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Open Access May 20, 2025

Periprosthetic Joint Infections in Total Hip Arthroplasty: Diagnostic Advances, Treatment Algorithms, and Technological Innovations — A Comprehensive Review

Abstract Objective: This integrative review aims to critically examine the clinical management of periprosthetic joint infections (PJI) in total hip arthroplasty (THA), emphasizing decision-making strategies, diagnostic advancements, and therapeutic innovations. The study focuses on the complexity of infection control, microbial resistance, and individualized treatment planning. Methods: [...] Read more.
Objective: This integrative review aims to critically examine the clinical management of periprosthetic joint infections (PJI) in total hip arthroplasty (THA), emphasizing decision-making strategies, diagnostic advancements, and therapeutic innovations. The study focuses on the complexity of infection control, microbial resistance, and individualized treatment planning. Methods: A systematic review of the literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar, targeting studies published between 2015 and 2025. Articles were selected based on their contribution to understanding the clinical, microbiological, and surgical aspects of PJI in THA. Fifty-five studies met the inclusion criteria and were analyzed descriptively. Results: PJI in THA is influenced by multifactorial risk profiles, including obesity, diabetes, and immunosuppression. Staphylococcus aureus, particularly MRSA, remains the most frequently isolated pathogen, followed by Gram-negative organisms and fungal species. Diagnostic innovations such as next-generation sequencing have enhanced pathogen detection, while two-stage revision remains the gold standard for chronic infections. Emerging strategies—such as antimicrobial coatings, tailored antibiotic protocols, and multidisciplinary care models—demonstrate promise in improving clinical outcomes. Conclusion: Managing PJI in THA necessitates a comprehensive and individualized approach, integrating early and accurate diagnosis, pathogen-specific treatment, and advanced preventive measures. The integration of emerging technologies and personalized care pathways is critical to optimizing outcomes and reducing the clinical and economic burden of PJI.
Review Article
Open Access December 18, 2023

Leveraging AI, ML, and Generative Neural Models to Bridge Gaps in Genetic Therapy Access and Real-Time Resource Allocation

Abstract This paper leverages gene and cell therapy research in diverse disorders ranging from monogenic to infectious diseases to cancer and emerging breakthroughs, where one can harness individual genes or a synthetic gene sequence designed based on a shared molecular pattern in infected cells to better fight various disorders [1]. A pivotal task is to predict the performances of candidate gene therapies [...] Read more.
This paper leverages gene and cell therapy research in diverse disorders ranging from monogenic to infectious diseases to cancer and emerging breakthroughs, where one can harness individual genes or a synthetic gene sequence designed based on a shared molecular pattern in infected cells to better fight various disorders [1]. A pivotal task is to predict the performances of candidate gene therapies to guide clinical translational research using methods such as retrospective bioinformatic analyses. Implementing them to a large-scale gene therapy database reveals that it is feasible to construct and apply well-performing interpretable, supervised learning models [2]. Preliminary evidence of machine learning approaches' statistical significance helps clinicians and biomedical researchers, market participants, and regulatory and economic experts derive relevant, practical applications, thereby enhancing the deployment of gene therapy and genomics to achieve positive, long-term growth for humanity while alleviating the ongoing worldwide economic burden precipitated by prolonged and recurring diseases. Deploying machine learning techniques to accelerate gene and cell therapy drug development and trials shall also mitigate the existing obstacle of limited patient access to emerging, transformative medical innovations such as gene therapy due to skyrocketing prices, which often herald gene therapy products as the world's most expensive medicines [3]. Moreover, in preventing patients from accessing effective, life-saving genetic medicines, there commonly exists a multidimensional access gap encompassing the availability, affordability, and quality or acceptability of these clinical treatments. The ensuing substantial gap has repeatedly been documented and mainly emanates from differential institutional and socio-political choices around resource allocation at international and domestic levels [4]. Particularly, it is also due to the stringent licensure and regulatory approval processes underpinned by insufficient evidence for novel safety and clinical efficacy profiles for genetic therapies in multiple micro-local diagnoses and subpopulations. We believe that a higher likelihood of gene therapy adoption shall result when the clinical evidence path contains adequate representation from the most diverse and relevant patient populations [5].
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Keyword:  Economic Burden

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