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Klein A, Kosinski L, Loupy A, Frey E, Stegall M, Helanterä I, Newell K, Meier-Kriesche HU, Mannon RB, Fitzsimmons WE. Comparing the prognostic performance of iBOX and biopsy-proven acute rejection for long-term kidney graft survival. Am J Transplant 2024:S1600-6135(24)00275-2. [PMID: 38642711 DOI: 10.1016/j.ajt.2024.04.004] [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: 12/13/2023] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
Biopsy-proven acute rejection (BPAR) occurs in approximately 10% of kidney transplant recipients in the first year, making superiority trials unfeasible. iBOX, a quantitative composite of estimated glomerular filtration rate, proteinuria, antihuman leukocyte antigen donor-specific antibody, and + full/- abbreviated kidney histopathology, is a new proposed surrogate endpoint. BPAR's prognostic ability was compared with iBOX in a pooled cohort of 1534 kidney transplant recipients from 4 data sets, including 2 prospective randomized controlled trials. Discrimination analyses showed mean c-statistic differences between both iBOX compared with BPAR of 0.25 (95% confidence interval: 0.17-0.32) for full iBOX and 0.24 (95% confidence interval: 0.16-0.32) for abbreviated iBOX, indicating statistically significantly higher c-statistic values for the iBOX prognosis of death-censored graft survival. Mean (± standard error) c-statistics were 0.81 ± 0.03 for full iBOX, 0.80 ± 0.03 for abbreviated iBOX, and 0.57 ± 0.03 for BPAR. In calibration analyses, predicted graft loss events from both iBOX models were not significantly different from those observed. However, for BPAR, the predicted events were significantly (P < .01) different (observed: 64; predicted: 70; full iBOX: 76; abbreviated iBOX: 173 BPAR). IBOX at 1-year posttransplant is superior to BPAR in the first year posttransplant in graft loss prognostic performance, providing valuable additional information and facilitating the demonstration of superiority of novel immunosuppressive regimens.
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Affiliation(s)
| | | | - Alexandre Loupy
- Université de Paris, Cité, Institut national de la santé et de la recherche médicale, U970, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Eric Frey
- Critical Path Institute, Tucson, Arizona, USA
| | - Mark Stegall
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Ilkka Helanterä
- Helsinki University Hospital, Department of Transplantation and Liver Surgery, and University of Helsinki, Finland
| | - Kenneth Newell
- Division of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Roslyn B Mannon
- Department of Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Roehl JC, Katzer L, Jakstat HA, Wetselaar P, Ahlers MO. Tooth Wear Evaluation System 2.0-Evaluation of diagnostic reliability in the assessment of signs and symptoms for tooth wear by non-experts. J Oral Rehabil 2024; 51:712-723. [PMID: 38087990 DOI: 10.1111/joor.13633] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/18/2023] [Accepted: 11/20/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Tooth wear is a multifactorial condition that manifests through various signs and symptoms. These individual signs and symptoms were described in multiple studies, leading to the inclusion in TWES 2.0 (Tooth Wear Evaluation System 2.0) and the forthcoming DC-TW (Diagnostic Criteria for Tooth Wear). However, a study evaluating their reliability has yet to be conducted. OBJECTIVE The aim of the study was to examine the reliability in the assessment of 6 signs of pathological tooth wear and 18 clinical signs and symptoms determining aetiology, all of which are included in the TWES 2.0/DC-TW. METHODS 48 dental students (operators) evaluated patient cases from a patient pool of 14 patients on dental casts and high-resolution intraoral photographs. The agreement between all operators for each sign and symptom was calculated based on ICC (Intraclass Correlation Coefficients). Additionally, the agreement of each operator's evaluation with a predefined sample solution was calculated based on Cohen's kappa. RESULTS Inter-user agreement ranged from near perfect (0.91) to poor (0.02) for the various pathology signs or aetiology symptoms of tooth wear (mean 0.32). The agreements of the operator's ratings compared to the sample solution resulted in Cohen's kappa from 0.18 to 1 (mean 0.59) for the pathology signs and ranged from 0.02 to 0.51 for the aetiology signs (mean 0.38). CONCLUSIONS The reliability of the signs and symptoms examined and the ability of individual investigators to correctly identify and assign signs and symptoms varied widely. The current assessment tools for the qualification of tooth wear need further refinement, and examiners need intensive training in tooth wear assessment.
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Affiliation(s)
- Jakob C Roehl
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- CMD-Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Holger A Jakstat
- Department of Prosthetic Dentistry and Dental Materials and Special Care, Center for Dental and Oral Medicine, University of Leipzig, Leipzig, Germany
| | - Peter Wetselaar
- Department of General Oral Health Care, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Oliver Ahlers
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- CMD-Center Hamburg-Eppendorf, Hamburg, Germany
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Vveinhardt J, Kaspare M. Connections of bullying experienced by Kyokushin karate athletes with the psychological state: is "a Cure for Bullying" safe? Front Sports Act Living 2024; 6:1304285. [PMID: 38333430 PMCID: PMC10850300 DOI: 10.3389/fspor.2024.1304285] [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: 09/29/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Although some authors propose practicing martial arts as a prevention against bullying, little is known about bullying among karate athletes and the consequences of negative behaviour for athletes' psychological state. This study aims to explore the effect of bullying on the psychological state of Kyokushin karate athletes. A total of 371 athletes were surveyed to measure bullying experiences and signs of stress, anxiety, and depression. It was determined that 75.5% of Kyokushin karate athletes had experienced unethical behaviour by their coaches or other athletes towards them at least once, and the scores on the signs of stress, anxiety, and depression correlated with damage in the fields of communication, social relations, and physical health. The results of binary logistic regression have shown that the qualifications of karate athletes and their participation in competitions influence the risk of being bullied. Organisations in which Kyokushin karate athletes do sports should devote more attention to preventing bullying among karate athletes themselves, especially when preparing for competitions as bullying can harm communication, social relations, and physical health.
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Affiliation(s)
- Jolita Vveinhardt
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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Brommeyer M, Liang Z, Whittaker M, Mackay M. Developing Health Management Competency for Digital Health Transformation: Protocol for a Qualitative Study. JMIR Res Protoc 2023; 12:e51884. [PMID: 37921855 PMCID: PMC10656658 DOI: 10.2196/51884] [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: 08/16/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Globally, the health care system is experiencing a period of rapid and radical change. In response, innovative service models have been adopted for the delivery of high-quality care that require a health workforce with skills to support transformation and new ways of working. OBJECTIVE The aim of this research protocol is to describe research that will contribute to developing the capability of health service managers in the digital health era and enabling digital transformation within the Australian health care environment. It also explains the process of preparing and finalizing the research design and methodologies by seeking answers to the following three research questions: (1) To what extent can the existing health service management and digital health competency frameworks guide the development of competence for health service managers in understanding and managing in the digital health space? (2) What are the competencies that are necessary for health service managers to acquire in order to effectively work with and manage in the digital health context? (3) What are the key factors that enable and inhibit health service managers to develop and demonstrate digital health competence in the workplace? METHODS The study has adopted a qualitative approach, guided by the empirically validated management competency identification process, using four steps: (1) health management and digital health competency mapping, (2) scoping review of literature and policy analysis, (3) focus group discussions with health service managers, and (4) semistructured interviews with digital health leaders. The first 2 steps were to confirm the need for updating the current health service management curriculum to address changing competency requirements of health service managers in the digital health context. RESULTS Two initial steps have been completed confirming the significance of the study and study design. Step 1, competency mapping, found that nearly half of the digital competencies were only partially or not addressed at all by the health management competency framework. The scoping review articulated the competencies health service managers need to effectively demonstrate digital health competence in the workplace. The findings effectively support the importance of the current research and also the appropriateness of the proposed steps 3 and 4 in answering the research questions and achieving the research aim. CONCLUSIONS This study will provide insights into the health service management workforce performance and development needs for digital health and inform credentialing and professional development requirements. This will guide health service managers in leading and managing the adoption and implementation of digital health as a contemporary tool for health care delivery. The study will develop an in-depth understanding of Australian health service managers' experiences and views. This research process could be applied in other contexts, noting that the results need contextualization to individual country jurisdictions and environments. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51884.
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Affiliation(s)
- Mark Brommeyer
- College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, Australia
| | - Zhanming Liang
- College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, Australia
| | - Maxine Whittaker
- College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, Australia
| | - Mark Mackay
- College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, Australia
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Cubelo F, Langari MNM, Jokiniemi K, Turunen H. Recognition of nursing qualification and credentialing pathway of Filipino nurses in Finland: A qualitative study. Int Nurs Rev 2023. [PMID: 37916617 DOI: 10.1111/inr.12901] [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: 05/10/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
AIM To understand the experiences of Filipino internationally educated nurses (FIENs) on their recognition and credentialing pathway in the recruitment process in Finland. BACKGROUND The nursing shortage in Finland results in the recruitment of internationally educated nurses (IENs) such as those from the Philippines. In the context of migration, IENs experience a rigorous process to become qualified nurses in the destination country. METHODS A thematic analysis of the secondary data from qualitative interviews was conducted. Ten FIENs (n = 10) were recruited from university hospitals in Finland through purposeful and snowball sampling. The study adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS Three main themes were identified. First, pre-migration victories and predicaments described the experiences of FIENs during the recruitment process and the pathway to acquiring a Registered Nurse qualification. Second, ambiguous integration implied integrating into the workplace while working on the top-up education programme as a prerequisite to nursing registration. Lastly, migration uncertainty discussed the interest among FIENs to continue practising as Registered Nurses (RNs) in Finland. CONCLUSIONS Pre-migration orientation and workplace integration experiences influenced FIENs' choice to practise as RNs in Finland. The licensure pathway for FIENs required collaboration from various stakeholders in Finnish society. It is recommended to structure the system for the recognition and qualification process of IENs by creating a national model in line with international standards and requirements in collaboration with higher education institutions. IMPLICATION FOR NURSING POLICY Recognition of previous education and clinical experience can facilitate the transition to becoming an RN for IENs, but the lack of a clear education model and recognition of foreign nursing qualifications leads to deskilling and hinders IENs from practising. Policies prioritising education and integration into the local healthcare system can facilitate the integration and professional growth of IENs, enabling them to contribute significantly to the healthcare system.
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Affiliation(s)
- Floro Cubelo
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
- School of Wellbeing and Culture, Oulu University of Applied Sciences, Oulu, Finland
| | | | - Krista Jokiniemi
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Hannele Turunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, North Savo Welfare Region, Kuopio, Finland
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Kofanova O, Paul S, Pexaras A, Bellora C, Petersons A, Schmitt M, Baker Berjaoui M, Qaoud Y, Kenk M, Wagner H, Fleshner N, Betsou F. Biospecimen Qualification in a Clinical Biobank of Urological Diseases. Biopreserv Biobank 2023. [PMID: 37878356 DOI: 10.1089/bio.2022.0190] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Development of novel biomarkers for diagnosis of disease and assessment of treatment efficacy utilizes a wide range of biospecimens for discovery research. The fitness of biospecimens for the purpose of biomarker development depends on the clinical characteristics of the donor and on a number of critical and potentially uncontrolled pre-analytical variables. Pre-analytical factors influence the reliability of the biomarkers to be analyzed and can seriously impact analytic outcomes. Sample quality stratification assays and tools can be utilized by biorepositories to minimize bias resulting from samples' inconsistent quality. In this study, we evaluated the quality of biobanked specimens by comparing analytical outcomes at 1, 5, and 10 years after collection. Our results demonstrate that currently available assays and tools can be used by biobank laboratories to support objective biospecimen qualification. We have established a workflow to monitor the quality of different types of biospecimens and, in this study, present the results of a qualification exercise applied to fluid samples and their derivatives in the context of urological diseases.
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Affiliation(s)
- Olga Kofanova
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Sangita Paul
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Achilleas Pexaras
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Camille Bellora
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Ala Petersons
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Margaux Schmitt
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Mohamad Baker Berjaoui
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Yazan Qaoud
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Miran Kenk
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Heidi Wagner
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Neil Fleshner
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Fay Betsou
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
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Koutsoumanis K, Allende A, Alvarez‐Ordóñez A, Bolton D, Bover‐Cid S, Chemaly M, De Cesare A, Hilbert F, Lindqvist R, Nauta M, Nonno R, Peixe L, Ru G, Simmons M, Skandamis P, Suffredini E, Cocconcelli PS, Suarez JE, Fernández EN, Istace F, Aguillera J, Brozzi R, Liébana E, Guerra B, Correia S, Herman L. Statement on how to interpret the QPS qualification on 'acquired antimicrobial resistance genes'. EFSA J 2023; 21:e08323. [PMID: 37915981 PMCID: PMC10616732 DOI: 10.2903/j.efsa.2023.8323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
The qualified presumption of safety (QPS) approach was developed to provide a regularly updated generic pre-evaluation of the safety of microorganisms intended for use in the food or feed chains. Safety concerns identified for a taxonomic unit (TU) are, where possible, confirmed at the species/strain or product level and reflected by 'qualifications' which should be assessed at strain and/or product level by EFSA's Scientific Panels. The generic qualification 'the strains should not harbour any acquired antimicrobial resistance (AMR) genes to clinically relevant antimicrobials' applies to all QPS bacterial TUs. The different EFSA risk assessment areas use the same approach to assess the qualification related to AMR genes. In this statement, the terms 'intrinsic' and 'acquired' AMR genes were defined for the purpose of EFSA's risk assessments, and they apply to bacteria used in the food and feed chains. A bioinformatic approach is proposed for demonstrating the 'intrinsic'/'acquired' nature of an AMR gene. All AMR genes that confer resistance towards 'critically important', 'highly important' and 'important' antimicrobials, as defined by the World Health Organisation (WHO), found as hits, need to be considered as hazards (for humans, animals and environment) and need further assessment. Genes identified as responsible for 'intrinsic' resistance could be considered as being of no concern in the frame of the EFSA risk assessment. 'Acquired' AMR genes resulting in a resistant phenotype should be considered as a concern. If the presence of the 'acquired' AMR gene is not leading to phenotypic resistance, further case-by-case assessment is necessary.
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Klein A, Loupy A, Stegall M, Helanterä I, Kosinski L, Frey E, Aubert O, Divard G, Newell K, Meier-Kriesche HU, Mannon RB, Dumortier T, Aggarwal V, Podichetty JT, O'Doherty I, Gaber AO, Fitzsimmons WE. Qualifying a novel clinical trial endpoint (iBOX) predictive of long-term kidney transplant outcomes. Am J Transplant 2023; 23:1496-1506. [PMID: 37735044 DOI: 10.1016/j.ajt.2023.04.018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/30/2023] [Accepted: 04/12/2023] [Indexed: 09/23/2023]
Abstract
New immunosuppressive therapies that improve long-term graft survival are needed in kidney transplant. Critical Path Institute's Transplant Therapeutics Consortium received a qualification opinion for the iBOX Scoring System as a novel secondary efficacy endpoint for kidney transplant clinical trials through European Medicines Agency's qualification of novel methodologies for drug development. This is the first qualified endpoint for any transplant indication and is now available for use in kidney transplant clinical trials. Although the current efficacy failure endpoint has typically shown the noninferiority of therapeutic regimens, the iBOX Scoring System can be used to demonstrate the superiority of a new immunosuppressive therapy compared to the standard of care from 6 months to 24 months posttransplant in pivotal or exploratory drug therapeutic studies.
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Affiliation(s)
| | - Alexandre Loupy
- Université de Paris, Cité, Institut national de la santé et de la recherche médicale, U970, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Mark Stegall
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Ilkka Helanterä
- Department of Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland
| | | | - Eric Frey
- Critical Path Institute, Tucson, Arizona, USA
| | - Olivier Aubert
- Université de Paris, Cité, Institut national de la santé et de la recherche médicale, U970, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Gillian Divard
- Université de Paris, Cité, Institut national de la santé et de la recherche médicale, U970, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Kenneth Newell
- Division of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Roslyn B Mannon
- Department of Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | | | | | | | - Ahmed Osama Gaber
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA, and Weill Cornell Medicine, New York, New York, USA
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Lee KC, Wan KX, Barricklow J, Lim CN, Clarke S, Potts D, Holmes K, Gonzalez P, Kavetska O. Using Mitra sampling to support first-in-human pharmacokinetic evaluations for PF-07059013. Bioanalysis 2023; 15:1083-1094. [PMID: 37584365 DOI: 10.4155/bio-2023-0066] [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] [Indexed: 08/17/2023] Open
Abstract
Aim: A sensitive and selective method for the determination of PF-07059013 in dried blood collected by Mitra™ tips was developed and qualified from 50 to 50,000 ng/ml. Materials & methods: PF-07059013 is isolated from 10 μl of human dried blood by extraction with methanol and analyzed by HPLC-MS/MS. Results & conclusions: In addition to routine validation elements, impact of hematocrit and Mitra tip's lot-to-lot variation on assay accuracy were evaluated. The qualified method was used in one clinical study with excellent performance. Correlation coefficient between blood concentrations obtained from liquid-incurred blood samples and dried-incurred blood samples is 0.95. Clinical Trial Registration: NCT04323124 (ClinicalTrials.gov).
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Affiliation(s)
| | | | | | | | - Stephen Clarke
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
| | - Daniel Potts
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
| | - Kevin Holmes
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
| | - Pilar Gonzalez
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
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Colson S, Gagnayre R, Margat A, Muller A, Simar C, Visier L. Information concerning the application to become an associate professor in the nursing sciences section of the French Conseil national des universités des disciplines de santé (National Council of Universities for Health Disciplines). Rech Soins Infirm 2023; 152:77-80. [PMID: 37438255 DOI: 10.3917/rsi.152.0077] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
In 2019, the nursing sciences section of the Conseil national des universités des disciplines de santé was created. One of its missions is to evaluate the applications of candidates wishing to qualify as university professors and associate professors. Qualification authorizes the applicant to apply a competitive examination for the position of university professor or assistant professor at a French university offering a position. The members of the section must assess whether the requirements in terms of research, teaching, and expertise have been met by the candidate so that they can sit the competitive examination. As a result, there are a number of requirements, which it is useful to reiterate in order to enhance the quality of future applications. Only those requirements relating to qualification as a associate professor will be covered here.
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Affiliation(s)
- Sébastien Colson
- Professeur des universités en sciences infirmières, Ph.D, HDR, 1er vice-président de la section 92 CNU Santé, directeur de l’École des sciences infirmières, UR 3279-CEReSS, Faculté SMPM, Aix-Marseille Université, Marseille, France
| | - Rémi Gagnayre
- Professeur des universités en sciences de l’éducation et de la formation, Ph.D, HDR, président de la section 92 CNU Santé, directeur de l’UR 3412-LEPS, Université Sorbonne Paris-Nord, Bobigny, France
| | - Aurore Margat
- Maîtresse de conférences en sciences infirmières, Ph.D, HDR, 2e vice-présidente de la section 92 CNU Santé, directrice adjointe de l’UR 3412-LEPS, Université Sorbonne Paris-Nord, Bobigny, France
| | - Anne Muller
- Maîtresse de conférences en sciences de l’éducation et de la formation, Ph.D, assesseur de la section 92 CNU Santé, UMR 8533-IDHES, Université Paris 1 Panthéon-Sorbonne, Paris, France
| | - Carine Simar
- Maîtresse de conférences en sciences de l’éducation et de la formation, Ph.D, membre de la section 92 CNU Santé, UR 4281-ACTÉ, Université de Clermont-Ferrand, Clermont-Ferrand, France
| | - Laurent Visier
- Professeur des universités en sociologie, Ph.D, HDR, membre de la section 92 CNU Santé, faculté de médecine, UR CEPEL, Université de Montpellier, Montpellier, France
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11
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Sawant S, Gurley SA, Overman RG, Sharak A, Mudrak SV, Oguin T, Sempowski GD, Sarzotti-Kelsoe M, Walter EB, Xie H, Pasetti MF, Moody MA, Tomaras GD. H3N2 influenza hemagglutination inhibition method qualification with data driven statistical methods for human clinical trials. Front Immunol 2023; 14:1155880. [PMID: 37090729 PMCID: PMC10117676 DOI: 10.3389/fimmu.2023.1155880] [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: 01/31/2023] [Accepted: 03/09/2023] [Indexed: 04/09/2023] Open
Abstract
Introduction Hemagglutination inhibition (HAI) antibody titers to seasonal influenza strains are important surrogates for vaccine-elicited protection. However, HAI assays can be variable across labs, with low sensitivity across diverse viruses due to lack of standardization. Performing qualification of these assays on a strain specific level enables the precise and accurate quantification of HAI titers. Influenza A (H3N2) continues to be a predominant circulating subtype in most countries in Europe and North America since 1968 and is thus a focus of influenza vaccine research. Methods As a part of the National Institutes of Health (NIH)-funded Collaborative Influenza Vaccine Innovation Centers (CIVICs) program, we report on the identification of a robust assay design, rigorous statistical analysis, and complete qualification of an HAI assay using A/Texas/71/2017 as a representative H3N2 strain and guinea pig red blood cells and neuraminidase (NA) inhibitor oseltamivir to prevent NA-mediated agglutination. Results This qualified HAI assay is precise (calculated by the geometric coefficient of variation (GCV)) for intermediate precision and intra-operator variability, accurate calculated by relative error, perfectly linear (slope of -1, R-Square 1), robust (<25% GCV) and depicts high specificity and sensitivity. This HAI method was successfully qualified for another H3N2 influenza strain A/Singapore/INFIMH-16-0019/2016, meeting all pre-specified acceptance criteria. Discussion These results demonstrate that HAI qualification and data generation for new influenza strains can be achieved efficiently with minimal extra testing and development. We report on a qualified and adaptable influenza serology method and analysis strategy to measure quantifiable HAI titers to define correlates of vaccine mediated protection in human clinical trials.
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Affiliation(s)
- Sheetal Sawant
- Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, United States
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
| | - Sarah Anne Gurley
- Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, United States
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
| | - R. Glenn Overman
- Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, United States
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
| | - Angelina Sharak
- Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, United States
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
| | - Sarah V. Mudrak
- Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, United States
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
| | - Thomas Oguin
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
| | | | - Marcella Sarzotti-Kelsoe
- Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, United States
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
| | - Emmanuel B. Walter
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Pediatrics, Duke University, Durham, NC, United States
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Hang Xie
- Division of Viral Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, United States
| | - Marcela F. Pasetti
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, United States
| | - M. Anthony Moody
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
- Department of Pediatrics, Duke University, Durham, NC, United States
| | - Georgia D. Tomaras
- Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, United States
- Duke Human Vaccine Institute, Duke University, Durham, NC, United States
- Department of Immunology, Duke University, Durham, NC, United States
- Duke Global Health Institute, Duke University, Durham, NC, United States
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12
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Kumar M, Sharma Y, Chahar K, Kumari L, Mishra L, Patel P, Singh D, Kurmi BD. Validation of a Novel Supercritical Fluid Extractor/Dryer Combo Instrument. Assay Drug Dev Technol 2023; 21:126-136. [PMID: 36999897 DOI: 10.1089/adt.2023.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
The current pharmaceutical manufacturing scenario involves different techniques for the processing of materials. For example, the extraction unit is one of the essential aspects of plant-based pharmaceuticals. Recently, various kinds of extraction techniques have been used for analytical and preparative scales; among them, a supercritical fluid extractor (SCFE) is the most widely used technique for extraction. It is used for an extensive range of crude drugs and can be possible with the help of SCFE by varying temperature/pressure. Notably, it uses carbon dioxide (CO2) for extraction instead of other solvents. Simultaneously, lyophilization is an important technique used at different processing steps along with other methods. In lyophilization, CO2 is used as a cooling agent in the shelves of lyophilized equipment. It behaves as a supercritical fluid at critical pressure (Pc) of 72.7 atm and critical temperature (Tc) of 31°C. Considering the criteria mentioned earlier, there is a possibility that liquid CO2 or supercritical carbon dioxide (SC-CO2) can be used as a cooling agent in a lyophilizer and extraction solvent in SCFE. This review presents a brief outline for the possible validation parameters of the proposed novel processor; that is, SCFE/Dryer combo instrument containing Design Qualification, Installation Qualification, Operational Qualification, and Performance Qualification.
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Affiliation(s)
- Mritunjay Kumar
- Department of Pharmaceutical Quality Assurance, ISF College of Pharmacy, Moga, India
| | - Yash Sharma
- Department of Pharmaceutical Quality Assurance, ISF College of Pharmacy, Moga, India
| | - Kanak Chahar
- Department of Pharmaceutical Quality Assurance, ISF College of Pharmacy, Moga, India
| | - Lakshmi Kumari
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, India
| | - Lopamudra Mishra
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, India
| | - Preeti Patel
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Moga, India
| | - Dilpreet Singh
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, India
| | - Balak Das Kurmi
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, India
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13
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Schouten H, Nieuwenhuis M, van der Schans C, Niemeijer A, van Zuijlen P. Considerations in determining the severity of burn scar contractures with focus on the knee joint. J Burn Care Res 2023:7031353. [PMID: 36752774 DOI: 10.1093/jbcr/irad016] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Indexed: 02/09/2023]
Abstract
Scar contractures are a common complication after burn injuries. These contractures are characterized by impairment of joint mobility, leading to risk for limitations during daily activities, and restrictions in participation in society. Qualifying its severity is not well established in burn care. This study therefore examined different approaches to determine the severity of limited mobility in the knee joint due to a scar contracture. To determine the severity of burn scar contractures development of the knee over time, the following approaches were analyzed: prevalence, the degree of limitation, ability to perform basic daily activities, and the need for reconstructive surgery. Range of motion data of the knee joint were extracted from a 12-month prospective multicenter cohort study in the Netherlands. Based on prevalence, mean degree of limitation, and the classification based on mathematical division, limitations in knee flexion would be seen as giving most problems. On the other hand, when classified in terms of impact on function, limitations in extension were found to be giving most problems, although flexion limitations interfered slightly longer with the basic activities standing, walking, and climbing stairs. Depending on the chosen approach, the severity of burn scar contractures is projected differently. Interpreting the severity of a burn scar contracture of the knee, preferably should be based on a function-based classification system of the degree of ROM impairment, activity limitations and participation restrictions in society. Because that does justice to the real impact of burn scar contracture for the individual burn survivor.
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Affiliation(s)
- Hennie Schouten
- Association of Dutch Burn Centers, Burn Centre, Red Cross Hospital Beverwijk, The Netherlands.,Burn Centre and Dept of Plastic & Reconstructive Surgery, Red Cross Hospital, Beverwijk, The Netherlands.,Department of Physiotherapy, Red Cross Hospital, Beverwijk, The Netherlands.,Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Science's Amsterdam UMC (location VUmc), Amsterdam, The Netherlands.,The Dutch Working Group on Burn Rehabilitation
| | - Marianne Nieuwenhuis
- Association of Dutch Burn Centers, Burn Centre, Martini Hospital Groningen, The Netherlands.,Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.,The Dutch Working Group on Burn Rehabilitation
| | - Cees van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen.,Health Psychology, University Medical Center Groningen, University of Groningen
| | - Anuschka Niemeijer
- Association of Dutch Burn Centers, Burn Centre, Martini Hospital Groningen, The Netherlands.,Research Institute, Martini Hospital Groningen, The Netherlands
| | - Paul van Zuijlen
- Burn Centre and Dept of Plastic & Reconstructive Surgery, Red Cross Hospital, Beverwijk, The Netherlands.,Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Science's Amsterdam UMC (location VUmc), Amsterdam, The Netherlands.,The Dutch Working Group on Burn Rehabilitation.,Pediatric Surgical Centre, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
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14
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Gu C, Zhang Y, Liu L, Wei B, Gong D, Cui B. [Differentiation of grazing pressure expressions and its applicable scenarios]. Ying Yong Sheng Tai Xue Bao 2023; 34:433-441. [PMID: 36803721 DOI: 10.13287/j.1001-9332.202302.003] [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] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
High intensity grazing is considered as an important cause of grassland degradation. Numerous studies have explored effects of grazing activities on grassland ecosystems. Nevertheless, the research regarding grazing activity itself, especially the quantification methods and gradient division of grazing pressure, is relatively insufficient. Based on a total of 141 Chinese and English papers containing keywords such as 'grazing pressure', 'grazing intensity', and giving specific quantification methods and classification standards, we sorted out the definition, quantification methods, and grading standards of grazing pressure. The results showed that the definition of grazing pressure in current studies could be classified into two categories: considering the number of livestock carried in the current grassland ecosystem only from the perspective of the amount of grazing livestock; or considering the impacts or consequences on grassland ecosystems. Small-scale manipulative experiments mainly quantified and divided gra-zing pressure by controlling the number of livestock, grazing duration, grazing area, etc. Ecosystem responses to grazing activities were also converted by the above indicators, while the large-scale data spatialization method only considered number of livestock per unit area. The method of remote sensing inversion focused on ecosystem responses, that is, the impacts of grazing activities on grasslands, and it was difficult to separate the role of climatic factors. The quantitative standards of grazing pressure in different grassland types were quite different, even in the same grassland type, and such difference was directly related to grassland productivity.
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Affiliation(s)
- Changjun Gu
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China.,National Disaster Reduction Center of China, Ministry of Emergency Management, Beijing 100124, China
| | - Yili Zhang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Linshan Liu
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Bo Wei
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Dianqing Gong
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Bohao Cui
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
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15
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Heimes D, Mark NA, Kuchen R, Pabst A, Becker P, Kyyak S, Thiem DGE, Schulze R, Kämmerer PW. Evaluation of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Terms of Staging and Treatment Strategies by Dental Students at Different Educational Levels. Medicina (Kaunas) 2023; 59. [PMID: 36837455 DOI: 10.3390/medicina59020252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/15/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
Background: The role of medication-related osteonecrosis of the jaw (MRONJ) as a dento-maxillo-facial pathology is becoming increasingly important due to its growing prevalence. The success of preventive and therapeutic measures relies mainly on the dentist's ability to correctly diagnose the disease. Methods: The aim of this study was to evaluate the skills of dental students of different educational levels in choosing the correct stage, diagnostics, and treatment option for MRONJ based on clinical and radiographic imaging (panoramic radiograph, CBCT). The study was designed as a cross-sectional cohort study. Twenty dental students were asked to complete a questionnaire in their third and fifth year of studies in which they had to correctly stage the disease, choose the radiological diagnostics and recommend the treatment. The control group contained experienced oral and maxillofacial surgeons. Results: With an overall performance of 59% (third year: 145.2/248 points; fifth year: 145.3/248 points), no statistically significant difference between the educational levels could be observed. The classification based on CBCT imaging was significantly more often correct compared to panoramic radiographs (p < 0.001). Conclusions: This study highlights students' lack of knowledge in staging, diagnostics, and treatment of MRONJ, even though the CBCT positively affected decision-making. No significant increase in knowledge could be confirmed through clinical education. This study highlights the need for students to catch up on MRONJ diagnostics and treatment planning. Further expansion of teaching in this disease's context and X-ray diagnostics is needed.
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16
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Peter S, Volkert AM, Radbruch L, Rolke R, Voltz R, Pfaff H, Scholten N. Influence of Palliative Care Qualifications on the Job Stress Factors of General Practitioners in Palliative Care: A Survey Study. Int J Environ Res Public Health 2022; 19:14541. [PMID: 36361420 PMCID: PMC9655917 DOI: 10.3390/ijerph192114541] [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] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/24/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Due to demographic change, the number of patients in palliative care (PC) is increasing. General Practitioners (GPs) are important PC providers who often have known their patients for a long time. PC can be demanding for GPs. However, there are few studies on the job stress factors of GPs performing PC and the potential influence of their PC training. To get more insights, a postal survey was performed with GPs in North Rhine, Germany. The questionnaire was based on a literature search, qualitative pre-studies, and the Hospital Consultants' Job Stress & Satisfaction Questionnaire (HCJSSQ). Participants state that a high level of responsibility, conflicting demands, and bureaucracy are the most important stressors they experienced in PC. The influence of PC qualification level on their perceived job stress factors is low. Only advanced but not specialist qualification shows a correlation with renumeration-related stress. Gender and work experience are more dominant influences. In our study, female GPs and physicians with more work experience tend to be more stressed. In conclusion, organisational barriers, such as administration, should be reduced and renumeration should be increased to facilitate the daily work of GPs.
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Affiliation(s)
- Sophie Peter
- Faculty of Human Sciences, University of Cologne, 50933 Cologne, Germany
- Faculty of Medicine, University of Cologne, 50933 Cologne, Germany
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University Hospital Cologne, 50933 Cologne, Germany
| | - Anna Maria Volkert
- Faculty of Human Sciences, University of Cologne, 50933 Cologne, Germany
- Faculty of Medicine, University of Cologne, 50933 Cologne, Germany
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University Hospital Cologne, 50933 Cologne, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, 53127 Bonn, Germany
| | - Roman Rolke
- Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
| | - Raymond Voltz
- Faculty of Medicine, University of Cologne, 50933 Cologne, Germany
- Department of Palliative Medicine, University Hospital Cologne, 50933 Cologne, Germany
- CIO Aachen Bonn Cologne Düsseldorf, 50937 Cologne, Germany
| | - Holger Pfaff
- Faculty of Human Sciences, University of Cologne, 50933 Cologne, Germany
- Faculty of Medicine, University of Cologne, 50933 Cologne, Germany
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University Hospital Cologne, 50933 Cologne, Germany
| | - Nadine Scholten
- Faculty of Human Sciences, University of Cologne, 50933 Cologne, Germany
- Faculty of Medicine, University of Cologne, 50933 Cologne, Germany
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University Hospital Cologne, 50933 Cologne, Germany
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17
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Borgonje PE, Wibier L, Noordman P, Woerdenbag HJ, Gareb B. The Development and Implementation of Airflow Visualization Studies ("Smoke" Studies) as a Training Tool in Aseptic Hospital Compounding Facilities. Pharmacy (Basel) 2022; 10. [PMID: 36136834 DOI: 10.3390/pharmacy10050101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
In the compounding facilities of hospital pharmacies, extemporaneous preparations for parenteral administration are produced using aseptic handling. The designated environment for this practice is a clean area, such as a laminar airflow (LAF) cabinet placed in a classified cleanroom complying with good manufacturing practices (GMP) and International Organization for Standardization (ISO) 14644-1 guidelines. The European GMP Annex 1 (Revision 2020) and United States Pharmacopeia (USP) <797> monograph state that airflow visualization studies (“smoke” studies) should be performed to substantiate the cleanroom and LAF cabinet performance and their qualification status. Even though smoke studies are required by these guidelines, current literature does not describe detailed practical protocols and acceptance criteria. The objective of this study was to develop and implement a practical smoke study protocol to ensure compliance with aseptic handling guidelines in hospital pharmacies. First, a literature search was performed to collect information about smoke study protocols and acceptance criteria. Subsequently, a smoke study protocol was developed for a downflow and crossflow LAF cabinet as well as for grade C/B cleanroom areas. As a proof of concept, the smoke study protocol for the downflow LAF cabinet was executed in the at-rest and in-operation states. Video recordings of the smoke studies were analyzed to assess the performance of the cabinet. Finally, the video recordings obtained from the smoke studies were used in a training program for hospital pharmacy operators, which showed that smoke studies might aid in operators’ aseptic handling awareness. To the best of our knowledge, the present study provides for the first time a practical approach for the development of smoke study protocols in a hospital pharmacy setting and shows potential for training operators, process optimization, and continuous quality improvement.
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18
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Frechen S, Rostami-Hodjegan A. Quality Assurance of PBPK Modeling Platforms and Guidance on Building, Evaluating, Verifying and Applying PBPK Models Prudently under the Umbrella of Qualification: Why, When, What, How and By Whom? Pharm Res 2022; 39:1733-1748. [PMID: 35445350 PMCID: PMC9314283 DOI: 10.1007/s11095-022-03250-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 01/31/2022] [Accepted: 03/31/2022] [Indexed: 12/19/2022]
Abstract
Modeling and simulation emerges as a fundamental asset of drug development. Mechanistic modeling builds upon its strength to integrate various data to represent a detailed structural knowledge of a physiological and biological system and is capable of informing numerous drug development and regulatory decisions via extrapolations outside clinically studied scenarios. Herein, physiologically based pharmacokinetic (PBPK) modeling is the fastest growing branch, and its use for particular applications is already expected or explicitly recommended by regulatory agencies. Therefore, appropriate applications of PBPK necessitates trust in the predictive capability of the tool, the underlying software platform, and related models. That has triggered a discussion on concepts of ensuring credibility of model-based derived conclusions. Questions like 'why', 'when', 'what', 'how' and 'by whom' remain open. We seek for harmonization of recent ideas, perceptions, and related terminology. First, we provide an overview on quality assurance of PBPK platforms with the two following concepts. Platform validation: ensuring software integrity, security, traceability, correctness of mathematical models and accuracy of algorithms. Platform qualification: demonstrating the predictive capability of a PBPK platform within a particular context of use. Second, we provide guidance on executing dedicated PBPK studies. A step-by-step framework focuses on the definition of the question of interest, the context of use, the assessment of impact and risk, the definition of the modeling strategy, the evaluation of the platform, performing model development including model building, evaluation and verification, the evaluation of applicability to address the question, and the model application under the umbrella of a qualified platform.
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Affiliation(s)
- Sebastian Frechen
- Bayer AG, Pharmaceuticals, Research & Development, Systems Pharmacology & Medicine, Leverkusen, 51368, Germany.
| | - Amin Rostami-Hodjegan
- Centre for Applied Pharmacokinetic Research, University of Manchester, Manchester, UK
- Certara UK Limited (Simcyp Division), Sheffield, UK
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19
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Mosch L, Agha-Mir-Salim L, Sarica MM, Balzer F, Poncette AS. Artificial Intelligence in Undergraduate Medical Education. Stud Health Technol Inform 2022; 294:821-822. [PMID: 35612217 DOI: 10.3233/shti220597] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AI will take on an increasingly important role in medicine. Therefore, AI competencies should be taught in medical school. We investigated the inventory of AI-related courses at German medical schools. The majority of faculty offer courses on AI, but mainly at the elective and introductory levels. Regarding the topic of AI, there is a gap in German medical education that should be closed.
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Affiliation(s)
- Lina Mosch
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Germany
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Germany
| | | | - Merve M Sarica
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Germany
| | - Felix Balzer
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Germany
| | - Akira-Sebastian Poncette
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Germany
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Germany
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20
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Park M, Lee BI, Choi J, Park Y, Park SJ, Lim JH, Lee J, Shin YG. Quantitative Analysis of Daporinad (FK866) and Its In Vitro and In Vivo Metabolite Identification Using Liquid Chromatography-Quadrupole-Time-of-Flight Mass Spectrometry. Molecules 2022; 27:2011. [PMID: 35335372 DOI: 10.3390/molecules27062011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/05/2023] Open
Abstract
Daporinad (FK866) is one of the highly specific inhibitors of nicotinamide phosphoribosyl transferase (NAMPT) and known to have its unique mechanism of action that induces the tumor cell apoptosis. In this study, a simple and sensitive liquid chromatography–quadrupole-time-of-flight–mass spectrometric (LC-qTOF-MS) assay has been developed for the evaluation of drug metabolism and pharmacokinetics (DMPK) properties of Daporinad in mice. A simple protein precipitation method using acetonitrile (ACN) was used for the sample preparation and the pre-treated samples were separated by a C18 column. The calibration curve was evaluated in the range of 1.02~2220 ng/mL and the quadratic regression (weighted 1/concentration2) was used for the best fit of the curve with a correlation coefficient ≥ 0.99. The qualification run met the acceptance criteria of ±25% accuracy and precision values for QC samples. The dilution integrity was verified for 5, 10 and 30-fold dilution and the accuracy and precision of the dilution QC samples were also satisfactory within ±25% of the nominal values. The stability results indicated that Daporinad was stable for the following conditions: short-term (4 h), long-term (2 weeks), freeze/thaw (three cycles). This qualified method was successfully applied to intravenous (IV) pharmacokinetic (PK) studies of Daporinad in mice at doses of 5, 10 and 30 mg/kg. As a result, it showed a linear PK tendency in the dose range from 5 to 10 mg/kg, but a non-linear PK tendency in the dose of 30 mg/kg. In addition, in vitro and in vivo metabolite identification (Met ID) studies were conducted to understand the PK properties of Daporinad and the results showed that a total of 25 metabolites were identified as ten different types of metabolism in our experimental conditions. In conclusion, the LC-qTOF-MS assay was successfully developed for the quantification of Daporinad in mouse plasma as well as for its in vitro and in vivo metabolite identification.
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21
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Weaver JS, Pintar AL, Beauchamp C, Joress H, Moon KW, Phan TQ. Demonstration of a laser powder bed fusion combinatorial sample for high-throughput microstructure and indentation characterization. Mater Des 2021; 209:10.1016/j.matdes.2021.109969. [PMID: 36937330 PMCID: PMC10020991 DOI: 10.1016/j.matdes.2021.109969] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
High-throughput experiments that use combinatorial samples with rapid measurements can be used to provide process-structure-property information at reduced time, cost, and effort. Developing these tools and methods is essential in additive manufacturing where new process-structure-property information is required on a frequent basis as advances are made in feedstock materials, additive machines, and post-processing. Here we demonstrate the design and use of combinatorial samples produced on a commercial laser powder bed fusion system to study 60 distinct process conditions of nickel superalloy 625: five laser powers and four laser scan speeds in three different conditions. Combinatorial samples were characterized using optical and electron microscopy, x-ray diffraction, and indentation to estimate the porosity, grain size, crystallographic texture, secondary phase precipitation, and hardness. Indentation and porosity results were compared against a regular sample. The smaller-sized regions (3 mm × 4 mm) in the combinatorial sample have a lower hardness compared to a larger regular sample (20 mm × 20 mm) with similar porosity (< 0.03 %). Despite this difference, meaningful trends were identified with the combinatorial sample for grain size, crystallographic texture, and porosity versus laser power and scan speed as well as trends with hardness versus stress-relief condition.
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Affiliation(s)
- Jordan S. Weaver
- Engineering Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899
| | - Adam L. Pintar
- Information Technology Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899
| | - Carlos Beauchamp
- Materials Measurement Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899
| | - Howie Joress
- Materials Measurement Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899
| | - Kil-Won Moon
- Materials Measurement Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899
| | - Thien Q. Phan
- Engineering Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899
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22
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Pandey MS, Wang C, Umlauf S, Lin S. Simultaneous Inhibition of PD-1 and Stimulation of CD40 Signaling Pathways by Anti-PD-L1/CD40L Bispecific Fusion Protein Synergistically Activate Target and Effector Cells. Int J Mol Sci 2021; 22:11302. [PMID: 34768776 DOI: 10.3390/ijms222111302] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/22/2021] [Accepted: 10/15/2021] [Indexed: 12/15/2022] Open
Abstract
Bispecific antibodies (BsAbs) or fusion proteins (BsAbFPs) present a promising strategy for cancer immunotherapy. Numerous BsAbs targeting coinhibitory and costimulatory pathways have been developed for retargeting T cells and antigen presenting cells (APCs). It is challenging to assess the potency of BsAb that engages two different signaling pathways simultaneously in a single assay format, especially when the two antigen targets are expressed on different cells. To explore the potency of anti-PD-L1/CD40L BsAbFP, a fusion protein that binds to human CD40 and PD-L1, we engineered CHO cells as surrogate APCs that express T cell receptor activator and PD-L1, Jurkat cells with PD-1 and NFAT-luciferase reporter as effector T cells, and Raji cell with NFkB-luciferase that endogenously expresses CD40 as accessory B cells. A novel reporter gene bioassay was developed using these cell lines that allows anti-PD-L1/CD40L BsAbFP to engages both PD-1/PD-L1 and CD40/CD40L signaling pathways in one assay. As both reporters use firefly luciferase, the effects of activating both signaling pathways is observed as an increase in luminescence, either as a higher upper asymptote, a lower EC50, or both. This dual target reporter gene bioassay system reflects potential mechanism of action and demonstrated the ability of anti-PD-L1/CD40L BsAbFP to synergistically induce biological response compared to the combination of anti-PD-L1 monovalent monoclonal antibody and agonist CD40L fusion protein, or either treatment alone. The results also showed a strong correlation between the drug dose and biological response within the tested potency range with good linearity, accuracy, precision, specificity and stability indicating properties, suggesting that this “three-cell-in-one” dual target reporter gene bioassay is suitable for assessing potency, structure-function and critical quality attributes of anti-PD-L1/CD40L BsAbFP. This approach could be used for developing dual target bioassays for other BsAbs and antibodies used for combination therapy.
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Schneider MR, Oelgeschlaeger M, Burgdorf T, van Meer P, Theunissen P, Kienhuis AS, Piersma AH, Vandebriel RJ. Applicability of organ-on-chip systems in toxicology and pharmacology. Crit Rev Toxicol 2021; 51:540-554. [PMID: 34463591 DOI: 10.1080/10408444.2021.1953439] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Organ-on-chip (OoC) systems are microfabricated cell culture devices designed to model functional units of human organs by harboring an in vitro generated organ surrogate. In the present study, we reviewed issues and opportunities related to the application of OoC in the safety and efficacy assessment of chemicals and pharmaceuticals, as well as the steps needed to achieve this goal. The relative complexity of OoC over simple in vitro assays provides advantages and disadvantages in the context of compound testing. The broader biological domain of OoC potentially enhances their predictive value, whereas their complexity present issues with throughput, standardization and transferability. Using OoCs for regulatory purposes requires detailed and standardized protocols, providing reproducible results in an interlaboratory setting. The extent to which interlaboratory standardization of OoC is feasible and necessary for regulatory application is a matter of debate. The focus of applying OoCs in safety assessment is currently directed to characterization (the biology represented in the test) and qualification (the performance of the test). To this aim, OoCs are evaluated on a limited scale, especially in the pharmaceutical industry, with restricted sets of reference substances. Given the low throughput of OoC, it is questionable whether formal validation, in which many reference substances are extensively tested in different laboratories, is feasible for OoCs. Rather, initiatives such as open technology platforms, and collaboration between OoC developers and risk assessors may prove an expedient strategy to build confidence in OoCs for application in safety and efficacy assessment.
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Affiliation(s)
- Marlon R Schneider
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Michael Oelgeschlaeger
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Tanja Burgdorf
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Peter van Meer
- Section on Pharmacology, Toxicology and Kinetics, Medicines Evaluation Board, Utrecht, The Netherlands.,Department of Pharmaceutics, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Peter Theunissen
- Section on Pharmacology, Toxicology and Kinetics, Medicines Evaluation Board, Utrecht, The Netherlands
| | - Anne S Kienhuis
- Laboratory for Health Protection, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Aldert H Piersma
- Laboratory for Health Protection, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Rob J Vandebriel
- Laboratory for Health Protection, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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Mathews S, Rabani R, Rasti M, Viswanathan S. In-house abbreviated qualification of a real-time polymerase chain reaction method and strategies to amplify mycoplasma detection in human mesenchymal stromal cells. Cytotherapy 2021; 23:1036-1044. [PMID: 34446358 DOI: 10.1016/j.jcyt.2021.07.002] [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: 04/08/2021] [Revised: 06/27/2021] [Accepted: 07/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AIMS In this study, the authors performed an in-house abbreviated qualification of a commercially available real-time polymerase chain reaction (PCR) kit for limit of detection (LOD), matrix interference and ruggedness of mycoplasma detection in a human bone marrow-derived mesenchymal stromal cell (MSC(M)) investigational cell product (NCT02351011). The approach used was similar to an abbreviated qualification the authors previously conducted for endpoint PCR, which was accepted by Canadian regulators for final product release of the same MSC(M) investigational cell product for treatment of osteoarthritis patients (NCT02351011). With patient consent, biobanked MSCs(M) were re-analyzed by real-time PCR for mycoplasma detection to conduct in-house qualification of the kit. METHODS LOD was determined by spiking MSCs(M) with a series of 10-fold dilutions of two commercially available genomic DNA (gDNA) reference standards for Mycoplasma arginini (M. arginini) and Mycoplasma hominis (M. hominis). Matrix interference was tested by using 10-fold dilutions of MSC(M)s down to 4500 cells/mL. Polyadenylic acid (poly[A]) was used to improve DNA recovery in samples with 4500-45 000 MSCs(M)/mL. Real-time PCR tests performed on different days were compared to evaluate ruggedness. RESULTS Real-time PCR analysis showed a conservative LOD of 40 genome copies (GCs)/mL and 240 GCs/mL, which are equivalent to 10 colony-forming units (CFUs)/mL, for M. arginini and M. hominis, respectively. According to a less conservative manufacturer-based criterion for positivity, the kit detected 0.4 GC/mL (0.1 CFU/mL) and 24 GCs/mL (1 CFU/mL) M. arginini and M. hominis, respectively. Real-time PCR with different MSC(M) dilutions did not show matrix interference. However, DNA recovery was compromised at MSC(M) concentrations at or below 45 000 cells/mL. The addition of poly(A) as a DNA carrier improved DNA recovery and allowed an LOD, considered here to be equivalent to 10 CFUs/mL, to be achieved, which was not possible in diluted MSC(M) samples (≤45 000 cells/mL) in the absence of poly(A). Ruggedness was demonstrated with tests (n = 18) performed on different days, with an average overall inter-assay percent coefficient of variation of less than 4 for M. arginini (3.62 [400 GCs/mL], 3.61 [40 GCs/mL]) and less than 3 for M. hominis (2.83 [2400 GCs/mL], 1.95 [240 GCs/mL]). CONCLUSIONS A commercially available real-time PCR mycoplasma detection kit was qualified for evaluating mycoplasma contamination in investigational MSC(M) products and met the criteria used previously (and accepted by Canadian regulators) for in-house qualification of an endpoint PCR mycoplasma detection kit, and the addition of poly(A) addressed the poor recovery of mycoplasma gDNA in samples with low cell numbers.
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Affiliation(s)
- Smitha Mathews
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
| | - Razieh Rabani
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
| | - Mozhgan Rasti
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
| | - Sowmya Viswanathan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Toronto, Canada; Krembil Research Institute, University Health Network, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Canada; Division of Hematology, Department of Medicine, University of Toronto, Toronto, Canada.
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Catana C, Laforest R, An H, Boada F, Cao T, Faul D, Jakoby B, Jansen FP, Kemp BJ, Kinahan PE, Larson PEZ, Levine MA, Maniawski P, Mawlawi O, McConathy J, McMillan A, Price JC, Rajagopal A, Sunderland J, Veit-Haibach P, Wangerin KA, Ying C, Hope TA. A Path to Qualification of PET/MR Scanners for Multicenter Brain Imaging Studies: Evaluation of MR-based Attenuation Correction Methods Using a Patient Phantom. J Nucl Med 2021; 63:615-621. [PMID: 34301784 PMCID: PMC8973286 DOI: 10.2967/jnumed.120.261881] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/06/2021] [Indexed: 11/25/2022] Open
Abstract
PET/MRI scanners cannot be qualified in the manner adopted for hybrid PET/CT devices. The main hurdle with qualification in PET/MRI is that attenuation correction (AC) cannot be adequately measured in conventional PET phantoms because of the difficulty in converting the MR images of the physical structures (e.g., plastic) into electron density maps. Over the last decade, a plethora of novel MRI-based algorithms has been developed to more accurately derive the attenuation properties of the human head, including the skull. Although promising, none of these techniques has yet emerged as an optimal and universally adopted strategy for AC in PET/MRI. In this work, we propose a path for PET/MRI qualification for multicenter brain imaging studies. Specifically, our solution is to separate the head AC from the other factors that affect PET data quantification and use a patient as a phantom to assess the former. The emission data collected on the integrated PET/MRI scanner to be qualified should be reconstructed using both MRI- and CT-based AC methods, and whole-brain qualitative and quantitative (both voxelwise and regional) analyses should be performed. The MRI-based approach will be considered satisfactory if the PET quantification bias is within the acceptance criteria specified here. We have implemented this approach successfully across 2 PET/MRI scanner manufacturers at 2 sites.
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Affiliation(s)
- Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, United States
| | - Richard Laforest
- Mallinckrodt Institute of Radiology, Washington University School of Medicine
| | | | - Fernando Boada
- Department of Radiology, Center for Advanced Imaging Innovation and Research, New York University Langone Medical Center
| | - Tuoyu Cao
- Shanghai United Imaging Healthcare Co., Ltd., China
| | | | | | | | | | | | | | | | - Piotr Maniawski
- Philips Healthcare, Advanced Molecular Imaging, United States
| | | | | | - Alan McMillan
- University of Wisconsin School of Medicine and Public Health
| | | | - Abhejit Rajagopal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | | | | | | | - Chunwei Ying
- Department of Biomedical Engineering, Washington University in St. Louis
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Graf T, Seisenberger C, Wiedmann M, Wohlrab S, Anderka O. Best practices on critical reagent characterization, qualification, and life cycle management for HCP immunoassays. Biotechnol Bioeng 2021; 118:3633-3639. [PMID: 34241893 DOI: 10.1002/bit.27881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/28/2021] [Revised: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 11/06/2022]
Abstract
The performance of immunoassays for the detection and quantification of host-cell proteins (HCPs) in biopharmaceuticals depends on the quality of the critical assay reagents. Not only their preparation, but also a stringent life-cycle management, including reagent qualification, requalification, and replacement, plays a crucial role in ensuring consistent and reliable results. To provide a cross-industry perspective on HCP reagent management, we conducted a survey on common practices among several pharmaceutical and biotech companies. Based on its outcome, as well as informed by a corresponding roundtable session ("Managing critical reagents over time") at the BioPharmaceutical Emerging Best Practices Association HCP conference in 2019, this study presents specific recommendations and proven concepts to support immunoassay reagent management for monitoring HCPs.
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Abstract
Organ-on-chip (OoC) technology is thriving thanks to stem cells availability and international OoC programs. Concerted standardization, qualification, and independent testing of devices are needed to coherently develop OoC technology further and fulfill its potential in drug development, disease modeling, and personalized medicine. The OoC roadmap can lead the way forward.
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Hendrix SB, Mogg R, Wang SJ, Chakravarty A, Romero K, Dickson SP, Sauer JM, McShane LM. Perspectives on statistical strategies for the regulatory biomarker qualification process. Biomark Med 2021; 15:669-684. [PMID: 34037457 PMCID: PMC8293027 DOI: 10.2217/bmm-2020-0523] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Qualification of a biomarker for use in a medical product development program requires a statistical strategy that aligns available evidence with the proposed context of use (COU), identifies any data gaps to be filled and plans any additional research required to support the qualification. Accumulating, interpreting and analyzing available data is outlined, step-by-step, illustrated by a qualified enrichment biomarker example and a safety biomarker in the process of qualification. The detailed steps aid requestors seeking qualification of biomarkers, allowing them to organize the available evidence and identify potential gaps. This provides a statistical perspective for assessing evidence that parallels clinical considerations and is intended to guide the overall evaluation of evidentiary criteria to support a specific biomarker COU.
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Affiliation(s)
| | - Robin Mogg
- Bill & Melinda Gates Medical Research Institute, MA 02139, USA
| | - Sue Jane Wang
- Office of Biostatistics, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food & Drug Administration, MD 20993, USA
| | - Aloka Chakravarty
- Office of the Commissioner, US Food & Drug Administration, MD 20993, USA
| | - Klaus Romero
- Translational and Safety Sciences Program, Critical Path Institute, AZ 85718, USA
| | | | - John-Michael Sauer
- Translational and Safety Sciences Program, Critical Path Institute, AZ 85718, USA
| | - Lisa M McShane
- Biometric Research Program, Division of Cancer Treament and Diagnosis, National Cancer Institute, National Institutes of Health, MD 20892, USA
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Chorley BN, Atabakhsh E, Doran G, Gautier JC, Ellinger-Ziegelbauer H, Jackson D, Sharapova T, Yuen PST, Church RJ, Couttet P, Froetschl R, McDuffie J, Martinez V, Pande P, Peel L, Rafferty C, Simutis FJ, Harrill AH. Methodological considerations for measuring biofluid-based microRNA biomarkers. Crit Rev Toxicol 2021; 51:264-282. [PMID: 34038674 DOI: 10.1080/10408444.2021.1907530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
MicroRNAs (miRNAs) are small non-coding RNA that regulate the expression of messenger RNA and are implicated in almost all cellular processes. Importantly, miRNAs can be released extracellularly and are stable in these matrices where they may serve as indicators of organ or cell-specific toxicity, disease, and biological status. There has thus been great enthusiasm for developing miRNAs as biomarkers of adverse outcomes for scientific, regulatory, and clinical purposes. Despite advances in measurement capabilities for miRNAs, miRNAs are still not routinely employed as noninvasive biomarkers. This is in part due to the lack of standard approaches for sample preparation and miRNA measurement and uncertainty in their biological interpretation. Members of the microRNA Biomarkers Workgroup within the Health and Environmental Sciences Institute's (HESI) Committee on Emerging Systems Toxicology for the Assessment of Risk (eSTAR) are a consortium of private- and public-sector scientists dedicated to developing miRNAs as applied biomarkers. Here, we explore major impediments to routine acceptance and use of miRNA biomarkers and case examples of successes and deficiencies in development. Finally, we provide insight on miRNA measurement, collection, and analysis tools to provide solid footing for addressing knowledge gaps toward routine biomarker use.
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Affiliation(s)
- Brian N Chorley
- U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | | | | | | | | | - David Jackson
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Peter S T Yuen
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Rachel J Church
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | | | | | | | | | | | - Lauren Peel
- Health and Environmental Sciences Institute, Washington, DC, USA
| | | | | | - Alison H Harrill
- National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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30
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Chen W, Pandey M, Sun H, Rolong A, Cao M, Liu D, Wang J, Zeng L, Hunter A, Lin S. Development of a mechanism of action-reflective, dual target cell-based reporter bioassay for a bispecific monoclonal antibody targeting human CTLA-4 and PD-1. MAbs 2021; 13:1914359. [PMID: 33870864 PMCID: PMC8078673 DOI: 10.1080/19420862.2021.1914359] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
T-cell-mediated immunotherapy has generated much excitement after the success of therapeutic biologics targeting immune checkpoint molecules. Bispecific antibodies (BsAbs) that recognize two antigen targets are a fast-growing class of biologics offering promising clinical benefits for cancer immunotherapy. Due to the complexity of the molecule structure and the potential mechanism of action (MOA) that involves more than one signaling pathway, it is critical to develop appropriate bioassays for measuring potency and characterizing the biological properties of BsAbs. Here, we present a dual target, cell-based reporter bioassay for a BsAb that binds human CTLA-4 and PD-1 and targets two subsequent signaling pathways that negatively regulate T-cell activation. This reporter bioassay is capable of measuring the potency of both antigen target arms in one assay, which would not be achievable using two single target bioassays. This dual target reporter bioassay demonstrates good performance characteristics suitable for lot release, stability testing, critical quality attribute assessment, and biological properties characterization of the CTLA-4/PD-1 BsAb. Furthermore, this assay can capture the synergistic effect of anti-CTLA-4 and anti-PD-1 activity of the BsAb. Compared to single target assays, this dual target bioassay could better reflect the potential MOA of BsAbs and could be used for evaluation of other bispecific biologics, as well as antibody combination therapies.
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Affiliation(s)
- Weimin Chen
- Bioassay Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Madhu Pandey
- Bioassay Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Hong Sun
- Bioassay Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Andrea Rolong
- Bioassay Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Mingyan Cao
- Analytical Sciences, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Dengfeng Liu
- Analytical Sciences, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Jihong Wang
- Analytical Sciences, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Lingmin Zeng
- Late Oncology Biometrics, AstraZeneca, Gaithersburg, MD, USA
| | - Alan Hunter
- Purification Process Sciences, AstraZeneca, Gaithersburg, MD, USA
| | - Shihua Lin
- Bioassay Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
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Jachan DE, Müller‐Werdan U, Lahmann NA. Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services. Nurs Open 2021; 8:755-765. [PMID: 33570279 PMCID: PMC7877149 DOI: 10.1002/nop2.678] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/12/2020] [Revised: 09/22/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
AIM To identify factors for and perceived consequences of nursing errors by nursing staff in home care services in correlation with qualification, work experience, working hours and trainings. BACKGROUND Patient safety has increasingly been brought into focus of politics and care practices over the past few years. However, little evidence has been provided yet on nursing errors in out-of-hospital settings. DESIGN A cross-sectional study. METHODS Randomized sample of 107 home care services and 656 nurses and nursing assistants recruited from all 16 federal states in Germany. RESULTS Missing trainings on error management within the past 2 years were identified to be an important factor for mistakes regarding hygienic measures and medication administration. However, most errors arose in documentation without any significant differences in qualification, work experience, training and working hours. CONCLUSION Findings indicate that insufficient hygiene and medication administration might be reduced by implementing error management trainings on a regular basis in home care services.
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Affiliation(s)
- Deborah Elisabeth Jachan
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthDepartment of Geriatric MedicineNursing Research Group in GeriatricsCharitéplatz 1Berlin10117Germany
| | - Ursula Müller‐Werdan
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthDepartment of Geriatric MedicineNursing Research Group in GeriatricsCharitéplatz 1Berlin10117Germany
| | - Nils Axel Lahmann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthDepartment of Geriatric MedicineNursing Research Group in GeriatricsCharitéplatz 1Berlin10117Germany
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Gromova M, Vaggelas A, Dallmann G, Seimetz D. Biomarkers: Opportunities and Challenges for Drug Development in the Current Regulatory Landscape. Biomark Insights 2020; 15:1177271920974652. [PMID: 33343195 PMCID: PMC7727038 DOI: 10.1177/1177271920974652] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 10/11/2020] [Accepted: 10/25/2020] [Indexed: 12/17/2022] Open
Abstract
Biomarkers are widely used at every stage of drug discovery and development. Utilisation of biomarkers has a potential to make drug discovery, development and approval processes more efficient. An overview of the current global regulatory landscape is presented in this article with particular emphasis on the validation and qualification of biomarkers, as well as legal framework for companion diagnostics. Furthermore, this article shows how the number of approved drugs with at least 1 biomarker used during development (biomarker acceptance) is affected by the recent advances in the biomarker regulations. More than half of analysed approvals were supported by biomarker data and there has been a slight increase in acceptance of biomarkers in recent years, even though the growth is not continuous. For certain pharmacotherapeutic groups, approvals with biomarkers are more common than without. Examples include immunosuppressants, immunostimulants, drugs used in diabetes, antithrombotic drugs, antineoplastic agents and antivirals. As a conclusion, potential benefits, challenges and opportunities of using biomarkers in drug discovery and development in the current regulatory landscape are summarised and discussed.
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Fodor M, Mikola EE, Geösel A, Stefanovits-Bányai É, Mednyánszky Z. Application of Near-Infrared Spectroscopy to Investigate Some Endogenic Properties of Pleurotus ostreatus Cultivars. Sensors (Basel) 2020; 20:E6632. [PMID: 33228094 DOI: 10.3390/s20226632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 11/21/2022]
Abstract
Fourteen different Pleurotus ostreatus cultivars (Po_1–Po_14) were tested for free amino acid content (fAA), total polyphenol content (TPC), and antioxidant capacity (Ferric Reducing Ability of Plasma—FRAP) to select the cultivars with the most favorable traits. Automatic amino acid analyzer (fAA) and spectrophotometric assay (TPC, FRAP) results as well as Fourier-transform near infrared (FT-NIR) spectra were evaluated with different chemometric methods (Kruskal–Wallis test, Principal Component Analysis—PCA, Linear Discriminant Analysis—LDA). Based on total free amino acid concentrations and FRAP values, the Po_2 cultivar was found to be the most favorable. Types Po_3, Po_8, Po_10 and Po_12 were separated using PCA. Based on the spectral profile, they may contain polyphenols and reducing compounds of different qualities. LDA classification that was based on the concentrations of all free amino acids, cysteine, and proline of the cultivars was performed with an accuracy of over 90%. LDA classification that was based on the TPC and FRAP values was performed with an accuracy of over 83%.
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Isobe M, Kataoka Y, Chikazawa K, Hada T, Nishigori H, Takahashi T, Enomoto T. Correlation between the number of laparoscopy-qualified gynecologists and the proportion of laparoscopic surgeries for benign gynecological diseases in Japan: An ecological study. J Obstet Gynaecol Res 2020; 47:329-336. [PMID: 33059381 DOI: 10.1111/jog.14528] [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: 06/09/2020] [Revised: 09/08/2020] [Accepted: 09/30/2020] [Indexed: 11/26/2022]
Abstract
AIM We aimed to evaluate regional disparities in the proportion of the three main laparoscopic surgeries for benign gynecological diseases among 47 prefectures in Japan and their correlation with the number of laparoscopy-qualified gynecologists per population. METHODS In this retrospective ecological study, we collected the data of patients from 47 prefectures in 2017 using "The National Database of Health Insurance Claims and Specific Health Checkups of Japan" Open Data from the Ministry of Health, Labor and Welfare in Japan. The primary outcome of the study was the proportion of laparoscopic surgeries conducted for benign gynecologic diseases (hysterectomy, myomectomy and surgery for the benign ovarian diseases). The main exposure was the number of laparoscopy-qualified gynecologists per 100 000 females. RESULTS The average proportion of laparoscopic hysterectomies, myomectomies and surgeries for the benign ovarian disease were 38% (standard deviation (SD) 16, range 12-74), 48% (SD 18, range 9-81) and 60% (SD 11, range 36-79), respectively. Multiple regression analysis showed a significant correlation between the number of laparoscopy-qualified gynecologists per 100 000 females and the proportion of the three main laparoscopic surgeries. CONCLUSION There are obvious regional disparities in the proportion of the three main laparoscopic procedures for benign gynecological diseases among 47 prefectures. The number of laparoscopy-qualified gynecologists correlated significantly with these regional disparities. The academic society should monitor these regional disparities and make an effort to reduce these regional disparities by increasing laparoscopy-qualified gynecologists in areas where the widespread use of laparoscopic techniques is lagging.
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Affiliation(s)
- Masanori Isobe
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuki Kataoka
- Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kenro Chikazawa
- Department of Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Tomonori Hada
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan
| | - Hiroshi Nishigori
- Centre for Medical Education, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshifumi Takahashi
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Nemes E, Abrahams D, Scriba TJ, Ratangee F, Keyser A, Makhethe L, Erasmus M, Mabwe S, Bilek N, Rozot V, Geldenhuys H, Hatherill M, Lempicki MD, Holm LL, Bogardus L, Ginsberg AM, Blauenfeldt T, Smith B, Ellis RD, Loxton AG, Walzl G, Andersen P, Ruhwald M. Diagnostic Accuracy of Early Secretory Antigenic Target-6-Free Interferon-gamma Release Assay Compared to QuantiFERON-TB Gold In-tube. Clin Infect Dis 2020; 69:1724-1730. [PMID: 30668657 PMCID: PMC6821223 DOI: 10.1093/cid/ciz034] [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: 10/04/2018] [Accepted: 01/16/2019] [Indexed: 01/08/2023] Open
Abstract
Background Early secretory antigenic target-6 (ESAT-6) is an immunodominant Mycobacterium tuberculosis (M.tb) antigen included in novel vaccines against tuberculosis (TB) and in interferon-gamma (IFN-γ) release assays (IGRAs). Therefore, the availability of an ESAT-6–free IGRA is essential to determine M.tb infection status following vaccination with ESAT-6–containing vaccines. We aimed to qualify a recently developed ESAT-6–free IGRA and to assess its diagnostic performance in comparison to QuantiFERON-TB Gold In-tube (QFT). Methods Participants with different levels of M.tb exposure and TB disease were enrolled to determine the ESAT-6–free IGRA cutoff, test assay performance in independent cohorts compared to standard QFT, and perform a technical qualification of antigen-coated blood collection tubes. Results ESAT-6–free IGRA antigen recognition was evaluated in QFT-positive and QFT-negative South African adolescents. The ESAT-6–free IGRA cutoff was established at 0.61 IU/mL, based on receiver operating characteristic analysis in M.tb-unexposed controls and microbiologically confirmed pulmonary TB patients. In an independent cohort of healthy adolescents, levels of IFN-γ released in QFT and ESAT-6–free IGRA were highly correlated (P < .0001, r = 0.83) and yielded comparable positivity rates, 41.5% and 43.5%, respectively, with 91% concordance between the tests (kappa = 0.82; 95% confidence interval, 0.74–0.90; McNemar test P = .48). ESAT-6–free IGRA blood collection tubes had acceptable lot-to-lot variability, precision, and stability. Conclusions The novel ESAT-6–free IGRA had diagnostic accuracy comparable to QFT and is suitable for use in clinical trials to assess efficacy of candidate TB vaccines to prevent established M.tb infection.
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Affiliation(s)
- Elisa Nemes
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Deborah Abrahams
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Thomas J Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Frances Ratangee
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Alana Keyser
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Lebohang Makhethe
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Mzwandile Erasmus
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Simbarashe Mabwe
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Nicole Bilek
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Virginie Rozot
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Hennie Geldenhuys
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | - Mark Hatherill
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine & Division of Immunology, Department of Pathology, University of Cape Town
| | | | | | | | | | | | - Bronwyn Smith
- South Africa Department of Science and Technology-National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town
| | | | - Andre G Loxton
- South Africa Department of Science and Technology-National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town
| | - Gerhard Walzl
- South Africa Department of Science and Technology-National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town
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Borys M, Wiech M, Zyzak K, Majchrzak A, Kosztyła A, Michalak A, Janowska K, Bierut M, Sokol M, Walewska A, Czuczwar M. Job satisfaction among anesthetic and intensive care nurses - multicenter, observational study. Anaesthesiol Intensive Ther 2019; 51:102-6. [PMID: 31268270 DOI: 10.5114/ait.2019.85804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It is known that job satisfaction has an important impact on efficacy or burnout syndrome of medical personnel. Many studies have concerned job satisfaction among critical care nurses. Not as many have focused on anesthesia nurses working in operating theaters. In Poland, anesthesia and intensive care is a combined specialty for nurses. However, nurses work in an intensive care unit (ICU) or in an operating room (OR), and very rarely in both settings. We would like to compare satisfaction between ICU and OR nurses. METHODS It was a multicenter cross-sectional study. 406 nurses from thirteen hospitals participated in this study. All respondents filled in the questionnaire that contained fifteen Likert-like questions reflecting different aspects of job satisfaction. Demographic data were also collected. RESULTS We did not find a significant difference between ICU and OR nurses in the overall job satisfaction. Furthermore, the type of hospital did not significantly influence satisfaction of our study participants. The most important factor which differentiated the level of satisfaction among nurses was the region of Poland in which they worked. Interestingly, nurses who worked in ICUs were significantly younger in comparison to their colleagues from ORs. CONCLUSION The results of our study suggest that the region of the country in which nurses work might play a very important role in their satisfaction.
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Nepeina K, Istomina N, Bykova O. The Role of Field Training in STEM Education: Theoretical and Practical Limitations of Scalability. Eur J Investig Health Psychol Educ 2020; 10:511-529. [PMID: 34542500 PMCID: PMC8314252 DOI: 10.3390/ejihpe10010037] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 02/29/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022] Open
Abstract
In this article, we consider the features of the perception of student information in science, technology, engineering, and mathematics (STEM) education, in order to draw the attention of researchers to the topic of learning in practice through field training. The article shows the results of these studies in Russia and the Commonwealth of Independent States (CIS countries: Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, and Uzbekistan, as an example) to reflect the global trends. For this purpose, we examined the expectations of students in Russia and the CIS countries from training related to lectures and field training. We created a questionnaire and distributed it in three Moscow-based universities (Moscow State University of Geodesy and Cartography-MIIGAiK, Moscow Aviation Institute-MAI, and Moscow City University-MCU). Our key assumption is that field practices in Russian universities are qualitatively different from the phenomenon described in European literature, where digital or remote field practices have already emerged. The results obtained through the survey show the tendency of students' perceptions to fulfill practical duties (in a laboratory with instruments of field training) in STEM education.
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Affiliation(s)
- Kseniia Nepeina
- Research Station of the Russian Academy of Sciences in Bishkek (RS RAS), Bishkek-49, RS RAS, Bishkek 720049, Kyrgyzstan
- Correspondence: ; Tel.: +996-(312)613140 or +996-755-77-07-50; Fax: +996-312611459
| | - Natalia Istomina
- Moscow State University of Geodesy and Cartography (MIIGAiK), Gorokhovsky pereulok, 4, 105064 Moscow, Russia; (N.I.); (O.B.)
| | - Olga Bykova
- Moscow State University of Geodesy and Cartography (MIIGAiK), Gorokhovsky pereulok, 4, 105064 Moscow, Russia; (N.I.); (O.B.)
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Linsen L, Van Landuyt K, Ectors N. Automated Sample Storage in Biobanking to Enhance Translational Research: The Bumpy Road to Implementation. Front Med (Lausanne) 2020; 6:309. [PMID: 31998730 PMCID: PMC6962113 DOI: 10.3389/fmed.2019.00309] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/06/2019] [Indexed: 11/24/2022] Open
Abstract
The low reproducibility of biomarker research is a major holdback for the translation of research results to the bedside. Sample integrity has been identified as a key factor that contributes to improved reproducibility. The key mission of biobanks is to ensure that all activities and materials are managed according to standardized procedures and best practices to ensure and preserve sample integrity. When handling large numbers of biospecimens automation of sample handling and storage is often the method of choice to maintain and improve sample integrity. In December 2013, the centralized Biobank of the University Hospitals and the Catholic University of Leuven (UZ KU Leuven) decided to implement automated systems for sample storage and retrieval, one for storage at −20°C and one for storage at −80°C. Here we describe the extensive process of installation, acceptance, validation, and implementation of these two systems. Overall it took about 4 years to effectively take the systems into production. Multiple issues resulted in the delayed implementation, with labware change, quality of the initial installation, and misunderstanding of biobank concerns being the most impacting. Significant effort in terms of time and resources from both the automated store supplier as well as the biobank itself was needed to achieve a successful implementation. Within 15 months of actual integration in the biobank workflow, over 63 k samples were placed into the systems. Actual hands-on sample handling and retrieval times were substantially reduced, although this implied the shift of dedicated personnel time from the researchers' laboratories to the biobank. With the successful implementation of automated frozen sample storage systems, the centralized UZ KU Leuven Biobank is now also able to efficiently support large-scale translational research.
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Affiliation(s)
- Loes Linsen
- AC Biobanking, University Hospitals Leuven, Leuven, Belgium
| | | | - Nadine Ectors
- AC Biobanking, University Hospitals Leuven, Leuven, Belgium
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Ochman M, Urlik M, Tatoj Z, Zawadzki F, Wajda-Pokrontka M, Latos M, Przybyłowski P, Zembala M. Retrospective cohort study of patients qualified for lung transplantation due to idiopathic pulmonary fibrosis - single-centre experience. Arch Med Sci 2020; 16:621-626. [PMID: 32399111 PMCID: PMC7212221 DOI: 10.5114/aoms.2019.82662] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/14/2019] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive disease. Pharmacological treatment can only slow its progression. However, lung transplantation (LTx) is the only treatment for patients with its end-stage form. This study analysed the long-term results of the qualification process of patients with IPF recruited for LTx in a single centre. MATERIAL AND METHODS Retrospective analysis of 84 patients (56 patients who died while on the waiting list and 28 patients who underwent LTx) with end-stage IPF who were qualified for LTx between 2006 and 2017 at the Silesian Centre for Heart Diseases (Zabrze, Poland). RESULTS Cox proportional hazard analysis showed that the only parameter was 6-minute walk test (6MWT) distance, which statistically significantly impacted the probability of receiving a graft (parameter assessment, 0.00523; p = 0.006; 95% confidence interval (CI): 0.0015-0.009; hazard ratio (HR) = 1.005) as well as that of death while on the waiting list (parameter assessment, -0.0054; p = 0.003; 95% CI: -0.009- (-0.0017); HR = 0.995). Patients with a 253-350-m 6MWT distance had 3 times greater risk of dying while on the waiting list than those who walked more than 350 m. Other factors, such as height, sex, and blood group, also influenced the outcome. CONCLUSIONS The 6-minute walk test distance is an independent predictor of mortality on the lung transplant waiting list. Blood type and height also play a significant role in becoming a lung recipient.
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Affiliation(s)
- Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Zofia Tatoj
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Fryderyk Zawadzki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Marta Wajda-Pokrontka
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Piotr Przybyłowski
- 1 Chair of General Surgery, Jagiellonian University Medical College, Krakow, Poland
- Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Medical University of Silesia in Katowice, Poland
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Mastrangeli M, Millet S, Mummery C, Loskill P, Braeken D, Eberle W, Cipriano M, Fernandez L, Graef M, Gidrol X, Picollet-D'Hahan N, Van Meer B, Ochoa I, Schutte M, Van den Eijnden-van Raaij J. Building blocks for a European Organ-on-Chip roadmap. ALTEX 2019; 36:481-492. [PMID: 31329263 DOI: 10.14573/altex.1905221] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/27/2019] [Indexed: 11/23/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Mart Graef
- Delft University of Technology Delft, The Netherlands
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Kim TW, Papagiannis C, Capaldi D, McPherson AK, Mahdi F, Luu N, Rodriguez AA, Hoffmaster C, Serota D, Henry SP. Impurity Qualification Toxicology Study for a 2'-O-Methoxyethyl-Modified Antisense Inhibitor in Mice. Nucleic Acid Ther 2019; 30:14-21. [PMID: 31687889 DOI: 10.1089/nat.2019.0780] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Safety assessment of drug impurities is a routine part of the drug development process. For oligonucleotide-based drugs, impurities can arise from impurities in starting materials, as by-products of the manufacturing process or from degradation, and are generally structurally similar to the parent oligonucleotide. To study the potential impact of impurities, a representative batch of a 2'-O-methoxyethyl (MOE) antisense oligonucleotide (ASO) was compared to batches of drug that were enriched with nine of the common impurities encountered with the chemical class. Mice were treated for 3 months with weekly subcutaneous injection of 10 or 30 mg/kg. The impurity content of the parent batch was 0.25%-2.5% of total drug substance. The enriched impurity mixtures contained from 3% to 10% of the various impurities. The expected common class effects were observed at the 30 mg/kg/week dose level in hematology, serum chemistry, and histopathology. However, there were no differences between the representative batch of material and those enriched with impurities. Based on these data, common oligonucleotide impurity studies do not appear to contribute to the overall toxicology profile.
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Affiliation(s)
- Tae-Won Kim
- Ionis Pharmaceuticals, Inc., Carlsbad, California
| | | | | | | | - Farah Mahdi
- Ionis Pharmaceuticals, Inc., Carlsbad, California
| | - Nhuy Luu
- Ionis Pharmaceuticals, Inc., Carlsbad, California
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Azadeh M, Sondag P, Wang Y, Raines M, Sailstad J. Quality Controls in Ligand Binding Assays: Recommendations and Best Practices for Preparation, Qualification, Maintenance of Lot to Lot Consistency, and Prevention of Assay Drift. AAPS J 2019; 21:89. [PMID: 31297703 PMCID: PMC6647453 DOI: 10.1208/s12248-019-0354-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/06/2019] [Indexed: 01/25/2023]
Abstract
Quality controls (QCs) are the primary indices of assay performance and an important tool in assay lifecycle management. Inclusion of QCs in the testing process allows for the detection of system errors and ongoing assessment of the reliability of the assay. Changes in the performance of QCs are indicative of changes in the assay behavior caused by unintended alterations to reagents or to the operating conditions. The focus of this publication is management of QC life cycle. A consensus view of the ligand binding assay (LBA) community on the best practices for factors that are critical to QC life cycle management including QC preparation, qualification, and trending is presented here.
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Affiliation(s)
- Mitra Azadeh
- Bioanalytical and Biomarker Development, Shire, Lexington, Massachusetts, USA.
| | | | - Ying Wang
- BioMedicine Design, Pfizer, Andover, Massachusetts, USA
| | - Maribeth Raines
- Laboratory Services at Pacific Biomarkers, Inc., Seattle, Washington, USA
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Strawbridge J, Barlow J, O’Leary A, Spooner M, Clarke E, Arnett R, Langley C, Wilson K, Gallagher P. Design and Evaluation of a New National Pharmacy Internship Program in Ireland. Am J Pharm Educ 2019; 83:6678. [PMID: 31223152 PMCID: PMC6581339 DOI: 10.5688/ajpe6678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 11/20/2017] [Indexed: 05/11/2023]
Abstract
Objective. To design, deliver, and evaluate a National Pharmacy Internship Program that met the educational requirements of pharmacy graduates to register as competent pharmacists and earned graduates a master's level degree. Methods. The National Pharmacy Internship Program was designed as a 12-month, full-time, blended-learning, competency-based program leading to a master's degree. Intern performance was assessed academically and by pharmacy preceptor (tutor) appraisals. Interns who demonstrated competency were invited to sit for the Professional Registration Examination (PRE). Feasibility and performance were evaluated and a longitudinal approach allowed intern and preceptor views to be compared to the former preregistration year. Results. Overall performance in the PRE was good and relatively consistent with almost all interns proceeding to register as pharmacists. Interns believed that the program had enabled them to develop the knowledge, skills, and overall competencies required for future independent practice as a pharmacist. Preceptors considered the program to have built on prior learning and provided a sufficiently rounded experience for professional practice. Preceptors also stated that the program was an improved educational experience over the former, less structured, preregistration training. Conclusion. The National Pharmacy Internship Program was perceived to be an improvement on the previous preregistration year. The program quality assured pharmacy education outcomes at the entry-to-practice level on a national basis, and uniquely recognized the students' accomplishment by awarding them a master's degree.
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Affiliation(s)
- Judith Strawbridge
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James Barlow
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aisling O’Leary
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Muirne Spooner
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Eric Clarke
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Richard Arnett
- Quality Enhancement Office, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Chris Langley
- Aston Pharmacy School, Aston University, Birmingham, England
| | - Keith Wilson
- Aston Pharmacy School, Aston University, Birmingham, England
| | - Paul Gallagher
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
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Abstract
KIRO® Oncology (Kiro Grifols, Spain) is a robotic system for automated compounding of sterile injectable drugs including intravenous cytotoxic treatments. The present article describes the qualification procedure applied prior to production phases. Peristaltic pumps which ensure the reconstitution of drugs were tested with water and NaCl 0.9%. The performance of the robot (accuracy and precision) to prepare bags, syringes and elastomeric pumps was evaluated with three placebo solutions (aqueous, foaming and viscous) using gravimetric controls. Microbiological controls were also performed. The pumps met the requirements set for volumes ranging from 5 to 100 mL. A total of 274 preparations was compounded. For the bags, the filling accuracy was within the limit of ±10% from 1 to 48 mL with aqueous solution, from 0.6 to 48 mL with foaming solution and from 5 to 48 mL with viscous solution. For all syringes and elastomeric pumps, it was within the limit of ±10%. The precision was validated for all preparations, except for bags and syringes prepared with 0.6 and 0.25 mL, respectively. The samples of surfaces and air complied with ISO 5 class environment. Among the 24 gloves tests performed, two presented microbiological growth. All Media fill tests were validated. The qualification procedure led us to exclude injections of any active principle volume strictly lower than 1 mL. The microbiological contamination of operators' gloves remains a critical point. Our operators will be made aware of the issue during the training period.
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Affiliation(s)
- Marion Jobard
- Service de Pharmacie clinique, Hôpitaux Universitaires Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Marie-Laure Brandely-Piat
- Service de Pharmacie clinique, Hôpitaux Universitaires Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - François Chast
- Service de Pharmacie clinique, Hôpitaux Universitaires Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Rui Batista
- Service de Pharmacie clinique, Hôpitaux Universitaires Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France
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Lee BI, Park MH, Shin SH, Byeon JJ, Park Y, Kim N, Choi J, Shin YG. Quantitative Analysis of Tozadenant Using Liquid Chromatography-Mass Spectrometric Method in Rat Plasma and Its Human Pharmacokinetics Prediction Using Physiologically Based Pharmacokinetic Modeling. Molecules 2019; 24:molecules24071295. [PMID: 30987056 PMCID: PMC6479388 DOI: 10.3390/molecules24071295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 03/06/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
Tozadenant is one of the selective adenosine A2a receptor antagonists with a potential to be a new Parkinson's disease (PD) therapeutic drug. In this study, a liquid chromatography-mass spectrometry based bioanalytical method was qualified and applied for the quantitative analysis of tozadenant in rat plasma. A good calibration curve was observed in the range from 1.01 to 2200 ng/mL for tozadenant using a quadratic regression. In vitro and preclinical in vivo pharmacokinetic (PK) properties of tozadenant were studied through the developed bioanalytical methods, and human PK profiles were predicted using physiologically based pharmacokinetic (PBPK) modeling based on these values. The PBPK model was initially optimized using in vitro and in vivo PK data obtained by intravenous administration at a dose of 1 mg/kg in rats. Other in vivo PK data in rats were used to validate the PBPK model. The human PK of tozadenant after oral administration at a dose of 240 mg was simulated by using an optimized and validated PBPK model. The predicted human PK parameters and profiles were similar to the observed clinical data. As a result, optimized PBPK model could reasonably predict the PK in human.
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Affiliation(s)
- Byeong Ill Lee
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
| | - Min-Ho Park
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
| | - Seok-Ho Shin
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
| | - Jin-Ju Byeon
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
| | - Yuri Park
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
| | - Nahye Kim
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
| | - Jangmi Choi
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
| | - Young G Shin
- College of Pharmacy and Institute of Drug Research and Development, Chungnam National University, Daejeon 34134, Korea.
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Abstract
Background: Ensuring the delivery of quality care and patient safety requires that nurses improve their self-reflection and insight as well as their critical thinking. To understand the factors that influence self-reflection, insight, and critical thinking, more evidence-based research is needed. Purpose: The purpose of this study was to examine whether professional qualifications (i.e. age, years of job experience, and position on the clinical ladder) would affect self-reflection and critical thinking in the experienced registered nurses (RNs) group. Methods: This quantitative and correlational study included 597 RNs (297 novice nurses and 300 experienced nurses), recruited from one medical center hospital in central Taiwan, as participants. Data were collected on self-reflection and critical thinking, using the Chinese-version of the Self-Reflection and Insight Scale and the Taiwan Critical Thinking Disposition Inventory. A structural equation modeling approach was used to examine the relationships among variables. Findings: The results showed a non-significant mean difference in self-reflection with insight scores between the two groups. Experienced RNs had a significantly higher mean score for critical thinking. Further analysis of the data of experienced nurses revealed that self-reflection with insight significantly affected critical thinking (β = 0.24, t = 4.141, p < .001). Qualifications also affected self-reflection with insight (β = 0.11, t = 1.808, p > .05) and critical thinking (β = 0.18, t = 3.143, p < .001). The correlation between qualifications and self-reflection with insight, however, was non-significant. Discussion: Nurses who perceived that they had greater self-reflection and insight reported more critical thinking in clinical care practice. Nurses' qualifications had more of an effect on critical thinking than on self-reflection and insight.
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Affiliation(s)
- Fen-Fang Chen
- a Taichung Veterans General Hospital , Taichung City , Taiwan
| | - Shu-Yueh Chen
- b Department of Nursing , Central Taiwan University of Science and Technology (Adjunct Associate Professor) , Taiwan
| | - Hsiang-Chu Pai
- c Department of Nursing , Chung-Shan Medical University; Chung-Shan Medical University Hospital , No.110,Sec.1,Jianguo N.Rd., Taichung City 40201 , Taiwan, R.O.C
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47
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Davison E, Housden S, Lindqvist S. Using interprofessional dementia learning opportunities to prepare the future healthcare workforce: findings from a pilot study. J Interprof Care 2018; 33:816-819. [PMID: 30497307 DOI: 10.1080/13561820.2018.1551863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Nearly 50 million people worldwide are living with dementia. Communication difficulties linked to this illness demand that all healthcare professionals are prepared to meet the needs of this group of service users. In response to this, the United Kingdom government is calling for professionals to acquire a basic (Tier 1) Dementia Awareness (DA) qualification. As healthcare students need to engage in interprofessional learning (IPL), this report describes the development, implementation and evaluation of an initiative to link the DA qualification to an existing IPL module delivered to first-year healthcare students (IPL1). A DA learning package was developed by a group of educators from a range of professions to ensure an interprofessional focus. It comprised of a set of practical exercises that students completed during and after IPL1. Sixty students evaluated the DA learning package by completing a post-intervention survey. 57 students rated it helpful or very helpful, in enhancing their knowledge of how to care for a person with dementia, while 3 students rated it as average. Two themes emerged from open-ended questions, which highlighted the importance of: i) learning to work together; and ii) blended learning. Students also suggested some changes for the full roll out, such as moving the Dementia Friends component into IPL1. This is an innovative approach that can be used to meet the challenges linked with the large-scale preparation of our future workforce and to ensure purposeful IPL.
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Affiliation(s)
- Elizabeth Davison
- Centre for Interprofessional Practice, University of East Anglia, Norwich, UK
| | - Sarah Housden
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Susanne Lindqvist
- Centre for Interprofessional Practice, University of East Anglia, Norwich, UK
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48
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Ellingson BM, Wen PY, Cloughesy TF. Evidence and context of use for contrast enhancement as a surrogate of disease burden and treatment response in malignant glioma. Neuro Oncol 2018; 20:457-471. [PMID: 29040703 PMCID: PMC5909663 DOI: 10.1093/neuonc/nox193] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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] [Indexed: 12/25/2022] Open
Abstract
The use of contrast enhancement within the brain on CT or MRI has been the gold standard for diagnosis and therapeutic response assessment in malignant gliomas for decades. The use of contrast enhancing tumor size, however, remains controversial as a tool for accurately diagnosing and assessing treatment efficacy in malignant gliomas, particularly in the current, quickly evolving therapeutic landscape. The current article consolidates overwhelming evidence from hundreds of studies in the field of neuro-oncology, providing the necessary evidence base and specific contexts of use for consideration of contrast enhancing tumor size as an appropriate surrogate biomarker for disease burden and as a tool for measuring treatment response in malignant glioma, including glioblastoma.
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Affiliation(s)
- Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- UCLA Neuro-Oncology Program, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- UCLA Brain Research Institute, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- Department of Physics in Medicine and Biology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science at UCLA, University of California Los Angeles, Los Angeles, California
| | - Patrick Y Wen
- Department of Neurooncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California
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Suh CH, Kim KW, Park SH, Lee SS, Kim HS, Tirumani SH, Lee JG, Pyo J. Shear Wave Elastography as a Quantitative Biomarker of Clinically Significant Portal Hypertension: A Systematic Review and Meta-Analysis. AJR Am J Roentgenol. 2018;210:W185-W195. [PMID: 29570374 DOI: 10.2214/ajr.17.18367] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To qualify shear wave elastography (SWE) as a biomarker for clinically significant portal hypertension (CSPH) beyond proof of concept, we aimed to accumulate and summarize the current evidence through systematic review and meta-analysis. MATERIALS AND METHODS A computerized literature search was performed to identify studies from MEDLINE and EMBASE up to February 9, 2017. Studies on the diagnostic performance of liver stiffness measurements using SWE for CSPH with hepatic venous pressure gradient (HVPG) as the reference standard were included. Various aspects of SWE were comprehensively assessed. The summary diagnostic performance of SWE for the diagnosis of CSPH and the summary correlation coefficient between liver stiffness measured using SWE and HVPG were evaluated through a meta-analysis. RESULTS Nine articles (including 746 patients) were retrieved. The diagnostic performance of SWE for the diagnosis of CSPH was fairly good, with a summary sensitivity of 85% (95% CI, 75-91%; I2 = 78.56%) and summary specificity of 85% (95% CI, 77-90%; I2 = 0%); the area under the ROC curve was 0.88 (95% CI, 0.85-0.91). The summary correlation coefficient between liver stiffness and HVPG measurements was 0.741 (95% CI, 0.658-0.825; I2 = 0%). These results support the value of SWE as a diagnostic biomarker for CSPH. However, there was significant heterogeneity in the imaging devices, protocols, liver stiffness measurement methods, and cutoff values used, which suggests that standardization is required. CONCLUSION The consistent evidence favoring SWE as a biomarker for CSPH should be considered in the biomarker qualification process and management of patients with CSPH.
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Myakotnykh VS. [Age-associated pathology and the location of geriatrics as a medical specialty (reflections of Clinician).]. Adv Gerontol 2018; 31:55-63. [PMID: 29860729] [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: 06/08/2023]
Abstract
In this article from the perspective of an experienced Clinician discusses controversial issues of pathological processes associated with the elderly and senile age, and some aspects of the problem of the formation of the geriatric services that require further discussion. The contents of this document may be submitted for all General discussion on the pages of the magazine.
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Affiliation(s)
- V S Myakotnykh
- Ural state medical University, 3, Repin str., Yekaterinburg, 620028, Russian Federation;
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