College students often face obstacles in achieving optimal cognitive performance due to the demands of academic stress during workload and the side effects of cutting-edge media that destroy the students’ attention and cognitive skills. This study aimed to investigate the effectiveness of the adaptive moment estimation (Adam), an optimization algorithm designed for training deep learning (DL) models, assisted with brain biofeedback to enhance students’ brain synapse transportation by boosting the cognitive performance of college students. The contribution of the study is to improve the academic cognitive skills of college students by processing input data (text, and videos). The study used an electroencephalogram (EEG) headset to read attention signals as brain biofeedback combined with the Adam optimization algorithm that trained on the student attention dataset to improve cognitive performance parameters. Adam’s optimization algorithm represents the suggested deep learning model. Results improved the attention accuracy (97.51%), mental fatigue and drowsiness (3%), and precision at predicting learning performance improved by (20%) for college students trained on the Adam optimization algorithm-assisted brain biofeedback system compared with state-of-the-art models concerning the same attention dataset. The study provides evidence that combining Adam and brain biofeedback effectively boosts college students’ performance, cognitive skills and synapse transportation system.

Characterization and bioaccessibility of Fe2+-oat bran peptide chelate.

Despite efficacy of COVID-19 vaccines in preventing severe complications of infection, there remains vaccine hesitancy. We examined COVID-19 vaccine uptake and vaccine hesitancy among persons living with HIV (PWH). A nested survey was administered to women in the District of Columbia MACS-WIHS Combined Cohort Study (October 01, 2020-September 30, 2022). The survey included questions on vaccine receipt, medical mistrust, government trust, and vaccine attitudes. Sociodemographic and medical comorbidity data were collected at routine study visits. Among 254 women, 75% (n = 190) were African American/Black, and 70% (n = 178) were PWH, and 82% (n = 208) received a complete COVID-19 vaccine series. Vaccine completion rate was similar among PWH and women without HIV. The top reasons for a participant's vaccine decision were personal choice 46% (n = 113), health care provider recommendation 24% (n = 60), and family influence 31% (n = 13). Sixty-five percent (n = 159) endorsed concern about unknown vaccine side effects. The mean medical mistrust score was 32.4 (SD 3.8, range 12-60, higher scores indicate more mistrust). In adjusted analysis, older age [aOR = 1.05 (95% CI: 1 to 1.1, P = 0.032)], prior testing for COVID-19 [aOR = 3.50 (95% CI: 1.23 to 9.99, P = 0.019)], and feeling protected after being vaccinated [aOR = 4.65 (95% CI: 1.98 to 10.91, P < 0.001)] were associated with receipt of COVID-19 vaccines. There was no association between medical mistrust [aOR = 1.01 (95% CI: 0.95 to 1.06, P = 0.87)] or concerns about vaccine safety [aOR = 0.57 (95% CI: 0.26 to 1.28, P = 0.17)] and receipt of COVID-19 vaccines. Concern about potential risks associated with vaccines remains a significant challenge. Interventions emphasizing protective benefits of vaccines using shared decision making may be useful for public health campaigns.

Introduction: Breast cancer remains the most prevalent malignancy among Indonesian women, comprising approximately 30% of all cases. Most patients present in advanced stages, necessitating chemotherapy, which often causes side effects such as alopecia, nausea, and anxiety that may reduce treatment adherence. Family support plays a vital psychosocial role in enhancing motivation and compliance. Methods: This observational analytical study employed a cross-sectional design at Dr. H. Abdul Moeloek Regional General Hospital, Bandar Lampung, from June 20–30, 2025. A total of 47 breast cancer patients undergoing chemotherapy were selected through purposive sampling. Family support was assessed via a validated questionnaire, and adherence data were extracted from medical records. The Chi-square test was applied with a significance level of α = 0.05. Results: Most respondents were aged 46–60 (44.7%) and worked as housewives (55.3%). Good family support was reported by 68.1% of participants, and 72.3% demonstrated good chemotherapy adherence. Statistical analysis revealed a significant association between family support and chemotherapy adherence (p = 0.000 &lt; 0.05). Patients with strong family support consistently showed higher adherence levels. Conclusion: Family support significantly influences chemotherapy adherence in breast cancer patients. Interventions that strengthen family involvement could enhance treatment success and improve patient quality of life. Integrating psychosocial support into cancer care programs is essential to address both medical and emotional needs, thereby promoting optimal adherence and therapeutic outcomes

Elastin-like peptides for efficient and safe delivery of mRNA.

Squalene-adenosine nanoparticles enhance cardioprotection in myocardial infarction: Efficacy and mechanistic insights.

Background &amp; objective: Modified Radical Mastectomy (MRM) is typically performed under general anesthesia that often necessitates opioid administration, which can lead to side effects such as sedation, respiratory depression, and nausea. Fascial plane blocks, including the Erector Spinae Plane Block (ESPB), offer an effective analgesic alternative to opioids. This study aimed to assess the effectiveness of bi-level ESPB with either dexmedetomidine or dexamethasone as adjuvants to bupivacaine, compared with opioid-based analgesia, in patients undergoing MRM. Methods: This randomized controlled study included female cancer patients scheduled for MRM. Patients were randomized into four groups; Group D (control group) received conventional anesthesia with intraoperative morphine, and the other three groups received bi-level ESPB at T2 and T4. Group A received ESPB with 0.25% bupivacaine, Group B received ESPB with 0.25% bupivacaine and 0.1 mg/kg dexamethasone, and Group C received ESPB with 0.25% bupivacaine and 0.5μg/kg dexmedetomidine. Results: The time to first rescue morphine was significantly shorter in Group D compared with Groups A, B, and C (P &lt; 0.001). Postoperative morphine consumption was significantly higher in group D than in the other groups (P &lt; 0.001). Intraoperative fentanyl consumption was lower in Group C compared with the rest of the groups (P &lt; 0.001). Conclusions: In MRM, adding dexmedetomidine as an adjuvant to bupivacaine in ultrasound-guided bi-level ESPB showed a better analgesic profile compared to no adjuvant, dexamethasone, and conventional opioid analgesia with lower pain scores and lower intraoperative opioid consumption. However, dexmedetomidine and dexamethasone, when used as adjuvants, had a comparable effect to no adjuvant with respect to postoperative opioid consumption and the time to first analgesic administration. Keywords: Dexmedetomidine; Dexamethasone; Modified Radical Mastectomy; Analgesia; Morphine. Citation: Shehab NN, Fahmy RM, Abdelrahman AS, Omran AF, Elsabeeny WY. Analgesic efficacy of adding adjuvants to local anesthetics in bi-level erector spinae plane block for breast surgeries: a randomized controlled study. Anaesth. Pain Intensive Care 2025;29(6):787-795. DOI: 10.35975/apic.v29i6.2979. Received: April 16, 2025; Revised: August 02, 2025; Accepted: August 05, 2025

Nasal-to-brain siRNA delivery based on trace amine associated receptor for improving cognitive function.

Adjuvant endocrine therapy (AET) lowers breast cancer recurrence risk and improves overall survival. However, some women have suboptimal adherence, mainly due to difficulties coping with side effects. We identified different long-term AET adherence trajectories and investigated associated side effects. We used multisource data from the French national VICAN2 study, which interviewed women two years after breast cancer diagnosis. We measured AET adherence using the monthly proportion of days covered (PDC) over 41months (median) after enrolment in VICAN2. Group-Based Trajectory Modelling (GBTM) helped identify adherence trajectory groups. The 637 women included were categorized into three trajectories: continuous optimal adherence (70.6%), late non-adherence (19.8%), and near-simultaneous discontinuation (9.6%). The most common side effects were hot flashes (78.2%) and joint pain (74.4%). Living alone, always or regularly feeling sad or blue, not receiving chemotherapy, and switching AET were all associated with increased odds of belonging to the near-simultaneous discontinuation group. Younger age (44-54years), low household income, no contact with a social worker, not receiving chemotherapy, being first prescribed aromatase inhibitors for AET, always experiencing hot flashes, and occasionally experiencing joint pain were all associated with increased odds of belonging to the late non-adherence group. This study provides valuable insight into the dynamics of AET adherence patterns and related side effects. Identifying women who experience hot flashes and joint pain two years after diagnosis may strongly predict future non-adherence. Managing these side effects could foster long-term adherence and optimise health outcomes.

The expansion of haemophilia treatment to include non-factor prophylaxis provides new options with various benefits, risks, administration modes, and device types, necessitating trade-offs in decision-making. This study evaluated prophylactic treatment preferences of people with haemophilia and their caregivers, assessing their willingness to make trade-offs among treatment attributes. A web-based survey containing a discrete-choice experiment (DCE) was completed by adults (≥ 18 years old) and caregivers of children (aged 8-17 years) with haemophilia in the United States and United Kingdom. Participants were asked to complete 10 choice tasks, choosing their preferred prophylaxis from two hypothetical profiles defined by seven attributes. The primary analysis employed a mixed logit model, and subgroup analyses explored preference heterogeneity. Participants were 194 adults with haemophilia (US: 150; UK: 44) and 169 caregivers (US: 150; UK: 19). Avoiding daily treatment administration had the highest attribute importance among both adults and caregivers, followed by changes in annual bleeds. Participants were willing to accept an increased risk of serious side effects or developing inhibitors, or reduced efficacy in preventing annual bleeds, to switch from intravenous to subcutaneous administration. Refrigeration requirements and the need for a second treatment for breakthrough bleeds had lower importance. Participants highly value avoiding daily administration and reducing bleeds, and they are willing to accept increased risks or reduced efficacy to have subcutaneous rather than intravenous administration. As new treatments become available, understanding these preferences can facilitate shared decision-making in treatment selection and enhance patient-centred drug development and patient communication.

Abstract Objectives Youth with type 1 diabetes (T1D) and obesity face challenges in achieving optimal glycemic control and experience higher risk for long-term complications. While glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown weight and glycemic benefits in adults with type 1 diabetes, data in pediatric populations are scarce. We report here changes in glycemia, weight, and insulin doses in youth with T1D and obesity prescribed GLP-1RA. Methods We conducted a single-center retrospective observational study of adolescents and young adults (ages 10–20) with T1D and obesity prescribed GLP-1RA (liraglutide, exenatide, dulaglutide, semaglutide, or tirzepatide) between 2019 and 2024. Data collected included HbA1c, body weight, BMI, total daily insulin dose (TDD), and continuous glucose monitoring (CGM) metrics. Linear mixed effects models assessed changes over time, adjusting for age and gender. Results Among 24 patients (75 % female, 67 % public insurance, 88 % CGM users, 67 % insulin pump users), 12 months of GLP-1RA treatment led to significant reductions in weight (−9.49 kg, p&lt;0.0001), BMI (−3.69 kg/m 2 , p&lt;0.0001), and BMI Z-score (−0.30, p=0.04). CGM time-in-range increased by +7.96 % (p=0.08), and time above range (180–250 mg/dL) decreased by −3.04 % (p=0.06). TDD among pump users declined by −21.42 % (p=0.002). After approximately 16 months, HbA1c decreased by −0.81 % (p=0.04). Side effects were mainly gastrointestinal and transient. Conclusions This first longitudinal report of GLP-1RA use in youth with T1D and obesity shows clinically meaningful improvements in weight, glycemia, and insulin requirements, supporting the potential role of GLP-1RA as adjunct therapy. Larger prospective studies are needed to guide clinical practice.

Abstract Background To describe in a pediatric patient with ADHD and behavioral dysregulation a clinically significant case of risperidone-induced nocturnal enuresis. Case Presentation Due to ongoing aggression and emotional lability, a 10-year-old boy diagnosed with combined-type ADHD and persistent behavioral dysregulation was treated with long-acting methylphenidate and subsequently risperidone (0.5–1 mg/night). The patient started risperidone and soon after developed frequent nocturnal enuresis. A thorough medical assessment ruled out organic causes. Behavioral interventions were ineffective. After discontinuing risperidone, the enuresis resolved but returned upon rechallenge, suggesting a likely causal relationship. Switching to aripiprazole resulted in clinical improvement free from enuresis recurrence. Conclusions Temporally linked to risperidone initiation, the patient’s nocturnal enuresis resolved upon discontinuation and re-emerged upon rechallenge. Transitioning to aripiprazole provided good behavioral control with a more favorable side effect profile. In children, risperidone can cause nocturnal enuresis, a side effect that is often underreported but can seriously affect quality of life and treatment compliance. During antipsychotic treatment, clinicians should actively monitor for urinary symptoms and, when needed, consider pharmacological alternatives. This case emphasizes the need for tailored, side-effect-conscious strategies in pediatric psychopharmacology.

Idiopathic inflammatory myopathies (IIMs) carry substantial extra-muscular comorbidities. The purpose of this review is to provide a focused synthesis of recent population-based data on the epidemiology of key comorbidities in IIMs: atherosclerotic cardiovascular disease (ASCVD), venous thromboembolism (VTE), psychiatric and neurocognitive disorders, and bone health. IIM patients have approximately two-fold increased risk of ASCVD and of other cardiovascular events, like VTE. These risks likely result from several factors, including chronic systemic inflammation, physical inactivity, treatment side effects. Anti-HMGCR immune necrotizing inflammatory myopathy (IMNM), is a subtype of IIM that requires special consideration regarding dyslipidemia management, where statin alternatives are necessary. Furthermore, psychiatric and neurocognitive comorbidities are common, and likely under-recognized among IIM patients, and perhaps especially so in inclusion body myositis (IBM) patients. Finally, IIM patients have an increased risk of accelerated bone loss likely due to systemic inflammation, muscle damage and physical inactivity, and glucocorticoid exposure. Cardiovascular care, psychiatric/neurocognitive disorders, and osteopenia/osteoporosis are highly prevalent and often underrecognized in IIMs. Effective management of these IIM-associated comorbidities requires a multidisciplinary, comprehensive care approach, and further work is needed to adapt existing risk-stratification and screening tools for the unique needs of IIMs patients.

Methotrexate (MTX) is one of the most commonly used therapeutic agents for rheumatologic inflammatory diseases and is generally considered a safe medication. Its negative effects on bone mineral density and the occurrence of fractures were first described as side effects of high-dose MTX in pediatric cancer patients. MTX-associated osteopathy in adults receiving moderate or low doses of MTX (up to 25mg/week) for rheumatic musculoskeletal disorders remains a controversial topic. The pathogenesis and clinical significance of MTX-associated osteopathy are still incompletely understood. Clinically, it presents as atraumatic stress fractures of the distal or proximal tibia and the calcaneus, most often in elderly women with longstanding rheumatic musculoskeletal diseases, particularly rheumatoid arthritis (RA) and reduced bone mineral density. Its characteristic hallmark remains the imaging finding of band- or meander-shaped fractures along the growth plate, which are commonly multiple. The diagnosis is challenging and requires the exclusion of other causes of lower limb pain. Moreover, overlapping risk factors for insufficiency fractures are common and should be carefully investigated. The diagnosis must be made with caution, as the clinical consequences are discontinuation of MTX. In this paper, we describe four female patients with RA who presented with stress, meander-shaped fractures of the calcaneus and tibia (two with multiple fractures), showing rapid clinical improvement after MTX discontinuation, which can be attributed to MTX-associated osteopathy. Additionally, we performed a systematic review of this condition, focusing on its most common clinical and radiological features, as well as the effects of MTX on bone mineral density and fracture risk.

Perovskite solar cells (PSCs) hold great promise as photovoltaic technology, with power conversion efficiencies exceeding 27%. To further reduce the levelized cost of energy, simplifying PSC manufacturing processes is essential. In this study, a streamlined one-step solution-coating strategy is introduced that simultaneously deposits both the hole-conductor and perovskite layers. It is demonstrated that doped self-assembled monolayers (SAMs), containing phosphonic or carboxylic acids, diffuse and spontaneously assemble on both indium tin oxide (ITO) substrates and perovskite surfaces during film formation. This process results in a stable monolayer that functions as an efficient hole-selective contact while promoting favorable perovskite crystallization. Moreover, the incorporation of a functional isolation layer effectively mitigates the side effects induced by perovskite-anchored SAMs, thereby enhancing device efficiency and stability. The resulting PSCs exhibit a remarkable power conversion efficiency of 25.1% and maintain over 85% of their initial performance after 1000h of maximum power point tracking under continuous illumination.

Chemotherapy remains one of the principal treatment strategies in cancer treatment, is widely used but often limited by the development of chemoresistance and adverse side effects. This study aimed to develop highly effective chemotherapeutic agents with minimal or no adverse effects, specifically focusing on synthesizing a diisothiocyanatozinc(II) complex, [Zn(LCX)(NCS)₂], and evaluating its antineoplastic efficacy and host toxicity. The compound's in vitro anticancer activity was assessed against MCF7 cells using cell growth inhibition, apoptotic morphological observation, and gene expression analysis. In vivo antitumor properties of the compound were assayed in Swiss albino mice bearing EAC cells by monitoring key parameters such as tumor burden, survival rate, tumor cell proliferation, and hematological profiles. Toxicity was evaluated through biochemical, hematological, and histological assessments in mice. The compound demonstrated dose-dependent growth (11-85%) inhibition at 20-500µg/mL doses against MCF7 cells. Compound-treated cells showed apoptotic body formation under fluorescent and phase-contrast microscopes. Notably, mRNA expressions of proapoptotic genes such as p53, Bax, PARP1, Caspase-3, -8, -9, etc., were upregulated while anti-apoptotic genes such as Bcl2 were downregulated in compound-treated cells. Also, the compound showed 83% and 86% inhibition of tumor cell proliferation at doses of 100 and 200µg/kg/day, respectively, compared to the control group of EAC-bearing mice (p < 0.001). Mice treated with 200µg/kg/day showed a 60.3% increase in mean survival time compared to untreated controls (p < 0.001). Hematological parameters (RBC, WBC, hemoglobin), which were significantly reduced in EAC-bearing control mice, were restored to near-normal levels in treated mice. Transient alterations in hematological and biochemical parameters (serum glucose, cholesterol, creatinine, SGOT, SGPT) were observed during treatment; however, they normalized post-treatment, indicating minimal host toxicity. The compound also demonstrated a low LC50 value (7.734µg/mL) in the brine shrimp lethality bioassay, further confirming its pharmacological potential. The [Zn(LCX)(NCS)₂] complex demonstrated potent anticancer activity, followed by induction of apoptosis with minor host toxicity, positioning it as a viable option for advancement as an efficient chemotherapeutic agent. However, more research and clinical studies with animal and human models are needed to further develop the compound as a chemotherapeutic agent.

2-(Cyclohexyldimethylammoniumethyl)ether of 4-stilbenol (2), and its styryl-modified analogues 21 and 22, were identified as lead compounds from a series targeting human α9α10, α9, and α7 nicotinic acetylcholine receptors (nAChRs). Compounds 2 and 21 exhibited potent, and subtype-selective modulation of α9-containing receptors, with low nanomolar IC50 values and dual agonist/antagonist activity in a concentration-dependent manner. In contrast, compound 22 acted as a selective, pure antagonist. Molecular dynamics (MD) simulations of compound 21 supported a concentration-dependent allosteric mechanism, with orthosteric binding at low concentrations and vestibular site interaction at higher levels. In a human monocytic cell line, all three compounds inhibited ATP-induced IL-1β release at nanomolar concentrations. These findings identify α9α10-selective ligands as promising scaffolds for the development of nonopioid analgesics and immunomodulators, with favorable selectivity over α7 nAChRs to minimize CNS-related side effects.

Alzheimer's disease (AD) is a complex neurodegenerative disorder characterized by progressive cognitive decline and multifaceted pathogenic mechanisms (including amyloid-β [Aβ] plaques, tau neurofibrillary tangles, synaptic dysfunction, and neuroinflammation). Importantly, no effective disease-modifying treatment is currently available for AD. Emerging evidence implicates dysregulated mammalian target of rapamycin (mTOR) signaling as a key contributor to AD pathogenesis. This review analyzes how aberrant mTOR signaling influences major aspects of AD pathology, including Aβ production and clearance, tau protein hyperphosphorylation, autophagy dysfunction, synaptic plasticity impairments, neuroinflammation, and oxidative stress. Notably, hyperactivated mTOR accelerates AD progression through multiple mechanisms. It promotes Aβ accumulation and tau pathology, suppresses autophagic clearance of toxic aggregates, and disrupts neuronal homeostasis, thereby exacerbating cognitive decline. Consequently, mTOR has gained attention as a therapeutic target. This review evaluates the therapeutic potential of various mTOR-targeted interventions, such as the mTORC1 inhibitor rapamycin and its analogues (rapalogs), second-generation ATP-competitive mTOR inhibitors, and certain natural compounds and traditional Chinese medicine approaches. These strategies have demonstrated promise in mitigating AD-related pathology by enhancing autophagy, reducing Aβ/tau burden, and preserving synaptic and cognitive function in preclinical studies. However, the clinical translation of mTOR-targeted therapies faces key challenges, including poor blood-brain barrier penetration of many mTOR inhibitors, potential systemic side effects, and limited clinical validation to date. Further research is needed to optimize brain delivery, dosing regimens, and target specificity to fully realize the therapeutic potential of mTOR modulation in AD.

Abstract Background CAR T cells still face numerous obstacles in treating hematologic and solid malignancies. Although gene editing technologies have improved CAR T cell therapy, there are currently no systematic reviews to broadly address preclinical and clinical outcomes of gene-edited CAR T cells. Therefore, we aimed to systematically review the preclinical and clinical studies that evaluate the outcomes of knocked-out/knocked-down (KO/KD) CAR T cells. Methods This study was submitted to international Prospective Register of Systematic Reviews (PROSPERO) with the ID CRD42022320541 and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. We searched Five databases (PubMed, EMBASE, Cochrane Library, Web of Science, and Clinicaltrials.gov) up to March 19th, 2022 for the keywords of “CAR T cell” and “knock-out/knock-down”. The retrieved records then underwent a two-step screening process based on the inclusion criteria, first title/abstract and then full-text screenings, and their data were used for qualitative synthesis. Results Our search results yielded 3780 records. Finally, a total of 241 records, including 193 animal and 52 human studies (four concurrent in both groups) that reported KO/KD genes for 105 proteins were included. The positive effects of these 105 KO/KD were categorized into five groups: (1) enabling allogeneic CAR production while limiting GVHD, (2) increasing the efficacy of CAR T cells, (3) Decreasing their side effects, (4) limiting CAR T cell fratricide, and (5) enabling the use of concurrent therapies. In the human section, solid tumors had fewer studies with less favorable outcomes compared to hematologic malignancies. Conclusions This systematic review emphasized the various mechanisms by which CAR T cell effects could be boosted. Future researchers can choose their desired genes out of the 105 mentioned candidates. We also encourage the researchers to increase their efforts on solid tumors to compensate for the lack of increased efficacy in this group.

Background. Rheumatoid arthritis (RA) is a severe chronic disease affecting the joints and associated with autoimmune imbalance and inflammation in the synovium. Despite the introduction of biologic drugs, a significant proportion of patients remain refractory to standard therapy. In this regard, the development of monoclonal antibodies (mA) with fundamentally new targets is of particular interest, as well as utilizing the potential of nanotheranostics to improve the efficacy and selectivity of therapy. Objectives. To critically review promising targets for future mA-based therapies: IFN-γ, GM-CSF, IL-7RA, BSSL, PD-1. To evaluate nanotheranostic approach as a method to improve RA treatment. Results. Novel mAs against inflammatory effectors including emapalumab, otilimumab, OSE-127, SOL-116, and perezolimumab can reduce RA progression and increase the chances of favorable outcome. However, the nonspecificity of mA toward autoreactive cells may lead to serious side effects, and this fact requires consideration of more advanced approaches such as nanotheranostics. Current trends in RA therapy point to the increasing use of nanomaterials, particularly liposomes delivered with monoclonal antibodies. Liposome-encapsulated drugs, such as miRNAs, which are able to inhibit specific genes responsible for the development and persistence of RA, may enhance the efficacy of such a combination. Targeted localization and internalization of liposome contents can be activated by physical factors including IR radiation, ultrasound, or realized by targeting cellular receptors that are overexpressed on autoreactive cells and that are capable of internalization into cellular compartments. Conclusion. The integration of monoclonal antibodies with nanomaterials as drug carriers represents a promising direction in RA therapy, providing higher selectivity, safety and potential for a personalized approach. Further development of these strategies has the potential to significantly improve the prognosis and quality of life of patients resistant to conventional therapies.