A systematic review of the early dialogue frameworks used within health technology assessment and their actual adoption from HTA agencies

Introduction

Early advice in the process of developing health technologies allows manufacturers to plan their production and transfer to health care systems more accurately. This review aims to describe frameworks used within HTA and their current use by HTA Agencies.

Material and methods

We carried out a systematic literature review in Pubmed, Embase, Scopus, and WoS, including all references published in Spanish and English. This was last updated in March 2022. We extracted all available information regarding the organizations involved, services offered, types of technology, collaborators involved, fees, output and impact. Websites of several HTA organizations and Google were also searched in order to update and complete the information obtained from this generic search.

Results

Five-hundred and forty one articles were identified and screened, of which 26 met the eligibility criteria and were selected. Seven of them were non-systematic reviews that described two or more HTA organizations. Ten studies were focused on the advice offered by individual organizations, and eight described the EMA and EUnetHTA parallel or joint advice. We found variations in the technology assessed, services offered, stage of development and costs for advisory services.

Conclusions

Early and scientific advice would help manufacturers focus their product development on what is needed for the management of specific diseases. Most of the examples or services found refer to drugs as well as to some medical devices and diagnostics. A common definition of the type of advice that could be offered for different health technologies by HTA bodies to ascertain health care systems and manufacturers' needs, in addition to the timeline in which that advice needs to be given, would help HTA bodies provide the right support at the right time.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020219401, PROSPERO CRD42020219401.

Competence-Based Assessment of Biomedical Equipment Management and Maintenance System (e-Upkaran) Using Benefit Evaluation Framework

Introduction To establish a centralized inventory management system for the efficient functioning of all healthcare facilities, e-Upkaran (equipment management and maintenance system) was launched in 2015 in the state of Rajasthan. This study is conducted to assess the functioning of e-Upkaran in Rajasthan. Methods The assessment of the e-Upkaran system for primary and secondary healthcare centers was carried out using a systematic review of the literature and a multi-indicator stakeholder questionnaire. The benefits evaluation framework focused on the system quality, information and service quality, use and user satisfaction, and net benefits utilized for the assessment. A review of the literature was done to highlight the importance of computerized medical equipment management and maintenance systems and appraise the challenges and benefits associated with such systems as compared to the traditional pen-paper register. Information was gathered based on available documents, field observation, and data obtained from specific hospital staff, including the bioengineers and other users of e-Upkaran. Results The finding of this study suggests that e-Upkaran efficiently improves documentation, reporting, maintenance, and management of medical equipment. It is more efficient than the traditional paper-pen system. It is designed to minimize downtime and maintain equipment in good operating condition and has potential benefits in terms of improving information quality, use, and net benefit. The cost of service ratio is within the benchmark value. This system has also considerably reduced out-of-pocket expenditure. Computer proficiency and the workload of other e-health programs pose a challenge in the implementation of this program. Conclusion The e-Upkaran system is competent in terms of improving information quality, use, and net benefit. Other Indian states could also adopt this system to improve their biomedical equipment management and maintenance system.

Imaging and detection of long-lived fluorescence probes in presence of highly emissive and scattering background

Optical biomedical imaging and diagnostics is a rapidly growing field that provides both structural and functional information with uses ranging from fundamental to practical clinical applications. Nevertheless, imaging/visualizing fluorescence objects with high spatial resolution in a highly scattering and emissive biological medium continues to be a significant challenge. A fundamental limiting factor for imaging technologies is the signal-to-background ratio (SBR). For a long time to improve the SBR, we tried to improve the brightness of fluorescence probes. Many novel fluorophores with improved brightness (almost reaching the theoretical limit), redshifted emission, highly improved photostability, and biocompatibility greatly helped advance fluorescence detection and imaging. However, autofluorescence, scattering of excitation light, and Raman scattering remain fundamental limiting problems that drastically limit detection sensitivity. Similarly, significant efforts were focused on reducing the background. High-quality sample purification eliminates the majority of autofluorescence background and in a limited confocal volume allows detection to reach the ultimate sensitivity to a single molecule. However, detection and imaging in physiological conditions does not allow for any sample (cells or tissue) purification, forcing us to face a fundamental limitation. A significant improvement in limiting background can be achieved when fluorophores with a long fluorescence lifetime are used, and time-gated detection is applied. However, all long-lived fluorophores present low brightness, limiting the potential improvement. We recently proposed to utilize multipulse excitation (burst of pulses) to enhance the relative signal of long-lived fluorophores and significantly improve the SBR. Herein, we present results obtained with multipulse excitation and compare them with standard single-pulse excitation. Subtraction of images obtained with a single pulse from those obtained with pulse burst (differential image) highly limits background and instrumental noise resulting in more specific/sensitive detection and allows to achieve greater imaging depth in highly scattering media, including skin and tissue.

Biomedical Applications of an Ultra-Sensitive Surface Plasmon Resonance Biosensor Based on Smart MXene Quantum Dots (SMQDs)

In today's world, the use of biosensors occupies a special place in a variety of fields such as agriculture and industry. New biosensor technologies can identify biological compounds accurately and quickly. One of these technologies is the phenomenon of surface plasmon resonance (SPR) in the development of biosensors based on their optical properties, which allow for very sensitive and specific measurements of biomolecules without time delay. Therefore, various nanomaterials have been introduced for the development of SPR biosensors to achieve a high degree of selectivity and sensitivity. The diagnosis of deadly diseases such as cancer depends on the use of nanotechnology. Smart MXene quantum dots (SMQDs), a new class of nanomaterials that are developing at a rapid pace, are perfect for the development of SPR biosensors due to their many advantageous properties. Moreover, SMQDs are two-dimensional (2D) inorganic segments with a limited number of atomic layers that exhibit excellent properties such as high conductivity, plasmonic, and optical properties. Therefore, SMQDs, with their unique properties, are promising contenders for biomedicine, including cancer diagnosis/treatment, biological sensing/imaging, antigen detection, etc. In this review, SPR biosensors based on SMQDs applied in biomedical applications are discussed. To achieve this goal, an introduction to SPR, SPR biosensors, and SMQDs (including their structure, surface functional groups, synthesis, and properties) is given first; then, the fabrication of hybrid nanoparticles (NPs) based on SMQDs and the biomedical applications of SMQDs are discussed. In the next step, SPR biosensors based on SMQDs and advanced 2D SMQDs-based nanobiosensors as ultrasensitive detection tools are presented. This review proposes the use of SMQDs for the improvement of SPR biosensors with high selectivity and sensitivity for biomedical applications.

Graphene Quantum Dots as Bimodal Imaging Agent for X-Ray and Computed Tomography

The urgency of new contrast agents, especially for X-Ray and Computed Tomography (CT) is increasing each day. Although both imaging modalities are the most routinely used imaging techniques, the availability of contrast agent is very limited. In this scenario, the use of graphene quantum dots (GQDs), a member of the graphene family, which has several characteristics, including low toxicity, good biocompatibility and physical-chemical properties, may represent an important application of this material. Thus, using X-Ray (conventional) and CT analysis was evaluated the applicability of GQDs as contrast agent for both imaging modalities. The results demonstrated that GQDs are able to attenuate X-Ray forming sharp imaging in both modalities. The data broaden the spectrum of GQDs use.

Advances in Electrostatic Spinning of Polymer Fibers Functionalized with Metal-Based Nanocrystals and Biomedical Applications

Considering the metal-based nanocrystal (NC) hierarchical structure requirements in many real applications, starting from basic synthesis principles of electrostatic spinning technology, the formation of functionalized fibrous materials with inorganic metallic and semiconductor nanocrystalline materials by electrostatic spinning synthesis technology in recent years was reviewed. Several typical electrostatic spinning synthesis methods for nanocrystalline materials in polymers are presented. Finally, the specific applications and perspectives of such electrostatic spun nanofibers in the biomedical field are reviewed in terms of antimicrobial fibers, biosensing and so on.

Review of Flexible Wearable Sensor Devices for Biomedical Application

With the development of cross-fertilisation in various disciplines, flexible wearable sensing technologies have emerged, bringing together many disciplines, such as biomedicine, materials science, control science, and communication technology. Over the past few years, the development of multiple types of flexible wearable devices that are widely used for the detection of human physiological signals has proven that flexible wearable devices have strong biocompatibility and a great potential for further development. These include electronic skin patches, soft robots, bio-batteries, and personalised medical devices. In this review, we present an updated overview of emerging flexible wearable sensor devices for biomedical applications and a comprehensive summary of the research progress and potential of flexible sensors. First, we describe the selection and fabrication of flexible materials and their excellent electrochemical properties. We evaluate the mechanisms by which these sensor devices work, and then we categorise and compare the unique advantages of a variety of sensor devices from the perspective of in vitro and in vivo sensing, as well as some exciting applications in the human body. Finally, we summarise the opportunities and challenges in the field of flexible wearable devices.

Lessons learned from an enterprise-wide clinical datathon

In 2020, Baylor College of Medicine held a datathon to inform potential users of a new data warehouse, allow users to address clinical questions, identify warehouse capabilities and limitations, foster collaborations, and engage trainees. Senior faculty selected proposals based on feasibility and impact. Selectees worked with Information Technology for 2 months and presented findings. A survey of participants showed diverse levels of experience, high perceived value of the datathon, high rates of collaboration, and significant increases in knowledge. A datathon can promote familiarity with a new data warehouse, guide data warehouse improvement, and promote collaboration.

Synthesis and Characterization of Calcium Carbonate Obtained from Green Mussel and Crab Shells as a Biomaterials Candidate

Green mussel and crab shells are natural sources of CaCO₃, which is widely used as a bioceramic for biomedical applications, although they are commonly disposed of in landfills. The improper disposal of green mussel and crab shells can cause environmental pollution, reducing the quality of life in the community. Many studies have reported the preparation of CaCO₃ from green mussels and crab shells. However, there are limited studies comparing the characteristics, including the crystal phase obtained, weight percentage (%) of crystal, crystal size, crystal system, and elemental composition of CaCO₃ from green mussel shells, crab shells, and commercial CaCO3. The objective of this research was to compare the calcium carbonate properties formed from green mussel (PMS) and crab (PCS) shells to commercial CaCO₃. Green mussel and crab shells were crushed to powder and were calcined at 900 °C for 5 h. Precipitated Calcium Carbonate (PCC) was synthesized from calcined green mussel and crab shells using a solution of 2M HNO₃, NH₄OH, and CO₂ gas. The effect of setting parameters on the synthesized product was analyzed using XRD and SEM-EDX methods. This study shows that the chemical composition of PMS is nearly identical to that of commercial CaCO₃, where no contaminants were identified. In contrast, PCS has N components other than Ca, C, and O. Furthermore, the predominance of the vaterite crystal phases in PMS and PCS, with respective weight percentages of 91.2% and 98.9%, provides a benefit for biomaterial applications. The crystallite sizes of vaterite in PMS, PCS, and calcite in commercial CaCO₃ are 34 nm, 21 nm, and 15 nm, respectively.

Reconfiguring the biomedical dominance of pain: time for alternative perspectives from health promotion?

Strategies to reduce the burden of persistent pain in society are rooted in a biomedical paradigm. These strategies are located downstream, managing persistent pain once it has become a problem. Upstream activities that create social conditions to promote health and well-being are likely to help, yet health promotion discourse and research are lacking in pain literature. In this article, we argue that the subjective nature of pain has not sat comfortably with the objective nature of medical practice. We argue that the dominance of the biomedical paradigm, with a simplistic 'bottom-up' model of pain being an inevitable consequence of tissue damage, has been detrimental to the health and well-being of people living with persistent pain. Evidence from neuroscience suggests that bodily pain emerges as a perceptual inference based on a wide variety of contextual inputs to the brain. We argue that this supports community, societal and environmental solutions to facilitate whole-person care. We call for more salutogenic orientations to understand how people living with persistent pain can continue to flourish and function with good health. We suggest a need for 'upstream' solutions using community-based approaches to address cultural, environmental, economic and social determinants of health, guided by principles of equity, civil society and social justice. As a starting point, we recommend appraising the ways human society appreciates the aetiology, actions and solutions towards alleviating persistent pain.

Western blotting: a powerful staple in scientific and biomedical research

Western blotting (WB), also known as immunoblotting, is a well-known molecular biology method that biologists often use to investigate many features of the protein, ranging from basic protein analysis to disease detection. WB is simple, unique, rapid, widely used routine tool with easy interpretation and definite results. It is being used in various fields of science, research and development, diagnostic labs and hospitals. The principle of WB is to accomplish the separation of proteins based on molecular weight and charge. This review addresses in detail the individual steps involved in the WB technique, its troubleshooting, internal loading controls, total protein staining and its diverse applications in scientific research and clinical settings, along with its future perspectives.

While Ethical Considerations Predominate, Scientific Merit Can Impact Institutional Review Board (IRB) Determinations A Cross-sectional Study

OBJECTIVE

To determine the most common reasons for Institutional Review Boards deferral of biomedical research proposals.

STUDY DESIGN AND SETTING

Cross-sectional study administered to chairs, vice-chairs, and co-chairs of IRBs at NIH-funded institutions.

RESULTS

Data forms were distributed to IRB chairs at 21 of 25 NIH-funded institutions (4 declined to participate), with an institutional response rate of 86% (18/21). Overall, ethical considerations were more likely than scientific merit to be a reason for protocol deferral. Common ethical considerations for deferral were inadequate informed consent, inadequate detail for risk assessment, insufficient protection of participant safety, and inadequate minimization of risks. Important elements of scientific merit were appropriate research design, adequate adverse event reporting, and the importance of knowledge to be gained. Non-sponsored, investigator-initiated proposals (including those receiving internal funding) were more likely to be deferred (66%), usually due to inadequate protocol development (43%), less external vetting and oversight (20%), and submissions from inexperienced faculty (16%).

CONCLUSION

Deferrals may be avoided by careful compliance with ethical considerations, and by ensuring sufficient scientific merit of the proposal, with research design optimized for participant safety. Those submitting investigator-initiated proposals may consider obtaining at least partial funding to decrease the risk of deferral.

Review on the Application of Hyperspectral Imaging Technology of the Exposed Cortex in Cerebral Surgery

The study of brain science is vital to human health. The application of hyperspectral imaging in biomedical fields has grown dramatically in recent years due to their unique optical imaging method and multidimensional information acquisition. Hyperspectral imaging technology can acquire two-dimensional spatial information and one-dimensional spectral information of biological samples simultaneously, covering the ultraviolet, visible and infrared spectral ranges with high spectral resolution, which can provide diagnostic information about the physiological, morphological and biochemical components of tissues and organs. This technology also presents finer spectral features for brain imaging studies, and further provides more auxiliary information for cerebral disease research. This paper reviews the recent advance of hyperspectral imaging in cerebral diagnosis. Firstly, the experimental setup, image acquisition and pre-processing, and analysis methods of hyperspectral technology were introduced. Secondly, the latest research progress and applications of hyperspectral imaging in brain tissue metabolism, hemodynamics, and brain cancer diagnosis in recent years were summarized briefly. Finally, the limitations of the application of hyperspectral imaging in cerebral disease diagnosis field were analyzed, and the future development direction was proposed.

Biomedical engineering aspects of nanocellulose: a review

Cellulose is one of the most abundant renewable biopolymer in nature and is present as major constituent in both plant cell walls as well as synthesized by some microorganisms as extracellular products. In both the systems, cellulose self-assembles into a hierarchical ordered architecture to form micro to nano-fibrillated structures, on basis of which it is classified into various forms. Nanocellulose (NCs) exist as rod-shaped highly crystalline cellulose nanocrystals to high aspect ratio cellulose nanofibers, micro-fibrillated cellulose and bacterial cellulose (BC), depending upon the origin, structural and morphological properties. Moreover, NCs have been processed into diversified products ranging from composite films, coatings, hydrogels, aerogels, xerogels, organogels, rheological modifiers, optically active birefringent colored films using traditional-to-advanced manufacturing techniques. With such versatility in structure-property, NCs have profound application in areas of healthcare, packaging, cosmetics, energy, food, electronics, bioremediation, and biomedicine with promising commercial potential. Herein this review, we highlight the recent advancements in synthesis, fabrication, processing of NCs, with strategic chemical modification routes to tailor its properties for targeted biomedical applications. We also study the basic mechanism and models for biosynthesis of cellulose in both plant and microbial systems and understand the structural insights of NC polymorphism. The kinetics study for both enzymatic/chemical modifications of NCs and microbial growth behavior of BC under various reactor configurations are studied. The challenges associated with the commercial aspects as well as industrial scale production of pristine and functionalized NCs to meet the growing demands of market are discussed and prospective strategies to mitigate them are described. Finally, post chemical modification evaluation of biological and inherent properties of NC are important to determine their efficacy for development of various products and technologies directed for biomedical applications.

In Vitro and In Vivo Cytotoxicity of Boron Nitride Nanotubes: A Systematic Review

Boron nitride nanotubes (BNNTs) are an exciting class of nanomaterials due to their unique chemical and physical characteristics. In recent decades, BNNTs have gained huge attention in research and development for various applications, including as nano-fillers for composites, semiconductor devices, hydrogen storage, and as an emerging material in biomedical and tissue engineering applications. However, the toxicity of BNNTs is not clear, and the biocompatibility is not proven yet. In this review, the role of BNNTs in biocompatibility studies is assessed in terms of their characteristics: cell viability, proliferation, therapeutic outcomes, and genotoxicity, which are vital elements for their prospective use in biomedical applications. A systematic review was conducted utilising the databases Scopus and Web of Science (WOS) (2008-2022). Additional findings were discovered manually by snowballing the reference lists of appropriate reviews. Only English-language articles were included. Finally, the significant analysis and discussion of the chosen articles are presented.

Recent Studies on Hydrogels Based on H2O2-Responsive Moieties: Mechanism, Preparation and Application

H₂O₂ is essential for cellular processes and plays a vital role in the regulation of cell signaling pathways, which can be viewed as a warning signal for many kinds of disease including cancer, cardiovascular disease, reproductive abnormalities, diabetes, and renal failure. A H₂O₂-responsive hydrogel (H₂O₂-Gel) is a promising candidate for biomedical applications because of its good biocompatibility, similarity to soft biological tissues, ease of preparation, and its ability to respond to H₂O₂. In this study, the H₂O₂-responsive moieties used to fabricate H₂O₂-Gels were reviewed, including thioethers, disulfide bonds, selenides, diselenium bonds, diketones, boronic, and others. Next, the preparation method of H₂O₂-Gel was divided into two major categories according to their reaction mechanisms: either self-crosslinking or mechanisms entailing the addition of difunctional crosslinkers. Last, the applications of H₂O₂-Gels were emphasized, which have been viewed as desirable candidates in the fields of drug delivery, the detection of H₂O₂, glucose-responsive systems, ROS scavengers, tissue engineering, and cell-encapsulation.

Biomedical Applications of Polyhydroxyalkanoate in Tissue Engineering

Tissue engineering technology aids in the regeneration of new tissue to replace damaged or wounded tissue. Three-dimensional biodegradable and porous scaffolds are often utilized in this area to mimic the structure and function of the extracellular matrix. Scaffold material and design are significant areas of biomaterial research and the most favorable material for seeding of in vitro and in vivo cells. Polyhydroxyalkanoates (PHAs) are biopolyesters (thermoplastic) that are appropriate for this application due to their biodegradability, thermo-processability, enhanced biocompatibility, mechanical properties, non-toxicity, and environmental origin. Additionally, they offer enormous potential for modification through biological, chemical and physical alteration, including blending with various other materials. PHAs are produced by bacterial fermentation under nutrient-limiting circumstances and have been reported to offer new perspectives for devices in biological applications. The present review discusses PHAs in the applications of conventional medical devices, especially for soft tissue (sutures, wound dressings, cardiac patches and blood vessels) and hard tissue (bone and cartilage scaffolds) regeneration applications. The paper also addresses a recent advance highlighting the usage of PHAs in implantable devices, such as heart valves, stents, nerve guidance conduits and nanoparticles, including drug delivery. This review summarizes the in vivo and in vitro biodegradability of PHAs and conducts an overview of current scientific research and achievements in the development of PHAs in the biomedical sector. In the future, PHAs may replace synthetic plastics as the material of choice for medical researchers and practitioners.

Current Perspectives on Synthetic Compartments for Biomedical Applications

Nano- and micrometer-sized compartments composed of synthetic polymers are designed to mimic spatial and temporal divisions found in nature. Self-assembly of polymers into compartments such as polymersomes, giant unilamellar vesicles (GUVs), layer-by-layer (LbL) capsules, capsosomes, or polyion complex vesicles (PICsomes) allows for the separation of defined environments from the exterior. These compartments can be further engineered through the incorporation of (bio)molecules within the lumen or into the membrane, while the membrane can be decorated with functional moieties to produce catalytic compartments with defined structures and functions. Nanometer-sized compartments are used for imaging, theranostic, and therapeutic applications as a more mechanically stable alternative to liposomes, and through the encapsulation of catalytic molecules, i.e., enzymes, catalytic compartments can localize and act in vivo. On the micrometer scale, such biohybrid systems are used to encapsulate model proteins and form multicompartmentalized structures through the combination of multiple compartments, reaching closer to the creation of artificial organelles and cells. Significant progress in therapeutic applications and modeling strategies has been achieved through both the creation of polymers with tailored properties and functionalizations and novel techniques for their assembly.

Tubular glassy carbon microneedles with fullerene-like tips for biomedical applications

Glassy carbon, in general, is made by the pyrolysis of polymeric materials and has been the subject of research for at least fifty years. However, as understanding its microstructure is far from straightforward, it continues to be an area of active research. Glassy carbon adopts different allotropes depending on the hybridizations of the C-C bond, that is, sp, sp², or sp³ . Furthermore, a variety of short-range ordering effects can interact with each other and this, along with the effects of microporosity, grain boundaries, and defects, render this a fascinating material. Following the nanoarchitectonics concept of bottom-up creation of functional materials, we use methane rather than a polymer to form glassy carbon. Here we show that tubular glassy carbon microneedles with fullerene-like tips form when methane undergoes pyrolysis on a curved alumina surface. X-ray diffraction of these glassy carbon tubules shows long-range order with a d-spacing of 4.89 Å, which is indicative of glassy carbon. Raman spectroscopy shows the material to be graphitic in nature, and SEM shows the fullerene-like structure of the material. This work provides new insights into the structure of glassy carbons relevant to the application of glassy carbons as a biomaterial, for example, as a new form of carbon-based microneedles. Since metallic needles can introduce toxic/allergenic species into susceptible subjects, this alternative carbon-based microneedle form has great potential as a replacement biomedical material for metallic needles in the field of neural engineering and as acupuncture needles.

Hyperspectral Imaging: A Review and Trends towards Medical Imaging

Hyperspectral Imaging (HSI) is a pertinent technique to provide meaningful information about unique objects in the medical field. In this paper, the basic principles, imaging methods, comparisons, and current advances in the medical applications of HSI are discussed to accentuate the importance of HSI in the medical field. To date, there are numerous tools and methods to fix the problems, but reliable medical HSI tools and methods need to be studied. The enactment and analytical competencies of HSI for medical imaging are discussed. Specifically, the recent successes and limitations of HSI in biomedical are presented to offer the readers an insight into its current potential for medical research. Lastly, we have discussed the future challenges concerning medical applications and possible ways to overcome these limitations.

Cellulose-Based Nanomaterials Advance Biomedicine: A Review

There are various biomaterials, but none fulfills all requirements. Cellulose biopolymers have advanced biomedicine to satisfy high market demand and circumvent many ecological concerns. This review aims to present an overview of cellulose knowledge and technical biomedical applications such as antibacterial agents, antifouling, wound healing, drug delivery, tissue engineering, and bone regeneration. It includes an extensive bibliography of recent research findings from fundamental and applied investigations. Cellulose-based materials are tailorable to obtain suitable chemical, mechanical, and physical properties required for biomedical applications. The chemical structure of cellulose allows modifications and simple conjugation with several materials, including nanoparticles, without tedious efforts. They render the applications cheap, biocompatible, biodegradable, and easy to shape and process.

The Latest in Animal Models of Pulmonary Hypertension and Right Ventricular Failure

Pulmonary hypertension (PH) describes heterogeneous population of patients with a mean pulmonary arterial pressure >20 mm Hg. Rarely, PH presents as a primary disorder but is more commonly part of a complex phenotype associated with comorbidities. Regardless of the cause, PH reduces life expectancy and impacts quality of life. The current clinical classification divides PH into 1 of 5 diagnostic groups to assign treatment. There are currently no pharmacological cures for any form of PH. Animal models are essential to help decipher the molecular mechanisms underlying the disease, to assign genotype-phenotype relationships to help identify new therapeutic targets, and for clinical translation to assess the mechanism of action and putative efficacy of new therapies. However, limitations inherent of all animal models of disease limit the ability of any single model to fully recapitulate complex human disease. Within the PH community, we are often critical of animal models due to the perceived low success upon clinical translation of new drugs. In this review, we describe the characteristics, advantages, and disadvantages of existing animal models developed to gain insight into the molecular and pathological mechanisms and test new therapeutics, focusing on adult forms of PH from groups 1 to 3. We also discuss areas of improvement for animal models with approaches combining several hits to better reflect the clinical situation and elevate their translational value.

PH Responsive Polyurethane for the Advancement of Biomedical and Drug Delivery

Due to the specific physiological pH throughout the human body, pH-responsive polymers have been considered for aiding drug delivery systems. Depending on the surrounding pH conditions, the polymers can undergo swelling or contraction behaviors, and a degradation mechanism can release incorporated substances. Additionally, polyurethane, a highly versatile polymer, has been reported for its biocompatibility properties, in which it demonstrates good biological response and sustainability in biomedical applications. In this review, we focus on summarizing the applications of pH-responsive polyurethane in the biomedical and drug delivery fields in recent years. In recent studies, there have been great developments in pH-responsive polyurethanes used as controlled drug delivery systems for oral administration, intravaginal administration, and targeted drug delivery systems for chemotherapy treatment. Other applications such as surface biomaterials, sensors, and optical imaging probes are also discussed in this review.

The Efficacy of Health Information Technology in Supporting Health Equity for Black and Hispanic Patients With Chronic Diseases: Systematic Review

Background

Racial inequity persists for chronic disease outcomes amid the proliferation of health information technology (HIT) designed to support patients in following recommended chronic disease self-management behaviors (ie, medication behavior, physical activity, and dietary behavior and attending follow-up appointments). Numerous interventions that use consumer-oriented HIT to support self-management have been evaluated, and some of the related literature has focused on racial minorities who experience disparate chronic disease outcomes. However, little is known about the efficacy of these interventions.

Objective

This study aims to conduct a systematic review of the literature that describes the efficacy of consumer-oriented HIT interventions designed to support self-management involving African American and Hispanic patients with chronic diseases.

Methods

We followed an a priori protocol using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-Equity 2012 Extension guidelines for systematic reviews that focus on health equity. Themes of interest included the inclusion and exclusion criteria. We identified 7 electronic databases, created search strings, and conducted the searches. We initially screened results based on titles and abstracts and then performed full-text screening. We then resolved conflicts and extracted relevant data from the included articles.

Results

In total, there were 27 included articles. The mean sample size was 640 (SD 209.5), and 52% (14/27) of the articles focused on African American participants, 15% (4/27) of the articles focused on Hispanic participants, and 33% (9/27) included both. Most articles addressed 3 of the 4 self-management behaviors: medication (17/27, 63%), physical activity (17/27, 63%), and diet (16/27, 59%). Only 15% (4/27) of the studies focused on follow-up appointment attendance. All the articles investigated HIT for use at home, whereas 7% (2/27) included use in the hospital.

Conclusions

This study addresses a key gap in research that has not sufficiently examined what technology designs and capabilities may be effective for underserved populations in promoting health behavior in concordance with recommendations.