Injection Device Research Articles

Intravitreal Injection of AAV for the Transduction of Mouse Retinal Ganglion Cells.

The injection of therapies into the eye is common practice, both clinically and pre-clinically. The most straightforward delivery route is via an intravitreal injection, which introduces the treatment into the largest cavity at the posterior of the eye. This technique is frequently used to deliver gene therapies, including those containing recombinant adeno-associated viral vectors (AAVs), to the back of the eye to enable inner retinal targeting. This chapter provides detailed methodology on how to successfully perform an intravitreal injection in mice. The chapter covers vector preparation considerations, advice on how to minimize vector loss in the injection device, and ways to reduce vector reflux from the eye when administering a therapy. Finally, a protocol is provided on common retinal histology processing techniques to assess vector-mediated expression in retinal ganglion cells. It is hoped that this chapter will enable researchers to carry out effective and consistent intravitreal injections that transduce the inner retinal surface while avoiding common pitfalls.

Sensor/actuator colocation feasibility for distributed damping control using active power modulation

Multi-use distributed active power modulation devices, including energy storage, have the potential to transform the dynamic performance and resilience of modern power systems. Rapid response characteristics relative to traditional power delivery equipment paired with traditional uses (arbitrage, reserve, etc.) make storage an obvious choice for multi-use operation, adding value for asset owners while augmenting stability for reliable operation. Limitations to distributed power control are investigated to provide guidance for those interested in separated sensors and actuators. Substantive distance between the sensor/actuator pair results in non-minimum phase (NMP) which complicates the control design, reducing feedback system effectiveness. It is shown that wide-area control (WAC) is limited by the presence of NMP induced by closed right-half plane (CRHP) zeros - a consequence of sensors placed at locations separated from modulation bus(es). Such geographic separation may be driven by economics, asset owner jurisdiction, technology and/or policy, and is therefore unavoidable. This work suggests that system designers must perform a collocation study before control design and testing. A well-known WAC architecture using synchrophasors as sensors and energy storage devices for active power injection is presented as a detailed case study. • Collocated sensor–actuators pose difficulties which may force modest separation. • Closed right-half plane (CRHP) zeros may result due to such separation. • Noncollocated sensor–actuator pairs may reduce performance and threaten stability. • Bandwidth and performance limitations regarding collocation are determined.

Is long‐acting reversible contraceptive method use associated with HIV testing frequency in KwaZulu‐Natal, South Africa and Lusaka, Zambia? Findings from the CUBE study

ObjectivesTo assess differences in HIV testing at 6-months intervals over 24 months among intramuscular depot medroxyprogesterone acetate (DMPA-IM) injectable, levonorgestrel implant, or copper intrauterine devices (IUD) users in KwaZulu-Natal, South Africa, and Lusaka, Zambia. Testing at recommended intervals has not been previously assessed in long-acting reversible contraceptive (LARC) users (implant and IUD users) compared to those using effective but shorter-acting methods (such as DMPA-IM) in sub-Saharan Africa. Study designAs part of the longitudinal contraceptive use beyond ECHO (CUBE) study, we measured HIV testing over 24 months. Participants were considered continuous users of DMPA-IM, levonorgestrel implant, or copper IUD if they used the same method across all months of their study participation, or not continuous users of their baseline CUBE method if they switched or discontinued their method. We used multivariable logistic regression models with generalized estimating equations and robust standard errors, stratified by country, to assess differences in HIV testing. ResultsAmong the 498 participants, HIV testing rates were higher in Zambia for all methods compared to South Africa. In bivariate analyses, continuous implant or IUD users (the LARC users) were significantly less likely to report having received HIV testing at the 6-months and 24-months surveys, compared to continuous DMPA-IM users. In adjusted longitudinal models, continuous IUD users (adjusted odds ratio: 0.42, 95% CI: 0.24, 0.74), continuous implant users (adjusted odds ratio: 0.23, 95% CI: 0.12, 0.42) in South Africa had significantly lower odds of HIV testing compared to continuous DMPA-IM users. There were no significant differences in Zambia in the adjusted models. ConclusionLARC use may reduce opportunities for HIV testing and users should be counseled on regular HIV testing and the option of HIV self-testing. ImplicationsDue to infrequent clinical contacts which may lead to lower rates of HIV testing at recommended intervals, LARC users should be provided opportunities to test for HIV at home or when seeking other health services.

Харчова алергія. Сучасний погляд на діагностику та лікування

Abstract. Food allergy is an urgent health care problem. The incidence of food allergies has been increasing since the 1990s. The main factors contributing to the emergence of food allergies are presented: the hygienic hypothesis; sibling effect; the theory of double allergen exposure, etc. The gut microbiome plays a role in the pathogenesis and the course of food allergy. Patients with food allergy have distinct gut microbiomes compared to healthy controls. The development of food allergy is preceded by an imbalance of the intestinal microbial ecosystem. Diet, probiotics, prebiotics, symbiotics, and faecal microbiota transfer are potential microbial therapeutics for the prevention and treatment of food allergy. Diseases and syndromes associated with food allergy are considered. Diseases and syndromes associated with food allergy are considered. The main methods of food allergy diagnosis are provided: skin prick tests, laboratory serum tests, oral provocation test. Changing perceptions about the treatment of food allergies: treating food allergies with different methods of specific immunotherapy instead of avoiding allergenic foods. The FDA has already approved the oral immunotherapy treatment of peanut allergy with Palforzia AR101 allergen. The article lists the main drugs for medical treatment of food allergies, in particular omalizumab. Patients with food allergies should always carry an epinephrine injection device, which is the mainstay of pharmacotherapy for anaphylaxis.

Oil-gated isoporous membrane with micro-apertures for controllable pressure-induced passive flow regulator.

The pressure-driven liquid flow controller is one of the key components in diverse applications including microfluidic systems, biomedical drug injection devices, and pressurized water supply systems. Electric feedback loop based flow controllers are fine-tunable but expensive and complex. The conventional safety valves based on spring force are simple and low cost, but their diverse application is limited due to their fixed pressure range, size, and shape. Herein, we propose a simple and controllable liquid-flowing system combining a closed liquid reservoir and an oil-gated isoporous membrane (OGIM). The ultra-thin and flexible OGIM acts as an immediately responsive and precisely controlled gas valve to maintain internal pneumatic pressure as designed to induce constant liquid flow. The oil filling apertures act as a gate for gas flow depending on the applied pressure and the threshold (gating) pressure of the gate is determined by the surface tension of the oil and the gate diameter. It is confirmed that the gating pressure is precisely controlled by varying the gate diameter, which agrees with the theoretically estimated pressures. Based on stably maintained pressure due to the function of OGIM, the constant liquid flow rate is achieved even with the high gas flow rate.

A novel intradermal tattoo-based injection device enhances the immunogenicity of plasmid DNA vaccines

In recent years, tattooing technology has shown promising results toward evaluating vaccines in both animal models and humans. However, this technology has some limitations due to variability of experimental evaluations or operator procedures. The current study evaluated a device (intradermal oscillating needle array injection device: IONAID) capable of microinjecting a controlled dose of any aqueous vaccine into the intradermal space. IONAID-mediated administration of a DNA-based vaccine encoding the glycoprotein (GP) from the Ebola virus resulted in superior T- and B-cell responses with IONAID when compared to single intramuscular (IM) or intradermal (ID) injection in mice. Moreover, humoral immune responses, induced after IONAID vaccination, were significantly higher to those obtained with traditional passive DNA tattooing in guinea pigs and rabbits. This device was well tolerated and safe during HIV vaccine delivery in non-human primates (NHPs), while inducing robust immune responses. In summary, this study shows that the IONAID device improves vaccine performance, which could be beneficial to the animal and human health, and importantly, provide a dose-sparing approach (e.g., monkeypox vaccine).

A highly efficient needle-free-injection delivery system for mRNA-LNP vaccination against SARS-CoV-2

Despite the various vaccines that have been developed to combat the coronavirus disease 2019 (COVID-19) pandemic, the persistent and unpredictable mutations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) require innovative and unremitting solutions to cope with the resultant immune evasion and establish a sustainable immune barrier. Here we introduce a vaccine-delivery system with a combination of a needle-free injection (NFI) device and a SARS-CoV-2-Spike-specific mRNA-Lipid Nanoparticle (LNP) vaccine. The benefits are duller pain and a significant increase of immunogenicity compared to the canonical needle injection (NI). From physicochemical and bioactivity analyses, the structure of the mRNA-LNP maintains stability upon NFI, contradictory to the belief that LNPs are inclined towards destruction under the high-pressure conditions of NFI. Moreover, mRNA-LNP vaccine delivered by NFI induces significantly more binding and neutralizing antibodies against SARS-CoV-2 variants than the same vaccine delivered by NI. Heterogeneous vaccination of BA.5-LNP vaccine with NFI enhanced the generation of neutralizing antibodies against Omicron BA.5 variants in rabbits previously vaccinated with non-BA.5-specific mRNA-LNP or other COVID-19 vaccines. NFI parameters can be adjusted to deliver mRNA-LNP subcutaneously or intramuscularly. Taken together, our results suggest that NFI-based mRNA-LNP vaccination is an effective substitute for the traditional NI-based mRNA-LNP vaccination.

Making and selecting the best embryo in the laboratory

Over the past 4 decades our ability to maintain a viable human embryo invitro has improved dramatically, leading to higher implantation rates. This has led to a notable shift to single blastocyst transfer and the ensuing elimination of high order multiple gestations. Future improvements to embryo culture systems will not only come from new improved innovative media formulations (such as the inclusion of antioxidants), but plausibly by moving away from static culture to more dynamic perfusion-based systems now made a reality owing to the breakthroughs in three-dimensional printing technology and micro fabrication. Such an approach has already made it feasible to create high resolution devices for intracytoplasmic sperm injection, culture, and cryopreservation, paving the way not only for improvements in outcomes but also automation of assisted reproductive technology. Although improvements in culture systems can lead to further increases in pregnancy outcomes, the ability to quantitate biomarkers of embryo health and viability will reduce time to pregnancy and decrease pregnancy loss. Currently artificial intelligence is being used to assess embryo development through image analysis, but we predict its power will be realized through the creation of selection algorithms based on the integration of information related to metabolic functions, cell-free DNA, and morphokinetics, thereby using vast amounts of different data types obtained for each embryo to predict outcomes. All of this will not only make assisted reproductive technology more effective, but it will also make it more cost effective, thereby increasing patient access to infertility treatment worldwide.

A Small Capacity Methane-Hydrogen Blend Fueled Gas Turbine

Nowadays the environmental problem is of issue for many scientists around the world. This is stemming from climate changes caused by greenhouse gas emissions (the industrial sector accounts for 50% of them). Therefore, urgent measures have to be taken to reduce the emissions of these gases significantly. In this connection, we are witnessing a worldwide trend toward predominant use of renewable energy sources, with the hydrogen energy being the most significant one of them. The aim of the work was to study the effect an addition of hydrogen to methane as fuel has on the thermal characteristics of a 100 kWe micro gas turbine unit and on the geometrical dimensions of the fuel admission device at constant values of the volumetric flow rates of air supplied and flue combustion gases generated in the same installation. The study, which was carried out using the EPSILON computer program, has shown that the addition of hydrogen to methane leads to an increase in the volumetric fuel flowrate and, hence, generates the need to increase the fuel admission device cross-section area. An increase in the percentage content of hydrogen leads to a decrease of temperatures upstream of the turbine by no more than 12°C. If methane is completely replaced by hydrogen, the power unit efficiency decreases by only 1%. Thus, the thermal characteristics of the micro gas turbine unit under study do not change significantly; however, the design of the fuel injection device has to be modified.

Biochar-supported nano-scale zerovalent iron activated persulfate for remediation of aromatic hydrocarbon-contaminated soil: an in-situ pilot-scale study

Biochar supported nano-scale zerovalent iron (nZVI/BC) for persulfate (PS) activation has been studied extensively for the degradation of pollutants on the lab scale, but it was rarely applied in practical soil remediation in the field. In this research, we developed a facile ball-milling method for the mass production of nZVI/BC, which was successfully applied to activate persulfate for the remediation of organic polluted soil on an in-situ pilot scale. In-situ high-pressure injection device was developed to inject nZVI/BC suspension and PS solution into the soil with a depth of 0–70 cm. The removal efficiency of target pollutants such as 2-ethylnitrobenzene (ENB, 1.47–1.56 mg/kg), biphenyl (BP, 0.19–0.21 mg/kg), 4-(methylsulfonyl) toluene (MST, 0.32–0.43 mg/kg), and 4-phenylphenol (PP, 1.70–2.46 mg/kg) at different soil depths was 99.7%, 99.1%, 99.9% and 99.7%, respectively, after 360 days of remediation. The application of nZVI/BC significantly increased the degradation rates of contaminants by 11–322%, ascribed to its relatively higher efficiency of free radical generation than that of control groups. In addition, it was found that nZVI/BC-PS inhibited soil urease and sucrase enzyme activities by 1–61% within 55 days due to the oxidative stress for microbes induced by free radicals, while these inhibition effects disappeared with remediation time prolonged (> 127 days). Our research provides a useful implementation case of remediation with nZVI/BC-PS activation and verifies its feasibility in practical contaminated soil remediation.Graphical

Stabilization formation characterization of metal single droplet by pneumatic drop-on-demand

Metal single droplets are widely used in electronic packaging and flexible circuit printing. However, liquid metals are characterized by high density and interfacial tension, so that stable injection of single droplet occurs only in an extremely small printable region, which limits the application of metal droplets. In this study, based on a drop-on-demand pneumatic injection device, the evolutionary process and mechanism of metal droplet generation are analyzed through experiments and numerical simulations, the theoretical solution of the injection velocity is obtained, the printable region that can stably generate the single droplet dimensionless parameters Wej (Jet Weber number) and Z (1/Ohnesorge number) is plotted, and the prediction model of the single droplet dimensionless limit jet length is established. Results show that in the range 400 < Z < 1100, the printable region where single droplets can be generated is extremely narrow (1.3 < Wej < 2). When Wej < 1.3, the inertial force of the jet is not sufficient to overcome the interfacial capillary force, and no droplets can be generated. When Wej > 2, the inertial force of the jet is so large that satellite droplets are generated. The prediction results obtained by the prediction model of single droplet dimensionless limit jet length are consistent with the experimental results and can accurately predict whether a single droplet can be generated or not. The results can reveal the mechanism of stable generation of on-demand pneumatic metal droplets. Furthermore, the results can serve as theoretical references for the further development of on-demand pneumatic metal droplet injection technology.

Effects of injection styles on heating performance of a heat pump with sub-cooler refrigerant injection: Experimental and thermodynamic analysis

The performance improvement of heat pump depends on the appropriate injection style such as liquid injection, vapour injection and two-phase injection. In this work, experimental and theoretical investigation on the heat pump with R410A refrigerant reveals three kinds of injection styles can be selectively achieved in the same injection device by suitable control of the sub-cooling electronic expansion valve. Liquid injection and vapour injection improve the heating capacity (Qh), mainly due to the increase of heat exchange in the sub-cooler and compressor compression work, respectively. Two-phase injection lifts the Qh owing to these two effects. Subsequently, the effect of two-phase injection on improving the heat pump performance is superior to the other two injection styles. For instance, the maximum Qh were 14.4 kW at 60 rps with the liquid injection, 12.5 kW and 13.4 kW at 85 rps with vapour injection and two-phase injection, and 8.1%, 7.0% and 18.3% higher than those without injection, respectively. The corresponding coefficient of performance was improved by 10.4%, 4.5% and 10.6%, respectively. Furthermore, the model based on the pressure-enthalpy diagram has been developed to analyze the experimental results and expound the main factors affecting the heat pump performance under different ambient temperatures.

Top-Down Approach to Retention Time Prediction in Comprehensive Two-Dimensional Gas Chromatography-Mass Spectrometry.

In this contribution, we describe a novel modeling approach to predicting retention times (tr) in comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC × GC-ToF-MS) with a particular emphasis on the second-dimension (2D) retention time predictions (2tr). This approach is referred to as a "top-down" approach in that it breaks down the complete GC × GC separation into two independent one-dimensional gas chromatography separations (1D-GC). In this regard, both dimensions, that is, first dimension (1D) and second dimension (2D) are treated separately, and the cryogenic modulator is simply considered as a second consecutive injection device. Separate 1D-GC tr predictions are performed on both dimensions using the same flow rate as the one deployed in the conventional GC × GC system. The separate tr predictions are then combined to account for the two-dimensional separation. This model was applied to 24 analytes from 2 standard mixtures (Grob Test Mix and Fragrance Materials Test Mix) and assessed across 9 GC × GC chromatographic conditions. The experimental and predicted chromatographic retention space occupations were assessed by using the convex hull approach defined by the Delaunay triangulation. The predicted percentage of space occupation corresponded favorably with the experimental values. Furthermore, the top-down approach enabled an accurate prediction of the 2tr of all investigated analytes, providing an average 2tr modeling error of 0.26 ± 0.01 s.

Thermosensitive Injectable Gradient Hydrogel-Induced Bidirectional Differentiation of BMSCs.

Osteochondral defects threaten the quality of life of patients to a great extent. To simulate gradient changes in osteochondral tissue, a gradient-mixing injection device consisting of a controller and injection pumps is design. Bioactive glass (BG) and gellan gum (GG) are used to prepare thermosensitive injectable gradient hydrogels (B0.5 G, B1 G) with an upper critical solution temperature (UCST) range of 37.7-40.2 °C using this device for the first time. The mechanical properties of gradient hydrogels are significantly better than those of pure GG hydrogels. The gradients in the composition, structure, and morphology of gradient hydrogels are confirmed via physicochemical characterization. Cytocompatibility tests show that hydrogels, especially B0.5 G gradient hydrogels, promote the proliferation of bone marrow mesenchymal stem cells (BMSCs). Most importantly, qRT-PCR shows that the different components in B0.5 G gradient hydrogels simultaneously induce the osteogenic and chondrogenic differentiation of BMSCs. Experimental injection in porcine osteochondral defects indicates that the B0.5 G gradient hydrogel seamlessly fills irregular osteochondral defects in a less invasive manner by controlling the temperature to avoid cellular and tissue damage arising from crosslinkers or other conditions. These results show that thermosensitive injectable B0.5 G gradient hydrogels have the potential for less invasive integrated osteochondral repair.

Factors associated with failed contraception in women attending level one hospitals in Lusaka, Zambia.

Background: Unintended pregnancy is a major public health concern due to its impact on maternal morbidity and mortality. Contraceptive failure is one of the causes of unintended pregnancy. Data on factors associated with contraceptive method failure is scarce. This study therefore aimed to determine the proportions of contraceptive failure for various methods and factors associated with it.
 Methodology: Unmatched case-control study was conducted at five Level One Hospitals in Lusaka. Convenience sampling was used to enrol 108 cases for whom pregnancy occurred while on a modern contraceptive method and 108 controls who were on a modern contraceptive method and not pregnant. Binary and multiple logistic regressions were utilized for assessment of factors associated with failed contraception.
 Results: Among the 108 cases, 46 (42.6%), 40 (37%), 17 (15.7%) and 1 (0.9%) were on the oral contraceptive pill, injectable, implant and intrauterine device contraception methods respectively while 2 (1.9%) were on barrier and emergency contraceptive methods respectively. The odds of contraceptive failure when using the oral contraceptive pill was more than 7 times (AOR 7.790, 95% CI 1.210-50.161, p=0.031). Those who had contraception failure were more than 3 times more likely to be younger than 30 years old compared to those whose contraceptive method did not fail (AOR 3.559, 95% CI 1.100-11.521, p=0.034 and AOR 3.596, 95% CI 1.354-9.550, p=0.010 respectively for age groups 18-24 years and 24-30 years old). Other factors associated with a higher odds of contraceptive failure were duration of marriage greater than one year, with the highest odds in those married for more than 10 years (AOR 9.744, 95% CI 2.232-42.537, p=0.002), higher social support (AOR 2.402, 95% CI 1.085-5.321, p=0.031), multiparity (AOR 15.299, 95% CI 3.034-77.151, p=0.001), and duration of use of antecedent contraception method of more than 2-3 years (AOR 4.913, 95% CI 1.662-14.526, p=0.004).
 Conclusion: The oral contraceptive pill, younger age, marriage duration of more than one year and contraceptive use more than three years were associated with contraceptive failure. Good messaging and counseling on usage of the oral contraceptive pill is recommended.

Fast-acting and injectable cryoneurolysis device

Cryoneurolysis is an opioid-sparing therapy for long-lasting and reversible reduction of pain. We developed a nerve-selective method for cryoneurolysis by local injection of ice-slurry (− 5 to − 6 °C) that induced decrease in nocifensive response starting from about a week after treatment and lasting up to 8 weeks. In this study, we test the hypothesis that injection of colder slurry leads to faster onset of analgesia. Colder slurry (− 9ºC) was injected around the rat sciatic nerve to induce cryoneurolysis. Hematoxylin and Eosin (H&E) staining was used to examine histologic effects on surrounding tissues. Coherent anti-Stokes Raman scattering (CARS) microscopy was used to study effects on myelin sheaths. Functional tests were used to assess changes in sensory and motor function in the treated hind paw. No inflammation or scarring was detected in surrounding skin and muscle tissues at day 7 post slurry injection. Functional tests showed rapid onset reduction in mechanical pain sensitivity starting from day 1 and lasting up to day 98. CARS imaging demonstrated disintegration of myelin sheaths post treatment followed by complete recovery of nerve structure by day 140. In this study we showed that colder slurry (− 9 °C) produces more rapid onset and longer duration of analgesia, while remaining nerve-selective

Prevalence of Lipohypertrophy and its Associations in Insulin-Treated Diabetic Patients.

Lipohypertrophy is a major complications of insulin therapy especially attributed to incorrect insulin technique. The objective was to determine the frequency of lipohypertrophy in diabetic population on insulin and its associations. This cross-sectional study was conducted at the Services Hospital Lahore from July 1st, 2020 to December 31st, 2020. Total of 363 diabetic patients, fulfilling the inclusion criteria were approached. The patients were examined and interviewed through a validated questionnaire. The data was stratified according to the age, gender, duration of diabetes, duration of insulin use, frequency of LH and duration since last instructions reviewed. The chi-square test was applied. Data was analyzed using SPSS 22. Mean age of the study population was 49.71± 13.36 years. Majority were females (57.6%). LH was noted in 22.86% of participants (n=83). There was significant statistical difference noted (P <0.05) between different age groups as 29.7 % of patients in age group above 45 had LH as compared to 19.6% in the below 45 years age group. More females (28.2%) were having LH than the males (15.6%) with P<0.05. Also, significant difference was noted for needle reuse more than 10 times, more than two injections per day and longer duration since last instructions reviewed. No significant difference was noted between different devices for injection as well as for duration of diabetes. LH is strongly associated with hypoglycemia and hyperglycemia with P<0.05. A significant diabetic population on insulin has noted to have LH, and the risk is more with aged population, female gender, more injections per day and multiple time needle reuses. Risk of LH can be reduced by reinforcing education.

Azo-Functionalized Thermoplastic Polyurethane for Light-Driven Shape Memory Materials.

Shape memory polymers have great potential in the fields of soft robotics, injectable medical devices, and as essential materials for advanced electronic devices. Herein, light-triggered shape-memory thermoplastic polyurethane (TPU) is reported using azido TPU grafted by the photoswitchable azo compound. The trans-cis transitions of the azobenzene on the side chain of the TPU induce the recoiling of the main chain, leading to shaping memory behavior. Under UV irradiation, cis-azo allows the oriented main chain to recoil to release residual stress and realize light-triggered shape memory behavior. The facile method proposed here for the preparation of azo-functionalized TPU can provide viable opportunities for soft robotics and smart TPU applications.

Therapeutic efficacy of 166Holmium siloxane in microbrachytherapy of induced glioblastoma in minipig tumor model.

Glioblastoma is considered the most common malignant primary tumor of central nervous system. In spite of the current standard and multimodal treatment, the prognosis of glioblastoma is poor. For this reason, new therapeutic approaches need to be developed to improve the survival time of the glioblastoma patient. In this study, we performed a preclinical experiment to evaluate therapeutic efficacy of 166Ho microparticle suspension administered by microbrachytherapy on a minipig glioblastoma model. Twelve minipigs were divided in 3 groups. Minipigs had injections into the tumor, containing microparticle suspensions of either 166Ho (group 1; n = 6) or 165Ho (group 2; n = 3) and control group (group 3; n = 3). The survival time from treatment to euthanasia was 66 days with a good state of health of all minipigs in group 1. The median survival time from treatment to tumor related death were 8.6 and 7.3 days in groups 2 and control, respectively. Statistically, the prolonged life of group 1 was significantly different from the two other groups (p < 0.01), and no significant difference was observed between group 2 and control (p=0.09). Our trial on the therapeutic effect of the 166Ho microparticle demonstrated an excellent efficacy in tumor control. The histological and immunohistochemical analysis showed that the efficacy was related to a severe 166Ho induced necrosis combined with an immune response due to the presence of the radioactive microparticles inside the tumors. The absence of reflux following the injections confirms the safety of the injection device.

Interventions Designed to Improve Adherence to Growth Hormone Treatment for Pediatric Patients and Their Families: A Narrative Review.

Even though growth hormone (GH) treatment is still the only active treatment option to correct growth failure and increase stature for patients with GH deficiencies, evidence has shown that non-adherence remains high. The aim of this review was to identify and review the existing interventional strategies that have been designed to address and improve adherence to GH treatment for pediatric patients and their families. An extensive search of several electronic databases was undertaken to identify relevant interventional studies, published in English, between 1985 and 2021. Additional search strategies included hand-searching topic review articles to identify eligible studies. Articles were screened against the inclusion eligibility criteria and data on sample characteristics, intervention features, and key findings was extracted. A total of fifteen interventional studies were included in the review. The interventions identified were divided into two broad categories: novel injection devices, and patient choice of device. In conclusions, this review acknowledges that there is a lack of evidence-based, theory-driven intervention strategies, designed with the purpose of optimizing treatment adherence and improve clinical and psychosocial outcomes.