RESUMO
The fields of drug and gene delivery have been revolutionized by the discovery and characterization of polymer-based materials. Polymeric nanomaterials have emerged as a strategy for targeted delivery because of features such as their impressive biocompatibility and improved availability. Use of naturally derived polymers in these nanomaterials is advantageous due to their biodegradability and bioresorption. Natural biopolymer-based particles composed of silk fibroins and other silk fiber-inspired proteins have been the focus of research in drug delivery systems due to their simple synthesis, tunable characteristics, and ability to respond to stimuli. Several silk and silk-inspired polymers contain a high proportion of reactive side groups, allowing for functionalization and addition of targeting moieties. In this review, we discuss the main classes of silk and silk-inspired polymers that are being used in the creation of nanomaterials. We also focus on the fabrication techniques used in generating a tunable design space of silk-based polymeric nanomaterials and detail how that translates into use for drug delivery to several distinct microenvironments.
RESUMO
Certified anesthesiologist assistants (CAAs) are Advanced Practice Providers (APPs) within the anesthesia care team. This research evaluated their burnout. CAAs were surveyed nationally about their professional/work characteristics, perceived fairness of salary/benefits compared to certified registered nurse anesthetists/CAAs, the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the Conditions for Work Effectiveness Questionnaire II, and questions regarding wellness resources at their place of employment. The survey was completed by 457 respondents (19.7%). Of them, 110 (24.1%) scored high on the Emotional Exhaustion subscale of the MBI-HSS. Factors associated with greater emotional exhaustion included younger age, full-time status, perception that salary/benefits were unfair/inadequate compared to other CAAs, more information about the state of their employer and related values/goals of administration, but fewer resources (i.e., time), lower job-related empowerment, and lower formal power. Forty-seven (10.3%) scored high on the Depersonalization subscale. Factors associated with greater depersonalization include younger age, full-time status, more information about state of employer and related values/goals, but less global empowerment, which predicted greater depersonalization. CAAs may report lower levels of burnout compared to other professionals in the anesthesia team but are, nonetheless, susceptible to effects of burnout. Both leaders of organizations and the APPs themselves hold responsibility in protecting against burnout.
