1
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Franklin BD, Bartel R, Howitt P. Avoiding harm through hearing our patients. BMJ 2024; 384:q532. [PMID: 38448087 DOI: 10.1136/bmj.q532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Affiliation(s)
- Bryony Dean Franklin
- NIHR North West London Patient Safety Research Collaboration, Imperial College Healthcare NHS Trust, London, UK
| | | | - Peter Howitt
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
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2
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McKinley LL, Goedken CC, Balkenende EC, Hockett Sherlock SM, Knobloch MJ, Bartel R, Perencevich EN, Reisinger HS, Safdar N. Using a human-factors engineering approach to evaluate environmental cleaning in Veterans' Affairs acute and long-term care facilities: A qualitative analysis. Infect Control Hosp Epidemiol 2024; 45:351-359. [PMID: 37873620 DOI: 10.1017/ice.2023.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Environmental cleaning is important in the interruption of pathogen transmission. Although prevention initiatives have targeted environmental cleaning, practice variations exist and compliance is low. Evaluation of human factors influencing variations in cleaning practices can be valuable in developing interventions to standardized practices. We conducted a work-system analysis using a human-factors engineering (HFE) framework to identify barriers and facilitators to environmental cleaning practices in acute and long-term care settings within the Veterans' Affairs health system. METHODS We conducted a qualitative study with key stakeholders at 3 VA facilities. We analyzed transcripts for thematic content and mapped themes to the HFE framework. RESULTS Staffing consistency was felt to improve cleaning practices and teamwork. We found that many environmental management service (EMS) staff were veterans who were motivated to serve fellow veterans, especially to prevent infections. However, hiring veterans comes with regulatory hurdles that affect staffing. Sites reported some form of monitoring their cleaning process, but there was variation in method and frequency. The EMS workload was affected by whether rooms were occupied by patients or were semiprivate rooms; both were reportedly more difficult to clean. Room design and surface finishes were identified as important to cleaning efficiency. CONCLUSION HFE work analysis identified barriers and facilitators to environmental cleaning. These findings highlight intervention entry points that may facilitate standardized work practices. There is a need to develop task-specific procedures such as cleaning occupied beds and semiprivate rooms. Future research should evaluate interventions that address these determinants of environmental cleaning.
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Affiliation(s)
- Linda L McKinley
- William S. Middleton Memorial Veterans' Hospital, Madison, Wisconsin
| | - Cassie C Goedken
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City, Iowa
- Iowa City VA Health Care System, Iowa City, Iowa
| | - Erin C Balkenende
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City, Iowa
- Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Stacey M Hockett Sherlock
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City, Iowa
- Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Mary Jo Knobloch
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Rosie Bartel
- Patient-Centered Outcomes Research Institute (PCORI), Washington, DC
| | - Eli N Perencevich
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City, Iowa
- Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Heather S Reisinger
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City, Iowa
- Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Institute for Clinical and Translational Science, Iowa City, Iowa
| | - Nasia Safdar
- William S. Middleton Memorial Veterans' Hospital, Madison, Wisconsin
- University of Wisconsin-Madison, Madison, Wisconsin
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3
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McKinley L, Goedken CC, Balkenende E, Clore G, Hockett SS, Bartel R, Bradley S, Judd J, Lyons G, Rock C, Rubin M, Shaughnessy C, Reisinger HS, Perencevich E, Safdar N. Evaluation of daily environmental cleaning and disinfection practices in veterans affairs acute and long-term care facilities: A mixed methods study. Am J Infect Control 2023; 51:205-213. [PMID: 35644297 DOI: 10.1016/j.ajic.2022.05.014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To describe daily environmental cleaning and disinfection practices and their associations with cleaning rates while exploring contextual factors experienced by healthcare workers involved in the cleaning process. METHODS A convergent mixed methods approach using quantitative observations (ie, direct observation of environmental service staff performing environmental cleaning using a standardized observation form) and qualitative interviews (ie, semistructured interviews of key healthcare workers) across 3 Veterans Affairs acute and long-term care facilities. RESULTS Between December 2018 and May 2019 a total of sixty-two room observations (N = 3602 surfaces) were conducted. The average observed surface cleaning rate during daily cleaning in patient rooms was 33.6% for all environmental surfaces and 60.0% for high-touch surfaces (HTS). Higher cleaning rates were observed with bathroom surfaces (Odds Ratio OR = 3.23), HTSs (OR = 1.57), and reusable medical equipment (RME) (OR = 1.40). Lower cleaning rates were observed when cleaning semiprivate rooms (OR = 0.71) and rooms in AC (OR = 0.56). In analysis stratified by patient presence (ie, present, or absent) in the room during cleaning, patient absence was associated with higher cleaning rates for HTSs (OR = 1.71). In addition, the odds that bathroom surfaces being cleaned more frequently than bedroom surfaces decreased (OR = 1.97) as well as the odds that private rooms being cleaned more frequently than semi-private rooms also decreased (OR = 0.26; 0.07-0.93). Between January and June 2019 eighteen qualitative interviews were conducted and found key themes (ie, patient presence and semiprivate rooms) as potential barriers to cleaning; this supports findings from the quantitative analysis. CONCLUSION Overall observed rates of daily cleaning of environmental surfaces in both acute and long-term care was low. Standardized environmental cleaning practices to address known barriers, specifically cleaning practices when patients are present in rooms and semi-private rooms are needed to achieve improvements in cleaning rates.
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Affiliation(s)
| | - C C Goedken
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA
| | - E Balkenende
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - G Clore
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - Sherlock S Hockett
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - R Bartel
- Patient-Centered Outcomes Research Institute (PCORI), Washington DC
| | - S Bradley
- Ann Arbor VA, Ann Arbor, MI; University of Michigan, Ann Arbor, MI
| | - J Judd
- Salt Lake City VA, Salt Lake City, UT; University of Utah, Salt Lake City, UT
| | - Goedken Lyons
- Ann Arbor VA, Ann Arbor, MI; University of Michigan, Ann Arbor, MI
| | - C Rock
- Johns Hopkins University, Baltimore, MD
| | - M Rubin
- Salt Lake City VA, Salt Lake City, UT; University of Utah, Salt Lake City, UT
| | | | - H S Reisinger
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - E Perencevich
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, IA; University of Iowa, Iowa City, IA
| | - N Safdar
- Madison VA, Madison, WI; University of Wisconsin - Madison, Madison, WI
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4
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Gurwitz JH, Quinn CC, Abi-Elias IH, Adams AS, Bartel R, Bonner A, Boxer R, Delude C, Gifford D, Hanson B, Ito K, Jain P, Magaziner JS, Mazor KM, Mitchell SL, Mody L, Nace D, Ouslander J, Reifsnyder J, Resnick B, Zimmerman S. Advancing clinical trials in nursing homes: A proposed roadmap to success. Geriatr Nurs 2022; 45:230-234. [PMID: 35361514 PMCID: PMC8960155 DOI: 10.1016/j.gerinurse.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
An effective clinical research effort in nursing homes to address prevention and treatment of COVID-19 faced overwhelming challenges. Under the Health Care Systems Research Network-Older Americans Independence Centers AGING Initiative, a multidisciplinary Stakeholder Advisory Panel was convened to develop recommendations to improve the capability of the clinical research enterprise in US nursing homes. The Panel considered the nursing home as a setting for clinical trials, reviewed the current state of clinical trials in nursing homes, and ultimately developed recommendations for the establishment of a nursing home clinical trials research network that would be centrally supported and administered. This report summarizes the Panel's recommendations, which were developed in alignment with the following core principles: build on available research infrastructure where appropriate; leverage existing productive partnerships of researchers with groups of nursing homes and nursing home corporations; encompass both efficacy and effectiveness clinical trials; be responsive to a broad range of stakeholders including nursing home residents and their care partners; be relevant to an expansive range of clinical and health care delivery research questions; be able to pivot as necessary to changing research priorities and circumstances; create a pathway for industry-sponsored research as appropriate; invest in strategies to increase diversity in study populations and the research workforce; and foster the development of the next generation of nursing home researchers.
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Affiliation(s)
- Jerry H Gurwitz
- Meyers Health Care Institute, Worcester, MA, USA; UMass Chan Medical School, Worcester, MA, USA.
| | | | | | - Alyce S Adams
- Stanford University School of Medicine, Stanford, CA, USA
| | - Rosie Bartel
- AGING Patient/Caregiver Advisory Council, Worcester, MA, USA
| | - Alice Bonner
- Institute for Healthcare Improvement, Boston, MA, USA; Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | | | - David Gifford
- American Health Care Association, Washington, DC, USA
| | - Bruce Hanson
- AGING Patient/Caregiver Advisory Council, Worcester, MA, USA
| | - Kouta Ito
- Meyers Health Care Institute, Worcester, MA, USA; UMass Chan Medical School, Worcester, MA, USA
| | - Paavani Jain
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jay S Magaziner
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kathleen M Mazor
- Meyers Health Care Institute, Worcester, MA, USA; UMass Chan Medical School, Worcester, MA, USA
| | - Susan L Mitchell
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA
| | - Lona Mody
- University of Michigan, Ann Arbor, MI, USA
| | - David Nace
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
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5
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Gurwitz JH, Quinn CC, Abi-Elias IH, Adams AS, Bartel R, Bonner A, Boxer R, Delude C, Gifford D, Hanson B, Ito K, Jain P, Magaziner JS, Mazor KM, Mitchell SL, Mody L, Nace D, Ouslander J, Reifsnyder J, Resnick B, Zimmerman S. Advancing Clinical Trials in Nursing Homes: A Proposed Roadmap to Success. J Am Geriatr Soc 2022; 70:701-708. [PMID: 35195276 PMCID: PMC8910690 DOI: 10.1111/jgs.17696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 02/02/2023]
Abstract
An effective clinical research effort in nursing homes to address prevention and treatment of COVID-19 faced overwhelming challenges. Under the Health Care Systems Research Network-Older Americans Independence Centers AGING Initiative, a multidisciplinary Stakeholder Advisory Panel was convened to develop recommendations to improve the capability of the clinical research enterprise in US nursing homes. The Panel considered the nursing home as a setting for clinical trials, reviewed the current state of clinical trials in nursing homes, and ultimately developed recommendations for the establishment of a nursing home clinical trials research network that would be centrally supported and administered. This report summarizes the Panel's recommendations, which were developed in alignment with the following core principles: build on available research infrastructure where appropriate; leverage existing productive partnerships of researchers with groups of nursing homes and nursing home corporations; encompass both efficacy and effectiveness clinical trials; be responsive to a broad range of stakeholders including nursing home residents and their care partners; be relevant to an expansive range of clinical and health care delivery research questions; be able to pivot as necessary to changing research priorities and circumstances; create a pathway for industry-sponsored research as appropriate; invest in strategies to increase diversity in study populations and the research workforce; and foster the development of the next generation of nursing home researchers.
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Affiliation(s)
- Jerry H. Gurwitz
- Meyers Health Care Institute, Worcester, MA, USA,UMass Chan Medical School, Worcester, MA, USA,Address correspondence to Jerry H. Gurwitz MD, Meyers Health Care Institute, 385 Grove Street, Worcester, MA 01605, USA. (J.H. Gurwitz)
| | | | | | - Alyce S. Adams
- Stanford University School of Medicine, Stanford, CA, USA
| | - Rosie Bartel
- AGING Patient/Caregiver Advisory Council, Worcester, MA, USA
| | - Alice Bonner
- Institute for Healthcare Improvement, Boston, MA, USA,Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | | | - David Gifford
- American Health Care Association, Washington, DC, USA
| | - Bruce Hanson
- AGING Patient/Caregiver Advisory Council, Worcester, MA, USA
| | - Kouta Ito
- Meyers Health Care Institute, Worcester, MA, USA,UMass Chan Medical School, Worcester, MA, USA
| | - Paavani Jain
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Kathleen M. Mazor
- Meyers Health Care Institute, Worcester, MA, USA,UMass Chan Medical School, Worcester, MA, USA
| | - Susan L. Mitchell
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA
| | - Lona Mody
- University of Michigan, Ann Arbor, MI, USA
| | - David Nace
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
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6
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Bartel R, Hoel S, Mckinley L, Baubie K, Keating JA, Safdar N. The patient engagement in education and research (PEER) healthcare-associated infection prevention project: A patient perspective. Am J Infect Control 2022; 50:233-234. [PMID: 35101178 DOI: 10.1016/j.ajic.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Rosie Bartel
- Patient-Centered Outcomes Research Institute (PCORI), Washington, DC; Department of Medicine, University of Wisconsin-Madison, Madison, WI
| | - Sydney Hoel
- Department of Medicine, University of Wisconsin-Madison, Madison, WI.
| | - Linda Mckinley
- William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Kelsey Baubie
- William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Julie A Keating
- William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Nasia Safdar
- Department of Medicine, University of Wisconsin-Madison, Madison, WI; William S. Middleton Memorial Veterans Hospital, Madison, WI
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7
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Gurwitz JH, Quinn CC, Abi-Elias IH, Adams AS, Bartel R, Bonner A, Boxer R, Delude C, Gifford D, Hanson B, Ito K, Jain P, Magaziner JS, Mazor KM, Mitchell SL, Mody L, Nace D, Ouslander J, Reifsnyder J, Resnick B, Zimmerman S. Advancing Clinical Trials in Nursing Homes: A Proposed Roadmap to Success. J Am Med Dir Assoc 2021; 23:345-349. [PMID: 34953784 PMCID: PMC8692165 DOI: 10.1016/j.jamda.2021.11.034] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 12/26/2022]
Abstract
An effective clinical research effort in nursing homes to address prevention and treatment of COVID-19 faced overwhelming challenges. Under the Health Care Systems Research Network-Older Americans Independence Centers AGING Initiative, a multidisciplinary Stakeholder Advisory Panel was convened to develop recommendations to improve the capability of the clinical research enterprise in US nursing homes. The Panel considered the nursing home as a setting for clinical trials, reviewed the current state of clinical trials in nursing homes, and ultimately developed recommendations for the establishment of a nursing home clinical trials research network that would be centrally supported and administered. This report summarizes the Panel’s recommendations, which were developed in alignment with the following core principles: build on available research infrastructure where appropriate; leverage existing productive partnerships of researchers with groups of nursing homes and nursing home corporations; encompass both efficacy and effectiveness clinical trials; be responsive to a broad range of stakeholders including nursing home residents and their care partners; be relevant to an expansive range of clinical and health care delivery research questions; be able to pivot as necessary to changing research priorities and circumstances; create a pathway for industry-sponsored research as appropriate; invest in strategies to increase diversity in study populations and the research workforce; and foster the development of the next generation of nursing home researchers.
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Affiliation(s)
- Jerry H Gurwitz
- Meyers Health Care Institute, Worcester, MA, USA; UMass Chan Medical School, Worcester, MA, USA.
| | | | | | - Alyce S Adams
- Stanford University School of Medicine, Stanford, CA, USA
| | - Rosie Bartel
- AGING Patient/Caregiver Advisory Council, Worcester, MA, USA
| | - Alice Bonner
- Institute for Healthcare Improvement, Boston, MA, USA; Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | | | - David Gifford
- American Health Care Association, Washington, DC, USA
| | - Bruce Hanson
- AGING Patient/Caregiver Advisory Council, Worcester, MA, USA
| | - Kouta Ito
- Meyers Health Care Institute, Worcester, MA, USA; UMass Chan Medical School, Worcester, MA, USA
| | - Paavani Jain
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jay S Magaziner
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kathleen M Mazor
- Meyers Health Care Institute, Worcester, MA, USA; UMass Chan Medical School, Worcester, MA, USA
| | - Susan L Mitchell
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA
| | - Lona Mody
- University of Michigan, Ann Arbor, MI, USA
| | - David Nace
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
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8
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Bartel R, Hoel S, Safdar N, Knobloch MJ. How to address fear: A patient’s perspective of seeking care during COVID-19. Patient Experience Journal 2021. [DOI: 10.35680/2372-0247.1604] [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: 11/05/2022] Open
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9
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Westlund K, Montera M, Goins A, Alles S, Afaghpour-Becklund M, Bartel R, Durvasula R, Kunamneni A. Single-chain Fragment variable antibody targeting cholecystokinin-B receptor for pain reduction. Neurobiol Pain 2021; 10:100067. [PMID: 34458647 PMCID: PMC8378781 DOI: 10.1016/j.ynpai.2021.100067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 05/13/2023]
Abstract
The cholecystokinin B receptor and its neuropeptide ligand are upregulated in chronic neuropathic pain models. Single-chain Fragment variable antibodies were generated as preferred non-opioid targeting therapy blocking the cholecystokinin B receptor to inhibit chronic neuropathic pain models in vivo and in vitro. Engineered antibodies of this type feature binding activity similar to monoclonal antibodies but with stronger affinity and increased tissue penetrability due to their smaller size. More importantly, single-chain Fragment variable antibodies have promising biotherapeutic applications for both nervous and immune systems, now recognized as interactive in chronic pain. A mouse single-chain Fragment variable antibody library recognizing a fifteen amino acid extracellular peptide fragment of the cholecystokinin B receptor was generated from immunized spleens. Ribosome display, a powerful cell-free technology, was applied for recombinant antibody selection. Antibodies with higher affinity, stability, solubility, and binding specificity for cholecystokinin B not A receptor were selected and optimized for in vivo and in vitro efficacy. A single dose of the lead candidate reduced mechanical and cold hypersensitivity in two rodent models of neuropathic pain for at least seven weeks. Continuing efficacy was evident with either intraperitoneal or intranasal dosing. Likewise, the lead single-chain Fragment variable antibody totally prevented development of anxiety- and depression-like behaviors and cognitive deficits typical in the models. Reduction of neuronal firing frequency was evident in trigeminal ganglia primary neuronal cultures treated in vitro with the cholecystokinin B receptor antibody. Immunofluorescent staining intensity in the trigeminal neuron primary cultures was significantly reduced incrementally after overnight binding with increasingly higher dilutions of the single-chain Fragment variable antibody. While it is reported that single-chain Fragment variable antibodies are removed systemically within 2-6 h, Western blot evidence indicates the His-tag marker remained after 7 weeks in the trigeminal ganglia and in the dorsolateral medulla, providing evidence of brain and ganglia penetrance known to be compromised in overactivated states. This project showcases the in vivo efficacy of our lead single-chain Fragment variable antibody indicating its potential for development as a non-opioid, non-addictive therapeutic intervention for chronic pain. Importantly, studies by others have indicated treatments with cholecystokinin B receptor antagonists suppress maintenance and reactivation of morphine dependence in place preference tests while lowering tolerance and dose requirements. Our future studies remain to address these potential benefits that may accompany the cholecystokinin B receptor biological therapy. Both chronic sciatic and orofacial pain can be unrelenting and excruciating, reducing quality of life as well as diminishing physical and mental function. An effective non-opiate, non-addictive therapy with potential to significantly reduce chronic neuropathic pain long term is greatly needed.
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Key Words
- ANOVA, analysis of variance
- ARM, antibody ribosome mRNA
- Anxiety
- BBB, blood–brain barrier
- CCK-8, cholecystokinin octapeptide
- CCK-BR, cholecystokinin B receptor
- CPP, conditioned place preference
- Chronic pain
- DRG, dorsal root ganglia
- Depression
- Eukaryotic ribosome display
- FRICT-ION, foramen rotundum inflammatory compression trigeminal infraorbital nerve model
- GPCR, G-protein-coupled receptor
- IACUC, Institutional Animal Care and Use Committee
- ION, infraorbital nerve
- MΩ, megaOhms
- PBS, phosphate buffered saline
- SEM, standard error of the mean
- TG, trigeminal ganglia
- ms, milliseconds
- pA, picoAmps
- scFv
- scFv, single-chain Fragment variable antibody
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Affiliation(s)
- K.N. Westlund
- Department of Anesthesiology & Critical Care Medicine, University of
New Mexico Health Sciences Center, Albuquerque, NM 87106-0001, USA
- Biomedical Laboratory Research & Development (121F), New Mexico VA
Health Care System, Albuquerque, NM, USA
| | - M.A. Montera
- Department of Anesthesiology & Critical Care Medicine, University of
New Mexico Health Sciences Center, Albuquerque, NM 87106-0001, USA
| | - A.E. Goins
- Department of Anesthesiology & Critical Care Medicine, University of
New Mexico Health Sciences Center, Albuquerque, NM 87106-0001, USA
| | - S.R.A. Alles
- Department of Anesthesiology & Critical Care Medicine, University of
New Mexico Health Sciences Center, Albuquerque, NM 87106-0001, USA
| | - M. Afaghpour-Becklund
- Department of Anesthesiology & Critical Care Medicine, University of
New Mexico Health Sciences Center, Albuquerque, NM 87106-0001, USA
| | - R. Bartel
- Department of Anesthesiology & Critical Care Medicine, University of
New Mexico Health Sciences Center, Albuquerque, NM 87106-0001, USA
| | - R. Durvasula
- Division of Infectious Diseases, Department of Internal Medicine, Mayo
Clinic, Jacksonville, FL, USA
- Department of Medicine, Loyola University Medical Center, Maywood, IL
60153-3328, USA
| | - A. Kunamneni
- Division of Infectious Diseases, Department of Internal Medicine, Mayo
Clinic, Jacksonville, FL, USA
- Department of Medicine, Loyola University Medical Center, Maywood, IL
60153-3328, USA
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Kawamoto A, Furukawa Y, Fujita Y, Kobayashi S, Tobita K, Yamaguchi J, Shimizu W, Takagi G, Matsumura H, Murata N, Nakamura M, Kitano I, Yokoi H, Azuma N, Kozuki A, Obara H, Furukawa M, Sietsema W, Takagi H, Wang J, Bartel R, Losordo D. Honedra® (CLBS12) autologous CD34+ cells improve outcomes in patients with Buerger’s disease. Cytotherapy 2021. [DOI: 10.1016/s146532492100390x] [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: 11/26/2022]
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11
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Bartel R, Levorato M, Adroher M, Cardelus S, Diaz A, Lacima J, Vazquez C, Veneri A, Wienberg P, Claveria M, Haag O. Performance of endoscopic repair with endonasal flaps for congenital choanal atresia. A systematic review. Acta Otorrinolaringologica (English Edition) 2021. [DOI: 10.1016/j.otoeng.2020.01.003] [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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12
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Bartel R, Levorato M, Adroher M, Cardelus S, Diaz A, Lacima J, Vazquez C, Veneri A, Wienberg P, Claveria MA, Haag OH. Performance of endoscopic repair with endonasal flaps for congenital choanal atresia. A systematic review. Acta Otorrinolaringol Esp (Engl Ed) 2020; 72:51-56. [PMID: 32439138 DOI: 10.1016/j.otorri.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 01/07/2020] [Accepted: 01/19/2020] [Indexed: 01/15/2023]
Abstract
Endoscopic repair of congenital choanal atresia is the gold standard surgical treatment today. Though several controversies on treatment have been reported, surgical techniques for better outcomes are still in discussion. The objective of this study is to evaluate the performance of endoscopic choanal atresia repair with endonasal flaps and no stents. Publications in English in the last 5 years were searched in the PUBMED database and were systematically reviewed. A total of 9 articles were included according to the inclusion criteria, obtaining a total of 266 patients managed for congenital choanal atresia with endoscopic surgery, endonasal flaps, and no stents. Surgical results, type of atresia, atresia laterality, associated pathologies and follow up were evaluated. Successful surgery was obtained in 237 (89%) patients while 29 (11%) patients required a new surgical intervention during the follow-up period. Fourteen percent of the patients were diagnosed with CHARGE syndrome and 5% of the patients had some associated heart disease. Bony-Membranous stenosis was observed in 74% of the patients, while a total bony obstruction was recognized in 26% of the patients. Unilateral atresia was observed in 37% of the cases and 63% of the cases had bilateral atresia. The mean follow-up period was 39.5 months (range 3-168 months). An important functional success rate can be accomplished by correcting congenital choanal atresia using functional endoscopic surgery, covering raw areas with endonasal vascularized flaps, avoiding postoperative endonasal stenting.
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Affiliation(s)
- R Bartel
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain.
| | - M Levorato
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - M Adroher
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - S Cardelus
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - A Diaz
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - J Lacima
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Vazquez
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - A Veneri
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - P Wienberg
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - M A Claveria
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
| | - O H Haag
- Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain
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Pagni G, Kaigler D, Rasperini G, Avila-Ortiz G, Bartel R, Giannobile W. Bone repair cells for craniofacial regeneration. Adv Drug Deliv Rev 2012; 64:1310-9. [PMID: 22433781 DOI: 10.1016/j.addr.2012.03.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/02/2012] [Accepted: 03/05/2012] [Indexed: 12/17/2022]
Abstract
Reconstruction of complex craniofacial deformities is a clinical challenge in situations of injury, congenital defects or disease. The use of cell-based therapies represents one of the most advanced methods for enhancing the regenerative response for craniofacial wound healing. Both somatic and stem cells have been adopted in the treatment of complex osseous defects and advances have been made in finding the most adequate scaffold for the delivery of cell therapies in human regenerative medicine. As an example of such approaches for clinical application for craniofacial regeneration, Ixmyelocel-T or bone repair cells are a source of bone marrow derived stem and progenitor cells. They are produced through the use of single pass perfusion bioreactors for CD90+ mesenchymal stem cells and CD14+ monocyte/macrophage progenitor cells. The application of ixmyelocel-T has shown potential in the regeneration of muscular, vascular, nervous and osseous tissue. The purpose of this manuscript is to highlight cell therapies used to repair bony and soft tissue defects in the oral and craniofacial complex. The field at this point remains at an early stage, however this review will provide insights into the progress being made using cell therapies for eventual development into clinical practice.
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Hansbrough JF, Morgan JL, Greenleaf GE, Bartel R. Composite grafts of human keratinocytes grown on a polyglactin mesh-cultured fibroblast dermal substitute function as a bilayer skin replacement in full-thickness wounds on athymic mice. J Burn Care Rehabil 1993; 14:485-94. [PMID: 8245102 DOI: 10.1097/00004630-199309000-00001] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We have developed and tested in athymic mice a new, cultured, dermal-epidermal graft composed of two human cell types coupled with a biodegradable dermal scaffold. Cultured, proliferating human keratinocytes (HK) were applied to the surface of a living dermal tissue replacement that is composed of human fibroblasts cultured on a polyglactin mesh. After 4 to 6 days of coculture, proliferating HKs achieved confluency on the surface of the living dermal tissue replacement. Grafts were then transferred to full-thickness wounds on the dorsum of athymic mice. Sixteen animals were grafted, and the mean percentage of graft take (original wound area covered) on day 20 after grafting was 51.25%. Staining with antibody specific for human involucrin confirmed the presence of HKs on closed wounds, and staining with antibody specific for human laminin revealed a continuous layer of laminin at the dermal-epidermal junction on day 20. Animals closed with living dermal tissue replacement alone markedly contracted, whereas application of living dermal tissue replacement-HK grafts appeared to retard contraction. Because polyglactin mesh fibers are absorbed by hydrolysis rather than by enzymatic degradation, this living composite graft may be more resistant to destruction when placed on excised human wounds than are composite grafts, which are composed of a collagen matrix. The inclusion of the living dermal substitute may ultimately provide better skin quality than is achieved from the use of cultured keratinocytes alone. Fragility of the epidermal layer is probably due to the short-term culture of HKs on the living dermal tissue replacement, and further efforts to develop a thicker epithelial layer may improve graft durability.
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Affiliation(s)
- J F Hansbrough
- Department of Surgery, University of California, San Diego Medical Center 92103
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Abstract
Glutamate analogues have been used in many different experimental approaches in neurobiology. A small number of these analogues have been classified as gliotoxic. We have examined the effect of seven glutamate analogues (five gliotoxic and two neurotoxic) on the growth and viability of four human glioma cell lines, one human medulloblastoma cell line, and one human sarcoma cell line. Aminoadipic acid and homocysteic acid predominantly affected the growth of two glioma cell lines in the presence of 4 mM glutamine. Phosphonobutyric acid predominantly affected the other two glioma cell lines and the medulloblastoma cell line in the presence of 4 mM glutamine. In medium containing no glutamine, all three analogues had marked effects on all the cell lines except the sarcoma cell line. These effects were dose dependent. We postulate that these results can in part be explained on the basis of metabolic compartmentalization.
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