Precision medicine across endocrine, metabolic, immune, and oncologic systems: an integrated mechanistic review

The pharmacological therapy of neonates is extremely complicated due to the immature organ systems of the body, high water content, and low numbers of clinical studies in children of this age. Conventional dosing strategies, usually based on weight or age, are often inaccurate and may result in either underexposure or toxicity. A structured literature search was performed in PubMed/MEDLINE and Scopus, as well as in Web of Science, from the year 2000 until September 2025. The search was based on neonatal pharmacokinetics, model-informed precision dosing ( MIPD ), Bayesian dosing, and artificial intelligence/machine learning. Following the removal of duplicates and 2-stage screening (title/abstract and full-text review), 82 studies were used in the end to conduct this review. This review follows the PRISMA 2020 flow selection style. We established that pharmacokinetic and pharmacodynamic ( popPK/PD ) models, with the help of Bayesian strategies, can offer a context of therapy individualization, but they are still limited by the absence of complete information and high intersubjective differences. Artificial intelligence ( AI ) can also be used to provide an extra level of support by processing vast and multifaceted data, discovering latent trends, and improving predictions of doses in real time. Our review concluded that applications of AI -driven tools are now emerging in neonatal intensive care, particularly for antibiotics and analgesics, where accurate dosing is critical. Combining AI with the known pharmacometric practices could assist clinicians to minimize adverse drug reactions, enhance treatment outcomes, and get closer to the actual personalized pharmacotherapy in neonates.

Bleeding evaluation in patients with liver cirrhosis due to therapeutic approach: a statistical overview

In patients with decompensated liver cirrhosis, the presence of acute hemorrhage is a common clinical finding. The different types of bleeding that may be observed include variceal and non-variceal gastrointestinal bleeding and systemic bleeding due to abnormalities in overall coagulation status. This retrospective study included 438 patients with liver cirrhosis who were selected from the endoscopy records. Of all admitted patients, 323 had a variceal source of bleeding. The remaining 115 patients had non-variceal bleeding. The findings show that the most frequent etiology was variceal bleeding. Peptic ulcer (gastric and duodenal ulcer) was dominant (60%) in the etiology of non-variceal upper gastrointestinal bleeding. The significant rate of all acute GI hemorrhage in cirrhosis was variceal, but a considerable proportion had non-variceal causes. Our study showed that in about 26.3% of the cirrhotic patients with upper gastrointestinal hemorrhage, the bleeding occurred from non-variceal sources, of which the most frequent one was ulcer. These results show that therapy should be approached after clinical evaluation and upper gastrointestinal endoscopy.

Antibiotic prescribing practice for pediatric respiratory tract infections in a tertiary care hospital in Iraq

Prescribing antibiotics for pediatric patients with respiratory tract infections ( RTIs ) remains poorly studied in many low- and middle-income countries. This study aims to evaluate the quality of antibiotic prescribing for in-hospital pediatric patients with RTIs , identify predictors of this practice, and evaluate patients’ clinical outcomes. A cross-sectional study was conducted at Baghdad Medical City from September 2025 to January 2026. Pediatric inpatients were selected using consecutive sampling, and data were collected from their medical records. Antibiotics were prescribed in 81.0% of cases, mostly cephalosporins (43.8%) and penicillins (34.6%). The intravenous (IV) route of administration was prescribed in 84.0% of cases. Prescribing quality was moderate (mean = 6.12 + 1.24). Antibiotics were prescribed for viral infections in 29.5% of cases (59 out of 200 patients); weight-based dosing was not documented in 27.3% of cases; and 7.1% of cases had a microbiological test performed. A longer hospital stay ( β = -0.18, P < 0.001) and the use of IV antibiotics (β = - 0.72, P = 0.004) were the only independent variables associated with lower prescribing quality. Most pediatric patients (94.5%) achieved successful treatment, with few adverse events (1.0%) and readmissions (3.5%). Despite the positive short-term clinical outcomes, significant shortcomings in diagnostic and prescribing practices remain.

Efficacy of trimebutine maleate as treatment for patients with functional gastrointestinal disorders: a multicenter prospective trial

Trimebutine, a selective antispasmodic and gastrointestinal motility modulator, was evaluated for symptom control in functional dyspepsia and overlapping functional gastrointestinal disorders. A multicenter, prospective observational study was conducted in four centers in Sofia, Bulgaria, enrolling 161 patients aged 24–75 years diagnosed according to the Rome IV criteria. All patients received trimebutine maleate 300 mg once daily for four weeks, with symptom severity assessed on a 0–5 self-reported scale. At study completion, more than 90% of patients demonstrated symptomatic improvement across upper and lower gastrointestinal symptoms. No statistically significant difference was observed between trimebutine monotherapy and combined proton pump inhibitor therapy in alleviating upper gastrointestinal symptoms at week four. The findings suggest that trimebutine at a 300 mg daily dose is effective in reducing functional gastrointestinal symptoms over a four-week period. These results support further investigation through randomized controlled trials to confirm efficacy and optimize combination strategies.

Developing Stronger Brands: How Brand Awareness Drives Purchase Intention Through Image and Trust?

This paper examined the interconnectedness of brand awareness (BA), brand image (BI), brand trust (BT), and purchase intention (PI) in a sample of consumer of comparably locally produced in the Kingdom of Saudi Arabia. In a sample of 900 consumers who purchased Saudi-made products, the authors applied Partial Least Squares Structural Equation Modelling (PLS-SEM) methodology to assess the proposed conceptual model. The analysis revealed that BA positively enhanced BI significantly, and BI subsequently paved a significant path to BT and PI. BA and PI were followed partially by BI and BT respectively, and a serial mediation was found. It requests branding policies which aren't naive BA, but rather influence BI and maintain BT. It is retrospect to the local initiatives that signifies the significance of the drivers of BA and how they translate into a more salient BI and PI, and favor for local product. It provided the findings that are critical to marketers, managers, and policymakers in planning to allocate the local brands as trustworthy and competitive slogans in the local marketplace.

Workplace Spirituality, Employee Well-Being, and Individual Work Performance in Public Universities: A Gender-Integrated Model

This research analyzes the relationships among workplace spirituality (WS), employee well-being (EW), and individual work performance (IP) in Saudi public universities, with a special focus on gender. Drawing on positive organizational theory, a research model linking WS, EW, and IP is developed. A survey of 373 faculty members in Riyadh at four major public universities was conducted, and structural equation modelling (SEM) with AMOS program was used to examine the indicated relationships. Findings indicate that workplace spirituality positively influences employee well-being and employee well-being positively influences individual work performance. Workplace spirituality also has a direct positive influence on individual work performance, while relying on employee well-being as a moderator of this relationship.

Techno-Stress and Value Pathways in Metaverse-Enabled E-Commerce Services: Evidence From Palestine

E-commerce increasingly involves adopting advanced technologies and digital transformation in the retail sector, notably including awareness of and intentions to adopt emerging innovations such as the metaverse. This study explores intentions to adopt metaverse technology for e-commerce by examining the impact of the key constructs of the UTAUT model on both hedonic and utilitarian value. The study was conducted in the context of e-commerce consumers in Palestine. A structured questionnaire was used to gather data from 344 shoppers. The study's results revealed that effort expectancy, social influence, and facilitating conditions had a positive impact on both hedonic and utilitarian value. Hedonic value had a greater impact than utilitarian value on intentions to adopt the metaverse in e-commerce. This finding underscores the selective influence of techno-stress on shoppers' adoption of the metaverse.

Travel Time as an Indicator of Poor Access to Care in Surgical Emergencies

Sex Differences in Long COVID

Firearm-Related Injury Hospital Admissions During the COVID-19 Pandemic