Chronic disease management for diabetes: Baylor Health Care System's coordinated efforts and the opening of the Diabetes Health and Wellness Institute

Solid lipid nanoparticles: a promising tool for insulin delivery

INTRODUCTION

Insulin plays a critical role in metabolism modulation including carbohydrate, lipid, and protein metabolism. There is room to improve insulin delivery but optimizing the best carrier remains challenging. Traditional and conventional approaches for insulin delivery do not emulate the normal fate of insulin release in the body. Despite extensive research attempts to overcome this and other challenges, the goal of achieving optimal insulin delivery that emulates the natural system remains unresolved.

AREAS COVERED

Solid Lipid Nanoparticles (SLNs) may provide a solution, because they are nontoxic, biocompatible, and straightforward to formulate thus providing a promising platform for achieving targeted and controlled delivery of various therapeutic agents. This review aims to provide an overview on the suitability and application of SLNs for insulin delivery. A special emphasis is placed on the biopharmaceutical aspects of insulin loaded SLNs which have not been explored in detail to date.

EXPERT OPINION

SLNs have proven to be safe and versatile drug delivery systems suitable for insulin delivery and capable of improving the efficacy and pharmacokinetic profile of encapsulated insulin. There is still some work to be done to fully explore SLNs' true potential as drug delivery and specifically insulin delivery vehicles suitable for clinical use.

Single-Droplet Multiplex Bioassay on a Robust and Stretchable Extreme Wetting Substrate through Vacuum-Based Droplet Manipulation

Herein, a droplet manipulation system with a superamphiphobic (SPO)-superamphiphilic (SPI) patterned polydimethylsiloxane (PDMS) substrate is developed for a multiplex bioassay from single-droplet samples. The SPO substrate is fabricated by sequential spraying of adhesive and fluorinated silica nanoparticles onto a PDMS substrate. It is subsequently subjected to oxygen plasma with a patterned mask to form SPI patterns. The SPO layer exhibits extreme liquid repellency with a high contact angle (>150°) toward low surface tension and viscous biofluidic droplets (e.g., ethylene glycol, blood, dimethyl sulfoxide, and alginate hydrogel). In contrast, the SPI exhibits liquid adhesion with a near zero contact angle. Using the droplet manipulation system, various liquid droplets can be precisely manipulated and dispensed onto the predefined SPI patterns on the SPO PDMS substrate. This system enables a multiplex colorimetric bioassay, capable of detecting multiple analytes, including glucose, uric acid, and lactate, from a single sample droplet. In addition, the detection of glucose concentrations in a plasma droplet of diabetic and healthy mice are performed to demonstrate the feasibility of the proposed system for efficient clinical diagnostic applications.

New Roles for Medical Assistants in Innovative Primary Care Practices

OBJECTIVE

To identify and describe new roles for medical assistants (MAs) in innovative care models that improve care while providing training and career advancement opportunities for MAs.

DATA SOURCES/STUDY SETTING

Primary data collected at 15 case study sites; 173 key informant interviews and de-identified secondary data on staffing, wages, patient satisfaction, and health outcomes.

STUDY DESIGN

Researchers used snowball sampling and screening calls to identify 15 organizations using MAs in new roles. Conducted site visits from 2010 to 2012 and updated information in 2014.

DATA COLLECTION/EXTRACTION METHODS

Thematic analysis explored key topics: factors driving MA role innovation, role description, training required, and wage gains. Categorized outcome data in patient and staff satisfaction, quality of care, and efficiency.

PRINCIPAL FINDINGS

New MA roles included health coach, medical scribe, dual role translator, health navigator, panel manager, cross-trained flexible role, and supervisor. Implementation of new roles required extensive training. MA incentives and enhanced compensation varied by role type.

CONCLUSIONS

New MA roles are part of a larger attempt to reform workflow and relieve primary care providers. Despite some evidence of success, spread has been limited. Key challenges to adoption included leadership and provider resistance to change, cost of additional MA training, and lack of reimbursement for nonbillable services.