1
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Virmani T, Pillai L, Smith V, Glover A, Abrams D, Farmer P, Syed S, Spencer HJ, Kemp A, Barron K, Murray T, Morris B, Bowers B, Ward A, Imus T, Larson-Prior LJ, Lotia M, Prior F. Feasibility of regional center telehealth visits utilizing a rural research network in people with Parkinson's disease. J Clin Transl Sci 2024; 8:e63. [PMID: 38655451 PMCID: PMC11036429 DOI: 10.1017/cts.2024.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/08/2024] [Accepted: 03/11/2024] [Indexed: 04/26/2024] Open
Abstract
Background Impaired motor and cognitive function can make travel cumbersome for People with Parkinson's disease (PwPD). Over 50% of PwPD cared for at the University of Arkansas for Medical Sciences (UAMS) Movement Disorders Clinic reside over 30 miles from Little Rock. Improving access to clinical care for PwPD is needed. Objective To explore the feasibility of remote clinic-to-clinic telehealth research visits for evaluation of multi-modal function in PwPD. Methods PwPD residing within 30 miles of a UAMS Regional health center were enrolled and clinic-to-clinic telehealth visits were performed. Motor and non-motor disease assessments were administered and quantified. Results were compared to participants who performed at-home telehealth visits using the same protocols during the height of the COVID pandemic. Results Compared to the at-home telehealth visit group (n = 50), the participants from regional centers (n = 13) had similar age and disease duration, but greater disease severity with higher total Unified Parkinson's disease rating scale scores (Z = -2.218, p = 0.027) and lower Montreal Cognitive Assessment scores (Z = -3.350, p < 0.001). Regional center participants had lower incomes (Pearson's chi = 21.3, p < 0.001), higher costs to attend visits (Pearson's chi = 16.1, p = 0.003), and lived in more socioeconomically disadvantaged neighborhoods (Z = -3.120, p = 0.002). Prior research participation was lower in the regional center group (Pearson's chi = 4.5, p = 0.034) but both groups indicated interest in future research participation. Conclusions Regional center research visits in PwPD in medically underserved areas are feasible and could help improve access to care and research participation in these traditionally underrepresented populations.
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Affiliation(s)
- Tuhin Virmani
- Department of Neurology, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
- Department of Biomedical Informatics, University of Arkansas
for Medical Sciences, Little Rock, AR,
USA
| | - Lakshmi Pillai
- Department of Neurology, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Veronica Smith
- Translational Research Institute, University of Arkansas for
Medical Sciences, Little Rock, AR,
USA
- Rural Research Network, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Aliyah Glover
- Department of Neurology, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Derek Abrams
- Regional Programs, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Phillip Farmer
- Department of Biomedical Informatics, University of Arkansas
for Medical Sciences, Little Rock, AR,
USA
| | - Shorabuddin Syed
- Department of Biomedical Informatics, University of Arkansas
for Medical Sciences, Little Rock, AR,
USA
| | - Horace J. Spencer
- Department of Biostatistics, University of Arkansas for
Medical Sciences, Little Rock, AR,
USA
| | - Aaron Kemp
- Department of Biomedical Informatics, University of Arkansas
for Medical Sciences, Little Rock, AR,
USA
| | - Kendall Barron
- Regional Programs, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Tammaria Murray
- Regional Programs, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Brenda Morris
- Regional Programs, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Bendi Bowers
- Regional Programs, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Angela Ward
- Regional Programs, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Terri Imus
- Institute for Digital Health and Innovation, University of
Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Linda J. Larson-Prior
- Department of Neurology, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
- Department of Biomedical Informatics, University of Arkansas
for Medical Sciences, Little Rock, AR,
USA
| | - Mitesh Lotia
- Department of Neurology, University of Arkansas for Medical
Sciences, Little Rock, AR,
USA
| | - Fred Prior
- Department of Biomedical Informatics, University of Arkansas
for Medical Sciences, Little Rock, AR,
USA
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Redwood T, Ward A, Ali T, Poole C, O'Dell C, Rebaudo D. In praise of postgraduate career clinics: Translating health professionals' willingness to engagement. Nurs Open 2024; 11:e2113. [PMID: 38366785 PMCID: PMC10873677 DOI: 10.1002/nop2.2113] [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: 10/31/2022] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/18/2024] Open
Abstract
AIM To capture and retain healthcare staff in postgraduate courses relevant to individual career aspirations, service requirements and continuous practice development (CPD) within an English UK university. DESIGN Two virtual career clinics for postgraduate practitioners to engage in CPD offers within the university. An online post-enrolment online survey to explore their experiences of engagement with the university. METHODS Mixed: qualitative and quantitative methods. Engaging 10 participants attended the career clinics, and 42 participants with an online survey. RESULTS The career clinics were well received by participants who mapped CPD requirements and individual career aspirations. The surveys exposed challenges with marketing and enrolment; however, these were mitigated with support. Four recommendations are presented within this paper applicable to the international postgraduate education of all health practitioners.
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Affiliation(s)
| | - A. Ward
- University of NorthamptonNorthamptonUK
| | - T. Ali
- University of NorthamptonNorthamptonUK
| | - C. Poole
- University of NorthamptonNorthamptonUK
| | - C. O'Dell
- University of NorthamptonNorthamptonUK
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3
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Walker NF, Schutz C, Ward A, Barr D, Opondo C, Shey M, Elkington PT, Wilkinson KA, Wilkinson RJ, Meintjes G. Elevated plasma matrix metalloproteinases associate with Mycobacterium tuberculosis blood stream infection and mortality in HIV-associated tuberculosis. medRxiv 2023:2023.12.12.23299845. [PMID: 38168355 PMCID: PMC10760259 DOI: 10.1101/2023.12.12.23299845] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Mortality from HIV-associated tuberculosis (HIV-TB) is high, particularly among hospitalised patients. In 433 people living with HIV admitted to hospital with symptoms of TB, we investigated plasma matrix metalloproteinases (MMP) and matrix-derived biomarkers in relation to TB diagnosis, mortality and Mycobacterium tuberculosis (Mtb) blood stream infection (BSI). Compared to other diagnoses, MMP-8 was elevated in confirmed TB and in Mtb-BSI, positively correlating with extracellular matrix breakdown products. Baseline MMP-3, -7, -8, -10 and procollagen III N-terminal propeptide (PIIINP) associated with Mtb-BSI and 12-week mortality. These findings implicate MMP dysregulation in pathophysiology of advanced HIV-TB and support MMP inhibition as a host-directed therapeutic strategy for HIV-TB.
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Affiliation(s)
- N F Walker
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- TB Centre and Department of Clinical Research, London School of Hygiene and Tropical Medicine, WC1E 7HT, United Kingdom
| | - C Schutz
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
| | - A Ward
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
| | - D Barr
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Wellcome Liverpool Glasgow Centre for Global Health Research, University of Liverpool, Liverpool, L69 3BX, United Kingdom
- Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | - C Opondo
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, WC1E 7HT, United Kingdom
| | - M Shey
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
| | - P T Elkington
- NIHR Biomedical Research Centre, School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, United Kingdom
| | - K A Wilkinson
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
- The Francis Crick Institute, London, NW1 1AT, United Kingdom
| | - R J Wilkinson
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
- The Francis Crick Institute, London, NW1 1AT, United Kingdom
- Department of Infectious Diseases, Imperial College London, W12 0NN, United Kingdom
| | - G Meintjes
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
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Perlow HK, Nalin A, Ritter A, Addington M, Ward A, Liu M, Nappi C, Blakaj DM, Beyer S, Thomas EM, Grecula JC, Raval R, Kotecha R, Boulter D, Dawson E, Zoller W, Palmer JD. Advancing beyond the Hippocampus to Preserve Cognition for Patients with Brain Metastases: Dosimetric Results from a Phase 2 Trial of Memory-Avoidance Whole Brain Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e145-e146. [PMID: 37784722 DOI: 10.1016/j.ijrobp.2023.06.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Recent advances to preserve neurocognitive function in patients treated for brain metastases include stereotactic radiosurgery (SRS), hippocampal avoidance whole brain radiation therapy (HA-WBRT), and memantine administration. However, 23% of patients receiving HA-WBRT and memantine on NRG-CC001 still experienced executive function deterioration at 4 months, with 12% experiencing total recall and delayed recognition deterioration at 6 months. The hippocampus, corpus callosum, fornix, and amygdala are key neurocognitive substructures with a low propensity for brain metastases. Herein, we report our preliminary experience using an advanced "memory-avoidance" WBRT (MA-WBRT) approach sparing these substructures for patients with multiple (>15) brain metastases. MATERIALS/METHODS Ten consecutive patients treated with MA-WBRT on a phase 2 clinical trial (OSU-21074) were reviewed. In each patient, the hippocampi, amygdalae, corpus callosa, and fornix were contoured. Patients were not eligible for MA-WBRT if they had metastases in these substructures. A memory- avoidance region created using a 5mm volumetric expansion around these substructures. Hotspots were avoided in the hypothalamus and pituitary gland. Dose constraints for these avoidance structures were modeled after NRG CC-001 and include a D100% ≤ 9 Gy and a D0.03 cc ≤ 16 (acceptable to 20 Gy). Coverage of brain metastases was prioritized over memory avoidance dose constraints. Linac-based volumetric modulated arc therapy (VMAT) plans were generated for a prescription dose of 30 Gy in 10 fractions. RESULTS On average, the memory avoidance structure volume was 37.1 ccs (Range: 25.2-44.6 ccs), occupying 2.5% of the entire whole brain target volume. All treatment plans met the D100% dose constraint, and 8/10 plans met the D0.03cc constraint, with priority given to tumor coverage for the remaining 2 cases. VMAT spared the memory avoidance structures with a median dose range of 10.8-14.2 Gy and a maximum dose (D0.03cc) range of 15.6-22.7 Gy. The mean dose to the memory avoidance structures was 12.7 Gy (Range: 11.5-13.8 Gy). Target coverage (D98% > 25 Gy) and homogeneity (D2% ≤ 37.5 Gy) were achieved for all plans. CONCLUSION Modern VMAT techniques allow for sparing of the hippocampus, amygdala, corpus callosum, and fornix with good target coverage and homogeneity. Prospective quality of life and cognitive data including are being collected and include the Functional Assessment of Cancer Therapy - Brain (Fact-Br), Hopkins Verbal Learning Test (HLVT-R), Trail Making Test A/B (TMT-A/B) and Controlled Oral Word Association Test (COWAT). After enrollment is completed, these data will be evaluated to assess the efficacy of MA-WBRT to mitigate declines in quality of life and cognition after whole brain radiation.
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Affiliation(s)
- H K Perlow
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - A Nalin
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - A Ritter
- The Ohio State University, Columbus, OH
| | - M Addington
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - A Ward
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - M Liu
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - C Nappi
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - D M Blakaj
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - S Beyer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - E M Thomas
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - J C Grecula
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - R Raval
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - R Kotecha
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - D Boulter
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - E Dawson
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - W Zoller
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - J D Palmer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
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5
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Wink S, Schroader BK, Giglio T, Ward A. Impact of health system specialty pharmacies on total cost of care in cancer treatment, a multisite review. J Oncol Pharm Pract 2023:10781552231190016. [PMID: 37649402 DOI: 10.1177/10781552231190016] [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] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Integrated delivery networks can use medically integrated dispensing of oral oncolytics on site through health system specialty pharmacies. There is little published research examining cost savings. Our objective was to demonstrate the financial value of health system specialty pharmacies among patients receiving oral oncolytics dispensed through fully, partially, and non-integrated dispensing strategies. METHODS This was a retrospective cohort study of adult patients from Symphony Health's Integrated Dataverse® repository who filled a prescription for an agent of interest from 7/1/16-6/30/20 that was written within 25 US health systems. Outcomes included costs, healthcare resource utilization, and duration of therapy. RESULTS In total, 36,816 patients were included; 986 patients (2.7%) integrated, 1,822 (4.9%) partially integrated, and 34,008 (92.4%) non-integrated. Mean 6-month medical charge and oncolytic prescription costs were lower for the integrated group ($36,831; $55,786) than the partially integrated ($46,304, p = 0.053; $63,295, p = 0.071) and non-integrated groups ($54,261, p < 0.001; $65,005, p = 0.004). In most healthcare resource utilization categories, the integrated group had the lowest patient percentage utilizing medical care. Duration of therapy was lower on average by ∼3 months in the integrated vs non-integrated group, which may represent closer monitoring of patient medical records and need for fills vs autoship practices. CONCLUSIONS Patients receiving oral oncolytics through medically integrated dispensing at health system specialty pharmacies may have lower medical and pharmacy costs and decreased healthcare resource utilization. This study adds to the growing body of literature supporting integrated delivery networks and integrated dispensing. Further research is needed to demonstrate the value of medically integrated dispensing through health system specialty pharmacies in the delivery of treatment to patients with cancer and other high-cost diseases.
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Affiliation(s)
- Scott Wink
- AmerisourceBergen Integrated Health Systems Outcomes Coalition (IHOC), Conshohocken, PA, USA
| | | | - Toni Giglio
- AmerisourceBergen Integrated Health Systems Outcomes Coalition (IHOC), Conshohocken, PA, USA
| | - Angela Ward
- AmerisourceBergen Integrated Health Systems Outcomes Coalition (IHOC), Conshohocken, PA, USA
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6
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Parsons LA, Lo F, Ward A, Shindell D, Raman SR. Higher Temperatures in Socially Vulnerable US Communities Increasingly Limit Safe Use of Electric Fans for Cooling. Geohealth 2023; 7:e2023GH000809. [PMID: 37577109 PMCID: PMC10413955 DOI: 10.1029/2023gh000809] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/09/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023]
Abstract
As the globe warms, people will increasingly need affordable, safe methods to stay cool and minimize the worst health impacts of heat exposure. One of the cheapest cooling methods is electric fans. Recent research has recommended ambient air temperature thresholds for safe fan use in adults. Here we use hourly weather reanalysis data (1950-2021) to examine the temporal and spatial evolution of ambient climate conditions in the continental United States (CONUS) considered safe for fan use, focusing on high social vulnerability index (SVI) regions. We find that although most hours in the day are safe for fan use, there are regions that experience hundreds to thousands of hours per year that are too hot for safe fan use. Over the last several decades, the number of hours considered unsafe for fan use has increased across most of the CONUS (on average by ∼70%), with hotspots across the US West and South, suggesting that many individuals will increasingly need alternative cooling strategies. People living in high-SVI locations are 1.5-2 times more likely to experience hotter climate conditions than the overall US population. High-SVI locations also experience higher rates of warming that are approaching and exceeding important safety thresholds that relate to climate adaptation. These results highlight the need to direct additional resources to these communities for heat adaptive strategies.
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Affiliation(s)
- L. A. Parsons
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
- Global ScienceThe Nature ConservancyDurhamNCUSA
| | - F. Lo
- Environmental Defense FundNew York CityNYUSA
| | - A. Ward
- Nicholas Institute for Energy, Environment, and SustainabilityDuke UniversityDurhamNCUSA
| | - D. Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - S. R. Raman
- Population Health SciencesDuke UniversityDurhamNCUSA
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Ward A, Copertino D, Stevenson E, McNeil E, Chukwukere U, Gandhi R, McMahon D, Bosch R, Mellors J, Jones B, Macatangay B, Cyktor J, Eron J. OP 4.6 – 00185 No associations between magnitudes of HIV-specific CTL responses on stable art and subsequent decay of intact proviruses or cell-associated HIV mRNA. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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8
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Ward A, Ives P, Koumousidis A. Complications of oxidised regenerated cellulose at Caesarean section: A report of two cases. Facts Views Vis Obgyn 2022; 14:347-352. [PMID: 36724429 PMCID: PMC10364339 DOI: 10.52054/fvvo.14.4.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Two patients underwent surgical deliveries within four months of one another at a single maternity unit. Both patients had complications of infection-like symptoms such as offensive vaginal discharge and pyrexia, months following their caesarean sections resulting in further surgery. The incidents were thought to be secondary to woven oxidised regenerated cellulose (ORC) use. ORC must be used according to its relevant product literature which can vary between brands. Surgeons must keep abreast of changes to the haemostatic material provided to them and therefore the properties of each type, especially when faced with bleeding not suitable for suturing or electrocautery.
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9
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Yakushev A, Lens L, Düllmann CE, Khuyagbaatar J, Jäger E, Krier J, Runke J, Albers HM, Asai M, Block M, Despotopulos J, Di Nitto A, Eberhardt K, Forsberg U, Golubev P, Götz M, Götz S, Haba H, Harkness-Brennan L, Herzberg RD, Heßberger FP, Hinde D, Hübner A, Judson D, Kindler B, Komori Y, Konki J, Kratz J, Kurz N, Laatiaoui M, Lahiri S, Lommel B, Maiti M, Mistry AK, Mokry C, Moody KJ, Nagame Y, Omtvedt JP, Papadakis P, Pershina V, Rudolph D, Samiento L, Sato T, Schädel M, Scharrer P, Schausten B, Shaughnessy DA, Steiner J, Thörle-Pospiech P, Toyoshima A, Trautmann N, Tsukada K, Uusitalo J, Voss KO, Ward A, Wegrzecki M, Wiehl N, Williams E, Yakusheva V. On the adsorption and reactivity of element 114, flerovium. Front Chem 2022; 10:976635. [PMID: 36092655 PMCID: PMC9453156 DOI: 10.3389/fchem.2022.976635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/19/2022] [Indexed: 12/01/2022] Open
Abstract
Flerovium (Fl, element 114) is the heaviest element chemically studied so far. To date, its interaction with gold was investigated in two gas-solid chromatography experiments, which reported two different types of interaction, however, each based on the level of a few registered atoms only. Whereas noble-gas-like properties were suggested from the first experiment, the second one pointed at a volatile-metal-like character. Here, we present further experimental data on adsorption studies of Fl on silicon oxide and gold surfaces, accounting for the inhomogeneous nature of the surface, as it was used in the experiment and analyzed as part of the reported studies. We confirm that Fl is highly volatile and the least reactive member of group 14. Our experimental observations suggest that Fl exhibits lower reactivity towards Au than the volatile metal Hg, but higher reactivity than the noble gas Rn.
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Affiliation(s)
- A. Yakushev
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- *Correspondence: A. Yakushev,
| | - L. Lens
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Ch. E. Düllmann
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - J. Khuyagbaatar
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - E. Jäger
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - J. Krier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - J. Runke
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - H. M. Albers
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - M. Asai
- Japan Atomic Energy Agency, Tokai, Japan
| | - M. Block
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - J. Despotopulos
- Lawrence Livermore National Laboratory, Livermore, CA, United States
| | - A. Di Nitto
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - K. Eberhardt
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | | | - M. Götz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - S. Götz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | | | | | - F. P. Heßberger
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - D. Hinde
- Australian National University, Canberra, ACT, Australia
| | - A. Hübner
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - D. Judson
- University of Liverpool, Liverpool, United Kingdom
| | - B. Kindler
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | - J. Konki
- University of Jyväskylä, Jyväskylä, Finland
| | - J.V. Kratz
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - N. Kurz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - M. Laatiaoui
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - S. Lahiri
- Saha Institute of Nuclear Physics, Kolkata, India
| | - B. Lommel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - M. Maiti
- Indian Institute of Technology Roorkee, Roorkee, India
| | - A. K. Mistry
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - Ch. Mokry
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - K. J. Moody
- Lawrence Livermore National Laboratory, Livermore, CA, United States
| | - Y. Nagame
- Japan Atomic Energy Agency, Tokai, Japan
| | | | - P. Papadakis
- University of Liverpool, Liverpool, United Kingdom
| | - V. Pershina
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | | | - T.K. Sato
- Japan Atomic Energy Agency, Tokai, Japan
| | - M. Schädel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - P. Scharrer
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - B. Schausten
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - D. A. Shaughnessy
- Lawrence Livermore National Laboratory, Livermore, CA, United States
| | - J. Steiner
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - P. Thörle-Pospiech
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | - N. Trautmann
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - K. Tsukada
- Japan Atomic Energy Agency, Tokai, Japan
| | | | - K.-O. Voss
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - A. Ward
- University of Liverpool, Liverpool, United Kingdom
| | - M. Wegrzecki
- Łukasiewicz Research Network—Institute of Electron Technology, Warsaw, Poland
| | - N. Wiehl
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - E. Williams
- Australian National University, Canberra, ACT, Australia
| | - V. Yakusheva
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
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Pilbury M, Lockley C, McGloughlin E, Ward A, Hogarth L, Hebberd B, Powrie B. ePS2.03 A service evaluation of ‘CF THRIVE’: an online, student-led group for children with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00291-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Yakushev A, Lens L, Düllmann CE, Block M, Brand H, Calverley T, Dasgupta M, Di Nitto A, Götz M, Götz S, Haba H, Harkness-Brennan L, Herzberg RD, Heßberger FP, Hinde D, Hübner A, Jäger E, Judson D, Khuyagbaatar J, Kindler B, Komori Y, Konki J, Kratz J, Krier J, Kurz N, Laatiaoui M, Lommel B, Lorenz C, Maiti M, Mistry A, Mokry C, Nagame Y, Papadakis P, Såmark-Roth A, Rudolph D, Runke J, Sarmiento L, Sato T, Schädel M, Scharrer P, Schausten B, Steiner J, Thörle-Pospiech P, Toyoshima A, Trautmann N, Uusitalo J, Ward A, Wegrzecki M, Yakusheva V. First Study on Nihonium (Nh, Element 113) Chemistry at TASCA. Front Chem 2021; 9:753738. [PMID: 34917588 PMCID: PMC8669335 DOI: 10.3389/fchem.2021.753738] [Citation(s) in RCA: 4] [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: 08/10/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Nihonium (Nh, element 113) and flerovium (Fl, element 114) are the first superheavy elements in which the 7p shell is occupied. High volatility and inertness were predicted for Fl due to the strong relativistic stabilization of the closed 7p 1/2 sub-shell, which originates from a large spin-orbit splitting between the 7p 1/2 and 7p 3/2 orbitals. One unpaired electron in the outermost 7p 1/2 sub-shell in Nh is expected to give rise to a higher chemical reactivity. Theoretical predictions of Nh reactivity are discussed, along with results of the first experimental attempts to study Nh chemistry in the gas phase. The experimental observations verify a higher chemical reactivity of Nh atoms compared to its neighbor Fl and call for the development of advanced setups. First tests of a newly developed detection device miniCOMPACT with highly reactive Fr isotopes assure that effective chemical studies of Nh are within reach.
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Affiliation(s)
- A. Yakushev
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - L. Lens
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Ch. E. Düllmann
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - M. Block
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - H. Brand
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - T. Calverley
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - M. Dasgupta
- Department of Nuclear Physics, Australian National University, Canberra, ACT, Australia
| | - A. Di Nitto
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - M. Götz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - S. Götz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | | | - R-D. Herzberg
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - F. P. Heßberger
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - D. Hinde
- Department of Nuclear Physics, Australian National University, Canberra, ACT, Australia
| | - A. Hübner
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - E. Jäger
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - D. Judson
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - J. Khuyagbaatar
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - B. Kindler
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | - J. Konki
- Department of Physics, University of Jyväskylä, Jyväskylä, Finland
| | - J.V. Kratz
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - J. Krier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - N. Kurz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - M. Laatiaoui
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - B. Lommel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | - M. Maiti
- Indian Institute of Technology Roorkee, Roorkee, India
| | - A.K. Mistry
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
| | - Ch. Mokry
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Y. Nagame
- Japan Atomic Energy Agency, Tokai, Japan
| | - P. Papadakis
- Department of Physics, University of Jyväskylä, Jyväskylä, Finland
| | | | - D. Rudolph
- Department of Physics, Lund University, Lund, Sweden
| | - J. Runke
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | - T.K. Sato
- Japan Atomic Energy Agency, Tokai, Japan
| | - M. Schädel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - P. Scharrer
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - B. Schausten
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - J. Steiner
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - P. Thörle-Pospiech
- Helmholtz-Institut Mainz, Mainz, Germany
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | - N. Trautmann
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - J. Uusitalo
- Department of Physics, University of Jyväskylä, Jyväskylä, Finland
| | - A. Ward
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - M. Wegrzecki
- Łukasiewicz-Instytut Mikroelektroniki I Fotoniki, Warsaw, Poland
| | - V. Yakusheva
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz-Institut Mainz, Mainz, Germany
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Hosain A, Mladkova N, Zoller W, Zoller I, Ward A, DiConstanzo D, Blakaj D. Effects of Radiation Treatment on Pituitary Gland and Hypothalamus Function. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Ward A, Ahmed R, Adedeji J, McGregor-Riley J. 1065 Exposing the Incidence of Ileus in Pelvic and Acetabular Fractures: A Retrospective Case Analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Paralytic ileus is a temporary inhibition of gastrointestinal mobility in the absence of mechanical obstruction. Ileus has previously been observed in up to 40% of patients undergoing bowel surgery, leading to increased morbidity and length of stay. Pelvic and acetabular fractures are often caused by high energy trauma and are associated with a risk of visceral injury. This is the first study to report the incidence of and risk factors for ileus following admission with pelvic and/or acetabular fractures.
Method
All patients over the age of 16 presenting to a major trauma centre throughout 2019 were included. Data included patient demographics, injury pattern, fracture management and presence of ileus. Previous studies identified patients as having ileus if they failed to tolerate an oral diet and open their bowels for more than three days (GI-2). Analysis assessed risk factors for ileus as well as its effect on length of stay.
Results
An incidence of ileus of 40.35% was observed in the 57 included patients. Ileus was three times more common in patients with a diagnosis of diabetes mellitus (p = 0.56) and 2.5 times more common in the presence of an open pelvic/acetabular fracture (p = 0.73). Length of stay was significantly longer in patients under 65 years identified as having ileus (p = 0.046). Gender, age, opiate use, fracture management and surgical approach were not identified as risk factors.
Conclusions
The authors have identified the essentiality of early risk factor identification and hope to encourage further research to create a prognostic tool.
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Affiliation(s)
- A Ward
- Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - R Ahmed
- The University of Sheffield, Sheffield, United Kingdom
| | - J Adedeji
- Southend University Hospital, Essex, United Kingdom
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14
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Phoon KM, Ward A, O'Dowd D, Pitcher F, Amos L, Butler J, Brewer P, Davies M, Chadwick C, Davies H, Blundell C. 965 Complication Rates in Operatively Managed Ankle Fracture/Dislocations - The Effect of Pre-Reduction Imaging and Compliance with BOAST 12 Guidance. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
The BOAST-12 guidelines for the management of ankle fractures aims to optimise functional recovery and reduce complications. They advise against having radiographs prior to urgent reduction of clinically deformed ankles as it could cause an unacceptable delay to subsequent management. Our study aimed to assess the effect of time to acceptable reduction on the risk of complications and time to definitive reduction.
Method
This was a retrospective observational study of patients with ankle fracture-dislocations between 2013 to 2017 at the Northern General Hospital’s Emergency Department (ED). Information collected from 2 patient groups (with and without pre-reduction radiographs), included patient demographics, time to accepted reduction, number of manipulations, operations, and subsequent complications.
Results
242 patients were identified. Time from arrival in ED to acceptable reduction was significantly longer in patients with pre-reduction radiographs versus patients without (184.5 vs 82 minutes, p < 0.00), but did not increase the overall risk of complications (p = 0.62). Pre-reduction radiographs were associated with insignificantly higher rates of post-traumatic osteoarthritis (p = 0.17) and slightly longer wait time for definitive intervention (1 vs 2 days, p = 0.72). However, this had no relationship with the number of manipulations (p = 0.53).
Conclusions
The use of pre-reduction radiographs significantly increased time to acceptable reduction of ankle fracture-dislocations. However, this was not associated with increased risk of complications or time to definitive management.
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Affiliation(s)
- K M Phoon
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - A Ward
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - D O'Dowd
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - F Pitcher
- The University of Sheffield Medical School, Sheffield, United Kingdom
| | - L Amos
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - J Butler
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - P Brewer
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - M Davies
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - C Chadwick
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - H Davies
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - C Blundell
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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15
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Ortega Franco A, Adamson-Raieste A, Rahman R, Pihlak R, Peters N, Scott JA, Aruketty S, Thomson C, Dransfield S, Henshaw A, Ward A, Cutts T, Carter L, Thistlethwaite F, Cook N, Graham D, Stevenson J, Krebs M. 44P Value of comprehensive genomic profiling in pre-screening patients for NTRK fusion in STARTRK2 trial: Single centre experience. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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16
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Ganjoo K, Madison R, Rosenzweig M, Oxnard G, Venstrom J, Ward A, Schrock A. 1532P Fusion and rearrangement (RE) detection using DNA and RNA-based comprehensive genomic profiling (CGP) of sarcomas. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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17
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Almond E, Fullarton R, Kidane G, Withers D, Ward A, Graham S. PO-1605 Sensitivity of DoseCHECK and Mobius3D for patient-specific QA of Ethos Therapy on-line adaptive RT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08056-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Fung A, Ward A, Patel K, Krkovic M. 1005 Antibiotic-Impregnated Calcium Sulfate Beads Are Not Effective in the Primary Prevention of Infection in Open Femur and Tibia Fractures. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Infection is a major complication of open fractures. Antibiotic-impregnated calcium sulfate (AICS) beads are widely used as an adjuvant to systemic antibiotics. Whilst their efficacy in the secondary prevention of infection is established, we present the first retrospective study evaluating AICS beads in the primary prevention of infection in open fractures.
Method
214 open femur and tibia fractures in 207 patients were reviewed over a seven-year period. 148 fractures received only systemic antibiotic prophylaxis. 66 fractures also received AICS beads. The occurrence of acute infection (wound infection and acute osteomyelitis) was recorded, as well as that of long-term complications (chronic osteomyelitis, non-union and death).
Results
Fractures that received AICS with systemic antibiotics had an overall acute infection rate of 42% (28/66), compared to 43% (63/148) in fractures that received only systemic antibiotics (p > 0.05). There was no significant difference in infection rate even when fractures were stratified by Gustilo-Anderson grade. There was also no significant difference in the rate of long-term complications.
Conclusions
Our results indicate that the adjuvant use of AICS beads is not effective for the primary prevention of acute infection or long-term complications in open leg fractures. Further research is needed to elucidate the factors influencing the outcomes of AICS use.
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Affiliation(s)
- A Fung
- University of Cambridge, Cambridge, United Kingdom
| | - A Ward
- University of Cambridge, Cambridge, United Kingdom
| | - K Patel
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - M Krkovic
- Addenbrooke's Hospital, Cambridge, United Kingdom
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19
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Santiago C, Huttner I, Chand R, Humphreys D, Young P, Ward A, Fatkin D. TTNtv Carriers do not Have Increased Susceptibility to Chemotherapy-Induced Cardiomyopathy. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Cryopreservation has been successfully used in the banking and maintenance of cultures of microorganisms, from bacteria to yeasts, since the onset of cryobiology. Biobanking of marine biological resources is crucial for development of scientific knowledge as researchers rely on guaranteed access to reliable, stable resources. Culture collections play a key role in the provision of marine biological resources as they ensure long-term ex situ storage of biological resources that are made available for public and private sector research and education. In this chapter, we provide protocols for cryopreservation of different types of algae cultures.
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Affiliation(s)
| | - Angela Ward
- The Marine Biological Association of the UK (MBA), Plymouth, UK
| | - Ian Probert
- Sorbonne Université-CNRS, Roscoff Culture Collection, FR2424 Station Biologique de Roscoff, Roscoff, France
| | - Léna Gouhier
- Sorbonne Université-CNRS, Roscoff Culture Collection, FR2424 Station Biologique de Roscoff, Roscoff, France
| | - Christine N Campbell
- Culture Collection of Algae and Protozoa, Scottish Association for Marine Science, Oban, Argyll, UK
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Drullinsky D, Ward A, Graciano C, Harap R, Pham D. MINIMALLY INVASIVE HEARTMATE 3 VENTRICULAR ASSIST DEVICE IMPLANTATION. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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22
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Welford J, Rafferty R, Hunt K, Duncan L, Richardson O, Ward A, Rushton C, Short D, Greystoke A. CN14 The utility of a brief clinical frailty scale (CFS) in predicting prognosis and discharge destination in oncology inpatients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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23
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Berry P, Burrows K, Hall R, Gater A, Bradley H, Ward A, Tolley C, Delong P, Hsia EC. AB1332-HPR ASSESSING THE PATIENT EXPERIENCE OF LUPUS NEPHRITIS: DEVELOPMENT OF A CONCEPTUAL MODEL AND REVIEW OF EXISTING PATIENT-REPORTED OUTCOME (PRO) MEASURES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Lupus nephritis (LN) is an autoimmune disease characterized by inflammation of the kidneys as a result of systemic lupus erythematosus (SLE). Approximately 50% of SLE patients will develop LN, which is considered to be one of the most severe manifestations of SLE and the leading cause of morbidity and mortality in SLE. While there is ample existing evidence on disease experience and PROs used in extra-renal SLE, little research has been done in LN. Qualitative interviews with patients can help identify concepts that are both important and relevant to the patient. In order to effectively evaluate treatment benefit, it is critical that PRO measures used to assess such concepts and define clinical trial endpoints are fit for purpose and have strong evidence of content validity in the specific context of use.Objectives:The objective of this study was to understand the patient experience of LN and to identify and characterize the signs and symptoms of LN and their impact on health-related quality of life (HRQoL) through the development of a disease-specific conceptual model. This model was then used to evaluate the content validity of existing PRO measures available for use in LN.Methods:A structured literature search was conducted in Medline, Embase and PsycINFO to identify qualitative research articles documenting the patient experience of LN. PRO measures developed or commonly used to assess patient experiences of LN were also identified. Semi-structured concept elicitation interviews were conducted with 15 adult patients in the US with a clinician-confirmed diagnosis of LN (defined in accordance with established clinical guidelines). Supplementary qualitative data were also collected from a review of publicly available online blogs/forums. Findings were used to inform the development of a conceptual model detailing the impact of LN signs, symptoms and HRQoL and evaluate the validity of existing measures used within LN.Results:Searches revealed a paucity of qualitative research conducted with LN patients, supporting the need for prospective research in LN. Consistent with existing literature in SLE, the core signs and symptoms identified from the qualitative literature review, interviews and blog/forum review included joint pain, fatigue, joint stiffness, swelling (particularly in the extremities) and skin rashes. LN patients also reported urinary frequency, urgency, foamy urine and blood in their urine. Disease impact on physical functioning, activities of daily living, emotions, social life, work/finances and sleep were reported. PRO measures commonly used to evaluate patient experiences in LN included the SF-36, LupusQOL, LupusPRO, SLE Symptom Checklist, KDQoL and KSQ. Conceptual mapping of instruments against the newly developed conceptual model (Figure 1) highlighted that no single measure provides a comprehensive assessment of all symptoms/impact important to LN patients. Furthermore, items are largely focused on impact of symptoms with few items on symptom severity.Figure 1.Conceptual model of lupus nephritis symptoms and associated impactsConclusion:The presentation of signs and symptoms in LN patients appears similar to those reported in extra-renal SLE populations, with the addition of swelling and urinary symptoms. Qualitative research with LN patients guided the development of a comprehensive LN conceptual model outlining the disease experience from the patients’ perspective. These insights can be useful to inform PRO measurement strategies for clinical trials in LN.Acknowledgments:With thanks to Dr. Betty Diamond and Dr. David Wofsy for their collaboration and helpful insightsDisclosure of Interests:Pamela Berry Employee of: Janssen, Kate Burrows Consultant of: Adelphi Values a health outcomes research company commissioned by Janssen to conduct the research reported in this abstract, Rebecca Hall Consultant of: Adelphi Values a health outcomes research company commissioned by Janssen to conduct the research reported in this abstract., Adam Gater Consultant of: Adelphi Values a health outcomes research company commissioned by Janssen to conduct the research reported in this abstract, Helena Bradley Consultant of: Adelphi Values a health outcomes research company commissioned by Janssen to conduct the research reported in this abstract, Amy Ward Consultant of: Adelphi Values a health outcomes research company commissioned by Janssen to conduct the research reported in this abstract, Chloe Tolley Consultant of: Adelphi Values a health outcomes research company commissioned by Janssen to conduct the research reported in this abstract, Patricia Delong Employee of: Janssen, Elizabeth C Hsia Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC
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Greystoke A, Ward A, Welford J, Rushton C, Short D, Todd A, Rafferty R, Hunt K, Duncan L, Tanner L, Gardiner J. Implementation of the Rockwood Clinical Frailty Score (CFS) into the Newcastle upon Tyne NHS Trust lung cancer practice. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30220-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Santiago C, Chand R, Humphreys D, Young P, Ward A, Huttner I, Fatkin D. 002 Titin Truncation Provides a Sensitised Template for Cardio-Depressant Effects of Alcohol. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Frandrup J, Hall J, Reed D, Young J, Ward A, Sun X. Predicting Early Stages of Beef Respiratory Disease Using Thermal Imaging Technology. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesThe objective of this research was to utilize thermal imaging technology to estimate body temperature, so that an early stage of BRD can be detected.Materials and MethodsNinety-two steers were restrained in a squeeze chute that is housed in an indoor handling facility on 6 separate occasions. At least one image was taken of each side of the head using a thermal infrared camera (FLIR E8 WiFi, FLIR, Wilsonville, OR). The distance at which the images were taken was approximately 1 m from the steer. The rectal temperature was used as the control method to compare thermal imaging data. After thermal image acquisition, images were analyzed using the FLIR ResearchIR Max software (v. 4.40.8.28, FLIR, Wilsonville, OR), with the regions of interest being the eye and nasal cavity.ResultsThe analysis focused on minimum (MIN), maximum (MAX), mean, standard deviation (SD), and range of temperatures in the regions of interest. The REG procedure in SAS (v. 9.4, SAS Institute, Inc., Cary, NC) was used to perform stepwise regression to predict rectal temperature from the outdoor temperature (OTEMP) and all imaging features. When OTEMP was greater than –17.8°C, the regression model contained OTEMP, left nasal MAX, left nasal SD, and left eye MAX temperature and right eye temperature range, with an R2 of 0.24. When OTEMP was above freezing (0°C), the regression model contained left nasal temperature range, right eye temperature range, and average nasal mean temperature, with an R2 increase to 0.50. When using all data, the regression model fit left nasal MAX, right nasal MIN, average nasal mean, and left eye MAX temperatures and right eye temperature range, with an R2 of 0.08. These results show that thermal imaging technology has higher prediction accuracy in warmer temperature ranges than extreme cold conditions.ConclusionMore validation research on this thermal imaging technology needs to be conducted at warmer temperatures since all the current data was collected on cold winter days and a large portion of U.S. cattle are reared in more temperate and warmer areas than North Dakota such as Nebraska, Kansas, Texas, Oklahoma, and Florida. Overall, these results show promise for using thermal imaging technology to help detect BRD in an earlier stage by detecting fever before other clinical signs of BRD are present.
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Affiliation(s)
- J. Frandrup
- North Dakota State University Animal Science
| | - J. Hall
- North Dakota State University Animal Science
| | - D. Reed
- North Dakota State University Animal Science
| | - J. Young
- North Dakota State University Animal Science
| | - A. Ward
- North Dakota State University Animal Science
| | - X. Sun
- North Dakota State University Agricultural & Biosystems Engineering
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Nath SD, Ward A, Knutson E, Sun X, Keller W, Bauer M, Swanson K, Carlin K. Effect of Feeding a Low Vitamin a Diet to Beef Steers on Calpain 1 Activation during Meat Aging. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesThe objective of the study was to determine if a vitamin A deficient diet during beef finishing influences calpain 1 activation during meat aging.Materials and MethodsSixty-four steers of approximately 7 mo of age were subjected to a 14-d acclimation period followed by a 95-d growing period on a low vitamin A diet (1017 IU vitamin A/kg DM) designed to deplete liver vitamin A stores. Steers were assigned to a randomized complete blocked design with a 2 × 2 arrangement of treatments (breed: commercial Angus, n = 32, and purebred Simmental, n = 32; and a Low Vitamin A diet or a control diet). The low Vitamin A (LVA) treatment was a finishing diet with no supplemental vitamin A (723 IU vitamin A/kg DM). The control (CON) treatment was the LVA diet plus supplementation with 2200 IU vitamin A/kg DM for a total of 2923 IU vitamin A/kg DM. Serum retinol concentrations were monitored at the beginning and end of treatment. Upon completion of finishing, steers were slaughtered in two groups at a commercial plant. After fabrication, boneless strip loins (IMPS 180) were collected and transported to NDSU. Samples (approximately 40 g) were collected from the anterior portion of the strip loin on d-2 and d-7 of aging and immediately frozen. Protein was extracted from meat samples in fractionation buffers to yield sarcoplasmic and myofibrillar portions, separated by SDS-PAGE, and transferred to PVDF membranes. Immunoblot analysis was done using anti-desmin (d-2 and d-7) and anti-calpain 1 (d-2) antibodies, and results were visualized and documented. A pooled control was run on all membranes and set to a value of one for normalizing results. All experimental data were analyzed using the Proc Mixed procedure of SAS with breed of steers, dietary treatments, their interaction and slaughter date used as a fixed effect.ResultsCalpain 1 autolysis in the sarcoplasmic protein fraction of the d-2 aged loin samples were not affected by treatment or breed. The myofibrillar protein fraction from Angus loins had greater (P = 0.02) accumulation of the 76 kDa calpain 1 autolysis product than that from the Simmental loins; the myofibrillar fraction of the loins from the LVA treatment tended (P = 0.07) to have more 76 kDa calpain 1 autolysis product than that from the CON. There were not any differences (P > 0.19) in the 80 kDa calpain 1 band or the 78 kDa calpain 1 intermediate autolysis product in the myofibrillar fraction. There was a treatment by breed interaction (P = 0.01) for desmin in the d-7 aged loins where Angus loins from the CON treatment had less accumulation of the 46 kDa band than Angus loins on the LVA treatment and Simmental loins from either treatment.ConclusionVitamin A restriction increased protein proteolysis in Angus but not in Simmental steers. The increased calpain 1 autolysis in Angus vs. Simmental, regardless of Vitamin A treatment, indicates a genetic difference that may be the driver for the increased protein degradation in steers a restricted vitamin A diet.
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Affiliation(s)
- S. D. Nath
- North Dakota State University Animal Sciences
| | - A. Ward
- North Dakota State University Animal Sciences
| | - E. Knutson
- North Dakota State University Animal Sciences
| | - X. Sun
- North Dakota State University Agricultural and Biosystems Engineering
| | - W. Keller
- North Dakota State University Animal Sciences
| | - M. Bauer
- North Dakota State University Animal Sciences
| | - K. Swanson
- North Dakota State University Animal Sciences
| | - K. Carlin
- North Dakota State University Animal Sciences
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Warburton KL, Ward A, Turner D, Goulden V. Home phototherapy: experience of setting up a new service in the U.K.'s National Health Service. Br J Dermatol 2019; 182:251-253. [PMID: 31498877 DOI: 10.1111/bjd.18511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- K L Warburton
- Leeds Centre for Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, U.K
| | - A Ward
- Leeds Centre for Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, U.K
| | - D Turner
- Leeds Centre for Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, U.K
| | - V Goulden
- Leeds Centre for Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, U.K
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Liu W, Fakir H, Randhawa G, Kassam Z, Chung H, Chung P, Ward A, Zukotynski K, Emmett L, Bauman G. DRIVE: Defining Radiorecurrent Intraprostatic Target Volumes. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Smith C, Hoover D, Surry K, D'Souza D, Cool D, Gomez-Lemus J, Moussa M, Bauman G, Ward A. Does MRI Prostatic Lesion Targeting Using High Dose Rate Brachytherapy Lead to Elevated Dose to the Corresponding Histologic Lesions. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Moset V, Wahid R, Ward A, Møller HB. Modelling methane emission mitigation by anaerobic digestion: effect of storage conditions and co-digestion. Environ Technol 2019; 40:2633-2642. [PMID: 29498588 DOI: 10.1080/09593330.2018.1447999] [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: 09/05/2017] [Accepted: 02/28/2018] [Indexed: 06/08/2023]
Abstract
In this work the methane conversion factor (MCF) of untreated and anaerobically digested cattle manure (CM) as a function of storage temperature, time and co-digestion was measured in an in vitro experiment and modelled based on IPCC (2006) methodology (Tier 2). For this, one sample of untreated CM, one sample of mono-digested CM and three samples of CM co-digested with grass were incubated at seven different temperatures (from 5°C to 50°C) over 346 days. The main results showed that ultimate methane yield (B0) of CM is higher than the B0 reported by the IPCC (2006). Two temperature ranges should be considered for MCF evolution, below 15°C very low MCF was measured in this work for untreated CM, mono and co-digested samples. At higher temperatures, MCF obtained in this work and that provided by the IPCC could be comparable depending on storage time. Anaerobic mono-digestion decreased MCF compared to untreated CM at all temperatures and times, except in the temperature range between 20°C and 25°C if storage time is low, due to a lag phase observed in CM. This lag phase would probably not happen in real storage conditions depending on the proportion of old manure remaining in the storage tank. Co-digestion with grass-decreased MCF compared to mono-digestion, but increased CH4 production in terms of fresh matter due to the higher B0 of the mixture. Storage time, temperature and co-digestion should be considered in the quantification of CH4 emission from digested material.
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Affiliation(s)
- Veronica Moset
- a Department of Engineering, Aarhus University , Aarhus , Denmark
| | - R Wahid
- a Department of Engineering, Aarhus University , Aarhus , Denmark
| | - A Ward
- a Department of Engineering, Aarhus University , Aarhus , Denmark
| | - H B Møller
- a Department of Engineering, Aarhus University , Aarhus , Denmark
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Kagan V, Mehta C, Michel E, Ward A, Jivan A, Ricciardi M, Anderson A, Pham D, Rich J. Approaches to Repairing Outflow Graft Stenosis in Left Ventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Bi Y, Liu J, Furmanski B, Zhao H, Yu J, Osgood C, Ward A, Keegan P, Booth BP, Rahman A, Wang Y. Model-informed drug development approach supporting approval of the 4-week (Q4W) dosing schedule for nivolumab (Opdivo) across multiple indications: a regulatory perspective. Ann Oncol 2019; 30:644-651. [PMID: 30715147 DOI: 10.1093/annonc/mdz037] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 08/08/2023] Open
Abstract
BACKGROUND A nivolumab dosage regimen of 480 mg intravenously (i.v.) every 4 weeks (Q4W) was approved by FDA for the majority of the approved indications for nivolumab. METHODS The proposed new dosage regimen was supported by pharmacokinetic modeling and simulation, dose/exposure-response relationships for efficacy and safety in the indicated patient populations, and the clinical safety data with the 480 mg Q4W dosage regimen. Pharmacokinetic exposures achieved with 480 mg Q4W were predicted for 4166 patients in 21 clinical studies with various types of solid and hematological tumors. Exposure-response analyses were conducted to predict 480 mg Q4W safety and efficacy across all FDA-approved indications for nivolumab. RESULTS For the overall population, the geometric mean exposure achieved with 480 mg i.v. Q4W was 5.2% higher for steady state Cavg and 15.6% lower for Ctrough than those with 3 mg/kg i.v. Q2W, the approved dosage regimen. The simulated concentration-time course achieved with 480 mg Q4W regimen was below the median concentration achieved with 10 mg/kg i.v. Q2W that was also studied in clinical trials. The predicted probability of adverse events was similar between 480 mg Q4W and that observed with the 3 mg/kg Q2W regimen. Efficacy results were found to be similar between Q2W and Q3W dosage regimens in patients with renal cell carcinoma. The predicted efficacy for each indication suggested that the efficacy with 480 mg Q4W is unlikely to be compromised compared with that observed with 3 mg/kg Q2W. CONCLUSIONS The model-informed analyses of predicted exposure, efficacy and safety based on data from extensive clinical experience with nivolumab suggest that the benefit-risk profile of 480 mg Q4W regimen is comparable to the approved 3 mg/kg Q2W regimen, thus providing the regulatory basis for the approval of 480 mg Q4W regimen in the absence of clinical efficacy data with this new dosage regimen.
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Affiliation(s)
- Y Bi
- Divisions of Pharmacometrics, Office of Clinical Pharmacology, FDA, USA
| | - J Liu
- Divisions of Pharmacometrics, Office of Clinical Pharmacology, FDA, USA.
| | - B Furmanski
- Clinical Pharmacology V, Office of Clinical Pharmacology, FDA, USA
| | - H Zhao
- Clinical Pharmacology V, Office of Clinical Pharmacology, FDA, USA
| | - J Yu
- Divisions of Pharmacometrics, Office of Clinical Pharmacology, FDA, USA
| | - C Osgood
- Oncology Products II, Office of Hematology and Oncology Products, FDA, USA
| | - A Ward
- Oncology Products II, Office of Hematology and Oncology Products, FDA, USA
| | - P Keegan
- Oncology Products II, Office of Hematology and Oncology Products, FDA, USA
| | - B P Booth
- Clinical Pharmacology V, Office of Clinical Pharmacology, FDA, USA
| | - A Rahman
- Clinical Pharmacology V, Office of Clinical Pharmacology, FDA, USA
| | - Y Wang
- Divisions of Pharmacometrics, Office of Clinical Pharmacology, FDA, USA.
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Abstract
PURPOSE The considerations that leaders of multihospital health systems must take into account in developing and implementing initiatives to build and maintain an exceptional pharmacy workforce are described. SUMMARY Significant changes that require constant individual and organizational learning are occurring throughout healthcare and within the profession of pharmacy. These considerations include understanding why it is important to have a succession plan and determining what types of education and training are important to support that plan. Other considerations include strategies for leveraging learners, dealing with a large geographic footprint, adjusting training opportunities to accommodate the ever-evolving demands on pharmacy staffs in terms of skill mix, and determining ways to either budget for or internally develop content for staff development. All of these methods are critically important to ensuring an optimized workforce. Especially for large health systems operating multiple sites across large distances, the use of technology-enabled solutions to provide effective delivery of programming to multiple sites is critical. Commonly used tools include live webinars, live "telepresence" programs, prerecorded programming that is available through an on-demand repository, and computer-based training modules. A learning management system is helpful to assign and document completion of educational requirements, especially those related to regulatory requirements (e.g., controlled substances management, sterile and nonsterile compounding, competency assessment). CONCLUSION Creating and sustaining an environment where all pharmacy caregivers feel invested in and connected to ongoing learning is a powerful motivator for performance, engagement, and retention.
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Frandrup J, Hall J, Jr DR, Young J, Ward A, Sun X. Predicting Early Stages of Beef Respiratory Disease Using Thermal Imaging Technology. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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36
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Nath SD, Ward A, Knutson E, Sun X, Keller W, Bauer M, Swanson K, Carlin K. Effect of Feeding a Low Vitamin a Diet to Beef Steers on Calpain 1 Activation during Meat Aging. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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37
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Anderson V, Doe S, Ward A. Management recommendations of the lung cancer MDT: are they being followed? Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30199-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Maharjan D, Rodas-González A, Tanner A, Kennedy V, Kirsch J, Gaspers J, Negrin-Pereira N, Fontoura A, Bauer M, Swanson K, Reynolds L, Stokka G, Ward A, Dahlen C, Neville B, Wittenberg K, McGeough E, Vonnahme K, Schaefer A, López-Campos Ó, Aalhus J, Ominski K. PSIX-14 Impact of needle-free injection device on injection-site tissue damage in beef sub-primals. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Maharjan
- University of Manitoba, Winnipeg, MB, Canada
| | | | - A Tanner
- North Dakota State University,Fargo, ND, United States
| | - V Kennedy
- North Dakota State University,Fargo, ND, United States
| | - J Kirsch
- North Dakota State University,Fargo, ND, United States
| | - J Gaspers
- North Dakota State University,Fargo, ND, United States
| | | | - A Fontoura
- Cornell University,Ithaca, NY, United States
| | - M Bauer
- North Dakota State University,Fargo, ND, United States
| | - K Swanson
- North Dakota State University,Fargo, ND, United States
| | - L Reynolds
- North Dakota State University,Fargo, ND, United States
| | - G Stokka
- North Dakota State University,Fargo, ND, United States
| | - A Ward
- North Dakota State University,Fargo, ND, United States
| | - C Dahlen
- North Dakota State University,Fargo, ND, United States
| | - B Neville
- Carrington REC,Carrington, ND, United States
| | | | - E McGeough
- University of Manitoba, Winnipeg, MB, Canada
| | - K Vonnahme
- North Dakota State University,Fargo, ND, United States
| | - A Schaefer
- University of Alberta,Lacombe, AB, Canada
| | - Ó López-Campos
- Agriculture and Agri-Food Canada, Lacombe Research and Development Centre, 6000 C & E Trail,Lacombe, Alberta, Canada T4L 1W1
| | - J Aalhus
- Agriculture and Agri-Food Canada, Lacombe Research and Development Centre, 6000 C & E Trail,Lacombe, Alberta, Canada T4L 1W1
| | - K Ominski
- University of Manitoba, Winnipeg, MB, Canada
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Crouse M, Greseth N, McLean K, Crosswhite M, Negrin-Pereira N, Ward A, Reynolds L, Dahlen C, Neville B, Borowicz P, Caton J. PSI-11 Maternal nutrition and stage of early pregnancy in beef heifers: Influence on glutamine transporter SLC38A7 in utero-placental tissues from d 16 to 50 of gestation. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Crouse
- North Dakota State University,Fargo, ND, United States
| | - N Greseth
- University of Wisconsin Madison,Madison, WI, United States
| | - K McLean
- University of Kentucky,Lexington, KY, United States
| | - M Crosswhite
- Oklahoma State University,Stillwater, OK, United States
| | | | - A Ward
- North Dakota State University,Fargo, ND, United States
| | - L Reynolds
- North Dakota State University,Fargo, ND, United States
| | - C Dahlen
- North Dakota State University,Fargo, ND, United States
| | - B Neville
- Carrington REC,Carrington, ND, United States
| | - P Borowicz
- North Dakota State University,Fargo, ND, United States
| | - J Caton
- North Dakota State University,Fargo, ND, United States
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Maharjan D, Rodas-González A, Tanner A, Kennedy V, Kirsch J, Gaspers J, Negrin-Pereira N, Fontoura A, Bauer M, Swanson K, Reynolds L, Stokka G, Ward A, Dahlen C, Neville B, Wittenberg K, McGeough E, Vonnahme K, Schaefer A, López-Campos Ó, Aalhus J, Gardiner P, Ominski K. PSI-35 Corn supplementation of beef cows and its impact on growth performance and carcass outcomes of their progeny. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Maharjan
- University of Manitoba, Winnipeg, MB, Canada
| | | | - A Tanner
- North Dakota State University,Fargo, ND, United States
| | - V Kennedy
- North Dakota State University,Fargo, ND, United States
| | - J Kirsch
- North Dakota State University,Fargo, ND, United States
| | - J Gaspers
- North Dakota State University,Fargo, ND, United States
| | | | - A Fontoura
- Cornell University,Ithica, NY, United States
| | - M Bauer
- North Dakota State University,Fargo, ND, United States
| | - K Swanson
- North Dakota State University,Fargo, ND, United States
| | - L Reynolds
- North Dakota State University,Fargo, ND, United States
| | - G Stokka
- North Dakota State University,Fargo, ND, United States
| | - A Ward
- North Dakota State University,Fargo, ND, United States
| | - C Dahlen
- North Dakota State University,Fargo, ND, United States
| | - B Neville
- Carrington REC, Foster County, ND, United States
| | | | - E McGeough
- University of Manitoba, Winnipeg, MB, Canada
| | - K Vonnahme
- North Dakota State University,Fargo, ND, United States
| | - A Schaefer
- University of Alberta,Lacombe, AB, Canada
| | - Ó López-Campos
- Agriculture and Agri-Food Canada, Lacombe Research and Development Centre,Lacombe, AB, Canada
| | - J Aalhus
- Agriculture and Agri-Food Canada, Lacombe Research and Development Centre,Lacombe, AB, Canada
| | - P Gardiner
- University of Manitoba, Winnipeg, MB, Canada
| | - K Ominski
- University of Manitoba, Winnipeg, MB, Canada
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Nelson M, Ward A, Swanson K, Vonnahme K, Berg E. PSII-2 Effects of Replacing Supplemental Sucrose with Beef on Maternal Health and Fetal Growth and Development Using a Sow Biomedical Model. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Nelson
- North Dakota State University,Fargo, ND, United States
| | - A Ward
- North Dakota State University,Fargo, ND, United States
| | - K Swanson
- North Dakota State University,Fargo, ND, United States
| | - K Vonnahme
- North Dakota State University,Fargo, ND, United States
| | - E Berg
- North Dakota State University,Fargo, ND, United States
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Crouse M, Caton J, Cushman R, Greseth N, McLean K, Reynolds L, Dahlen C, Borowicz P, Ward A. 139 Wettemann Graduate Scholar in Physiology: Maternal nutrition alters concentrations of nutrients in fetal fluids and expression of genes impacting production efficiencies in bovine fetal liver, muscle, and cerebrum during the first 50. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Crouse
- North Dakota State University,Fargo, ND, United States
| | - J Caton
- North Dakota State University,Fargo, ND, United States
| | - R Cushman
- USDA/ARS/US MARC, Clay Center, NE, United States
| | - N Greseth
- University of Wisconsin Madison,Madison, WI, United States
| | - K McLean
- University of Kentucky,Louisville, KY, United States
| | - L Reynolds
- North Dakota State University,Fargo, ND, United States
| | - C Dahlen
- North Dakota State University,Fargo, ND, United States
| | - P Borowicz
- North Dakota State University,Fargo, ND, United States
| | - A Ward
- North Dakota State University,Fargo, ND, United States
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Vishnoi V, Liebenberg P, Reid F, Ward A, Draganic B. A primary germ cell tumour in the gastrointestinal tract: a caecal lesion of yolk-sac morphology in a young patient. J Surg Case Rep 2018; 2018:rjy291. [PMID: 30397438 PMCID: PMC6210665 DOI: 10.1093/jscr/rjy291] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/23/2018] [Accepted: 10/10/2018] [Indexed: 11/13/2022] Open
Abstract
A 24-year-old man with a history of Crohns disease, whilst undergoing surveillance colonoscopy was found to have an ulcerated caecal lesion. The histopathology from the mucosal biopsy was suggestive of a yolk sac tumour. After thorough re-examination, the patient had no radiological evidence of malignancy in his testes or retroperitoneum. His alpha-fetoprotein levels returned as 2145, whilst his carcinoembryonic antigen was negligible. The patient was therefore consented for and underwent a laparoscopic right hemi-colectomy with an ileocolic anastomosis, without any complications. The formal histopathology confirmed the results from the biopsy, of a yolk sac non seminous germ cell tumour with positive lymph nodes and lymphovascular invasion. The patient was referred on to medical oncology for neoadjuvant chemotherapy. As the literature in his instance is scarce, the patient's overall prognosis remains unclear. To the best of our knowledge this is the first reported primary germ cell tumour of the gastrointestinal tract.
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Affiliation(s)
- V Vishnoi
- Department of Surgery, John Hunter Hospital, New Lambton Road, New Lambton Heights, Australia
| | - P Liebenberg
- Department of Surgery, John Hunter Hospital, New Lambton Road, New Lambton Heights, Australia
| | - F Reid
- Department of Surgery, John Hunter Hospital, New Lambton Road, New Lambton Heights, Australia
| | - A Ward
- Department of Pathology, John Hunter Hospital, New Lambton Heights, Australia
| | - B Draganic
- Department of Surgery, John Hunter Hospital, New Lambton Road, New Lambton Heights, Australia
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Palma D, Louie A, Malthaner R, Fortin D, Rodrigues G, Yaremko B, Laba J, Kwan K, Gaede S, Lee T, Ward A, Warner A, Inculet R. OA06.06 MISSILE-NSCLC: A Phase II Trial Measuring the Integration of Stereotactic Radiotherapy Plus Surgery in Early-Stage Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Levy ML, Ward A, Nelson S. Management of children and young people (CYP) with asthma: a clinical audit report. NPJ Prim Care Respir Med 2018; 28:16. [PMID: 29785053 PMCID: PMC5962615 DOI: 10.1038/s41533-018-0087-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/13/2018] [Accepted: 05/01/2018] [Indexed: 12/03/2022] Open
Abstract
An asthma attack or exacerbation signals treatment failure. Most attacks are preventable and failure to recognize risk of asthma attacks are well recognized as risk factors for future attacks and even death. Of the 19 recommendations made by the United Kingdom National Review of Asthma Deaths (NRAD) (1) only one has been partially implemented—a National Asthma Audit; however, this hasn’t reported yet. The Harrow Clinical Commissioning Group (CCG) in London implemented a clinical asthma audit on 291 children and young people aged under 19 years (CYP) who had been treated for asthma attacks in 2016. This was funded as a Local Incentive Scheme (LIS) aimed at improving quality health care delivery. Two years after the publication of the NRAD report it is surprising that risks for future attacks were not recognized, that few patients were assessed objectively during attacks and only 10% of attacks were followed up within 2 days. However, it is encouraging that CYP hospital admissions following the audit were reduced by 16%, with clear benefit for patients, their families and the local health economy. This audit has provided an example of how clinicians can focus learning on patients who have had asthma attacks and utilize these events as a catalyst for active reflection in particular on modifiable risk factors. Through identification of these risks and active optimization of management, preventable asthma attacks could become ‘never events’. Encouraging self-reflection and best practice can help doctors improve patient care following asthma attacks. A recent UK national review uncovered multiple shortfalls in asthma management. Mark Levy at Harrow Clinical Commissioning Group in London and co-workers conducted a clinical asthma audit to assess the after-care of 291 patients under the age of 19 who had been treated for an asthma attack in Harrow during 2016. Analysis of patient records showed that risks of future attacks were not routinely highlighted during follow-up consultations. Only a third of patients had a personal asthma action plan and only 10 per cent of attacks were followed up within two days. During the audit, doctors from each surgery attended focus groups aimed at encouraging best practice. Following the audit, patient hospital admissions from these surgeries dropped by 16 per cent.
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Affiliation(s)
- Mark L Levy
- Respiratory Clinical Lead, Harrow Clinical Commissioning Group, Harrow, Middlesex, HA1 3AW, UK.
| | - Angela Ward
- Interim Programme Director for Models of Care, Harrow Clinical Commissioning Group Harrow, Middlesex, Harrow, HA1 3AW, UK
| | - Sara Nelson
- Queens Nurse: Programme Lead Children and Young People, Healthy London Partnership, Governing Body Nurse Bromley Clinical Commissioning Group, Ferguson House, London, NW1 5JD, UK
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Lemons B, Khaing H, Ward A, Thakur P. A rapid method for the sequential separation of polonium, plutonium, americium and uranium in drinking water. Appl Radiat Isot 2018; 136:10-17. [PMID: 29448060 DOI: 10.1016/j.apradiso.2018.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/10/2017] [Accepted: 02/05/2018] [Indexed: 10/18/2022]
Abstract
A new sequential separation method for the determination of polonium and actinides (Pu, Am and U) in drinking water samples has been developed that can be used for emergency response or routine water analyses. For the first time, the application of TEVA chromatography column in the sequential separation of polonium and plutonium has been studied. This method utilizes a rapid Fe+3 co-precipitation step to remove matrix interferences, followed by plutonium oxidation state adjustment to Pu4+ and an incubation period of ~ 1 h at 50-60 °C to allow Po2+ to oxidize to Po4+. The polonium and plutonium were then separated on a TEVA column, while separation of americium from uranium was performed on a TRU column. After separation, polonium was micro-precipitated with copper sulfide (CuS), while actinides were micro co-precipitated using neodymium fluoride (NdF3) for counting by the alpha spectrometry. The method is simple, robust and can be performed quickly with excellent removal of interferences, high chemical recovery and very good alpha peak resolution. The efficiency and reliability of the procedures were tested by using spiked samples. The effect of several transition metals (Cu2+, Pb2+, Fe3+, Fe2+, and Ni2+) on the performance of this method were also assessed to evaluate the potential matrix effects. Studies indicate that presence of up to 25 mg of these cations in the samples had no adverse effect on the recovery or the resolution of polonium alpha peaks.
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Affiliation(s)
- B Lemons
- Carlsbad Environmental Monitoring & Research Center, 1400 University Drive, Carlsbad, NM 88220, United States
| | - H Khaing
- Carlsbad Environmental Monitoring & Research Center, 1400 University Drive, Carlsbad, NM 88220, United States
| | - A Ward
- US Department of Energy, Carlsbad Field Office, 4021 National Parks Highway, Carlsbad, NM 88220, United States
| | - P Thakur
- Carlsbad Environmental Monitoring & Research Center, 1400 University Drive, Carlsbad, NM 88220, United States.
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Ronden M, van Sörnsen de Koste J, Johnson C, Slotman B, Spoelstra F, Haasbeek C, Blom G, Bongers E, Warner A, Ward A, Palma D, Senan S. Incidence of High-Risk Radiologic Features in Patients Without Local Recurrence After Stereotactic Ablative Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2018; 100:115-121. [DOI: 10.1016/j.ijrobp.2017.09.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/11/2017] [Accepted: 09/14/2017] [Indexed: 12/25/2022]
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Rogers JW, Fleming M, Tipton J, Ward A, Garey KW, Pitman EP. Investigating inpatient medication administration using the theory of planned behavior. Am J Health Syst Pharm 2017; 74:2065-2070. [DOI: 10.2146/ajhp160502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Marc Fleming
- University of Houston College of Pharmacy–Texas Medical Center Campus, Houston, TX
| | | | | | - Kevin W. Garey
- University of Houston College of Pharmacy–Texas Medical Center Campus, Houston, TX
| | - Elizabeth P. Pitman
- University of Houston College of Pharmacy–Texas Medical Center Campus, Houston, TX
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Ward A, Charleus E, Karandish S, Benko E, Kovacs C, Chan D, Ramezani A, Jones R. Patient-derived HIV reservoirs can be stably engrafted into NSG mice and reactivated by latency-reversing agents in vivo. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30536-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ward A. Re-Admissions in Trauma and Orthopaedic Surgery (Rates). A Prospective Multi-Centre Observational Service Evaluation Assessing 30-Day Re-Admissions Following Trauma and Orthopaedic Procedures. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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