While there are a number of nanomaterials that can lead to on demand drug delivery or longterm delivery, there are limited nanotechnologies that are stable for long times, deliver sustained amounts of drugs, and achieve repeated, on demand delivery. We have developed a system based on polyurethane nanocapsules as a platform for long-term and on demand delivery. We synthesized nanocapsules encapsulating either a model drug, fluorescein, or a clinically relevant drug, acriflavine, a HIF-1alpha inhibitor. The nanocapsules were ~250 nm in diameter as measured by DLS and confirmed via SEM, and the molecules were localized in the walls of the nanocapsules as determined by confocal microscopy. Release studies were performed at 37 C in PBS, and both the fluorescein and acriflavine were delivered over several weeks. At the end of the release, no pellet was detectable upon centrifugation of the nanocapsules confirming degradation of the polyurethane shells. The same particles released a fraction of their payload upon the application of either an ultrasonic probe or a clinical grade, ultrasound imaging system used for assessing the retina. The amount of drug released could be tailored by the energy applied to the nanocapsules. One of the most exciting findings beyond being able to tailor how much was released based on the energy applied and the time it was applied was that these nanocapsules could be triggered to release multiple times with at least 10 separate release events triggered for each formulation. Being able to tailor the on-demand release over multiple cycles has the potential to fundamentally change how we can approach delivery of drugs for a variety of applications.
3D printing has revolutionized making tissue models, but the instruments are often quite expensive, and the approach can involve heat and/or shear forces that can damage cells. As a complement to more traditional 3D printing approaches, we looked at screen printing. Screen printing is an additive manufacturing technique used to pattern inks through screens supporting patterns onto different surfaces. It has a wide range of applications ranging from the traditional printing to printing electric circuit boards. Taking cues from this we have developed a process of screen printing live cells along with a suitable scaffold on to different surfaces to generate in vitro models. The process is not only inexpensive and simple to use, it offers a wide range of advantages like the ability to use a range of bioinks limited only by their gelation time, printing on different surfaces, and the ability to autoclave all of the major components. In this paper we present the screen assembly and the setup we used to print the cells along with the resolution and limits of features printed and the effect of the printing on the cells.
Background The opioid epidemic is a progressively worsening public health crisis that continues to impact healthcare system strategies such as overdose reversal and destigmatization. Even among healthcare professionals, there remains a lack of confidence in naloxone administration and a prevalence of stigma. While training can play a major impact in reducing these shortcomings, the long-term effectiveness has yet to be characterized in training healthcare professionals. This study examined the long-term retention of opioid overdose awareness and reversal training (OOART) by evaluating performance at two-time intervals, immediately post-training and at a 3-month follow-up. Methods Voluntary training was offered to first-year (M1) medical students at the Drexel University College of Medicine in 2021. At this training, 118 students completed training, 95 completed the post-training survey, and 42 completed the 3-month follow-up. Results Opioid reversal knowledge questions assessed significantly increased scores post-training and at the 3-month follow-up. In three of the attitude questions, scores were improved at both follow-up timepoints. In addition, three attitude questions indicating a participant’s confidence to respond to an opioid overdose situation increased directly after the training, but regressed at the 3-month follow-up. The remaining questions did not show any statistical difference across the survey intervals. Conclusions This study establishes that while OOART provides participants with the knowledge of how to respond to an opioid overdose, the retention of this knowledge at a 3-month interval is reduced. The results were mixed for longitudinal assessment of participant’s attitudes toward people with opioid use disorder. Some positive increases in attitudes were retained at the 3-month interval, while others trended back toward pre-training levels. These results support the effectiveness of the training but also provide evidence that OOART must be reinforced often.
Bone cements and dental resins are methacrylate-based materials that have been in use for many years, but their failure rates are quite high with essentially all dental resins failing within 10 years and 25% of all prosthetic implants will undergo aseptic loosening. There are significant healthcare costs and impacts on quality of life of patients. Self-healing bone cements and resins could improve the lifespan of these systems, reduce costs, and improve patient outcomes, but they have been limited by efficacy and toxicity of the components. To address these issues, we developed a self-healing system based on a dual nanocapsule system. Two nanocapsules were synthesized, one containing an initiator and one encapsulating a monomer, both in polyurethane shells. The monomer used was triethylene glycol dimethacrylate. The initiator capsules synthesized contained benzoyl peroxide and butylated hydroxytoluene. Resins containing the nanocapsules were tested in tension until failure, and the fractured surfaces were placed together. 33% of the samples showed self-healing behaviors to the point where they could be reloaded and tested in tension. Furthermore, the capsules and their components showed good biocompatibility with Caco-2 cells, a human epithelial cell line suggesting that they would be well tolerated in vivo.
Currently, there is a multitude of methods for evaluating the costs and benefits of programs, tools, etc. While cost-benefit analysis (CBA) is commonly used, cost-effectiveness analysis (CEA) is a more appropriate method of evaluation in clinical contexts, such as radiology practices, as CEAs use units such as life years gained as opposed to money (as is the case for CBAs). This review examines CEAs performed within the past 15 years to highlight their applications and key findings in the context of medical imaging.In total, 20 articles published between 2006 and 2022 were identified using a PubMed search for keywords including "cost-effectiveness analysis," "breast cancer," and "medical imaging," with studies lacking a substantial discussion of CEA or a related topic being excluded.CEAs have traditionally been criticized for lack of a standard methodology, despite their utility in the detection and treatment of various pathologies. Although mammography and magnetic resonance imaging (MRI) are the preferred and cost-effective imaging modalities for breast cancer, other imaging modalities, such as contrast-enhanced mammography and digital breast tomosynthesis, may be more cost-effective in the appropriate clinical context. Different combinations of mammography and MRI screenings for certain breast cancers may also prove to be more cost-effective compared to current mammography/MRI screening schedules.While CEA has shown potential utility in estimating the costs (per unit of health gained) of different imaging tools, CEA risks ignoring important outcomes not included in the analysis and cannot address if the benefits of the imaging tool exceed its costs, as a CBA would, suggesting the need for combining several economic evaluations for a more complete understanding.
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