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Montgomery C, Hickman SE, Wilkins C, Fromme EK, Anderson S. Montgomery et al's Response to Morrison: Advance Directives/Care Planning: Clear, Simple, and Wrong (DOI: 10.1089/jpm.2020.0272). J Palliat Med 2020; 24:12-13. [PMID: 32881594 DOI: 10.1089/jpm.2020.0523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Tiu C, Tzankov A, Plummer R, Rulach R, Vivanco I, Mulholland P, Gurel B, Figueiredo I, Haris NM, Anderson S, Bachmann F, Engelhardt M, Kaindl T, Lane H, Litherland K, Pognan C, Berezowska S, Evans J, Kristeleit R, Lopez J. 382P The potential utility of end-binding protein 1 (EB1) as response-predictive biomarker for lisavanbulin: Final results from a phase I study of lisavanbulin (BAL101553) in adult patients with recurrent glioblastoma (GBM). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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McSheehy P, Guo J, Beebe K, Eisner J, Anderson S, Braun S, Engelhardt M, Kellenberger L, Lane H, Milburn M. 1960P Differential induction of gene expression may explain differences in reported adverse event profiles between the FGFR-inhibitors derazantinib and erdafitinib: An analysis in safety relevant normal tissues from urothelial cancer (UC) patient-derived mouse xenograft (PDX) models. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Anderson S, McDermott A, Davis N. Waiting Lists and Pandemics: A Prospective Multi-Institutional Study on The Impact Of Covid-19 on a Tertiary Referral Urology Centre. EUR UROL SUPPL 2020. [PMCID: PMC7834160 DOI: 10.1016/s2666-1683(20)35237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Anderson S, Davis N. Improving Your Surgical Technical Skill: The Challenges Facing Surgical Trainees and The Role of Video-Based Coaching. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35236-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Nichols IS, Chiem E, Tahara Y, Anderson S, Trotter D, Whittaker D, Ghiani C, Colwell C, Paul K. 0426 Time Restricted Feeding Consolidates Sleep in the BACHD Mouse Model of Huntington’s Disease. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Disturbances in the daily sleep-wake cycle are common in individuals with neurodegenerative disorders. Huntington’s disease (HD) is a genetic neurodegenerative disorder in which patients exhibit a variety of impairments that include, poor motor function, disrupted circadian rhythms, and sleep abnormalities such as difficulty initiating sleep at bedtime and more frequent nighttime arousals. In the BACHD mouse model time restricted feeding (TRF) has been successful at improving motor functions and circadian rhythms. The BACHD mouse model has a bacterial artificial chromosome that expresses the full-length human mutant huntingtin gene.
Methods
In order to determine the effects of TRF on sleep-wake architecture, EEG/EMG polysomnographic records were examined in mice between 3-4 months old bearing the BAC knock-in of a human genetic mutation of HD and WT litter mates, first during ad libitum (ad lib) feeding then during an 18 hour fasting protocol. TRF protocol consisted of 6 hours of food access limited between ZT15-ZT21 and 18 hours of fasting.
Results
A two-way ANOVA revealed that TRF significantly decreased the amount of total sleep (p=0.04) and NREM sleep (p=0.04) in the dark phase in both WT and BACHD mice. TRF did not significantly affect sleep in the light phase, however trends suggest that BACHD mice have more sleep in the light phase under TRF than ad lib.
Conclusion
This data suggests that TRF improves sleep by consolidating sleep to the light phase and wake to the dark phase. In conclusion, TRF may be a promising tool that can improve the negative effects of neurodegenerative diseases on sleep-wake processes.
Support
These experiments were supported by R01-NS078410 and UCLA start-up funds.
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Huynh R, Anderson S, Chen VM, Yeoh T. A case report of recurrent transient ischaemic attacks on dabigatran for atrial fibrillation: real-world insight into treatment failure. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-4. [PMID: 32352054 PMCID: PMC7180529 DOI: 10.1093/ehjcr/ytaa041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/22/2019] [Accepted: 02/03/2020] [Indexed: 11/22/2022]
Abstract
Background Non-valvular atrial fibrillation (AF) is an important risk factor for acute ischaemic stroke. There has been an increase in the use of direct-acting oral anticoagulants (DOAC therapy) in stroke prophylaxis due to their convenience and rapid action of onset. However, there is a lack of information in the literature regarding management options and possible mechanisms with the apparent failure of DOAC therapy. Case summary We present a clinical case of a 51-year-old man presenting with transient ischaemic attacks on a background of AF on therapeutic doses of dabigatran. His medication box suggested 100% compliance and his admission coagulation studies showed a marginally prolonged activated partial thromboplastin time and thrombin time (TT). While in hospital, our patient had supervised doses of dabigatran (150 mg b.i.d.). Despite this, his peak dabigatran level was undetectable (<40 ng/mL). With the apparent failure of therapy, he was switched to apixaban 5 mg b.i.d., which showed subsequent peak levels in the target range. Discussion There are a number of isolated case reports of DOAC failure in stroke prophylaxis and management has simply involved switching to another DOAC or warfarin. This case is unique as we have discovered undetectable levels of dabigatran providing a mechanism for failure.
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Singla R, Wall D, Anderson S, Zia N, Korte J, Kravets L, McKiernan G, Butler J, Gammilonghi A, Arora J, Wright M, Solomon B, Hicks R, Cain T, Darcy P, Cullinane C, Neeson P, Ramanathan R, Shukla R, Bansal V, Harrison S. First in Human Study of In-vivo Imaging of Ex-Vivo Labelled CAR T Cells with Dual PET-MR. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.04.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Shah N, Bishop C, Anderson S, Sandow T, Hon C, Ramalingam V. Abstract No. 387 Evaluation of renal function and contrast-induced nephropathy in patients with clinical concern for lower gastrointestinal bleed: comparison of patients with negative initial computed tomography angiography and positive computed tomography angiography with subsequent catheter-directed angiography. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Wang H, Lane J, Jones S, Dashti H, Ollila H, Wood A, van Hees V, Brumpton B, Winsvold B, Kantojärvi K, Palviainen T, Cade B, Sofer T, Song Y, Patel K, Anderson S, Bechtold D, Bowden J, Emsley R, Kyle S, Little M, Loudon A, Scheer F, Purcell S, Richmond R, Spiegelhalder K, Tyrrell J, Zhu X, Hublin C, Kaprio J, Kristiansson K, Sulkava S, Paunio T, Hveem K, Nielsen J, Willer C, Zwart JA, Strand L, Frayling T, Ray D, Lawlor D, Rutter M, Weedon M, Redline S, Saxena R. Genome-wide association analysis of self-reported daytime sleepiness identifies 42 loci that suggest biological subtypes. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thiex NJ, Manson H, Anderson S, Persson JÅ, Anderson S, Bogren E, Bolek G, Budde D, Ellis C, Eriksson S, Field G, Frankenius E, Henderson C, Henry C, Kapphahn M, Lundberg L, Manson H, Moller J, Russell M, Sefert-Schwind J, Spann M. Determination of Crude Protein in Animal Feed, Forage, Grain, and Oilseeds by Using Block Digestion with a Copper Catalyst and Steam Distillation into Boric Acid: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.309] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was conducted to evaluate the repeatability and reproducibility of an extension of AOAC Official Method 991.20, Nitrogen (Crude) in Milk, to animal feed, forage (plant tissue), grain, and oilseed materials. Test portions are digested in an aluminum block at 420°C in sulfuric acid with potassium sulfate and a copper catalyst. Digests are cooled and diluted, and concentrated sodium hydroxide is added to neutralize the acid and make the digest basic; the liberated ammonia is distilled by using steam distillation. The liberated ammonia is trapped in a weak boric acid solution and titrated with a stronger standardized acid, hydrochloric acid; colorimetric endpoint detection is used. Fourteen blind samples were sent to 13 collaborators in the United States, Denmark, Sweden, Germany, and the United Kingdom. Recoveries of nitrogen from lysine, tryptophan, and acetanilide were 86.8, 98.8, and 100.1%, respectively. The within-laboratory relative standard deviation (RSDr, repeatability) ranged from 0.40 to 2.38% for crude protein. The among-laboratories (including within-) relative standard deviation (RSDR, reproducibility) ranged from 0.44 to 2.38%. It is recommended that the method be adopted First Action by AOAC INTERNATIONAL. A lower concentration (1% H3BO3) of trapping solution was compared with the concentration specified in the original protocol (4% H3BO3) and was found comparable for use in an automatic titration system in which titration begins automatically as soon as distillation starts. The Study Directors recommend that 1% H3BO3 as an optional alternative to 4% boric acid trapping solution be allowed for automatic titrators that titrate throughout the distillation.
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Anderson S, Alexandru C, Alhambra-Borrás T. Steps forward for the SCIROCCO tool and its evaluation as part of SCIROCCO Exchange. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The ambition of the SCIROCCO Exchange project is to maximise the value and impact of the B3-Maturity Model and the SCIROCCO tool. To this aim, SCIROCCO Exchange will develop an enhanced tool including a Knowledge Management Hub. The first objective of this presentation will be describing the progress and plans towards this enhanced tool.
The SCIROCCO enhanced tool will support measures for scaling up integrated care, and an important part of it will involve building cross system community to facilitate transfer and scaling. Through its Knowledge Management Hub, the enhanced tool will include the capacity to integrate knowledge from highly relevant sources of information on integrated care practice and advice. To support and augment twinning and coaching activities, it will allow the searching for, combination of this knowledge and its adjustment to the maturity levels of health systems and the maturity requirements of good practices. The enhanced tool will also support the tracking of the evolution of the maturity of the health systems and the maturity requirements of good practices, which will allow the development of further functionality for improvement planning and monitoring.
The second objective of this presentation will be outlining progress and plans towards the evaluation of the enhanced SCIROCCO tool. This evaluation will focus on the assessment of the enhanced tool’s personalised knowledge transfer and capacity-building support. It will provide feedback on the processes of knowledge transfer and capacity-building support, and help conclude on the key mechanisms supporting these processes. Moreover, this evaluation will feed into the development of Improvement Plans in the 9 SCIROCCO Exchange regions. The ultimate goal of this evaluation is to optimise the potential of the enhanced SCIROCCO tool as a key facilitator and integrator of knowledge transfer and capacity-building support for integrated care.
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Anderson S. Maturity of integrated care in Scotland - What can we learn? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Issue/Problem
Multiple chronic conditions and the complexity of needs arising from them demands a rethinking of delivery systems, innovation, and resourcing. Tools and methodologies that help understand these complex transformational processes and orchestrate discussions of all stakeholders involved are core to this process. As a result, Scotland was keen to apply SCIROCCO tool to assess their readiness for integrated care.
Results
The application of SCIROCCO self-assessment tool showed a range of strengths and weaknesses of Flanders region to adopt and implement integrated care. More than 15 stakeholders were involved in this process which proved the importance and added value to the assessment process. In addition, the outcomes of this process help to identify the potential focus of the capacity-building support.
Lessons
SCIROCCO tool is a very useful participatory tool which can help to drive the transformational change towards integrated care.
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Deshmukh V, O'Green AL, Bossard C, Seo T, Lamangan L, Ibanez M, Ghias A, Lai C, Do L, Cho S, Cahiwat J, Chiu K, Pedraza M, Anderson S, Harris R, Dellamary L, Kc S, Barroga C, Melchior B, Tam B, Kennedy S, Tambiah J, Hood J, Yazici Y. Modulation of the Wnt pathway through inhibition of CLK2 and DYRK1A by lorecivivint as a novel, potentially disease-modifying approach for knee osteoarthritis treatment. Osteoarthritis Cartilage 2019; 27:1347-1360. [PMID: 31132406 DOI: 10.1016/j.joca.2019.05.006] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/23/2019] [Accepted: 05/14/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Wnt pathway upregulation contributes to knee osteoarthritis (OA) through osteoblast differentiation, increased catabolic enzymes, and inflammation. The small-molecule Wnt pathway inhibitor, lorecivivint (SM04690), which previously demonstrated chondrogenesis and cartilage protection in an animal OA model, was evaluated to elucidate its mechanism of action. DESIGN Biochemical assays measured kinase activity. Western blots measured protein phosphorylation in human mesenchymal stem cells (hMSCs), chondrocytes, and synovial fibroblasts. siRNA knockdown effects in hMSCs and BEAS-2B cells on Wnt pathway, chondrogenic genes, and LPS-induced inflammatory cytokines was measured by qPCR. In vivo anti-inflammation, pain, and function were evaluated following single intra-articular (IA) lorecivivint or vehicle injection in the monosodium iodoacetate (MIA)-induced rat OA model. RESULTS Lorecivivint inhibited intranuclear kinases CDC-like kinase 2 (CLK2) and dual-specificity tyrosine phosphorylation-regulated kinase 1A (DYRK1A). Lorecivivint inhibited CLK2-mediated phosphorylation of serine/arginine-rich (SR) splicing factors and DYRK1A-mediated phosphorylation of SIRT1 and FOXO1. siRNA knockdowns identified a role for CLK2 and DYRK1A in Wnt pathway modulation without affecting β-catenin with CLK2 inhibition inducing early chondrogenesis and DYRK1A inhibition enhancing mature chondrocyte function. NF-κB and STAT3 inhibition by lorecivivint reduced inflammation. DYRK1A knockdown was sufficient for anti-inflammatory effects, while combined DYRK1A/CLK2 knockdown enhanced this effect. In the MIA model, lorecivivint inhibited production of inflammatory cytokines and cartilage degradative enzymes, resulting in increased joint cartilage, decreased pain, and improved weight-bearing function. CONCLUSIONS Lorecivivint inhibition of CLK2 and DYRK1A suggested a novel mechanism for Wnt pathway inhibition, enhancing chondrogenesis, chondrocyte function, and anti-inflammation. Lorecivivint shows potential to modify structure and improve symptoms of knee OA.
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Sayre K, Carver K, Anderson S, Moe J. Barriers to Women in Oral and Maxillofacial Surgery: A Cross Sectional Survey. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Metodiev Y, Anderson S, Kondov K. Successful placement of an epidural catheter through a split skin graft after degloving injury of the lower back. Int J Obstet Anesth 2019; 40:149-151. [PMID: 31443931 DOI: 10.1016/j.ijoa.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/01/2019] [Accepted: 03/08/2019] [Indexed: 10/27/2022]
Abstract
Degloving soft tissue injuries of the back are uncommon in women of child-bearing age. Treatment of such injuries may include split skin grafting of the affected area. We present the case of a 30-year-old primigravid woman who suffered degloving of the skin over the lumbar area that had been treated by split skin grafting three years prior to her pregnancy. She was seen in the antenatal anaesthetic clinic where she expressed a desire to have early epidural analgesia for her labour and delivery. An epidural catheter was placed successfully through the skin graft. The considerations for performing an invasive procedure through a skin graft and the available evidence are discussed.
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Martinez Naharro A, Kotecha T, Gonzalez-Lopez E, Corovic A, Anderson S, Chacko L, Brown J, Knight DS, Baksi AJ, Moon JC, Kellman P, Garcia-Pavia P, Gillmore J, Hawkins P, Fontana M. 549High prevalence of intracardiac thrombi in cardiac amyloidosis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Martinez Naharro A, Kotecha T, Chacko L, Brown J, Knight DS, Anderson S, Moon J, Gillmore JD, Hawkins PN, Xue H, Kellman PN, Fontana M. P176Fat water gadolinium enhancement imaging in myocarditis: shifting the goalpost. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lopez JS, Kristeleit RS, Rulach R, Haris NM, Scaranti M, Mulholland PJ, Crawford D, Bashir S, Aversa C, Hannah AL, Anderson S, Engelhardt M, Kaindl T, Larger P, McKernan P, Evans TRJ, Plummer E. Phase 1/2a study of once daily oral BAL101553, a novel tumor checkpoint controller (TCC), in adult patients with progressive or recurrent glioblastoma (GBM) or high-grade glioma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.2025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2025 Background: BAL101553 (prodrug of BAL27862) is a novel TCC that promotes tumor cell death by modulating the spindle assembly checkpoint. BAL27862 is a lipophilic, small molecule shown in rodents to penetrate the brain (brain/plasma ratio around unity), with promising antitumor activity in orthotopic preclinical GBM models as monotherapy or in combination with radiotherapy (RT) with or without temozolomide. In this ongoing study (NCT02490800, CDI-CS-002), daily oral BAL101553 was initially examined in solid-tumor patients, with an MTD of 16 mg/d and DLTs of G4 hyponatremia and G2 hallucinations (Lopez 2018, JCO 36, 2018, suppl. A2530). Subsequently the study was expanded by including a separate cohort of patients with progressive or recurrent GBM or high-grade glioma (Ingles Garces 2017, JCO 35, 2018, suppl. TPS2601). Methods: Patients with histologically-confirmed GBM or high-grade glioma, with progressive or recurrent disease after prior RT with/without chemotherapy, received once-daily oral BAL101553 (28-day cycles) in a 3+3 dose-escalation design to determine the maximum tolerated dose (MTD). Adverse events were assessed by CTCAE v4.03 grade (G), and tumor response by RANO every two cycles. Pharmacokinetics (PK) were evaluated on Day 1 of Cycles 1 and 2. Results: In the ongoing study, 23 pts (13M/10F; median age 50 y), median (min–max) number of prior regimens = 2 (1–5), received doses of 8, 15, 20, 25 or 30 mg oral BAL101553 once daily. One DLT of reversible G2 depression and fatigue occurred at 20 mg. Both mean Cmax and AUC increased with dose between 8 and 30 mg. The PK exposure in GBM patients was lower than for solid tumor patients, in particular at 20 and 25 mg. At 25 mg/d (n = 3), one patient with IDH-mutated GBM had a partial response (63% area reduction per RANO) and continues on study > 8 months, and another patient had stable disease for 5 months. At 15–20 mg/d, stable disease was observed in 3/10 patients. Conclusions: The current data in patients with GBM or high-grade glioma suggest that BAL101553 is well tolerated at dose levels above the MTD established in patients with advanced solid tumors, and shows indications of clinical activity. Clinical trial information: 02490800.
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Kazadi Mbamba C, Lindblom E, Flores-Alsina X, Tait S, Anderson S, Saagi R, Batstone DJ, Gernaey KV, Jeppsson U. Plant-wide model-based analysis of iron dosage strategies for chemical phosphorus removal in wastewater treatment systems. WATER RESEARCH 2019; 155:12-25. [PMID: 30826592 DOI: 10.1016/j.watres.2019.01.048] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/16/2019] [Accepted: 01/25/2019] [Indexed: 05/06/2023]
Abstract
Stringent phosphorus discharge standards (i.e. 0.15-0.3 g P.m-3) in the Baltic area will compel wastewater treatment practice to augment enhanced biological phosphorus removal (EBPR) with chemical precipitation using metal salts. This study examines control of iron chemical dosing for phosphorus removal under dynamic loading conditions to optimize operational aspects of a membrane biological reactor (MBR) pilot plant. An upgraded version of the Benchmark Simulation Model No. 2 (BSM2) with an improved physico-chemical framework (PCF) is used to develop a plant-wide model for the pilot plant. The PCF consists of an equilibrium approach describing ion speciation and pairing, kinetic minerals precipitation (such as hydrous ferric oxides (HFO) and FePO4) as well as adsorption and co-precipitation. Model performance is assessed against data sets from the pilot plant, evaluating the capability to describe water and sludge lines across the treatment process under steady-state operation. Simulated phosphorus differed as little as 5-10% (relative) from measured phosphorus, indicating that the model was representative of reality. The study also shows that environmental factors such as pH, as well operating conditions such as Fe/P molar ratios (1, 1.5 and 2), influence the concentration of dissolved phosphate in the effluent. The time constant of simultaneous precipitation in the calibrated model, due to a step change decrease/increase in FeSO4 dosage, was found to be roughly 5 days, indicating a slow dynamic response due to a multi-step process involving dissolution, oxidation, precipitation, aging, adsorption and co-precipitation. The persistence effect of accumulated iron-precipitates (HFO particulates) in the activated sludge seemed important for phosphorus removal, and therefore solids retention time plays a crucial role according to the model. The aerobic tank was deemed to be the most suitable dosing location for FeSO4 addition, due to high dissolved oxygen levels and good mixing conditions. Finally, dynamic model-based analyses show the benefits of using automatic control when dosing chemicals.
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Walocko F, Anderson S, Adams-Huet B, Chong B. 559 Higher skin disease scores distinguish patients who progress from cutaneous lupus erythematosus to systemic lupus erythematosus. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Colosimo BL, Weinberger K, Hasan S, Gresswell S, Anderson S, Wegner RE, Trombetta M. Abstract P6-02-05: Downstream workup after post-treatment mammography in breast conservation therapy: Is there a significant difference between tomosynthesis and 2-dimensional mammograms? Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-02-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction:
Emerging data suggest that tomosynthesis mammograms (TS) are considerably superior to two-dimensional (2D) screening mammograms (2DMG) at reducing false positive biopsies for breast cancer screening. However, very little is reported about the comparative efficacy of the two modalities in the post-treatment setting. We compared the rate of downstream workup up after undergoing post-radiation screening 2DMG and TS following breast conservation therapy at our institution.
Methods:
Between the years 2011-2017, 712 breast cancer patients (range 31-91 years) were treated with lumpectomy and adjuvant radiotherapy. As per institutional standard, follow up included either screening 2DMG (n=569) or TS(n=143) and reviewed in this IRB-approved study. The primary endpoint for comparison was the rate of further imaging/workup post-treatment . Comparative analysis was conducted via multivariable binomial regression with propensity matching between the 2DMG and TS groups. Patients with clinical suspicion of recurrence otherwise were excluded.
Results:
The patient cohort in both groups included the following clinical characteristics,: 129 patients with ductal carcinoma in-situ (the remainder were invasive carcinoma; ductal or lobular). A total of 418 patients had T1 lesions, 143 T2, and 22 T3/T4. Eighty-five patients were node positive. Of those, 501 ER+/Her2-, 101 triple negative, and 96 triple positive. Adjuvant radiation included conventional fraction (457) or hypofractionation (153) with boost to the surgical cavity in523Accelerated Partial Breast Irradiation (APBI) was delivered in 106 patients. Post treatment scans occurred within 3 months (166), at 3-6 months (256), or 6+ months (281). The aforementioned characteristics were similarly distributed between 2DMG and TS groups, except for slightly more DCIS in the 2D group.
There was a significantly higher proportion of patients that were recommended for immediate downstream workup in the 2D group (40.7%) compared to in the tomo group (16.8%) (HR = 3.40, P <0.001), leading to 12 biopsies in the 2D group (3 positive) and 4 biopsies in the TS group (0 positive). Upon multivariate analysis, the use of tomo was the lone correlate of reduced downstream workup (p < 0.05), although there was a trend toward significance in patients who were first imaged at a post-treatment interval of 6+ months and in patients not undergoing a radiation boost (P < 0.10).
Conclusion:
Post-breast conservation follow-up with tomo synthesis mammography resulted in significantly less downstream workup as compared to conventional 2D screening mammography. Further investigation is warranted to unveil the absolute and relative cost-effectiveness between the two modalities.
Citation Format: Colosimo BL, Weinberger K, Hasan S, Gresswell S, Anderson S, Wegner RE, Trombetta M. Downstream workup after post-treatment mammography in breast conservation therapy: Is there a significant difference between tomosynthesis and 2-dimensional mammograms? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-02-05.
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Ghelani R, Maclean E, Adra M, Anderson S, Arora A, Aylward C, Bindra H, Carter C, Denning M, Dib N, Egan S, Ganis L, Illing H, Kerwat DR, Knight M, Maden S, Murphy M, Myers S, Mootein G, Penicott H, Rooney MC, Seehra H, Shams F, Yauwan D, Yogarajah R, Zhu H. Identifying avoidable switchboard delays in England's NHS hospitals: phase one of the national SWITCH project. Acute Med 2019; 18:210-215. [PMID: 31912051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Inter-hospital communication frequently requires mediation via a switchboard. Identifying and eliminating switchboard inefficiencies may improve patient care. METHODS All 175 acute hospital switchboards in England were contacted six times. Call contents and duration were recorded. No clinician calls or bleeps were connected. RESULTS The mean delay before contacting a switchboard operative was 55±46 seconds. 115 hospitals (66%) used automated switchboards; 34 of these (30%) had infection control messages. Robot operators introduced an additional 40 second delay versus humans (mean 70.3±28 versus 29.8±23 seconds, p<0.0001). Multivariate analysis identified robot operators (HR 5.1, p<0.0001) and infection control messages (HR 2.9, p=0.003) as predictors of delays over 60 seconds. CONCLUSIONS There are significant avoidable delays in contacting switchboard operatives across England. Quality improvement is underway.
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Anderson S, Snyder N, Bloom A, Brasile D, Gocial B, Orris J, Glassner M. Cumulus cell acetyl-CoA enrichment from acetate found to decrease with maternal age using a novel approach to measure metabolism in individual cumulus cell complexes. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Anderson S, Sethuram R, Hartlein T, Brasile D, Gocial B, Glassner M, Orris J. Association between embryo quality and aneuploidy after a standardized controlled ovarian stimulation (COS) protocol. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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