Future Science OA最新文献

Cocaine can trigger severe splanchnic vasoconstriction and non-occlusive mesenteric ischemia, occasionally mimicking common surgical emergencies. A previously healthy 27-year-old woman presented with 5 days of worsening right lower quadrant pain, nausea, and fever. CT suggested appendicitis. Laparoscopy revealed a normal appendix but ischemic ileum and cecal gangrene, requiring conversion to laparotomy and ileocecal resection with stoma. Histopathology showed transmural ischemic necrosis without vascular occlusion. Postoperatively, the patient disclosed recent cocaine use. Cocaine-related ischemia often affects young adults without vascular risk factors, may be radiologically subtle, and carries higher mortality when diagnosis is delayed. In young adults with unexplained acute abdomen, clinicians should consider cocaine-associated ischemia and obtain toxicology screening when the etiology is unclear, enabling timely management and improved outcomes.

Background: A rapid, simple, accurate, and robust reverse-phase high-performance liquid chromatography (RP-HPLC) method was developed to quantify curcumin and dexamethasone in polymeric micelle nanoparticle formulations simultaneously.

Methods: The optimized chromatographic conditions involved a Universal HS C18 column, isocratic elution with a methanol: acidic water (pH 3.5, 80:20, v/v) mobile phase, and detection wavelengths of 425 nm for curcumin and 254 nm for dexamethasone. The developed method was subsequently validated according to ICH guidelines, and demonstrated excellent linearity (R² > 0.999), precision (RSD% < 2%), and accuracy (mean recovery was 98.7% for curcumin and 101.7% for dexamethasone).

Results: The limits of detection (LOD) were 0.0035 mg/mL for curcumin and 0.0029 mg/mL for dexamethasone, while limits of quantification (LOQ) were 0.0106 mg/mL for curcumin and 0.0088 mg/mL for dexamethasone, respectively. The method was applied to evaluate the encapsulation efficiency (EE%) of curcumin and dexamethasone into polymeric micelle nanoparticles formulated using Soluplus^® and DOPE in a 1:10 molar ratio. EE% values were 78.84 ± 0.05% for curcumin and 54.33 ± 0.05% for dexamethasone.

Conclusions: the current developed method indicates suitability for the simultaneous determination of curcumin and dexamethasone, thereby facilitating the quality control and optimization of such advanced drug delivery systems.

Infertility poses a significant global health burden, especially in cases where diminished ovarian reserve and endometrial injury limit the success of standard assisted reproductive technology treatments. Platelet-Rich Plasma (PRP) have gained attention as novel regenerative tool and adipose-derived stem cells (ADSCs) has recently gained lots of interest owing to their easy availability, multipotent characteristics, and paracrine activity. The combination of PRP and ADSCs acts better than each one individually and acts synergistically to promote tissue regeneration. This review addresses studies on the application of PRP and ADSCs in reproductive medicine, specifically targeting ovaries and uterus. In ovaries, ADSCs and PRP demonstrated potential for functional recovery in premature ovarian insufficiency, early menopause, and chemotherapy-induced ovarian damage, showing menstrual restoration, hormonal normalization, and stimulation of follicle growth. ADSC-derived exosomes and conditioned medium promoted oocyte maturation, lowered oxidative stress, improved blastocyst development, and increased embryo survival. Additionally, findings indicate that intrauterine delivery of ADSCs and PRP enhances endometrial thickness, angiogenesis, and receptivity, with reports of improved implantation and pregnancy outcomes in women with thin endometrial lining or Asherman's syndrome. Collectively, these results underscore the regenerative promise of ADSCs and PRP in overcoming various infertility causes.

Monkeypox has reemerged as a major global public health threat, with 2024 witnessing the rise of Clade Ib, a new, more transmissible and potentially severe variant. This review analyzes recent outbreaks, uncovering how Clade Ib has accelerated human-to-human and zoonotic spread, increasing case counts across both endemic and non-endemic regions. The study synthesizes current evidence on the virus's evolving epidemiology, diagnostic advances such as CRISPR and PCR techniques, and progress in vaccine development, focusing on JYNNEOS and ACAM2000. Despite these advancements, significant challenges persist, including timely diagnosis and equitable vaccine access, particularly in low-resource settings. Our findings underscore the importance of sustained genomic surveillance, integrative One Health strategies that unite human, animal, and environmental health data, and robust global collaboration. Addressing these gaps is vital for curbing monkeypox and preparing for future zoonotic threats.

Background: Spirometry is essential for diagnosing and managing respiratory diseases. Accurate interpretation relies on reference equations that reflect population-specific lung function. Global equations, such as those from the Global Lung Function Initiative (GLI), may not suit all populations, including Iraqis.

Objective: To develop sex-specific spirometric reference equations for healthy Iraqi adults using machine learning (ML) and compare their performance with the GLI 2012 and 2022 equations.

Methods: This cross-sectional study included 3,959 healthy, nonsmoking Iraqi adults aged ≥18 years. Spirometry was performed per ATS/ERS guidelines. Five ML models (linear regression, random forest, support vector machine, gradient boosting machine (GBM), and k-nearest neighbors) were trained using age and height. Data were split into training (70%) and validation (30%) sets. Performance was assessed using RMSE, R², and z-score calibration. GBM was selected as the best model.

Results: GBM outperformed all other models and GLI equations. In females, R² was 0.4473 for FEV₁ and 0.4519 for FVC; in males, 0.3509 and 0.3674, respectively. GLI equations underestimated lung volumes, while GBM predictions were well calibrated with mean z-scores near zero.

Conclusion: GBM-derived equations show improved accuracy and calibration over GLI standards for Iraqi adults, offering a more suitable tool for spirometry interpretation.

Aim: Predict Hemoglobin A1c (HbA1c) trends, a key metric in diabetes mellitus (DM) management, using readily available patient variables and language models (LMs).

Methods: We propose GLM (Language Model Boosted Neural Network) -DM, which leverages data augmentation and language model-driven feature encoding to predict HbA1c trends using easily accessible patient-level variables. Our model captures complex relationships among patient characteristics and enhances predictive performance through Generative Adversarial Networks (GANs) for synthetic data augmentation and LMs for feature embedding. By transforming patient profiles into rich latent representations, our approach enables a more comprehensive analysis of how patient-level variables correlate with HbA1c trends over time.

Results: Using clinical data from 257 DM patients, GLM-DM achieves 70.2% accuracy of HbA1c trend prediction, outperforming classic classifiers and transformer-based models. Ablation studies confirm the effectiveness of GAN-based augmentation and LM-driven embedding. Our model achieves 68.2% prediction accuracy for Type 1 DM and 72.7% for Type 2 DM.

Conclusion: Proposed approach learns the underlying complex function of HbA1c using clinical variables easily available at the patient visit and leveraging the power of LMs to accurately predict the trend of HbA1c in a period. The model can enhance patient advisories for daily diabetes management without the need for continuous glucose monitoring.

Triple overlap syndrome involving autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) is an exceptionally rare autoimmune hepatopathy, posing major diagnostic and therapeutic challenges. A 51-year-old woman initially diagnosed with AIH-PBC overlap presented persistent hepatocellular cytolysis despite corticosteroids and ursodeoxycholic acid. Autoimmune screening revealed ANA, anti-M2, and anti-gp210 positivity. Repeat liver biopsy showed interface hepatitis, ductopenic lymphocytic cholangitis, and periductal fibrosis. Magnetic resonance cholangiography demonstrated an attenuated intrahepatic biliary tree with a "pruned-tree" appearance, confirming PSC features. The diagnosis of AIH-PBC-PSC triple overlap was established. Due to azathioprine intolerance and hepatotoxicity, therapy was switched to mycophenolate mofetil with UDCA and low-dose corticosteroids, resulting in biochemical stabilization. This case represents one of the few well-documented instances of AIH-PBC-PSC overlap. It underscores the importance of integrating serology, histology, and advanced imaging for accurate diagnosis and individualized therapy. In the absence of standardized guidelines, management relies on tailored immunosuppression and supportive care to prevent progression toward liver failure.

Computer Vision Syndrome is a growing health concern in the digital age, with a reported prevalence of 69.0%. It is caused by screen-related, environmental, ergonomic, and physiological factors, affecting diverse demographics. The COVID-19 pandemic significantly amplified CVS due to increased screen time for remote work, online learning, and social media use, with studies reporting symptoms in up to 74% of individuals. Unique visual challenges from digital screens, including reduced clarity and glare, exacerbate symptoms like dry eyes and discomfort, especially in those with uncorrected vision. Understanding CVS is crucial for mitigating its impact through effective prevention and management strategies. This study explores the causes, diagnosis, management, and prevention strategies of CVS by synthesizing recent findings from optometry, occupational health, digital health, and ergonomics. It also highlights emerging trends such as AI, wearables, and augmented reality while providing practical management strategies. A narrative review of literature from 2014 to 2024 was conducted, focusing on PubMed-indexed, peer-reviewed articles, including meta-analyses and systematic reviews, with priority given to recent, highly cited studies.

This review explores the potential of polymeric nanoparticles (PNPs) as targeted drug delivery systems for arthritic treatment, overcoming the limitations of the present therapy. A thorough literature search was conducted on the databases PubMed, Scopus, and Web of Science to find published articles on the use of polymeric nanoparticles in the treatment of arthritis. This includes synthesis methods, mechanisms in drug delivery, and applications of PNPs. Polymeric nanoparticles showed excellent promise in the management of arthritis through enhanced stability of drugs, controlled and sustained drug release, and reduced systemic side effects. Some of the highlighted biocompatible and targeting capabilities of natural and synthetic polymers include chitosan, hyaluronic acid, and PLGA. Bioactive compounds such as curcumin and resveratrol delivered by PNPs enhanced therapeutic efficacy in preclinical arthritis models. Despite their promise, challenges such as rapid clearance and manufacturing scalability remain critical barriers. Polymeric nanoparticles offer a transformative approach to arthritis management by enabling targeted, sustained, and safe drug delivery. Translation into clinical applications would thus require developments in nanoparticle design, personalized medicine, and scalable production techniques.

Chimeric Antigen Receptor (CAR)-T cell therapies, as potentially curative treatments, are a group of immunotherapy agents that are changing the paradigm for the treatment of hematologic malignancies. Ongoing research on CAR-T cell therapy is expected to expand the currently approved indications, which, given the high prices of these innovative therapeutic solutions, will increase the pressure on the sustainability of health systems, enhancing the need to establish adjusted financial solutions and promote the implementation of post-marketing monitoring procedures. This study examines the specific challenges in the development of robust clinical evidence to support the value measurement and cost-effectiveness assessment of CAR-T cell therapies and in the selection of adequate financing solutions. Managed Entry Agreements, which create mechanisms in which the risk associated with the uncertainty in long-term outcomes of these therapies is shared between the manufacturer and the payer, have emerged as preferred solutions in several European Union countries. The access barriers to CAR-T cell therapies are described, and recommendations on potential solutions to address affordability concerns using a framework of a life cycle approach to value assessment involving different stakeholders and adapted financing tools are proposed.