Delivery Capacity Research Articles

Surface Modification of Hydroxyapatite Coating for Enhanced Antibiotic Therapy

A major strategy to combat implant-associated infections is to develop implant coatings with intrinsic antibacterial activity. Since hydroxyapatite (HAp) coatings and antibiotic administration are commonly used in clinical settings, developing HAp-coated implants with localized antibiotic-releasing properties has attracted popularity. Considering the antibacterial metal species (Ag, Zn, Cu, etc.) in metal–organic frameworks and their drug delivery capacity, in this study, a gentamicin-loaded zeolitic imidazolate framework-8 nanolayer was deposited on a plasma-sprayed HAp coating (HAp/ZIF-8@Gent), which served as a Gent and Zn2+ reservoir. The investigation on the binding interaction between ZIF-8 and HAp indicated that the growth of ZIF-8 was through a Zn2+ seed layer on the HAp coating via an adsorption–replacement mechanism, instead of simple physical adsorption. The HAp/ZIF-8@Gent coating exhibited a sustained drug-release property, and the cumulative concentration of released Gent reached 239.8 ± 7.1 μg/mL on day 8. Compared to the HAp-Zn and HAp/ZIF-8 coatings, the HAp/ZIF-8@Gent coating exhibited significantly higher antibacterial activity against E. coli. This was ascribed to the combined antibacterial effects of Zn2+ and Gent. The cytocompatibility of the HAp/ZIF-8@Gent coating was confirmed via cell proliferation. Above all, the ZIF-8-modified HAp coating with localized delivery of Gent and Zn2+ possessed excellent antibacterial activity and acceptable cytocompatibility, showing potential in mitigating implant-associated infections.

Innovations in Breaking Barriers: Liposomes as Near-Perfect Drug Carriers in Ischemic Stroke Therapy.

Liposomes, noted for their tunable particle size, surface customization, and varied drug delivery capacities, are increasingly acknowledged in therapeutic applications. These vesicles exhibit surface flexibility, enabling the incorporation of targeting moieties or peptides to achieve specific targeting and avoid lysosomal entrapment. Internally, their adaptable architecture permits the inclusion of a broad spectrum of drugs, contingent on their solubility characteristics. This study thoroughly reviews liposome fabrication, surface modifications, and drug release mechanisms post-systemic administration, with a particular emphasis on drugs crossing the blood-brain barrier (BBB) to address lesions. Additionally, the review delves into recent developments in the use of liposomes in ischemic stroke models, offering a comparative evaluation with other nanocarriers like exosomes and nano-micelles, thereby facilitating their clinical advancement.

Social media for learning: A qualitative exploration of the factors that impact clinical learners' attitudes and intentions.

Social media has created a revolution in learning and teaching. This study set out to provide a theory-informed exploration of the factors influencing medical students' perspectives of learning with social media using the theory of planned behaviour (TPB) as a framework. The study collected data using semi-structured interviews from seven third year medical students at an undergraduate Australian medical school, who were in their first clinical year. The data were analysed inductively and deductively using TPB. Three themes emerged relating to the factors that influence medical students' attitudes and intentions regarding using social media for learning: (1) Social media aligns with the needs and preferences of the contemporary learner; (2) rise of medical professionals on social media during the COVID-19 pandemic; and (3) being an informed user of social media for learning. Participants had largely positive views and attitudes towards social media as a learning tool especially for preclinical content due to its capacity for multimodal information delivery and evolving social norms. However, this positivity was tempered by the challenges they faced in determining quality of resources, linking their learning to clinical medicine and accessing specialist content. Social media can play a significant role in medical students' learning. However, its potential as an educational tool can be enhanced by widening access to resources, and implementing strategies that help students increase their evaluative judgement skills to make informed decisions regarding the quality of social media resources and to translate their social media-mediated learning into clinical practice.

Anaesthesia delivery systems in low and lower-middle-income Asian countries: A scoping review of capacity and effectiveness.

Literature on anaesthesia systems in low and lower middle-income countries is limited, focused on the Africa region, and provides minimal data on anaesthesia or associated disciplines within intensive care, pain management and emergency medicine. We thus conducted a scoping review of primary and secondary research literature on capacity and effectiveness of anaesthesia delivery in low and lower middle-income countries in the Asia region from 2000-2021, to clarify existing knowledge, important gaps, and possible subsequent steps. We applied Arksey and O'Malley's scoping literature review method to search five databases (i.e. EMBASE, CINAHL, Medline, Scopus, Web of Science), screen, extract, and synthesise data under three themes: (i) availability and type of anaesthesia workforce; (ii) anaesthesia system infrastructure, equipment, and supplies; and (iii) effectiveness of anaesthesia provision. We included 25 eligible sources of 603 identified. Only ten (40%) were published in the last 5 years and Asian lower-income countries were primarily represented in 15 multi-country sources. Fifteen (60%) sources used quantitative methods and provided limited information on data collection, e.g. sampling criteria or geographic areas included. No sources included countrywide data, despite anaesthesia delivery and resources differing significantly sub-nationally (e.g. central versus rural/remote, or insecure areas). Data on anaesthesiology delivery were limited, with findings including insufficiencies in workforce, supplies, training, and skills-building of anaesthesia personnel, along with the lack of consistent strategies for overcoming maldistribution of resources and improving anaesthesia delivery systems in the region. This review, a first attempt to synthesise existing data on anaesthesia delivery systems in low and lower-middle-income Asian countries, shows the anaesthesia literature is still limited. Findings highlight the urgent need for additional research and collaboration nationally and regionally to strengthen anaesthesia delivery and surgical facilities in resource-constrained settings.

Validation of Air Storage System for Hypoxia Exposure During Exercise.

Norberto, Matheus S., João Victor G. Torini, Matheus S. Firmino, and Marcelo Papoti. Validation of air storage system for hypoxia exposure during exercise. High Alt Med Biol. 00:000-000, 2024.-Considering the importance of optimizing normobaric hypoxia exposure (i.e., higher delivery capacity), the current study aims to validate a hypoxic air storage system. The study has a cross-over, one-blind randomized design. The air storage is composed of a piping system that directs hypoxic air from a hypoxia generator into nylon bags. Sixteen men (age, 25.4 ± 4.8 years; height, 174.9 ± 9.4 cm; weight, 77.1 ± 17.2 kg) performed three incremental treadmill tests until exhaustion on different days. For test-retest, the subjects repeated two tests in similar hypoxia conditions (H1 and H2; fraction of inspired O2 [FIO2] = ∼0.13; reliability analysis), and one time in normoxia (FIO2 = ∼0.20; condition comparison). Subjects' performance, blood lactate concentration ([La-]), arterial oxygen saturation (SpO2), oxygen consumption (VO2), heart rate (HR), and several respiratory-derived variables were evaluated. A comparison was made between the rest, moderate intensity, and exhaustion stages. All variables were compared using the Friedman test with Durbin-Conover post hoc (p < 0.05). The hypoxia test-retest showed no statistical differences for any variable. Time analysis showed similar behavior for SpO2, HR, and cardiorespiratory variables (p < 0.01) for both conditions. The mean FIO2 at rest and during the incremental treadmill test was higher for normoxia (20.6 ± 0.2%) than for H1 (13.8 ± 0.8%) and H2 (13.7 ± 0.3%) (p < 0.001). The VO2 response was higher in normoxia than during hypoxia exposure at moderate intensity (Normoxia = 43.1 ± 8.1; H1 = 38.7 ± 5.7; H2 = 35.8 ± 8.8 ml.kg-1.min-1) and at the exhaustion stage (Normoxia = 52.7 ± 12.5; H1 = 41.9 ± 8.8; H2 = 40.5 ± 8.9 ml.kg-1.min-1) (p < 0.01). SpO2 and HR showed excellent intraclass correlation coefficient (ICC) during all moments, whereas VO2, SpO2, ratio between ventilation and CO2 production (VE/VCO2), ratio between oxygen consumption and ventilation (VE/VO2), and HR showed moderate or good ICC and coefficient of variation <9% during hypoxia test-retest exercises. Thus, the air storage system showed validity for its application and reliability in the measurements associated.

Carboxymethylcellulose-induced depletion attraction to stabilize high internal phase Pickering emulsions for the elderly: 3D printing and β-carotene delivery

In this study, a carboxymethylcellulose (CMC) induced depletion attraction was developed to stabilize high internal phase Pickering emulsions (HIPPEs) as age-friendly 3D printing inks. The results demonstrated that depletion force induced the adsorption of yolk particles at the droplet interface and the formation of osmotic droplet clusters, thereby increasing the stability of HIPPEs. In addition, the rheological properties and nutrient delivery properties of HIPPEs could be adjusted by the mass ratio of yolk/CMC. The HIPPEs stabilized at yolk/CMC mass ratio 20:7.5 showed optimal printability, viscoelastic, structural recovery, and swallowability. HIPPEs have been applied to 3D printing, International Dysphagia Dietary Standardization Initiative (IDDSI) test, and in vitro digestive simulation in the elderly, indicating their attractive appearance, safe swallowability, and enhanced bioaccessibility of β-carotene. Our work provides new ideas for developing age-friendly foods with plasticity and nutrient delivery capacity by depletion attraction stabilizing HIPPEs.

Synchronizing crowdsourced co-modality between passenger and freight transportation services

This study introduces a synchronized passenger and freight co-modality problem (SPFCP), exploring a crowdsourced co-modality transportation mode where passengers, viewed as an external crowd, volunteer to participate in logistics activities in exchange for compensation. In SPFCP, decision-makers have the option to utilize both crowdsourced passengers (CPs) and self-operated professional couriers (PCs) for deliveries. We formalize the problem and employ a population-based variable neighborhood search to solve it. Our findings indicate that the availability of CPs crucially enhances delivery capacity and efficiency, with the system benefiting from a larger pool of CPs and a higher variability in their travel distances. However, challenges arise from extreme average parcel distances, necessitating precise matching for short distances and extensive crowdsourced resources for long distances. The study underscores the viability of integrating crowdsourced logistics into urban transport systems, suggesting a strategic balance between leveraging crowdsourced solutions and managing logistical complexities.

Biomimetic Erythrocyte-Like Particles from Microfluidic Electrospray for Tissue Engineering

Microparticles have demonstrated value for regenerative medicine. Attempts in this field tend to focus on the development of intelligent multifunctional microparticles for tissue regeneration. Here, inspired by erythrocytes-associated self-repairing process in damaged tissue, we present novel biomimetic erythrocyte-like microparticles (ELMPs). These ELMPs, which are composed of extracellular matrix-like hybrid hydrogels and the functional additives of black phosphorus, hemoglobin, and growth factors (GFs), are generated by using a microfluidic electrospray. As the resultant ELMPs have the capacity for oxygen delivery and near-infrared-responsive release of both GFs and oxygen, they would have excellent biocompatibility and multifunctional performance when serving as microscaffolds for cell adhesion, stimulating angiogenesis, and adjusting the release profile of cargoes. Based on these features, we demonstrate that the ELMPs can stably overlap to fill a wound and realize controllable cargo release to achieve the desired curative effect of tissue regeneration. Thus, we consider our biomimetic ELMPs with discoid morphology and cargo-delivery capacity to be ideal for tissue engineering.

An update on the global disparities in kidney disease burden and care across world countries and regions

Since 2015, the International Society of Nephrology (ISN) Global Kidney Health Atlas (ISN-GKHA) has spearheaded multinational efforts to understand the status and capacity of countries to provide optimal kidney care, particularly in low-resource settings. In this iteration of the ISN-GKHA, we sought to extend previous findings by assessing availability, accessibility, quality, and affordability of medicines, kidney replacement therapy (KRT), and conservative kidney management (CKM). A consistent approach was used to obtain country-level data on kidney care capacity during three phases of data collection in 2016, 2018, and 2022. The current report includes a detailed literature review of published reports, databases, and registries to obtain information on the burden of chronic kidney disease and estimate the incidence and prevalence of treated kidney failure. Findings were triangulated with data from a multinational survey of opinion leaders based on the WHO's building blocks for health systems (ie, health financing, service delivery, access to essential medicines and health technology, health information systems, workforce, and governance). Country-level data were stratified by the ISN geographical regions and World Bank income groups and reported as counts and percentages, with global, regional, and income level estimates presented as medians with interquartile ranges. The literature review used information on prevalence of chronic kidney disease from 161 countries. The global median prevalence of chronic kidney disease was 9·5% (IQR 5·9-11·7) with the highest prevalence in Eastern and Central Europe (12·8%, 11·9-14·1). For the survey analysis, responses received covered 167 (87%) of 191 countries, representing 97·4% (7·700 billion of 7·903 billion) of the world population. Chronic haemodialysis was available in 162 (98%) of 165 countries, chronic peritoneal dialysis in 130 (79%), and kidney transplantation in 116 (70%). However, 121 (74%) of 164 countries were able to provide KRT to more than 50% of people with kidney failure. Children did not have access to haemodialysis in 12 (19%) of 62 countries, peritoneal dialysis in three (6%) countries, or kidney transplantation in three (6%) countries. CKM (non-dialysis management of people with kidney failure chosen through shared decision making) was available in 87 (53%) of 165 countries. The annual median costs of KRT were: US$19 380 per person for haemodialysis, $18 959 for peritoneal dialysis, and $26 903 for the first year of kidney transplantation. Overall, 74 (45%) of 166 countries allocated public funding to provide free haemodialysis at the point of delivery; use of this funding scheme increased with country income level. The median global prevalence of nephrologists was 11·8 per million population (IQR 1·8-24·8) with an 80-fold difference between low-income and high-income countries. Differing degrees of health workforce shortages were reported across regions and country income levels. A quarter of countries had a national chronic kidney disease-specific strategy (41 [25%] of 162) and chronic kidney disease was recognised as a health priority in 78 (48%) of 162 countries. This study provides new information about the global burden of kidney disease and its treatment. Countries in low-resource settings have substantially diminished capacity for kidney care delivery. These findings have major policy implications for achieving equitable access to kidney care. International Society of Nephrology.

Progress towards health equity in Vietnam: evidence from nationwide official health statistics, 2010-2020

IntroductionOne of the ultimate goals of strengthening the health system is to achieve health equity. Vietnam is considered one of the ‘fast-track countries’ to achieve the health-related Millennium Development Goals,...

Advances of Recombinant Adenoviral Vectors in Preclinical and Clinical Applications.

Adenoviruses (Ad) have the potential to induce severe infections in vulnerable patient groups. Therefore, understanding Ad biology and antiviral processes is important to comprehend the signaling cascades during an infection and to initiate appropriate diagnostic and therapeutic interventions. In addition, Ad vector-based vaccines have revealed significant potential in generating robust immune protection and recombinant Ad vectors facilitate efficient gene transfer to treat genetic diseases and are used as oncolytic viruses to treat cancer. Continuous improvements in gene delivery capacity, coupled with advancements in production methods, have enabled widespread application in cancer therapy, vaccine development, and gene therapy on a large scale. This review provides a comprehensive overview of the virus biology, and several aspects of recombinant Ad vectors, as well as the development of Ad vector, are discussed. Moreover, we focus on those Ads that were used in preclinical and clinical applications including regenerative medicine, vaccine development, genome engineering, treatment of genetic diseases, and virotherapy in tumor treatment.

Decoding of the surfaceome and endocytome in primary glioblastoma cells identifies potential target antigens in the hypoxic tumor niche

Immunotherapies with antibody–drug-conjugates (ADC) and CAR-T cells, targeted at tumor surface antigens (surfaceome), currently revolutionize clinical oncology. However, target identification warrants a better understanding of the surfaceome and how it is modulated by the tumor microenvironment. Here, we decode the surfaceome and endocytome and its remodeling by hypoxic stress in glioblastoma (GBM), the most common and aggressive brain tumor in adults. We employed a comprehensive approach for global and dynamic profiling of the surfaceome and endocytosed (endocytome) proteins and their regulation by hypoxia in patient-derived GBM cultures. We found a heterogeneous surface-endocytome profile and a divergent response to hypoxia across GBM cultures. We provide a quantitative ranking of more than 600 surface resident and endocytosed proteins, and their regulation by hypoxia, serving as a resource to the cancer research community. As proof-of-concept, the established target antigen CD44 was identified as a commonly and abundantly expressed surface protein with high endocytic activity. Among hypoxia induced proteins, we reveal CXADR, CD47, CD81, BSG, and FXYD6 as potential targets of the stressed GBM niche. We could validate these findings by immunofluorescence analyses in patient tumors and by increased expression in the hypoxic core of GBM spheroids. Selected candidates were finally confronted by treatment studies, showing their high capacity for internalization and ADC delivery. Importantly, we highlight the limited correlation between transcriptomics and proteomics, emphasizing the critical role of membrane protein enrichment strategies and quantitative mass spectrometry. Our findings provide a comprehensive understanding of the surface-endocytome and its remodeling by hypoxia in GBM as a resource for exploration of targets for immunotherapeutic approaches in GBM.

Defining Practice Capacity for Cancer Care Delivery to Adolescents and Young Adults in the Community Setting: 2022 Landscape Assessment Results.

Background: Adolescents and young adults (AYAs) commonly receive cancer care in the community setting, but the availability of treatment options, resources, and support services for this population is not well known. The National Cancer Institute Community Oncology Research Program (NCORP) funds a network of practices whose mission is to increase access to cancer care and clinical trials in the community setting. We describe our interdisciplinary methodological approach to identify and characterize NCORP practices where AYAs receive cancer care. Methods: NCORP practices completed a cross-sectional Landscape Assessment to describe resources and practice characteristics. We established an interdisciplinary team of stakeholders to analyze the Landscape Assessment data relating to AYAs. Through an iterative process, we assessed NCORP practice responses to questions assessing AYA cancer care capacity, determined a threshold to define practices treating AYAs, and characterized these practices. Results: We determined that practices provide cancer care to AYAs if the following criteria were met: (1) endorsed having an AYA program (n = 20), (2) AYAs comprised ≥5% of annual cancer cases (n = 55), or (3) the practice treated ≥50 AYA cancer cases annually (n = 70). Of 271 NCORP practices, 100 (37%) met any criteria, whereas 87 (32%) did not; 84 (31%) could not be classified due to missing or unknown data. Conclusion: Using an interdisciplinary process, we define practices that treat AYAs in the community. We posit a uniform approach to examine resources and practice capacity for AYAs receiving cancer care across the United States to guide future AYA-focused cancer care delivery research development.

Sustaining Natural Dye Plants with Post-Consumer Textile Waste

Aligned with the circular economy framework, this study aims to address pertinent research gaps regarding material and chemical properties of clothing and suitability for closed-loop applications. Primary research questions include: (1) what are the material and chemical properties of post-consumer textile waste from a sustainable fashion take-back program; (2) which natural post-consumer textile waste is most suitable to support the growth of natural dye plants in a hydroponics system; and (3) can the use of post-consumer textile waste in a hydroponics system be scaled to support a circular fashion supply chain? This study focuses on wool, cotton, linen, silk, rayon, and Tencel® lyocell as substrates to nurture the growth of purple basil, a natural dye plant. Vertical hydroponics is a farming method that uses nutrient water to grow plants in place of soil throughout the year. The system can be indoors, making resourceful use of limited space available and the water is recirculated. Standard hydroponic substrates, like peat moss and rockwool, have good porosity for oxygen transport and suitable moisture holding capacity for nutrient delivery. In this study, we compared the performance of the standard hydroponic substrates with various textiles. The impact on water quality, color release, moisture wicking, stability against degradation, and survival rate of the plants was used to evaluate suitability in the application. Wool, silk, and Tencel lyocell demonstrated good durability in the hydroponic system, like peat moss and rockwool, during the first growth cycle. During the second growth cycle, protein fibers—wool and silk—supported plant survival at a greater capacity than Tencel lyocell. Future research can confirm that wool and silk can support the growth of natural dye plants with a larger sample size. This research aligns with several circular economy objectives and provides a model for future research to support circular fashion supply chains.

Procurement of last-mile delivery capacity: a reverse auction mechanism considering logistics service quality

ABSTRACT The increasing demand for last-mile delivery has created a challenge for urban consolidation centers (UCCs). Due to UCC’s limited delivery capacity, it has to purchase spare capacity from carriers. In the procurement, the UCC cannot observe the carriers’ efforts, resulting in low-quality logistics services. Thus, we propose a reverse auction mechanism considering logistics service quality (LSQ) for the UCC’s procurement of last-mile delivery capacity. First, we construct the benchmark of the mechanism by introducing the LSQ in last-mile delivery and presenting a reverse auction. Then, we develop an auction model with ideas of ensuring the UCC’s incentive and awarding business to the carriers who deliver high-quality services. The case study shows that the proposed mechanism is an efficient procurement tool for the UCC with a guarantee of LSQ, and the UCC will benefit from the proposed mechanism by significant total cost saving as well as effective use of resources.

Identification of Potent siRNA Delivery Peptides Using Computer Modeling.

Peptides with suitable aggregation behavior and electrical properties are potential siRNA delivery vectors. However, identifying suitable peptides with ideal delivery and safety features is difficult owing to the variations in amino acid sequences. Here, a holistic program based on computer modeling and single-cell RNA sequencing (scRNA-seq)is used to identify ideal siRNA delivery peptides. Stage one of this program consists of a sequential screening process for candidates with ideal assembly and delivery ability; stage two is a cell subtype-level analysis program that screens for high in vivo tissue safety. The leading candidate peptide selected from a library containing 12 amino acids showed strong lung-targeted siRNA delivery capacity after hydrophobic modification. Systemic administration of these compounds caused the least damage to liver and lung tissues and has little impact on macrophage and neutrophil numbers. By loading STAT3 siRNA, strong anticancer effects are achieved in multiple models, including patient-derived xenografts (PDX). This screening procedure may facilitate the development of peptide-based RNA interference (RNAi) therapeutics.

Cloud-Kitchens: Value Creation Through Co-Location

“Cloud Kitchens” are delivery-only facilities that house multiple restaurants. Food-delivery platforms operate such kitchens to exploit two advantages: (a) Location advantage, arising due to a cloud-kitchen’s central location—this enables lower delivery times to customers. (b) Consolidation advantage, which accrues when multiple restaurants choose to co-locate at the cloud kitchen—this enables the platform to use a common pool of delivery drivers, thereby reducing costs. However, a cloud-kitchen’s eventual impacts on both the restaurants and the platform are intricately connected through their respective decisions—namely, the restaurants’ location decisions and the platform’s delivery capacity and delivery time. We examine conditions under which a cloud kitchen simultaneously benefits the primary stakeholders: delivery platform, restaurants, and customers. Our game-theoretic analysis considers two restaurants and a delivery platform. The restaurants simultaneously decide whether to stay at their initial (extreme) locations or relocate to a centrally located cloud kitchen. The platform decides the driver headcount and the delivery times for customers. In line with industry trends, we show that as population density increases beyond a threshold, the restaurants co-locating at the cloud kitchen is first a Pareto-dominant equilibrium and then the unique equilibrium. The platform and customers also prefer this equilibrium, leading to a win-win-win for the stakeholders. A cloud-kitchen’s benefit to the platform further increases as the drivers’ operational environment becomes more constrained, i.e. drivers’ carry-limit and speed decrease, and driver cost increases.

Policing and politics of law enforcement in Nigeria’s fourth republic

ABSTRACT Historically, policing and law enforcement operations of the Nigeria Police Force have generally been characterised by covert and overt politicisation. Against this background, this article critically analysed the politicisation of policing and law enforcement in Nigeria’s fourth republic. It argues that the influence of politics on the enforcement of the law by the police agency manifests under different guises and circumstances at both the macro and micro levels. Police personnel are not only routinely being used by politicians and the ruling class to further their own personal political gains, the management and operational philosophy of the agency are also often a product of systematic politicisation and power struggles amongst groups. Consequently, the overall service delivery capacity of the Nigeria Police Force is being hampered by politicisation.

Policy for Attacking Poverty Case: Cambodia

What are the causes of poverty? And why is poverty so widespread in the world? To answer these frequently asked questions, there are several factors to consider when it comes to the aspects that contribute to the causes of poverty. Factors such as economic, political, institutional and cultural aspects can all influence the case. As can be seen in Cambodia, the last decade has seen significant economic growth and poverty reduction, accompanied by numerous structural policy changes. However, a significant wealth and income gap still exists between the country's lower and upper classes, while the sudden onset of the COVID-19 pandemic has devastated Cambodia and pushed many people into poverty. Additionally, rural and low-income families face challenges accessing services and jobs, necessitating the focus on improving public institutions' capacities for effective resource management and responsible service delivery. This article hopes to provide valuable information to future researchers on poverty alleviation policies in Cambodia and the factors that contribute to urban-rural poverty.

A moment in and out of time: precarity, liminality, and autonomy in crisis teaching

ABSTRACT This paper explores tensions and ambiguities for UK HE teachers during COVID-19. It analyses changed behaviours and routines for existing hybrid workers experienced in online pedagogy through three core axes of precarity and security; time and perceptions of time; and communication. Twelve participants supplied photographs and written narratives depicting their teaching during the pandemic. To understand working lives at this liminal time, we undertook three-level photographic and content analysis, examining the interplay between homeworking challenges and extremities with an accompanying range of emotional responses. Findings include changed routines, new independence, and tensions around resulting autonomy in a liminal lockdown phase when everyday life was anything but. Recommendations for HE management are to ensure that effective communication and collaboration are privileged between management and academic staff. Moving forward, the value of academic judgement and voice should be acknowledged as much as teaching capacity in strategic planning and tuition delivery.