Patient Convenience Research Articles

Abuse-deterrent wearable device with potential for extended delivery of opioid drugs

Abstract Purpose Unethical attempts to misuse and overdose opioids have led to strict prescription limits, necessitating frequent hospital visits and prescriptions for long-term severe pain management. Therefore, this study aimed to develop a prototype wearable device that facilitates the extended delivery of opioid drugs while incorporating abuse-deterrent functionality, referred to as the abuse deterrent device (ADD). Methods The ADD was designed and fabricated using 3D-printed components, including reservoirs for the drug and contaminant, as well as an actuator. In vitro tests were conducted using a skin-mimicking layer and phosphate-buffered saline (PBS) to evaluate the drug release profile and the effectiveness of the ADD abuse-deterrent mechanism. Results Under simulated skin attachment, ADD demonstrated sustained drug release with the potential to persist for up to 200 days. Upon detachment from the skin mimic, the mechanical components of the ADD facilitated immediate exposure of the contaminant to the drug and effectively halted further drug exposure throughout-diffusion. Conclusion Wearable ADD provides a secure and practical solution for the long-term treatment of high-risk medications such as opioids, enhances patient convenience, and addresses important public health concerns.

Thumb-sized 3D-Printed cymbal microneedle array (CyMA) for enhanced transdermal drug delivery.

Transdermal drug delivery presents a compelling alternative to both needle injection and oral ingestion of medication, as it enhances patient adherence and convenience through its non-invasive and painless administration method. The use of microneedles penetrates the barrier of the stratum corneum, facilitating the sustained delivery of drugs across the skin. However, their efficacy has been limited by the slow diffusion of molecules and often requires external triggers. Herein, a lightweight and minimized 3D-printed microneedle array is introduced, employing a cymbal-type ultrasound transducer, as the external engine for deeper and faster transdermal drug delivery. A theoretical finite element model was developed and the optimization design was conducted for structural parameters. The optimized assembled prototype was fabricated using high-precision 3D printing and weighs only 20g. In vivo experiments using a diabetic mouse model demonstrate that local insulin delivery with CyMA achieves systemic effects comparable to intraperitoneal administration. Such compact and effective microneedle delivery technology offers considerable promise therapeutic applications on the skin and intraoral use.

HSPICE simulation and analysis of current reused operational transconductance amplifiers for biomedical applications

The proposed work focuses on the design of a current-reused biomedical amplifier; it is a microwatt-level electrocardiogram (ECG) analog circuit design that addresses low power consumption and noise efficiency. As implantable devices require unobtrusiveness and longevity, the current reuse technique in this circuit effectively enhances power and noise efficiencies. Using 90 nm technology enables efficient circuit implementation, yielding promising simulation results. At 100 Hz, the noise performance reaches 62.095 nV/√Hz, while the power consumption is only 8.3797 µW. These advancements are pivotal for next-generation implantable devices, ensuring reliable operation and reducing frequent battery replacements, improving patient convenience. Moreover, the high noise efficiency ensures that ECG signals are captured with high fidelity, crucial for accurate monitoring and diagnosis. This research addresses the challenges in implantable ECG analog circuit design and sets a benchmark for future developments. The techniques employed can be adapted for other bio signal monitoring devices, broadening the impact on healthcare technology. Ultimately, this advancement contributes to more efficient, reliable, and long-lasting medical devices, enhancing patient monitoring and healthcare on a broader scale.

Overcoming Skin Barrier with Transfersomes: Opportunities, Challenges, and Applications.

Transdermal drug delivery systems (TDDS) offer several advantages over traditional methods such as injections and oral administration. These advantages include preventing first-pass metabolism, providing consistent and sustained activity, reducing side effects, enabling the use of short half-life drugs, improving physiological response, and enhancing patient convenience. However, the permeability of skin poses a challenge for TDDS, as it is impermeable to large molecules and hydrophilic drugs but permeable to small molecules and lipophilic drug. To overcome this barrier, researchers have investigated vesicular systems, such as transfersomes, liposomes, niosomes, and ethosomes. Among these vesicular systems, transfersomes are particularly promising for noninvasive drug administration due to their deformability and flexible membrane. They have been extensively studied for delivering anticancer drugs, insulin, corticosteroids, herbal medicines, and NSAIDs through the skin. Transfersomes have demonstrated efficacy in treating skin cancer, improving insulin delivery, enhancing site-specific corticosteroid delivery, and increasing the permeation and therapeutic effects of herbal medicines. They have also been effective in delivering pain relief with minimal side effects using NSAIDs and opioids. Transfersomes have been used for transdermal immunization and targeted drug delivery, offering site-specific release and minimizing adverse effects. Overall, transfersomes are a promising approach for transdermal drug delivery in various therapeutic applications. The aim of the present review is to discuss the various advantages and limitations of transfersomes and their mechanism to penetration across the skin, as well as their application for the delivery of various drugs like anticancer, antidiabetic, NSAIDs, herbal drugs, and transdermal immunization. Data we searched from PubMed, Google Scholar, and ScienceDirect. In this review, we have explored the various methods of preparation of transfersomes and their application for the delivery of various drugs like anticancer, antidiabetic, NSAIDs, herbal drugs, and transdermal immunization. In comparison to other vesicular systems, transfersomes are more flexible, have greater skin penetration capability, can transport systemic medicines, and are more stable. Transfersomes are capable of delivering both hydrophilic and hydrophobic drugs, making them suitable for transdermal drug delivery. The developed transfersomal gel could be used to improve medicine delivery through the skin.

The role of digital health in modern pharmacy: A review of emerging trends and patient impacts

The integration of digital health into modern pharmacy practices has revolutionized patient care and medication management, ushering in a new era of convenience, accessibility, and personalized healthcare services. This review provides an insightful review of the evolving role of digital health in pharmacy, focusing on emerging trends and their impacts on patients. Digital health technologies, such as telepharmacy services, mobile health applications, and virtual consultations, have transformed the traditional pharmacy model by bridging geographical barriers and expanding access to healthcare services. Pharmacists can now engage with patients remotely, providing medication counselling, monitoring, and adherence support through digital platforms. These innovations enhance patient convenience, empower individuals to take control of their health, and ultimately improve health outcomes. Furthermore, digital health solutions leverage advanced technologies like artificial intelligence (AI) and data analytics to optimize medication therapy and personalize patient care. AI-driven algorithms analyze patient data to identify trends, predict health outcomes, and optimize medication regimens, leading to more effective treatment plans and reduced medication errors. Moreover, digital health fosters greater collaboration and communication among healthcare providers, enabling seamless coordination of care and improved patient outcomes. Through secure electronic health records and interoperable systems, pharmacists can access comprehensive patient information, facilitating informed decision-making and enhanced patient safety. However, the adoption of digital health in pharmacy also presents challenges, including data privacy concerns, regulatory complexities, and disparities in digital literacy among patients. Addressing these challenges is crucial to ensure the ethical and effective implementation of digital health technologies in pharmacy practice. In conclusion, the integration of digital health into modern pharmacy represents a paradigm shift in patient care delivery, offering unprecedented opportunities to enhance accessibility, efficiency, and quality of care. By embracing emerging digital health trends, pharmacists can revolutionize medication management, improve patient engagement, and ultimately contribute to better health outcomes for individuals and communities.

Pharmacokinetics-Based Design of Subcutaneous Controlled Release Systems for Biologics.

Protein therapeutics have emerged as an exceedingly promising treatment modality in recent times but are predominantly given as intravenous administration. Transitioning to subcutaneous (SC) administration of these therapies could significantly enhance patient convenience by enabling at-home administration, thereby potentially reducing the overall cost of treatment. Approaches that enable sustained delivery of subcutaneously administered biologics offer further advantages in terms of less frequent dosing and better patient compliance. Controlled release technologies, such as hydrogels and subcutaneous implantable technologies, present exciting solutions by enabling the gradual release of biologics from the delivery system. Despite their substantial potential, significant hurdles remain in appropriately applying and integrating these technologies with the ongoing development of complex biologic-based therapies. We evaluate the potential impact of subcutaneously delivered controlled release systems on the downstream pharmacokinetics (PK) of several FDA-approved biologics by employing rigorous mathematical analysis and predictive PK simulations. By leveraging linear time-invariant (LTI) systems theory, we provide a robust framework for understanding and optimizing the release dynamics of these technologies. We demonstrate simple quantitative metrics and approaches that can inform the design and implementation of controlled release technologies. The findings highlight key opportunity areas to reduce dosing frequency, stabilize concentration profiles, and synergize the codelivery of biologics, calling for collaboration between drug delivery and PK scientists to create the most convenient, optimized, and effective precision therapies.

Analysis of satisfaction with hospitalization in the gynecology department: service design project

Aim of the study. Analysis of satisfaction with hospitalization in the gynecology department using service design.Materials and methods. The study used a service design, including observation and interviews with 18 respondents (12 patients and 6 nurses) in the gynecological department of the Municipal State Enterprise on the Right of Economic Management «Multidisciplinary hospital named after prof. Kh. Zh. Makazhanov». The study, conducted from October to December 2023, included data analysis by a team of two researchers using content analysis.Results and discussion. The study revealed problems in organizing hospitalizations of patients in the gynecological department. In order to improve the efficiency of hospitalization, a solution to problems with long waits and inconvenience for patients, as well as improving communication and empathy of medical staff, was proposed.Conclusion. Increasing patient awareness, ensuring comfort and confidentiality, optimizing admission processes and providing psychological support are highlighted as priority areas.

Hypofractionated image-guided radiotherapy with 70 Gy in 28 fractions for prostate cancer confined to the pelvis: a single institute experience in Taiwan

BackgroundThe incidence of prostate cancer is increasing in Asian countries. Although moderately hypofractionated radiotherapy is not inferior to conventional fractionated radiation according to the updated guidelines, data regarding its efficacy and safety in Taiwan are currently lacking. The aim of this study was to investigate the outcomes of prostate cancer patients treated with hypofractionated image-guided radiotherapy at a single institution in Taiwan.MethodsWe retrospectively included patients with prostate cancer across all risk groups who were treated with hypofractionated image-guided radiotherapy 70 Gy (Gy) in 28 fractions (at 2.5 Gy/fraction) between 2007 and 2022. We analyzed treatment efficacy by assessing overall survival, prostate cancer-specific survival, event-free survival, biochemical failure, locoregional recurrence, and distant metastasis. The safety of the treatment was evaluated through acute and late gastrointestinal (GI) and genitourinary (GU) toxicity grading based on the Radiation Therapy Oncology Group criteria. Event-free survival, overall survival, prostate cancer-specific survival, biochemical failure, locoregional recurrence, and distant metastasis were evaluated using the Kaplan–Meier method.ResultsWe identified 150 consecutive men with prostate cancer: 12.7% were at low risk, 32.7% were at intermediate risk, 44.6% were at high risk, and 10% had N1 disease. The median follow-up time was 68.9 months (range: 2.3–172 months). The 5-year overall survival rate was 91.7% for the entire cohort, with rates of 100%, 94.3%, 93.3% and 71.1% for the low-risk, intermediate-risk, high-risk, and N1-disease groups, respectively (p < 0.001). The 5-year event-free survival rate for all patients was 75.8%. Among the risk groups, the 5-year event-free survival rates were 100%, 86.3%, 68.3% and 52.5% for the low-risk, intermediate-risk, high-risk, and N1 disease groups, respectively (p < 0.001). Grade ≥ 2 late GI toxicity was rare (0.7%), and grade ≥ 2 late GU toxicity was observed in 9.3% of the patients.ConclusionsHypofractionated image-guided radiotherapy, delivering 70 Gy at 2.5 Gy per fraction, is both effective and safe for Taiwanese patients with prostate cancer across all risk groups, consistent with findings from existing large randomized trials. Therefore, as a solution to enhance patient convenience, hypofractionated radiotherapy is a reasonable option for the definitive treatment of prostate cancer.Trial registrationNot applicable.

Differentiating aspects of oral and long-acting injectable antipsychotic drugs for tailoring the therapy of schizophrenia in clinical practice: a narrative review.

Schizophrenia is a serious psychiatric condition requiring continuous treatment with antipsychotic medications available in different formulations, including oral antipsychotics (OAPs) and long-acting injectables (LAIs). This narrative review aims to comprehensively outline the advantages and disadvantages of OAPs and LAIs to support clinicians in choosing different formulations based on the presentation of clinical symptoms. An electronic search of the PubMed database was performed in June 2024, and additional articles were retrieved from the references or personal knowledge of the authors. Relevant advantages of OAPs identified in the literature include dosing flexibility, ease of discontinuation, lower cost, autonomy of patient administration, shorter time to steady-state, and wide choice of molecules, including risk of nonadherence, plasma level fluctuations, food and drug interactions, and polypharmacy. LAIs' advantages include improved adherence leading to reduced relapse rates and hospitalizations, patient convenience, and stable drug levels while disadvantages include discomfort of injection, possible stigma, less manageable drug interactions, organization of administration centers, and patient preference possibly contrary to physician preference. When treating schizophrenia, it is critical to consider patients' needs, preferences, and history of medication adherence. Combining patient education with individualized treatment plans may optimize outcomes and improve the quality of life.

Bioavailability Enhancement and Formulation Technologies of Oral Mucosal Dosage Forms: A Review

The oral mucosa is a versatile surface for drug administration, supporting both local and systemic therapies. Many active substances are effectively absorbed in the oral cavity, offering an alternative to enteral administration by bypassing the harsh gastrointestinal environment and hepatic first-pass metabolism. This has made oral mucosal drug delivery a growing area of research. Enhancing the bioavailability of active ingredients is a key focus in pharmaceutical technology, especially given the challenges of developing new drugs. Numerous strategies to improve bioavailability are compatible with oral mucosal delivery, with the unique anatomy of the oral cavity enabling specialized applications. A variety of dosage forms tailored for oral mucosal delivery meet therapeutic needs while addressing biopharmaceutical and patient compliance challenges. Proper formulation can achieve controlled release, improved bioavailability, and patient convenience. This review highlights the potential of oral mucosal drug delivery, focusing on bioavailability enhancement methods and the types and production technologies of dosage forms optimized for use in the oral cavity.

Effect of internet shutdown on postgraduate trainees in Manipur: A qualitative study.

Background & objectives Internet shutdowns, although rare can be imposed by governments or affiliated entities and can intentionally disrupt online information and communication systems. While justified for maintaining public order, these shutdowns cause substantial economic losses, public suffering, and reputational damage. The internet shutdown in Manipur, initiated on May 3, 2023, due to civil unrest, has affected various sectors. The impact on doctors, amidst an era where internet access is considered as an integral part of practice, warrants deeper exploration of the challenges faced during such a prolonged shutdown period. Therefore, this study was conducted to explore the impact of internet shutdown among postgraduate trainees from two tertiary care hospitals in Manipur. Methods A study was conducted in two tertiary healthcare centers in Manipur from July to August 2023 among medical postgraduate trainees. Participants were selected using purposive sampling. Twenty-two in-depth interviews (IDIs) were conducted, recorded, and transcribed verbatim. Thematic analysis was done to identify codes, categories and themes. Results This qualitative study was undertaken among postgraduate trainees in two different academic institutes. A total of 21 IDIs were carried out. The major themes emerged from the study, namely, impact on professional life, impact on personal life, social consequences and coping. Internet shutdown affected patient care such as seeking timely opinions from consultants, delays in sharing patient reports and inconveniences in the hand-off process and the academic performance of postgraduate trainees like unavailability of study materials or keeping up with recent advancements. On a personal level, it negatively affected communication with family and friends, mental well-being and caused inconvenience in shopping and transactions. The study also found some positive impacts, such as less screen time leading to better sleep and increased physical activities. Interpretation & conclusions The findings of this study suggest that the internet shutdown significantly affected both the professional and personal aspects of postgraduate trainees' lives in Manipur. The implementation of a targeted ban on social media platforms and the establishment of designated internet access points are proposed as potential alternatives.

P1159 New onset acne reported in the majority of patients with upadacitinib-treated Inflammatory Bowel Disease

Abstract Background Upadacitinib (UPA), a janus kinase inhibitor (JAKi) with selectivity for JAK-1, is licensed in ulcerative colitis (UC) and Crohn’s disease (CD). Acne was seen commonly in the CD and UC registration studies of UPA. We sought to investigate the prevalence of acne in a real-world cohort of IBD patients using UPA. Methods We performed a retrospective review of all patients who received UPA for UC, CD or IBD-unclassified (IBD-U) between Sep 2022 and Sep 2024 at a large tertiary referral centre. Data were collated from electronic health records supplemented by telephone calls to individual patients. Demographic data, previous advanced treatments, dose and length of time on UPA were recorded in addition to skin related adverse effects. Self-reported acne was considered acceptable as a diagnosis, given that it is easily recognisable by the general public. Results The patient cohort is described in table 1. Out of 159 eligible subjects, 132 (83%) were reachable by telephone, 50 (38%) of whom were females. The indication for UPA was UC (67, 51%), CD (60, 45%), and IBD-U (5, 4%). 14 patients (11%) reported a history of acne at time of starting UPA and 60 (45%) were aware that acne was a potential side effect prior to starting the medication (Table 1). After a median duration of UPA therapy of 10 months (IQR 4-12), acne was reported by 77 (58%) patients (34 (51%) UC and 39 (65%) CD; 50 (61%) male and 27 (54%) female). Acne was reported to have involved the face (n=30, 41%), body (n=7, 9%) or both (n=37, 50%). The majority of UPA-associated acne was reported during the initial higher dose 45mg daily induction period (70, 91%) although acne persisted in 45 (58%) patients after reduction to 30mg. Notably, 35 (45%) patients with UPA-associated acne consulted their general practitioners, and 15 (19%) required specialist input from dermatologists. Importantly, acne-induced UPA dose reduction occurred in 4 (5%) patients and 3 (4%) patients discontinued UPA because of acne (Table 1). Conclusion The study suggests that self-reported acne is very common amongst patients who are receiving UPA for IBD, although acne-driven dose reduction or discontinuation is infrequent. Nearly half of the affected patients required GP assessments, and one fifth needed specialist dermatology input, suggesting substantial patient inconvenience and considerable impact on healthcare resource utilisation. Specific risk factors for acne, as well as potential benefits of dose reduction, should be further explored amongst upadacitnib users in larger, prospective studies.

Utility of Monitoring Fasting Phase During Pediatric Colonic Manometry Studies.

Colonic manometry (CM) is a diagnostic procedure used to evaluate pediatric patients with refractory constipation, fecal incontinence, Hirschsprung disease, and pediatric intestinal pseudo-obstruction. Pan-colonic high-amplitude propagated contractions (HAPCs), measured by CM, reflect an intact neuromuscular function of the colon. Current guidelines recommend starting CM with fasting recording for 1-2 h, but no prior evaluation has determined the diagnostic yield of the fasting phase. We aimed to determine the utility of the fasting phase during CM studies. We evaluated CM studies conducted at a tertiary pediatric center (2018-2022). Fasting phases of normal CM studies were evaluated. In 433 included studies 241 (55.7%) females, median age (9.7 years), the average fasting recording lasted 126 min. A total of 193 (44.6%) studies exhibited fasting HAPCs, with 123 (28.4%) being pan-colonic. The presence of pan-colonic HAPCs was based solely on the fasting phase in 11 (2.5%) studies. Patients with fasting pan-colonic HAPCs were younger (median age of 6.9 vs. 9.8 years, p = 0.0001) and had a higher rate of postprandial HAPCs (69.1% vs. 25.2%, p < 0.0001). Most fasting pan-colonic HAPCs presented during the first 60 min (94/123, 76.4%). All studies demonstrated HAPCs after stimulation with bisacodyl. In analyzing just the initial 30 min of fasting on CM, only 2 (0.5%) studies would have been misclassified as abnormal, with no bisacodyl administration in these studies. Shortening the fasting phase minimally affects next-day CM results and could reduce patient inconvenience, hospital-related costs, and potential side effects.

The Evaluation and Modification of Standard Airway Assessment Tests for Virtual Anaesthetic Assessments: A Pilot Study.

Background/Objectives: Virtual preoperative anaesthetic assessments can significantly reduce healthcare costs and improve patient convenience. The challenge with virtual consults is often the airway assessments, which screen for potentially difficult airways (PDAs). The objective of this pilot study was to determine the reliability of standard airway screening tests for detecting PDAs when conducted virtually. Methods: An observational longitudinal study was conducted between July 2021 and April 2022 at a tertiary hospital in Singapore. We compared the Mallampati score (MS), upper lip bite test (ULBT), thyromental distance, mouth opening test, and neck movements in 94 patients, first during virtual assessments before surgery and subsequently at face-to-face preoperative assessments (gold standard) on the day of surgery by the same team of anaesthesiology trainees. Goodman and Kruskal's gamma coefficient measured concordance between virtual and face-to-face assessment results. Logistic regression (LR) identified virtual predictors of PDAs in clinical practice. AUROC values informed tool performance. Results: LR showed that elevated virtual MS, virtual ULBT, and body mass index (BMI) were potential predictors of clinical PDAs. Termed the "MBBS", this collective score showed good performance with a sensitivity of 95% and an AUROC of 0.79. Importantly, all screening tests performed poorly in virtual assessments when applied individually (sensitivity < 50%). Conclusions: In this pilot study, BMI combined with MS and ULBT could reliably detect PDAs during virtual airway assessments. The data herein support further large multi-centre studies to validate the MBBS for clinical use.

Flow prediction in sound-based uroflowmetry

Sound-based uroflowmetry (SU) offers a non-invasive alternative to traditional uroflowmetry (UF) for evaluating lower urinary tract dysfunctions, enabling home-based testing and reducing the need for clinic visits. This study compares SU and UF in estimating urine flow rate and voided volume in 50 male volunteers (aged 18–60), with UF results from a Minze uroflowmeter as the reference standard. Audio signals recorded during voiding were segmented and machine learning algorithms (gradient boosting, random forest, and support vector machine) estimated flow parameters from three devices: Ultramic384k, Mi A1 smartphone, and Oppo smartwatch. The mean absolute error for flow rate estimation were 2.6, 2.5 and 2.9 ml/s, with R2 values of 84%, 83%, and 79%, respectively. Analysis of the Ultramic384k’s frequency range showed that the 0–8 kHz band contained 83% of significant components, suggesting higher sampling frequencies are unnecessary. A 1000 ms segment size was optimal for balancing computational efficiency and accuracy. Lin’s concordance coefficients for urine flow and voided volume using the smartwatch (0–8 kHz, 1000 ms) were 0.9 and 0.85, respectively, demonstrating that SU is a reliable, cost-effective alternative to UF for estimating key uroflowmetry parameters, with added patient convenience.

Subcutaneous Injection of Efgartigimod, a New Therapeutic Agent for Generalized Myasthenia Gravis

Patients with generalized myasthenia gravis (gMG) suffer from significant physical and social burdens. Although immunotherapies have been widely used for the treatment of gMG, some patients do not achieve or maintain remission. Recently, several molecular-targeting therapies of gMG, including the intravenous infusion of efgartigimod alfa (efgartigimod IV), a neonatal Fc receptor inhibitor, have been developed and are clinically used in Japan. In 2024, combination subcutaneous injection of efgartigimod alfa and vorhyaluronidase alfa (efgartigimod SC) was approved for the treatment of patients with gMG (only when treatment with steroids or non-steroidal immunotherapies does not lead to sufficient response). Efgartigimod SC contains vorhyaluronidase alfa, which temporarily and locally facilitates diffusion of efgartigimod alfa, resulting in its absorption enhancement. An international phase III, ADAPT-SC study in patients with gMG, including Japanese demonstrates the non-inferiority of efgartigimod SC to efgartigimod IV in reduction of total IgG by 4 weeks treatment. An extension ADAPT-SC+ study demonstrates the long-term safety and tolerability as well as repeatable clinical benefit across multiple efgartigimod SC treatment cycles. As a self-injectable drug, efgartigimod SC may not only contribute to satisfy unmet medical needs in gMG therapy, but also improve convenience for patients and healthcare providers. (Received July 11, 2024; Accepted September 13, 2024; Published January 1, 2025).

Navigating Recent Changes in Dosing Information: Dynamics of FDA-Approved Monoclonal Antibodies in Post-Marketing Realities.

Monoclonal antibodies (mAbs) are critical components in the therapeutic landscape, but their dosing strategies often evolve post-approval as new data emerge. This review evaluates post-marketing label changes in dosing information for FDA-approved mAbs from January 2015 to September 2024, with a focus on both initial and extended indications. We systematically analyzed dosing modifications, categorizing them into six predefined groups: Dose increases or decreases, inclusion of new patient populations by body weight or age, shifts from body weight-based dosing to fixed regimens, and adjustments in infusion rates. Among the 86 mAbs evaluated, 21% (n = 18) exhibited changes in dosing information for the initial indication, with a median time to modification of 37.5 months (range: 5-76 months). Furthermore, for mAbs with extended indications (n = 26), 19.2% (n = 5) underwent dosing changes in their first extensions, with a median time to adjustment of 31 months (range: 8-71 months). Key drivers for these adjustments included optimizing therapeutic efficacy, addressing safety concerns, accommodating special populations, and enhancing patient convenience. We also discuss the role of model-informed drug development, real-world evidence, and pharmacogenomics in refining mAb dosing strategies. These insights underscore the importance of ongoing monitoring and data integration in the post-marketing phase, providing a foundation for future precision medicine approaches in mAb therapy.

Recent Developments and Applications of 3D-Printing Technology in Pharmaceutical Drug Delivery Systems: A New Research Direction and Future Trends.

The advent of 3D printing technology has emerged as a key technical revolution in recent years, enabling the development and production of innovative medication delivery methods in the pharmaceutical sector. The designs, concepts, techniques, key challenges, and potential benefits during 3D-printing technology are the key points discussed in this review. This technology primarily enables rapid, safe, and low-cost development of pharmaceutical formulations during the conventional and additive manufacturing processes. This phenomenon has wide-ranging implications in current as well as future medicinal developments. Advanced technologies such as Ink-Jet printing, drop-on-demand printing, Zip dose, Electrohydrodynamic Printing (Ejet) etc., are the current focus of the drug delivery systems for enhancing patient convenience and improving medication compliance. The current and future applications of various software, such as CAD software, and regulatory aspects in 3D and 4D printing technology are discussed briefly in this article. With respect to the prospective trajectory of 3D and 4D printing, it is probable that the newly developed methods will be predominantly utilized in pharmacies and hospitals to accommodate the unique requirements of individuals or niche groups. As a result, it is imperative that these technologies continue to advance and be improved in comparison to 2D printing in order to surmount the aforementioned regulatory and technical obstacles, render them applicable to a vast array of drug delivery systems, and increase their acceptability among patients of every generation.

Comparison of Acute and Late toxicities with Daily vs. Every-Other-Day Five Fraction Partial Breast Radiation Therapy.

Partial breast irradiation (PBI) delivered with intensity modulated radiation therapy (IMRT) over five fractions every other day (QOD) represents an attractive, convenient method of delivering adjuvant radiation therapy for well selected patients without compromising oncologic or toxicity outcomes. Condensing this regimen to a week of treatment through consecutive daily delivery may further increase patient convenience, though comparison of toxicities between daily and QOD regimens are limited. We retrospectively reviewed 507 patients from an institutional registry undergoing PBI for DCIS or early-stage breast cancer (T1-2N0/x) from 2015 to 2022. All patients received 30 Gy in 5 fractions with IMRT. Acute (toxicity within 90 days of treatment) and chronic toxicity were recorded. Of the 507 patients, 351 were treated with QOD and 159 were treated daily. Median follow up was longer in the QOD group (2.4 vs 1.9 years, p<0.001). With regards to acute toxicity there was slightly reduced grade 1-2 dermatitis with daily treatment (39% QOD vs 35% daily, p=0.06) while rates of fatigue (18% QOD vs 20% daily, p=0.09) were similar. Rates of chronic toxicities were comparable between the two approaches with no differences in the rates of chronic hyperpigmentation (14% QOD vs 14% daily, p=0.97), telangiectasias (1% QOD vs 1% daily, p=0.92), mild fibrosis/induration (13% QOD vs 13% daily, p=0.91), and lymphedema (0% QOD vs. 1% daily, p=0.31). Overall, five fraction partial breast irradiation delivered daily appears to be well tolerated with similar acute and chronic toxicity to every other day fractionation.

The application of conductive hydrogels for self-powered wearable devices: medical field

Wearable devices are playing an increasingly important role in various fields, particularly in healthcare. These devices not only detect vital signs but also quantify health indicators and thus play a crucial role in disease prevention. The demand for flexible wearable devices continues to rise. In this context, conductive hydrogels (CHs) have emerged as a novel flexible material that has garnered significant attention from researchers due to its excellent flexibility and biocompatibility. This article will focus on the applications and recent advancements of conductive hydrogels in the medical field, particularly in self-powered devices. Based on their functions, the applications can be categorized into two main areas: medical detection and treatment. In the realm of medical detection, conductive hydrogels can monitor physiological signals in real-time, such as electrocardiograms (ECG), electromyograms (EMG), and skin temperature. Researchers have successfully combined conductive hydrogels with flexible electrodes to achieve highly sensitive signal acquisition. This technological advancement enables long-term monitoring, greatly enhancing patient comfort and convenience. In terms of treatment, conductive hydrogels are applied in electrical stimulation therapies and drug delivery systems. They not only effectively conduct electricity but also can interact with drugs to achieve precise therapeutic effects. Despite their promise, challenges remain, including long-term stability, material integration, and scaling up manufacturing processes. Overall, the future of conductive hydrogels in wearable devices is promising, poised to advance personalized medicine and smart health management.