Successful Delivery Research Articles

Home / Archives / Volume 11 Issue 1 / EDUCATION & LANGUAGE STUDIES Validity Assessment Of Student's Acceptance Towards Online Distance Learning

Online distance learning is one approach for delivering teaching and learning that is becoming popular nowadays. The student's acceptance of online distance learning should be measured because it indicates the successful teaching and learning delivery level. For this purpose, we need an evaluated and validated instrument to measure students' acceptance of online distance learning. To achieve this, Exploratory Factor Analysis (EFA) and Nomology Analysis are used to evaluate and validate students' acceptance of online distance learning instruments. The EFA of this study on 32 items resulted in the construction of seven dimensions: Self-Productivity, Content Productivity, Effort Expectancy, External Influence, Personal Innovativeness, Self-Management Learning and Behavioural Intention. The correlation analysis indicates that all the bivariate relationships among the components were significantly correlated with at least a 95% confidence level. This result shows that the instrument can be considered valid and reliable and used to measure students' acceptance of online distance learning.

Geographical Information Systems (GIS) in Municipal Planning and Management: A Pathway to Improve South African Service Delivery

In the years after 1994, the democratic government of South Africa worked to transfer and extend basic service provision to practically all sections of the country. The delivery of public services continues to be an embarrassment to humanity and the developmental state. Without proper basic services such as water, sanitation, power, infrastructure, health facilities, and housing, a large section of South Africa’s people would continue to live and die. As a result, society remains disenfranchized and exposed to socioeconomic shocks, contributing to the economy's decline and destruction. To support successful service delivery, the integration of Geographical Information Systems (GIS) as a shift from human-led operations to computerized operations is now recognized and required in municipal planning and management. The central purpose of this study is to evaluate the feasibility of applying GIS as a crucial planning tool infused within integrated development planning in municipal planning and management. The current state of service delivery in existing municipal planning and management procedures, as well as the factors that influence it and the effect it has on society, will be examined. This conceptual study employs secondary data and follows a certain methodology. Using the Critical Discourse Analysis (CDA) methodology, secondary data were examined. The results demonstrate that political influence and manipulation, a lack of openness and accountability, insufficient citizen participation, a lack of personnel capability, and poor planning, monitoring, and evaluation contribute to poor public service delivery in South Africa. Furthermore, the findings indicate that GIS functions as a tool for visualization and collation of spatial information, map production, and data capturing and storage in local municipalities with the aim of enhancing public service delivery.

Advancements and innovations in requirements elicitation: Developing a comprehensive conceptual model

Requirements elicitation is a crucial phase in the software development lifecycle, ensuring that stakeholders' needs are understood and translated into system specifications. Traditional methods often face challenges such as ambiguity, inconsistency, and evolving requirements, leading to project delays and cost overruns. This review proposes a conceptual model that integrates advancements and innovations in requirements elicitation to address these challenges comprehensively. The proposed model leverages various techniques, including but not limited to, natural language processing (NLP), machine learning (ML), and human-computer interaction (HCI), to enhance the accuracy and efficiency of requirements elicitation. NLP techniques enable automated analysis of textual requirements documents, extracting key information and identifying implicit requirements. ML algorithms facilitate the prediction of potential changes in requirements based on historical data and project context, enabling proactive management of evolving requirements. Moreover, the integration of HCI principles in the requirements elicitation process enhances stakeholder engagement and collaboration. Interactive interfaces and visualization tools enable stakeholders to provide feedback in real-time, fostering a more iterative and participatory approach to requirement gathering. Additionally, techniques such as prototyping and simulation facilitate early validation of requirements, reducing the risk of misinterpretation and ensuring alignment with stakeholders' expectations. Furthermore, the proposed model emphasizes the importance of context-awareness in requirements elicitation. By considering the organizational, cultural, and environmental context of a project, the model adapts its elicitation strategies and techniques to suit specific needs and constraints. Context-awareness also enables the identification of implicit requirements that may not be explicitly stated but are crucial for the success of the system. The model also addresses the challenge of managing conflicting requirements by introducing a systematic approach to requirements prioritization and negotiation. By employing multi-criteria decision-making techniques, stakeholders can collaboratively prioritize requirements based on their importance, feasibility, and impact on project objectives. Conflict resolution mechanisms facilitate consensus-building and trade-off analysis, ensuring that the final set of requirements reflects the collective interests of all stakeholders. Additionally, the proposed model emphasizes the iterative nature of requirements elicitation, advocating for continuous refinement and validation of requirements throughout the development lifecycle. Feedback loops enable stakeholders to review and revise requirements based on evolving needs and changing circumstances, thereby enhancing the adaptability and resilience of the system. The conceptual model presented in this review represents a holistic approach to requirements elicitation, leveraging advancements and innovations in technology, human interaction, and context-awareness. By integrating these elements, the model aims to enhance the accuracy, efficiency, and stakeholder satisfaction in the requirements elicitation process, ultimately contributing to the successful delivery of high-quality software systems.

Identifying the influence of land logistic driver cognitive energy impact on supply chain performance through agent-based simulation

Logistic transports link demand generators, distributors, and producers in a supply chain network (SCN). The existence of logistic transports is critical to ensure whole nodes’ economic sustainability. This study explores the impact of human factors on SCN performance through cognitive energy expenditure (CEE) tracking. Agent-based model (ABM) simulation was used to analyze the impact of CEE from truck driver’s electroencephalography (EEG) data to obtain the postsynaptic potential values, which were then transformed to calorific energy. The fleet agents, retailers and distributor models were built based on the East Java, Indonesia, logistic transport route around Karanglo, Gempol, Bungurasih, and Gubeng. The frequency and the peak value of the EEG data, postsynaptic potential, and energy data indicate the same information. All data indicate that more challenging routes have higher frequency and higher peak values. The ABM simulation of the fleet agents shows balanced CEE throughout entire routes due to the precise rest period and eat scheduling. The average delivery success rate was 8 out of 30 or 26.7 % in each simulation time step. Hence, most goods delivery tasks can be completed by fleet agents in a balanced system. As a consequence, the SCN performance is also balanced due to the fluid inventory shift without overstock and stockouts. The rest and eat periods of a fleet agent were scheduled after the CEE has been peaked. The time lag between rest periods and transport operations has to be maintained to overcome fleet agents task buildup. Task buildup has a potential to decay both transport safety and inventory shift rates. Therefore, the upgrade in SCN performance is possible through proper fleet agents scheduling

Public-Private Partnership: Optimising the Outcomes for Plastic Surgery in a Resource-Limited Setting at the University of Port Harcourt, (UPTH) Rivers State, Nigeria

Background: Public Private Partnership (PPP) refers to a form of cooperation between public authorities and the world of business which aims to ensure the funding, construction, renovation, management and maintenance of an infrastructure or the provision of better services, better quality, better and better health in a relatively cost- effective manner or approach to the society.  Aim and Objectives: This paper highlights the role of PPP in optimizing outcomes for patients who require plastic surgical services.  Materials and Methods: This study was carried out to bring to light the perennial problems of the health care mixes within a period of 6 months in the Plastics and Reconstructive Surgery unit of The University of Port Harcourt Teaching Hospital. This work looked at the Public Private sector mixes in health care system using Nigeria as a case study.  Results: Cases managed at the public facility alone, cases managed at the private facility alone and the cases managed through the combined effort of both the Private and Public sector (PPP) were analyzed.  Conclusion: Public Private Partnership is key to the success and effectiveness of healthcare delivery in a resource poor setting as the PPP drives the marriage of effectiveness in administration and business prototype in the marriage of government infrastructure and large medical market with turn over into a partnership where the private component brings in the specific funding and equipment and expertise needed to make the medical business model.

Telerehabilitation in Chronic Obstructive Pulmonary Disease (COPD) Management: Exploring Experiences and Effectiveness

Telerehabilitation has emerged as a promising approach to address the challenges posed by chronic obstructive pulmonary disease (COPD) management. This article provides a comprehensive review of telerehabilitation’s characteristics,components, efficacy, patient experiences, and the implications for COPD patients. Telerehabilitation involves the use of telecommunication technologies to remotely deliver rehabilitation services, including exercise training, education, and monitoring, to individuals with COPD. It addresses barriers such as geographical distance and limited access to specialized facilities, making rehabilitation accessible from home. Telerehabilitation encompasses various approaches, including telemonitoring, teleconsultation, and tele-education. Several studies have indicated positive outcomes in exercise capacity, dyspnea, and quality of life when comparing telerehabilitation interventions to standard care or traditional rehabilitation programs. However, challenges related to technology access, digital literacy, and privacy need to be addressed for equitable implementation. Interdisciplinary collaboration among healthcare professionals is essential for the successful delivery of telerehabilitation. Future research should focus on refining the interventions, standardizing the protocols, and evaluating the long-term maintenance effects. By integrating patient-centered approaches and leveraging advancements in digital technologies, telerehabilitation can revolutionize COPD management strategies, enhancing patient outcomes in the modern healthcare landscape.

Comparison of trans-vaginal ultrasound cervical length measurement and Bishop score in predicting successful labour induction in term pregnancies at Ahmadu Bello University Teaching Hospital Zaria

The goal of induction of labour (IOL) is to achieve successful vaginal delivery and reduce caesarean section (CS). The gold standard method for assessing cervical status has been the use of the Bishop score (BS) which is not flawless leading to unnecessary intervention. Trans-vaginal ultrasound cervical length (CL) measurement has been compared with BS in predicting successful IOL. The objective of this study was to compare CL and BS in predicting successful IOL at Ahmadu Bello University Teaching Hospital. It was a cross sectional comparative study design conducted among pregnant women at 37-42 weeks of gestation slated for IOL between November 2017 to November 2018. Eighty-seven (87) women were recruited as participants. Each participant, had a trans-vaginal ultrasound (TVS) CL measured and each was followed by a digital cervical assessment using BS. Relevant data obtained was analysed using SPSS version 23. The significance level was considered at P< 0.05 IOL was successful in 66.2% (47) of the participants, while 15% (13) had CS. The receiver operating characteristic curve (ROC) demonstrated a better performance of the BS (AUC= 0.556, P= 0.433, CI= 0.426-0.673, PPV=52.8%) in predicting successful IOL than the TVS-CL measurement (AUC= 0.446, P=0.391, CI= 0.317-0.574) PPV=60.2%). Results further showed that the best cut off values for favourability for IOL for TVS-CL and BS were ≤2.5 cm and ≥5 respectively. The most important component of the BS predictive of successful IOL was cervical dilatation (OR= 0.603, P=0.011). TVS-CL did not demonstrate a diagnostic accuracy in predicting successful IOL in term pregnancies compared to BS.

Feasibility of Direct Vitrectomy-Sparing Subretinal Injection for Gene Delivery in Large Animals

Purpose To assess the safety and feasibility of direct vitrectomy-sparing subretinal injection for gene delivery in a large animal model. Methods The experimental Liběchov minipigs were used for subretinal delivery of a plasmid DNA vector (pS/MAR-CMV-copGFP) with cytomegalovirus (CMV) promoter, green fluorescent protein (GFP) reporter (copGFP) and a scaffold/matrix attachment region (S/MAR) sequence. The eyes were randomized to subretinal injection of the vector following pars plana vitrectomy (control group) or a direct injection without prior vitrectomy surgery (experimental group). Intra- and post-operative observations up to 30 days after surgery were compared. Results Six eyes of three mini-pigs underwent surgery for delivery into the subretinal space. Two eyes in the control group were operated with a classical approach (lens-sparing vitrectomy and posterior hyaloid detachment). The other four eyes in the experimental group were injected directly with a subretinal cannula without vitrectomy surgery. No adverse events, such as endophthalmitis, retinal detachment and intraocular pressure elevation were observed post-operatively. The eyes in the experimental group had both shorter surgical time and recovery while achieving the same surgical goal. Conclusions This pilot study demonstrates that successful subretinal delivery of gene therapy vectors is achievable using a direct injection without prior vitrectomy surgery.

Elective Induction of Labor Following Prior Cesarean Delivery.

Following the ARRIVE trial, induction of labor at 39 weeks has increased in the United States. The risk of uterine rupture and optimal timing of elective induction in those patients with a prior cesarean delivery is not well described, and they were not included in the original trial. We aim to determine the risk of uterine rupture in those patients undergoing elective induction of labor with prior cesarean delivery. This was a retrospective cohort of participants with prior cesarean delivery from 1996 to 2000. Participants were included if they had ≤ 2 prior cesareans. Participants were excluded if they had a history of an unknown prior incision, a classical incision, gestational age < 39 weeks, any diabetes, chronic hypertension, twin gestation, collagen or vascular disease, or HIV. Those undergoing expectant management were compared to those undergoing elective induction with no medical or obstetrical indications for delivery. Analysis was performed at three gestational age groups: 39 weeks, 40 weeks, and 41 weeks. The primary outcomes were uterine rupture, rates of successful vaginal delivery, and a composite major morbidity risk. Multivariable logistic regression was performed. At 39 weeks, 618 (10.3%) elective inductions were compared to 5365 (89.7%) undergoing expectant management; uterine rupture occurred more frequently (13 patients (2.1%) vs. 49 patients (0.9%); aOR, 2.5; 95% CI, 1.3 - 4.6) with fewer successful VBAC (66.8% vs. 75%; aOR, 0.6; 95% CI, 0.5 - 0.7). The risk of uterine rupture was similar between groups at 40 (5 patients (0.8%) vs. 21 patients (1.2%); P=0.387) and 41 weeks (7 patients (1.4%) vs. 2 patients (0.8%); P=0.448). Patients undergoing elective induction of labor with a prior cesarean scar had an increased risk of uterine rupture when compared to expectant management at 39 weeks, with fewer successful VBAC.

Palliative Care Clinicians' Views on Metrics for Successful Specialist Palliative Care Delivery in the ICU

ContextA quarter of palliative care (PC) clinicians’ consultations are now requested from the intensive care unit (ICU). Despite this high usage, a standardized set of quality metrics for PC delivery in the ICU does not exist. ObjectivesTo explore PC clinicians’ views on how to best measure quality of care delivery in their role as a consultant in the ICU setting. MethodsSecondary analysis of a parent dataset consisting of qualitative data from semi-structured interviews exploring ways to optimize PC clinicians’ role in the ICU. Nineteen participants were recruited across five academic medical centers in the US. Participants included PC physicians (n = 14), nurse practitioners (n = 2), and social workers (n = 3). Thematic analysis with an inductive approach was used to generate themes. ResultsWe identified two central themes: difficulties in measuring PC quality in the ICU (theme 1) and tension between the role of PC and metrics (theme 2). Theme 1 had two subthemes related to logistical challenges in measuring outcomes and PC clinicians’ preference for metrics that incorporate subjective feedback from patients, family members, and the primary ICU team. Theme 2 described how PC clinicians often felt a disconnect between the goal of meeting a metric and their goals in delivering high-quality clinical care. ConclusionOur findings provide insight into PC clinician perspectives on quality metrics and identify major barriers that need to be addressed to successfully implement quality measurement in the ICU setting.

Characteristics Associated with Trial of Labor among Patients with Twin Pregnancies.

This study aimed to identify patient and provider factors associated with undergoing trial of labor (TOL) among eligible patients with twin gestations. This retrospective cohort study of patients with twin gestations who received care at a large tertiary care center from 2000 to 2016 included individuals with live pregnancies greater than 23 weeks of gestation and cephalic-presenting twin. Patients with a prior uterine scar or contraindication to vaginal delivery were excluded from analyses. Maternal and clinical characteristics were compared among patients who did and did not undergo TOL. Multivariable logistic regression models included characteristics chosen a priori and those with bivariable associations with p < 0.1. Interactions between parity and other significant variables in the primary models were also investigated. Among 1,888 eligible patients, 80.7% (N = 1,524) underwent TOL. Those undergoing TOL were more likely to be younger, multiparous, and have a maternal-fetal medicine physician as the delivering provider (p < 0.01). Hypertensive disorders of pregnancy were less prevalent among patients undergoing TOL (20.2 vs. 27.8%, p < 0.01). In multivariable analysis, advanced maternal age (adjusted odds ratio [aOR]: 0.55, 95% confidence interval [CI]: 0.40-0.74) and nulliparity (aOR: 0.36, 95% CI: 0.25-0.52) conferred a lower odds of TOL, while having a maternal-fetal medicine provider (aOR: 2.74, 95% CI: 1.55-4.83) was associated with higher odds. Interaction analyses demonstrated no significant interaction effects between parity and other characteristics. Among those undergoing a TOL, 76.0% (1,158/1,524) had a successful vaginal delivery of both twins, with 48.1% (557/1,158) having breech extraction of the second twin. In this cohort of twin gestations with a high frequency of TOL, patient and provider characteristics are associated with attempting vaginal delivery. Variation in provider practices suggests differing skills and comfort with twin vaginal delivery may influence route of delivery decision-making in patients with twins. · Most patients with twin pregnancies undergoing TOL had successful vaginal deliveries.. · Having an MFM delivering provider was associated with higher odds of attempting twin TOL.. · Nulliparity and advanced maternal age were associated with lower odds of twin TOL..

A Strategic Human Resource Management Approach to Facilitating Volunteer Legacies From Mega-Sport Events: The Moderating Impact of Gender and Experience in the Case of Rio 2016

Volunteers are crucial for successful event delivery, from community to mega-events. Mega-sport events (MSE) are sold on their generative potential for social legacies for host communities like volunteering to support future community and tourism activity. With the lens of the temporal extension of the socioecological framework (TESEF), we propose that strategic human resource management (SHRM) across the volunteer journey will facilitate post-MSE legacy. A previously used online questionnaire and then structural equation modeling (SEM) are used to test 10 hypotheses with 4,824 Rio 2016 Olympic and Paralympic Games volunteers. Analysis revealed four predictors (SHRM: recruitment, job allocation, and supervision; and Motivational: variety) have significant positive effects on overall satisfaction. However, volunteer training and overall satisfaction had a highly negative influence on legacy potential. SEM revealed the moderating effect of volunteers??? gender and prior experience. Gender moderated five relationship paths and experience moderated six relational paths. MSE management implications are explored.

Discrete Multiwalled Carbon Nanotubes for Versatile Intracellular Transport of Functional Biomolecular Complexes

In recent years, carbon nanotubes have emerged as a potentially revolutionary material with numerous uses in biomedical applications. Compared to other nanoparticles, discrete multiwalled carbon nanotubes (dMWCNTs) have been shown to exhibit advantageous characteristics such as a high surface area-to-volume ratio, biocompatibility, and unique chemical and physical properties. dMWCNTs can be modified to load various molecules such as proteins and nucleic acids and are capable of crossing the cell membrane, making them attractive delivery vehicles for biomolecules. To investigate this, we measured the impact of dMWCNTs on the number of live and dead cells present during different stages of cell proliferation. Furthermore, we used transmission electron microscopy to produce evidence suggesting that dMWCNTs enter the cytoplasm of mammalian cells via an endocytosis-like process and ultimately escape into the cytoplasm. And lastly, we used live-cell staining, qPCR, and a T-cell activation detection assay to quantify the use of dMWCNTs as a delivery vehicle for a toxic, membrane-impermeable peptide, mRNA, siRNA, and a T-cell activating synthetic dsRNA. We demonstrate successful delivery of each payload into a range of cell types, providing further evidence of dMWCNTs as a versatile delivery platform for biomolecular cargo.

Isotretinoin self-nano-emulsifying drug delivery system: Preparation, optimization and antibacterial evaluation

PurposeIsotretinoin (ITN) is a poorly water-soluble drug. The objective of this study was to design a successful liquid self-nanoemulsifying drug delivery system (L-SNEDDS) for ITN to improve its solubility, dissolution rate, and antibacterial activity. MethodsAccording to solubility and emulsification studies, castor oil, Cremophor EL, and Transcutol HP were selected as system excipients. A pseudo ternary phase diagram was constructed to reveal the self-emulsification area. The developed SNEDDS were visually assessed, and the droplet size was measured. In vitro release studies and stability studies were conducted. The antimicrobial effectiveness against multiple bacterial strains, including Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), and different accessory gene regulator (Agr) variants were investigated for the optimum ITN-loaded SNEDDS formulation. ResultsCharacterization studies showed emulsion homogeneity and stability (%T 95.40–99.20, A graded) with low droplet sizes (31.87 ± 1.23 nm–115.47 ± 0.36 nm). It was found that the developed ITN-SNEDDS provided significantly a higher release rate (>96 % in 1 h) as compared to the raw drug (<10 % in 1 h). The in vitro antimicrobial activities of pure ITN and ITN-loaded SNEDDS demonstrated a remarkable inhibitory effect on bacterial growth with statistically significant findings (p < 0.0001) for all tested strains when treated with ITN-SNEDDS as compared to the raw drug. ConclusionThese outcomes suggested that SNEDDS could be a potential approach for improving solubility, dissolution rates, and antibacterial activity of ITN.

Comparing the outcomes of termination of second trimester pregnancy with a live fetus using intravaginal misoprostol between women with and without previous cesarean section

ObjectiveTo compare the outcomes of termination of pregnancy with live fetuses in the second trimester (14–28 weeks), using misoprostol 400 mcg intravaginal every 6 h, between women with previous cesarean section (PCS) and no previous cesarean section (no PCS).MethodsA comparative study was conducted on a prospective database of pregnancy termination in the second trimester, Chiang Mai university hospital. Inclusion criteria included: (1) singleton pregnancy; (2) gestational age between 14 and 28 weeks; and (3) pregnancy with a live fetus and medically indicated for termination. The participants were categorized into two groups; PCS and no PCS group. All were terminated using misoprostol 400 mcg intravaginal every 6 h. The main outcomes were induction to fetal delivery interval and success rate, defined as fetal delivery within 48 h.ResultsA total of 238 women, including 80 PCS and 158 no PCS, were recruited. The success rate of fetal delivery within 48 h between both groups was not significantly different (91.3% vs. 93.0%; p-value 0.622). The induction to fetal delivery interval were not significantly different (1531 vs. 1279 min; p-value > 0.05). Gestational age was an independent factor for the success rate and required dosage of misoprostol. The rates of most adverse effects of misoprostol were similar. One case (1.3%) in the PCS group developed uterine rupture during termination, ending up with safe and successful surgical removal and uterine repair.ConclusionIntravaginal misoprostol is highly effective for second trimester termination of pregnancy with PCS and those with no PCS, with similar success rate and induction to fetal delivery interval. Gestational age was an independent factor for the success rate and required dosage of misoprostol. Uterine rupture could occur in 1.3% of PCS, implying that high precaution must be taken for early detection and proper management.SynopsisIntravaginal misoprostol is highly effective for termination of second trimester pregnancy with a live fetus, with a comparable success rate between women with and without previous cesarean section, with a 1.3% risk of uterine rupture among women with previous cesarean section.

Transdermal Delivery of Pramipexole Using Microneedle Technology for the Potential Treatment of Parkinson's Disease.

Parkinson's disease (PD) is a debilitating neurodegenerative disease primarily impacting neurons responsible for dopamine production within the brain. Pramipexole (PRA) is a dopamine agonist that is currently available in tablet form. However, individuals with PD commonly encounter difficulties with swallowing and gastrointestinal motility, making oral formulations less preferable. Microneedle (MN) patches represent innovative transdermal drug delivery devices capable of enhancing skin permeability through the creation of microconduits on the surface of the skin. MNs effectively reduce the barrier function of skin and facilitate the permeation of drugs. The work described here focuses on the development of polymeric MN systems designed to enhance the transdermal delivery of PRA. PRA was formulated into both dissolving MNs (DMNs) and directly compressed tablets (DCTs) to be used in conjunction with hydrogel-forming MNs (HFMNs). In vivo investigations using a Sprague-Dawley rat model examined, for the first time, if it was beneficial to prolong the application of DMNs and HFMNs beyond 24 h. Half of the patches in the MN cohorts were left in place for 24 h, whereas the other half remained in place for 5 days. Throughout the entire 5 day study, PRA plasma levels were monitored for all cohorts. This study confirmed the successful delivery of PRA from DMNs (Cmax = 511.00 ± 277.24 ng/mL, Tmax = 4 h) and HFMNs (Cmax = 328.30 ± 98.04 ng/mL, Tmax = 24 h). Notably, both types of MNs achieved sustained PRA plasma levels over a 5 day period. In contrast, following oral administration, PRA remained detectable in plasma for only 48 h, achieving a Cmax of 159.32 ± 113.43 ng/mL at 2 h. The HFMN that remained in place for 5 days demonstrated the most promising performance among all investigated formulations. Although in the early stages of development, the findings reported here offer a hopeful alternative to orally administered PRA. The sustained plasma profile observed here has the potential to reduce the frequency of PRA administration, potentially enhancing patient compliance and ultimately improving their quality of life. This work provides substantial evidence advocating the development of polymeric MN-mediated drug delivery systems to include sustained plasma levels of hydrophilic pharmaceuticals.

Lymphangioleiomyomatosis and pregnancy: a mini-review.

Lymphangioleiomyomatosis(LAM) is a slow progressive, rare cystic lung disease in women of reproductive age, associated with infiltration of the lung by atypical smooth muscle like cells, leading to the cystic destruction of the lung parenchyma. As LAM exclusively affects women of childbearing age, it can arise or exacerbate during pregnancy. Many patients with LAM are discouraged from pregnancy, although there is not much objective evidence effect on fertility. Patients diagnosed with LAM during pregnancy experience worse outcomes, so the safety of pregnancy is a vexing problem. What was worse, treatment strategies are limited on the effects of LAM on pregnancy outcomes. Pregnancy could be considered in LAM patients. Successful delivery in women with LAM depends on the condition of the LAM, which is in turn dependent on obstetricians and respiratory physicians. In this review, we describe the epidemiology, pathogenesis, diagnosis, clinical features and the treatment strategies of LAM during pregnancy.

Intelligent multi-agent model for energy-efficient communication in wireless sensor networks

The research addresses energy consumption, latency, and network reliability challenges in wireless sensor network communication, especially in military security applications. A multi-agent context-aware model employing the belief-desire-intention (BDI) reasoning mechanism is proposed. This model utilizes a semantic knowledge-based intelligent reasoning network to monitor suspicious activities within a prohibited zone, generating alerts. Additionally, a BDI intelligent multi-level data transmission routing algorithm is proposed to optimize energy consumption constraints and enhance energy-awareness among nodes. The energy optimization analysis involves the Energy Percent Dataset, showcasing the efficiency of four wireless sensor network techniques (E-FEERP, GTEB, HHO-UCRA, EEIMWSN) in maintaining high energy levels. E-FEERP consistently exhibits superior energy efficiency (93 to 98%), emphasizing its effectiveness. The Energy Consumption Dataset provides insights into the joule measurements of energy consumption for each technique, highlighting their diverse energy efficiency characteristics. Latency measurements are presented for four techniques within a fixed transmission range of 5000 m. E-FEERP demonstrates latency ranging from 3.0 to 4.0 s, while multi-hop latency values range from 2.7 to 2.9 s. These values provide valuable insights into the performance characteristics of each technique under specified conditions. The Packet Delivery Ratio (PDR) dataset reveals the consistent performance of the techniques in maintaining successful packet delivery within the specified transmission range. E-FEERP achieves PDR values between 89.5 and 92.3%, demonstrating its reliability. The Packet Received Data further illustrates the efficiency of each technique in receiving transmitted packets. Moreover the network lifetime results show E-FEERP consistently improving from 2550 s to round 925. GTEB and HHO-UCRA exhibit fluctuations around 3100 and 3600 s, indicating variable performance. In contrast, EEIMWSN consistently improves from round 1250 to 4500 s.

Integrating technology into a successful apomorphine delivery program in Thailand: a 10-year journey of achievements with a five-motto concept.

Apomorphine, a potent dopamine agonist, is a therapeutic option for patients with Parkinson's disease and motor fluctuations. However, the adoption of and adherence to this therapy have been limited by the need for complex delivery devices and specialized care as well as resource consumption, posing challenges for new physicians. Thailand is a unique example of a developing nation that has successfully implemented and continued the use of this therapy by employing cooperative technology that has dramatically enhanced apomorphine delivery services. Establishing apomorphine delivery services requires significant resources and step-by-step solutions. We began our services by implementing various strategies in three chronological stages: the initial stage (2013-2015), intermediate stage (2016-2019), and current stage (2020-present), each presenting unique challenges. Together, we also implemented a proposed set of five mottos to strengthen our apomorphine delivery service. Using additive technology, we developed a patient registry platform that combined electronic data acquisition, video and remote monitoring using wearable sensors, and in-house mobile applications to support our service. At the initial stage, we assembled a team to enhance the efficacy and confirm the safety of apomorphine treatment in our hospital. At the intermediate stage, we expanded our apomorphine delivery services beyond just the patients at our hospital. We supported other hospitals in Thailand in setting up their own apomorphine services by educating both physicians and nurses regarding apomorphine therapy. With this educational undertaking, increased apomorphine-related knowledge among medical professionals, and a greater number of hospitals providing apomorphine services, an increasing number of patients were administered apomorphine in subsequent years. Currently, we are providing effective apomorphine delivery to improve patient outcomes and are seamlessly integrating technology into clinical practice. Incorporating integrative technologies in our apomorphine delivery program yielded positive results in data collection and support throughout patient care, in tracking patients' statuses, in the long-term use of this treatment, and in increasing medication adherence rates. This perspective paper describes how technology can help provide supportive healthcare services in resource-constrained environments, such as in Thailand, offering a step-by-step approach to overcoming several limitations. The valuable insights from our 10-year journey in successfully integrating technology into apomorphine delivery services can benefit new physicians seeking to replicate our success.

Abstract LB019: Comprehensive therapeutic impact: Follistatin mRNA-loaded lipid nanoparticles halt lung metastases and prolong survival in murine head &amp; neck squamous cell carcinoma

Abstract Head and neck squamous cell carcinoma (HNSCC) poses a significant public health challenge due to its aggressive nature, late-stage diagnosis, and association with cancer-associated cachexia. Activin A (ActA), a member of the TGF-β superfamily, has been implicated in HNSCC pathogenesis and cachexia development. Our study proposes a novel therapeutic approach utilizing follistatin (FST) mRNA-loaded lipid nanoparticles (LNPs) to inhibit activin A and address HNSCC progression and cancer cachexia. We engineered LNPs with pseudouridine-substituted FST mRNA for enhanced stability and translational efficiency. In vitro experiments on murine cell lines demonstrated successful FST protein upregulation and subsequent reduction in ActA expression, particularly in HNSCC cells (7.75 ng/mL ActA levels decreased to 6.12 ng/mL by adding 500ng/mL FST mRNA LNP, p = 0.0184). Scratch assays further indicated decreased cellular mobility (26% increase in open “wound area,” p=0.0029), suggesting potential implications for decreased metastatic behavior. For in vivo validation, C57BL/6 mice bearing MLM3 HNSCC tumors were chosen as the experimental model. Our FST mRNA LNP therapy exhibited tolerability with minimal impact on food intake, body weight, and reactogenic cytokine levels. Comprehensive blood analyses revealed no significant alterations in red blood cell parameters, while liver and spleen samples confirmed successful mRNA delivery and elevated FST protein levels (180-times increase, p = 0.0243) with reduced ActA levels (3-times decrease, p= 0.0467) in the serum. Subcutaneous administration of FST mRNA LNP formulation ipsilateral to MLM3 HNSCC tumors resulted in a significant reduction in tumor size (1.7 times reduction, p=0.0418). Intraperitoneal injections yielded a similar outcome with a significant decrease in tumor burden. Our findings revealed a remarkable and unprecedented outcome: the FST mRNA LNP formulation completely inhibited the development of lung metastases originating from primary MLM3 tumors. Survival analysis demonstrated a significant extension of the lifespan of treated mice compared to control groups, emphasizing the therapeutic efficacy of the FST mRNA LNP formulation in preventing lung metastatic spread. Notably, the administration of FST mRNA LNP demonstrated a significant muscle-sparing effect in the context of cancer-associated cachexia. In conclusion, our study introduces a novel and safe therapeutic strategy for HNSCC, leveraging LNPs to deliver FST mRNA for ActA inhibition. This approach holds promise for future clinical applications, addressing the dual challenges of HNSCC progression and cancer-associated cachexia. Citation Format: Oleh Taratula, Tetiana Korzun, Antony Jozic, Vladislav Grigoriev, Gaurav Sahay, Daniel L. Marks. Comprehensive therapeutic impact: Follistatin mRNA-loaded lipid nanoparticles halt lung metastases and prolong survival in murine head &amp; neck squamous cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB019.