Action Points Research Articles

Implantable drug delivery systems: An overviews

Implant are sterile solid mass that contains medicine, prepared by different ways like extrusion, moulding or contraction. The conventional routes of medicine administration has limited control over medicine release and maintaining constant tube remedial medicine attention for longer ages of time. To avoid these problems associated with application of traditional lozenge forms, there was essential need for development of new lozenge forms which would discharge medicines at controlled rate for original exertion. This led to enhancement of Novel Drug Delivery Systems (NDDS) that offers optimisation of remedial parcels of medicines and makes them safer, productive and reliable over traditional ways of administration. Implantable medicine delivery system IDDS forms a part of new medicine delivery system. This route of administering specifics allows targeted distribution, position particularity, constant release rate, low quantum of medicine conditions, and minimisation of adverse goods with bettered efficacity. It provides possibility of administering medicines once daily to monthly which else preliminarily bear frequent diurnal dosing. Different implantable technologies are presently in use for numerous remedial operations similar as in dentistry, ophthalmology, contraception and oncology. Remedial medicine Delivery styles give veritably little, if any, control over the timing and pattern of medicine release drug attention immersion at the point of action. Undetermined drug attention in tube is a typical and egregious issue with the Traditional cure system. Therefore to overcome similar problems sweats have been made by experimenters and pharmaceutical scientists to the Betterment of the medicine delivery system and that lead to the development of the Novel Drug Delivery System (NDDS). NDDS is the Approach and technology to deliver the medicine in low attention and follow the zero- order release of the medicine in a controlled manner. Also, the NDDS’s development results in the creation of an implantable medicine delivery system (IDDS). A system for implantable drug delivery is a new approach of drug delivery. In this fashion, the drug is delivered under controlled conditions to the precise position where the implant is placed. The expression, medication, evaluation criteria, and unborn aspects of the implantable medicine delivery system are the subjects of this study.

Population-based cancer registries: an essential partner in monitoring and establishing critical action points.

Population-based cancer registries: an essential partner in monitoring and establishing critical action points.

Health among youth and young adults born in the nordic countries to immigrant parents- a scoping review

IntroductionA considerable number of individuals born in the Nordic countries to immigrant parents are now entering youth and young adulthood, but we have limited knowledge about their health. This scoping review aimed to map and summarize existing knowledge on the health of this group.MethodsThis research followed guidelines from the Joanna Briggs Institute. The literature search was performed in the databases Ovid Medline, Embase, APA PsycInfo, CINAHL, Scopus, SveMed+, Cochrane Central Register of Controlled Trials Issue, and Epistemonikos. Two researchers screened titles and abstracts of all records, and then full-texts of potentially relevant studies. Any disagreements were solved by discussion. Reference lists of the included studies were screened for additional relevant articles. Included articles should report on health outcomes among persons aged 16–30 years, born in a Nordic country to immigrant parents. Evidence was extracted and summarized.ResultsThe initial search resulted in 2452 unique records. A total of 11 articles were included in the final scoping review. Most of the studies were on mental health and concluded that descendants of immigrants had higher levels of self-reported mental health problems than native-background youths and young adults. They were, however, less likely to use mental health services.ConclusionAvailable studies suggest that young adults born in the Nordics to immigrant parents have a greater burden of mental health problems but use mental health services less, than natives. Further studies on the reasons for this are warranted to elucidate possible action points.

Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study

BackgroundAfrican Americans experience cardiovascular disease (CVD) disparities, and the burden is greatest in the rural south. Although evidence-based CVD prevention and management programs have been tailored to this context, implementation has been limited and not sustained long-term. To understand how to implement and sustain evidence-based CVD programs at scale, we must explore the perspectives of organizations serving rural African American communities and situate findings within foundational Implementation Science frameworks.MethodsThis study used group concept mapping (GCM) to elicit and synthesize stakeholder perspectives into an action-focused conceptual model depicting factors influencing implementation of evidence-based CVD programs. Representatives of community-based, faith, and healthcare organizations serving African Americans in five rural North Carolina counties were recruited via purposive sampling techniques. Participants (total n = 31) completed three activities: 1) brainstorming in response to an open-ended prompt (n = 31); 2) sorting brainstorm data into wider concepts and rating each in terms of relative importance and feasibility (n = 26); and 3) collaborative interpretation and refinement of the concept map (n = 19). Multivariate statistical analysis was used to generate a concept map. Absolute pattern matches comparing ratings of the relative importance and feasibility of each factor were generated and depicted via ladder graphs.ResultsThe final concept map included five factors: Accessibility, Community and Social Factors, Education and Training, Financial/Resource Development, and Organization Capacity and Staffing. There was high agreement (r = .98) between ratings of importance and feasibility. Education and Training, both within organizations and the wider community, was rated as the most important and feasible factor and Financial/Resource Development was the least important and feasible.ConclusionsThe concept map emphasizes aspects of organizations (inner setting), their surrounding community (outer setting), and individual stakeholders (participants, implementers) as influencing implementation of evidence-based CVD prevention and management programs in rural African American communities. The nature of the intervention or implementation processes were de-emphasized. Organizations in rural African American communities may feel equipped to implement a range of evidence-based programs, provided strategies address the contextual and structural barriers that impede their success. Group concept mapping helped distill and prioritize initial leverage points for action in our project catchment area by facilitating a community-engaged process of data generation and interpretation.

An analytical study of active earth pressure in cohesive soil considering interlayer shear stress.

The impact of interlayer shear stress on the distribution of earth pressure in cohesive soil is notable, but currently, there lacks a comprehensive theory that integrates this factor in the calculation of active earth pressure. Drawing from the Mohr stress circle specific to clay soils, a formula to calculate interlayer shear stress has been derived. Moreover, a robust model has been formulated to compute the active earth pressure in clay soils, incorporating elements such as interlayer shear stress, effects of displacement, soil arching, and the morphology of the sliding surface. To address the challenge of integrating interlayer shear stress in clay soils for an explicit solution, a numerical iteration framework was developed. This framework facilitates the calculation of the strength, resultant force, and point of action for the active earth pressure in cohesive soil. The efficacy of this solution was evaluated by comparing it with the Rankine solution, other existing analytical solutions, and outcomes from standard model tests. Notably, when compared with the experimental findings of the word previous study, this new method exhibited a higher congruence, with discrepancies no greater than 9.8%. This indicates a significant enhancement in accuracy, providing a methodological advancement in calculating earth pressure from static to ultimate active states, inclusive of non-limit active earth pressure during controlled wall displacement scenarios. This novel approach not only supplements but also refines the theoretical framework for earth pressure calculations, offering a more precise computational tool for practical engineering applications.

Governance and resilience as entry points for transforming food systems in the countdown to 2030

Due to complex interactions, changes in any one area of food systems are likely to impact—and possibly depend on—changes in other areas. Here we present the first annual monitoring update of the indicator framework proposed by the Food Systems Countdown Initiative, with new qualitative analysis elucidating interactions across indicators. Since 2000, we find that 20 of 42 indicators with time series have been trending in a desirable direction, indicating modest positive change. Qualitative expert elicitation assessed governance and resilience indicators to be most connected to other indicators across themes, highlighting entry points for action—particularly governance action. Literature review and country case studies add context to the assessed interactions across diets, environment, livelihoods, governance and resilience indicators, helping different actors understand and navigate food systems towards desirable change.

A roadmap toward promoting and improving brain health in Europe and closing the awareness and funding gap.

The global burden of neurological diseases exceeds 43.1%, imposing a significant burden on patients, caregivers and society. This paper presents a roadmap to reduce this burden and improve brain health (BH) in Europe. The roadmap is based on the European Academy of Neurology's (EAN) five-pillar BH strategy: advancing a global BH approach (P1), supporting policymaking (P2), fostering research (P3), promoting education (P4), and raising awareness of prevention and treatment (P5). It reviews current efforts, collaborations and future directions aligned with the WHO Intersectoral Global Action Plan (iGAP) for Neurological Disorders and suggests future initiatives and call for action. P1: Support WHO-iGAP through defined action points, international collaborations, in particular, the WHO BH Unit, and the EAN Brain Health Mission. P2: Collaborate with 48 national neurological societies to promote National Brain Plans (NBPs), addressing local needs, and improving access to care. P3: Advocate for more research funding; identify determinants of BH; develop preventive measures. P4: Provide educational opportunities for neurologists, public education programs, and advocacy training, including tools to educate the public. P5: Spearhead global awareness campaigns, organize public educational activities, and train BH advocates to contribute toward sustainable and long-term public health campaigns and policy engagement. The paper highlights the importance of a unified approach, integrating international collaborations and local initiatives, to improve BH outcomes based on the WHO-iGAP, and support sustainable development goals, in particular SDG 3: Good Health and Well-being and SDG 4: Quality Education.

Pitfalls in gut single-cell eukaryote research.

Gut single-celled eukaryotes (GSCEs) are found in billions of people worldwide, but we still know little about their functions and relationships in human gut ecology. Lately, retrospective analysis of bacterial data obtained by next-generation sequencing (NGS) methods has been used to identify links between GSCEs, gut bacteria, host metabolism, and host phenotypical traits, suggesting possible direct or indirect associations to favorable gut microbiome features and other health parameters. Here, we highlight some of the pitfalls related to the research strategy typically used so far and propose action points that could pave the way for a more accurate understanding of GSCEs in human health and disease.

Unveiling relationships of human instinctive behaviors and blood pressure in Chinese adults: A network analysis.

Human behaviors and blood pressure (BP) are closely intertwined, affecting health. However, few studies have demonstrated their complex relationships. Using network analysis, we aimed to untangle the intricate and potential causal relationships between BP and human instinctive behaviors, identifying potential action points for hypertension prevention and control. Cohort study. This study is based on two-wave data from 11,277 Chinese adults in the China Multi-Ethnic Cohort (CMEC) and an independent validation cohort of 21,947 adults from the Chinese Cohort of Working Adults (CCWA). We conducted a cross-sectional network analysis to estimate the interrelationships between measured BP and self-reported physical activity (PA), diet, and sleep. The centrality of each variable within the network was estimated using strength centrality index. Additionally, we performed a longitudinal network analysis to infer the potential causal relationships between BP and human instinctive behaviors in participants with normal or above-normal BP. The network models suggested that BP exhibited negative associations with the dietary score (edge weight: -0.09) and sleep duration (-0.05). Non-sedentary behavior and dietary score were the most central variables, strongly connecting BP and other lifestyles. Higher BP predicted a poorer dietary score (β=-0.21) in participants with above-normal BP. The effect of BP on dietary score was replicated in the validation cohort and validated by linear regression analysis. Non-sedentary behaviors and dietary behaviors may be the potential action points in promoting healthy behaviors and contributing to BP management. It is essential to manage individuals' BP status, non-sedentary behaviors, and dietary behaviors to disrupt malignant cycles.

An exploratory qualitative study of inter-agency health and social service partnerships focused on Aboriginal and Torres Strait Islander clients

BackgroundThe siloed nature of the health and social service system threatens access for clients engaging numerous organisations. Many Aboriginal and Torres Strait Islander people face adverse circumstances which contribute to multiple health and social needs. Effective relationships between health and social services are integral to coordinated service provision to meet the diverse needs of Aboriginal and Torres Strait Islander clients. Place-specific insights into inter-agency relationships are needed to inform targeted strategies that bolster service coordination to benefit Aboriginal and Torres Strait Islander people.MethodsThis study sought to understand experiences of inter-agency partnerships among health and social service providers on Kaurna Country in northern Adelaide using semi-structured interviews and yarning circles to explore partnership actions, outcomes, enablers, challenges, and identify strategies to strengthen partnerships. Fifty-nine service providers (78% female, 62% Aboriginal) participated including six from non-government organisations, 17 from Aboriginal community-controlled services and 36 from government organisations.ResultsA content analysis identified partnership actions such as client advocacy, referrals, sharing information, case management meetings and collaborative tender submissions which were seen to improve client access, navigation and outcomes and strengthen worker connectedness and job satisfaction. Motivated workers, listening to Aboriginal people, shared goals and values, and partnership agreements (e.g., memorandum of understanding, service contracts) were identified enablers of partnerships. Racism and ignorance, lack of networking events, communication breakdown, red tape and administrative barriers, competition between services, short-term funding, high turnover of staff and a focus on key performance indicators rather than community needs were among the challenges. Effective partnerships to benefit Aboriginal communities in northern Adelaide was reported to require aligned intersectoral strategic intentions, reforms to service commissioning processes, sustainable funding, regular network events for management and frontline workforce, Aboriginal practitioner-led service coordination approaches and a network of Aboriginal and Torres Strait Islander workers across organisations.ConclusionsThis study identified key leverage points for action on inter-agency partnerships to benefit Aboriginal and Torres Strait Islander communities on Kaurna Country. System drivers such as funded inter-agency networks and reforms to commissioning of services must support organisational- and practitioner-level enablers to strengthen partnerships between health and social services across northern Adelaide.

A Qualitative Analysis of Students' Perceptions and Experiences of Stressors and Well-Being in Dentistry.

Well-being is increasingly regarded as an integral component of a graduating dentist's professional responsibility, yet studies demonstrate significant levels of stress and poor mental health in the dental student population. The aim of this qualitative study was to explore final-year dental students' perceptions of stressors in dentistry and their experiences of managing their individual well-being and supporting the well-being of their colleagues and patients. A literature search was performed to guide the development of an interview framework which included questions centred around three higher domains based on self, peers and patients. Participants were randomly sampled and the interviews audio recorded and transcribed verbatim. An inductive-deductive approach was adopted for thematic analysis of the results. Fourteen interviews were conducted, revealing four themes and 15 subthemes. Students were acutely aware of poor well-being symptoms amongst themselves and their peers. Treating dental patients with mental illness was common but some students expressed uncertainties in managing these patients. The key stressors were assessments and clinical stress. Students frequently sought support from peers and half had received professional help. Barriers to approaching faculty staff were identified. The role of stigma in preventing students from openly sharing their well-being experiences was discussed. A range of curricular and clinical stressors, and potential sources of support to manage these stressors, have been explored from the perspectives of final-year dental students. From these experiences, action points have been proposed to address knowledge gaps and enhance faculty-level wellness support for dental students.

Interferential Current Stimulation Enhances Rectal Motor Activity: Insights from an Isolated Perfused Porcine Model.

Interferential current (IFC) has been studied in several clinical trials for the treatment of bowel motility disorders, most often in children. However, only moderate effects are reported, and in contrast to IFC, the so-called placebo application is indiscernible. The mechanisms and neuroanatomic points of action remain elusive. Therefore, this therapy remains being questioned. To gain objective experimental data about IFC stimulation, we examined this method ex vivo in an isolated perfused porcine rectum including the mesorectum. To elucidate the role of plexus nerve fibers and enteric ganglia, we performed IFC stimulation also in the presence of tetrodotoxin (TTX) or hexamethonium (HXN). We applied the commonly used stimulation modes with a beat frequency sweeping between 5 and 25 Hz (IFCd5-25) and 80 and 150 Hz (IFCd80-150). We monitored intraluminal pressure and motility by online barometry and video recording, respectively. Motor activity, reflected by changes in the intraluminal pressure (cm H2O·s-1) and longitudinal movements (pixels·s-1), was quantified over time as root mean squares (RMSs). After IFCd5-25, we observed a 30% increase in the rectal motility in the pressure changes which was sustained over 30 minutes post-stimulation (p < 0.02); only a minor effect was detected for IFCd80-150. Both TTX and HTX abolished the stimulation. This suggests neuronal modulation. IFCd5-25 stimulates rectal motor activity in the isolated perfused porcine rectum. Ganglia in the enteric nervous system are modulated to allow increased activity for at least 30 minutes. Therefore, the isolated porcine rectum is a suitable tool to study the effectiveness of various IFC settings in the rectum.

Forced Vasohibin-1 Expression Increases Paclitaxel Sensitivity of Ovarian Cancer by Inhibiting Microtubule Activity.

Vasohibin-1 (VASH1), an angiogenic inhibitor, exhibits tubulin carboxypeptidase activity, which is involved in microtubule functions. Paclitaxel, the core chemotherapeutic agent for ovarian cancer chemotherapy, has a point of action on microtubules and may interact with VASH1. To examine the influence of VASH1 on intracellular tubulin detyrosination status, cyclin B1 expression, and paclitaxel chemosensitivity using VASH1-overexpressing ovarian cancer cell lines. Gene-transfected human ovarian cancer cell lines were subjected to western blot analysis. Western blot analysis of VASH1-overexpressing ovarian cancer cells revealed upregulated expression of detyrosinated tubulin and cyclin B1 compared with control cells. By WST-1 assay, paclitaxel chemosensitivity of VASH1-overexpressing ovarian cancer cells was markedly enhanced compared with that of control cells, whereas there was no significant difference in chemosensitivity to cisplatin. The forced expression of VASH1 enhanced tubulin carboxypeptidase activity and increased cyclin B1 expression, resulting in augmented paclitaxel chemosensitivity in ovarian cancer cells. Ovarian cancer treatment strategies targeting VASH1 can potentiate the effects of conventional chemotherapy by inhibiting angiogenesis and regulating microtubule activity.

Constructing nested coordinates inside strongly shaped toroids using an action principle

A new approach for constructing polar-like boundary-conforming coordinates inside a toroid with strongly shaped cross-sections is presented. A coordinate mapping is obtained through a variational approach, which involves identifying extremal points of a proposed action in the mapping space from $[0, 2{\rm \pi} ]^2 \times [0, 1]$ to a toroidal domain in $\mathbb {R}^3$ . This approach employs an action built on the squared Jacobian and radial length. Extensive testing is conducted on general toroidal boundaries using a global Fourier–Zernike basis via action minimisation. The results demonstrate successful coordinate construction capable of accurately describing strongly shaped toroidal domains. The coordinate construction is successfully applied to the computation of three-dimensional magnetohydrodynamic equilibria in the GVEC code where the use of traditional coordinate construction by interpolation from the boundary failed.

Comparative assessment of commercial ELISA kits for the screening of chloramphenicol residues in meat and aquaculture products according to European Regulation (EU) 2021/808 and to the new Reference Point for Action (Commission Regulation (EU) 2019/1871)

This study covered the evaluation of performance characteristics and validation of five commercial ELISA kits for the detection of a banned antimicrobial, chloramphenicol (CAP), in muscle and aquaculture products. CAP has been banned in the European Union since 1994, but is still authorised in some countries in the world. In 2019, the European Union set a new Reference Point for Action (RPA), decreasing the acceptable limit of CAP in animal tissues for human consumption from 0.30 µg/kg to 0.15 µg/kg. Validations were performed according to the European Regulation EC/2021/808 and to the European Guideline on Screening Method Validation (2023). The detection capabilities CCβ were all determined under the RPA, but were 3 to 15 times higher than the announced limit of detection (LOD). False negative rates were satisfactory for all the kits (≤ 5%) and false positive rates were acceptable. All of them were found out to be applicable to aquaculture products and meat at a common CCβ.

Liberatory Race-Conscious Mentorship Practices: Collaborating for Change

ABSTRACT Mentoring can have an equalizing impact on educational outcomes by critically taking on the deeper issues around oppression and marginalization while bringing to light the cultural and institutional roots of intrapsychic (e.g. implicit bias) and interpersonal racism (e.g. microaggressions). Educators of teacher candidates have two openings for change: they can model an antiracist curriculum and pedagogy in their classrooms, and they can support teacher candidates to become teachers who adopt race-conscious, egalitarian, and humanistic teaching philosophies and practices. Using a liberatory race-conscious mentorship (LRCM) framework, we conceptualized 12 mentoring practices derived from eight years of critically-informed research training for nearly 330 undergraduate students and after delivering critical race theory-based mentorship training to 128 faculty mentors in biomedical fields. Each set of LRCM practices reflects one of four liberatory phases of antiracism – awareness, deconstruction, reconstruction, and praxis – and focuses on intrapsychic, interpersonal, and institutional levels of antiracism practice as starting points for local action.

Performance monitoring of improvisation and score-playing in a turn-taking piano duet: An EEG study using altered auditory feedback.

In music ensemble performance, perception-action coupling enables the processing of auditory feedback from oneself and other players. However, improvised actions may affect this coupling differently from predetermined actions. This study used two-person EEG to examine how pianists responded to altered pitch feedback to their own or their partner's actions while they alternated scores or improvised melodies. Feedback-related negativity (FRN) response for self-action was greater in scored than improvised conditions, indicating the enhanced action encoding by playing the score. However, subsequent P3a and P3b responses for self-action were not different across score and improvisation. Further, the P3b response was greater when the two pianists exchanged similar types of melodies (i.e., both improvised or both scores) compared with different types of melodies, suggesting that later cognitive processes may be associated with the task relevance or level of jointness. The presence of the FRN and P3 complex in self-generated improvised action points to the dynamic nature of performance monitoring even without preconceived action plans. In contrast, the FRN and P3 complex in partner-generated improvised actions were subdued compared to the baseline, likely due to the unpredictable nature of the improvised actions of others. Finally, we found a tendency that higher trait empathy was associated with smaller self-action FRN, possibly implying musicians' prioritization of joint goals. Overall, our results suggest that improvisation in a musical turn-taking task may be distinct from score-playing for the earlier processes of performance monitoring, whereas later processes might involve updating a joint representation of the musical context.

Supporting diversity in clinical trials: the equitable breakthroughs in medicine site maturity model

BackgroundAmong the most powerful barriers to broader inclusion of diverse participants in clinical trials are social determinants of health, trustworthiness of health care providers and research institutions, and competing pressures on potential participants. Nevertheless, current tools to assess organizational capabilities for clinical trial diversity focus primarily on trial infrastructure, rely solely on quantitative self-reported data, and lack meaningful assessment of capabilities related to community engagement.MethodsThe Equitable Breakthroughs in Medicine (EQBMED) initiative developed a holistic, collaborative, site-driven formative model and accompanying assessment to catalog sites’ current capabilities and identify opportunities for growth in both conducting industry-sponsored clinical trials and enriching diversity of those trials. The model builds upon prior work and reflects unification of two historically distinct components—research operations and community engagement—since sustainable clinical trial diversity efforts must overcome these silos. Here we present the methodology we used to develop the model and accompanying assessment, describe how findings can support clinical trial diversity efforts, and report findings from early field testing at three U.S. sites.ResultsThe first three sites were diverse in size (e.g., < 250–1 K beds), with varying levels of clinical trial capabilities and community engagement. The maturity assessment laid the foundation for sites to identify and prioritize key areas to advance clinical trial diversity capabilities, and each has made tangible progress. In parallel to completing the assessment with these early sites to understand their maturity and set actionable goals, we also collected their feedback on content validity (e.g., clarity, comprehensiveness, terminology) and feasibility (e.g., ability to collect needed information and data, time required). We describe refinements made to improve the assessment and streamline the process. The EQBMED program will deploy the assessment across various site types (e.g., FQHCs, safety net hospitals) and make further refinements as warranted.ConclusionsStrategic investment in clinical trial diversity requires structured assessment of site maturity as a starting point for collaborative action. We propose the EQBMED maturity model as a first step toward informing efforts to increase representation of diverse populations in clinical research.

Pathways to a sustainable electricity sector in Kenya: Challenges and transformational factors

Which factors may enable a secure, affordable, and sustainable development of the Kenyan energy system? The present study aims to understand how the country's energy system could be structured in 2050, to unravel the main challenges, and to identify critical leverage points for policy action. To this end, we designed energy scenarios for Kenya using cross-impact balance and succession analysis, drawing extensively from expert judgments. The results highlight the importance of improving the quality of the grid, further reforming the electricity market structure, encouraging more competition, and promoting decentralization as the main leverage points for ensuring a secure and sustainable energy future.

Assessing the landscape and charting paths: UK neurology trainees’ opinions on neuroinflammation subspecialty

Therapeutics of neuroinflammatory disorders including multiple sclerosis is one of the fastest growing areas in neurology. However, pressures on higher specialty training in neurology together with an expanding curriculum have led to challenges in adequately preparing trainees for a subspecialist career. In this study we set out to understand current perceptions and barriers to training in neuroinflammatory disorders among neurology trainees in the UK. A structured questionnaire was used to assess trainees' perspectives on training opportunities and career aspirations. Findings reveal significant gaps in training, including insufficient training opportunities, lack of mentorship, and concerns about managing complex treatment regimes. We used these findings to develop structured action points with aim of improving training and retention in this subspecialty. These include early exposure to subspecialty experiences, enhanced mentorship, and equal access to training opportunities regardless of geographical location. Our findings underscore the need for further curriculum development in neurology training, potentially combining early support with dedicated fellowships later in training, in order to ensure sustainability of neuroinflammation as a subspecialty and to meet the growing demand for expertise in MS and related conditions.