Using Pathology Synoptic Reporting Data to Create Individual Dashboards for Pathologists and Surgeons.

CONTEXT.­: Electronic synoptic pathology reporting using xPert from mTuitive is available to all pathologists in British Columbia, Canada. Comparative feedback reports for pathologists and surgeons were created by using the synoptic reporting software. OBJECTIVE.­: To use data stored in a single central data repository to provide nonpunitive confidential comparative feedback reports (dashboards) to individual pathologists and surgeons for reflection on their practice and to use aggregate data for quality improvement initiatives. DESIGN.­: Integration of mTuitive middleware in 5 different laboratory information systems to have 1 software solution (xPert) sending discrete data elements to the central data repository was performed. Microsoft Office products were used to build comparative feedback reports and made the infrastructure sustainable. Two different types of reports were developed: individual confidential feedback reports (dashboards) and aggregated data reports. RESULTS.­: Pathologists have access to an individual confidential live feedback report for the 5 major cancer sites. Surgeons get an annual confidential emailed PDF report. Several quality improvement initiatives were identified from the aggregate data. CONCLUSIONS.­: We present 2 novel dashboards: a live pathologist dashboard and a static surgeon dashboard. Individual confidential dashboards incentivize use of nonmandated electronic synoptic pathology reporting tools and have increased adoption rates. Use of dashboards has also led to discussions about how patient care may be improved.

Enzyme Prodrug Therapy Engineered into Electrospun Fibers with Embedded Liposomes for Controlled, Localized Synthesis of Therapeutics.

Enzyme prodrug therapy (EPT) enables localized conversion of inert prodrugs to active drugs by enzymes. Performance of EPT necessitates that the enzyme remains active throughout the time frame of the envisioned therapeutic application. ß-glucuronidase is an enzyme with historically validated performance in EPT, however it retains its activity in biomaterials for an insufficiently long period of time, typically not exceeding 7 d. Herein, the encapsulation of ß-glucuronidase in liposomal subcompartments within poly(vinyl alcohol) electrospun fibers is reported, leading to the assembly of biocatalytically active materials with activity of the enzyme sustained over at least seven weeks. It is further shown that liposomes provide the highly beneficial stabilization of the enzyme when incubated in cell culture media. The assembled biocatalytic materials successfully produce antiproliferative drugs (SN-38) using externally administered prodrugs (SN-38-glucuronide) and effectively suppress cell proliferation, with envisioned utility in the design of cardiovascular grafts.