Search Results (479)

Continuous intraocular pressure (IOP) monitoring is crucial for glaucoma management. Currently, traditional static IOP measurements often fail to detect circadian fluctuations, leading to a clinical dilemma where “normal IOP” is observed despite persistent visual field deterioration. This study presents a wireless, passive localized surface plasmon resonance (LSPR) sensing platform integrated into flexible silicone hydrogel contact lenses. Gold nanoparticles (AuNPs), synthesized via the sodium citrate reduction method, were incorporated into the lens periphery using a “swelling-induced nano-doping” technique to transduce IOP-induced corneal strain into detectable spectral shifts. Ex vivo porcine eye investigations established a physical mapping model, confirming significant LSPR peak wavelength response trends in correlation with IOP variations (10–50 mmHg) and corneal curvature changes. Subsequent 21-day in vivo rabbit studies demonstrated excellent ocular surface biocompatibility; quantitative histopathological analysis (HE, PAS, and Ki67 staining) revealed no significant adverse alterations in corneal endothelial cell density or conjunctival goblet cell function compared to control groups (p > 0.05). Furthermore, the platform maintained high structural integrity and anterior segment tolerance under transient high-IOP conditions. While currently a proof-of-concept, these results indicate that the LSPR-active hybrid system effectively captures dynamic IOP fluctuation patterns as an optical response to acute interventions, providing a foundational engineering path for next-generation, battery-free wearable diagnostics in personalized glaucoma care without the need for built-in electronics. Full article

The convergence of artificial intelligence and robotic surgery is redefining the management of genitourinary cancers by enhancing diagnostic accuracy, surgical precision, and training efficiency. This narrative review explores recent advancements in artificial intelligence applications across the cancer care continuum, with a focus on prostate, kidney, and bladder malignancies. Artificial intelligence tools, particularly those based on machine learning and deep learning, have demonstrated strong performance in analyzing imaging data, segmenting tumors, predicting pathological features, and supporting clinical decision-making. Intraoperatively, artificial intelligence enables skill assessment, personalized feedback, and real-time navigation by processing data from surgical videos and robotic system sensors. Augmented reality and intraoperative modeling further enhance visualization and margin control during complex procedures. The review also discusses emerging technologies such as single-port robotic platforms, which offer advantages in confined anatomical spaces and support less invasive approaches. Additionally, the growing field of telesurgery is addressed, highlighting its feasibility for complex urologic operations across vast distances. While many of these innovations are still in early stages of clinical validation, their integration into practice has the potential to improve oncologic and functional outcomes, expand access to expert care, and foster the development of next-generation surgical strategies in urologic oncology. Full article

Background: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a major extra-articular manifestation of rheumatoid arthritis (RA), contributing substantially to morbidity, mortality, and patient burden. Its diagnosis and management require integration of rheumatologic, pulmonary, and radiologic perspectives. Multidisciplinary approaches may provide a practical framework for implementing personalized medicine by integrating clinical and immunologic heterogeneity into individualized care strategies, although real-world data remain limited. Objectives: To synthesize primary studies published between 2015 and 2025 examining diagnostic, organizational, educational, and clinical aspects of RA-ILD within a multidisciplinary care framework. Methods: A narrative review of original research was conducted using PubMed and major publisher platforms from 1 January 2015 to 30 November 2025. Search terms included “rheumatoid arthritis,” “interstitial lung disease,” “RA-ILD,” “connective-tissue disease ILD,” “multidisciplinary,” “diagnosis,” “management,” and “patient experience.” Reviews and consensus statements were excluded. Results: Fifteen articles underwent full-text review, and five primary studies met all inclusion criteria and were incorporated into the final synthesis. RA-ILD emerged as a condition requiring coordinated interpretation of imaging, pulmonary physiology, and rheumatologic features. Multidisciplinary evaluation may improve diagnostic accuracy, reduce unclassifiable ILD, and support differentiation of autoimmune-related from idiopathic disease. A global assessment of ILD multidisciplinary team practices revealed substantial variability in structures and processes. Patient-reported data demonstrated significant emotional distress and a need for clearer communication and coordinated educational support. Conclusions: Effective RA-ILD management depends on collaborative assessment across specialties. Multidisciplinary care may support diagnostic precision and provide a practical framework for personalized medicine by integrating clinical, radiologic, and immunologic heterogeneity into tailored diagnostic and therapeutic strategies. Full article

Helicobacter pylori (H. pylori) infection is closely associated with the development of chronic gastritis, peptic ulcers, and gastric cancer, highlighting the importance of rapid and accurate detection for disease prevention and clinical management. In this study, a one-pot LAMP-CRISPR/Cas12b assay targeting the CagA gene was developed for H. pylori detection. First, the LAMP system was optimized by systematically screening key reaction components. Subsequently, a one-step LAMP-CRISPR/Cas12b detection platform was established through optimization of the ratio between the LAMP premix and CRISPR buffer, reaction temperature, Cas12b concentration, and ssDNA reporter concentration. Under optimal conditions, the assay achieved a detection limit of 3.14 × 10¹ copies/µL, representing a tenfold improvement in sensitivity compared with conventional LAMP and PCR assays (3.14 × 10² copies/µL). In addition, the entire detection process could be completed within 1 h. Validation using 17 culture-positive and 17 culture-negative samples demonstrated complete concordance with culture-based results, with no false-positive or false-negative detections observed. These findings indicate that the proposed platform possesses high sensitivity, excellent specificity, rapid turnaround, and operational simplicity, demonstrating strong potential for point-of-care testing and applications in resource-limited settings. Full article

Since the discovery of RNA interference (RNAi), small interfering RNA (siRNA) has emerged as a transformative therapeutic modality, shifting the paradigm from permanent genomic modification to the flexible interception of genetic information. Despite the delivery gap caused by biological barriers, innovations in chemical stabilization and delivery platforms have propelled siRNA from niche applications to the mainstream management of chronic conditions. This review provides a comprehensive analysis of the distinct mechanistic advantages of siRNA over antisense oligonucleotides, with particular emphasis on its catalytic turnover via the RISC and high target specificity. We further evaluate the critical transition from first-generation lipid nanoparticles to ligand-conjugated systems, specifically trivalent N-acetylgalactosamine (GalNAc). Through an examination of the clinical success of Inclisiran and the recent approval of Plozasiran, we discuss how these advances have improved patient compliance and extended dosing intervals. Furthermore, this article explores the emerging frontier of extra-hepatic delivery and the expansion toward metabolic and oncological targets. Ultimately, this review highlights the potential of siRNA to become a programmable standard of care for a broad spectrum of previously intractable diseases. Full article

The emergence of multifunctional wound dressings represents a significant transformation in the care of cutaneous tissue injuries, providing advanced solutions that surpass traditional dressings. This study is poised to fabricate multifunctional hydrogels through dual-dynamic cross-linking, integrating antibacterial and antioxidant properties, which are capable of accelerating wound healing while improving therapeutic outcomes. The hydrogel, which exhibits excellent adhesion, rapid self-healing ability, and on-demand removability, was synthesized employing poly(vinyl alcohol) (PVA)–borax as the backbone, followed by the incorporation of silk fibroin (SF), tannic acid (TA), and chitosan (CS). Total saponins of Panax notoginseng flower buds (PNF) with anti-inflammatory and angiogenic properties were loaded in porous structural materials yielding the PBCTS@PNF hydrogel. The prepared hydrogel exhibited outstanding antioxidant properties and cytocompatibility, along with favorable antibacterial capabilities, achieving inhibition rates of 84.30 ± 2.34% against Escherichia coli (E. coli) and 98.12 ± 0.76% against Staphylococcus aureus (S. aureus), respectively. Animal experiments demonstrated that PBCTS@PNF significantly reduced inflammation and promoted multidimensional tissue regeneration, encompassing re-epithelialization, neovascularization, and hair follicle regeneration, along with ordered collagen matrix organization, leading to substantially accelerated wound healing. The multifunctional PBCTS@PNF hydrogel provides a potent bioengineered therapeutic platform for wound healing management through the synergistic interplay among antibacterial, anti-inflammatory, and tissue regenerative functionalities. Full article

Background/Objectives: Metabolic and bariatric surgery (MBS) is increasingly performed worldwide and requires specific anesthetic management due to the complex physiological alterations associated with severe obesity. Although several international guidelines provide recommendations for perioperative care in bariatric patients, their implementation in routine clinical practice may vary. This study aimed to report anesthetic practices among Polish anesthesiologists providing anesthesia for bariatric procedures. Methods: A cross-sectional survey study was conducted in October 2025 among Polish anesthesiologists. The questionnaire consisted of 13 closed-ended questions addressing demographic characteristics, anesthetic management and blood pressure management, including preoperative thresholds for postponement of elective surgery and intraoperative thresholds for pharmacological treatment of hypotension. The survey was distributed via social media platforms. Participation was anonymous and voluntary. Results: A total of 71 anesthesiologists participated in the study. The most commonly used intubation device was the Macintosh laryngoscope (57.7%), while videolaryngoscopy was used by 42.2% of respondents. Positive end-expiratory pressure (PEEP) was routinely applied by most respondents, with 63.4% adjusting its level according to patient body weight. Multimodal analgesia components were commonly used, with paracetamol (95.8%), dexamethasone (91.5%), metamizole (90.1%), and lignocaine (84.5%) being the most frequently administered drugs. Most anesthesiologists reported postponing elective surgery when blood pressure exceeded 180/110 mmHg. More experienced anesthesiologists more often considered lower thresholds for postponement of elective surgery (p = 0.006). Conclusions: Reported practices among surveyed anesthesiologists for MBS in Poland are generally consistent with international recommendations, particularly regarding the use of PEEP. However, variability remains in airway management strategies and the use of videolaryngoscopy, highlighting the need for continued education and broader implementation of evidence-based perioperative protocols. Full article

Background and Objectives: Temporomandibular disorders (TMDs) are prevalent conditions affecting the temporomandibular joint and associated musculature, arising from a complex interplay of biomechanical, neuromuscular, and psychosocial factors. Increasing evidence supports functional interconnections among the TMJ, cervical spine, and shoulder girdle, suggesting that dysfunction in one region may influence others; however, these relationships remain incompletely understood. This study aimed to evaluate the association between scapulohumeral trauma, postural abnormalities, and TMDs, and to assess their evolution following interdisciplinary rehabilitation. Materials and Methods: A retrospective observational study with prospective follow-up was conducted in patients with scapulohumeral fractures associated with TMD and postural abnormalities. Postural parameters and the clinical features of temporomandibular disorders (TMDs) were evaluated at baseline and follow-up using a structured clinical assessment informed by the DC/TMD framework, together with clinical examination, electromyographic analysis, and mandibular mobility measurements. Postural evaluation was performed using digital baropodometric analysis (Free Med™ platform with FreeStep™ software, standard Medica sensor, Rome, Italy. Patients received individualized multidisciplinary treatment, including orthopaedic rehabilitation, occlusal splint therapy, physiotherapy (twice weekly), pharmacological management, and odonto-periodontal care. Statistical analyses were performed using non-parametric tests (p < 0.05). Results: Significant postural improvement was observed (p < 0.01), with the proportion of patients with normal posture increasing from 0% to 22.2% and the proportion with moderate forward lean decreasing from 53.3% to 15.6%. TMD severity decreased progressively across evaluations (Friedman χ² = 72.35, p < 0.01). No statistically significant differences were found between treatment groups with respect to postural outcomes, although descriptive differences in TMD improvement were observed at later evaluation points. Conclusions: Interdisciplinary rehabilitation was associated with significant improvements in both postural alignment and TMD severity. Scapulohumeral trauma may be associated with alterations in TMJ function and overall posture, while multimodal therapy supports functional recovery. Further randomized controlled studies are needed to confirm these findings. Full article

Chronic wounds, diabetic foot ulcers, venous leg ulcers, and pressure injuries affect millions of patients worldwide and cost healthcare systems in the order of $150 billion annually, yet treatment options have changed less than the scale of the problem would suggest. Biofilm formation, documented in up to 78% of chronic wounds, is a central cause: bacteria embedded in extracellular polymeric matrices tolerate antimicrobial concentrations up to 1000-fold higher than planktonic cells and sustain a chronic inflammatory state that actively prevents tissue repair. Hydrogels, crosslinked polymer networks with high water content and tunable physicochemical properties, have been widely studied as platforms for addressing these challenges, though the distance between laboratory results and clinical practice remains considerable. While recent reviews have summarized hydrogel materials or antimicrobial strategies in isolation, this review takes a different approach: we treat infection, biofilm persistence, and impaired regeneration as interconnected processes that must be addressed simultaneously, and we examine biofilm management as a distinct therapeutic target rather than merely a subset of antimicrobial delivery. We analyze hydrogel-based wound care across three integrated domains: design principles (natural, synthetic, and hybrid polymer systems; crosslinking strategies; and stimuli-responsive architectures), antimicrobial delivery (silver, antibiotics, antimicrobial peptides, natural agents, and controlled-release systems), and biofilm management (nanoparticle-mediated disruption, enzymatic EPS degradation, photodynamic approaches, quorum-sensing inhibition, and anti-adhesive surface engineering). For each area, we critically evaluate what the preclinical evidence supports, where it falls short, and what would be needed to bridge the gap to clinical application. Translation remains uneven. Among the many FDA- and EMA-cleared hydrogel dressings currently in clinical use, most are simple moisture-retaining or silver-containing formulations, while the multifunctional systems that dominate the research literature are at earlier stages of development. We discuss the main translational priorities, including more predictive preclinical models, long-term nanomaterial safety, harmonized outcome reporting, manufacturing scalability, and health economic evidence, as areas where further work can meaningfully accelerate clinical adoption. Full article

Sepsis remains a leading cause of mortality worldwide and is increasingly recognized as a syndrome of dynamic immune dysregulation rather than a uniform inflammatory condition. The traditional paradigm of sequential hyperinflammation followed by immunosuppression has been replaced by a more complex view in which these processes coexist and evolve over time, contributing to marked interindividual variability in clinical outcomes. Despite advances in supportive care, current diagnostic and therapeutic approaches are still largely non-specific and fail to account for this biological heterogeneity. Extracellular vesicles (EVs) have emerged as key mediators of intercellular communication and potential integrators of immune activity in sepsis. These nanosized particles carry proteins, nucleic acids, lipids, and metabolites that reflect the functional state of their cells of origin and actively participate in immune regulation. Experimental and clinical evidence indicate that EVs exert context-dependent effects, contributing both to the propagation of inflammatory processes and the establishment of immunosuppressive states through the transfer of regulatory signals. Beyond their mechanistic role, EVs represent a promising platform for immune monitoring. Their cell-specific and dynamic molecular signatures have been associated with disease severity, organ dysfunction, and clinical trajectories, suggesting their role as biomarkers for patient stratification. In parallel, engineered and stem cell-derived EVs are being explored as therapeutic vectors capable of modulating immune responses and restoring immune homeostasis. In this review, we examine current concepts of immune dysregulation in sepsis and discuss how EVs may serve as both mediators and decoders of immune heterogeneity. We propose that EV-based approaches could bridge the gap between high-dimensional immunological profiling and precision immunotherapy, enabling more adaptive and individualized management of septic patients. Full article

Despite the demand for personalized wound care, integrating diagnostics and therapeutics into a unified platform remains a significant challenge. To address this, we developed a 3D-printed theranostic hydrogel using vat photopolymerization, enabling precise, multifunctional wound management. The hydrogel matrix, composed of poly(acrylamide-co-hydroxyethyl acrylate) and carboxymethyl cellulose, was chemically crosslinked with poly(ethylene glycol) diacrylate. Bromocresol purple was integrated into the photosensitive resin to enhance printing fidelity and serve as a diagnostic indicator, providing a distinct colorimetric shift upon skin infection. For controlled drug delivery, graphene oxide (GO) and levofloxacin were incorporated into the system. The 3D-printed hydrogel demonstrated superior swelling capacity (>600%), ideal for absorbing wound exudate. A semi-quantitative linear colorimetric response was observed across varying pH levels, allowing for clear differentiation between healthy healing skin (pH 4.0–6.0) and infected conditions (pH 7.0 and above). Furthermore, the hydrogel exhibited infection-stimulated therapy, with a cumulative levofloxacin release of 92.63% at pH 8, significantly higher than in acidic conditions. Moreover, the incorporation of GO further optimized the delivery profile by tuning absorption and release rates. Synergizing real-time monitoring and on-demand therapeutic action, this 3D-printed system offers a scalable, robust solution for future-ready, personalized wound management. Full article

Sepsis remains a leading cause of preventable morbidity and mortality worldwide, and adherence to the Centers for Medicare & Medicaid Services Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) remains modest and variable across institutions. Simultaneously, controversy persists regarding fixed-volume fluid resuscitation mandates, particularly given the increasing emphasis on individualized, physiology-guided management. Artificial intelligence (AI) has emerged as a potential strategy to address both operational and clinical gaps in sepsis care. This review examines the current state of SEP-1 implementation, key barriers to compliance, and ongoing debates surrounding early fluid administration. We then discuss contemporary evidence on AI-enabled tools designed to accelerate bundle processes and support personalized fluid management. Early warning systems, natural language processing-augmented models, and telemedicine-integrated platforms have demonstrated improvements in process measures such as time-to-antibiotics and bundle component completion when embedded within defined clinical workflows. Reinforcement learning, causal machine learning, and predictive models offer promise for individualized fluid strategies, although most data remain retrospective and hypothesis-generating. Successful integration will require prospective validation, clinician-in-the-loop oversight, governance frameworks, and continuous monitoring for safety, equity, and model drift. AI should augment—rather than replace—clinical judgment to improve reliability, timeliness, and personalization in sepsis management. Full article

Smart care applications impose increasingly stringent requirements on low-latency execution, privacy preservation, and continuous monitoring. These requirements are driving intelligent services from cloud-centric architectures toward edge-side deployment. When multiple care-related workloads are deployed on resource-constrained edge devices, performance bottlenecks arise not only from model inference itself, but also from process scheduling, inter-process communication, and resource coordination overhead. To address this issue, this paper presents a task scheduling and management platform for multi-workload smart elderly care on a single pure-edge CPU–TPU heterogeneous node. The platform adopts a shared-memory and event-driven synchronization mechanism together with fine-grained process partitioning, thereby establishing a data-sharing and runtime-coordination framework for concurrent multi-workload execution. To evaluate the effectiveness of the proposed platform, experiments were conducted under single-workload, multi-workload, multi-resolution, and long-term runtime settings. The results show that, compared with two baseline schemes, the proposed platform improves the average frame rate by 66.7% and 71.1%, reduces net memory usage by 96.3% and 45.3%, and lowers net power consumption by 46.8% and 37.7%, respectively, under the single-workload setting. Under 10 concurrent workload instances, the system still maintains a stable frame rate of 42.03 ± 0.73 fps, demonstrating strong concurrency scalability. Multi-resolution experiments further indicate that the performance degradation at higher resolutions is mainly constrained by the front-end data supply stage. A continuous 10-day runtime experiment additionally verifies the sustained operating capability and resource stability of the platform under pure-edge deployment. These results demonstrate that node-level shared-memory and event-driven coordination can effectively improve the execution efficiency, scalability, and stability of real-time multi-workload analytics on such pure-edge heterogeneous nodes, providing a useful basis for future extensions to multi-node edge environments and edge–cloud collaborative task scheduling. Full article

Background/Objectives: Persistent gastrointestinal (GI) symptoms following oncologic treatment represent a major unmet need in survivorship care, often managed symptomatically without addressing underlying biological mechanisms. This study aimed to evaluate the clinical efficacy and biological correlates of an artificial intelligence (AI)-guided, personalized microbiome modulation strategy in oncology patients with chronic secondary GI dysfunction. Methods: We conducted a prospective, single-arm, open-label validation study including 29 adult female oncology patients with persistent GI symptoms lasting ≥3 months. Participants underwent baseline multidimensional assessment integrating shotgun metagenomic sequencing, inflammatory and nutritional biomarkers, and clinical symptom profiling. An AI-guided platform generated individualized dietary, supplement, and lifestyle recommendations. Outcomes were assessed at baseline and after a 3-month intervention, focusing on intra-individual changes in stool frequency (primary endpoint), self-reported energy, microbiome composition, and metabolic biomarkers. Paired statistical analyses, correlation testing, and multivariable regression were performed. Results: After three months, stool frequency significantly decreased (4.69 ± 2.41 to 2.07 ± 1.19 episodes/day; p < 0.0001), accompanied by a marked increase in energy levels (4.00 ± 1.04 to 7.24 ± 1.12; p < 0.0001). Microbiome analysis revealed consistent enrichment of butyrate-producing and barrier-supportive taxa, including Faecalibacterium prausnitzii, Eubacterium rectale, Roseburia intestinalis, Akkermansia muciniphila, and Bifidobacterium longum. Butyrate-related biomarkers and vitamin-associated parameters (B-complex, vitamin D) showed significant improvement, while lactate levels normalized. Changes in Bifidobacterium longum were independently associated with stool frequency reduction (β = −0.783, p = 0.0082). Conclusions: AI-guided personalized microbiome modulation was associated with significant clinical improvement and biologically coherent microbial and metabolic shifts in oncology patients with persistent GI symptoms. These findings support a precision supportive-care approach targeting microbiome restoration, warranting further validation in randomized controlled trials. Full article

Background/Objectives: Duchenne muscular dystrophy (DMD) is a fatal, progressive neuromuscular disorder caused by mutations in the dystrophin gene, leading to the absence of functional dystrophin protein. As the largest gene in the human genome, the DMD locus is highly susceptible to mutations, contributing to a prevalence of approximately 1 in 3800–6300 live male births worldwide. This review aims to provide a comprehensive and critical synthesis of current and emerging therapeutic strategies for DMD. Methods: We conducted a narrative review of the literature, integrating findings from clinical trials, regulatory approvals, and preclinical studies. We categorized therapeutic approaches into mutation-agnostic and mutation-specific strategies, with emphasis on the mechanism of action, clinical progress, and translational limitations. Results: Current standards of care, including corticosteroids and supportive interventions, remain foundational in disease management. Mutation-specific approaches such as exon skipping and adeno-associated virus (AAV)-mediated gene replacement can restore dystrophin expression, although clinical benefit remains variable and is influenced by factors such as mutation type, delivery efficiency, and durability. Emerging genome editing strategies offer the potential for permanent correction but face significant challenges related to delivery, safety, and scalability. Emerging mutation-agnostic therapies targeting inflammation, fibrosis, and membrane instability provide broader applicability but do not directly address the underlying genetic defect. Across modalities, key limitations include modest functional outcomes, safety concerns, and variability in clinical trial endpoints. Conclusions: The DMD therapeutic landscape is rapidly evolving, and future progress will likely depend on optimizing delivery platforms, improving durability, and integrating combination strategies to address the multifaceted nature of disease progression. Full article