Phytochemical constituents, bioactivities, and applications of custard apple (Annona squamosa L.): A narrative review.

Annona squamosa L. (Annonaceae) is a versatile tree with an edible fruit showing abundant medicinal and industrial applications. The nutritional values of this plant are due to carbohydrates, proteins, amino acids, and vitamins. Ethnopharmacological uses referred to treatment of dysentery, headlice, cancer sores, purgative, and tonic effects. The main reported biological activities for A. squamosa L. were cytotoxic, antidiabetic, antimicrobial, antiparasitic, antioxidant, antimalarial, molluscidal, anthelmintic and insecticidal activities, and its chemical classes encompassed alkaloids, diterpenes, acetogenins, and cyclopeptides. The nutritional content of A. squamosa L. and their main chemical components, biological effects, and the different applications were discussed in this review. This comprehensive review strived to compile all the relevant data in the period between 1990 and 2023 covering databases PubMed, ScienceDirect, Web of Science, Googlescholar and Reaxys concerning A. squamosa L. different parts with their reported phytochemical constituents and biological activities to integrate a better understanding of the medicinal values.

The effect of self-care education with smart phone applications on the severity of nausea and vomiting after stem cell transplantation in leukemia patients.

INTRODUCTION: Common side effects after stem cell transplantation (SCT), such as anorexia, nausea, and vomiting, can disrupt the quality of life of patients. Therefore, this study aimed to determine the effect of self-care education with smart phone applications on the severity of nausea and vomiting after SCT in leukemia patients. MATERIALS AND METHODS: In this clinical trial study, using the blocked randomization method 104 leukemia patients undergoing SCT were assigned to two groups, intervention and control. The patients of the Control Group received routine care, and the Intervention Group received self-care education with a smart mobile phone application, in addition to routine care. Two weeks, one month, and three months after the start of the intervention, the severity of nausea and vomiting was evaluated using the visual analog scale (VAS) and the Khavar Oncology scale, both of which were completed by both Control and Intervention Groups. Data were analyzed using chi-square, Fisher's exact, Mann-Whitney, and Friedman tests using the Statistical Package for Social Sciences version 25 software. RESULTS: The severity of nausea and vomiting in leukemia patients undergoing SCT was significantly different in the two groups at all three timepoints (two weeks, one month, and three months) after transplantation (p-value = 0.000). CONCLUSION: The severity of nausea and vomiting after SCT in leukemia patients was improved by self-care education with a smart phone application. Therefore, this method is recommended to reduce the severity of nausea and vomiting in leukemia patients who undergo transplantation.

Electronic Glycemic Management System Improved Glycemic Control and Reduced Complications in Patients With Diabetes Undergoing Coronary Artery Bypass Surgery: A Randomized Controlled Trial.

BACKGROUND: In-hospital hyperglycemia poses significant risks for patients with diabetes mellitus undergoing coronary artery bypass graft (CABG) surgery. Electronic glycemic management systems (eGMSs) like InsulinAPP offer promise in standardizing and improving glycemic control (GC) in these settings. This study evaluated the efficacy of the InsulinAPP protocol in optimizing GC and reducing adverse outcomes post-CABG. METHODS: This prospective, randomized, open-label study was conducted with 100 adult type 2 diabetes mellitus (T2DM) patients post-CABG surgery, who were randomized into two groups: conventional care (gCONV) and eGMS protocol (gAPP). The gAPP used InsulinAPP for insulin therapy management, whereas the gCONV received standard clinical care. The primary outcome was a composite of hospital-acquired infections, renal function deterioration, and symptomatic atrial arrhythmia. Secondary outcomes included GC, hypoglycemia incidence, hospital stay length, and costs. RESULTS: The gAPP achieved lower mean glucose levels (167.2 ± 42.5 mg/dL vs 188.7 ± 54.4 mg/dL; P = .040) and fewer patients-day with BG above 180 mg/dL (51.3% vs 74.8%, P = .011). The gAPP received an insulin regimen that included more prandial bolus and correction insulin (either bolus-correction or basal-bolus regimens) than the gCONV (90.3% vs 16.7%). The primary composite outcome occurred in 16% of gAPP patients compared with 58% in gCONV (P < .010). Hypoglycemia incidence was lower in the gAPP (4% vs 16%, P = .046). The gAPP protocol also resulted in shorter hospital stays and reduced costs. CONCLUSIONS: The InsulinAPP protocol effectively optimizes GC and reduces adverse outcomes in T2DM patients' post-CABG surgery, offering a cost-effective solution for inpatient diabetes management.

Emotional health screening of mothers, preliminary validation of a 3-item instrument: A research brief.

A number of countries now recommend population-wide depression screening for perinatal women, using validated tools. A stepped-approach to screening - involving universal screening with a brief measure, followed by targeted screening using a longer measure for those women identified as at greater risk - is used in some settings. This brief report describes the test performance characteristics of a 3-item mood screening instrument, developed for use within a digital parenting program. Participants (n = 404) in this cross-sectional study were mothers of children aged up to 3 years. The majority (65.5 %) were first-time mothers, and their mean age was 32.8 years. Data were collected using an online survey. The test performance of the brief 3-item mood screening instrument (possible score range = 0-300) was examined using Receiver Operating Characteristic (ROC) analysis, with a score of 13 or more on the Edinburgh Postnatal Depression Scale (EPDS) used as the reference standard. The mood screening instrument demonstrated excellent range when compared to the reference standard. Optimal balance between sensitivity (0.77) and specificity (0.78), was achieved at a cut-point of 160 or less. Analysis was limited by using only the EPDS as the reference standard. This preliminary data supports the use of this 3-item mood screening instrument to screen for postnatal depression symptoms and may be integrated into a mobile Health or online tool. Future research should examine the test performance of the 3-item mood screening instrument against a diagnostic tool.

Effectiveness of self-reported management program of cancer patients.

Objective: This study aimed to analyze the effect of Smart Cancer Care program on the quality of life and ease of chemotherapy continuation in cancer patients and the effect of additional tele-management on frequency of use and satisfaction with the Smart Cancer Care program. Methods: 'Smart Cancer Care' is a mobile program that allows cancer patients undergoing chemotherapy to report symptoms of adverse events and receive remote management. In this study, patients were randomly assigned to three groups: Group A, who received only classical face-to-face management; Group B, who used the Smart Cancer Care program as addition; and Group C, who used the Smart Cancer Care program and received telephone management. After 12 weeks of follow-up, the effectiveness of using the Smart Cancer Care program was analyzed by examining the quality of life, ease of maintaining chemotherapy, and unplanned hospital visits in each group. The frequency of use and satisfaction with the Smart Cancer Care program were also analyzed. Results: Cancer patients who used the Smart Cancer Care program had 1.93-fold (1.15-3.25) higher overall quality of life than those who did not. This became 2.33-fold (1.34-4.04) higher when phone care was added. Patients with tele-management were significantly more likely to use the Smart Cancer Care program (odds ratio (OR) = 25.80; 95% confidence interval (CI), 11.28-58.97). Conclusions: A mobile self-reported management program has a positive effect on the quality of life of cancer patients undergoing chemotherapy. Tele-management is conducive to active and effective use of this program.

Exploring the uses of digital health in palliative care in Southeast Asia.

BACKGROUND: This integrative review explores the use of digital health technologies in palliative care within Southeast Asia. Despite extensive documentation of digital health in palliative care in Western nations, its application in Southeast Asia remains underdeveloped. METHOD: The review includes a total of four papers meeting the eligibility criteria. FINDINGS: The findings reveal limited studies of digital health adoption in palliative care. Key technologies include mobile health applications, electronic health records and telemedicine platforms. Challenges, such as health inequities, data security and the need for technology validation were identified. The review underscores the necessity for region-specific research to address these challenges and improve the integration of digital health in palliative care. CONCLUSION: This study highlights the potential of digital health to enhance palliative care delivery and patient outcomes in Southeast Asia, advocating for increased adoption and tailored implementation strategies.

Recent Progress in Organic Electrochemical Transistor-Structured Biosensors.

The continued advancement of organic electronic technology will establish organic electrochemical transistors as pivotal instruments in the field of biological detection. Here, we present a comprehensive review of the state-of-the-art technology and advancements in the use of organic electrochemical transistors as biosensors. This review provides an in-depth analysis of the diverse modification materials, methods, and mechanisms utilized in organic electrochemical transistor-structured biosensors (OETBs) for the selective detection of a wide range of target analyte encompassing electroactive species, electro-inactive species, and cancer cells. Recent advances in OETBs for use in sensing systems and wearable and implantable applications are also briefly introduced. Finally, challenges and opportunities in the field are discussed.

Sustainable utilization of Fe3O4-modified activated lignite for aqueous phosphate removal and ANN modeling.

Lignites are widely available and cost-effective in many countries. Sustainable methods for their utilization drive innovation, potentially advancing environmental sustainability and resource efficiency. In the present study, Fe3O4 (∼25.1 nm) supported on KOH-activated lignite (A-L) displayed 8 times higher phosphate removal than pristine A-L (67.6 mg/g vs. 8.5 mg/g at pH 5, 50 mg of absorbent in 25 mL of 1500 ppm [phosphate]), owing to its abundant Fe3O4 (10 wt% of Fe) nanoparticle content. The removal occurred within ∼2 h, following a pseudo-second-order kinetic model. Across pH levels ranging from 5.0 to 9.0, Fe3O4-A-L's phosphate removal occurs via both chemisorption and precipitation, as evident by kinetic, pH, and XPS analyses. The phosphate adsorption fits better with the Freundlich isotherm. The combined benefits of facile recovery, rapid phosphate uptake, straightforward regeneration, and attractive post-adsorption benefits (e.g., possibly use as a Fe, P-rich fertilizer) make magnetic Fe3O4-A-L a promising candidate for real-world applications. Artificial Neural Network (ANN) modeling indicates an excellent accuracy (R2 = 0.99) in predicting the amount of phosphate removed by Fe3O4-A-L. Sensitivity analysis revealed both temperature and initial concentration as the most influencing factors. Leveraging lignite in environmentally friendly applications not only addresses immediate challenges but also aligns with sustainability goals. The study clearly articulates the potential benefits of utilizing lignite for sustainable phosphate removal and recovery, offering avenues for mitigating environmental concerns while utilizing resources efficiently.

Favorable efficacy and reduced acute neurotoxicity by antisense oligonucleotides with 2',4'-BNA/LNA with 9-(aminoethoxy)phenoxazine.

An increasing number of antisense oligonucleotides (ASOs) have been approved for clinical use. However, improvements of both efficacy and safety in the central nervous system (CNS) are crucial for the treatment with CNS diseases. We aimed to overcome the crucial issues by our development of various gapmer ASOs with a novel nucleoside derivative including a 2',4'-BNA/LNA with 9-(aminoethoxy)phenoxazine (BNAP-AEO). The various gapmer ASOs with BNAP-AEO were evaluated for thermal stability, in vitro and in vivo efficacy, and acute CNS toxicity. Thermal stability analysis of the duplexes with their complementary RNAs showed that ASOs with BNAP-AEO had a higher binding affinity than those without BNAP-AEO. In vitro assays, when transfected into neuroblastoma cell lines, demonstrated that ASOs with BNAP-AEO, had a more efficient gene silencing effect than those without BNAP-AEO. In vivo assays, involving intracerebroventricular injections into mice, revealed ASOs with BNAP-AEO potently suppressed gene expression in the brain. Surprisingly, the acute CNS toxicity in mice, as assessed through open field tests and scoring systems, was significantly lower for ASOs with BNAP-AEO than for those without BNAP-AEO. This study underscores the efficient gene-silencing effect and low acute CNS toxicity of ASOs incorporating BNAP-AEO, indicating the potential for future therapeutic applications.

Sources and Applications of Tyrosinase in Life Sciences.

BACKGROUND: Tyrosinase, often recognized as polyphenol oxidase, plays a pivotal role as an enzyme in catalyzing the formation of melanin-a complex process involving the oxidation of monophenols and o-diphenols. OBJECTIVE: Tyrosinase functions as a monooxygenase, facilitating the o-hydroxylation of monophenols to generate the corresponding catechols, as well as catalyzing the oxidation of monophenols to form the corresponding o-quinones, exhibiting diphenolase or catecholase activity. This versatile enzymatic capability is not limited to specific organisms but is found across various sources, including bacteria, fungi, plants, and mammals. METHOD: Pertinent research articles, reviews, and patents on tyrosinase were gathered through a comprehensive literature search. These materials were analyzed to gain insights into the diverse applications of tyrosinase. The review was structured by categorizing these applications and offering a thorough summary of the current state of knowledge in the field. RESULT: Based on the literature survey, tyrosinase exhibits promising potential across a spectrum of biotechnological applications. These include but are not limited to: synthesizing L-DOPA, creating innovative mixed melanins, manufacturing phenolic biosensors, deploying in food and feed industries, facilitating protein cross-linking, eliminating phenols and dyes, and serving as a biocatalyst. Moreover, immobilized tyrosinase demonstrates multiple utility avenues within the pharmaceutical sector. CONCLUSION: The article offers a comprehensive exploration of tyrosinase, encompassing its structural features, evolutionary origins, biochemical characteristics, and contemporary applications in various fields.

The Potential Role of Non-coding RNAs in Regulating Ferroptosis in Cancer: Mechanisms and Application Prospects.

Cancer is the second leading cause of death globally. Despite some successes, conventional cancer treatments are insufficient to address the growing problem of drug resistance in tumors and to achieve efficient treatment outcomes. Therefore, there is an urgent need to explore new therapeutic options. Ferroptosis, a type of iron- and reactive oxygen species-dependent regulated cell death, has been closely associated with cancer development and progression. Non-coding RNAs (ncRNAs) are a class of RNAs that do not code for proteins, and studies have demonstrated their involvement in the regulation of ferroptosis in cancer. This review aims to explore the molecular regulatory mechanisms of ncRNAs involved in ferroptosis in cancer and to emphasize the feasibility of ferroptosis and ncRNAs as novel therapeutic strategies for cancer. We conducted a systematic and extensive literature review using PubMed, Google Scholar, Web of Science, and various other sources to identify relevant studies on ferroptosis, ncRNAs, and cancer. A deeper understanding of ferroptosis and ncRNAs could facilitate the development of new cancer treatment strategies.

Safe and effective degradation of aflatoxins by food-grade culture broth of Aspergillus oryzae.

Aflatoxins (AFs) are carcinogenic fungal toxins contaminating up to 25% of the global food supply. Over half of the world's population is exposed to unmonitored levels of AFs, mostly aflatoxin B1 (AFB1). Despite numerous efforts over the past 60 years, there are no solutions to remove AFs safely from food. Here, we present a safe and effective AF-degrading product called "D-Tox", a filtered culture broth of Aspergillus oryzae grown in a food-grade liquid medium. When 5 ppm of AFB1 is added to D-Tox, ∼90% is degraded at 48 and 24 hr at room temperature and 50°C, respectively. Moreover, when varying amounts (0.1 ppm ∼ 100 ppm) of AFB1 are added to D-Tox at 100°C, over 95% of AFB1 is degraded in 1 hr, suggesting a nonenzymatic process. Examining degradation of 100 ppm AFB1 reveals that aflatoxin D1 (AFD1) is the major transient degradant of AFB1, indicating that degradation occurs irreversibly by lactone ring hydrolysis followed by decarboxylation. D-Tox further degrades AFD1 to unknown fragmented products. Importantly, the practical application of D-Tox is also demonstrated, as more than 70% of AFB1 is degraded when wheat, corn, and peanuts naturally contaminated with high levels of AFB1 (0.3 ∼ 4.5 ppm) are boiled in D-Tox for 1 hr. Additionally, D-Tox can degrade other lactone-ring containing mycotoxins, including patulin and ochratoxin. D-Tox exhibits no cytotoxicity under the conditions tested in MCF-7 breast cancer cell lines. In summary, D-Tox is a safe and effective AF-detoxifying product that can enhance global food safety.

Stainless Steel Mesh in Electrochemistry: Comprehensive Applications and Future Prospects.

Stainless steel mesh (SSM) has emerged as a cornerstone in electrochemical applications owing to its exemplary versatility, electrical conductivity, mechanical robustness, and corrosion resistance. This state-of-the-art review delves into the diverse roles of SSM across a spectrum of electrochemical domains, including energy conversion and storage devices, water treatment technologies, electrochemical sensors, and catalysis. We meticulously explore its deployment in supercapacitors, batteries, and fuel cells, highlighting its utility as a current collector, electrode, and separator. The review further discusses the critical significance of SSM in water treatment processes, emphasizing its efficacy in supporting membranes and facilitating electrocoagulation, as well as its novel uses in electrochemical sensing and catalysis, which include electrosynthesis and bioelectrochemistry. Each section delineates the recent advancements, identifies the inherent challenges, and suggests future directions for leveraging SSM in electrochemical technologies. This comprehensive review showcases the current state of knowledge and articulates the novel integration of SSM with emerging materials and technologies, thereby establishing a new paradigm for sustainable and efficient electrochemical applications. Through critical analysis and insightful recommendations, this review positions itself as a seminal contribution, paving the way for researchers and practitioners to harness the full potential of SSM in advancing the electrochemistry frontiers.

Relating caregiver experiences to personalized "push" content in mobile applications among caregivers of pediatric patients with oncology conditions.

OBJECTIVE: With the evolution of data algorithms and personalized push systems in mobile applications, patients who have searched for disease-related information may repeatedly receive similar content on app homepages or through notifications. This study aims to assess the influence of health-related content delivered through mobile applications on the anxiety and depression levels of caregivers of pediatric oncology patients. METHODS: A survey consisting of 16 questions was conducted among 91 caregivers of pediatric oncology patients at the Children's Hospital affiliated with Chongqing Medical University. The questionnaire was designed by oncologists and the Hospital Anxiety and Depression Scale was used to assess the caregivers' psychological states. RESULTS: The study found that 31.5% of caregivers exhibited borderline anxiety symptoms, while 20.2% displayed borderline depression symptoms. Caregivers who noticed changes in homepage recommendations reported higher levels of anxiety (p = .004) and depression (p = .034). Additionally, 50.6% occasionally felt anxious or uneasy due to personalized notifications and 19.1% frequently felt this way. Moreover, 53.9% of the caregivers reported a negative impact on their emotions or daily life. SIGNIFICANCE: Personalized push notifications related to disease information in mobile applications can impose a significant psychological burden on patients and their caregivers. Mobile application developers and healthcare providers must strengthen their support in the digital health domain to enhance the emotional well-being of cancer patients and their caregivers.

Biological Applications, In Vitro Cytotoxicity, Cellular Uptake, and Apoptotic Pathway Studies Induced by Ternary Cu (II) Complexes Involving Triflupromazine with Biorelevant Ligands.

The novel mixed-ligand complexes derived from the parent antidepressant phenothiazine drug triflupromazine (TFP) were synthesized along with the secondary ligands glycine and histidine. [Cu(TFP)(Gly)Cl]·2H2O (1) and [Cu(TFP)(His)Cl]·2H2O (2) were examined for their in vitro biological properties. Cyclic voltammetry was used to study the binding of both complexes to CT-DNA. The two complexes were examined for antiviral, antiparasite, and anti-inflammatory applications. An in vitro cytotoxicity study on two different cancer cell lines, MCF-7, HepG2, and a normal cell line, HSF, shows promising selective cytotoxicity for cancer cells. An investigation of the cell cycle and apoptosis rates was evaluated by flow cytometry with Annexin V-FITC/Propidium Iodide (PI) staining of the treated cells. Gene expression and western blotting were carried out to determine the expression levels of the pro-apoptotic markers and the anti-apoptotic marker Bcl2. The tested complexes decreased cell viability and triggered apoptosis in human tumor cell lines. Molecular docking was also used to simulate Bcl2 inhibition. Finally, complex (2) has potent antitumor effects on human tumor cells, especially against HepG2 cells, as seen in the cellular drug uptake assay. Consequently, complex (2) may prove useful against cancer, especially liver cancer. For further understanding, it needs to be explored in vivo.

Intricate effects of post-translational modifications in liver cancer: mechanisms to clinical applications.

Liver cancer is a significant global health challenge, with hepatocellular carcinoma (HCC) being the most prevalent form, characterized by high incidence and mortality rates. Despite advances in targeted therapies and immunotherapies, the prognosis for advanced liver cancer remains poor. This underscores the urgent need for a deeper understanding of the molecular mechanisms underlying HCC to enable early detection and the development of novel therapeutic strategies. Post-translational modifications (PTMs) are crucial regulatory mechanisms in cellular biology, affecting protein functionality, interactions, and localization. These modifications, including phosphorylation, acetylation, methylation, ubiquitination, and glycosylation, occur after protein synthesis and play vital roles in various cellular processes. Recent advances in proteomics and molecular biology have highlighted the complex networks of PTMs, emphasizing their critical role in maintaining cellular homeostasis and disease pathogenesis. Dysregulation of PTMs has been associated with several malignant cellular processes in HCC, such as altered cell proliferation, migration, immune evasion, and metabolic reprogramming, contributing to tumor growth and metastasis. This review aims to provide a comprehensive understanding of the pathological mechanisms and clinical implications of various PTMs in liver cancer. By exploring the multifaceted interactions of PTMs and their impact on liver cancer progression, we highlight the potential of PTMs as biomarkers and therapeutic targets. The significance of this review lies in its potential to inform the development of novel therapeutic approaches and improve prognostic tools for early intervention in the fight against liver cancer.

Properties and Applications of Iron-Chalcogenide Superconductors.

Iron-chalcogenide superconductors continue to captivate researchers due to their diverse crystalline structures and intriguing superconducting properties, positioning them as both a valuable platform for theoretical investigations and promising candidates for practical applications. This review begins with a comprehensive overview of the fabrication techniques employed for various iron-chalcogenide superconductors, accompanied by a summary of their phase diagrams. Subsequently, it delves into the upper critical field, anisotropy, and critical current density. Furthermore, it discusses the successful fabrication of meters-long coated conductors and explores their applications in superconducting radio-frequency cavities and coils. Finally, several prospective avenues for future research are proposed.

Recent Advances in the Health Benefits and Application of Tangerine Peel (Citri Reticulatae Pericarpium): A Review.

Citrus fruits, renowned for their abundant of phytochemicals and bioactive compounds, hold a prominent position as commercially grown fruits with health-promoting properties. In this context, tangerine peel (Citri Reticulatae Pericarpium, CRP) is garnering attention as a byproduct of citrus fruits. Within the framework of the circular economy, CRP has emerged as a focal point due to its potential health benefits. CRP, extracted from Citrus reticulata cv. and aged for over three years, has attracted increasing attention for its diverse health-promoting effects, including its anticancer, cardiovascular-protecting, gastrointestinal-modulating, antioxidant, anti-inflammatory, and neuroprotective properties. Moreover, CRP positively impacts skeletal health and various physiological functions. This review delves into the therapeutic effects and molecular mechanisms of CRP. The substantial therapeutic potential of CRP highlights the need for further research into its applications in both food and medicine. As a value-added functional ingredient, CRP and its constituents are extensively utilized in the development of food and health supplements, such as teas, porridges, and traditional medicinal formulations.

Phage Display Technology in Biomarker Identification with Emphasis on Non-Cancerous Diseases.

In recent years, phage display technology has become vital in clinical research. It helps create antibodies that can specifically bind to complex antigens, which is crucial for identifying biomarkers and improving diagnostics and treatments. However, existing reviews often overlook its importance in areas outside cancer research. This review aims to fill that gap by explaining the basics of phage display and its applications in detecting and treating various non-cancerous diseases. We focus especially on its role in degenerative diseases, inflammatory and autoimmune diseases, and chronic non-communicable diseases, showing how it is changing the way we diagnose and treat illnesses. By highlighting important discoveries and future possibilities, we hope to emphasize the significance of phage display in modern healthcare.

Engineering of Erythrocytes as Drug Carriers for Therapeutic Applications.

Erythrocytes, also known as red blood cells (RBCs), have garnered considerable attention as potential carriers for drug delivery, owing to their inherent properties such as biocompatibility, biodegradability, and prolonged circulation half-life. This paper presents a comprehensive overview of the role of erythrocytes in drug delivery, elucidating recent advancements in delivering a diverse array of therapeutic agents, including small molecules, nucleic acids, antibodies, protein enzymes, and nanoparticles. Two primary strategies for encapsulating drugs within erythrocytes are systematically discussed: internal loading and surface loading. Each strategy offers distinct advantages in terms of drug stability and release kinetics. Notably, the utilization of erythrocyte membrane camouflaged nanocarriers holds promise for enhancing the biocompatibility of conventional nanoparticles and facilitating targeted drug delivery. Furthermore, the broad spectrum of biomedical applications of erythrocyte-based drug delivery systems are examined, ranging from cancer treatment to diabetes management, thrombosis prevention, and immunotherapy. This review provides a comprehensive evaluation of current technologies in erythrocyte-loaded drug delivery, highlighting the strengths, weaknesses, and future directions for advancing therapeutic interventions in various disease contexts.