Successful Uptake Research Articles

BIOM-20. EVALUATING THE POTENTIAL OF PSMA TARGETING IN CNS TUMORS: INSIGHTS FROM LARGE-SCALE TRANSCRIPTOME PROFILING

Abstract PURPOSE Prostate-specific membrane antigen (PSMA) is a well-established target in prostate cancer therapy that has shown potential as a theranostic target across non-central nervous system (CNS) and CNS tumor types. We aimed to investigate the pan-tissue expression pattern of the PSMA-encoding gene FOLH1 to assess whether transcriptome profiling can inform tumor theranostics. EXPERIMENTAL DESIGN We assessed FOLH1 expression from the Open Pediatric Cancer Project (OpenPedCan, n = 2132 specimens), The Cancer Genome Atlas (TCGA, n = 10411 specimens), and the Genotype Tissue Expression Project (GTEx, n = 17382 specimens) in relation to published reports of PSMA radionuclide uptake. RESULTS When comparing FOLH1 expression across tumor versus normal tissues, we found that non-CNS tumors exhibiting elevated expression of at least two-fold (FDR < 0.05) were reported to have successful PSMA radionuclide uptake in contrast to tumors with less than a two-fold elevation or with lower expression of FOLH1 relative to normal. Notably, CNS tumors universally exhibited lower expression of FOLH1 relative to normal brain tissue, but we observed considerable variation in the expression of blood-tumor barrier (BTB) components associated with reports of BTB integrity and uptake of PSMA radiotracers. CONCLUSIONS Large-scale transcriptomics data may help guide the application of PSMA-based radionuclide therapies in non-CNS tumors, but care should be taken to account for BTB effects in CNS tumors when assessing the potential for radionuclide success. Our analysis demonstrated that FOLH1 showed a lack of tumor-specific expression for both adult and pediatric CNS tumors when compared to normal brain tissue, suggesting that PSMA is not a desirable target in this disease type. This study highlights the utility of utilizing large-scale molecular data to guide the selection of theranostic targets.

IMMU-63. MESSENGER RNA CHALLENGE PREDICTS CANCER IMMUNOGENICITY AND RESPONSE TO CHECKPOINT INHIBITORS

Abstract BACKGROUND Checkpoint inhibition has emerged as a promising cancer therapeutic approach. Checkpoint inhibitors (CIs) function by overcoming the adaptive T cell exhaustion induced by solid tumor microenvironment including brain tumors, particularly in the neoadjuvant setting. Unfortunately, not every patient who receives CIs will unlock effective antitumor immunity. Objectives: Microsatellite instability and high mutational burden are considered key criteria to predict response to CIs. However, only a minority of patients will fulfill these criteria suggesting the need to develop innovative technologies to identify CI responsive patients. METHODS To determine whether glioma tumors will respond to CIs, we have developed a novel multilamellar mRNA-lipid particle tool to predict response ex vivo. Messenger RNA is complexed into multilamellar lipid particles to form aggregates (RNA-LPAs) to induce pathogen recognition receptor signaling in tumor cells to define an inflammatory profile as an indirect predictor to CI response. RESULTS In naïve mice, we found that multilamellar RNA-LPAs induce activation of Type I IFN system as supported by decreased secretion of IFN-α in MyD88 KO mice compared with wild type mice. We next selected murine glioma cell lines with known response profile to CIs (responders – GL261 and SMA560 vs non-responders – KR158b and CT2A). Prior to evaluation of cytokine profiling, successful uptake of RNA-LPAs was achieved in all cell lines. In 2D cell lines cultures and their corresponding 3D tumor spheroids, we demonstrated that treatment of CI responsive murine glioma models showed a differential cytokine signature (increased secretion of IFN-β/IL-6/CCL4 versus non-responsive models). CONCLUSION We identified a unique inflammatory signature after ex vivo RNA-LPAs challenge that correlates with checkpoint blockade activity. These findings allow for creation of a diagnostic assay to quickly assess tumor immunogenicity, allowing for informed immunotherapeutic treatment.

A case study of the development of a valid and pragmatic implementation science measure: the Barriers and Facilitators in Implementation of Task-Sharing Mental Health interventions (BeFITS-MH) measure

BackgroundFew implementation science (IS) measures have been evaluated for validity, reliability and utility – the latter referring to whether a measure captures meaningful aspects of implementation contexts. We present a real-world case study of rigorous measure development in IS that assesses Barriers and Facilitators in Implementation of Task-Sharing in Mental Health services (BeFITS-MH), with the objective of offering lessons-learned and a framework to enhance measurement utility.MethodsWe summarize conceptual and empirical work that informed the development of the BeFITS-MH measure, including a description of the Delphi process, detailed translation and local adaptation procedures, and concurrent pilot testing. As validity and reliability are key aspects of measure development, we also report on our process of assessing the measure’s construct validity and utility for the implementation outcomes of acceptability, appropriateness, and feasibility.ResultsContinuous stakeholder involvement and concurrent pilot testing resulted in several adaptations of the BeFITS-MH measure’s structure, scaling, and format to enhance contextual relevance and utility. Adaptations of broad terms such as “program,” “provider type,” and “type of service” were necessary due to the heterogeneous nature of interventions, type of task-sharing providers employed, and clients served across the three global sites. Item selection benefited from the iterative process, enabling identification of relevance of key aspects of identified barriers and facilitators, and what aspects were common across sites. Program implementers’ conceptions of utility regarding the measure’s acceptability, appropriateness, and feasibility clustered across several common categories.ConclusionsThis case study provides a rigorous, multi-step process for developing a pragmatic IS measure. The process and lessons learned will aid in the teaching, practice and research of IS measurement development. The importance of including experiences and knowledge from different types of stakeholders in different global settings was reinforced and resulted in a more globally useful measure while allowing for locally-relevant adaptation. To increase the relevance of the measure it is important to target actionable domains that predict markers of utility (e.g., successful uptake) per program implementers’ preferences. With this case study, we provide a detailed roadmap for others seeking to develop and validate IS measures that maximize local utility and impact.

A scoping review of human papillomavirus and cervical cancer knowledge, attitudes, practices, and prevention among female sex workers in Africa

Background Global initiatives have emphasized the elimination of cervical cancer (CC) among female sex workers (FSW) in Africa. Yet screening remains low, and few interventions have been outlined to target this group. This scoping review sought to understand the knowledge, attitudes, and practices (KAP) among FSW in Africa regarding human papillomavirus (HPV) and CC prevention, and to identify the most effective intervention strategies. Methods A systematic literature search was performed in PubMed, Scopus, Web of Science, and African Index Medicus for work published between January 2012 through August 2022. Eligible studies included those relating to HPV and CC prevention among FSW in Africa. Studies were categorized as KAP, intervention, or both. A Logic Model was used to guide content analysis of the interventions, and a thematic analysis of all studies was performed. Results The search resulted in 79 articles of which 11 were included in the study. Six African countries were represented including South Africa, Mozambique, Uganda, Kenya, Ethiopia, and Nigeria. Five of the articles described KAP, while the other six described interventions. The intervention studies were categorized into 3 groups: “screen and treat”, self-collection HPV testing, and a “diagonal intervention” which included a multi-faceted approach. Conclusions Limited literature exists regarding KAP and interventions for HPV and CC prevention among FSW in Africa. While FSW in the literature had a moderate level of knowledge regarding HPV and CC prevention, studies identified a lack of detailed and nuanced knowledge. Successful uptake of screening was seen when services were provided at convenient locations, integrated into routine or HIV care, and recommended by healthcare providers. Future interventions should be context-specific, include improved counselling and education, and be integrated with other services.

Outcomes of Microscopic vs. Endoscopic Tympanoplasty at a Tertiary Healthcare Institution in Western Maharashtra.

Introduction Chronic suppurative otitis media (CSOM) involves tympanic membrane perforation and is traditionally treated with microscopic tympanoplasty. Recent advancements in endoscopic techniques offer enhanced visibility and outcomes. This retrospective study compares endoscopic and microscopic tympanoplasty outcomes in CSOM patients between 2023 and 2024. Aim This study aims to evaluate outcomes of endoscopic vs. microscopic tympanoplasty in patients suffering from CSOM who are presenting at our tertiary care center. Methodology A retrospective study of 100 patients of CSOM undergoing tympanoplasty. Sixty patients underwent microscopic tympanoplasty and 40 endoscopic tympanoplasty. Postoperative successful uptake of graft and resultant hearing were compared between the two groups. Results Ninety-seven out of 100 patients had a successful graft uptake at three months. Fifty-eight patients in the microscopic tympanoplasty group (96.67%) and 39 in the endoscopic group (97.5%) had healed the tympanic membrane at three months of follow-up (p = 0.864). At postoperative three months, no statistically significant difference was found in the improvements in air conduction levels of the two groups (p = 0.995). No significant difference in the air-bone gap between the two groups (p = 0.095). The average air-bone gap at three months postoperative was 7.95 ± 4.20 decibel (dB) in the microscopic tympanoplasty group and 7.80 ± 4.10 dB in the endoscopic tympanoplasty group (p = 0.680). The incidence of postoperative wound area pain, numbness, and ear discharge was significantly higher in patients undergoing microscopic tympanoplasty (p < 0.05). Conclusion The two methods did not significantly differ in terms of the outcome of the hearing test or the rate of graft uptake. However, a better result was noted in endoscopic tympanoplasty compared to the microscopic tympanoplasty group. Postoperative complications encountered were less in the endoscopic tympanoplasty group.

Novel Pseudomonas putida-derived nanoliposomes enhance the inhibition of MCF-7 breast cancer cells by superb intracellular uptake of doxorubicin

In this study, we aimed to utilize phospholipids from the bacterium Pseudomonas putida (PP) as a plentiful, safe, and accessible resource for creating nanoliposomes to deliver doxorubicin (Dox) to MCF-7 breast cancer cells. This bacterium provides a cost-effective source of phospholipids commonly used in nanoliposome production, with no toxicity or adverse environmental impact. To this end, molecular dynamics (MD) simulations were first conducted to evaluate the feasibility of this approach and to analyze the behavior and interaction of Dox with the nanoliposomes. The phospholipids of PP were then extracted using Folch's technique. Subsequently, Dox-loaded PP-derived nanoliposomes (PNL-Dox) were developed using the thin-film method. The physicochemical properties of the fabricated nanocarrier were then investigated and the anticancer effects of this system were tested on MCF-7 cells. The results of the MD simulations indicated that Dox reacted with all of the phospholipids through hydrogen bonds without affecting the fluidity, stability, and thickness of the nanoliposome membrane. Additionally, a small number of Dox molecules interacted with the nanocarrier membrane, while the remaining were located in its interior. The physicochemical investigation results showed that PNL-Dox had an average particle size and zeta potential of 271.7 ± 7.1 nm and −8.8 ± 3.3 mV, respectively. Scanning electron microscopy revealed that the particles were spherical and did not show any signs of aggregation. Drug release of PNL-Dox was gradual at pH 7.4 and 6.5, with a significantly higher release at pH 6.5. In vitro studies demonstrated successful uptake of PNL-Dox by MCF-7 cells, resulting in cytotoxicity within 24 and 48 h of treatment. Also, it increased apoptosis and reduced the production of reactive oxygen species (ROS) in these cells. Our study showcased the potential of PP phospholipids to form a promising anti-cancer drug delivery system, opening up new possibilities for the treatment of all types of cancers.

A Review of 15 Years of Public Earthquake Forecasting in Aotearoa New Zealand

Abstract New Zealand entered a period of increased seismic activity in 2003, which, to date, has included around 20 large or damaging earthquakes. Building on decades of forecast model research and including research into formal model evaluation, GNS Science, the governmental institution tasked with providing natural hazards information, began issuing public earthquake forecasts following the 2009 Mw 7.2 Darfield earthquake. This article provides a review of the public earthquake forecasting methods and outcomes since that time. Initially the release of forecasts was motivated by the scientific team, but interest, use and understanding quickly rose in the public, government, and private sectors which led to regular refinement and additions to the type of forecast information provided. The basic tenet of forecasting has remained the same, with the forecasts being used to inform decisions requiring consideration of timeframes from days to decades. The operational models were all based on the previous 10–20 years of research in model development and testing; this included the development of methods for combining multiple models into a single hybrid model that typically provides increased statistical forecast skill. The hybrid models combine models from three classes of time horizons: (1) short-term aftershock clustering based on the epidemic-type aftershock sequence class of models, (2) medium-term clustering with time horizons of years to decades, and (3) long-term models with time horizons of decades to nominally time independent. Forecasts have been issued in response to 14 large or significant earthquakes with the forecasts and accompanying information regularly updated on the GeoNet webpages. An important component to the successful deployment and uptake of the models was the foundation laid in the previous decades in model development and testing. This provided understanding and confidence in the models’ ability to provide useful forecasts for response and recovery decisions.

Exploring Important Attributes, the Potential Use Cases and Feasibility of Introduction of Measles and Rubella Microarray Patches (MR-MAPs): Insights from Nine Countries.

Background: Microarray patches (MAPs) are innovative, needle-free vaccine delivery systems, suitable for administration by minimally trained health care workers or trained community health workers. Their introduction may transform immunization programmes, particularly for vaccines where high coverage is required for population immunity, such as measles, and where vaccine delivery is challenging, such as in low- and middle-income countries. Recognizing the need to understand how best to tailor these products to reflect country priorities, workshops on measles and rubella MAPs (MR-MAPs) were conducted in multiple regions to collect insights on needs and preferences from relevant stakeholders at country level. Methods: The CAPACITI Innovation Framework was used to structure stakeholder discussions in nine countries in the period from August 2022 to July 2023. The discussions, building on the findings from a situation analysis on the barriers related to measles and rubella vaccine delivery, followed the four-step process outlined in the framework. Results: Key barriers hindering delivery of measles and rubella vaccines across the countries were in the categories of human resource management, service delivery, and demand generation. MR-MAP attributes that stakeholders believed would reduce or eliminate these barriers included ease of preparation and administration, improved thermostability, fewer (ancillary) components, and single-dose presentation. Some attributes such as the site of administration, wear time, and storage volume could exacerbate certain barriers. Based on an understanding of key barriers, product attributes, and underserved populations, stakeholders identified several potential use cases for MR-MAPs: (i) delivery at a fixed health post, (ii) delivery through outreach sessions conducted by health workers, and (iii) administration by community health workers. To enable robust national decision making about the introduction of MR-MAPs and successful implementation, global and national evidence on feasibility and acceptability of MR-MAPs should be generated. To prepare for the potential introduction of MR-MAPs, immunization programmes should evaluate their immunization policies based on their preferred use cases and modify them if needed, for example, to enable community health workers to administer vaccines, along with making programmatic adjustments to waste management and training. Conclusions: MR-MAPs have the potential to reduce key barriers to MR delivery. Yet, their future impact depends on the ability of global stakeholders to steer the development of MR-MAPs to be responsive to country needs and preferences. The generation of evidence to enable robust decision making, timely modification of vaccine policies, and addressing programmatic considerations will be key to successful uptake.

Qualitative assessment of evidence-informed adolescent mental health policymaking in India: insights from project SAMA

BackgroundThe importance of evidence-informed health policymaking is widely recognized. However, many low- and middle-income countries lack evidence-informed mental health policies due to insufficient data, stigma or lack of resources. Various policies address adolescent mental health in India, but published knowledge on their evidence-informed nature is limited. In this paper, we report results of our analysis of the role of evidence in adolescent mental health policymaking in India.MethodsThis paper reports findings from the document analysis of key policy documentation (n = 10) and in-depth interviews with policy actors including policymakers, researchers, practitioners and intermediaries (n = 13). Framework analysis was used, informed by the components of a conceptual framework adapted from the literature: actors, policy and evidence processes, nature of evidence itself and contextual influences.ResultsResults show that adolescent mental health policies in India were generally evidence-informed, with more key evidence becoming generally available from 2010 onwards. Both formal and informal evidence informed mental health policies, particularly agenda-setting and policy development. Mental health policymaking in India is deemed important yet relatively neglected due to competing policy priorities and structural barriers such as stigma. Use of evidence in mental health policymaking reflected differing values, interests, relative powers and ideologies of policy actors. Involvement of government officials in evidence generation often resulted in successful evidence uptake in policy decisions. Policy actors often favoured formal and quantitative evidence, with a tendency to accept global evidence that aligns with personal values.ConclusionsThere is a need to ensure a balanced and complementary combination of formal and informal evidence for policy decisions. Evidence generation, dissemination and use for policy processes should recognize evidence preferences by key stakeholders, while prioritizing locally available evidence where possible. To help this, a balanced involvement of policy actors can ensure complementary perspectives in evidence production and policy agendas. This continued generation and promotion of evidence can also help reduce societal stigma around mental health and promote mental health as a key policy priority.

Qualitative assessment of the enablers and barriers of COVID-19 vaccination integration, into routine immunization Programme at primary health care facilities in Ekiti state, Nigeria

BackgroundThe introduction of the COVID-19 vaccine influenced discussions to explore integrating COVID-19 vaccination into routine immunization (RI) programs. Subsequently, the WHO Strategic Advisory Group Experts (SAGE) on immunization plausibly advised countries to leverage the COVID-19 vaccination rollout as a transformative opportunity to establish a resilient immunization system, through an integrated immunization system, resulting in strengthened primary healthcare services.ObjectiveThis study assessed the enablers and barriers to integrating COVID-19 vaccination into the routine immunization programme in Ekiti state, Nigeria.MethodsThis study utilized a qualitative research approach to obtain information from 40 participants selected purposively across the primary healthcare facilities, LGA, and state levels. A three-tier approach was employed to select the LGAs. At the same time, In-depth interviews were conducted to elicit relevant information on the assessment of enablers and barriers to integrating COVID-19 vaccination into routine immunization through an interview guide. All the audio interview files were transcribed into English Language, coded, and presented using a thematic approach.ResultsA total of 40 healthcare workers across Ekiti state were selected to participate in this study. Our study found the enablers of integrating COVID-19 into routine immunization to include demand generation and social mobilization, health education, health workers training, data validation, financing, and supervision. However, rumors, demand for incentives, Adverse Events Following Immunization (AEFI), manpower shortage, poor internet network services, and bad road networks were reported as barriers to integrating COVID-19 vaccination into routine immunization in Ekiti state.ConclusionWhile the enablers of integrating COVID-19 vaccination into routine immunization may outweigh its barriers, it is pertinent to know that the efforts towards integrating COVID–19 vaccination in the RI Program is a call to all stakeholders to ensure sustainability. The identified barriers in the study must be addressed to ensure a strengthened health system. Therefore, achieving a successful integration and uptake of vaccination/immunization is anchored on driving demand generation, social mobilization, health education, availability of healthcare workers, integrated supervision, and financing.

A user-centred future for agricultural digital innovation: demonstrating the value of design thinking in an animal health context

ABSTRACT Purpose Much of the literature investigating farmer engagement with digital technology has focused on farmer-centred adoption factors. However, more recent research has called for new user-centred approaches to technology design to promote more responsive development and ultimately more successful uptake. Methodology Responding to these calls, this study draws on Stanford’s design thinking framework and principles to design a digital innovation for use in an animal health context. Findings The study details how a co-design workshop was used to incorporate end-user needs, values, and requirements for a digital animal health innovation. Additionally, it outlines how co-design approaches can be useful to identify and address innovation design issues early on in the design process. Practical implications This study highlights the importance of end-user engagement for the design, development, and implementation of digital innovations for the agricultural sector and the importance this has for successful technology development and user uptake. Theoretical implications This study contributes to the literature on innovation development for agriculture and to the theory on farmer engagement. Originality/value This study is one of few that applies co-design and design thinking methodologies to the creation of a digital animal health diagnostic tool.

Adsorption and Distribution of Triplex-Hybridizing Bioconjugated Gold Nanoclusters Inside Spermatozoa- A Study Using Confocal Microscopy and Fluorescence Lifetime Imaging.

The study of the interactions between biofunctionalized gold nanoclusters (Au NCs) and spermatozoa is highly relevant to evaluate the potential of Au NCs as imaging probes and transfection agents in reproductive biology. In this work, confocal laser scanning microscopy (CLSM) was used to investigate the distribution of Au NCs bioconjugated with peptide (nuclear localisation sequence, NLS) and oligonucleotide (locked nucleic acid, LNA) ligands in bovine spermatozoa. Fluorescence lifetime imaging (FLIM) was employed to detect changes in the NC's chemical environment. We observed a pronounced regio-selective accumulation of the bioconjugates in spermatozoa with high concentration at the equatorial segment. Furthermore, 3D-CLSM showed successful non-endosomal cellular uptake of the conjugates by intact sperm cells and the distribution of the bioconjugates was found to be influenced by the ligand types. Interestingly, the FLIM data showed differences in lifetime depending on membrane integrity. Furthermore, ligand-dependent changes in lifetime between NC bioconjugates carrying peptide and oligonucleotide ligands were found, probably attributed to specific interactions with sperm cell compartments.

Towards an idealized model of feedback uptake: longitudinal development of feedback literacy from a social constructivist perspective

ABSTRACT One of the potentials and challenges for the implementation of effective feedback processes lies in promoting and enacting purposeful student uptake of teacher written feedback. The theoretical framework in addressing this puzzle emanates from the inter-related concepts of social constructivist approaches to feedback and student feedback literacy. Feedback from a social constructivist perspective is underpinned by social and relational interaction in co-constructing inferences from feedback information. Feedback literacy represents the capacities to use feedback information productively. The aim of this longitudinal qualitative inquiry is to analyze how an undergraduate student interprets and uses teacher written feedback to enhance her work and her feedback literacy over a four-year period, in collaboration with a co-researcher. The main data sources comprise all written feedback provided by teachers over the four-year period; co-constructed analysis and action planning; enactment of action plans; and the student’s reflective journal of feedback experiences. The findings are presented in three chronological stages to demonstrate the main feedback literacy development of the student in appreciating the value of feedback, enhancing emotional resilience in response to critical feedback and managing feedback uptake. Experiencing successful feedback uptake is identified as a significant factor in enhancing self-efficacy and supporting the development of student feedback literacy. On the basis of the longitudinal evidence, an idealized model of feedback uptake is proposed underpinned by social constructivist principles. The originality of our contribution to social constructivist feedback research lies in illustrating how its principles are implemented over time.

In-vitro cytotoxicity of biosynthesized nanoceria using Eucalyptus camaldulensis leaves extract against MCF-7 breast cancer cell line

Cerium oxide nanoparticles possess unique properties that make them promising candidates in various fields, including cancer treatment. Among the proposed synthesis methods for CNPs, biosynthesis using natural extracts, offers an eco-friendly and convenient approach for producing CNPs, particularly for biomedical applications. In this study, a novel method of biosynthesis using the aqueous extract of Eucalyptus camaldulensis leaves was used to synthesize CNPs. Scanning electron microscopy and Transmission electron microscopy (TEM) techniques revealed that the synthesized CNPs exhibit a flower-like morphology. The particle size of CNPs obtained using Powder X-ray diffraction peaks and TEM as 13.43 and 39.25 nm. Energy-dispersive X-ray spectroscopy and Fourier transform infrared spectroscopy confirmed the effect of biomolecules during the synthesis process and the formation of CNPs. The cytotoxicity of biosynthesized samples was evaluated using the MTT method demonstrating the potential of these samples to inhibit MCF-7 cancerous cells. The viability of the MCF-7 cell line conducted by live/dead imaging assay confirmed the MTT cytotoxicity method and indicated their potential to inhibit cancerous cells. Furthermore, the successful uptake of CNPs by MCF-7 cancer cells, as demonstrated by confocal microscopy, provides evidence that the intracellular pathway contributes to the anticancer activity of the CNPs. In general, results indicate that the biosynthesized CNPs exhibit significant cytotoxicity against the MCF-7 cancerous cell line, attributed to their high surface area.

Our Experience in Endoscopic Button Tympanoplasty Providing High Success Rate in Varying Sizes of Perforation : A Case Series.

Cartilage tympanoplasty is a fast growing technique used to restore hearing in chronic suppurative otitis media. The technique has misnomers such as limited applicability in only small size perforations, interference with sound conducting mechanism and durability. Our experience in out tertiary care Institution with over 100 retrospective study cases prove that there is a scope of proving it to be well established technique. That could be used in par with other tympanoplasty techniques. Our retrospective case series of 100 operated between 2021 and 2024 were taken, having unilateral perforation convenience data collection purpose. The overall success rates of cartilage / button tympanoplasty of varying perforation sizes, having a wide range of pure tone audiometry statuses having successful results were discussed, which is indicated as a percentage format. In our retrospective case series, out of our 100 cases we had 90 successful graft uptake cases. The 10% cases were later followed up in our study. It was analysed and concluded that the technique was not the inhibiting factor but the post operative care had prevented the patients from having the desired results. Our results are in accordance with previous case studies for support. Pure tone audiometry were taken pre operatively and post operatively that support cartilage / button tympanoplasty. Cartilage tympanoplasty is a commonly misunderstood technique which if corrected has a wide scope to be used a s a common treatment modality. Data collected and inference were in concordance with previous studies conducted. Tragal cartilage due to its durability, low inflammatory reaction to tympanic membrane, lesser chances of retraction and long term assurance of withstanding environmental conditions has proven to be technique which can be used in regular basis. Cartilage / button tympanoplasty is a technique that has a shorter learning curve for surgeons. With a high demand of cases in chronic suppurative otitis media-Tubotympanic type, button tympanoplasty technique is an assest.

Synthesising the Outputs of Cognitive Work Analysis and Participatory Design Approaches to Identify Design Requirements: An Incident Reporting Tool Case Study

Identifying design requirements for new technologies is vitally important for successful uptake, yet few structured approaches exist to guide the process. Given increasing concerns regarding gig economy worker road safety, this study involved the use of Cognitive Work Analysis (CWA), alongside a participatory design process, to identify requirements for a novel, app-based incident reporting tool for gig economy workers. Study 1 involved a stakeholder workshop to refine a Work Domain Analysis model and define stakeholder requirements for the tool. Study 2 involved focus groups to identify barriers and facilitators to using the tool and a survey to inform the development of a Contextual Activity Template, in addition to identifying further barriers and facilitators. Design requirements for the tool were identified through synthesising the CWA outputs and themes identified from stakeholder and end user input.

Role of Tympanometric Ear Canal Volumes in Determining Outcome of Myringoplasty in Chronic Suppurative Otitis Media Patients.

Middle ear aeration is a predictive indicator of myringoplasty's successful outcome and tympanometric ear canal volume is a novel investigation that can estimate the volume of middle ear cleft and mastoid air cells. Our aim of this study is to determine the role of tympanometric ear canal volume on myringoplasty outcome in Chronic Suppurative Otitis Media Patients. Prospective analysis involving 50 patients of CSOM was performed on patients undergoing myringoplasty from April 2022 to December 2023. Smokers, Patients with squamosal COM, Bilateral COM, Otitis Externa, and Revision surgery were excluded from the study. The successful outcome of surgery was defined as no tympanic membrane perforation on postoperative follow-up. Analysis was carried out using SPSS. V. 25 and P-value less than 0.05 was considered significant. A total of 50 patients were included in the study with a mean age of 24.4 ± 8.965 and male predominance. Overall graft uptake was 64%. Graft uptake had no significant statistical correlation with age, gender, type, location, or size of perforation. However, there is a significant effect of tympanometric ear canal volume of pathological ear and interaural tympanometric ear canal volume difference on graft uptake with p-values of 0.023 and 0.033 respectively. Tympanometric ear canal volume can predict middle ear aeration and the higher the interaural tympanometric canal difference more are the chances of successful graft uptake.

Assessing Acceptability of Biodegradable Contraceptive Implants in Kenya and Senegal.

Contraceptive implants are popular in Africa, but barriers to removal exist. Biodegradable implants (BDIs) offer an alternative to the need for removal. This study explored potential user, provider, and other stakeholder perspectives on 2 BDI prototypes, revealing opportunities and challenges for introduction. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) with women, men, family planning (FP) providers, community influencers, and FP policymakers and program staff in Kenya and Senegal. Characteristics of the 2 BDI prototypes were shared, and participants held and interacted with placebo prototypes. Structural coding was used to analyze the data focused on key product attributes, including biodegradation, removal potential, size, material, insertion site, and duration of effectiveness. We conducted 16 FGDs and 35 IDIs with 106 participants in Kenya and 15 FGDs and 43 IDIs with 102 participants in Senegal. Overall, respondents liked the idea of a BDI, noting the avoidance of pain and scarring and reduced transport and costs as benefits of no removal requirement. Kenyan respondents expressed greater understanding of the biodegradation process than those in Senegal, though potential users in both countries expressed concerns about possible side effects associated with the process. In Senegal, mention of cholesterol in a BDI caused concern, while Kenyan participants responded positively to the same BDI being composed of organic materials. The second BDI product was viewed as more similar to existing implants, which providers preferred. Participants suggested increasing the pregnancy protection duration beyond 18 months. No clear preference between products emerged, and participants liked and disliked some characteristics of both. Kenyan and Senegalese participants expressed interest in the BDI concept but expressed some reservations related to biodegradation, material, and side effects. BDIs offer the opportunity to expand contraceptive choice. However, messaging around product characteristics will be required for successful introduction and uptake.

Ground Source Heat Pumps in Buildings Revisited and Prospects

A large number of ground-source heat pump (GSHP) systems have been used in residential and commercial buildings throughout the world due to their attractive advantages of high energy and environmental performances. In particular, GSHPs constitute a proven renewable energy technology for space heating and cooling. This paper provides a detailed literature review of the primary aspects of GSHP systems. These include the technological characteristics of HPs and the main types and variations in GSHPs, along with their environmental impact. Other aspects addressed are the integration of GSHPs with other systems, as well as their optimal design and control and energy analysis. The important aspect of the system’s performance is also dealt with through case studies and also the barriers hindering the further adoption of GSHPs in buildings. Two important challenges for the adoption of GSHPs is their cost and environmental efficiency. Studies have shown that GSHPs can reach a &gt;&gt;24% lower environmental impact than air-source HPs, while today’s technology can allow for a payback period for installing a GSHP of &lt;&lt;5 years. Finally, based on the above review, the future challenges and prospects for the successful uptake of GSHPs is discussed. It seems that through the right steps, the wide adoption of GSHPs as an important form of ‘implemented’ renewable energy system can become a reality.

Moonshot. Long shot. Or sure shot. What needs to happen to realize the full potential of AI in the fertility sector?

Quality healthcare requires two critical components: patients' best interests and best decisions to achieve that goal. The first goal is the lodestar, unchanged and unchanging over time. The second component is a more dynamic and rapidly changing paradigm in healthcare. Clinical decision-making has transitioned from an opinion-based paradigm to an evidence-based and data-driven process. A realization that technology and artificial intelligence can bring value adds a third component to the decision process. And the fertility sector is not exempt. The debate about AI is front and centre in reproductive technologies. Launching the transition from a conventional provider-driven decision paradigm to a software-enhanced system requires a roadmap to enable effective and safe implementation. A key nodal point in the ascending arc of AI in the fertility sector is how and when to bring these innovations into the ART routine to improve workflow, outcomes, and bottom-line performance. The evolution of AI in other segments of clinical care would suggest that caution is needed as widespread adoption is urged from several fronts. But the lure and magnitude for the change that these tech tools hold for fertility care remain deeply engaging. Exploring factors that could enhance thoughtful implementation and progress towards a tipping point (or perhaps not) should be at the forefront of any 'next steps' strategy. The objective of this Opinion is to discuss four critical areas (among many) considered essential to successful uptake of any new technology. These four areas include value proposition, innovative disruption, clinical agency, and responsible computing.