Future Science OA最新文献

Background: To evaluate the efficacy and safety of chemo-immunotherapy combined with residual lesions irradiation of advanced stage esophageal squamous cell carcinoma.

Methods: Treatment-naïve patients with radiologically and histologically confirmed advanced or metastatic squamous-cell esophageal carcinoma were enrolled. Participants received four cycles of the TP regimen combined with the PD-1 inhibitor sintilimab. Patients who completed four cycles of chemo-immunotherapy with stable disease (SD) or partial response (PR) subsequently received 50 Gy of radiation in 25 fractions for residual tumors. Maintenance sintilimab therapy was administered every 21 days for up to 31 cycles or until disease progression or intolerable toxicity occurred.

Results: A total of 39 patients were enrolled in this study, of whom 30 were evaluable for efficacy and toxicity. The complete response (CR) rate was 6.7% (2/30), the partial response (PR) rate was 53.3% (16/30). The median depth of response (DpR) was 34.5% for chemo-immunotherapy and increased to 64.0% after radiotherapy. The progression-free survival (PFS) was 16.4 months, while overall survival (OS) has not yet been reached.

Conclusions: Chemo-immunotherapy followed by radiotherapy for residual tumors and maintenance sintilimab, demonstrated high response rates, prolonged PFS, and tolerable toxicity as a first-line treatment for patients with advanced or metastatic esophageal squamous-cell carcinoma.

Objectives: Global concerns were focused on the improper disposal of unwanted medications and using out-of-date medicines. This study aims to assess pharmacists' knowledge, attitudes, and practices regarding this issue, recognizing the role pharmacies can play as local collection points for the safe disposal of unwanted medications.

Methods: A cross-sectional study design including a random sample of 603 pharmacists responded to the questionnaire via face-to-face interview. Multivariate logistic regression models determined significant factors affecting the knowledge, attitudes, and practices of pharmacists.

Results: The levels of knowledge, attitudes, and practices were generally low. Only 32.8% showed good knowledge, 17.7% had positive attitudes, and 32% exhibited good practices. Certain demographic factors were positively associated with higher levels of knowledge, attitudes, and practices. These include male pharmacists, longer duration of experience, working in a chain pharmacy, working as a chief pharmacist, and receiving training about environmental impact and waste management.

Conclusion: This study illustrated serious gaps in knowledge and practices among community pharmacists in the United Arab Emirates regarding medicines waste reduction. Despite awareness, nearly half had poor knowledge, and best practices were inconsistently implemented. Proper educational campaigns and courses, comprehensive training, and policy interventions are essential to address these gaps.

Aims: Ficus vasta Forssk. is a valuable but relatively less explored medicinal and edible plant. This study focused on analyzing the biochemical properties, molecular docking, and ADMET profiling of its n-hexane extract (NHFV).

Materials and methods: Phytochemical screening was performed using GC-MS and total bioactive content assays (TPC, TFC, and TTC). Antioxidant potential (NOS and TAC), antiurease, antityrosinase, and hemolytic activities were also assayed. Molecular docking was performed for GC-MS identified ligands against urease and tyrosinase. ADMET investigation was performed to assess drug-likeness and safety profiles.

Results: NHFV showed significant concentration of TPC (48.01 ± 0.73 mg GA.Eq.g^-1), TFC (65.33 ± 0.67 mg QU.Eq.g^-1), and TTC (3.45 ± 0.31 mg TA.Eq.g^-1). GC-MS analysis identified 43 phytochemicals. Antioxidant assays revealed 91.34 ± 0.86 mg AA.Eq.g^-1 NOS and 72.90 ± 0.10 mg AA.Eq.g^-1 TAC activity. The extract showed 4.64 ± 0.08% hemolysis, 60.20 ± 1.39% urease, and 75.61 ± 0.64% tyrosinase inhibition. Docking results revealed Cycloartenol (-8.2 kcal/mol) and Lupeol acetate (-8.3 kcal/mol) as potent inhibitors, surpassing standard agents.

Conclusion: NHFV possesses prominent antioxidant, antiulcer, and skin-whitening potential. Molecular docking and ADMET data support its therapeutic relevance and potential for future drug design.

Artificial intelligence (AI) has demonstrated remarkable potential in transforming medical diagnostics across various healthcare domains. This paper explores AI applications in cancer detection, dental medicine, brain tumor database management, and personalized treatment planning. AI technologies such as machine learning and deep learning have enhanced diagnostic accuracy, improved data management, and facilitated personalized treatment strategies. In cancer detection, AI-driven imaging analysis aids in early diagnosis and precise treatment decisions. In dental healthcare, AI applications improve oral disease detection, treatment planning, and workflow efficiency. AI-powered brain tumor databases streamline medical data management, enhancing diagnostic precision and research outcomes. Personalized treatment planning benefits from AI algorithms that analyze genetic, clinical, and lifestyle data to recommend tailored interventions. Despite these advancements, AI integration faces challenges related to data privacy, algorithm bias, and regulatory concerns. Addressing these issues requires improved data governance, ethical frameworks, and interdisciplinary collaboration among healthcare professionals, researchers, and policymakers. Through comprehensive validation, educational initiatives, and standardized protocols, AI adoption in healthcare can enhance patient outcomes and optimize clinical decision-making, advancing the future of precision medicine and personalized care.

Chemotherapy, especially for malignant tumors, can affect the thymus, leading to its atrophy and a decreased production of naïve T lymphocytes. However, regenerative process can occur in children and rarely in adults manifesting as thymic hyperplasia. A 49-year-old female patient was diagnosed with stage I breast cancer. She was treated with surgery, adjuvant chemotherapy followed by radiotherapy and hormonotherapy. Follow-up computed tomography scan showed a mediastinal retro-sternal mass, raising concern for tumor recurrence. However, no other signs of relapse were evident. A thymic rebound was suspected, with the lesion presenting as a triangular-shaped mediastinal mass suggestive of thymic morphology and consisting of mixed fat and soft tissue density with smooth borders. Close monitoring was then decided. A follow-up CT scan of the chest showed regression of the mediastinal mass. The diagnosis of thymic rebound after chemotherapy was then retained. The patient is currently in remission, seven years from her original diagnosis of breast cancer. Thymic hyperplasia after chemotherapy can rarely occur in adults. Clinicians should be aware of this unusual presentation to prevent needless investigation and therapy.

Background: The recruitment of underrepresented racial and ethnic groups in clinical trials remains a challenge.

Methods: The ClinicalTrials.gov database was queried for phase III trials related to non-Hodgkin lymphoma (NHL), leukemia, and multiple myeloma (MM). A reference population was sourced from the Surveillance, Epidemiology, and End Results (SEER) database.

Results: A total of 53,821 pooled participants from 119 phase III trials were included in the analyses. Race and ethnicity data were reported in 95.8% and 81.5% of trials, respectively. Globally, the majority of participants were predominantly White (77.3%), followed by Asian (8.2%), Black/African American (5.4%), American Indian/Alaska Native (0.4%), and Native Hawaiian/Other Pacific Islander (0.2%), while Hispanic/Latino individuals constituted 11.0% of trial participants. In comparison to data in SEER, the proportions were lower for Asian/Pacific Islander and Hispanic/Latino across all cancers, and for Black/African American and American Indian/Alaska Native in leukemia and MM in US only trials.

Conclusions: Despite progress, reporting and representation of non-White population remain insufficient in trials. Innovative strategies to enhance representation in trial enrollment are warranted, as well as the utilization of real-world data to establish recruitment goals by more effectively assessing the demographic and geographic distribution of target patient populations.

Background: This study incorporates Fitbit wearable sensor technology into a mobile application named Cancer Wellness Program (CWP) for patient monitoring. The objective of this study is to explore the experiences of healthcare providers in using the CWP application for managing symptoms of people with cancer and in delivering health education programs. Methods: A qualitative study design with a purposive sampling approach was employed, using a structured, in-depth interview method to involve 15 healthcare workers. Results: Key features of the CWP application include a patient education platform, a dashboard to monitor patient health data and learning progress, and interactive communication between the two parties. Multiple advantages of this application were identified by healthcare providers, namely user-friendliness, data aggregation and personalization. Conclusion: Despite minor technical drawbacks, the CWP application proves to be a powerful assistant for healthcare providers to optimize patient care.

Objective: This study assesses the cost-effectiveness of carfilzomib plus lenalidomide and dexamethasone (KRd) versus ixazomib plus lenalidomide and dexamethasone for relapsed and refractory multiple myeloma (RRMM) in China.

Methods: A survival model was used to analyze health states and costs over a lifetime, with a 4-week cycle. Treatment effects on progression-free survival (PFS) and overall survival (OS) were modeled using hazard ratios (HRs) derived from the network meta-analysis (NMA). Health state utility values and disutility values for adverse events were obtained from published literature. Direct medical costs included drug costs, disease management costs, and costs associated with adverse event management. Costs and utilities were discounted by 5% annually. Both one-way and probabilistic sensitivity analyses were conducted.

Results: The carfilzomib combination was found to be cost-effective, saving $127,513.22 per additional quality-adjusted life year (QALY) gained compared to the ixazomib combination. Sensitivity analysis showed that ixazomib's price, progression state utility, and carfilzomib's price significantly affected the results. At a $40,023.27 willingness-to-pay (WTP) threshold, the carfilzomib combination has a 100% probability of being cost-effective.

Conclusions: The study shows that, based on evidence from indirect comparisons, KRd is a cost-effective treatment option for RRMM patients in China.

Background: The intelligent decision support system (IDSS) is designed for patients to acquire hearing aids that better meet their needs, because they often agree to pay from their funds for a better, more customized hearing aid.

Objective: The article aims to present the IDSS for selecting personal hearing aids in healthcare institutions.

Methods: The article proves that the SAW (simple additive waiting) multi-criteria evaluation method is the most suitable for creating the IDSS. Hearing aids are evaluated according to 12 reasonable criteria, which are differentiated into two groups. The proposed methodology is flexible, allowing for changing the significance of differentiated criteria groups.

Results: The created IDSS system helps increase the effectiveness of choosing the best hearing aid. Even 92% of the surveyed patients positively evaluated the choice of hearing aid. This situation indicates greater patient satisfaction than usual when selecting these measures.

Conclusion: The proposed IDSS is suitable for adaptation in a computer program, and such a solution greatly facilitates the selection of a hearing aid. Applying the proposed IDSS makes the choice more objective, thus better meeting patients' needs.