Medical Delivery Research Articles

Leveraging the Fetal and Infant Mortality Review (FIMR) Process to Advance Health Equity.

The fetal and infant mortality review (FIMR) process is a community-oriented strategy focused on improving the health services systems for pregnant persons, infants, and their families. FIMR helps communities to understand and change systems that contribute to racial disparities in birth outcomes. FIMR equally values the medical and social services delivery records and the personal narratives of families who have suffered a fetal or infant loss when creating the de-identified case summaries to be reviewed by teams. A two-tiered process, FIMR uses a multidisciplinary Case Review Team (CRT) as the information processor and the Community Action Team (CAT) as the action arm of the process. Pediatricians are vital to both teams, helping to bring about systems change to improve maternal and child health. This paper examines how the well-established FIMR team serving Indianapolis (Marion County, IN) worked to build the capacity of its CAT to address racial disparities in birth outcomes through 5 distinct steps: focus on the primary causes of local fetal or infant mortality, focus on neighborhoods with the highest stable fetal or infant mortality rates, designation of a CAT leader, creation of a culture of regular CAT meetings inclusive of a health-equity skill building curriculum, and inclusion of Grassroots Maternal and Child Health Leaders on the CAT. This paper demonstrates how the synergy between local organizations and community members can effectively address racial disparities in birth outcomes.

Fortifying SNEDDS with Hybrid Technologies: Present and Future Prospects

Self-nano-emulsifying drug delivery systems (SNEDDS) have gained attention in recent years as an effective approach for improving the solubility and oral bioavailability of poorly water-soluble drugs. However, there have been reports of drawbacks such as low drug loading, limited stability and variability in absorption. Various technologies have been investigated in conjunction with SNEDDS to alleviate such issues such as polymers being used to improve stability and drug loading; phospholipid complexes used to improve absorption and reduce inter and intrasubject variability; SNEDDS for drug targeting improves the targeting of drugs to specific site reducing the dosage required for action. 3D printing is used to create personalized and precise dosages; supersaturated SNEDDS is used to increase drug concentration; and solid SNEDDS are used to improve storage stability and patient compliance. The amalgamation of SNEDDS with these technologies has demonstrated promising results with regard to the improvement of medication delivery and has control over SNEDDS limitations. The present review elucidates the application of blended technologies with SNEDDS and the future potential for such drug delivery.

Enhancing HIV/AIDS and TB medication logistics: A comprehensive approach to global healthcare distribution

The distribution of HIV/AIDS and tuberculosis (TB) medications is critical to the success of global healthcare initiatives, particularly in regions with limited infrastructure and resources. This review examines the logistical challenges hindering the efficient delivery of these life-saving medications, including supply chain inefficiencies, poor infrastructure, and geographical barriers. It also explores innovative approaches to optimizing logistics, such as the use of blockchain, drones, and artificial intelligence (AI), alongside public-private partnerships (PPPs) and supportive policy frameworks. These emerging technologies have the potential to enhance the availability and effectiveness of HIV/AIDS and TB treatments by improving supply chain transparency, reducing stockouts, and overcoming transportation challenges in remote areas. The paper further assesses the impact of these logistical improvements on healthcare outcomes, demonstrating how they contribute to improved patient adherence, reduced disease transmission, and cost savings. Finally, recommendations are provided for policymakers, healthcare organizations, and stakeholders to adopt these innovations, and future research directions are proposed to expand these models to other medications and diseases.

A Comprehensive Review of the Evaluation of in Situ Gels

In situ gels are now among the most widely used and widely available systems. These systems minimize drug administration frequency because of their special sol-to-gel transition properties, increasing patient comfort. Other benefits of these systems include easy production, improved adherence, and ease of use. 'Sol-gel' produces a colloidal suspension or solution by hydrolyzing the precursor and then polymerizing it through condensation. These in situ gelling techniques gel at the accomplishment site because they can be administered as solutions. Recently, several researchers developed liposomes, microspheres, nanoemulsions, nanospheres, and other in situ gelling systems. One of the greatest innovative drug delivery methods to date is the "in situ gel" system, which promotes better patient comfort and compliance as well as a prolonged and regulated release of the medication. With in situ gel formation, a variety of natural and synthetic polymers may find application in oral, ophthalmic, transdermal, buccal, intraperitoneal, parenteral, injectable, rectal, and vaginal routes. Research on the in-situ gel system has a lot of potential to offer cutting-edge methods for medication delivery systems.

The Ability of Indigenous Plants in Alleviating Rheumatoid Arthritis: A Comprehensive Review.

Rheumatoid Arthritis is a long-lasted, inflammatory, systemic autoimmune disease that predominantly manifests in people between the ages of 30 and 50 Rheumatoid arthritis is characterized by more than a half-hour of morning stiffness in the affected joints, fever, soreness, swelling, weight loss, tiredness, warm joints, and subcutaneous rheumatoid nodules. Hormonal, genetic, epigenetic, reproductive, and neuroendocrine risk factors, as well as comorbid host variables, are the categories of host-related risk factors associated with the evolution of RA. Additional risk variables that have been linked to RA include food, environmental variables, socioeconomic status, smoking, microbiome, infection agents, and other airborne exposures. The objective of RA therapies is to minimise joint deformity and destruction, minimise discomfort and inflammation in the joints, and maximise joint function.Growing data suggests that the course of Rheumatoid Arthritis is affected by the minimisation of disease activity caused by disease-modifying medications, and that patients may benefit from early antirheumatic medication delivery that modifies illness. While numerous herbs have been explored for their anti-inflammatory properties, it is important to note that not all herbs have been thoroughly researched. This review focuses on seventeen native plant species that have shown either promising or established anti-arthritic effects based on preclinical and clinical studies where available. The review highlights the biochemical and immunological attributes of these herbs, summarizing their therapeutic potential for RA management while also acknowledging the limitations and gaps in current research. This examination provides insights into the potential of these herbal treatments for RA and calls for further research to explore their efficacy and safety in greater depth.

Nanoparticles based drug delivery system for cancer

A medication delivery system based on nanoparticles is seen to be promising for the treatment of neoplasia. It demonstrates increased efficacy by prolonging the half-lives of the drug and proteins, improving the solubility of lipophilic medicines, and allowing for the precise and controlled release of the medication into the affected area. The main benefit of medication delivery systems based on nanoparticles is the treatment of tumors. It was also mentioned that tumors can be treated through angiogenesis. Patients using traditional medication therapy for tumor surfers may experience negative side effects from the chemotherapy medicines' non-selective activity on healthy cells.

An updated review on carbon nanomaterials: Types, synthesis, functionalization and applications, degradation and toxicity

Abstract As carbon-based nanomaterials have such remarkable physical, chemical, and electrical capabilities, they have become a major focus of materials science study. A thorough examination of several carbon nanomaterial varieties, such as carbon nanotubes, graphene, fullerenes, and carbon nanodiamonds, is given in this review work. These materials all have distinctive qualities that qualify them for particular uses. This work starts by examining the synthesis processes of these nanomaterials, outlining the ways by which they are made and the variables affecting their ultimate characteristics. The specific features of each kind of carbon nanomaterial will then be briefly discussed in this study, along with their size, structure, and special physical and chemical properties. These materials have a wide range of possible uses in several fields. They are employed in the electronics industry to fabricate sensors, high-speed transistors, and other devices. Their high surface area and electrical conductivity make them useful in energy storage devices like supercapacitors and batteries. They are applied to environmental remediation and water purification in environmental science. They are employed in biomedicine for biosensing, bioimaging, and medication delivery. Notwithstanding the encouraging uses, the large-scale synthesis and functionalization of carbon nanomaterials present several difficulties. This review discusses the importance of carbon nanomaterials by studying their multifaceted properties and potential applications in industries. The novelty of this work lies in its detailed examination of the degradation and toxicity of these materials, which is essential for their safe integration into various technological and biomedical applications. By thoroughly analysing recent experimental results, this review aims to bridge the gap between fundamental research and practical applications.

Exploring nanoparticle dynamics in binary chemical reactions within magnetized porous media: a computational analysis

Artificial Neural Networks are incredibly efficient at handling complicated and nonlinear mathematical problems, making them very useful for tackling these challenges. Artificial neural networks offer a special computational architecture that is extremely valuable in disciplines like biotechnology, biological computing, and computational fluid dynamics. The present work investigates the applicability of back-propagation artificial neural networks in conjunction with the Levenberg-Marquardt algorithm for evaluating heat transmission in hybrid nanofluids. This work focuses on the computational analysis of a MgO + GO/EG hybrid nanofluid’s steady mixed convection flow over an exponentially stretched sheet, considering multiple slip boundary conditions, thermal conductivity, heat generation, and thermal radiation. A nonlinear system of ordinary differential equations is produced from the basic associated partial differential system by performing the proper exponential similarities modifications. For generating benchmark datasets, the resulting ordinary differential equations are processed employing the bvp4c method. Considering benchmark datasets set aside for training (70%), testing (15%), and validation (15%), the Levenberg-Marquardt algorithm, which employs back-propagation in artificial neural networks, is implemented. The accuracy of the suggested strategy for handling nonlinear problems is verified utilizing mean squared error, error histograms, and regression analysis, which are all used to evaluate the methodology. Outstanding agreement is seen when ANN outputs are compared to numerical results. The flow properties, including temperature, velocity, and concentration profiles, are shown graphically and numerically. For practical purposes, it is therefore essential to analyze the flow and heat transfer in hybrid nanofluids over exponentially extending and shrinking surfaces under mixed convection and heat source scenarios. Hybrid nanofluid problems have a wide range of practical and industrial applications, such as medication delivery, manufacturing, microelectronics, nuclear plant cooling, and marine engineering.

Variability in treatment of postoperative pain in children with severe neurologic impairment.

Treatment of postoperative pain for children with severe neurologic impairment (SNI) is challenging. We describe the type, number of classes, and duration of postoperative pain medications for procedures common among children with SNI, as well as the variability across children's hospitals in pain management with an emphasis on opioid prescribing. This retrospective cohort study included children with SNI ages 0-21 years old who underwent common procedures between January 1, 2019 and December 31, 2019 within 49 children's hospitals in the Pediatric Health Information System. We defined SNI using previously described high-intensity neurologic impairment diagnosis codes and identified six common procedures which included fracture treatment, tracheostomy, spinal fusion, ventriculoperitoneal shunt placement (VP shunt), colostomy, or heart valve repair. Medication classes included benzodiazepines, opioids, and other nonopioid pain medications. Acetaminophen and nonsteroidal anti-inflammatory drugs were excluded from analysis. All findings were summarized using bivariate statistics. A total of 7184 children with SNI underwent a procedure of interest. The median number of classes of pain medications administered varied by procedure (e.g., VP shunt: 0 (interquartile range [IQR] 0-1); tracheostomy: 3 (IQR 2-4)). Across all procedures, opioids and benzodiazepines were the most commonly prescribed pain medications (48.8% and 38.7%, respectively). We observed significant variability in the percentage of postoperative days with opioids across hospitals by procedure (all p < .001). There is substantial variability in the postoperative delivery of pain medications for children with SNI. A standardized approach may decrease the variability in postoperative pain control and enhance care for children with SNI.

An Assessment of an Inpatient Robotic Nurse Assistant: A Mixed-Method Study

The worldwide nursing shortage has led to the exploration of using robotics to support care delivery and reduce nurses’ workload. In this observational, mixed-method study, we examined the implementation of a robotic nurse assistant (RNA) in a hospital ward to support vital signs measurements, medication, and item delivery. Human–robot interaction was assessed in four domains: usability, social acceptance, user experience, and its societal impact. Patients in a general medicine ward were recruited to participate in a one-time trial with the RNA and a post-trial 75-question survey. Patients’ interactions with the RNA were video recorded for analysis including patients’ behaviours, facial emotions, and visual attention. Focus group discussions with nurses elicited their perceptions of working with the RNA, areas for improvement, and scalability. Sixty-seven patients aged 21–79 participated in the trial. Eight in 10 patients reported positive interactions with the RNA. When the RNA did not perform to expectations, only 25% of patients attributed fault to the RNA. Video analysis showed patients at ease interacting with the RNA despite some technical problems. Nurses saw potential for the RNA taking over routine tasks. However, they were sceptical of real time savings and were concerned with the RNA’s ability to work well with older patients. Patients and nurses suggested greater interactivity between RNA and patients. Future studies should examine potential timesaving and whether time saved translated to nurses performing higher value clinical tasks. The utility of improved RNA’s social capability in a hospital setting should be explored as well.

Functionalized nanostructures and targeted delivery systems with a focus on plant-derived natural agents for COVID-19 therapy: A review and outlook

Abstract The COVID-19 pandemic strongly stimulated research on anti-SARS-CoV-2 virus treatments. The present study reviews a nanotechnology approach to this task, i.e., in other terms, a nanomedicine approach. Nanotechnology aims to create nanostructures or nanoparticles, also called nanoformulations, for targeted delivery of drugs, as well as improved drug release control. This approach is particularly promising to enhance the antiviral effect of natural pro-drugs. Here, we review several nanoformulations developed for the targeted delivery of medications against SARS-CoV-2. We draw special attention to repurposing strategies for known antiviral and natural therapies. Also, functionalized nanoparticles with specific targeting moieties and functional groups were discussed. The summary could motivate researchers to pursue more studies in this exciting area by seeking nanotechnology-based, cutting-edge, tailored delivery strategies for the SARS-CoV-2 virus.

Balance of Antioxidants vs. Oxidants in Perinatal Asphyxia

Perinatal asphyxia refers to an acute event of cerebral ischemia and hypoxia during the perinatal period, leading to various degrees of brain injury. The mechanisms involved in perinatal asphyxia include the production of reactive oxygen species (ROS), accumulation of intracellular calcium, lipid peroxidation, excitatory amino acid receptor overactivation, energy failure, and caspase-mediated cell death. Both primary and secondary neuronal damage are caused by the overproduction of ROS following a hypoxic/ischemic event. ROS can react with nearly any type of molecule, including lipids, proteins, polysaccharides, and DNA. Neonates who suffer from perinatal asphyxia are prone to oxidative stress, which is characterized by a disruption in the oxidant/antioxidant balance, favoring oxidants over the intracellular and extracellular antioxidant scavenging mechanisms. Current research has focused on developing treatment strategies that potentially improve the endogenous antioxidant neuroprotective mechanisms or minimize injury resulting from hypoxia/ischemia. In this narrative review, we aim to present evidence regarding the contribution of oxidant/antioxidant balance to the pathogenesis and progression of perinatal asphyxia. Also, we aim to explore the role of potential antioxidant therapies as promising treatment strategies for perinatal asphyxia, especially as an adjunct to therapeutic hypothermia in infants with perinatal asphyxia. The current literature on antioxidant treatments in newborns is limited; however, allopurinol, melatonin, and erythropoietin have shown some positive effects in clinical trials. Inhibitors of nitric oxide synthase, N-acetylcysteine, and docosahexaenoic acid have shown promising neuroprotective effects in preclinical studies. Finally, nanotherapeutics could potentially modulate oxidative stress in hypoxemic/ischemic brain injury by targeted medication delivery. Future research on neuroprotectants and their processes is warranted to develop innovative treatments for hypoxia/ischemia in clinical practice.

Detecting clinical medication errors with AI enabled wearable cameras

Drug-related errors are a leading cause of preventable patient harm in the clinical setting. We present the first wearable camera system to automatically detect potential errors, prior to medication delivery. We demonstrate that using deep learning algorithms, our system can detect and classify drug labels on syringes and vials in drug preparation events recorded in real-world operating rooms. We created a first-of-its-kind large-scale video dataset from head-mounted cameras comprising 4K footage across 13 anesthesiology providers, 2 hospitals and 17 operating rooms over 55 days. The system was evaluated on 418 drug draw events in routine patient care and a controlled environment and achieved 99.6% sensitivity and 98.8% specificity at detecting vial swap errors. These results suggest that our wearable camera system has the potential to provide a secondary check when a medication is selected for a patient, and a chance to intervene before a potential medical error.

Delivery strategies to improve piglets exposure to oral antimicrobials

BackgroundThe widespread practice of delivering antimicrobials through drinking water to livestock leads to considerable variability in exposure levels among animals, raising concerns regarding disease outbreaks and the emergence of antimicrobial resistance. This variability is primarily driven by three pivotal factors: fluctuations in drug concentration within water pipes, variances in drinking behavior among animals, and differences in individual pharmacokinetic parameters. The objective of this study is to develop and evaluate a strategy that tailors medication delivery based on the drinking patterns of pigs, aiming to improve medication distribution without increasing the overall dose of medication.ResultsOur results demonstrate that several distribution strategies based on the animals’ drinking behavior can effectively increase their overall exposure. These strategies include increasing the exposure of the least exposed animals, raising the average exposure, maximizing the exposure of the majority of the well-exposed animals, or increasing exposure to ensure that a Pharmacokinetics/Pharmacodynamics (PK/PD) criterion reaches a threshold value for a large number of the animals. In summary, constructing an effective distribution strategy for drinking water requires optimizing a specific criterion. The various criteria and methods for optimizing then are detailed.ConclusionsAs examples, this article demonstrate that incorporating the drinking behavior into the delivery of amoxicillin results in an increase in the percentage of piglets reaching an AUC/MIC ratio greater than 25h. Specifically, with Pasteurella multocida, the percentage rises from 30%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\%$$\\end{document} to at least 60%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\%$$\\end{document}, while with Actinobacillus pleuropneumoniae, it increases from 20%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\%$$\\end{document} to more than 70%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\%$$\\end{document}.

Functionalized Nanomaterials In Pancreatic Cancer Theranostics And Molecular Imaging.

Pancreatic cancer (PC) is one of the most fatal malignancies in the world. This lethality persists due to lack of effective and efficient treatment strategies. Pancreatic ductal adenocarcinoma (PDAC) is an aggressive epithelial malignancy which has a high incidence rate and contributes to overall cancer fatalities. As of 2022, pancreatic cancer contributes to about 3 % of all cancers globally. Over the years, research has characterised germline predisposition, the origin cell, precursor lesions, genetic alterations, structural alterations, transcriptional changes, tumour heterogeneity, metastatic progression, and the tumour microenvironment, which has improved the understanding of PDAC carcinogenesis. By using molecular-based target therapies, these fundamental advancements support primary prevention, screening, early detection, and treatment. The focus of this review is the use of targeted nanoparticles as an alternative to conventional pancreatic cancer treatment due to the various side effects of the latter. The principles of nanoparticle based cancer therapy is efficient targeting of tumour cells via enhanced permeability and retention (EPR) effects and decrease the chemotherapy side effects due to their non-specificity. To increase the efficiency of existing therapies and modify target nanoparticles, several molecular markers of pancreatic cancer cells have been identified. Thus pancreatic cancer cells can be detected using appropriately functionalized nanoparticles with specific signalling molecules. Once cancer has been identified, these nanoparticles can kill the tumour by inducing hyperthermia, medication delivery, immunotherapy or gene therapy. As potent co-delivery methods for adjuvants and tumor-associated antigens; nanoparticles (NPs) have demonstrated significant promise as delivery vehicles in cancer therapy. This ensures the precise internalization of the functionalized nanoparticle and thus also activates the immune system effectively against tumor cells. This review also discusses the immunological factors behind the uptake of functionalized nanoparticles in cancer therapies. Theranostics, which combine imaging and therapeutic chemicals in a single nanocarrier, are the next generation of medicines. Pancreatic cancer treatment may be revolutionised by the development of a tailored nanocarrier with diagnostic, therapeutic, and imaging capabilities. It is extremely difficult to incorporate various therapeutic modalities into a single nanocarrier without compromising the individual functionalities. Surface modification of nanocarriers with antibodies or proteins will enable to attain multifunctionality which increases the efficiency of pancreatic cancer therapy.

Enhancing disaster management through multi-objective water wave optimization for medical supplies storage and distribution

This paper conducts a comparative analysis of advanced methodologies aimed at addressing the intricate task of scheduling medical supplies in both civilian and military sectors for epidemic prevention and control. This study introduces a multi-objective water wave optimization (MOWWO) algorithm and enhance its efficacy by incorporating a dynamically adjusted component to the metaheuristic approach (DAMOWWO). The primary goal of this research is to assess the proposed approach in contrast to established state of the art methods with similar objectives. The aim of this study is to optimize multiple aspects simultaneously, including the overall satisfaction rates of medical supply delivery and the reduction of scheduling costs, while ensuring a minimum military supply reservation ratio. This paper offers a comprehensive evaluation of the MOOW algorithm, emphasizing its potential applications in emergency response scenarios.

The Holistic Intelligent Healthcare Theory (HIHT): Integrating AI for Ethical, Transparent, and Human-Centered Healthcare Innovation

The rise of artificial intelligence (AI) in healthcare has the potential to significantly increase the efficiency, personalization, and overall efficacy of medical care delivery. However, its integration needs to be improved regarding ethical norms, data quality, openness, and human-centered care. This study proposes the Holistic Intelligent Healthcare Theory (HIHT), a comprehensive theory for guiding AI's ethical and practical use in healthcare. It draws on insights from theories such as the Technology Acceptance Model (TAM), the Unified Theory of Acceptance and Use of Technology (UTAUT), Socio-Technical Systems Theory (STS), Ethics of Care, Data Governance and Information Quality Theory, and Augmented Intelligence Theory. The HIHT highlights the importance of centralized governance, strong data quality, transparent AI methods, human-AI collaboration, and a reimagined role for healthcare practitioners—the "Intelligent Doctor." The study presents the theory's structures and investigates their implications for AI integration in healthcare, offering a road map for responsible and practical AI applications.

Molecular Mechanisms of Biofilm Formation in Helicobacter pylori.

Biofilm formation in Helicobacter pylori (H. pylori) helps bacteria survive antibiotic exposure and supports bacterial colonization and persistence in the stomach. Most of the published articles have focused on one aspect of the biofilm. Therefore, we conducted the current study to better understand the mechanism of biofilm formation, how the biofilm contributes to antibiotic resistance, and how the biofilm modifies the medication delivery mechanism. We conducted a literature review analysis of the published articles on the Helicobacter pylori biofilm between 1998 and 2024 from the PubMed database to retrieve eligible articles. After applying the inclusion and exclusion criteria, two hundred and seventy-three articles were eligible for our study. The results showed that biofilm formation starts as adhesion and progresses through micro-colonies, maturation, and dispersion in a planktonic form. Moreover, specific genes modulate each phase of biofilm formation. Few studies have shown that mechanisms, such as quorum sensing and diffusible signal factors, enhance coordination among bacteria when switching from biofilm to planktonic states. Different protein expressions were also observed between planktonic and biofilm strains, and the biofilm architecture was supported by exopolysaccharides, extracellular DNA, and outer membrane vesicles. This infrastructure is responsible for the increased survival of bacteria, especially in harsh environments or in the presence of antibiotics. Therefore, understanding the biofilm formation for H. pylori is crucial. This study illustrates biofilm formation in H. pylori to help improve the treatment of H. pylori infection.

Effectiveness of intraosseous access during resuscitation: a retrospective cohort study

PurposeDuring resuscitation in emergency situations, establishing intravascular access is crucial for promptly initiating delivery of fluids, blood, blood products, and medications. In cases of emergency, when intravenous (IV) access proves unsuccessful, intraosseous (IO) access serves as a viable alternative. However, there is a notable lack of information concerning the frequency and efficacy of IO access in acute care settings. This study aims to assess the efficacy of intraosseous (IO) access in acute care settings, especially focusing on children in a level 1 trauma center.MethodsThis retrospective study included patients with IO access presented in a level 1 trauma center emergency department (ED) between January 2015 and April 2020. Data regarding medication and fluid infusion was documented, and the clinical success rate was calculated.ResultsOf the 109,548 patients that were admitted to the ED, 25,686 IV lines were inserted. Documentation of 188 patients of which 73 (38.8%) children was complete and used for analysis. In these 188 patients, a total of 232 IO accesses were placed. Overall, 182 patients had a functional IO access (204 needles) (88%). In children (age < 18 years) success rate was lower as compared to adults, 71–84% as compared to 94%. However, univariate regression showed no association between the percentage of functional IO access and gender, age, weight, health care location (prehospital and in hospital), anatomical position (tibia as compared to humerus) or type of injury.ConclusionIntraosseous access demonstrates a high success rate for infusion, independent of gender, age, weight, anatomical positioning, or healthcare setting, with minimal complication rates. Caution is especially warranted for children under the age of six months, since success rate was lower.

Fullerenes in dentistry: A review on unlocking their therapeutic potential in oral medicine

Fullerenes are a family of carbon allotropes that have demonstrated great potential in oral medicine. They have a distinct cage-like structure and take the shape of hollow spheres, ellipsoids, or tubes with special structural and physicochemical features. When fullerenes are spherical, they are known as buckyballs, and when they are cylindrical, they are known as carbon nanotubes or buckytubes. Due of their flexible construction, they can be used in a variety of settings, including medication delivery, gene therapy, diagnostics, and oral illness treatment. Fullerenes have the ability to conjugate or encapsulate medicinal substances, allowing for the regulated and targeted administration of drugs to tissues afflicted by diseases including mouth cancer and periodontal disease. When treating infections and long-term inflammatory disorders in the oral cavity, their capacity to improve drug stability and bioavailability is very advantageous. Functionalized fullerenes improve biosensing platforms and imaging methods in diagnostics, facilitating the early detection of illnesses and oral malignancies. There are still obstacles to overcome in order to maximize their biocompatibility, toxicity profiles, and delivery methods for clinical application, despite their enormous potential. This review aims in revolutionizing the detection and treatment of numerous oral disorders, and ongoing research endeavours to fully investigate the therapeutic potential of fullerenes in oral healthcare.