Prediction of plasma ctDNA fraction and prognostic implications of liquid biopsy in advanced prostate cancer.

No consensus strategies exist for prognosticating metastatic castration-resistant prostate cancer (mCRPC). Circulating tumor DNA fraction (ctDNA%) is increasingly reported by commercial and laboratory tests but its utility for risk stratification is unclear. Here, we intersect ctDNA%, treatment outcomes, and clinical characteristics across 738 plasma samples from 491 male mCRPC patients from two randomized multicentre phase II trials and a prospective province-wide blood biobanking program. ctDNA% correlates with serum and radiographic metrics of disease burden and is highest in patients with liver metastases. ctDNA% strongly predicts overall survival, progression-free survival, and treatment response independent of therapeutic context and outperformed established prognostic clinical factors. Recognizing that ctDNA-based biomarker genotyping is limited by low ctDNA% in some patients, we leverage the relationship between clinical prognostic factors and ctDNA% to develop a clinically-interpretable machine-learning tool that predicts whether a patient has sufficient ctDNA% for informative ctDNA genotyping (available online: https://www.ctDNA.org ). Our results affirm ctDNA% as an actionable tool for patient risk stratification and provide a practical framework for optimized biomarker testing.

Comparative effectiveness of intra-articular therapies in knee osteoarthritis: a meta-analysis comparing platelet-rich plasma (PRP) with other treatment modalities.

Introduction: Knee osteoarthritis (KOA) is a progressive joint disease commonly treated with intra-articular injections, including platelet-rich plasma (PRP), hyaluronic acid (HA), or corticosteroids (CS). This updated meta-analysis aims to enhance the statistical power of the results and provide comprehensive clinical evidence that reflects the most current research. By doing so, the authors aim to suggest a reliable estimate for the development of guidelines, addressing the pressing need for effective and minimally invasive treatment options. Methods: PubMed, Scopus, clinicaltrials.gov, Cochrane Central were searched until March 2023, for randomized controlled trials (RCTs) comparing the effectiveness of intra-articular injectable therapies, including PRP, HA, CS, and placebo, in KOA. Data extraction involved baseline characteristics and outcome measures [Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Visual Analog Scale (VAS) pain scores, KOOS, and IKDC scores] at 1, 3, 6 and 12 months. Statistical analysis, including subgroup analysis, assessment of heterogeneity, and publication bias, was conducted using Review Manager. Results: Our meta-analysis of 42 studies involving 3696 patients demonstrated that PRP treatment resulted in significant pain relief compared to HA injections, as evidenced by improved WOMAC pain (MD: -0.74; 95% CI: -1.02 to -0.46; P≤0.00001; I 2=94%) and VAS pain (MD: -0.65; 95% CI: -1.24 to -0.06; P=0.03; I2=97%) outcomes. Similarly, PRP showed greater efficacy in reducing WOMAC pain (MD: -8.06; 95% CI: -13.62 to -2.51: P=0.004; I 2=96%) and VAS pain (MD: -1.11; 95% CI: -1.64 to -0.59; P≤0.0001; I 2=68%) compared to CS injections, with the most significant improvement observed at 6 months. Conclusions: PRP is an effective treatment for KOA. It provides symptomatic relief, has the potential to reduce disease progression, and has sustained effects up to 12 months. PRP offers superior pain relief and functional enhancement compared to CS and HA injections.

Increasing ecological sustainability using the combinations of technologies to produce power.

The study attempts to analyze the impact of hybrid energy systems on environmental sustainability in the context of the circular economy network. The hybrid energy sources follow the principle of circular economy, which aims to reduce raw material use and waste which is very fruitful in promoting environmental sustainability. However, the study uses quarterly data from Pakistan from 2011Q1 to 2020Q4 to accomplish the proposed study objective. The study constructs 5 hybrid systems of energy to analyze the impact and applies Auto Regressive Distributive Lag Model (ARDL) to estimate the results. It is found that electricity generation through solar photovoltaic (SPV), wind turbine (WND), hydroelectricity (HYDE) and nuclear power generation (NPG) play a positive role in increasing environment sustainability. The results explain that SPV, NPG, and HYDE contribute 2.29%, 2.04%, and 0.42% to environmental sustainability, respectively. Hybrid systems of energy (Hybrid 1,2,3,4 and 5) positively impact ecological sustainability, but the intensity of each hybrid system in sustaining the environment is different. Among five hybrid systems, the hybrid-5 (SPV-WND-HYDE-NPG) energy system is more environmentally friendly and has the highest contribution towards environmental sustainability. The study suggests incorporating hybrid energy systems provides the means of transition toward a circular economy, ultimately promoting ecological sustainability. The study proposes to the officials of the Pakistani government and policymakers to initiate effective policies to encourage hybrid energy systems because the significance of hybrid systems ensures a low carbon economy and makes a path towards sustainable economic development.

Prediction of superconductivity in sandwich XB4 (X = Li, Be, Zn and Ga) films.

Borophenes and 2D boron allotropes are metallic and exhibit a BCS superconducting state, unlike graphene. In-plane stretching vibrational modes in bulk MgB2 boron layers induce phonon-mediated superconductivity. However, the effect of stretching vibrational phonon modes on transition temperature (Tc) still requires further investigations. Here, we use first-principles calculations combined with conventional BCS theory to explore the superconducting properties in a series of dynamically stable boron-based sandwich films that have not been realized experimentally. The sandwich films of XB4 (where X = Li, Be, Zn, Ga) are predicted to exhibit good phonon-mediated superconductivity with high Tc values of 25.1 K, 28.7 K, 38.7 K, and 36.2 K, respectively. The origin of the superconducting states is mainly caused by the high metallicity and strong electron-phonon coupling (EPC), which can be attributed to the presence of intercalated atoms within the borophene layers. It is further demonstrated in the XB4 compounds (where X = Li, Be, Zn, Ga) that the pronounced EPC is not solely attributable to the in-plane vibrations of B atoms, but it is also influenced significantly by the out-of-plane vibrations of B atoms. Sandwich (Li,Be,Zn,Ga)B4 films may be a great choice for nanoscale superconductors as the electron-phonon coupling parameter becomes greater than unity, thereby providing a powerful approach for investigating these systems with high critical temperatures.

Paper-based facile capacitive touch arrays for wireless mouse cursor control pad.

Wireless devices have become extremely inexpensive and popular in recent years. The two most significant advantages of wireless devices over wired ones are convenience and flexibility. Considering this, a wireless mouse pad prototype for access has been developed in this study. A capacitive sensors-based mouse pad with basic operations and conventional features has been developed using sensing arrays on paper. A facile, do-it-yourself fabrication process was utilized to develop a cost-effective, thin, wearable, and cleanroom-free wireless mouse cursor control (MCC) pad. The ablation process was used to cut the traces of conductive tape and paste them onto the paper to develop the MCC pad. The pad was connected with Espressif Systems (ESP)32 to wirelessly control the cursor of mobile and laptop. The capacitive touch sensor array-based pad is easy to reproduce and recycle. This pad can contribute to future advancements in thin human-machine interfaces, soft robotics, and medical and healthcare applications.

Digitalized world and carbon footprints: does digitalization really matter for sustainable environment?

There is a growing demand for energy to support economic and social development. There will be many shifts in the energy sector as a result of digitization. Hence, we aim analyzing the linkage between digitalization and environment sustainability by incorporating energy consumption as a moderating factor using data of UK from 1990 to 2020. Different dimensions of digitalization are used as explanatory variables, ecological and carbon footprints are used as outcomes and energy consumption is used as moderator. The findings of autoregressive distributed lag model show that internet users and technological advancement (fixed telephone subscription and mobile cellular) are negatively (positively) linked with ecological and carbon footprints. Energy consumption causes to enhance ecological and carbon footprints and plays an antagonistic role in the nexus of internet users, technological advancement, and ecological and carbon footprints. The effects of mobile cellular and fixed telephone subscription have increased in the presence of energy consumption as moderator which exhibits that energy consumption plays an enhancing role in the links between mobile cellular, fixed telephone subscription and ecological and carbon footprints. The results underscore the importance of taking a holistic approach to addressing the environmental impact of digital technologies. By promoting sustainable communication practices and investing in the development of more energy-efficient technologies, practitioners, managers, and society as a whole can work together to reduce the carbon and ecological footprints of digital technologies and create a more sustainable future for all.

Fast Response Facile Fabricated IDE-Based Ultra-sensitive Humidity Sensor for Medical Applications.

An eco-friendly, biodegradable, flexible, and facile fabricated interdigital electrode-based capacitive humidity sensor with applications in health and medicine has been reported here. Several sensors use copper tape as electrodes on the polyethylene terephthalate (PET) substrate, with non-woven paper as the sensing layer. Two different configurations of sensors were tested, i.e., with and without pores in the PET substrate. The sensing performance of both sensors has been tested for relative humidity ranging from 35 to 100% at temperatures ranging from 20 to 50 °C. The capacitance of the sensor varies linearly in response to the change in humidity. The sensor with pores shows a response from 28 to 630 pF as the humidity varied from 35 to 100%, whereas the sensor without pores responded from 22 to 430 pF. The response and recovery times of the fabricated sensor are observed as ∼2.4, and ∼1.8 s, respectively, and the sensitivity is 9.67 pF/% RH. The sensors are tested multiple times, and repeatable results are achieved each time with an accuracy of ±0.22%. Further, the sensor's response is also stable for different ranges of temperatures. Finally, to demonstrate an application of the proposed sensor, it has been utilized to monitor respiration through nose and mouth breathing. The low-cost, stable, repeatable, and highly sensitive response makes our fabricated sensor a promising candidate for practical field applications.

Behavioural Phenomena of Family Firm Control Diversity and R&D Investment with Moderating Role CEO Compensation.

Purpose: The novel study describes the behXavioural phenomena of family firm types and explores the relationship between the family firm types of control diversity and Research and Development (R&D) investments. Acquiring controlling rights is a psychological phenomenon for family firm owners. The moderating effect of CEO compensations on R&D investments is investigated. Methodology: We collected data of listed A-share family firms in China from 2011 to 2020 in the China Stock Market and Accounting Research database. We used Tobit regression for data analysis. Results/Finding: The study concludes that lone-controller family firms (LCFFs) are less willing to invest in R&D and multi-controller family firms (MCFFs) have positive behaviour towards R&D. The moderating role of CEO compensation deviates the willingness and behaviour to invest in R&D. Conclusion/Originality: To the best of our knowledge, this study is the first to outline the paradoxical empirical evidence on family firms and R&D investments by analysing control diversity and how the moderating role of CEO compensation nexus can alter willingness towards R&D. The study is a novel attempt following De Massis et al's framework to test the willingness and ability of LCFFs and MCFFs. Previous studies based on agency theory have tacitly assumed that ability and willingness exist in family-controlled firms. However, this study challenges this implicit assumption.

Invisible touch sensors-based smart and disposable door locking system for security applications.

Nowadays, security is one of the living essentials, and there is a dire need for reliable, secure, and smarter locking systems. The stand-alone smart security systems are of great interest as they do not involve keys, cards, or unsecured communication in order to prevent carrying, loss, duplication, and hacking. Here, we report an invisible touch sensors-based smart door locking system (DLS). The passive transducer-based touch sensors are fabricated through a facile do-it-yourself (DIY) based fabrication process by pasting the hybrid geometry copper electrodes on cellulose paper. The employment of biodegradable, and non-toxic materials like paper and copper tape makes this configuration a good candidate for green electronics. For additional security, the keypad in the DLS is made invisible by covering it with paper and spray paint. One can only open the door by knowing the password as well as the location of each key on the sensor keypad. The system can efficiently recognize the exact pattern of passwords without any false values. Invisible touch sensors-based locking systems can easily contribute to the security applications in homes, banks, automobiles, apartments, lockers, and cabinets.

Facile Pressure-Sensitive Capacitive Touch Keypad for a Green Intelligent Human-Machine Interface.

There is a great demand for human-machine interfaces (HMIs) in emerging electronics applications. However, commercially available plastic-based HMIs are primarily rigid, application-specific, and hard to recycle and dispose of due to their non-biodegradability. This results in electronic and plastic waste, potentially damaging the environment by ending up in landfills and water resources. This work presents a green, capacitive pressure-sensitive (CPS), touch sensor-based keypad as a disposable, wireless, and intelligent HMI to mitigate these problems. The CPS touch keypads were fabricated through a facile green fabrication process by direct writing of graphite-on-paper, using readily available materials such as paper and pencils, etc. The interdigitated capacitive (IDC) touch sensors were optimized by analyzing the number of electrode fingers, dimensions, and spacing between the electrode fingers. The CPS touch keypad was customized to wirelessly control a robotic arm's movements based on the touch input. A low-pressure touch allows slow-speed robotic arm movement for precision movements, and a high-pressure touch allows high-speed robotic arm movement to cover the large movements quickly. The green CPS touch keypad, as a disposable wireless HMI, has the potential to enforce a circular economy by mitigating electronic and plastic waste, which supports the vision of a sustainable and green world.

Garage-Fabricated, Ultrasensitive Capacitive Humidity Sensor Based on Tissue Paper.

The role of humidity sensors in different industries and field applications, such as agriculture, food monitoring, biomedical equipment, heating, and ventilation, is well known. However, most commercially available humidity sensors are based on polymers or electronic materials that are not degradable and thus contribute to electronic waste. Here, we report a low-cost, flexible, easy-to-fabricate, and eco-friendly parallel-plate capacitive humidity sensor for field applications. The sensor is fabricated from copper tape and tissue paper, where copper tape is used to create the plates of the capacitor, and tissue paper is used as a dielectric sensing layer. Along with the low cost, the high sensitivity, better response and recovery times, stability, and repeatability make this sensor unique. The sensor was tested for relative humidity (RH), ranging from 40% to 99%, and the capacitance varied linearly with RH from 240 pF to 720 pF, as measured by an Arduino. The response time of the sensor is ~1.5 s, and the recovery time is ~2.2 s. The experiment was performed 4-5 times on the same sensor, and repeatable results were achieved with an accuracy of ±0.1%. Furthermore, the sensor exhibits a stable response when tested at different temperatures. Due to the above advantages, the presented sensor can find ready applications in different areas.

Validating LA/AIDS model in the food market of Pakistan.

The study aims to conduct a consumer demand analysis of the food market of Pakistan by estimating its own price and cross-price elasticities. This study also examines expenditure and income elasticities to show the influence of relative change in price, total expenditure, and income on the relative change in demanded quantities of the selected food products. The study takes meat, vegetables, fruits, and pulses as different food baskets and estimates income elasticities, including uncompensated (Marshallian) and compensated (Hicksian) own price and cross-price elasticities. The findings are concluded based on Marshallian elasticity as it provides more accurate images of substitutes and complements compared with Hicksian elasticity. The study applies the Linear Approximate Almost Ideal Demand System model to estimate the results by acquiring data from a household integrated economic survey of Pakistan from 2018 to 2019. The findings of expenditure elasticity (uncompensated own price elasticity) reveal that vegetables and pulses are normal (inelastic) goods, whereas meat and fruits are luxury (elastic) goods. The results of uncompensated cross-price elasticities reveal that vegetables and meat, and vegetables and fruits are substitutable commodities. In addition, pulses and vegetables, and pulses and meat are complementary goods. The study suggests fruitful implications for food policymakers.

Behavioural Psychology of Unique Family Firms Toward R&D Investment in the Digital Era: The Role of Ownership Discrepancy.

This study examines the R&D investment behaviour of different types of family-controlled firms with the moderating role of ownership discrepancy between cash-flow rights and excess voting rights by using the sufficiency conditions' theoretical framework of ability and willingness developed by De Massis. It uses data from family firms that have issued A-shares from 2008 to 2018. They used pooled OLS regression for data analysis and Tobit regression for robustness checks. This study classifies family firm types into two categories, namely, the lone-controller family firms (LCFFs) and the multi-controller family firms (MCFFs), with each being further classified as "excess" or "no excess" voting rights. Both LCFFs without excess voting rights and MCFFs with excess voting rights have the "ability" and "willingness" toward R&D investment. LCFFs with excess voting rights and MCFFs without excess voting rights only have the ability but low willingness to invest in R&D. The study also establishes that Chinese family-controlled firms are heterogeneous toward risky investment. To the best of our knowledge, this study is the first to differentiate Chinese family firms by their unique ownership structure characteristics in investigating the effect of the family firm structure on R&D investment. The study is a novel attempt to test the willingness and ability framework of LCFFs and MCFFs. Previous studies based on agency theory have tacitly assumed that ability and willingness exist in family-controlled firms. However, this study challenges this implicit assumption.

Behavior Towards R&D Investment of Family Firms CEOs: The Role of Psychological Attribute.

INTRODUCTION: This study aims to explore the effects of the behavior of chief executive officers (CEOs) within family firms on investment in research and development (R&D). We also investigate the effect of CEOs' psychological attributes of overconfidence on R&D investment and the moderating effect between the types of CEOs and R&D investment. METHODS: We obtained data on Chinese A-share firms from China Stock Exchange and Accounting Research from 2010 to 2018 for analysis. Then, we used the ordinary least squares model for regression results; moreover, the Tobit regression, GMM and firm fixed effect model are applied to check the robustness of the results. RESULTS: Family CEOs with actual control rights are more open to R&D investment, whereas those without actual control rights exhibit negative behavior. The study found that non-family CEOs exhibit insignificant results and negative predicted signs toward R&D investment. Moreover, the results show that overconfident CEOs are more inclined to amplify innovation. Furthermore, results on the moderating effects of CEO psychological attribute of overconfidence indicate that the CEO overconfidence mitigates the negative relationship between family CEOs with actual control rights and R&D investment. However, no moderating effect is found between family CEOs without actual control and R&D investment. The CEO psychological attribute behavior is positive between non-family CEOs and R&D investment. DISCUSSION: This novel study explores the behavioral effect of different types of family firm CEOs on R&D investment. This study will assist corporate board members to make more informed decisions about retaining (or bringing back) family CEOs (with or without actual control rights) or hiring non-family CEOs.

Evolution of Castration-Resistant Prostate Cancer in ctDNA during Sequential Androgen Receptor Pathway Inhibition.

PURPOSE: Cross-resistance renders multiple lines of androgen receptor (AR) signaling inhibitors increasingly futile in metastatic castration-resistant prostate cancer (mCRPC). We sought to determine acquired genomic contributors to cross-resistance. EXPERIMENTAL DESIGN: We collected 458 serial plasma cell-free DNA samples at baseline and progression timepoints from 202 patients with mCRPC receiving sequential AR signaling inhibitors (abiraterone and enzalutamide) in a randomized phase II clinical trial (NCT02125357). We utilized deep targeted and whole-exome sequencing to compare baseline and posttreatment somatic genomic profiles in circulating tumor DNA (ctDNA). RESULTS: Patient ctDNA abundance was correlated across plasma collections and independently prognostic for sequential therapy response and overall survival. Most driver alterations in established prostate cancer genes were consistently detected in ctDNA over time. However, shifts in somatic populations after treatment were identified in 53% of patients, particularly after strong treatment responses. Treatment-associated changes converged upon the AR gene, with an average 50% increase in AR copy number, changes in AR mutation frequencies, and a 2.5-fold increase in the proportion of patients carrying AR ligand binding domain truncating rearrangements. CONCLUSIONS: Our data show that the dominant AR genotype continues to evolve during sequential lines of AR inhibition and drives acquired resistance in patients with mCRPC.

Effectiveness of first-line abiraterone versus enzalutamide among patients ≥80 years of age with metastatic castration-resistant prostate cancer: A retrospective propensity score-weighted comparative cohort study.

BACKGROUND: Metastatic castration-resistant prostate cancer (mCRPC) disproportionately affects the elderly. There is limited data assessing the efficacy and tolerability of abiraterone acetate (AA) versus enzalutamide in this population. OBJECTIVE: To compare the clinical efficacy and tolerability of AA versus enzalutamide in patients ≥ 80 years with mCRPC. DESIGN, SETTING AND PARTICIPANTS: A retrospective propensity-weighted comparative cohort study of first-line AA versus enzalutamide among patients with mCRPC aged ≥80 years. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Inverse probability treatment weights based on propensity scores were generated to assess the treatment effect of AA versus enzalutamide on time to PSA progression (TTPP), time to progression (TTP) (first of PSA/radiographic/clinical progression) and overall survival using a weighted Cox proportional hazards model. PSA response rate (PSA RR) was compared between groups using Χ2. RESULTS AND LIMITATIONS: One hundred fifty-three patients received AA, and 125 received enzalutamide. Enzalutamide was associated with higher PSA RR (61.6% vs 43.8%, P < 0.004), and TTP (hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.50-0.88, P = 0.01) but not TTPP (HR 0.73, 95% CI 0.53-1.01, P = 0.06). There were significantly more dose reductions with enzalutamide (22.9% vs 44.8%, P > 0.001) but there was no interaction between median proportion of full dose received and TTPP or TTP for either drug. Rates of treatment discontinuation (for reasons other than progression) were also significantly different between AA and enzalutamide (28.8% vs 40.8%, respectively, P = 0.04). The most common reason for dose reductions and discontinuation of enzalutamide was fatigue (30.4% and 5.6%, respectively). CONCLUSIONS: Despite more dose reductions and a higher treatment discontinuation rate, enzalutamide was associated with a higher PSA RR and longer time to progression, than AA. Given that clinical outcomes were not adversely impacted by decreased treatment exposure, dose modification may be a useful treatment strategy to balance toxicity and tolerance.

Regional disparities in Preventive measures of COVID-19 pandemic in China. A study from international students' prior knowledge, perception and vulnerabilities.

The COVID-19 pandemic needs immediate solution before inflicting more devastation. So far, China has successfully controlled transmission of COVID-19 through implementing stringent preventive measures. In this study, we analyze the effectiveness of preventive measures taken in thirteen regions of China based on the feedback provided by 1135 international students studying in China. The study uses factor analysis combined with varimax rotation of variables. It was found that awareness raising and dispersing actionable knowledge regarding trust and adapting measures remained significantly important. Therefore, recognition of information gaps, improvements in the level of alertness, and development of preventive measures in each sector are imperative. The findings of this study revealed that trust, students' health, waste disposal, and the efforts of the Chinese government/international institute of education to prevent this pandemic were significantly and positively associated with preventive measures. The results showed that prior knowledge, global pandemics, and food and grocery purchases were firmly related to the preventive measures of COVID-19. Moreover, anxiety, transportation, and economic status were negatively related to the preventive measures. During this epidemic situation, international students suffered various types of mental stresses and anxiety, especially living in most affected regions of China. The study adopted a mixed (qualitative and quantitative) approach where the findings can act as a set of guidelines for governmental authorities in formulating, assisting in the preparation, instructing, and guiding policies to prevent and control the epidemic COVID-19 at national, local, and divisional levels.

Response surface methodology and artificial neural network for remediation of acid orange 7 using TiO2-P25: optimization and modeling approach.

The primary responsibility for continuously discharging toxic organic pollutants into water bodies and open environments is the increase in industrial and agricultural activities. Developing economical and suitable methods to continuously remove organic pollutants from wastewater is highly essential. The aim of the present research was to apply response surface methodology (RSM) and artificial neural networks (ANNs) for optimization and modeling of photocatalytic degradation of acid orange 7 (AO7) by commercial TiO2-P25 nanoparticles (TNPs). Dose of TNPs, pH, and AO7 concentration were selected as investigated parameters. RSM results reveal the reflective rate of AO7 removal of ~ 94.974% was obtained at pH 7.599, TNP dose of 0.748 g/L, and AO7 concentration of 28.483 mg/L. The resulting quadratic model is satisfactory with the highest coefficient of determination (R2) between the predicted and experimental data (R2 = 0.98 and adjusted R2 = 0.954). On the other hand, ANNs were successfully employed for modeling of AO7 degradation process. The proposed ANN model was absolutely fitted with experimental results producing the highest R2. Furthermore, root mean square error (RMSE), mean average deviation (MAD), absolute average relative error (AARE), and mean square error (MSE) were examined more to compare the predictive capabilities of ANN and RSM models. The experimental data was well fitted into pseudo-first-order and pseudo-second-order kinetics with more accuracy. Thermodynamic parameters, namely enthalpy, entropy, Gibbs' free energy, and activation energy, were also evaluated to suggest the nature of the degradation process. The increase of temperature was analyzed to be more suitable for the fast removal of AO7 over TNPs. Graphical abstract.

Targeted drug delivery systems: synthesis and in vitro bioactivity and apoptosis studies of gemcitabine-carbon dot conjugates.

Gemcitabine (GEM) is used to treat various cancers such as breast, pancreatic, non-small lung, ovarian, bladder, and cervical cancers. GEM, however, has the problem of non-selectivity. Water-soluble, fluorescent, and mono-dispersed carbon dots (CDs) were fabricated by ultrasonication of sucrose. The CDs were further conjugated with GEM through amide linkage. The physical and morphological properties of these carbon dot-gemcitabine (CD-GEM) conjugates were determined using different analytical techniques. In vitro cytotoxicity and apoptosis studies of CD-GEM conjugates were evaluated by various bioactivity assays on human cell lines, MCF-7 (human breast adenocarcinoma), and HeLa (cervical cancer) cell lines. The results of kinetic studies have shown a maximum drug loading efficacy of 17.0 mg of GEM per 50.0 mg of CDs. The CDs were found biocompatible, and the CD-GEM conjugates exhibited excellent bioactivity and exerted potent cytotoxicity against tumor cells with an IC50 value of 19.50 µg ml-1 in HeLa cells, which is lower than the IC50 value of pure GEM (∼20.10 µg ml-1). In vitro studies on CD-GEM conjugates demonstrated the potential to replace the conventional administration of GEM. CD-GEM conjugates are more stable, have a higher aqueous solubility, and are more cytotoxic as compared to GEM alone. The CD-GEM conjugates show reduced side effects in the normal cells along with excellent cellular uptake. Hence, CD-GEM conjugates are more selective toward cancerous cell lines as compared to non-cancerous cells. Also, the CD-GEM conjugates successfully induced early and late apoptosis in cancer cell lines and might be effective and safe to use for in vivo applications.