A review on tragacanth gum: A promising natural polysaccharide in drug delivery and cell therapy.

Tragacanth is an abundant natural gum extracted from some plants and is dried for use in various applications from industry to biomedicines. It is a cost-effective and easily accessible polysaccharide with desirable biocompatibility and biodegradability, drawing much attention for use in new biomedical applications such as wound healing and tissue engineering. Moreover, this anionic polysaccharide with a highly branched structure has been used as an emulsifier and thickening agent in pharmaceutical applications. In addition, this gum has been introduced as an appealing biomaterial for producing engineering tools in drug delivery. Furthermore, the biological properties of tragacanth gum have made it a favorable biomaterial in cell therapies, and tissue engineering. This review aims to discuss the recent studies on this natural gum as a potential carrier for different drugs and cells.

Cellulose-based composite scaffolds for bone tissue engineering and localized drug delivery.

Natural bone constitutes a complex and organized structure of organic and inorganic components with limited ability to regenerate and restore injured tissues, especially in large bone defects. To improve the reconstruction of the damaged bones, tissue engineering has been introduced as a promising alternative approach to the conventional therapeutic methods including surgical interventions using allograft and autograft implants. Bioengineered composite scaffolds consisting of multifunctional biomaterials in combination with the cells and bioactive therapeutic agents have great promise for bone repair and regeneration. Cellulose and its derivatives are renewable and biodegradable natural polymers that have shown promising potential in bone tissue engineering applications. Cellulose-based scaffolds possess numerous advantages attributed to their excellent properties of non-toxicity, biocompatibility, biodegradability, availability through renewable resources, and the low cost of preparation and processing. Furthermore, cellulose and its derivatives have been extensively used for delivering growth factors and antibiotics directly to the site of the impaired bone tissue to promote tissue repair. This review focuses on the various classifications of cellulose-based composite scaffolds utilized in localized bone drug delivery systems and bone regeneration, including cellulose-organic composites, cellulose-inorganic composites, cellulose-organic/inorganic composites. We will also highlight the physicochemical, mechanical, and biological properties of the different cellulose-based scaffolds for bone tissue engineering applications.

Effectiveness of Clinical Decision Support Systems on the Appropriate Use of Imaging for Central Nervous System Injuries: A Systematic Review.

BACKGROUND: One of the best practices for timely and efficient diagnoses of central nervous system (CNS) trauma and complex diseases is imaging. However, rates of imaging for CNS are high and impose a lot of costs to health care facilities in addition to exposing patients with negative impact of ionizing radiation. OBJECTIVES: This study aimed to systematically review the effects and features of clinical decision support systems (CDSSs) for the appropriate use of imaging for CNS injuries. METHOD: We searched MEDLINE, SCOPUS, Web of Science, and Cochrane without time period restriction. We included experimental and quasiexperimental studies that assessed the effectiveness of CDSSs designed for the appropriate use of imaging for CNS injuries in any clinical setting, including primary, emergency, and specialist care. The outcomes were categorized based on imaging-related, physician-related, and patient-related groups. RESULT: A total of 3,223 records were identified through the online literature search. Of the 55 potential papers for the full-text review, 11 eligible studies were included. Reduction of CNS imaging proportion varied from 2.6 to 40% among the included studies. Physician-related outcomes, including guideline adherence, diagnostic yield, and knowledge, were reported in five studies, and all demonstrated positive impact of CDSSs. Four studies had addressed patient-related outcomes, including missed or delayed diagnosis, as well as length of stay. These studies reported a very low rate of missed diagnosis due to the cancellation of computed tomography (CT) examine according to the CDSS recommendations. CONCLUSION: This systematic review reports that CDSSs decrease the utilization of CNS CT scan, while increasing physicians' adherence to the rules. However, the possible harm of CDSSs to patients was not well addressed by the included studies and needs additional investigation. The actual effect of CDSSs on appropriate imaging would be realized when the saved cost of examinations is compared with the cost of missed diagnosis.

Co-delivery of minocycline and paclitaxel from injectable hydrogel for treatment of spinal cord injury.

Spinal cord injury (SCI) induces pathological and inflammatory responses that create an inhibitory environment at the site of trauma, resulting in axonal degeneration and functional disability. Combination therapies targeting multiple aspects of the injury, will likely be more effective than single therapies to facilitate tissue regeneration after SCI. In this study, we designed a dual-delivery system consisting of a neuroprotective drug, minocycline hydrochloride (MH), and a neuroregenerative drug, paclitaxel (PTX), to enhance tissue regeneration in a rat hemisection model of SCI. For this purpose, PTX-encapsulated poly (lactic-co-glycolic acid) PLGA microspheres along with MH were incorporated into the alginate hydrogel. A prolonged and sustained release of MH and PTX from the alginate hydrogel was obtained over eight weeks. The obtained hydrogels loaded with a combination of both drugs or each of them alone, along with the blank hydrogel (devoid of any drugs) were injected into the lesion site after SCI (at the acute phase). Histological assessments showed that the dual-drug treatment reduced inflammation after seven days. Moreover, a decrease in the scar tissue, as well as an increase in neuronal regeneration was observed after 28 days in rats treated with dual-drug delivery system. Over time, a fast and sustained functional improvement was achieved in animals that received dual-drug treatment compared with other experimental groups. This study provides a novel dual-drug delivery system that can be developed to test for a variety of SCI models or neurological disorders.

A study of picture archiving and communication system adoption in one hospital: Applying the unified theory of acceptance and use of technology model.

CONTEXT: The advent of picture archiving and communication system (PACS) as medical image information system represent a major change of work pattern for radiologists and physicians and has proved to be a substantial challenge to the organization. AIMS: The study aimed to investigate the factors affecting the use of PACS through the unified theory of acceptance and use of technology model. SETTINGS AND DESIGN: It was an applied and analytical study. SUBJECTS AND METHODS: Ninety questionnaires were distributed in Kashani hospital of Esfahan which implemented web-based PACS, and 45 usable questionnaires were returned. The questionnaire consists of scales for performance expectancy (PE), effort expectancy, facility condition, social influences, and behavioral intention (BI) and was developed by the author comparing the similar studies in which validity was confirmed by a committee of experts and the reliability was calculated using a Cronbach's α (α = 0.946). STATISTICAL ANALYSIS USED: Data were analyzed using SPSS version 20. The statistical tests for data analysis were Pearson's correlation and multiple regression analysis. RESULTS: The findings suggested a direct correlation between BI and factors of PE (P < 0.001, r = 0.788), effort expectancy (P < 0.001, r = 0.564), social influences (P = 0.001, r = 0.472), and facility condition (P < 0.001, r = 0.477). CONCLUSIONS: According to the findings, only the PE is sufficient for predict and evaluation of user behavior toward PACS. The results could be useful in terms of designing new systems and understanding users' need.

Patient Accounting Systems: Are They Fit with the Users' Requirements?

OBJECTIVES: A patient accounting system is a subsystem of a hospital information system. This system like other information systems should be carefully designed to be able to meet users' requirements. The main aim of this research was to investigate users' requirements and to determine whether current patient accounting systems meet users' needs or not. METHODS: This was a survey study, and the participants were the users of six patient accounting systems used in 24 teaching hospitals. A stratified sampling method was used to select the participants (n = 216). The research instruments were a questionnaire and a checklist. The mean value of ≥3 showed the importance of each data element and the capability of the system. RESULTS: Generally, the findings showed that the current patient accounting systems had some weaknesses and were able to meet between 70% and 80% of users' requirements. CONCLUSIONS: The current patient accounting systems need to be improved to be able to meet users' requirements. This approach can also help to provide hospitals with more usable and reliable financial information.

Melittin adsorption and lipid monolayer disruption at liquid-liquid interfaces.

Melittin, a membrane-active peptide with antimicrobial activity, was investigated at the interface formed between two immiscible electrolyte solutions (ITIES) supported on a metallic electrode. Ion-transfer voltammetry showed well-defined semi-reversible transfer peaks along with adsorptive peaks. The reversible adsorption of melittin at the liquid-liquid interface is qualitatively discussed from voltammetric data and experimentally confirmed by real-time image analysis of video snapshots. It is also demonstrated that polarization of the water/1,2-DCE interface results in drastic drop shape variations caused by large variations of the interfacial tension. The experimental data also confirmed that maximum adsorption occurs near the ion transfer potential. Finally, the interaction of melittin with a monolayer of L-α-dipalmitoyl phosphatidylcholine (DPPC) was also investigated showing that melittin destabilizes the lipidic monolayer facilitating its desorption. The non-covalent complex formation between melittin and DPPC was confirmed by mass spectrometry.

Artificial photosynthesis at soft interfaces.

The concept of artificial photosynthesis at a polarised liquid membrane is presented. It includes two photosystems, one at each interface for the hydrogen and oxygen evolution respectively. Both reactions involve proton coupled electron transfer reactions, and some ultrafast steps at the photosensitization stage.