Search Results (386)

The environment of today’s companies is marked by increasing dynamism. Rapid technological developments, strong innovation impulses, and continual market entry of new competitors create volatile conditions that make the delivery of valuable products challenging. Long-term corporate success therefore depends on offering a product portfolio consistently aligned with evolving market needs. Customers expect products that show continuous improvements in performance and functionality over time, making systematic product upgrading a key success factor. Release planning addresses this need by enabling continuous product evolution through planned product upgrades. It focuses on selecting and combining functional units for structured publication within releases. This proactive management of product value offers substantial potential but also demands comprehensive know-how, particularly given rising product complexity and the interplay of multiple technologies. The objective of this work is to develop a methodology that supports effective planning of product upgrades. The method assists in the product-specific selection of release types and the derivation of suitable release strategies. It yields release units defined by product structure and provides recommendations for appropriate release strategies. The methodology is demonstrated through its application to an electric vehicle, illustrating its practical relevance for software-intensive products. Full article

This paper addresses the challenges of improving last-mile logistics delivery satisfaction in urban areas by studying a multi-trip vehicle routing problem with multiple delivery locations (MTVRPMDL). The MTVRPMDL simultaneously decides the visiting order of customers for each vehicle and selects an appropriate delivery location for every customer. The problem exhibits intrinsic spatial and decision symmetries, arising from interchangeable vehicle trips, alternative delivery locations for each customer, and symmetric route permutations that lead to equivalent operational outcomes. A mixed-integer programming model is proposed, aiming to minimize the total vehicle travel time. Within an iterated local search framework, a modified Solomon greedy insertion heuristic suitable for multi-delivery address and multi-trip settings is developed to generate initial solutions. During the iterative search phase, Or-opt and Relocate local search operators are employed, together with random swap perturbations, to enhance solution exploration. Computational experiments confirm the efficiency of the proposed model and algorithm, showing that allowing customers to have multiple delivery locations can significantly reduce overall travel time and improve the flexibility of vehicle routing decisions. Full article

Lung cancer in never-smokers (LCINS) represents a distinct clinical entity driven by dominant oncogenic alterations and characterized by a low tumor mutational burden. Although tyrosine kinase inhibitors (TKIs) achieve high initial response rates, their long-term efficacy is limited by suboptimal pharmacokinetics, restricted central nervous system (CNS) penetration, tumor microenvironment barriers, and acquired resistance. In this review, we critically assess the current state of nanotechnology-assisted drug delivery systems for LCINS, with a primary focus on how rationally designed nanocarriers can overcome biological barriers, enable molecular subtype-specific therapeutic strategies, and address mechanisms that limit clinical efficacy and durability of response. We conducted a structured literature search using PubMed and Web of Science (January 2022 to November 2025), focusing on primary studies reporting the preparation, physicochemical properties, and therapeutic performance of nanocarriers in in vitro and in vivo models, as well as available pharmacokinetic and clinical data. LCINS is characterized by inefficient vasculature, high extracellular matrix density, active efflux transporters, and immunosuppressive niches, and is frequently complicated by brain metastases. Nanocarrier-based platforms can enhance aqueous solubility, prolong systemic circulation, and improve tumor or CNS targeting. Co-delivery systems combining TKIs with nucleic acid-based therapeutics, together with stimuli-responsive platforms, offer the potential for simultaneous modulation of multiple oncogenic pathways and partial mitigation of resistance mechanisms. In summary, nanotechnology provides a promising strategy to improve both the efficacy and specificity of targeted therapies in LCINS. Successful clinical translation will depend on biologically aligned carrier–payload combinations, scalable and reproducible manufacturing processes, and biomarker-guided patient selection. Full article

Background/Objectives: Older adults often face nutrition challenges due to mobility issues, chronic conditions, and limited access to adequate nutrition. Digital and technology-based interventions, including those with nutrition education, nutrition counseling and Medically Tailored Meals [MTMs], can help address these barriers. However, the extent and characteristics of such programs in the United States remain unclear. This scoping review aimed to map the existing evidence on digital and technology-based (“digi-tech”) nutrition interventions for older adults in the United States, with particular attention to the presence, characteristics, and gaps related to MTMs. Methods: This scoping review followed the PRISMA-ScR framework to map existing evidence on technology-enabled nutrition care interventions for older adults aged ≥ 60 years in the United States. Systematic searches were conducted across multiple databases, yielding 18,177 records. Following title and abstract screening, full-text review, and eligibility assessment, 16 intervention studies were included. Study designs comprised randomized controlled trials, quasi-experimental and non-randomized studies, mixed-methods feasibility studies, pilot studies, and one retrospective longitudinal cohort study. Data were extracted on study design, population characteristics, intervention components, technology modalities, outcomes, feasibility, acceptability, and reported barriers. Results: Interventions varied in duration [8 weeks to ≥12 months] and content. Foci ranged from remote nutrition education and mobile app-based tracking to multicomponent interventions integrating exercise, nutrition counseling, health literacy, and meal delivery. Telehealth was the most commonly used technology modality, followed by mobile health applications, wearable devices, and online educational platforms. Most interventions reported high feasibility and acceptability, with improvements in diet quality, adherence to healthy eating patterns, clinical measures such as HbA1c and blood pressure, and functional performance. Common implementation barriers included declining technology use over time, digi-tech literacy, and access to devices or the internet. Notably, no studies evaluated a digi-tech-based MTMs intervention exclusively for older adults in the U.S. Conclusions: Digital and technology-based nutrition interventions show promise for improving dietary and health outcomes in older adults, but there is insufficient empirical evidence. Future research might develop and evaluate hybrid digi-tech intervention models that leverage the potential of digi-tech tools while addressing barriers to technology adoption among older adults. Full article

Background/Objectives: In England, gay, bisexual, and other men who have sex with men (GBMSM) are eligible for vaccination at NHS sexual health services, including human papillomavirus (HPV), hepatitis A virus (HAV), and hepatitis B virus (HBV) vaccines. However, current research shows limited understanding of the factors influencing vaccination uptake among GBMSM. This study aimed to examine the barriers and facilitators affecting the offer and uptake of these vaccination programmes. Methods: A qualitative interview study following the Person-Based Approach (a systematic method for developing and optimising health interventions) involving GBMSM and sexual health service staff from two regions of England. Purposive sampling aimed to include GBMSM with diverse backgrounds and engagement with sexual health services. Patient and public involvement shaped the study design and interview topic guides. The interviews were recorded, transcribed, and thematically analysed to identify barriers and facilitators which were interpreted using the COM-B model of behaviour change. Results: Twenty GBMSM and eleven staff took part. The findings showed that opportunistic delivery of HPV, HAV, and HBV vaccination within sexual health services is mostly acceptable and feasible for GBMSM and staff, while also highlighting areas for optimization. Despite low knowledge of these viruses and their associated risks, willingness to be vaccinated was high, with healthcare provider recommendations and the convenience of vaccine delivery during routine clinic visits acting as important facilitators. However, the reach of opportunistic models was limited, particularly for individuals underserved by sexual health services or disengaged from GBMSM social networks. System-level barriers such as complex vaccine schedules (particularly when multiple schedules are combined), inconsistent access to vaccination histories, and limited system-level follow-up processes (e.g., automated invites and reminders) were also found to act as obstacles to vaccination uptake and delivery. Conclusions: To improve equitable uptake, sexual health services should explore the feasibility of addressing both individual and structural barriers through additional strategies, including targeted and persuasive communication to increase knowledge, leveraging regular contact with GBMSM to promote uptake, and implementing enhanced approaches to support vaccination completion (e.g., automated prompts or reminders). Full article

Cancer remains one of the most prominent global health concerns, posing a substantial threat to public health. Millions of people die from cancer each year, and many cancer types remain incurable at present. Conventional cancer treatments, including surgery, chemotherapy, radiotherapy, and immunotherapy, often fail to achieve optimal clinical outcomes and are frequently associated with severe trauma and adverse effects. Consequently, there is an urgent need to develop novel therapeutic strategies to address these limitations. Hydrogels have been widely utilised as platforms for loading drugs, proteins, DNA, and stem cells in biomedical tissue repair and cancer therapy. Through modification of their physicochemical properties and functions, hydrogels can be endowed with responsiveness to multiple stimuli. In recent years, stimuli-responsive hydrogels (also known as smart-responsive hydrogels), as novel drug delivery systems, have demonstrated remarkable efficacy in cancer treatment. Stimuli-responsive hydrogels are capable of altering their mechanical properties, swelling behaviour, hydrophilicity, bioactivity, and molecular permeability in response to endogenous stimuli (including pH, ROS, and temperature) and exogenous stimuli (including light, ultrasound, and magnetic fields). This review highlights recent advances and applications of responsive hydrogels triggered by endogenous stimuli (including pH, ROS, and temperature) and exogenous stimuli (including light, ultrasound, and magnetic force) in cancer drug delivery and treatment. Finally, the current application limitations and future prospects of smart-responsive hydrogels are summarised. Full article

Next-generation therapeutic devices will rely on an intelligent integrated system that consolidates multiple functions into a single platform. These individual chemical components exhibit diverse physicochemical properties, demonstrating multifunctional characteristics. In this review, we focus on how the distinctive properties of upconversion nanoparticles (UCNPs), achieved via refined preparation methods, unlock novel functionalities in biomedical applications. Specifically, features such as near-infrared excitation, deep-tissue penetration, low autofluorescence, and tunable multicolor emission endow UCNPs with substantial potential in fields including deep-tissue imaging, targeted drug delivery, and photodynamic therapy. This article systematically reviews recent advances in the design and functionalization of UCNPs, elucidating their role in facilitating the development of integrated diagnostic and therapeutic platforms and fostering the establishment of intelligent responsive treatment systems. Finally, we address current technical challenges—including uniformity in large-scale production, long-term biosafety, and in vivo metabolic mechanisms—and provide insights into future interdisciplinary integration, clinical translation pathways, and their potential role in personalized medicine. Full article

This paper proposes a process-aware, tag-based digital identity framework that enhances interoperability while enabling identity unlinkability and selective disclosure across multi-party workflows involving sensitive data. We realize this framework within the self-sovereign identity (SSI) paradigm, employing zk-SNARK–based zero-knowledge proofs to enable verifiable identity authentication without plaintext disclosure. The framework introduces a protocol-tagging mechanism to support multiple proof systems within a unified architecture, thereby enhancing SSI scalability and interoperability. Its core innovation lies in combining identity unlinkability and process-driven data disclosure: derived sub-identities mitigate identity-linkage attacks, while layered encryption enables selective, stepwise decryption of sensitive information (e.g., delivery addresses), ensuring participants access only the minimal information necessary for their tasks. In addition, zero-knowledge proof-based verification guarantees that the validation of derived sub-identities can be performed without sharing any plaintext attributes or identifying factors. We applied the framework to logistics, where sub-identities anonymize participants and layered encryption allows for delivery addresses to be decrypted progressively along the logistics chain, with only the final courier authorized to access complete information. During the parcel receipt process, users can complete verification using derived sub-identities and zero-knowledge proofs alone, without disclosing any real personal information or attributes that could be linked back to their identity. Trusted Execution Environments (TEEs) ensure the authenticity of decryption requests, while blockchain provides immutable audit trails. A demonstration system was implemented, formally verified using Scyther, and performance-tested across multiple platforms, including resource-constrained environments, showing high efficiency and strong practical potential. The core paradigms of identity unlinkability and process-driven data disclosure are generalizable and applicable to multi-party scenarios involving sensitive data flows. Full article

Background/Objectives: A neonatal intensive care units (NICU) admission of a premature infant is lifesaving; however, it can also be emotionally devastating experiences for parents. Family-centered care (FCC) interventions are designed to support parents and infants in the NICUs by integrating families into care delivery through partnerships with healthcare professionals. Heterogeneity in outcome reporting across FCC studies limits comparability. Developing a core outcome set (COS) for FCC is essential to address this gap. Aim: The aim of this study was to explore the views of former neonatal patients, parents, and healthcare professionals who have experiences with FCC in neonatal settings and elucidate outcomes that are important to them. Methods: This study followed the Core Outcome Measures Effectiveness Trial Handbook, which suggests involving stakeholders in identifying outcomes to reflect what is important to them rather than to researchers. Nine focus group discussions were conducted with 27 international key stakeholders from multiple countries (former neonatal patient n = 1; parents n = 8; healthcare professionals n = 18), reflecting FCC experiences across different neonatal settings. Data were analyzed using a modified framework analysis. Findings: Five outcome domains were identified including 42 distinct outcomes: (1) Emotional functioning/wellbeing of parents, infants, and healthcare professionals, reflecting emotional responses to a NICU admission of an infant; (2) Role functioning of parents, healthcare professionals, and others, highlighting that FCC strengthens their roles; (3) Delivery of care, highlighting the role of staff attitudes and organizational factors in supporting FCC; (4) Physiological health, reflecting infant physical health; (5) Hospital environment and resource use, reflecting healthcare utilization outcomes. Conclusions: Participants’ experiences provide meaningful insights into outcomes that should be evaluated in neonatal research and practice. These findings will inform the development of a COS for FCC in neonatal settings. Full article

Atherosclerosis remains a leading cause of cardiovascular mortality despite advances in pharmacological and interventional therapies. Current treatment approaches face limitations including systemic side effects, inadequate local drug delivery, and restenosis following vascular interventions. Gel-based technologies offer unique advantages through tunable mechanical properties, controlled degradation kinetics, high drug-loading capacity, and potential for stimuli-responsive therapeutic release. This review examines gel platforms across multiple scales and applications in atherosclerosis research and intervention. First, gel-based in vitro models are discussed. These include hydrogel matrices simulating plaque microenvironments, three-dimensional cellular culture platforms, and microfluidic organ-on-chip devices. These devices incorporate physiological flow to investigate disease mechanisms under controlled conditions. Second, therapeutic strategies are addressed through macroscopic gels for localized treatment. These encompass natural polymer-based, synthetic polymer-based, and composite formulations. Applications include stent coatings, adventitial injections, and catheter-delivered depots. Natural polymers often possess intrinsic biological activities including anti-inflammatory and immunomodulatory properties that may contribute to therapeutic effects. Third, nano- and microgels for systemic delivery are examined. These include polymer-based nanogels with stimuli-responsive drug release responding to oxidative stress, pH changes, and enzymatic activity characteristic of atherosclerotic lesions. Inorganic–organic composite nanogels incorporating paramagnetic contrast agents enable theranostic applications by combining therapy with imaging-guided treatment monitoring. Current challenges include manufacturing consistency, mechanical stability under physiological flow, long-term safety assessment, and regulatory pathway definition. Future opportunities are discussed in multi-functional integration, artificial intelligence-guided design, personalized formulations, and biomimetic approaches. Gel technologies demonstrate substantial potential to advance atherosclerosis management through improved spatial and temporal control over therapeutic interventions. Full article

Background: Parents caring for preterm infants during hospital admission have unique needs. How these are addressed plays an important role in parents’ ability to cope with caregiving responsibilities. Educational programmes have proven beneficial to parents during their infant’s stay in the neonatal intensive care unit (NICU), for both parental and neonatal outcomes. Key components of parenting education during the NICU stay have been described; however, less is known about our understanding of parents’ educational needs, specifically in the South African context. Objectives: To explore parental needs and perceptions regarding a parenting education intervention provided to them while in the NICU, with a focus on programme content, structure, and mode of delivery. Methods: Three focus group discussions were conducted with mothers of preterm infants admitted to the NICU of a referral hospital in the North West province, South Africa. Inclusion criteria comprised parents of infants born in the hospital, singletons or multiples, with a gestational age below 37 weeks, and expected to stay in the NICU for at least 7 days. Discussions centred on mothers’ perceived needs regarding parenting education based on their experiences during their baby’s NICU admission. Results: Twenty-five mothers of singletons or multiples born before 37 weeks of gestation participated in the study. Three main themes were identified: (1) preference for content topics to include basic infant care, infant health and behaviours, and post-discharge related information; (2) education programme structure, which included instructional approaches and training logistics; and (3) support needs, including intrapersonal motivators, communication, and psychosocial and physical support. Conclusions: Participants recognised educational content needs that align with existing literature. However, they also emphasised the importance of addressing basic physical and emotional needs while receiving educational content, ensuring that parents feel empowered and capable of engaging with the information. Full article

Diabetes self-management education (DSME) programs are evidence-based interventions that improve glycemic control and self-care behaviors, yet their effectiveness may be limited by unaddressed health-related social needs (HRSN) (e.g., food insecurity, housing or utility instability, transportation barriers). This qualitative multiple case study examined the feasibility of integrating HRSN assessments into DSME delivery within three community-based organizations (CBOs) across urban and rural U.S. settings. Guided by the Consolidated Framework for Implementation Research, semi-structured interviews were conducted with 15 DSME facilitators and program leadership to identify contextual factors influencing implementation. Findings revealed that while DSME’s structured, manualized design promotes fidelity and client autonomy, it constrains responsiveness to the client’s HRSN. Facilitators expressed openness to integrating HRSN screening, particularly during intake, yet cited limited infrastructure, role clarity, and training as key barriers. CBOs were recognized as trusted, accessible spaces for holistic care, but growing expectations to address HRSN without adequate resources for referral created sustainability concerns. Participants recommended a parallel support model involving navigators or community health workers to manage HRSN screening and referrals alongside DSME sessions. Integrating HRSN assessment processes into DSME may enhance engagement, reduce attrition, and extend the reach of diabetes education to populations most affected by HRSN. However, successful implementation requires dedicated funding, workforce development, and cross-sector coordination. Findings underscore the importance of supporting CBOs as critical partners in bridging diabetes education and social care to advance whole-person, chronic disease management. Full article

Background/Objectives: Pediatric asthma remains a pressing public health issue, especially among low-income, minority children living in subsidized housing. Methods: This study employed a community-based participatory research approach to explore barriers and potential solutions for improving asthma management in this vulnerable population. Semi-structured interviews were conducted with 22 caregivers of children with asthma and 8 community health workers in Washington, DC—a city marked by high childhood asthma rates and concentrated subsidized housing. Results: Thematic analysis identified six core findings: (1) families frequently encountered multiple home environmental asthma triggers, including pests, mold, secondhand smoke, leaks, poor ventilation, and aging infrastructure; (2) healthy housing services were under implemented, often due to unresponsive landlords, inadequate inspections, and poor maintenance; (3) existing services such as pest control, mold remediation, and smoke-free policies were ineffectively implemented; (4) challenges to service delivery included difficulties faced by landlords and structural barriers tied to geography, race, and socioeconomic status; (5) substandard housing conditions contributed to residents’ feelings of powerlessness, frustration, and distrust, with some taking legal action to address persistent hazards; and (6) participants recommended stronger housing code enforcement, sustained funding for home-based environmental interventions, housing-health liaisons, strengthened landlord accountability, support for landlords to facilitate repairs, centering families’ voices, and advocacy. Conclusions: This study underscores the persistent challenges caregivers face in managing asthma triggers in subsidized housing. The findings highlight the critical need for improved housing conditions, greater landlord and housing authority accountability, and policy reforms to ensure consistent, equitable, and sustainable healthy housing services that reduce pediatric asthma disparities. Full article

Oral squamous cell carcinoma (OSCC) remains a highly prevalent and aggressive malignancy with limited improvements in survival rates. One of the major obstacles to successful treatment is the development of chemoresistance, which contributes to recurrence, metastasis, and treatment failure. This narrative review aims to integrate current evidence on the molecular and cellular mechanisms that drive chemoresistance in OSCC and to delineate how these processes converge under therapeutic pressure. A structured search was performed to identify relevant studies addressing chemoresistance in OSCC, focusing on preclinical and translational evidence. Multiple interconnected mechanisms have been implicated in driving resistance in OSCC, including epigenetic alterations, deregulated signaling pathways, cancer stem cell plasticity, epithelial–mesenchymal transition (EMT), interactions with the tumor microenvironment (TME), drug efflux mediated by ATP-binding cassette (ABC) transporters, and enhanced DNA damage response. In combination, these mechanisms support tumor persistence and limit effective antitumor immunity. Emerging strategies such as epigenetic modulators, signaling pathway inhibitors, immunomodulation, and nanomedicine-based delivery systems have shown promising results in preclinical models. By highlighting convergent resistance networks, this integrative perspective supports the rational design of combination therapies and biomarker-guided strategies aimed at overcoming chemoresistance in OSCC. Full article

This review addresses the recent advances made through various genetic engineering techniques to improve the properties of Lacticaseibacillus rhamnosus, not only for industrial applications, but also for the health-related benefits. However, due to the strict regulations on microorganisms intended for human consumption, concerning the insufficient characterization degree of the newly isolated strains and the lack of data regarding the safety of the genetically modified (GM) variants, the feasibility of bringing such L. rhamnosus strains to the market and their safety prospects were evaluated. Given their multiple in vivo functions in the contexts of synbiotic and symbiotic functionality, L. rhamnosus strains are more than classic probiotics and need furthermore attention. In the functional food context, this review highlights the impact of L. rhamnosus derived bioactives on the human gut–organ axis, pointing out recently demonstrated molecular mechanisms of action with the host’s gut microbiome to reduce the negative effects of obesity and its related metabolic disorders, as well as depression and Parkinson’s disease, as the major challenges confronting humans today. Beyond that, considering L. rhamnosus delivery and its postbiotics accessibility to consumers via functional foods, notable progress was made to enhance their stability by developing various encapsulation systems, which are also emphasized. Full article