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Introduction Medical education is a rigorous and demanding journey that requires intellectual ability and emotional resilience. Burnout among medical students is a growing concern as it affects individuals' well-being and can have long-term implications on the quality of patient care. Recognizing the protective effects of healthy lifestyle factors such as sleep, physical activity, eating patterns, and screen time, various institutions have implemented wellness programs to promote students' mental and physical well-being. Objectives The main objective of this study was to assess for variations and associations between first- and second-year osteopathic medical students' physical activity, eating patterns, sleep, perceived stress, and phone screen use across 10 different time points throughout the school year. The secondary objective was to assess the impact of month-long health behavior challenges among participants in the five areas studied. Methods A prospective cohort study was performed regarding first- and second-year medical students' physical activity, eating patterns, sleep, perceived stress, and phone screen use, as respectively assessed by the Physical Activity Vital Sign and smartphone step count data; Starting the Conversation diet assessment; Single Item Sleep Quality Scale and a portion of the Pittsburgh Sleep Quality Index; Perceived Stress Scale; and smartphone screen time use data. The assessments, built-in Qualtrics (Qualtrics International Inc., Provo, USA), were sent via email and class-wide GroupMe text message at 10-time points, capturing the beginning, middle, and end of curricular blocks and seasonal breaks. Participants could win one of 20 $25 Amazon gift cards each time they completed the assessment. Behavior challenges were implemented at six of the 10-time points and focused on facilitating health behavior change among participants. Results The response rate for the 10 assessments was low, ranging from 7% to 13%. The means (±SD) for each outcome of interest combined across the 10 time points were as follows: physical activity = 112 (±100) minutes/week; step count = 4,627 (±3179) steps/day; water intake = 5.6 (±4.0) cups/day; diet score = 6.3 (±2.1) where 0 = most healthful and 16 = least healthful; perceived stress = 6.6 (±5.8) where 0 = lowest and 40 = highest; sleep = 6.7 (±1.0) hours/night; sleep quality = 6.3 (±1.8) where 0 = terrible and 10 = excellent; and phone screen time = 328.5 (±147) minutes/day. Statistical analysis indicated variation (p<0.05) in physical activity minutes, steps per day, water intake, diet score, and phone screen time minutes over time. Given low participation, only 6 of the 10 behavior challenges were implemented, in which the participation rate ranged from 36% to 65% of assessment participants. Conclusion Results indicate room for improvement regarding lifestyle factors among medical students' physical activity, eating patterns, sleep, perceived stress, and phone screen time use. A primary limitation of this study is the low participation rate. Building on these efforts, students are developing and delivering monthly wellness workshops, including a research component., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Edward Via College of Osteopathic Medicine (VCOM) Institutional Review Board issued approval 2022-037. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: The budget of this project consisted entirely of incentives to maximize participation in the 10 time-point assessments. Two hundred Amazon gift cards worth $25 each were ordered (total budget of $5,000), supplying 20 gift cards per assessment. Participants were entered into a lottery to win 1 of 20 gift cards for each assessment that they completed. The funding/sponsor was the American Association of Colleges of Osteopathic Medicine (AACOM). No conflicts of interest with this project and the funding are identified. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Machireddy et al.)

Rheumatoid arthritis (RA) is a debilitating condition that results in impairment of joints and ligaments and thus constrained mobility and decreased array of movement. It is a broad expression that encompasses additional 100 very diverse disorders mainly affecting joints. In the field of drug discovery, there is no well-known treatment for RA that can eradicate the disease permanently and alleviate the pain. The common non-targeted treatment approaches leads to serious side effects and systemic complications for RA patients. Therefore, targeted drug delivery systems, strategies, and diverse therapeutic approach for treatment of RA have gained increasing attention in the past few years. However, with the current understandings, researchers aim at accomplishing complete and long-lasting remission by the development of smart formulations/smart drug-delivery systems. Treatment for RA patients can be more efficient and effective utilizing these smart approaches. The present review focuses on the existing novel drug-delivery systems, strategies, and current trends in the treatment of RA.