1
|
Chowdary P, Hastie R, Lino T, Middleton A, Capes G, Humphries A, Abed-Ali A, Anderson M, Mol BWJ, Horne A, Lim E, Andrew P, Brownfoot F, Tong S. Oral vinorelbine to treat women with ectopic pregnancy: a phase 1 clinical safety and tolerability study. Fertil Steril 2023; 120:695-696. [PMID: 37245616 DOI: 10.1016/j.fertnstert.2023.05.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/13/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Prathima Chowdary
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia; Clinical Trials Unit, Department of Obstetrics and Gynaecology, The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
| | - Roxanne Hastie
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Tu'uhevaha Lino
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Anna Middleton
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Gwyneth Capes
- Clinical Trials Unit, Department of Obstetrics and Gynaecology, The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
| | - Aimee Humphries
- Clinical Trials Unit, Department of Obstetrics and Gynaecology, The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
| | - Abir Abed-Ali
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Marti Anderson
- New Zealand Institute for Advanced Study, Massey University, Albany, Auckland, New Zealand
| | | | - Andrew Horne
- Department of Obstetrics and Gynaecology, Waitemata District Health Board, Auckland, New Zealand
| | - Eugene Lim
- Institute of Innovation and Improvement, Waitemata District Health Board, Auckland, New Zealand
| | - Penny Andrew
- Clinical Trials Unit, Department of Obstetrics and Gynaecology, The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
| | - Fiona Brownfoot
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Stephen Tong
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Whittaker R, Andrew P, Dobson R, Bramley D. Innovation in Aotearoa New Zealand's healthcare system-how to make it happen. N Z Med J 2022; 135:79-89. [PMID: 35834836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To date innovation in Aotearoa New Zealand healthcare services has varied around the country. As we move into a health system restructure, it is important to reflect on what has worked to date and how we can take these elements into the new system. In this paper we describe the approach at Waitematā District Health Board (DHB) including the establishment of an Institute for Innovation and Improvement. We highlight what we view as the key elements of an innovation enabling environment and suggest measures of success.
Collapse
Affiliation(s)
- Robyn Whittaker
- Associate Professor and Public Health Physician, i3, Waitematā DHB, Auckland, New Zealand; National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Penny Andrew
- Director, i3, Waitematā DHB, Auckland, New Zealand
| | - Rosie Dobson
- Psychologist and Senior Research Fellow, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand. i3, Waitematā DHB, Auckland, New Zealand
| | - Dale Bramley
- Chief Executive Officer, Waitematā DHB, Auckland, New Zealand
| |
Collapse
|
3
|
Dobson R, Baty C, Best G, Wells S, Wang K, Hallett K, Andrew P, Whittaker R. Digital solutions for providing patients access to hospital-held health information: what are the design issues that need to be addressed? N Z Med J 2022; 135:114-123. [PMID: 35728254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A patient and whānau centred healthcare system includes patients having easy access to their health records when and where they need it. Accessible digital solutions providing patients with access to their health information, including hospital-held healthcare records, will support patients and whānau to be active and informed participants in their health. A Northern Region proof-of-concept, providing patients with electronic access to their hospital-held health information, identified several challenges in the design of such "portals". The purpose of this paper is to present a discussion of these challenges, and to present a review of the literature on how other countries and health settings have managed them. The review has led to recommendations around how delegated access, auditing access, adding and correcting of information, the timing of test result availability, and retrospective records should be handled. However, more investigation is required into the challenges surrounding how various types of more sensitive information should be handled. There is still considerable work to be done on how to technically and operationally transform these "default design principles" into reality within the complexity of New Zealand hospitals' electronic health information systems.
Collapse
Affiliation(s)
- Rosie Dobson
- Health Psychologist and Senior Research Fellow, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand; i3, Waitematā District Health Board (DHB), Auckland, New Zealand
| | - Chris Baty
- Health Consumer. Waitematā DHB, Auckland, New Zealand
| | - Georgia Best
- Research Assistant, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Susan Wells
- Associate Professor, School of Population Health, University of Auckland, New Zealand; Associate Clinical Director, ProCare, Auckland, New Zealand
| | - Keming Wang
- Senior Business Analyst, healthAlliance, Auckland, New Zealand
| | - Karen Hallett
- Programme Manager, healthAlliance, Auckland, New Zealand
| | - Penny Andrew
- Director, i3, Waitematā DHB, Auckland, New Zealand
| | - Robyn Whittaker
- Associate Professor and Public Health Physician, i3, Waitematā DHB, Auckland, New Zealand; National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| |
Collapse
|
4
|
Mukhin E, Nelyubov V, Yukish V, Smirnova E, Solovei V, Kalinina N, Nagaitsev V, Valishin M, Belozerova A, Enin S, Borisov A, Deryabina N, Khripunov V, Portnov D, Babinov N, Dokhtarenko D, Khodunov I, Klimov V, Razdobarin A, Alexandrov S, Elets D, Bazhenov A, Bukreev I, Chernakov A, Dmitriev A, Ibragimova Y, Koval A, Kurskiev G, Litvinov A, Nikolaenko K, Samsonov D, Senichenkov V, Smirnov R, Tolstyakov S, Tereschenko I, Varshavchik L, Zhiltsov N, Mokeev A, Chernakov P, Andrew P, Kempenaars M. Radiation tolerance testing of piezoelectric motors for ITER (first results). Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
5
|
Dobson R, Whittaker R, Wihongi H, Andrew P, Armstrong D, Bartholomew K, Sporle A, Wells S. Patient perspectives on the use of health information. N Z Med J 2021; 134:48-62. [PMID: 35728109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM This survey aimed to investigate patient perspectives, including preferences, needs and concerns, on the use of, and access to, individual healthcare information. METHOD A mixed-methods cross-sectional survey of adult patients (n=1,377) in Waitematā District Health Board inpatient and outpatient services during November-December 2020. The survey was online and on paper and available in 10 languages. RESULTS Over 80% of participants were comfortable with their health information being used across the scenarios presented (range: 81-89%). Māori were significantly more likely than non-Māori to be comfortable with their health information being combined with the health information of others to better understand population needs (p=0.006). The level of comfort with the use of individual health information was related to assurances that its use was for public good, data were stored securely, individual privacy was maintained, the information was accurate and there was communication on how it was used. DISCUSSION This study has shown that most healthcare consumers are comfortable with the health service using their de-identified health information beyond their care if it benefits others.
Collapse
Affiliation(s)
- Rosie Dobson
- National Institute for Health Innovation, University of Auckland
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland; Waitematā District Health Board
| | - Helen Wihongi
- Waitematā District Health Board; Auckland District Health Board
| | | | | | | | - Andrew Sporle
- Department of Statistics, University of Auckland; iNZIght Analytics Ltd, Auckland
| | - Susan Wells
- ProCare Health Limited; Epidemiology and Biostatistics, School of Population Health, University of Auckland
| |
Collapse
|
6
|
Buslakov I, Kirienko I, Modestov V, Loginov I, Senichenkov V, Mukhin E, Litvinov A, Babinov N, Tolstyakov S, Chernakov P, Marinin G, Terentiev D, Bulkin R, Pashkovsky S, Mokeev A, Tanaka S, Andrew P, Nagy D. Structural analysis of the diagnostic rack locking in ITER lower port #8. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
7
|
Modestov V, Kirienko I, Buslakov I, Loginov I, Shagniev O, Lavrova V, Senichenkov V, Mukhin E, Litvinov A, Samsonov D, Tolstyakov S, Babinov N, Chernakov P, Marinin G, Terentiev D, Bulkin R, Pashkovsky S, Mokeev A, Tanaka S, Andrew P. Structural analysis of large-scale SS collecting mirrors for ITER diagnostics. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
8
|
Whittaker R, Dobson R, Hopley L, Armstrong D, Corning-Davis B, Andrew P. Training clinicians to lead clinical IT projects. N Z Med J 2020; 133:116-122. [PMID: 33332334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Across New Zealand, a huge programme of work is being initiated to improve the health information systems of our sector. The goals of this plan are to address major risks and issues such as cybersecurity and our inability to securely share health data across organisations for clinical care. To fulfil the promise of planned health IT initiatives, we must involve clinicians of all disciplines to help lead, design and implement projects. However, there is currently little pragmatic training available for clinicians to learn how to do so. In 2019, Waitematā District Health Board and the National Institute for Health Innovation developed and delivered a 'hands-on' Clinical Digital Academy training programme for multidisciplinary clinicians. This paper describes the programme, the initial cohort's evaluation feedback and recommendations for the future.
Collapse
Affiliation(s)
- Robyn Whittaker
- Associate Professor and Public Health Physician, i3, Waitematā DHB, Auckland, New Zealand, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Rosie Dobson
- Health Psychologist and Research Fellow, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Lara Hopley
- Clinical Advisor Digital Innovations and Anaesthetist, Waitematā DHB, Auckland, New Zealand
| | | | | | - Penny Andrew
- Director, i3, Waitematā DHB, Auckland, New Zealand
| |
Collapse
|
9
|
Millar JS, Lawes CM, Farrington B, Andrew P, Misur P, Merriman E, Walker M. Incidence of venous thromboembolism after total hip, total knee and hip fracture surgery at Waitemata District Health Board following a peer-reviewed audit. N Z Med J 2020; 133:52-60. [PMID: 32161421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM The incidence of venous thromboembolism (VTE) following arthroplasty and hip fracture surgery remains an important metric for quality and financial reasons. An audit at our institution between 2006-2010 showed a higher VTE rate than international data did at the time. This study aims to determine rates of DVT and PE in patients undergoing hip and knee arthroplasty and hip fracture surgery at Waitemata District Health Board (Waitemata DHB) between 1 January 2013 and 31 December 2016. METHODS This study is a retrospective review of all VTE within three months of elective hip or knee replacement or hip fracture surgery. Data were identified for the period between 2013 and 2016 from Waitemata DHB patient databases, including a dedicated VTE database. RESULTS The current rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) at our institution following hip or knee arthroplasty or hip fracture surgery are 1.5% and 0.6% respectively, a lower rate than 2.3% and 0.9% respectively in 2006-2010. DVTs were significantly more prevalent after hip fracture surgery than after elective hip or knee arthroplasty, and 71% of DVTs were confined to the distal veins. Of the patients undergoing surgery, 93% received post-operative chemoprophylaxis, mainly aspirin or low molecular-weight heparin (LMWH). CONCLUSION There has been a significant reduction in VTE rates following elective hip and knee joint replacement and hip fracture surgery between the time periods. This occurred over a period when Waitemata DHB introduced a multi-modal, interdisciplinary team approach to VTE prophylaxis utilising enhanced recovery after surgery (ERAS) pathways. These measures may therefore have contributed to the reduction in VTEs.
Collapse
Affiliation(s)
- James S Millar
- Orthopaedic Registrar, Orthopaedic Department, North Shore Hospital, Waitemata District Health Board, Auckland
| | - Carlene Mm Lawes
- Public Health Physician, North Shore Hospital, Waitemata District Health Board, Auckland
| | - Bill Farrington
- Orthopaedic Surgeon, Department of Orthopaedic Surgery, North Shore Hospital, Waitemata District Health Board, Auckland
| | - Penny Andrew
- Director of the Institute for Innovation and Improvement, North Shore Hospital, Waitemata District Health Board, Auckland
| | - Peter Misur
- Orthopaedic Surgeon, Department of Orthopaedic Surgery, North Shore Hospital, Waitemata District Health Board, Auckland
| | - Eileen Merriman
- Consultant Haematologist/Lead Thrombosis Clinician, Department of Haematology, North Shore Hospital, Waitemata District Health Board, Auckland
| | - Matt Walker
- Clinical Director of Orthopaedics, Department of Orthopaedic Surgery, North Shore Hospital, Waitemata District Health Board, Auckland
| |
Collapse
|
10
|
Gorbunov A, Mukhin E, Berik E, Melkumov M, Babinov N, Kurskiev G, Tolstyakov S, Vukolov K, Lisitsa V, Levashova M, Andrew P, Kempenaars M, Vayakis G, Walsh M. Laser-induced fluorescence of helium ions in ITER divertor. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.04.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
11
|
Kornev A, Davtian A, Kovyarov A, Makarov A, Oborotov D, Pokrovskii V, Porozov A, Sobolev S, Stupnikov V, Kurskiev G, Mukhin E, Tolstyakov S, Andrew P, Kempenaars M, Vayakis G, Walsh M. Nd:YAG lasers for ITER divertor Thomson scattering. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.01.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
12
|
Kirk RJ, Lawes CM, Farrington W, Misur P, Walker ML, Kluger M, Seow MY, Andrew P. Post-operative mortality rates for neck of femur fracture at Waitemata District Health Board. N Z Med J 2019; 132:17-25. [PMID: 30789885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM Mortality rates of up to 38% at one year have been reported following surgery for neck of femur fractures. The aim of this review is to evaluate the post-operative mortality rates and trends over time for patients with fractured neck of femur at Waitemata District Health Board. METHOD A retrospective cohort study of all patients who received surgery following a neck of femur fracture at Waitemata District Health Board between 2009 and 2016. Inpatient data was retrieved from electronic hospital records and mortality rates from the Ministry of Health, New Zealand. Analyses included crude mortality rates and trends over time, and time-to-theatre from presentation with neck of femur fracture. RESULTS A total of 2,822 patients were included in the study; mean age 81.9 years, 70.4% female and 29.6% male. Overall post-operative crude rates for inpatient, 30-day and one-year mortality were 3.7%, 7.2% and 23.8% respectively. Adjusted analyses showed a statistically significant decrease in mortality rates between 2009 and 2016 at inpatient (p=0.001), 30 days (p=<0.001) and one year (p=<0.001) time periods. There was also a significant association between time-to-theatre and mortality at inpatient (p=0.002), 30 days (p=0.0001), and one year (p=0.0002) time periods. CONCLUSION Mortality rates following surgery for fractured NOF have significantly improved over recent years at Waitemata District Health Board. Reduced time-to-theatre is associated with decreased inpatient, 30-day and one-year mortality.
Collapse
Affiliation(s)
- Reuben J Kirk
- House Surgeon, Department of Orthopaedics, Waitemata District Health Board, Auckland
| | - Carlene Mm Lawes
- Public Health Physician, Institute for Innovation and Improvement, Waitemata District Health Board, Auckland
| | - William Farrington
- Orthopaedic Surgeon, Department of Orthopaedics, Waitemata District Health Board, Auckland
| | - Peter Misur
- Orthopaedic Surgeon, Department of Orthopaedics, Waitemata District Health Board, Auckland
| | - Matthew L Walker
- Clinical Director of Orthopaedics, Waitemata District Health Board, Auckland
| | - Michal Kluger
- Anaesthetist, Department of Anaesthesiology and Perioperative Medicine, Waitemata District Health Board, Auckland
| | - Min Yee Seow
- Orthogeriatrician, Department of Orthopaedics, Waitemata District Health Board, Auckland
| | - Penny Andrew
- Director of the Institute of Innovation and Improvement, Waitemata District Health Board, Auckland
| |
Collapse
|
13
|
Ng J, Andrew P, Muir P, Greene M, Mohan S, Knight J, Hider P, Davis P, Seddon M, Scahill S, Harrison J, Zhou L, Selak V, Lawes C, Galgali G, Broad J, Crawley M, Pevreal W, Houston N, Brott T, Ryan D, Peach J, Brant A, Bramley D. Feasibility and reliability of clinical coding surveillance for the routine monitoring of adverse drug events in New Zealand hospitals. N Z Med J 2018; 131:46-60. [PMID: 30359356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM To explore the feasibility and reliability of Clinical Coding Surveillance (CCS) for the routine monitoring of Adverse Drug Events (ADE) and describe the characteristics of harm identified through this approach in a large district health board (DHB). METHOD All hospital admissions at Waitemata DHB from 2015 to 2016 with an ADE-related ICD10-AM code of Y40-Y59, X40-X49 or T36-T50 were extracted from clinical coded data. The data was analysed using descriptive statistics, statistical process control and Pareto charts. Two clinicians assessed a random sample of 140 ADEs for their accuracy against what was clinically documented in medical records. RESULTS A total of 11,999 ADEs were identified in 244,992 admissions (4.9 ADEs per 100 admissions). ADEs were more prevalent in older adults and associated with longer average length of stays and medicines such as analgesics, antibiotics, anticoagulants and diuretics. Only 2,164 (18%) of ADEs were classified as originating within hospital. Of ADEs originating outside of the hospital, the main causes were poisoning by psychotropics, anti-epileptics and anti-parkinsonism agents and non-opioid analgesics. Clinicians agreed that 91% of ADE positive admissions were accurately classified as per clinical documentation. CONCLUSION CCS is a feasible and reliable approach for the routine monitoring of ADEs in hospitals.
Collapse
Affiliation(s)
- Jerome Ng
- Lead Advisor, Improvement, Research & Informatics, Institute for Innovation and Improvement (i3), Waitemata DHB, Auckland
| | - Penny Andrew
- Director, Institute for Innovation and Improvement (i3), Waitemata DHB, Auckland
| | - Paul Muir
- Medical Fellow, Planning, Funding and Outcomes, Waitemata DHB, Auckland
| | - Monique Greene
- Information Analyst, Institute for Innovation and Improvement (i3), Waitemata DHB, Auckland
| | - Sabitha Mohan
- Clinical Coding Auditor, Health Information Group, Waitemata DHB, Auckland
| | - Jacqui Knight
- Clinical Coding Team Leader, Health Information Group, Waitemata DHB, Auckland
| | - Phil Hider
- Senior Lecturer, Department of Population Health, University of Otago, Christchurch
| | - Peter Davis
- Professor, Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland
| | - Mary Seddon
- Independent Consultant, Seddon Healthcare Quality, Auckland
| | - Shane Scahill
- Senior Lecturer, School of Management, Massey University, Auckland
| | - Jeff Harrison
- Associate Professor, School of Pharmacy, University of Auckland, Auckland
| | - Lifeng Zhou
- Chief Advisor for Asian International Collaboration, Waitemata District Health Board, Auckland
| | - Vanessa Selak
- Senior Lecturer, School of Population Health, University of Auckland, Auckland
| | - Carlene Lawes
- Public Health Physician (Surgical), Institute for Innovation and Improvement (i3), Waitemata DHB, Auckland
| | - Geetha Galgali
- Public Health Physician (Maternity), Child, Women and Family, Waitemata DHB, Auckland
| | - Joanna Broad
- Senior Research Fellow, Department of Geriatric Medicine, University of Auckland, Auckland
| | - Marilyn Crawley
- Chief Pharmacist, Pharmacy Department, Waitemata DHB, Auckland
| | - Wynn Pevreal
- Medication Safety Pharmacist, Pharmacy Department, Waitemata DHB, Auckland (Died 24 April 2018)
| | - Neil Houston
- Clinical Director for Safety and Quality in Primary Care, Waitemata DHB, Auckland
| | - Tamzin Brott
- Executive Director-Allied Health, Scientific & Technical Professions, Waitemata DHB, Auckland
| | - David Ryan
- Information Systems Change Manager, Health Information Group, Waitemata DHB, Auckland
| | - Jocelyn Peach
- Director of Nursing and Midwifery, Waitemata DHB, Auckland
| | | | - Dale Bramley
- Chief Executive Officer, Waitemata DHB, Auckland
| |
Collapse
|
14
|
Martin A, Andrew P, Jokinen T, Komarov V, Kukushkin A, Loarte A, Maruyama S, Merola M, Palmer J, Pearce R, Pick M, Pitts R, Walker C. ITER Divertor System Integration. Fusion Science and Technology 2017. [DOI: 10.13182/fst09-a8877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A. Martin
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - P. Andrew
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - T. Jokinen
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - V. Komarov
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - A. Kukushkin
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - A. Loarte
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - S. Maruyama
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - M. Merola
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - J. Palmer
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - R. Pearce
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - M. Pick
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - R. Pitts
- ITER Organization, St. Paul-lez-Durance, France, 13108
| | - C. Walker
- ITER Organization, St. Paul-lez-Durance, France, 13108
| |
Collapse
|
15
|
Kim J, Andrew P, Reichle R. Plasma-Wall-Interaction Diagnostics in ITER: Dust, Erosion, and Tritium Retention. Fusion Science and Technology 2017. [DOI: 10.13182/fst12-a13386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Junghee Kim
- ITER Organization, Diagnostics Division, 13115 Saint-Paul-lez-Durance Cedex, France
| | - P. Andrew
- ITER Organization, Diagnostics Division, 13115 Saint-Paul-lez-Durance Cedex, France
| | - R. Reichle
- ITER Organization, Diagnostics Division, 13115 Saint-Paul-lez-Durance Cedex, France
| |
Collapse
|
16
|
Ng J, Andrew P, Crawley M, Pevreal W, Peach J. Assessing a hospital medication system for patient safety: findings and lessons learnt from trialling an Australian modified tool at Waitemata District Health Board. N Z Med J 2016; 129:63-77. [PMID: 26914423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To undertake a review of Waitemata District Health Board's (WDHB) hospital medication system for patient safety assessment and improvement purposes. METHODS A multidisciplinary group rated current WDHB hospital medication systems against the Medication Safety Self-Assessment for Australian Hospitals (MSSA-AH) criterion of 247 aspirational practices using a five point scale ("no" to "fully implemented"). Items with a lesser extent of implementation represented practice gaps. The MSSA-AH database and weighted adjustment scoring system generated an overall hospital score. RESULTS Of the maximum possible score that could be obtained had all MSSA-AH practices been implemented, WDHB scored 63% and this was comparable to other demographically similar hospitals in Australia. Lowest scoring practices needing improvement related to staffing. Conflict resolution was a previously unidentified practice gap. Previously identified gaps, such as those relating to electronic medication systems suggested ongoing implementation was required. CONCLUSION This was the first documented use of the MSSA-AH's in a New Zealand hospital setting and helped WDHB identify areas in need of further improvement. The unique generation of a percentage score helped simplify understanding for non-technical stakeholders. Future repeated assessments would help WDHB track progress. Implicit benefits, such as stakeholder engagement, were observed. The MSSA-AH may be useful in other hospital settings.
Collapse
Affiliation(s)
- Jerome Ng
- Quality, Waitemata District Health Board, Auckland, New Zealand.
| | | | | | | | | |
Collapse
|
17
|
Andrew P, O'Connor S, Valdes M, Majeed H, Montenero A. DO STANDARD HEART FAILURE MEDICATIONS PREVENT FALL IN LVEF IN BREAST CANCER PATIENTS GIVEN TARGETED THERAPY? Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.545] [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: 10/22/2022] Open
|
18
|
Majeed H, Montenero A, Valdes M, O'Connor S, Andrew P. P081 Do standard heart failure medications prevent fall in LVEF in patients on trastuzumab? Breast 2015. [DOI: 10.1016/s0960-9776(15)70126-8] [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: 11/30/2022] Open
|
19
|
Johnson C, Andrew P, Sulpher J, Majeed H, Graham N, Turek M, Susan D. DATA-DRIVEN TIMING OF OPTIMAL LV EJECTION FRACTION ASSESSMENT IN BREAST CANCER PATIENTS EXPOSED TO TRASTUZUMAB. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.317] [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: 10/24/2022] Open
|
20
|
Sulpher J, Andrew P, Majeed H, Johnson C, Graham N, Dent S. Data-Driven Timing of Optimal Lvef Assessment in Breast Cancer Patients Exposed to Trastuzumab. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.46] [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: 11/12/2022] Open
|
21
|
Liu SC, Gillespie J, Atchison N, Andrew P. The recovery programme for the Regent honeyeaterAnthochaera phrygia:an example of conservation collaboration in Australia. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/izy.12040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. C. Liu
- Taronga Conservation Society Australia; Bradleys Head Road Mosman New South Wales 2088 Australia
| | - J. Gillespie
- Taronga Conservation Society Australia; Bradleys Head Road Mosman New South Wales 2088 Australia
| | - N. Atchison
- Taronga Conservation Society Australia; Bradleys Head Road Mosman New South Wales 2088 Australia
| | - P. Andrew
- Taronga Conservation Society Australia; Bradleys Head Road Mosman New South Wales 2088 Australia
| |
Collapse
|
22
|
Murtagh L, Gallagher TH, Andrew P, Mello MM. Disclosure-and-resolution programs that include generous compensation offers may prompt a complex patient response. Health Aff (Millwood) 2013; 31:2681-9. [PMID: 23213152 DOI: 10.1377/hlthaff.2012.0185] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Under "disclosure-and-resolution" programs, health systems disclose adverse events to affected patients and their families; apologize; and, where appropriate, offer compensation. Early adopters of this approach have reported reduced liability costs, but the extent to which these results stem from effective disclosure and apology practices, versus compensation offers, is unknown. Using survey vignettes, we examined the effects of different compensation offers on individuals' responses to disclosures of medical errors compared to explanation and apology alone. Our results show that although two-thirds of these individuals desired compensation offers, increasing the offer amount did not improve key outcomes. Full-compensation offers did not decrease the likelihood of seeking legal advice and increased the likelihood that people perceived the disclosure and apology as motivated by providers' desire to avoid litigation. Hospitals, physicians, and malpractice insurers should consider this complex interplay as they implement similar initiatives. They may benefit from separating disclosure conversations and compensation offers and from excluding physicians from compensation discussions.
Collapse
|
23
|
Patel K, Udintsev V, Hughes S, Walker C, Andrew P, Barnsley R, Bertalot L, Drevon J, Encheva A, Kashchuk Y, Maquet P, Pearce R, Taylor N, Vayakis G, Walsh M. ITER diagnostic system: Vacuum interface. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.01.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
24
|
Hayn MH, Andrew P, Hellenthal NJ, Poch MA, O’Malley RL, Guru KA. Robot-assisted radical cystectomy: Oncologic results of 150 consecutive cases with a median 19-month follow-up. J Am Coll Surg 2011. [DOI: 10.1016/j.jamcollsurg.2011.06.372] [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]
|
25
|
Reichle R, Andrew P, Counsell G, Drevon JM, Encheva A, Janeschitz G, Johnson D, Kusama Y, Levesy B, Martin A, Pitcher CS, Pitts R, Thomas D, Vayakis G, Walsh M. Defining the infrared systems for ITER. Rev Sci Instrum 2010; 81:10E135. [PMID: 21033997 DOI: 10.1063/1.3491199] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The International Thermonuclear Experimental Reactor will have wide angle viewing systems and a divertor thermography diagnostic, which shall provide infrared coverage of the divertor and large parts of the first wall surfaces with spatial and temporal resolution adequate for operational purposes and higher resolved details of the divertor and other areas for physics investigations. We propose specifications for each system such that they jointly respond to the requirements. Risk analysis driven priorities for future work concern mirror degradation, interfaces with other diagnostics, radiation damage to refractive optics, reflections, and the development of calibration and measurement methods for varying optical and thermal target properties.
Collapse
Affiliation(s)
- R Reichle
- ITER Organization, 13115 St. Paul-lez-Durance, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Whitney HM, Kolle M, Andrew P, Chittka L, Steiner U, Glover BJ. Floral Iridescence, Produced by Diffractive Optics, Acts As a Cue for Animal Pollinators. Science 2009; 323:130-3. [DOI: 10.1126/science.1166256] [Citation(s) in RCA: 282] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
27
|
Andrew P. On the limiting behaviour of Lévy processes at zero. Probab Theory Relat Fields 2008. [DOI: 10.1007/s00440-007-0059-0] [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: 10/23/2022]
|
28
|
Alonso JA, Andrew P, Neto A, de Pablos JL, de la Cal E, Fernandes H, Gafert J, Heesterman P, Hidalgo C, Kocsis G, Manzanares A, Murari A, Petravich G, Rios L, Silva C, Thomas PD, Gorini G, Orsitto FP, Sindoni E, Tardocchi M. Fast visible camera installation and operation in JET. ACTA ACUST UNITED AC 2008. [DOI: 10.1063/1.2905063] [Citation(s) in RCA: 6] [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: 11/15/2022]
|
29
|
Murari A, Edlington T, Brzozowski J, de La Luna E, Andrew P, Arnoux G, Cecil F, Cupido L, Darrow D, Kiptily V, Fessey J, Gauthier E, Hacquin S, Hill K, Huber A, Loarer T, McCormick K, Reich M. JET new diagnostic capability on the route to ITER. Fusion Engineering and Design 2007. [DOI: 10.1016/j.fusengdes.2007.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
30
|
Huber A, McCormick K, Andrew P, Beaumont P, Dalley S, Fink J, Fuchs J, Fullard K, Fundamenski W, Ingesson L, Mast F, Jachmich S, Matthews G, Mertens P, Philipps V, Pitts R, Sanders S, Zeidner W. Upgraded bolometer system on JET for improved radiation measurements. Fusion Engineering and Design 2007. [DOI: 10.1016/j.fusengdes.2007.03.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
31
|
Gauthier E, Roche H, Thomas E, Droineau S, Bertrand B, Migozzi J, Vliegenthart W, Dague L, Andrew P, Tiscornia T, Sands D. ITER-like wide-angle infrared thermography and visible observation diagnostic using reflective optics. Fusion Engineering and Design 2007. [DOI: 10.1016/j.fusengdes.2007.06.026] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
32
|
Liang Y, Koslowski HR, Thomas PR, Nardon E, Alper B, Andrew P, Andrew Y, Arnoux G, Baranov Y, Bécoulet M, Beurskens M, Biewer T, Bigi M, Crombe K, De La Luna E, de Vries P, Fundamenski W, Gerasimov S, Giroud C, Gryaznevich MP, Hawkes N, Hotchin S, Howell D, Jachmich S, Kiptily V, Moreira L, Parail V, Pinches SD, Rachlew E, Zimmermann O. Active control of type-I edge-localized modes with n=1 perturbation fields in the JET tokamak. Phys Rev Lett 2007; 98:265004. [PMID: 17678097 DOI: 10.1103/physrevlett.98.265004] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Indexed: 05/16/2023]
Abstract
Type-I edge-localized modes (ELMs) have been mitigated at the JET tokamak using a static external n=1 perturbation field generated by four error field correction coils located far from the plasma. During the application of the n=1 field the ELM frequency increased by a factor of 4 and the amplitude of the D(alpha) signal decreased. The energy loss per ELM normalized to the total stored energy, DeltaW/W, dropped to values below 2%. Transport analyses shows no or only a moderate (up to 20%) degradation of energy confinement time during the ELM mitigation phase.
Collapse
Affiliation(s)
- Y Liang
- Forschungszentrum Jülich GmbH, Association EURATOM-FZ Jülich, Institut für Plasmaphysik, Trilateral Euregio Cluster, D-52425 Jülich, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Pinto E, Andrew P, Faleiro L. P1423 The importance of signal recognition particle for viability of Streptococcus pneumoniae. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71262-1] [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: 10/23/2022]
|
34
|
Tilley S, Orlova E, Gilbert R, Andrew P, Saibil H. Structural changes in the bacterial toxin pneumolysin during pore formation. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305099563] [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: 11/10/2022] Open
|
35
|
Abstract
Coupled surface plasmon polaritons (SPPs) are shown to provide effective transfer of excitation energy from donor molecules to acceptor molecules on opposite sides of metal films up to 120 nanometers thick. This variant of radiative transfer should allow directional control over the flow of excitation energy with the use of suitably designed metallic nanostructures, with SPPs mediating transfer over length scales of 10(-7) to 10(-4) meters. In the emerging field of nanophotonics, such a prospect could allow subwavelength-scale manipulation of light and provide an interface to the outside world.
Collapse
Affiliation(s)
- P Andrew
- Thin Film Photonics, School of Physics, University of Exeter, Stocker Road, Exeter, EX4 4QL, UK
| | | |
Collapse
|
36
|
De Ponti R, Fournierp A, Sturmer M, Dubuc M, Gross G, Kirsh J, Chiu C, Hamilton R, Andrew P, O'Connor S. A09-2 Multicenter cryo ablation experience in paediatric patients. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b13-a] [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: 11/16/2022] Open
|
37
|
|
38
|
Brunner F, Andrew P, Wölkart G, Zechner R, Mayer B. Myocardial contractile function and heart rate in mice with myocyte-specific overexpression of endothelial nitric oxide synthase. Circulation 2001; 104:3097-102. [PMID: 11748107 DOI: 10.1161/hc5001.101966] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The major source of nitric oxide (NO) in the heart is the constitutive form of NO synthases (eNOS, NOS III) that is expressed in vascular endothelium and cardiac myocytes. NO mediates endothelium-dependent vasodilation and may modulate cardiac function. We examined the role of NO in hearts from transgenic (TG) mice overexpressing eNOS exclusively in cardiac myocytes. METHODS AND RESULTS Three independent TG lines with varying levels of NOS activity were selected, and the hearts were isolated and retrogradely perfused at constant flow. We found that NO is positively inotropic in spontaneously beating hearts from wild-type (WT) mice, whereas hearts overexpressing eNOS had reduced basal contractility that was partially reversed by NOS blockade. Heart rate was not altered. Acetylcholine (10 to 1000 nmol/L) increased contractility in unstimulated hearts and decreased contractility after beta-adrenergic stimulation with norepinephrine, and these responses were identical in WT and TG hearts. Finally, resting systolic intracellular calcium (Ca(2+)(i)) tended to be lower in TG than in WT hearts, and the beat-to-beat responsiveness to Ca(2+)(i) was reduced in hearts with eNOS overexpression. CONCLUSIONS High levels of endogenous myocyte-derived NO blunt myofilament Ca(2+) sensitivity. The similar effects of acetylcholine on contractility and heart rate, as well as the identical basal intrinsic heart rate in WT and TG hearts, provide a solid argument against NO as an important modulator of neurohormonal control of myocardial function.
Collapse
Affiliation(s)
- F Brunner
- Institut für Pharmakologie und Toxikologie, the Institut für Molekularbiologie, Biochemie und Mikrobiologie, Karl-Franzens-Universität Graz, Graz, Austria.
| | | | | | | | | |
Collapse
|
39
|
Schmidt K, Andrew P, Schrammel A, Groschner K, Schmitz V, Kojda G, Mayer B. Comparison of neuronal and endothelial isoforms of nitric oxide synthase in stably transfected HEK 293 cells. Am J Physiol Heart Circ Physiol 2001; 281:H2053-61. [PMID: 11668066 DOI: 10.1152/ajpheart.2001.281.5.h2053] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The neuronal and endothelial isoforms of nitric oxide (NO) synthase (nNOS and eNOS, respectively) both catalyze the production of NO but are regulated differently. Stably transfected HEK 293 cell lines containing nNOS, eNOS, and a soluble mutant of eNOS were therefore established to compare their activity in a common cellular environment. NOS activity was determined by measuring L-[3H]citrulline production in homogenates and intact cells, the conversion of oxyhemoglobin to methemoglobin, and the production of cGMP. The results indicate that nNOS is more active than eNOS, both in unstimulated as well as calcium-stimulated cells. Under basal conditions, the soluble mutant of eNOS appeared to be slightly more active than wild-type eNOS in terms of NO and cGMP formation, suggesting that membrane association may be crucial for inhibition of basal NO release but is not required for stimulation by Ca2+-mobilizing agents. The maximal activity of soluble guanylate cyclase was significantly reduced by transfection with wild-type eNOS due to downregulation of mRNA expression. These results demonstrate that nNOS and eNOS behave differently even in an identical cellular environment.
Collapse
Affiliation(s)
- K Schmidt
- Institut für Pharmakologie und Toxikologi, Karl-Franzens-Universität, A-8010 Graz, Austria
| | | | | | | | | | | | | |
Collapse
|
40
|
|
41
|
Abstract
1. We studied the effect of adrenomedullin (ADM) on fluid efflux from the splenic vasculature into extravascular spaces. 2. Splenic arterial infusion of ADM (1, 3 and 9 ng min(-1); n = 9, 11 and 10, respectively) caused a dose-dependent increase in intrasplenic fluid efflux (+0.6 +/- 0.3 (saline) vs. +2.0 +/- 0.3 ml min(-1) (9 ng min(-1) ADM), P < 0.05), and in splenic (venous minus arterial) haematocrit (+0.8 +/- 0.1 (saline, n = 6) vs. +3.1 +/- 0.3 % (9 ng min(-1) ADM, n = 7), P < 0.05). There was no change in splenic weight (0.99 +/- 0.02 (saline, n = 6) vs. 0.99 +/- 0.02 g (9 ng min(-1) ADM, n = 7), P > 0.05). 3. There was no change in MAP before (97.5 +/- 2.2 mmHg), during (98.4 +/- 3.4 mmHg), or after (100.2 +/- 2.2 mmHg) intrasplenic infusion of ADM (9 ng min(-1)) (n = 11, P < 0.05). 4. ADM (9 ng min(-1)) caused an increase in intrasplenic microvascular pressure (11.3 +/- 0.3 (saline, n = 5) vs. 13.0 +/- 0.3 mmHg (9 ng min(-1) ADM, n = 6), P < 0.05). 5. ADM (1 x 10(-11) to 1 x 10(-6) M) induced greater vasorelaxation of isolated preconstricted splenic resistance arteries than veins (maximal relaxation: 60 +/- 0.9 (artery, n = 9) vs. 43 +/- 1.7 % (vein, n = 8), P < 0.05). L-NMMA (10(-4) M) partially inhibited the ADM-induced relaxation in splenic arteries (maximal relaxation: 38 +/- 3 (ADM + L-NMMA, n = 5) vs. 60 +/- 3 % (ADM + D-NMMA, n = 5), P < 0.05). 6. It is concluded that ADM increases fluid efflux from the splenic vasculature by differentially reducing pre- vs. post-capillary resistance, thus increasing intrasplenic microvascular pressure.
Collapse
Affiliation(s)
- S Kaufman
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada T6G 2S2.
| | | | | | | |
Collapse
|
42
|
Abstract
By studying the transfer of excitation energy between dye molecules confined within an optical microcavity, we demonstrate experimentally that Förster energy transfer is influenced by the local photonic mode density. Locating donor and acceptor molecules at well-defined positions allows the transfer rate to be determined as a function of both mutual separation and cavity length. The results show that the Förster transfer rate depends linearly on the donor emission rate and hence photonic mode density, providing the potential to control energy transfer by modification of the optical environment.
Collapse
Affiliation(s)
- P Andrew
- Thin Film Photonics Group, School of Physics, University of Exeter, Exeter, EX4 4QL, UK.
| | | |
Collapse
|
43
|
Golser R, Gorren AC, Leber A, Andrew P, Habisch HJ, Werner ER, Schmidt K, Venema RC, Mayer B. Interaction of endothelial and neuronal nitric-oxide synthases with the bradykinin B2 receptor. Binding of an inhibitory peptide to the oxygenase domain blocks uncoupled NADPH oxidation. J Biol Chem 2000; 275:5291-6. [PMID: 10681501 DOI: 10.1074/jbc.275.8.5291] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Endothelial nitric-oxide synthase (type III) (eNOS) was reported to form an inhibitory complex with the bradykinin receptor B2 (B2R) from which the enzyme is released in an active form upon receptor activation (Ju, H., Venema, V. J., Marrero, M. B., and Venema, R. C. (1998) J. Biol. Chem. 273, 24025-24029). Using a synthetic peptide derived from the known inhibitory sequence of the B2R (residues 310-329) we studied the interaction of the receptor with purified eNOS and neuronal nitric-oxide synthase (type I) (nNOS). The peptide inhibited formation of L-citrulline by eNOS and nNOS with IC(50) values of 10.6 +/- 0.4 microM and 7.1 +/- 0.6 microM, respectively. Inhibition was not due to an interference of the peptide with L-arginine or tetrahydrobiopterin binding. The NADPH oxidase activity of nNOS measured in the absence of L-arginine was inhibited by the peptide with an IC(50) of 3.7 +/- 0.6 microM, but the cytochrome c reductase activity of the enzyme was much less susceptible to inhibition (IC(50) >0.1 mM). Steady-state absorbance spectra of nNOS recorded during uncoupled NADPH oxidation showed that the heme remained oxidized in the presence of the synthetic peptide consisting of amino acids 310-329 of the B2R, whereas the reduced oxyferrous heme complex was accumulated in its absence. These data suggest that binding of the B2R 310-329 peptide blocks flavin to heme electron transfer. Co-immunoprecipitation of B2R and nNOS from human embryonic kidney cells stably transfected with human nNOS suggests that the B2R may functionally interact with nNOS in vivo. This interaction of nNOS with the B2R may recruit the enzyme to allow for the effective coupling of bradykinin signaling to the nitric oxide pathway.
Collapse
Affiliation(s)
- R Golser
- Institut für Pharmakologie und Toxikologie, Karl-Franzens-Universität Graz, Universitätsplatz 2, A-8010 Graz, Austria
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
We recently demonstrated that fluid is filtered out of the splenic circulation and into the lymphatic system. The current experiments were designed to investigate the importance of this route of fluid extravasation in endotoxemia. Lipopolysaccharide (LPS) was infused into conscious intact and splenectomized rats (150 microg x kg(-1). h(-1) i.v. for 18 h). In the intact rats, mean arterial pressure (MAP) fell from 101+/-2.4 to 88+/-3.9 mm Hg (n = 7) and then stabilized at about 90 mm Hg. Hematocrit rose from 41+/-0.9 to 45+/-0.4% at 40 min, at which time plasma volume had fallen from 4.7+/-0.12 to 4.0+/-0.05 ml/100 g body wt. In the splenectomized rats MAP did not fall and hematocrit did not rise. There also was no change in plasma volume, i.e., splenectomy prevented the hypotension and hemoconcentration customarily induced by LPS. In a second series of experiments, splenic arterial and venous blood flows were simultaneously measured in anesthetized rats infused with LPS (150 microg x kg(-1) x h(-1)). LPS increased splenic fluid efflux. We conclude that during endotoxemia the initial fall in circulating blood volume may be attributed to fluid extravasation from the splenic vasculature.
Collapse
Affiliation(s)
- P Andrew
- Department of Physiology, University of Alberta, Edmonton, Alberta, T6G 2S2, Canada
| | | | | |
Collapse
|
45
|
Andrew P, Brennan P, Coad J, Ehrenberg J, Gadeberg M, Gibson A, Hillis D, How J, Jarvis O, Jensen H, Lässer R, Marcus F, Monk R, Morgan P, Orchard J, Peacock A, Pick M, Rossi A, Schild P, Schunke B, Stork D, Pearce R. Tritium retention and clean-up in JET. Fusion Engineering and Design 1999. [DOI: 10.1016/s0920-3796(99)00084-8] [Citation(s) in RCA: 135] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
46
|
Affiliation(s)
- S Gordon
- Unité de Génétique Moléculaire Bactérienne, Institut Pasteur, Paris, France
| | | | | |
Collapse
|
47
|
Mayer B, Andrew P. Nitric oxide synthases: catalytic function and progress towards selective inhibition. Naunyn Schmiedebergs Arch Pharmacol 1998; 358:127-33. [PMID: 9721014 DOI: 10.1007/pl00005233] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Biosynthesis of nitric oxide (NO) is performed by the dimeric, heme-containing enzyme nitric oxide synthase, which requires the flavins FAD and FMN, as well as the pteridine cofactor (6R)-5,6,7,8-tetrahydro-L-biopterin (H4biopterin) in order to catalyze the NADPH-dependent oxidation of L-arginine. The three major isoforms of nitric oxide synthase (NOS), although identical in that they contain a carboxy-terminal reductase and an amino-terminal oxygenase domain, fulfill diverse physiological functions, according to their differing expression patterns and mechanisms of activation. The pteridine H4biopterin, which affects both the conformational stability and activity of NOS, demonstrates anticooperative binding which results in the stoichiometric production of NO and O2-. Physiological mechanisms involving superoxide dismutase and reduced glutathione exist to avoid the subsequent formation of the potent oxidant peroxynitrite. With regard to inhibition of NO production, novel isoform-selective inhibitors are proving useful not only for dissecting the physiological functions of NOS, but also in the development of novel therapeutic agents.
Collapse
Affiliation(s)
- B Mayer
- Institut für Pharmakologie und Toxikologie, Karl-Franzens-Universität Graz, Austria
| | | |
Collapse
|
48
|
Dunne M, Andrew P. Fully automated assay for the determination of sumatriptan in human serum using solid-phase extraction and high-performance liquid chromatography with electrochemical detection. J Pharm Biomed Anal 1996; 14:721-6. [PMID: 8807547 DOI: 10.1016/0731-7085(95)01688-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A method is described for a fully automated, sensitive, accurate and precise assay for the determination of sumatriptan in human serum. The assay consists of solid-phase extraction followed by reversed-phase HPLC with electrochemical detection. The extraction procedure has been fully automated on a Zymate XP robot linked on-line to the HPLC system. The assay is linear over the analytical range 1-30 ng ml-1 and selective for sumatriptan with respect to endogenous plasma components and GR49336, the major circulating metabolite. The intra-assay data demonstrate a maximum bias and precision across the calibration range of 10% and 6.6% respectively. The inter-assay data demonstrate a maximum bias and precision across the calibration range of 6.7% and 8.8%, respectively. The extraction efficiency of the assay is approximately 90% and is constant across the calibration range. The assay was used for the determination of sumatriptan in serum clinical samples and was shown to be robust in sustained use over several months. The use of a Zymate XP robot allowed complete automation of the assay, which resulted in high-quality, high-throughput analyses.
Collapse
Affiliation(s)
- M Dunne
- Drug Metabolism Division, Glaxo Research and Development Limited, Ware, Herts, UK
| | | |
Collapse
|
49
|
Saibene G, Sartori R, Andrew P, How J, King Q, Peacock A. Tritium accounting during the first tritium experiment at JET. Fusion Engineering and Design 1992. [DOI: 10.1016/0920-3796(92)90068-f] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
50
|
Martin B, Humbert O, Camara M, Guenzi E, Walker J, Mitchell T, Andrew P, Prudhomme M, Alloing G, Hakenbeck R. A highly conserved repeated DNA element located in the chromosome of Streptococcus pneumoniae. Nucleic Acids Res 1992; 20:3479-83. [PMID: 1630918 PMCID: PMC312505 DOI: 10.1093/nar/20.13.3479] [Citation(s) in RCA: 288] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We report the discovery of a group of highly conserved DNA sequences located, in those cases studied, within intergenic regions of the chromosome of the Gram positive Streptococcus pneumoniae. The S. pneumoniae genome contains about 25 of these elements called BOX. From 5' to 3', BOX elements are composed of three subunits (boxA, boxB, and boxC) which are 59, 45 and 50 nucleotides long, respectively. BOX elements containing one, two and four copies of boxB have been observed; boxB alone was also detected in one instance. These elements are unrelated to the two most thoroughly documented families of repetitive DNA sequences present in the genomes of enterobacteria. BOX sequences have the potential to form stable stem-loop structures and one of these, at least, is transcribed. Most of these elements are located in the immediate vicinity of genes whose product has been implicated at some stage in the process of genetic transformation or in virulence of S. pneumoniae. This location raises the intriguing possibility that BOX sequences are regulatory elements shared by several coordinately controlled genes, including competence-specific and virulence-related genes.
Collapse
Affiliation(s)
- B Martin
- Microbiologie et Génétique Moléculaires, CNRS-UPR 9007, Université Paul Sabatier, Toulouse, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|