Delivery Techniques Research Articles

Novel approaches in Paediatric Drug Delivery System

The development of medication delivery technology has led to an increase in the popularity of pediatric formulations. However, there is absence of secure and efficient drug delivery mechanism for pediatric patients. It is crucial to design and create a novel and suitable delivery system to guarantee precise and reliable medication administration to pediatric patients, as their pharmacokinetics and pathophysiologic profiles differ from those of adults. Under this heading, discussion will be carried out in order to increase stability; new medication delivery techniques and technology are being developed to enhance the stability, toxicity, flexibility, moreover secure aspects of pediatric oral formulations. Specifically, issues with patient acceptability and manufacturability are discussed in this section, and innovative medication delivery methods are examined to address current issues.

Neuroimaging Applications for the Delivery and Monitoring of Gene Therapy for Central Nervous System Diseases.

Neurological disease due to single gene defects represents a targetable entity for adeno-associated virus (AAV) mediated gene therapy. The delivery of AAV-mediated gene therapy to the brain is challenging, owing to the presence of the blood-brain barrier. Techniques in gene transfer, such as convection-enhanced intraparenchymal delivery and image-guided delivery to the cerebrospinal fluid (CSF) spaces of the brain has led the field into highly accurate delivery techniques, which provide correction of genetic defects in specific brain regions or more broadly. These techniques commonly use magnetic resonance imaging (MRI), computed tomography (CT), and fluoroscopic guidance. Even more, the neuroimaging changes evaluated by MRI, MR spectroscopy (MRS), diffusion tensor imaging (DTI), and functional MRI (fMRI) can serve as important biomarkers of therapy effect and overall disease progression. Here, we discuss the role of neuroimaging in delivering AAV vectors and monitoring the effect of gene therapy.

Feasibility, Safety, and Factors Predicting Completion of CROSS Protocol–Based Neoadjuvant Chemoradiotherapy for Esophageal Squamous Carcinoma: Experience from an Indian Tertiary Care Cancer Center

Background Neoadjuvant chemoradiotherapy (NACRT) using the ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study (CROSS) protocol has improved esophageal cancer outcomes. This study reports the real-world experience of the CROSS regimen for esophageal squamous cell carcinoma (ESCC) regarding its feasibility, safety, and predictors of treatment completion from an Indian tertiary center. Methodology A retrospective review was conducted for patients with ESCC receiving CROSS (radiation dose: 41.4 Gy) or a modified CROSS (mCROSS; radiation dose: 45 Gy) protocol NACRT between 2015 and 2022. We studied the treatment tolerability, factors predicting NACRT completion, and the effect of completion of its chemotherapy component on the pathological outcomes. Results Of the109 patients (68.8% males; mean age, 56 ± 9 years; Charlson's comorbidity index [CCI] >2, 19.3%; stage III–IVA, 58%; mean tumor length, 5.5 ± 2.1cm; CROSS, 70.6%; mCROSS, 29.4%), all except 4 completed radiotherapy but only 58 (53.2%) patients completed ≥4 cycles of chemotherapy. Forty-nine patients belonged to the “extended” CROSS trial inclusion criteria. Among the 60 patients who fulfilled the CROSS inclusion criteria, only 51.7% were able to complete ≥4 chemotherapy cycles. The commonest reason for noncompletion of chemotherapy was the occurrence of neutropenia (60.8%). Pretreatment hemoglobin (≥12 vs. <12 g%; odds ratio [OR]: 2.76; 95% confidence interval [CI]: 1.10–6.96; p = 0.031), a low CCI (≤2 vs. >2; OR: 2.98; 95% CI: 1.02–8.73; p = 0.047), and radiation therapy techniques (conformal vs. conventional; OR: 3.29; 95% CI: 1.14–9.50; p = 0.028) were associated with completion of chemotherapy (≥4 cycles). Although there was a trend toward improved R0 resection (95.7 vs. 91.4%), reduced node positivity (17.0 vs. 31.4%), and a high pCR (57.4 vs. 48.6%) in patients completing chemotherapy (≥4 cycles) compared with those not completing chemotherapy (<4 cycles), these differences were statistically nonsignificant. Conclusion In this study, ESCC patients receiving the CROSS protocol NACRT could complete their radiotherapy component, but a significant proportion exhibited poor chemotherapy tolerance. Neutropenia was a major factor limiting chemotherapy delivery, but anemia, high CCI, and conventional radiation techniques were also associated with noncompletion of chemotherapy. The omission of a few chemotherapy cycles had no significant effect on the pathological response; however, its impact on cancer survival requires further evaluation.

A Review: Microneedle Drug Delivery

The various common techniques for transdermal medication delivery include hypodermic needles, topical lotions, and transdermal patches. Because the stratum corneum layer of the skin acts as a barrier for molecules, the action of most therapeutic medicines is restricted, and only a few molecules are able to penetrate and reach the location of action. A novel type of delivery technology known as micro needles aids in improving medication distribution through this channel and addressing the many issues associated with traditional formulations. Because of the problems associated with oral medication delivery methods, transdermal drug administration utilising micro needles is gaining popularity. The possibilities and uses of micro needles are discussed in this review. Micro needles of many sorts can be manufactured, including solid, dissolving, hydrogel, coated, and hollow micro needles. The fabrication process chosen is determined on the kind and material of the micro needle. This technique is now being used in a variety of sectors, including oligonucleotide distribution, vaccine administration, insulin delivery, and even cosmetics.

Updates for newly diagnosed and recurrent glioblastoma: a review of recent clinical trials.

Glioblastoma (GBM) is the most common and devastating primary malignant brain tumor. We summarize recent advances in radiotherapy, immunotherapy, and targeted therapy approaches for the treatment of newly diagnosed and recurrent glioblastoma. We also introduce ongoing clinical trials. Recent clinical trials have explored multiple novel strategies to treat GBM including the use of oncoviruses, chimeric antigen receptor (CAR) T cell therapy, vaccines, radiotherapy, and novel drug delivery techniques to improves drug penetrance across the blood brain barrier. Approaches to improve drug delivery to brain tumors have the potential to expand treatment options of existing therapies that otherwise have poor brain tumor penetrance. Immunotherapy has been of keen interest in both newly diagnosed and recurrent glioblastoma. Vaccines SurVaxM and DCVax-L have shown initial promise in phase II and III trials, respectively. CAR T cell therapy trials are in their early phases but hold promise in both newly diagnosed and recurrent glioblastoma. Although progress to improve outcomes for GBM patients has been modest, multiple novel strategies utilizing combination therapies, focused ultrasound to improve drug delivery, and novel immunotherapies are underway.

Trends on Novel Targets and Nanotechnology-Based Drug Delivery System in the Treatment of Parkinson's disease: Recent Advancement in Drug Development.

Parkinson's disease (PD) is a neurodegenerative disease (ND) that affects many people. However, there remains no cure for PD and difficulties exist with conventional medicines. There has been a lot of discussion about using nanotechnology to increase the bioavailability of smallmolecule drugs to target cells in recent years. It is possible that PD treatment might become far more effective and have fewer side effects if medication delivery mechanisms were to be improved. Potential alternatives to pharmacological therapy for molecular imaging and treatment of PD may lie in abnormal proteins such as parkin, α-synuclein, leucine-rich repeat serine and threonine protein kinase 2. Published research has demonstrated encouraging outcomes when nanomedicine-based approaches are used to address the challenges of PD therapy. So, to address the present difficulties of antiparkinsonian treatment, this review outlines the key issues and limitations of antiparkinsonian medications, new therapeutic strategies, and the breadth of delivery based on nanomedicine. This review covers a wide range of subjects, including drug distribution in the brain, the efficacy of drug-loaded nano-carriers in crossing the blood-brain barrier, and their release profiles. In PD, the nano-carriers are also used. Novel techniques of pharmaceutical delivery are currently made possible by vesicular carriers, which eliminate the requirement to cross the blood-brain barrier (BBB).

Effect of lipid type on betulin-stabilized water-in-oil Pickering emulsion: emulsion properties, in vitro digestion, and betulin bioaccessibility.

The Pickering emulsion delivery technique is widely acknowledged for its efficacy in serving as a carrier that can encapsulate functional components effectively. Previous studies have shown significant differences in the stability of Pickering emulsions composed of different oil phases and in the bioaccessibility of the encapsulated functional ingredients. This study therefore investigated the effects of different carrier oils in the betulin self-stabilized water-in-oil (W/O) Pickering emulsion on the stability of the emulsion and bioaccessibility of betulin. The results showed that the oil type was one of the main factors affecting the stability of the emulsion. Palm oil and coconut oil provided better storage stability and centrifugal stability due to the high saturated fatty acid content. The bioavailability of betulin correlated significantly with the composition and characteristics of fatty acids in carrier oils. Carrier oils rich in low-saturation long-chain fatty acids tended to release more free fatty acids (FFAs), thus forming larger and more mixed micelles with stronger swelling and dissolution ability, resulting in a relatively high bioaccessibility of betulin. In contrast, the bioaccessibility of betulin in the emulsion prepared by coconut oil (with high saturated fatty acid content) was relatively low (1.17%). The results of this study indicate that selecting an appropriate carrier oil is important for the design of self-stabilized W/O Pickering emulsions to improve the bioaccessibility of betulin and other lipophilic bioactivities effectively. © 2024 Society of Chemical Industry.

Design and Evaluation of New Gel-Based Floating Matrix Tablets Utilizing the Sublimation Technique for Gastroretentive Drug Delivery.

A gel-based floating matrix tablet was formulated and evaluated using the sublimation technique to enhance gastroretentive drug delivery. Anhydrous theophylline was employed as the active pharmaceutical ingredient, combined with sublimation agents and hydroxypropyl methylcellulose as the gel-forming polymer. The resulting tablets exhibited high porosity, immediate floatation, and sustained buoyancy for over 8 h. Optimization of the floating behavior and drug release profiles was achieved by adjusting the viscosity of and hydroxypropyl methylcellulose and the concentration of sublimation agents, specifically ammonium carbonate and menthol. These agents were selected for their effectiveness in creating a porous structure, thus reducing tablet density and enhancing floatation. Higher HPMC viscosity resulted in increased floating force, slower drug release, and improved swelling properties due to a slower erosion rate. A critical assessment of the balance between tablet porosity, mechanical strength, and drug release kinetics indicates that ammonium carbonate provided superior tablet hardness and lower friability compared to menthol, favoring a controlled release mechanism. The release dynamics of theophylline were best described by the anomalous (non-Fickian) diffusion model, suggesting a combined effect of diffusion and erosion. This research advances the development of gastroretentive drug delivery systems, highlighting the potential of sublimation-based floating matrix tablets for sustained drug release.

Clinical Observation of Zero-P System Interbody Fusion Combined with Traditional Chinese Medicine-Directed Drug Delivery Technology for Treating Cervical Spondylotic Myelopathy

Objective: To investigate the clinical efficacy of the Zero-profile fusion cage (Zero-P) combined with Traditional Chinese Medicine-directed drug delivery technique in the treatment of cervical spondylotic myelopathy, and to assess its impact on potential postoperative complications. Methods: 13 patients with cervical spondylotic myelopathy were selected from January 2022 to October 2023. The intraoperative bleeding volume, operation duration, and hospitalization days were recorded, the incidence and improvement of postoperative complications were observed, and the pain index and cervical function index were analyzed, including Visual Analogue Scale (VAS) score, Japanese Orthopedic Association (JOA) score, Neck Disability Index (NDI) index, etc. Results: The operation duration of patients was 65–110 (81.92 ± 13.47) min; mean intraoperative blood loss was 12.30 ± 7.80 ml, and mean postoperative hospital days were 9.62 ± 3.52 days. All patients in this group were followed up over 3 months after surgery, and the study found that the VAS, JOA, and NDI scores improved significantly compared with the preoperative difference (P < 0.01); and the VAS, JOA, and NDI scores 1 month postoperative improved significantly compared with 1 week postoperative (P < 0.01). In addition, the incidence of postoperative complications of the Zero-P system was low, with no incision infection, implant rejection, fracture, displacement, cerebrospinal fluid leakage, recurrent laryngeal nerve injury, and laryngeal edema; one patient had mild dysphagia (7.69%) and nine patients had throat dryness and discomfort (69.23%), which completely disappeared after 1 week of TCM-directed drug treatment and symptomatic treatment. Conclusion: Zero-P system interbody fusion has a significant effect on cervical spondylotic myelopathy, with a low incidence of postoperative complications and fast improvement speed, which can effectively enhance the impact of surgery on cervical spondylotic myelopathy patients, thus it is worthy of application and promotion.

Preparation irinotecan hydrochloride loaded PEGylated liposomes using novel method supercritical fluid and condition optimized by Box–Behnken design

A semi-synthetic camptothecin derivative known as irinotecan hydrochloride is frequently used to treat colorectal cancer, including colorectal adenocarcinoma and lung cancers involving small cells. Irinotecan has a very short half-life; therefore, continuous infusions are required to keep the drug’s blood levels at therapeutic levels, which could produce cumulative toxicities. Effective delivery techniques, including liposomes, have been developed to address these shortcomings. In this study, a continuous supercritical fluid approach dubbed Expansion Supercritical Fluid into an aqueous solution, in which the pressure decreases rapidly but remains over the critical pressure, is proposed to manufacture polyethylene glycolylated (PEGylated) liposomes carrying irinotecan hydrochloride. To accomplish this, PEGylated liposomes were created using a Box–Behnken design, and the operating parameters (flow rate, temperature, and pressure drop) were optimized. Encapsulation efficiency, mean size, and prepared liposome count were 94.6%, 55 nm, and 758 under ideal circumstances. Additionally, the stability of the PEGylated liposome was investigated during 8 weeks, and also PEGylated liposome-loaded irinotecan release profile was compared to conventional liposomes and free irinotecan, and a constant drug release was seen after the first burst release from liposomes.

Accelerating healing at high altitudes: Oxygen and bFGF delivery through nanoparticle-loaded gel dressings

High altitude environment is mainly characterized by low oxygen. Due to persistent hypoxia, nonhealing wounds are common in high-altitude areas. Moreover, Basic fibroblast growth factor (bFGF) is a versatile biologically active substance that has crucial impact on wound healing. Given the limited availability of atmospheric oxygen and reduced blood oxygen saturation in high-altitude area, and the challenge that arises from direct oxygen and bFGF delivery to wounds through the traumatized vascular structure, it necessitates an innovative solution for local and permeable delivery of oxygen and bFGF. In this study, we present a strategy that involves revamping traditional gel-based wound dressings through the incorporation of nanoparticles encapsulating oxygen and bFGF, engineered to facilitate the localized delivery of dissolved oxygen and bFGF to wound surfaces. The prospective evaluation of this delivery technique's therapeutic impacts on epithelial, endothelial and fibroblasts cells can be materialized. Further experiment corroborated these effects on a high-altitude wounds' murine model. Given its biocompatibility, efficacy, and utility, we posit that NOB-Gel exhibits remarkable translational potential for managing and hastening the healing process of an array of clinical wounds, more so for wounds inflicted at high altitudes.

A Comprehensive Review of Nanogel-Based Drug Delivery Systems.

Polymers can be crosslinked chemically or physically to create three-dimensional hydrogel particles with sub-micron dimensions, known as nanogels. Their customizable size, ease of manufacture, expansion potential, bio-integration, water affinity, and reactivity to various stimuli, including temperature, pH, light, and biological agents, provide them with considerable advantages over conventional drug delivery techniques. Nanogels possess properties of both hydrogels and nanoparticles and can be categorized into nanohydrogels and nano-organogels. These systems exhibit exceptional drug-loading capability, stability, biological consistency, and environmental responsiveness. Their hallmark lies in their swelling behavior, enabling substantial water absorption while maintaining structural integrity. Preparation methods involve polymer precursors or heterogeneous polymerization of monomers. Nanogels are promising for various drug administration techniques, including local anesthetics, vaccines, and transdermal drug delivery, due to their ability to encapsulate multiple bioactive ingredients, enhancing therapeutic efficacy and stability.

EXPLORING THE IMPACT OF MENTORS OBSERVATION FEEDBACK ON POSTGRADUATE PRESERVICE TEACHERS’ DEVELOPMENT

The purpose of this study was to explore the impact of mentors observation feedback on postgraduate certificate in education (PGCE) pre-service teachers’ development of the necessary competencies. The study which was qualitative in nature generated its data from 32 PGCE pre-service teachers using semi-structured interview protocol and this was analysed thematically. The findings of the study revealed that, the application of Hagger and Mclntyre’s theory of modelling, practice and feedback highlighted the positive impact of mentor-teacher observation feedback on PGCE pre-service teachers development of the necessary competencies required of a professional educator. The competencies revealed include lesson preparation and planning, pedagogical and content delivery techniques, classroom management promotion of inclusivity in the classroom, and grounding in disciplinary content knowledge among others. It was concluded that mentor-teacher observation feedback has the potential to improve and impact on pre-service teachers’ development of the necessary competencies required of a professional educator.

Prospective Approaches of Herbal Novel Delivery System with Special Reference to the Herbal Nanosciences

: Medicinal and culinary uses of plants date back centuries. Projects on a global scale are conducting laboratory research to identify plants with therapeutic properties, with the ultimate goal of developing such compounds into medicines with acceptable drug delivery mechanisms and bringing them to market. Non-synthetic medications derived from plant or herbal sources have attracted a lot of interest because of their high tolerability and low likelihood of adverse medication reactions. All diseases, the theory goes, can be cured by something found in nature. Medicines can be taken in a wide variety of forms, including tablets, capsules, powders, semi-liquid extracts, tinctures, decoctions, medicinal teas, solutions, and more. Longer release, patient adherence, and other objectives necessitate adjustments to herbal medications. Researchers into novel drug delivery systems had hitherto overlooked herbal remedies due to a lack of scientific validation and the challenges inherent in processing, standardizing, extracting, and identifying them. Transdisciplinary research and cuttingedge isolation, purification, and identification techniques have led to the development of novel herbal compositions. Bioactive plant extracts and phytoconstituents are used in a wide variety of Nano- Emulsions, microspheres, transferosomes, implants, and ethosomes. Compared to herbal remedies, novel formulations fared better. Among these advantages are increased solubility, bioavailability, toxicity, pharmacological activity, stability, delivery duration, and resistance to physical and chemical degradation. As a result, the pharmacokinetic and pharmacodynamic properties of herbal medications can be enhanced by the use of novel drug delivery systems, making them safer and more effective. : This article aims to provide a concise description of the many new drug delivery techniques that have been created for the administration of herbal medications. The ultimate goal is to increase the efficacy of therapies and to learn more about their significance and worldwide appeal.

Late effects following HSCT for childhood ALL: A national single-center study using three different modalities of delivery of total body irradiation.

Total body irradiation (TBI) is a pivotal part of conditioning prior to hematopoietic stem cell transplantation (HSCT) for childhood acute lymphoblastic leukemia (ALL), yet evidence is sparse regarding the effect of TBI delivery techniques on acute and late toxicities. In a national cohort of pediatric HSCT-recipients, we compared three TBI schedules; 12Gray (Gy) delivered as (i) 4Gy daily fractions from 2008 to 2011 (n=12); (ii) 2Gy fractions twice daily with two-dimensional (2D) planning technology from 2012 to 2015 (n=16); and (iii) 2Gy twice daily with three-dimensional (3D) planning intensity-modulated radiotherapy (IMRT) from 2016 to 2020 (n=14). The 5-year event-free survival was 75.0%, 81.3%, and 81.3% in Cohorts 1, 2, and 3, respectively. Acute toxicity assessed as maximum ferritin and C-reactive protein during the first 3months post HSCT did not differ between cohorts, nor did the time to first hospital discharge (median 28, 32, and 31days, p=.25). The incidences of acute graft-versus-host disease (GvHD) (66%, 56%, 71%) and chronic GvHD (25%, 31%, 14%) were comparable. Pulmonary function assessed by spirometry did not differ significantly. The 5-year cataract-free survival was 33.3%, 79%, and 100% in Cohorts 1, 2, and 3, respectively. We found a nonsignificant tendency toward more endocrinopathies in Cohort 1 compared to Cohorts 2 and 3. The change of modality did not result in more relapses. More fractionation led to improvement with a lower incidence of cataract and a tendency toward fewer endocrinopathies. The effect of 3D-planning-IMRT technology requires further evaluation in larger studies.

First Dosimetric and Biological Verification for Spot-Scanning Hadron Arc Radiation Therapy With Carbon Ions

Purpose: Spot-scanning Hadron Arc therapy (SHArc) is a novel delivery technique for ion beams with potentially improved dose conformity and dose-averaged linear energy transfer (LETd) redistribution. The first dosimetric validation and in vitro verification of carbon ion arc delivery is presented. Methods: Intensity Modulated Particle Therapy (IMPT) and SHArc plans were designed to deliver homogenous physical dose or biological dose in a cylindrical PMMA phantom. Additional IMPT carbon plans were optimized for testing different LETd-boosting strategies. Verifications of planned doses were performed with an ionization chamber and clonogenic survival assay was conducted using A549 cancer lung cell line. Radiation-induced nuclear 53BP1 foci were assessed to evaluate the cellular response in both normoxic and hypoxic conditions. Results: Dosimetric measurements and clonogenic assay results showed a good agreement to planned dose and survival distributions. Measured survival fractions and foci confirmed carbon ions SHArc as potential modality to overcome hypoxia-induced radio-resistance. LETd-boosted IMPT plans reached similar LETd in the target as in SHArc plans promising similar features against hypoxia but at the cost of an increased entrance dose. SHArc resulted, however, in a lower dose bath but in a larger volume around the target. Conclusion: The first proof of principle of carbon ions SHArc delivery was performed and experimental evidence suggests this novel modality as an attractive approach for treating hypoxic tumor.

Ensuring High Quality Treatment Plans with a Plan Quality Review Checklist

Treatment plan quality is a crucial component for a successful outcome of radiation therapy treatments. As the complexity of radiation therapy planning and delivery techniques increases, the role of the medical physicist in assessing treatment plan quality becomes more critical. Integrating plan quality review throughout the treatment planning process allows improvements without delaying treatment or rushing to produce changes at the last minute. In this work, we aim to provide practical check items for physicists to reference when assessing treatment plan quality with a critical eye, asking questions such as “is this the best dose distribution feasible for this patient?,” “could we change any planning parameters to improve plan quality?,” and “could we change the planning strategy for this particular patient or for future patients?”; and to work with planners and physicians to create a multidisciplinary collaborative culture that achieves the best plan feasible for every patient. We tabulate the features that affect plan quality in each process step and check details for individual items. This report is aimed at medical physicists, planners, radiation oncologists, and other professionals who are involved in treatment planning.

Biodistribution of PET radiotracers in tumor-bearing TRAMP mice administered by retroorbital or jugular vein injections

Nuclear medicine is an important tool for use in molecular imaging of important biological processes. Methods for intravenous delivery of radiotracers remains a challenge, with tail vein injections demonstrated to be technically difficult and lacking in reproducibility. Other intravenous methods include jugular vein (JV) injection, which requires a more invasive and precise microsurgical technique. Although the retroorbital (RO) sinus drains directly into the JV, and RO injections are minimally invasive and simpler to perform, they remain underutilized, perhaps due to a lack of studies demonstrating their performance. This study provides a comprehensive comparison of dynamic tissue biodistribution of three categories of commonly utilized radiopharmaceuticals between JV and RO injection methods in prostate tumor-bearing mice using PET-CT imaging. Results show that JV and RO injections have equivalent dynamic tissue biodistributions across the three categories of radiopharmaceuticals used: (1) small molecule measuring tumor metabolism (18F-flurodeoxyglucose [FDG]); (2) peptide-based probe measuring angiogenesis (64Cu-NOTA-PEG4-cRGD2); and (3) dextran-based nanocarrier (64Cu-NOTA-D20). Although RO injections present with some limitations such as type of injectate and difficulty for measuring acute, dynamic pharmacokinetics, this study demonstrates that RO injections are a viable, minimally invasive or stressful, and efficient alternative intravenous delivery technique for molecular imaging.

Liposomal Freight and Their Advanced Microstructure Characterization Techniques for Food and Nutraceutical Delivery

Liposomal Freight and Their Advanced Microstructure Characterization Techniques for Food and Nutraceutical Delivery

A Systematic Review of Online Teaching Methods in Higher Education

Since the pandemic began, online teaching methods have received increased interest and review. Educators rapidly developed delivery techniques to meet the needs of students forced to become remote learners. Some of these methods were successful; others did not meet program objectives, especially in educator preparation programs (EPPs). The speed of changing to an online environment limited the ability of educators to research and adapt known evidenced-based practices. This systematic literature review provides research and insight into student-focused outcomes related to effective online teaching practices. Over 600 articles, across multiple disciplines were reviewed based on research and results using different techniques, pedagogy, and design in the online environment. The five main strategies, methods, or philosophies that most affected student outcomes in the online community were engagement, collaboration, beliefs, knowledge, and enactment of knowledge/practice. Each topic is discussed in depth and recommendations are made for effective online teaching and also specific applications to EPPs.