582; Fax: +49-30-314-27-502
| |
Collapse
|
23
|
Wendin K, Berg J, Jönsson K, Andersson P, Birch K, Davidsson F, Gerberich J, Rask S, Langton M. Introducing mealworm as an ingredient in crisps and pâtés – sensory characterization and consumer liking. Future Foods 2021. [DOI: 10.1016/j.fufo.2021.100082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
24
|
Berg J, Jablonowski R, Mohammad M, Solem K, Borgquist R, Ostenfeld E, Arheden H, Carlsson M. Ventricular longitudinal shortening is an independent predictor of death in heart failure patients with reduced ejection fraction. Sci Rep 2021; 11:20280. [PMID: 34645886 PMCID: PMC8514526 DOI: 10.1038/s41598-021-99613-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/14/2021] [Indexed: 01/07/2023] Open
Abstract
Reduced ventricular longitudinal shortening measured by atrioventricular plane displacement (AVPD) and global longitudinal strain (GLS) are prognostic markers in heart disease. This study aims to determine if AVPD and GLS with cardiovascular magnetic resonance (CMR) are independent predictors of cardiovascular (CV) and all-cause death also in heart failure with reduced ejection fraction (HFrEF). Patients (n = 287) were examined with CMR and AVPD, GLS, ventricular volumes, myocardial fibrosis/scar were measured. Follow-up was 5 years with cause of death retrieved from a national registry. Forty CV and 60 all-cause deaths occurred and CV non-survivors had a lower AVPD (6.4 ± 2.0 vs 8.0 ± 2.4 mm, p < 0.001) and worse GLS (− 6.1 ± 2.2 vs − 7.7 ± 3.1%, p = 0.001). Kaplan–Meier analyses displayed increased survival for patients in the highest AVPD- and GLS-tertiles vs. the lowest tertiles (AVPD: p = 0.001, GLS: p = 0.013). AVPD and GLS showed in univariate analysis a hazard ratio (HR) of 1.30 (per-mm-decrease) and 1.19 (per-%-decrease) for CV death. Mean AVPD and GLS were independent predictors of all-cause death (HR = 1.24 per-mm-decrease and 1.15 per-%-decrease), but only AVPD showed incremental value over age, sex, body-mass-index, EF, etiology and fibrosis/scar for CV death (HR = 1.33 per-mm-decrease, p < 0.001). Ventricular longitudinal shortening remains independently prognostic for death in HFrEF even after adjusting for well-known clinical risk factors.
Collapse
Affiliation(s)
- J Berg
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.,Syntach AB, Lund, Sweden
| | - R Jablonowski
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - M Mohammad
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | | | - R Borgquist
- Cardiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - E Ostenfeld
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - H Arheden
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - M Carlsson
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
| |
Collapse
|
25
|
Tolksdorf B, Nie C, Niemeyer D, Röhrs V, Berg J, Lauster D, Adler JM, Haag R, Trimpert J, Kaufer B, Drosten C, Kurreck J. Inhibition of SARS-CoV-2 Replication by a Small Interfering RNA Targeting the Leader Sequence. Viruses 2021; 13:v13102030. [PMID: 34696460 PMCID: PMC8539227 DOI: 10.3390/v13102030] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 12/16/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected almost 200 million people worldwide and led to approximately 4 million deaths as of August 2021. Despite successful vaccine development, treatment options are limited. A promising strategy to specifically target viral infections is to suppress viral replication through RNA interference (RNAi). Hence, we designed eight small interfering RNAs (siRNAs) targeting the highly conserved 5′-untranslated region (5′-UTR) of SARS-CoV-2. The most promising candidate identified in initial reporter assays, termed siCoV6, targets the leader sequence of the virus, which is present in the genomic as well as in all subgenomic RNAs. In assays with infectious SARS-CoV-2, it reduced replication by two orders of magnitude and prevented the development of a cytopathic effect. Moreover, it retained its activity against the SARS-CoV-2 alpha variant and has perfect homology against all sequences of the delta variant that were analyzed by bioinformatic means. Interestingly, the siRNA was even highly active in virus replication assays with the SARS-CoV-1 family member. This work thus identified a very potent siRNA with a broad activity against various SARS-CoV viruses that represents a promising candidate for the development of new treatment options.
Collapse
Affiliation(s)
- Beatrice Tolksdorf
- Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 10623 Berlin, Germany; (B.T.); (V.R.); (J.B.)
| | - Chuanxiong Nie
- Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195 Berlin, Germany; (C.N.); (D.L.); (R.H.)
| | - Daniela Niemeyer
- German Centre for Infection Research (DZIF), Charitéplatz 1, 10117 Berlin, Germany; (D.N.); (C.D.)
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Viola Röhrs
- Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 10623 Berlin, Germany; (B.T.); (V.R.); (J.B.)
| | - Johanna Berg
- Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 10623 Berlin, Germany; (B.T.); (V.R.); (J.B.)
| | - Daniel Lauster
- Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195 Berlin, Germany; (C.N.); (D.L.); (R.H.)
| | - Julia M. Adler
- Department of Veterinary Medicine, Institute of Virology, Freie Universität Berlin, 14163 Berlin, Germany; (J.M.A.); (J.T.); (B.K.)
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Rainer Haag
- Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195 Berlin, Germany; (C.N.); (D.L.); (R.H.)
| | - Jakob Trimpert
- Department of Veterinary Medicine, Institute of Virology, Freie Universität Berlin, 14163 Berlin, Germany; (J.M.A.); (J.T.); (B.K.)
| | - Benedikt Kaufer
- Department of Veterinary Medicine, Institute of Virology, Freie Universität Berlin, 14163 Berlin, Germany; (J.M.A.); (J.T.); (B.K.)
| | - Christian Drosten
- German Centre for Infection Research (DZIF), Charitéplatz 1, 10117 Berlin, Germany; (D.N.); (C.D.)
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Jens Kurreck
- Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, 10623 Berlin, Germany; (B.T.); (V.R.); (J.B.)
- Correspondence: ; Tel.:+ 49-30-314-27581
| |
Collapse
|
26
|
Bacchus P, Nissen K, Berg J, Bråve A, Gyll J, Larsson C, Muradrasoli S, Tellström A, Salaneck E. Civil-Military Collaboration to Facilitate Rapid Deployment of a Mobile Laboratory in Early Response to COVID-19: A High-Readiness Exercise. Health Secur 2021; 19:488-497. [PMID: 34542343 DOI: 10.1089/hs.2021.0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Rapid and adaptable diagnostic capabilities are of great importance in the face of emerging infectious diseases. In an outbreak, timely establishment of diagnostic routines is crucial to identifying cases and preventing the spread of the disease, especially when faced with high-consequence pathogens. In this article, we describe a multiagency exercise including the rapid deployment and diagnostic adaptation of the Swedish Armed Forces mobile laboratory (biological field analysis laboratory) in the context of COVID-19. This deployment was initiated as a high-readiness exercise at the end of January 2020, when the global development of the outbreak was still uncertain. Through collaboration with the Public Health Agency of Sweden and a civilian hospital, a real-time reverse transcriptase polymerase chain reaction method specific to SARS-CoV-2 was made available and adapted to the mobile laboratory, and the team established and evaluated a functional and efficient diagnostic asset along with a logistical support chain. We also organized and evaluated mobile testing teams, and the method was later used in large-scale, national, cross-sectional COVID-19 surveys in several regions of Sweden. In this article, we focus on the challenges of overbridging the civil-military interface in this context and identifying lessons learned and added values to the response during the early pandemic. We propose that the experiences from this exercise and governmental agency collaboration are valuable in preparation for future outbreaks.
Collapse
Affiliation(s)
- Philip Bacchus
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Karolina Nissen
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Johanna Berg
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Andreas Bråve
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Jenny Gyll
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Christer Larsson
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Shaman Muradrasoli
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Andreas Tellström
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Erik Salaneck
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| |
Collapse
|
27
|
Larsson A, Berg J, Gellerfors M, Gerdin Wärnberg M. The advanced machine learner XGBoost did not reduce prehospital trauma mistriage compared with logistic regression: a simulation study. BMC Med Inform Decis Mak 2021; 21:192. [PMID: 34148560 PMCID: PMC8215793 DOI: 10.1186/s12911-021-01558-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Accurate prehospital trauma triage is crucial for identifying critically injured patients and determining the level of care. In the prehospital setting, time and data are often scarce, limiting the complexity of triage models. The aim of this study was to assess whether, compared with logistic regression, the advanced machine learner XGBoost (eXtreme Gradient Boosting) is associated with reduced prehospital trauma mistriage. Methods We conducted a simulation study based on data from the US National Trauma Data Bank (NTDB) and the Swedish Trauma Registry (SweTrau). We used categorized systolic blood pressure, respiratory rate, Glasgow Coma Scale and age as our predictors. The outcome was the difference in under- and overtriage rates between the models for different training dataset sizes. Results We used data from 813,567 patients in the NTDB and 30,577 patients in SweTrau. In SweTrau, the smallest training set of 10 events per free parameter was sufficient for model development. XGBoost achieved undertriage rates in the range of 0.314–0.324 with corresponding overtriage rates of 0.319–0.322. Logistic regression achieved undertriage rates ranging from 0.312 to 0.321 with associated overtriage rates ranging from 0.321 to 0.323. In NTDB, XGBoost required the largest training set size of 1000 events per free parameter to achieve robust results, whereas logistic regression achieved stable performance from a training set size of 25 events per free parameter. For the training set size of 1000 events per free parameter, XGBoost obtained an undertriage rate of 0.406 with an overtriage of 0.463. For logistic regression, the corresponding undertriage was 0.395 with an overtriage of 0.468. Conclusion The under- and overtriage rates associated with the advanced machine learner XGBoost were similar to the rates associated with logistic regression regardless of sample size, but XGBoost required larger training sets to obtain robust results. We do not recommend using XGBoost over logistic regression in this context when predictors are few and categorical. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-021-01558-y.
Collapse
Affiliation(s)
- Anna Larsson
- Emergency Department, Södersjukhuset, Sjukhusbacken 10, 11883, Stockholm, Sweden
| | - Johanna Berg
- Department of Emergency Medicine, Skåne University Hospital Malmö, Inga Marie Nilssons gata 47, 21421, Malmö, Sweden.,Department of Global Public Health, Karolinska Institutet, 171 77, Solna, Sweden
| | - Mikael Gellerfors
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Solna, Sweden.,Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden.,Swedish Air Ambulance (SLA), Mora, Sweden.,Rapid Response Cars, Stockholm, Sweden
| | - Martin Gerdin Wärnberg
- Department of Global Public Health, Karolinska Institutet, 171 77, Solna, Sweden. .,Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden.
| |
Collapse
|
28
|
Packer RA, Wachowiak I, Thomovsky SA, Berg J, Vasquez L, O'Brien DP. Phenotypic characterization of PIGN-associated paroxysmal dyskinesia in Soft-coated wheaten terriers and preliminary response to acetazolamide therapy. Vet J 2021; 269:105606. [PMID: 33593494 DOI: 10.1016/j.tvjl.2021.105606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
Abstract
A hereditary movement disorder in Soft coated wheaten terriers (SCWT) has been associated with a mutation in PIGN which encodes an enzyme involved in synthesis of glycosylphosphatidylinositol (GPI). The objective of this study was to describe and classify the clinical phenotype and assess therapeutic response. Twenty-five SCWT and related dogs homozygous for PIGN:c.398C>T with paroxysmal dyskinesia were available for inclusion. Medical records and video recordings of 17 dogs were evaluated in a retrospective case series. Affected dogs had episodes of involuntary, hyperkinetic movements and dystonia. Median age of onset was 2.5 years. A typical episode consisted of rapid, irregular hyperflexion and extension of the pelvic limbs with some degree of truncal dystonia. A mild episode consisted of spontaneous flexion of one pelvic limb while walking which could resemble a lameness. Episodes lasted several minutes to several hours and occurred up to 10 times/day or more. They were not associated with exercise or fasting but were sometimes triggered by excitement or stress. Acetazolamide therapy improved nine of 11 dogs, in seven cases abolishing episodes. Five of 17 dogs treated with other agents had mild improvement with clonazepam (n = 2), levetiracetam (n = 1), or phenobarbital (n = 2). Paroxysmal dyskinesias must be differentiated from seizure disorders since they often respond to different therapies. The SCWT phenotype consisted predominantly of hyperkinesia, and can respond dramatically to acetazolamide. GPI anchors proteins to the cell surface including carbonic anhydrase IV which modulates synaptic pH in the brain. Altered activity of this enzyme may be the target of acetazolamide therapy.
Collapse
Affiliation(s)
- R A Packer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
| | - I Wachowiak
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - S A Thomovsky
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, Indiana, USA
| | - J Berg
- Animal Specialty Center, Yonkers, New York, USA
| | - L Vasquez
- Gulf Coast Veterinary Neurology and Neurosurgery, Houston, Texas, USA
| | - D P O'Brien
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
29
|
Berg J, Kurreck J. Clean bioprinting - Fabrication of 3D organ models devoid of animal components. ALTEX 2020; 38:269-288. [PMID: 33264417 DOI: 10.14573/altex.2009151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022]
Abstract
Bioprinting is a rapidly developing technology that enables the exact positioning of living cells embedded in bio-materials in precise spatial arrangements to fabricate engineered tissues and organs. While the ultimate goal of bioprinting approaches is to produce organs for transplantation purposes, bioprinted organ models also hold great potential for research purposes to serve as alternatives to animal experiments. By using human cells, humanized organ models can be generated that may produce more relevant results for human (patho-)physiology than animal models. However, standard bioprinting procedures currently use numerous hidden animal components. Virtually all studies published in the field to date make use of cells grown in media with fetal bovine serum (FBS). In addition, Matrigel, the extracellular matrix (ECM) harvested from Engelbreth-Holm-Swarm sarcoma grown in mice, is widely employed to cultivate stem cells and 3D organ models. Finally, most bioinks currently in use contain gelatin or comparable animal components to improve cell viability and adhesion. The present review will give an introduction to the potential of bioprinting to fabricate 3D models that may be substituted for animal experiments and will go on to describe strategies to replace animal components currently included in standard procedures of bioprinting. These approaches comprise the adaptation of cells to FBS-free media, the use of bioinks composed of synthetic or plant material, and the replacement of animal ingredients by materials of human origin. We propose denoting bioprinting strategies devoid of animal components as clean bioprinting.
Collapse
Affiliation(s)
- Johanna Berg
- Institute of Biotechnology, Technische Universität Berlin, Berlin, Germany
| | - Jens Kurreck
- Institute of Biotechnology, Technische Universität Berlin, Berlin, Germany
| |
Collapse
|
30
|
Steck O, Bertschi N, Luther F, Berg J, Winkel D, Holbro A, Schlapbach C. Rapid and sustained control of itch and reduction in Th2 bias by dupilumab in a patient with Sézary syndrome. J Eur Acad Dermatol Venereol 2020; 35:1331-1337. [DOI: 10.1111/jdv.17001] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022]
Affiliation(s)
- O. Steck
- Department of Dermatology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| | - N.L. Bertschi
- Department of Dermatology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| | - F. Luther
- Department of Dermatology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| | - J. Berg
- Department of Hematology University Hospital Basel Basel Switzerland
- Blood Transfusion Center Swiss Red Cross Basel Switzerland
| | - D.J. Winkel
- Radiology & Nuclear Medicine Clinic University Hospital Basel Basel Switzerland
| | - A. Holbro
- Department of Hematology University Hospital Basel Basel Switzerland
- Blood Transfusion Center Swiss Red Cross Basel Switzerland
| | - C. Schlapbach
- Department of Dermatology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| |
Collapse
|
31
|
Schmidt K, Berg J, Roehrs V, Kurreck J, Al-Zeer MA. 3D-bioprinted HepaRG cultures as a model for testing long term aflatoxin B1 toxicity in vitro. Toxicol Rep 2020; 7:1578-1587. [PMID: 33304827 PMCID: PMC7708771 DOI: 10.1016/j.toxrep.2020.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/27/2022] Open
Abstract
3D-bioprinting method to produce 3D HepaRG constructs. 3D constructs are more resistant to aflatoxin B1. Long-term toxicity assessment is possible. An alternative method for animal testing relevance.
In recent years 3D-bioprinting technology has been developed as an alternative to animal testing. It possesses a great potential for in vitro testing as it aims to mimic human organs and physiology. In the present study, an alginate-gelatin-Matrigel based hydrogel was used to prepare 3D-bioprinted HepaRG cultures using a pneumatic extrusion printer. These 3D models were tested for viability and metabolic functions. Using 3D-bioprinted HepaRG cultures, we tested the toxicity of aflatoxin B1 (10 or 20 μM) in vitro and compared the results with 2D HepaRG cultures. There was a dose-dependent toxicity effect on cell viability, reduction of metabolic activity and albumin production. We found that 3D-bioprinted HepaRG cultures are more resistant to aflatoxin B1 treatment than 2D cultures. Although the metabolic activities were reduced upon treatment with aflatoxin B1, the 3D models were still viable and survived longer, up to 3 weeks, than the 2D culture, as visualized by fluorescence microscopy. Furthermore, albumin production recovered slightly in 3D models after one and two weeks of treatment. Taken together, we consider using 3D-bioprinting technology to generate 3D tissue models as an alternative way to study toxicity in vitro and this could also provide a suitable alternative for chronic hepatotoxicity studies in vitro.
Collapse
Affiliation(s)
- Konrad Schmidt
- Department of Applied Biochemistry, Institute of Biotechnology, 4/3-2, Technische Universität Berlin, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Johanna Berg
- Department of Applied Biochemistry, Institute of Biotechnology, 4/3-2, Technische Universität Berlin, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Viola Roehrs
- Department of Applied Biochemistry, Institute of Biotechnology, 4/3-2, Technische Universität Berlin, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Jens Kurreck
- Department of Applied Biochemistry, Institute of Biotechnology, 4/3-2, Technische Universität Berlin, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| | - Munir A Al-Zeer
- Department of Applied Biochemistry, Institute of Biotechnology, 4/3-2, Technische Universität Berlin, Gustav-Meyer-Allee 25, 13355 Berlin, Germany
| |
Collapse
|
32
|
Varpula J, Välimäki M, Lantta T, Berg J, Lahti M. Nurses' perceptions of risks for occupational hazards in patient seclusion and restraint practices in psychiatric inpatient care: A focus group study. Int J Ment Health Nurs 2020; 29:703-715. [PMID: 32086881 DOI: 10.1111/inm.12705] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 11/28/2022]
Abstract
Seclusion and restraint are regularly used to manage patient aggression events in psychiatric inpatient care, despite occupational safety concerns. There is currently a lack of information on how nurses perceive the use of patient seclusion and restraint as a risk for occupational safety. The aim of this study is to describe the risks for occupational hazards in patient seclusion and mechanical restraint practices as well as ideas for improvement identified by nurses. A qualitative descriptive design was adopted, using focus groups comprising nurses (N = 32) working in psychiatric inpatient care. The data were analysed using inductive content analysis, and the results were reported using the consolidated criteria for reporting qualitative studies (COREQ). Four themes of risk for occupational hazards were identified: patient-induced, staff-induced, organization-induced, and environment-induced risks. One significant finding was that nurses described that their actions can strongly contribute to occupational hazards during seclusion and mechanical restraint practices. The nurses gave various ideas for how occupational safety could be improved during seclusion and mechanical restraint events, ideas involving staff, the organization, and environmental enhancements.
Collapse
Affiliation(s)
- Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Tella Lantta
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Johanna Berg
- Turku University of Applied Science, Turku, Finland
| | - Mari Lahti
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University of Applied Science, Turku, Finland
| |
Collapse
|
33
|
Patriki D, Baltensperger N, Berg J, Cooper LT, Kissel CK, Kottwitz J, Lovrinovic M, Manka R, Scherff F, Schmied C, Tanner FC, Luescher TF, Heidecker B. A Prospective Pilot Study to Identify a Myocarditis Cohort who may Safely Resume Sports Activities 3 Months after Diagnosis. J Cardiovasc Transl Res 2020; 14:670-673. [PMID: 32367345 PMCID: PMC8397673 DOI: 10.1007/s12265-020-09983-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/02/2020] [Indexed: 12/12/2022]
Abstract
International cardiovascular society recommendations to return to sports activities following acute myocarditis are based on expert consensus in the absence of prospective studies. We prospectively enrolled 30 patients with newly diagnosed myocarditis based on clinical parameters, laboratory measurements and cardiac magnetic resonance imaging with mildly reduced or preserved left ventricular ejection fraction (LVEF) with a follow-up of 12 months. Cessation of physical activity was recommended for 3 months. The average age was 35 (19-80) years with 73% male patients. One case of non-sustained ventricular tachycardia was recorded during 48-h-Holter electrocardiogram. Except for this case, all patients were allowed to resume physical exercise after 3 months. At 6- (n = 26) and 12-month (n = 19) follow-up neither cardiac events nor worsening LVEF were recorded. The risk of cardiac events at 1 year after diagnosis of myocarditis appears to be low after resumption of exercise after 3 months among patients who recover from acute myocarditis.
Collapse
Affiliation(s)
- D Patriki
- Cardiology, University Heart Center, Zurich, Switzerland
| | | | - J Berg
- Cardiology, University Heart Center, Zurich, Switzerland
| | | | - C K Kissel
- Cardiology, University Heart Center, Zurich, Switzerland
| | - J Kottwitz
- Cardiology, University Heart Center, Zurich, Switzerland
| | - M Lovrinovic
- Cardiology, University Heart Center, Zurich, Switzerland
| | - R Manka
- Cardiology, University Heart Center, Zurich, Switzerland
| | - F Scherff
- Cardiology, University Heart Center, Zurich, Switzerland
| | - C Schmied
- Cardiology, University Heart Center, Zurich, Switzerland
| | - F C Tanner
- Cardiology, University Heart Center, Zurich, Switzerland
| | - T F Luescher
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.,Imperial College and Royal Brompton & Harefield Hospital, London, UK
| | - Bettina Heidecker
- Cardiology, University Heart Center, Zurich, Switzerland. .,Charite Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany, Hindenburgdamm 30, 12203, Berlin, Germany.
| |
Collapse
|
34
|
Berg J, Bonduelle Y, Golinval O. [Epithelioid trophoblastic tumour with pulmonary metastasis]. Rev Med Liege 2020; 75:145-150. [PMID: 32157837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Epithelioid trophoblastic tumours are rare kind of gestational trophoblastic disease. Their detection is made by repetitive measurement of ?HCG after any gestational period (including spontaneous abortion). Epithelioid trophoblastic tumour can cause pulmonary metastasis. We describe the clinical case of a 44-year old woman with a cystic lesion of the right pulmonary apex following a miscarriage which was an epithelioid trophoblastic tumour. She's still in complete remission after surgery and careful follow up.
Collapse
Affiliation(s)
- J Berg
- Service de Pneumologie, CHR Verviers, Belgique
| | - Y Bonduelle
- Service de Pneumologie, CHR Verviers, Belgique
| | - O Golinval
- Service de Pneumologie, CHR Verviers, Belgique
| |
Collapse
|
35
|
Abstract
OBJECTIVES To determine the relationship between plant food consumption and bone mineral density (BMD) in a healthy population when age, gender, BMI and physical activity are accounted for. DESIGN Cross-sectional study. SETTING Participants were recruited from the Sydney Adventist hospital and the University of New South Wales, Sydney, Australia. PARTICIPANTS 33 males and 40 females (total n=73) participated in this study. The mean age was 56.1 ± 8.5 years. All participants were non-diabetic and in general good health. MEASUREMENTS A principle component analysis (PCA) was performed on 12 month self-report food intake data, gathered using the Cancer Council Victoria Dietary Questionnaire for Epidemiological Studies Version 2. Dual-energy X-ray absorptiometry was used to measure total BMD. Fasting plasma total protein, calcium and 25-Hydroxy Vitamin D levels were analysed by the Sydney Adventist Hospital pathology laboratory. Anthropometric measures were obtained using a standardized protocol. Self-reported physical activity levels were assessed using the International Physical Activity Questionnaire. RESULTS The PCA revealed three principle components. These were termed 'Meat Based', 'Junk Food' and 'Plant Based.' After controlling for age, gender, physical activity and BMI, the Plant Based component correlated positively with BMD (p=0.054, R2=0.439) and T-score (p=0.053, R2=0.221). Using a similar model no association between the Meat Based component and BMD or T-score was found. However, when the Plant Based component was included the Meat Based component correlated positively with BMD (p=0.046, R2=0.474) and T-score (p=0.046, R2=0.279). There was no significant association between the Junk Food component and BMD or T-score. People in the third Plant (927 ± 339 vs 751 ± 255 g/day, p=0.025) and Meat Based (921 ± 270 vs 676 ± 241 g/day, p=0.002) tertile had higher calcium intakes than those in the first. People in the second Plant Based tertile had higher plasma Vitamin D levels than those in the first (63.5 ± 16.8 vs. 52.3 ± 22.1 nmol/L, p=0.053) while those in the third Junk Food tertile had lower levels than those in the first (52.4 ± 18.5 vs. 65.4 ± 19.8 nmol/L, p=0.027). No association between Plant Based tertiles and protein intake was observed, however those in the third Meat Based (99.7 ± 25.1 vs. 50.9 ± 13.8 g/day, p=0.000) and Junk Food (87.4 ± 30.7 vs. 56.6 ± 22.2 g/day, p=0.000) tertile had higher protein intake compared to those in the first tertile. CONCLUSION In a healthy middle aged population with normal BMD, an increase in plant food consumption, either alone or in combination with a diet containing meat, is associated with improved bone mineralisation markers. This positive relationship is most likely due to the extensive range of micronutrients and phytochemicals packaged within plants.
Collapse
Affiliation(s)
- J Berg
- Ross Grant, The University of Sydney Adventist Hospital Clinical School, 185 Fox Valley Rd, Wahroonga, NSW Australia, Phone: +61 2 9487 9602,
| | | | | |
Collapse
|
36
|
Berg J, Jablonowski R, Nordlund D, Kopic S, Bidhult S, Xanthis CG, Saeed M, Solem K, Arheden H, Carlsson M. Decreased atrioventricular plane displacement after acute myocardial infarction yields a concomitant decrease in stroke volume. J Appl Physiol (1985) 2019; 128:252-263. [PMID: 31854250 PMCID: PMC7052588 DOI: 10.1152/japplphysiol.00480.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Acute myocardial infarction (AMI) can progress to heart failure, which has a poor prognosis. Normally, 60% of stroke volume (SV) is attributed to the longitudinal ventricular shortening and lengthening evident in the atrioventricular plane displacement (AVPD) during the cardiac cycle, but there is no information on how the relationship changes between SV and AVPD before and after AMI. Therefore, the aim of this study was to determine how SV depends on AVPD before and after AMI in two swine models. Serial cardiac magnetic resonance imaging was carried out before and 1–2 h after AMI in a microembolization model (n = 12) and an ischemia-reperfusion model (n = 14). A subset of pigs (n = 7) were additionally imaged at 24 h and at 7 days. Cine and late gadolinium enhancement images were analyzed for cardiac function, AVPD measurements and infarct size estimation, respectively. AVPD decreased (P < 0.05) in all myocardial regions after AMI, with a concomitant SV decrease (P < 0.001). The ischemia-reperfusion model affected SV to a higher degree and had a larger AVPD decrease than the microembolization model (−29 ± 14% vs. −15 ± 18%; P < 0.05). Wall thickening decreased in infarcted areas (P < 0.001), and A-wave AVPD remained unchanged (P = 0.93) whereas E-wave AVPD decreased (P < 0.001) after AMI. We conclude that AVPD is coupled to SV independent of infarct type but likely to a greater degree in ischemia-reperfusion infarcts compared with microembolization infarcts. AMI reduces diastolic early filling AVPD but not AVPD from atrial contraction. These findings shed light on the physiological significance of atrioventricular plane motion when assessing acute and subacute myocardial infarction. NEW & NOTEWORTHY The link between cardiac longitudinal motion, measured as atrioventricular plane displacement (AVPD), and stroke volume (SV) is investigated in swine after acute myocardial infarction (AMI). This cardiac magnetic resonance study demonstrates a close coupling between AVPD and SV before and after AMI in an experimental setting and demonstrates that this connection is present in ischemia-reperfusion and microembolization infarcts, acutely and during the first week. Furthermore, AVPD is equally and persistently depressed in infarcted and remote myocardium after AMI.
Collapse
Affiliation(s)
- J Berg
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden
| | - R Jablonowski
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden
| | - D Nordlund
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden
| | - S Kopic
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden
| | - S Bidhult
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden
| | - C G Xanthis
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden
| | - M Saeed
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | | | - H Arheden
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden
| | - M Carlsson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| |
Collapse
|
37
|
Berg J, Lindberg M, Bengtson M, Brustugun O, Helland Å. EP1.18-12 The Neutrophil and Platelet to Lymphocyte Ratios and Glasgow Prognostic Score as a Predictor for Relapse After Stereotactic Radiation for Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
38
|
Iskandar Z, Huang JTJ, Mordi I, Miller LD, Chin C, Goudie D, McWilliam C, Berg J, Neagoie A, Lang CC, Choy AM. P6505Urinary desmosine, an elastin-specific degradation product is associated with maximum aortic root size and aortic z-scores in patients with bicuspid aortic valve. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Bicuspid aortic valve (BAV) is the commonest congenital cardiac abnormality affecting up to 2% of the general population. BAV is highly diverse in phenotype however a common feature is its inherent risk of morbidity and mortality from aortic root dilatation and dissection. Aortic dilatation involves elastin degradation and desmosine is an amino acid cross-link that is released into the bloodstream and urine following elastin degradation. It is known from an earlier pilot study (DESMA) of desmosine in Marfan Syndrome (MFS) patients that plasma desmosine among patients with MFS is significantly elevated and correlates with aortic size however whether this same observation is seen in other forms of inherited aortopathies such as BAV is unclear.
Objectives
1. To investigate whether patients with BAV have higher elastin degradation as indicated by plasma desmosine and urinary desmosine levels.
2. To explore the relationship between plasma and urinary desmosine levels with aortic root size in patients with BAV.
Methods
We measured urinary (ng/mg creatinine) and plasma desmosine (ng/mL) in 20 patients with BAV and healthy control subjects using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Aortic root size and corresponding Z-scores were measured on echocardiogram. Correlation was analysed with Spearman's rank test.
Results
The patients with BAV were predominantly male (n=15, 75%) with a mean age of 50.5 years ± 17.6 [SD]. All the BAV patients had normal LV systolic function and none had prior aortic root surgery or were current smokers. Nine BAV patients had treated hypertension. Compared to controls, both plasma desmosine (0.30±0.10 vs 0.26±0.075 ng/mL, p=0.01) and urinary desmosine (15.9±4.6 vs 7.2±2.8 ng/mg creatinine, p<0.001) were significantly elevated in patients with BAV. Urinary and plasma desmosine (Figure 1) were also significantly correlated (r=0.55, p=0.01). There was a significant association between urinary desmosine and maximal aortic root size and Z-scores in the BAV cohort (Figure 2) compared to controls (p=0.02), however this was not seen with plasma desmosine.
Conclusions
Urinary and plasma desmosine levels are significantly higher in patients with BAV compared to controls. Urinary desmosine is also significantly associated with maximal aortic root size, reflecting higher elastin degradation. This suggests a potential use of desmosine as a biomarker to monitor disease progression in patients with BAV.
Acknowledgement/Funding
Anonymous Trust
Collapse
Affiliation(s)
- Z Iskandar
- University of Dundee, Dundee, United Kingdom
| | - J T J Huang
- University of Dundee, Dundee, United Kingdom
| | - I Mordi
- University of Dundee, Dundee, United Kingdom
| | - L D Miller
- University of Dundee, Dundee, United Kingdom
| | - C Chin
- National Heart Centre Singapore, Singapore, Singapore
| | - D Goudie
- Ninewells Hospital, Dundee, United Kingdom
| | | | - J Berg
- Ninewells Hospital, Dundee, United Kingdom
| | - A Neagoie
- University of Dundee, Dundee, United Kingdom
| | - C C Lang
- University of Dundee, Dundee, United Kingdom
| | - A M Choy
- University of Dundee, Dundee, United Kingdom
| |
Collapse
|
39
|
Hiller T, Berg J, Elomaa L, Röhrs V, Ullah I, Schaar K, Dietrich AC, Al-Zeer MA, Kurtz A, Hocke AC, Hippenstiel S, Fechner H, Weinhart M, Kurreck J. Generation of a 3D Liver Model Comprising Human Extracellular Matrix in an Alginate/Gelatin-Based Bioink by Extrusion Bioprinting for Infection and Transduction Studies. Int J Mol Sci 2018; 19:E3129. [PMID: 30321994 PMCID: PMC6213460 DOI: 10.3390/ijms19103129] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/27/2018] [Accepted: 10/05/2018] [Indexed: 02/07/2023] Open
Abstract
Bioprinting is a novel technology that may help to overcome limitations associated with two-dimensional (2D) cell cultures and animal experiments, as it allows the production of three-dimensional (3D) tissue models composed of human cells. The present study describes the optimization of a bioink composed of alginate, gelatin and human extracellular matrix (hECM) to print human HepaRG liver cells with a pneumatic extrusion printer. The resulting tissue model was tested for its suitability for the study of transduction by an adeno-associated virus (AAV) vector and infection with human adenovirus 5 (hAdV5). We found supplementation of the basic alginate/gelatin bioink with 0.5 and 1 mg/mL hECM provides desirable properties for the printing process, the stability of the printed constructs, and the viability and metabolic functions of the printed HepaRG cells. The tissue models were efficiently transduced by AAV vectors of serotype 6, which successfully silenced an endogenous target (cyclophilin B) by means of RNA interference. Furthermore, the printed 3D model supported efficient adenoviral replication making it suitable to study virus biology and develop new antiviral compounds. We consider the approach described here paradigmatic for the development of 3D tissue models for studies including viral vectors and infectious viruses.
Collapse
Affiliation(s)
- Thomas Hiller
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| | - Johanna Berg
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| | - Laura Elomaa
- Institute of Chemistry and Biochemistry, Department of Organic Chemistry, Freie Universität Berlin, 14195 Berlin, Germany.
| | - Viola Röhrs
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| | - Imran Ullah
- Berlin-Brandenburger Centrum für Regenerative Therapien, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
| | - Katrin Schaar
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| | - Ann-Christin Dietrich
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| | - Munir A Al-Zeer
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| | - Andreas Kurtz
- Berlin-Brandenburger Centrum für Regenerative Therapien, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
| | - Andreas C Hocke
- Dept. of Internal Medicine/Infectious and Respiratory Diseases, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany.
| | - Stefan Hippenstiel
- Dept. of Internal Medicine/Infectious and Respiratory Diseases, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany.
| | - Henry Fechner
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| | - Marie Weinhart
- Institute of Chemistry and Biochemistry, Department of Organic Chemistry, Freie Universität Berlin, 14195 Berlin, Germany.
| | - Jens Kurreck
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355 Berlin, Germany.
| |
Collapse
|
40
|
Berg J, Hiller T, Kissner MS, Qazi TH, Duda GN, Hocke AC, Hippenstiel S, Elomaa L, Weinhart M, Fahrenson C, Kurreck J. Optimization of cell-laden bioinks for 3D bioprinting and efficient infection with influenza A virus. Sci Rep 2018; 8:13877. [PMID: 30224659 PMCID: PMC6141611 DOI: 10.1038/s41598-018-31880-x] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/28/2018] [Indexed: 01/12/2023] Open
Abstract
Bioprinting is a new technology, which arranges cells with high spatial resolution, but its potential to create models for viral infection studies has not yet been fully realized. The present study describes the optimization of a bioink composition for extrusion printing. The bioinks were biophysically characterized by rheological and electron micrographic measurements. Hydrogels consisting of alginate, gelatin and Matrigel were used to provide a scaffold for a 3D arrangement of human alveolar A549 cells. A blend containing 20% Matrigel provided the optimal conditions for spatial distribution and viability of the printed cells. Infection of the 3D model with a seasonal influenza A strain resulted in widespread distribution of the virus and a clustered infection pattern that is also observed in the natural lung but not in two-dimensional (2D) cell culture, which demonstrates the advantage of 3D printed constructs over conventional culture conditions. The bioink supported viral replication and proinflammatory interferon release of the infected cells. We consider our strategy to be paradigmatic for the generation of humanized 3D tissue models by bioprinting to study infections and develop new antiviral strategies.
Collapse
Affiliation(s)
- Johanna Berg
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355, Berlin, Germany
| | - Thomas Hiller
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355, Berlin, Germany
| | - Maya S Kissner
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355, Berlin, Germany
| | - Taimoor H Qazi
- Berlin-Brandenburg Center for Regenerative Therapies & Berlin-Brandenburg School for Regenerative Therapies, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Georg N Duda
- Berlin-Brandenburg Center for Regenerative Therapies & Berlin-Brandenburg School for Regenerative Therapies, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Andreas C Hocke
- Department of Internal Medicine/Infectious and Respiratory Diseases, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany, 10115, Berlin, Germany
| | - Stefan Hippenstiel
- Department of Internal Medicine/Infectious and Respiratory Diseases, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany, 10115, Berlin, Germany
| | - Laura Elomaa
- Institute of Chemistry and Biochemistry, Department of Organic Chemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - Marie Weinhart
- Institute of Chemistry and Biochemistry, Department of Organic Chemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - Christoph Fahrenson
- Center for electron microscopy (ZELMI), Technische Universität Berlin, 10623, Berlin, Germany
| | - Jens Kurreck
- Institute of Biotechnology, Department of Applied Biochemistry, Technische Universität Berlin, 13355, Berlin, Germany.
| |
Collapse
|
41
|
Riedel O, Ohlmeier C, Enders D, Elsässer A, Vizcaya D, Michel A, Eberhard S, Schlothauer N, Berg J, Garbe E. The contribution of comorbidities to mortality in hospitalized patients with heart failure. Clin Res Cardiol 2018; 107:487-497. [PMID: 29404680 DOI: 10.1007/s00392-018-1210-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/01/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Heart failure (HF) with reduced ejection fraction (HFrEF) has a worse prognosis than HF with preserved EF (HFpEF). The study aimed to evaluate whether different comorbidity profiles of HFrEF- and HFpEF-patients or HF-specific mechanisms contribute to a greater extent to this difference. METHODS We linked data from two health insurances to data from a cardiology clinic hospital information system. Patients with a hospitalization with HF in 2005-2011, categorized as HFrEF (EF < 45%) or HFpEF (EF ≥ 45%), were propensity score (PS) matched to controls without HF on comorbidites and medication to assure similar comorbidity profiles of patients and their respective controls. The balance of the covariates in patients and controls was compared via the standardized difference (SDiff). Age-standardized 1-year mortality rates (MR) with 95% confidence intervals (CI) were calculated. RESULTS 777 HFrEF-patients (1135 HFpEF-patients) were PS-matched to 3446 (4832) controls. Balance between patients and controls was largely achieved with a SDiff < 0.1 on most variables considered. The age-standardized 1-year MRs per 1000 persons in HFrEF-patients and controls were 267.8 (95% CI 175.9-359.8) and 86.1 (95% CI 70.0-102.3). MRs in HFpEF-patients and controls were 166.2 (95% CI 101.5-230.9) and 61.5 (95% CI 52.9-70.1). Thus, differences in MRs between patients and their controls were higher for HFrEF (181.7) than for HFpEF (104.7). CONCLUSIONS Given the similar comorbidity profiles between HF-patients and controls, the higher difference in mortality rates between HFrEF-patients and controls points more to HF-specific mechanisms for these patients, whereas for HFpEF-patients a higher contribution of comorbidity is suggested by our results.
Collapse
Affiliation(s)
- Oliver Riedel
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany.
| | - C Ohlmeier
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany
- IGES Institut GmbH, Berlin, Germany
| | - D Enders
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany
| | - A Elsässer
- Department of Cardiology, Klinikum Oldenburg, AöR, Oldenburg, Germany
| | - D Vizcaya
- Epidemiology, Bayer AG, Berlin, Germany
| | - A Michel
- Epidemiology, Bayer AG, Berlin, Germany
| | | | - N Schlothauer
- Hausarztpraxis Dr. Stephan Spiekermann&Partner im Gesundheitszentrum, Delmenhorst, Germany
| | - J Berg
- AOK Bremen/Bremerhaven, Bremerhaven, Germany
| | - E Garbe
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359, Bremen, Germany
| |
Collapse
|
42
|
Lacassagne K, Hearon K, Berg J, Séguin B, Hoyt L, Byer B, Selmic LE. Canine spinal meningiomas and nerve sheath tumours in 34 dogs (2008-2016): Distribution and long-term outcome based upon histopathology and treatment modality. Vet Comp Oncol 2018; 16:344-351. [DOI: 10.1111/vco.12385] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 12/26/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022]
Affiliation(s)
- K. Lacassagne
- Department of Surgery; Veterinary Specialty Center of Seattle; Lynnwood Washington
| | - K. Hearon
- Department of Surgery; Metropolitan Veterinary Associates; Valley Forge Pennsylvania
| | - J. Berg
- Department of Neurology; Guardian Veterinary Specialists; Brewster New York
| | - B. Séguin
- Flint Animal Cancer Center; Colorado State University; Fort Collins Colorado
| | - L. Hoyt
- Department of Radiology; Blue Pearl; New York New York
| | - B. Byer
- College of Veterinary medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
| | - L. E. Selmic
- Department of Veterinary Clinical Medicine, College of Veterinary medicine; University of Illinois Urbana-Champaign; Urbana Illinois
| |
Collapse
|
43
|
Zscheppang K, Berg J, Hedtrich S, Verheyen L, Wagner DE, Suttorp N, Hippenstiel S, Hocke AC. Human Pulmonary 3D Models For Translational Research. Biotechnol J 2018; 13:1700341. [PMID: 28865134 PMCID: PMC7161817 DOI: 10.1002/biot.201700341] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/23/2017] [Indexed: 12/13/2022]
Abstract
Lung diseases belong to the major causes of death worldwide. Recent innovative methodological developments now allow more and more for the use of primary human tissue and cells to model such diseases. In this regard, the review covers bronchial air-liquid interface cultures, precision cut lung slices as well as ex vivo cultures of explanted peripheral lung tissue and de-/re-cellularization models. Diseases such as asthma or infections are discussed and an outlook on further areas for development is given. Overall, the progress in ex vivo modeling by using primary human material could make translational research activities more efficient by simultaneously fostering the mechanistic understanding of human lung diseases while reducing animal usage in biomedical research.
Collapse
Affiliation(s)
- Katja Zscheppang
- Dept. of Internal Medicine/Infectious and Respiratory DiseasesCharité − Universitätsmedizin BerlinCharitèplatz 1Berlin 10117Germany
| | - Johanna Berg
- Department of BiotechnologyTechnical University of BerlinGustav‐Meyer‐Allee 25Berlin 13335Germany
| | - Sarah Hedtrich
- Institute for PharmacyPharmacology and ToxicologyFreie Universität BerlinBerlinGermany
| | - Leonie Verheyen
- Institute for PharmacyPharmacology and ToxicologyFreie Universität BerlinBerlinGermany
| | - Darcy E. Wagner
- Helmholtz Zentrum Munich, Lung Repair and Regeneration Unit, Comprehensive Pneumology CenterMember of the German Center for Lung ResearchMunichGermany
| | - Norbert Suttorp
- Dept. of Internal Medicine/Infectious and Respiratory DiseasesCharité − Universitätsmedizin BerlinCharitèplatz 1Berlin 10117Germany
| | - Stefan Hippenstiel
- Dept. of Internal Medicine/Infectious and Respiratory DiseasesCharité − Universitätsmedizin BerlinCharitèplatz 1Berlin 10117Germany
| | - Andreas C. Hocke
- Dept. of Internal Medicine/Infectious and Respiratory DiseasesCharité − Universitätsmedizin BerlinCharitèplatz 1Berlin 10117Germany
| |
Collapse
|
44
|
Valdor M, Wagner A, Röhrs V, Berg J, Fechner H, Schröder W, Tzschentke TM, Bahrenberg G, Christoph T, Kurreck J. RNA interference-based functional knockdown of the voltage-gated potassium channel Kv7.2 in dorsal root ganglion neurons after in vitro and in vivo gene transfer by adeno-associated virus vectors. Mol Pain 2017; 14:1744806917749669. [PMID: 29212407 PMCID: PMC5805000 DOI: 10.1177/1744806917749669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Activation of the neuronal potassium channel Kv7.2 encoded by the KCNQ2 gene has recently been shown to be an attractive mechanism to inhibit nociceptive transmission. However, potent, selective, and clinically proven activators of Kv7.2/Kv7.3 currents with analgesic properties are still lacking. An important prerequisite for the development of new drugs is a model to test the selectivity of novel agonists by abrogating Kv7.2/Kv7.3 function. Since constitutive knockout mice are not viable, we developed a model based on RNA interference-mediated silencing of KCNQ2. By delivery of a KCNQ2-specific short hairpin RNA with adeno-associated virus vectors, we completely abolished the activity of the specific Kv7.2/Kv7.3-opener ICA-27243 in rat sensory neurons. Results obtained in the silencing experiments were consistent between freshly prepared and cryopreserved dorsal root ganglion neurons, as well as in dorsal root ganglion neurons dissociated and cultured after in vivo administration of the silencing vector by intrathecal injections into rats. Interestingly, the tested associated virus serotypes substantially differed with respect to their transduction capability in cultured neuronal cell lines and primary dorsal root ganglion neurons and the in vivo transfer of transgenes by intrathecal injection of associated virus vectors. However, our study provides the proof-of-concept that RNA interference-mediated silencing of KCNQ2 is a suitable approach to create an ex vivo model for testing the specificity of novel Kv7.2/Kv7.3 agonists.
Collapse
Affiliation(s)
- Markus Valdor
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | - Anke Wagner
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Viola Röhrs
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Johanna Berg
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Henry Fechner
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Wolfgang Schröder
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | - Thomas M Tzschentke
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | | | - Thomas Christoph
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | - Jens Kurreck
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| |
Collapse
|
45
|
Berg J, Halvorsen A, Bengtson M, Taskén K, Mælandsmo G, Yndestad A, Halvorsen B, Brustugun O, Aukrust P, Ueland T, Helland Å. P2.02-053 The Prognostic Value of 18 Circulating Markers of Inflammation, Endothelial Activation and Extracellular Matrix Remodeling in Non-small Cell Lung Cancer Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
46
|
Marcus S, Piacquadio D, Houlihan A, Ferdon M, Berg J. LB941 Photodynamic therapy (PDT) with aminolevulinic acid (ALA) 20% and blue light reduces occurrence of actinic keratoses (AK) and de novo non-melanoma skin cancers (NMSCs) in patients with field cancerization. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
47
|
Kirkland CJ, Berg J, Cummings J, Banks S. A-17Sex Differences in Hippocampal Subfield Volume: The Impact of Amyloid Burden. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
48
|
Berg J, Björck L, Nielsen S, Lappas G, Rosengren A. Sex differences in survival after myocardial infarction in Sweden, 1987-2010. Heart 2017; 103:1625-1630. [PMID: 28784665 PMCID: PMC5739835 DOI: 10.1136/heartjnl-2016-310281] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 11/20/2022] Open
Abstract
Objective In this nationwide study, we investigated age-specific and sex-specific trends in sex differences in survival after acute myocardial infarction (AMI), including deaths from coronary heart disease (CHD) that occurred outside hospital. Methods Observational study in Sweden of 28-day and 1-year mortality among 658 110 persons (35.7% women) aged 35–84 years with a first-time CHD event 1987–2010 with data retrieved from the national Swedish death and hospital registries. Results Age-adjusted 28-day case fatality decreased from 23.5% to 8.5% over the period (p<0.05). In hospitalised cases, short-term survival in women aged 35–54 years compared with men of the same age was poorer, not changing appreciably over time (HRs for women relative to men 1.63 (95% CI 1.28 to 2.08) at age 35–54 years and 1.28 (95% CI 1.12 to 1.46) at age 55–64 years in 2005–2010), but after adjustment for comorbidities, differences between men and women were no longer significant (HR 1.25 (95% CI 0.97 to 1.61) and 1.05 (95% CI 0.91 to 1.20)). When CHD deaths outside hospital were included, women had better prognosis regardless of age and period. In patients surviving the first 28 days, age-adjusted 1-year case fatality decreased from 15.3% to 7.7% (p<0.05) for both men and women. After adjustment for comorbidities, no significant sex differences persisted below the age of 75 years in the last period. Female 28-day survivors 75–84 years old had a consistently better prognosis than older men. Conclusions The worse short-term outcomes in women <55 years of age hospitalised with AMI did not persist after adjustment for comorbidities. When CHD deaths outside hospital were included, women had consistently better short-term prognosis. In 28-day survivors, women did not fare worse than men when differences in comorbidities were considered.
Collapse
Affiliation(s)
- Johanna Berg
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Björck
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Nielsen
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Georgios Lappas
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
49
|
Berg J, Zscheppang K, Fatykhova D, Tönnies M, Bauer TT, Schneider P, Neudecker J, Rückert JC, Eggeling S, Schimek M, Gruber AD, Suttorp N, Hippenstiel S, Hocke AC. Tyk2 as a target for immune regulation in human viral/bacterial pneumonia. Eur Respir J 2017; 50:50/1/1601953. [PMID: 28705941 DOI: 10.1183/13993003.01953-2016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 04/07/2017] [Indexed: 12/14/2022]
Abstract
The severity and lethality of influenza A virus (IAV) infections is frequently aggravated by secondary bacterial pneumonia. However, the mechanisms in human lung tissue that provoke this increase in fatality are unknown and therapeutic immune modulatory options are lacking.We established a human lung ex vivo co-infection model to investigate innate immune related mechanisms contributing to the susceptibility of secondary pneumococcal pneumonia.We revealed that type I and III interferon (IFN) inhibits Streptococcus pneumoniae-induced interleukin (IL)-1β release. The lack of IL-1β resulted in the repression of bacterially induced granulocyte-macrophage colony-stimulating factor (GM-CSF) liberation. Specific inhibition of IFN receptor I and III-associated tyrosine kinase 2 (Tyk2) completely restored the S. pneumoniae-induced IL-1β-GM-CSF axis, leading to a reduction of bacterial growth. A preceding IAV infection of the human alveolus leads to a type I and III IFN-dependent blockade of the early cytokines IL-1β and GM-CSF, which are key for orchestrating an adequate innate immune response against bacteria. Their virally induced suppression may result in impaired bacterial clearance and alveolar repair.Pharmacological inhibition of Tyk2 might be a new treatment option to sustain beneficial endogenous GM-CSF levels in IAV-associated secondary bacterial pneumonia.
Collapse
Affiliation(s)
- Johanna Berg
- Dept of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Dept of Biotechnology, Technical University of Berlin, Berlin, Germany.,Both authors contributed equally
| | - Katja Zscheppang
- Dept of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Both authors contributed equally
| | - Diana Fatykhova
- Dept of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mario Tönnies
- HELIOS Clinic Emil von Behring, Dept of Pneumology and Dept of Thoracic Surgery, Chest Hospital Heckeshorn, Berlin, Germany
| | - Torsten T Bauer
- HELIOS Clinic Emil von Behring, Dept of Pneumology and Dept of Thoracic Surgery, Chest Hospital Heckeshorn, Berlin, Germany
| | - Paul Schneider
- Dept for General and Thoracic Surgery, DRK Clinics, Berlin, Germany
| | - Jens Neudecker
- Dept of General, Visceral, Vascular and Thoracic Surgery, Universitätsmedizin Berlin, Berlin, Germany
| | - Jens C Rückert
- Dept of General, Visceral, Vascular and Thoracic Surgery, Universitätsmedizin Berlin, Berlin, Germany
| | - Stephan Eggeling
- Dept of Thoracic Surgery, Vivantes Clinics Neukölln, Berlin, Germany
| | - Maria Schimek
- Dept of Thoracic Surgery, Vivantes Clinics Neukölln, Berlin, Germany
| | - Achim D Gruber
- Dept of Veterinary Pathology, College of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Norbert Suttorp
- Dept of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Hippenstiel
- Dept of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas C Hocke
- Dept of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
50
|
|