Search

Background: The research aims to investigate the impact of a single bout of functional fatigue on proprioception, coordination, and variability among lower extremity joints and segments in semi-skilled male cyclists. Cycling is recognized as a sport in both professional and public contexts, yet excessive activity and fatigue pose significant risks for injury during pedaling.Methods: The present study utilized a semi-experimental design employing a pretest-posttest method. It involved 24 randomly selected semi-skilled male cyclists with a mean age of 26.32±5.72 years. Before inducing fatigue through cycling, participants underwent pretest and posttest assessments to evaluate coordination and variability among segments of the lower extremities and proprioception of the knee and ankle joints. These assessments were conducted using a three-dimensional optoelectronic system with six cameras operating at a sampling frequency of 200 Hz. This system facilitated the acquisition of kinematic data related to the lower extremities. Statistical analysis included a one-way repeated measures ANOVA test and dependent t-test to compare all variables.Results: The significance level in all statistical tests was set at 0.05. The findings indicated a significant increase in knee and ankle proprioception (P < 0.001) as well as coordination and variability among lower extremity segments (P < 0.001).Conclusion: The presence of heightened proprioceptive errors in the joints, decreased coordination, and increased variability between segments indicates their association with sports injuries. Consequently, prolonged cycling and fatigue may contribute to an elevated prevalence and diversity of sports injuries among semi-skilled cyclists.

Background: It is important to screen athletes before the competition season to identify those at risk of injury. Three-person basketball is a team sport where injury risks should be closely monitored. The present study investigates the role of the Functional Movement Screen (FMS) test in predicting sports injuries in three-person basketball athletes.Methods: A cross-sectional study was conducted on 50 male athletes (22 athletes with injuries and 28 athletes without injuries) with an average age of 25.58±3.83, weight of 76.64±6.23, and height of 184.18±6.55. Multiple logistic regression analysis was performed to investigate the factors related to injury. SPSS software was used for data analysis, with a significance level of p

Background: Patients with foot drop may need compensatory mechanisms to improve their gait. Although several gait analysis parameters have been studied in these individuals, no prior research has examined their joint contact force. Thus, this study investigated multiple gait analysis parameters and the joint contact force in patients with foot drop.Methods: This experimental study recruited twenty individuals aged 15 to 60 (mean value 56.4 ± 3.68) with foot drop disorders. A control group was also matched with the first group based on age, height, and gender. The participants were instructed to walk along a 12-meter path. A motion analysis system with eight high-speed cameras and a Kistler force plate was used. During gait analysis, various parameters were measured, such as spatiotemporal, peak forces applied on the leg, range of motions, moments applied on the lower limbs, and joint contact forces.Results: The mean values of stride length and speed for normal subjects were 1.32±0.2 m and 1.24 ± 0.177 m/s, respectively, compared to 0.961±0.24 m and 0.686 ± 0.25 m/s for foot drop subjects (p-value = 0.00). The joint contact force components of the ankle joint increased significantly in foot drop subjects compared to normal subjects.Conclusion: The joint contact forces of the ankle joint increased significantly in foot drop patients, which should be considered in the rehabilitation treatment of these patients.

Background: Numerous studies have yielded conflicting results concerning the disparities in verbal (semantic and letter) fluency between monolingual and bilingual individuals. Given the linguistic variations among bilinguals and the influence of cultural differences on language, this study examined verbal fluency in Kurdish and Azari bilinguals and compared it with that of Farsi monolinguals.Methods: This cross-sectional study involved 30 Farsi monolingual students, 28 Kurdish-Farsi bilinguals, and 29 Azari-Farsi bilinguals. The study utilized semantic (fruits and animals) and letter fluency tasks (/f/, /a/, and /s/). Each bilingual participant was instructed to perform the verbal fluency tasks twice: once in their native language and once in Farsi.Results: In both fluency tasks, bilinguals demonstrated superior performance in Farsi compared to their mother languages (Azari and Kurdish) (P

BackgroundAnkle instability results in sensory and motor impairments. Typically, health professionals recommend conservative treatment as the initial approach for individuals with this condition. One such treatment option is Electrical Stimulation (ES). This systematic review assesses the effects of ES techniques on postural control measures in cases of ankle instability.MethodWe systematically searched five electronic databases: ClinicalTrials.gov, PubMed, Scopus, SPORTDiscus, and Web of Science. To evaluate the quality of the included articles, we utilized the PEDro checklist. We extracted data on population, intervention, and outcomes and synthesized them narratively.ResultES decreased the time needed to stabilize the center of pressure, velocity, displacement, and area, thereby enhancing the performance of clinical tests. While postural stability indexes remained unaffected, the gait inversion angle increased with electrical stimulation.ConclusionThese results suggest that ES interventions are crucial in enhancing postural control in subjects with ankle instability compared to coordination exercises therapy alone. Stochastic resonance reduced A/P and M/L TTS, COP velocity, COP displacement, and COP area, resulting in enhanced postural control.

Background: This study aimed to examine the impact of a regimen of scapular stabilization exercises on pain, shoulder position, and performance in volleyball players diagnosed with scapular dyskinesia.Methods: This semi-experimental, applied study involved 30 female volleyball players with scapular dyskinesia, who were purposefully selected and randomly assigned to control and training groups. The position of the shoulder, shoulder pain, and specific performance of the volleyball players were assessed using photographic methods, a numeric pain rating scale, and the AAHPERD service test. The training group performed scapular stabilization exercises for eight weeks. Post-tests were conducted after the exercise regimen. Parametric data were analyzed using paired t-tests and analysis of covariance, while non-parametric data were evaluated using the Wilcoxon and Yeoman-Whitney tests.Results: The findings indicated that an eight-week program of scapular stabilization exercises significantly improved shoulder position and specific performance and reduced shoulder pain in volleyball players with scapular dyskinesia.Conclusion: Scapular stabilization exercises can effectively enhance shoulder position, improve specific performance, and alleviate shoulder pain in volleyball players suffering from scapular dyskinesia.

Background: Cerebral palsy is one of the most prevalent physical disabilities in childhood. Children afflicted with this condition face a myriad of challenges and potential disabilities, which complicate treatment efforts. Integrating scales with other diagnostic instruments is increasingly crucial for accurately assessing these children and devising effective treatment strategies. This study primarily aims to review functional classification systems based on the International Classification of Functioning, Disability, and Health (ICF) for children with cerebral palsy and explore the relationships among these systems.methods: This study was designed to review the ICF-based functional classification systems. A comprehensive search was conducted across multiple databases, including Google Scholar, PubMed, ERIC, OVID, ProQuest, Scopus, Web of Knowledge, and OTseeker. Search terms related to cerebral palsy and various aspects of body function, activity, and participation were utilized. The search was conducted until September 2022 to gather relevant literature for analysis.Results: The analysis of the reviewed articles revealed the existence of five valid and reliable classification systems. In most studies, the correlation among these systems was moderate. Owing to their simplicity and comprehensiveness, these classification systems have significantly impacted the depiction of the functional status of children with cerebral palsy and the quality of their care. However, additional classification systems remain needed to address other overlooked functions and complete the overall description.Conclusion: The outcomes of this review indicated the development of classification systems for certain functions in children with cerebral palsy. In conjunction with the classifications above, creating additional new systems for overlooked functions could offer a comprehensive and integrated understanding of children with cerebral palsy's crucial functional capacities and performances.

Background: Identifying the risk factors and protective measures for Autism Spectrum Disorders (ASD) can significantly contribute to their prevention. This study aimed to ascertain the risk factors and protective measures associated with ASD.Methods: This retrospective case-control study was conducted in Sari, Iran, from 2020 to 2021. A total of 196 children, aged 2-17 years, were recruited by convenience sampling from the Baghban (Touba) Clinic, Zareh Psychiatric Hospital Clinic, and Bu-Ali Child and Adolescent Psychiatric Clinic. The case group consisted of 98 children with ASD, diagnosed based on the DSM-V criteria, while the control group included 98 children without ASD. Subsequently, potential risk factors in both groups were examined. The odds ratio was calculated at a 95% confidence level, with a significance level of P

Context: Prostate cancer remains a significant global health concern, and understanding the molecular drivers of this disease is crucial for developing effective diagnostic and therapeutic strategies. Steroid receptor coactivator-3 (SRC-3), a member of the SRC family, has emerged as a key player in prostate cancer pathogenesis. Aims: To examine the role of SRC-3 in prostate cancer, encompassing molecular mechanisms, clinical implications, and therapeutic opportunities. Methods: A systematic literature search following PRISMA guidelines was conducted in PubMed, PMC, and other relevant databases to identify studies that investigate SRC-3 in prostate cancer. Results: 785 articles were retrieved from databases using specific keywords and MeSH terms related to SRC-3 and Prostate Cancer. After removing 461 duplicates, 260 articles were excluded based on title and abstract review. Subsequently, a comprehensive screening by three researchers resulted in 47 relevant articles for this systematic review. Evidence suggests that SRC-3 expression correlates with prostate cancer aggressiveness, disease recurrence, and poor patient outcomes. Its potential as a diagnostic biomarker and therapeutic target if explored, offers insights into personalized medicine approaches. Conclusions: SRC-3 plays a pivotal role in prostate cancer, influencing disease progression and clinical outcomes. Understanding the molecular intricacies of SRC-3 in prostate cancer offers new opportunities for precision medicine and innovative therapeutic approaches. This review provides a comprehensive overview of SRC-3's involvement in prostate cancer, emphasizing its clinical relevance and potential as a therapeutic target, ultimately contributing to improved patient care in the era of personalized oncology.

Context: In the last decade, antimicrobial resistance cases have been widespread. The discovery and development of new drugs need to be done to overcome the case. Some research has found that some compounds, which are curcumin transformation derivatives, are able to inhibit the growth of Staphylococcus aureus. Aims: To evaluate the development of antimicrobial candidates of curcumin versus S. aureus. Methods: The in silico approach method, along with the QSAR technique, plays an important role in the process of discovery and development of new drugs. In this study, we focused on developing curcumin transformation derivatives that are much more potent by making the best QSAR equation of curcumin and eight curcumin transformation derivatives that have been tested in vitro for their antimicrobial activity against Staphylococcus aureus. Results: The best QSAR equation was obtained from curcumin transformation derivatives as antimicrobial activity against S. aureus, with pMIC = 0.812 (± 0.162)EHOMO +5.443 (± 1.659) (n = 9; Sig = 0.002; R = 0.884; R2 = 0.782; F = 25.153; Q2 = 0.57. Conclusions: In this study, an increase in the antimicrobial activity of curcumin transformation derivatives against S. aureus by increasing EHOMO was observed. The best QSAR equation can be a tool to obtain a more potential new chemical structure model and reduce trials and errors.

Context: Molecularly imprinted polymers (MIPs) are promising materials with tailored binding sites that can selectively recognize and bind target molecules. The combined approach of molecular docking and molecular dynamics (MD) simulation provides valuable insights into the interactions between 3-hydroxybutyrate (3HB) and the designed MIPs, shedding light on the intricate details of their binding mechanisms. This information is crucial for designing MIPs with high selectivity and affinity for 3HB, which is a key biomarker of diabetic ketoacidosis (DKA). Aims: To examine the interactions and dynamic behavior of 3HB in a complex with ten polymers by employing molecular docking and MD simulations. Methods: Initially, molecular docking was employed to predict the binding orientations and affinities of the 3HB molecule within the active sites of the polymers. Subsequently, molecular dynamics simulation was utilized to explore the dynamic behavior, stability, and interactions within these complexes for 100 ns. Metabolic and toxicological properties of 3HB using SwissADME were also predicted. Results: N-(hydroxymethyl)acrylamide (NHMAm), hydroxyethyl methacrylate (HEMA), itaconic acid (ITA), and N-[tris(hydroxymethyl)methyl]acrylamide (TrisNHMAm) displayed the strongest interactions with 3HB, with binding affinities of -2.64, 2.523, 2.469, and 2.305 kcal/mol, respectively. Various kinds of molecular interactions influence ligand-polymer binding in a variety of ways, as illustrated by the four polymers with the lowest binding affinities. In molecular dynamics, 4-vinylpyridine (4VP), N,N-dimethylacylamide (DMAm), N-(hydroxyethyl)acrylamide (NHEAm), and hydroxyethyl methacrylate (HEMA) suggest a strong stable complex with 3HB with an overall ΔTOTAL of -0.56, -0.35, -0.32, and -0.27 kcal/mol, respectively. The ADME prediction indicated that 3HB has favorable pharmacokinetic properties. Conclusions: HEMA shows the ability to interact well with 3HB both by molecular docking and molecular dynamics.

Context: Breast cancer therapy currently presents several uncomfortable side effects in patients, including effects on non-malignant tissues, recurrence, and resistance, which restrict their utilization. Consequently, researchers have directed their attention toward studying plant-derived anticancer compounds that exhibit high efficacy and safety profiles. Eugenol, a major component found in clove plants, demonstrates promising potential as a therapeutic agent for both estrogen receptor-positive and estrogen receptor-negative breast cancer. Aims: To predict the target of eugenol in estrogen receptor–positive breast cancer using network pharmacology and molecular docking analyses. Methods: Network pharmacology analysis was performed using the Chemical Toxigenomic Database, STITCH, GeneCards, Cytoscape, Enrichr, and Stringdb. Subsequently, molecular docking was performed using protein targets obtained from the RCSB-PDB and analyzed using AutoDock software. Results: Network pharmacology study and molecular docking revealed the anticancer effect of eugenol against breast cancer estrogen receptor–positive, especially in cancer and apoptotic pathways, by acting on caspase-3 (CASP3), epidermal growth factor receptor (EGFR), and poly [ADP-ribose] polymerase 1 (PARP1) signaling pathways. The docking results between the protein targets and eugenol showed that eugenol has the strongest binding with CASP3 (ligand binding energy: -5.78 kcal/mol), followed by eugenol binding with EGFR (ligand binding energy: -5.58 kcal/mol), and eugenol binding with PARP1 (ligand binding energy: -5.58 kcal/mol). Conclusions: Eugenol is a potential candidate for breast cancer therapy, especially for apoptosis mediated by CASP3 in breast cancer luminal A.

Context: Ensuring the quality of a generic drug is essential for its commercialization. Propranolol hydrochloride is a drug in great demand on the market as it is widely used as an antihypertensive, antianginal, antiarrhythmic, and for the treatment of migraine, requiring a complete evaluation to determine equivalence. Aims: To evaluate the dissolution biopharmaceutical characteristic in multisource products marketed in the Peruvian market, taking Inderal® as a reference product. Methods: In vitro conditions are simulated using the USP apparatus II at 50 rpm and 900 mL of the dissolution media pH 1.2, 4.5, and 6.8 at 37°C. The dependent mathematical models were characterized by the Akaike information criterion, and the similarity was evaluated using the independent parameters (MDT, DE, and the similarity factor f2). Results: The average dissolution percentages demonstrate a difference between the multisource and the innovator in the three-dissolution media. The model that best characterizes the dissolution kinetics in all products is that of Hixson–Crowell. A significant difference was obtained in the MDT and DE between the innovative and multisource products and in the three-dissolution media. The similarity factor was not within the acceptable range for multisource products in the three-dissolution media. Conclusions: The 40 mg propranolol hydrochloride tablets included in the study are not equivalent in vitro to the innovative product and, therefore, are not interchangeable.

Context: Vernonia amygdalina Delile (VAD) is known as a potential plant with a wide variety of medicinal properties, including anticancer. Aims: To evaluate the combination effect of VAD extract with cisplatin (CIS) against PANC-1 cells, focusing on cell cycle arrest and apoptosis activities. Methods: This study is an experimental study using PANC-1 cells as objects. The phytochemical compounds were analyzed with LC-MS/MS. The cytotoxic activity of extracts and their combinations was determined using the MTT assay method in the PANC-1 cell line. Apoptosis, cell cycle arrest, and PI3K/mTOR profiles were analyzed with flow cytometry. Immunocytochemistry was used to determine Bcl-2, Cyclin D1, and p53 expression. Results: The phytochemicals found were five compounds with retention times of 8.96, 9.85, 10.52, 12.59, and 10.36. The results of the MTT assay showed that the IC50 values of extract and CIS were 21.83 ± 0.46 µg/mL and 3.02 ± 0.44 µg/mL, respectively. The combination index (CI) value of extract and CIS had a synergistic effect. Combination extract and CIS induced early and late apoptosis, inhibited cell cycle progression on the G1 phase, inhibited Bcl-2 and cyclin D1 expression, induced p53 expression, and inhibited PI3K and mTOR expression. Conclusions: The combination of extract and CIS showed anticancer activity against PANC-1 cells through induction of apoptosis and cell cycle arrest via inhibition of PI3K and mTOR expressions.

Context: The search for antidiabetic drugs that target the receptors involved in diabetes has received significant attention in recent years. Peperomia pellucida (L.) Kunth's ethanol extract and ethyl acetate fraction have antihyperglycemic activity. 8,9-dimethoxy ellagic acid (DEA) has shown significant diabetes mellitus activity in mice, but its interaction with diabetes receptors remains unknown. Aims: To perform molecular docking and molecular dynamics simulations to explore the binding interactions and stability of DEA within the binding sites of enzymes involved in diabetes. Methods: At the outset, the utilization of molecular docking was limited to forecasting the DEA's binding orientations and affinities within the active sites of the enzymes implicated in diabetes. Following this, molecular dynamics simulation was employed to investigate the interactions, stability, and dynamic behavior of these complexes over a period of 100 nanoseconds. Results: Molecular docking results revealed that DEA interacts with all selected receptors involved in diabetes and interacts more strongly with the aldose reductase receptor (PDB ID 3S3G) than the native ligand, with a binding energy of -10.3 kcal/mol. However, further molecular dynamics simulations confirmed the stability of the receptor complex with DEA over 100 ns, which is less potent than that of the native ligand. This is probably due to the rigidity of the DEA molecular structure. Conclusions: This study highlights the potential of DEA derived from P. pellucida as an inhibitor of various receptors involved in diabetes.

Context: Non-Small Cell Lung Cancer (NSCLC) is the most common lung cancer type, with 80-85% prevalence. Usually, NSCLC is treated by chemotherapy and radiotherapy in collaboration with gefitinib or other anticancer drugs. Those treatments have many adverse effects, such as shortness of breath, bleeding, fever, hair loss, and radiation pneumonitis. Lack of treatment options and numerous mutations greatly contribute to lung cancer's shocking death toll. Therefore, potential EGFR mutant inhibitors need to be analyzed. Aims: To identify potential inhibitors of an epidermal growth factor receptor (EGFR) mutant derived from Calophyllum inophyllum L. leaf using an in silico approach. Methods: In silico analysis and literature study were carried out. Secondary metabolite compounds from C. inophyllum were obtained through the PubChem database, and their biological activity and ADMET were analyzed. Molecular docking with EGFR wild-type (5FED) and mutant (5HG7) was carried out using PyRx. Furthermore, amino acid residues were analyzed using Discovery Studio. Results: Based on overall screening and molecular docking, a non-toxic compound with a low binding affinity with EGFR mutant protein is 4-[2-(4-nitrophenyl)ethylcarbamoyl]benzenesulfonyl. Moreover, interactions and hydrogen bonds at Ala743, Gly796, Leu718, Phe856, Leu844, and Val726 are known to play a crucial role in ATP binding inhibition toward the tyrosine kinase domain, resulting in EGFR mutant inhibition. Conclusions: 4-[2-(4-nitrophenyl)ethylcarbamoyl]benzenesulfonyl is one of the potential candidates as an EGFR mutant protein by ATP binding inhibition. However, in vitro and in vivo research needs to be performed to confirm these results.

Context: Hypertension is highly prevalent in Vietnam, yet the rate of controlled hypertension remains low. Knowledge about hypertension is linked to patient beliefs and medication adherence. However, there's limited data on hypertension knowledge among primary care patients in Vietnam. Aims: To evaluate the knowledge of hypertension among hypertensive patients in primary care settings in Central Vietnam and identify factors affecting their knowledge. Methods: A cross-sectional study was conducted, and a thorough examination was performed to assess hypertension knowledge and its related factors. Utilizing the Hypertension Knowledge Level Scale and Medication Adherence Report Scale, hypertension knowledge and medication adherence were evaluated. Additionally, demographic, clinical, lifestyle, and patient belief data were gathered. Statistical analyses and logistic regression models were applied to pinpoint key factors associated with hypertension knowledge. Results: In the study involving 761 participants (55.7% male), the average hypertension knowledge score was 15.0 (SD = 4.6), with only 45.3% demonstrating a high level of knowledge. Significant correlations were observed between hypertension knowledge and variables such as education level, ethnicity, home blood pressure monitoring, patient beliefs, and medication adherence. Logistic regression analysis indicated that higher education levels and belonging to the majority ethnicity were linked to enhanced hypertension knowledge. Notably, individuals with better hypertension knowledge tended to recognize the necessity of their prescribed medications. Conclusions: Hypertension knowledge among primary care patients in Central Vietnam is suboptimal, with approximately half having a high knowledge level. These findings emphasize the importance of hypertension knowledge in shaping patient beliefs, perceptions, and medication adherence. Tailored educational interventions are crucial, especially for those with lower education and minority backgrounds, to enhance hypertension management.

Context: Traditional medicine and herbal extracts have long been recognized for their immunomodulatory effects, enhancing patient immune responses. The use of traditional medicine to target specific pathogens and support the immune system is increasingly studied. Linh Loc Son (LLS) hard capsule, a product derived from nature, consists of the main four natural ingredients: Curculigo orchioides Gaertn., Dioscorea persimilis Prain et Burk., Morinda officinalis F.C.How. and Fallopia multiflora (Thunb.) Haraldson. Aims: To evaluate the potential effects of LLS hard capsules in complementary treatment of immunodeficiency state in mice. Methods: An experiment was conducted to assess the impact of LLS hard capsules on an immunosuppressed model of cyclophosphamide-induced Swiss mice of either sex. Two doses of LLS hard capsules (0.69 and 1.38 g/kg body weight) and levamisole (100 mg/kg body weight), serving as a positive control, were administered orally for seven consecutive days; cyclophosphamide (200 mg/kg i.p.) was administered on the fourth day. Results: Both doses of LLS hard capsule did insignificantly ameliorate the immunosuppressive effects of cyclophosphamide on the delayed-type hypersensitivity response but maintained leukocyte counts, relative organ weight, and cytokines as compared to the levamisole group and showed a significant improvement in micro-histological images. Conclusions: This study has demonstrated in vivo the immunostimulatory effect of LLS hard capsules, highlighting their potential to boost and regulate the immune response in mice models of immunodeficiency.

Context: Ultraviolet B (UVB) light irradiation causes skin problems by increasing cellular oxidants, melanogenesis, and morphological changes of melanocytes. The use of active compounds derived from plants to mitigate these problems has been studied. Piceatannol (PCT), a phytochemical in the phenolic group contained in Passiflora edulis fruit seed (PFS), has gained interest for its anti-melanogenesis effects. However, the inhibitory effect on morphological differentiation related to melanin production of PFS extract is absent. Aims: To investigate the effect of PFS extract on the inhibition of morphological differentiation associated with microphthalmia-associated transcription factor (MITF) mRNA expression and F-actin polymerization in UVB-induced hyperpigmented B16F10 cells. Methods: Three fractions of PFS extract were analyzed for their total phenolics, PCT proportion, and antioxidant capacity. The fraction with the highest PCT proportion and antioxidant activity was investigated for its reductive effects on cellular oxidants, number of melanin-containing cells, melanin content, MITF mRNA expression, and tyrosinase activity in UVB-induced B16F10 cells. Morphological differentiation, as well as F-actin polymerization and arrangement, were analyzed. Results: The PFS-F3 extract showed the highest antioxidant effect related to the proportion of PCT and phenolic contents. It attenuated cellular oxidants, the number of melanin-containing cells, melanin content, MITF mRNA expression, and tyrosinase activity. Differentiation, polymerization, and the arrangement of F-actin of most UVB-irradiated cells were repressed after treatment with the extract. Conclusions: The PFS extract rich in PCT attenuated morphological differentiation by suppressing the functions of MITF mRNA and F-actin polymerization through the reduction of cellular oxidants, resulting in a decrease in melanin production.

Context: Diabetic nephropathy is the leading cause of end-stage renal disease and also death in the world. Administration of Szeto-Schiller-31 (SS-31) as a potential therapeutic candidate that can decrease the renal function damage progressivity in diabetes needs to be comprehensively analyzed. Aims: To assess the protective effects of SS31 against the progressivity of diabetic nephropathy. Methods: This systematic review follows PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines 2020. Searches of databases (Pubmed, Science Direct, Scopus, ProQuest, and Springer) were done on 17 September 2023 in order to find articles related to the animal diabetic model and SS-31 treatment. Manual searches from medRxiv were also conducted to obtain additional evidence. Renal function, histopathology analysis, reactive oxygen species in vivo, and in vitro analysis were described. Results: There were six in vivo studies, each of which discussed the renal function, histopathology, and reactive oxygen species (ROS), and four in vitro studies that discussed ROS. The available data suggested that SS-31 improves kidney function by lowering urinary albumin excretion, proteinuria, serum creatinine, creatinine clearance, and BUN, supported by histopathological improvements. In addition, SS-31 also has the effect of lowering 8-hydroxy-2-deoxyguanosine (8-OHdG) level, malondialdehyde (MDA) level, and nicotinamide adenine dinucleotide phosphate (NADPH) expression. Conclusions: SS31 had a renoprotective effect that could prevent the worsening of renal function in diabetic mice. In addition, the results of histopathology and ROS analysis also support the positive results of SS-31 treatment. Further studies are required to confirm its findings.

Context: The study of biofilms in the context of periodontal diseases is of paramount importance due to their central role in the pathogenesis of these oral diseases. Research has focused on understanding the formation, structure, and dynamics of biofilms, as well as developing therapeutic approaches for their eradication. However, there are still conceptual gaps in the scientific literature due to a lack of review studies. Aims: To examine research trends in the study of biofilms related to periodontal diseases. Methods: This study used a bibliometric analysis methodology of scientific literature based on the PRISMA-2020 statement. Results: The results showed a remarkable increase in research activity in recent years. Prominent authors, influential journals, and emerging keywords such as "multispecies biofilm", "biofilm formation" or "periodontal therapy" were identified, reflecting the areas of greatest interest. Conclusions: The need to balance the exploration of new areas with the consolidation of other key concepts is highlighted, as well as gaps in research that require more precise therapeutic approaches, longitudinal studies, and greater attention to underserved communities in developing countries.

Context: The process of assessing patents is complex, and there is a gap in the literature on patent assessment at the time of filing. Aims: To assess patent complexity and the human effort involved in research, we test the effectiveness of the Index of Internal Effort (IIE) framework using pharmaceutical patents developed within the Brazilian public sector as a proof of concept. Methods: Internal data were collected from innovation projects that included the filing of patents as a project outcome. The Spearman correlation test was applied to determine which internal patent variables could be used as metrics in IIE. Then, IIE was used to measure the complexity of the patents and the individual effort of inventors. Results were then compared with other metrics identified in the literature. Results: The IIE showed a positive and significant correlation with resources invested at the design stage, as well as commercial and social outcomes of the patents. Conclusions: The results indicate that the generic IIE framework is a new form of metrification that can be applied to pharmaceutical patents that have not been previously discussed in the literature.

Context: Ageratum conyzoides L. and eggshell membrane have the potential to be used as medicine. The independent use of A. conyzoides extract or eggshell membrane hydrolysates independently as a natural medicine has been widely known, but the mixture of the two as an anti-inflammatory has not been studied. Aims: To evaluate both the in vivo and in vitro anti-inflammatory effects of A. conyzoides extract and eggshell membrane hydrolysates, independently and in combination. In silico testing was conducted to identify chemicals that have a key role in inflammation signaling pathways. Methods: The chronic anti-inflammatory effects of A. conyzoides extract and eggshell membrane hydrolysates were evaluated on cotton pellet-induced rats using diclofenac-Na as a control. In vitro anti-inflammatory effects were studied via protein denaturation, membrane stability, and antiprotease activity. Furthermore, molecular docking was performed on the p38-MAPK signaling pathway using compounds found in A. conyzoides extract and eggshell membrane hydrolysates. Results: A. conyzoides extract and eggshell membrane hydrolysates given separately or in combination can inhibit the formation of exudates and granulomas. Molecular docking simulations showed that the metabolites in the extract and hydrolysate interact with p38-MAPK. Nobiletin in the extract is the potential metabolite that interacts with the p38-MAPK receptor with a free energy of binding and inhibition constant of -8.92 kcal/mol and 260.80 nM. Amino acids in the hydrolysates showed weaker interactions compared to the compound in the extract. Conclusions: A. conyzoides extract and eggshell membrane hydrolysates work additively to inhibit the severity of chronic inflammation.

Cancer is a formidable threat to human life, a cure for which in advanced stages remains challenging. Early detection and treatment of cancer are paramount, yet a substantial number of cancer patients receive diagnoses at an advanced stage, resulting in a lower 5-year survival rate. Early-stage cancers, however, frequently elude detection. Conventional tumor screening techniques, such as tumor biopsy, serve as essential means for an early cancer diagnosis. However, these procedures are invasive and may inadvertently facilitate cancer metastasis. A current research focal point involves liquid biopsy technologies, offering a potential solution to mitigate the above-mentioned issues, but often exhibiting low sensitivity. A research team from the Massachusetts Institute of Technology has recently pioneered an innovative approach to enhance the sensitivity of liquid biopsy for cancer diagnosis. By administering a pre-treatment agent 1–2 h prior to sampling, a greater than 10-fold increase in collected ctDNA was obtained. Subsequent tumor analysis using ctDNA not only demonstrated heightened sensitivity in detecting small tumors (>75%) but also presented a promising avenue for early clinical cancer detection and diagnosis. This discovery holds significant potential for advancing the prospects of early cancer detection, diagnosis, and treatment.

While many types of diabetes medications are currently available, orally administered formulations of glucagon-like peptide-1 (GLP-1) receptor agonists have recently been launched. Therefore, gastrointestinal epithelial cells will be increasingly exposed to GLP-1 receptor agonists; however, their effects on these cells remain unclear. The present study attempted to clarify the effects of GLP-1 receptor agonists on intestinal epithelial barrier functions. Semaglutide (5, 50, and 500 ng/mL) and dulaglutide (15, 150, and 1500 ng/mL) were selected as GLP-1 receptor agonists and applied to the Caco-2 cell line. Changes in mRNA and protein expression levels of epithelial cell barrier regulators due to exposure to GLP-1 receptor agonists were examined by real-time RT-PCR and Western blotting. Neither semaglutide nor dulaglutide changed the growth rate or ratio of Caco-2 cells. Furthermore, they did not significantly affect the mRNA expression levels of membrane proteins involved in epithelial cell barrier functions. However, dulaglutide increased the protein expression levels of these membrane proteins in a concentration-dependent manner, whereas semaglutide did not. Only dulaglutide enhanced epithelial cell barrier functions. Since various gastrointestinal symptoms develop in patients with diabetes and epithelial cell barrier functions may be compromised, medicines that promote barrier function, such as dulaglutide, may effectively attenuate these changes. However, their mechanisms of action remain unknown; therefore, further studies are warranted.

In case of exocrine pancreatic insufficiency (EPI), the replacement of digestive enzymes with, for example porcine pancreatin or fungal rizoenzymes, is unavoidable under certain conditions. Current guidelines indicate that preparations from porcine pancreas have more advantageous physicochemical properties compared to those from fungi, especially at high bile salt concentrations, and that the latter can, therefore, only be used clinically to a limited extent. Since rizoenzymes are increasingly used in clinical practice, the present in vitro study investigated efficiency of enzymatic activity of rizoenzymes in comparison to pancreatin under various physiological and partly extreme environmental conditions.

Abstract Background The present study aims to enhance the wound healing potential of the seed oil (SO) of Lagenaria siceraria (Egyptian cultivar) via the preparation of SO-loaded binary nanoethosomal (SO-BNE) gels. SO-BNEs were prepared using 23 factorial design, characterized for vesicle size, zeta potential, polydispersity index, linoleic and oleic acid EE% for ensuring improved skin permeability. The L. siceraria SO, optimized SO-BNE gels (0.5% and 5%) and Mebo® were topically applied in full-thickness wounded rat model twice daily for 10 days. Results In the SO-BNE gel groups, the normal appearance of the skin architecture and structure of the dermis was revealed. In addition, the levels of NRF2, TGF-β1 and FOXO1, collagen type I, SMA-α and MIP2 were significantly elevated. The wound healing potential of SO-BNE gels was proposed to be via suppression of oxidative stress and stimulation of skin regeneration biomarkers. Furthermore, the SO screening through GC/MS unveiled high percentages of unsaturated fatty acids. SO was also found to be nontoxic to human skin fibroblast cells; enhanced viability and migration rates at concentration of 50 g/mL by 99.76% and 75.9%, respectively. Conclusion These findings demonstrate that the Lagenaria siceraria SO-loaded BNE gels represent a promising delivery for wound healing with enhanced release and bioavailability.

Abstract Background Nowadays Alzheimer’s disease and its treatment methods are global concerns. Patients with this disease have poor prognosis and need supportive treatment. The antioxidant activity, anti-acetylcholinesterase (anti-AChE), anti-butyryl cholinesterase (anti-BChE) and Aβ-amyloid-42 inhibition activities of the ethanolic extracts of both leaves and flowers (LEE and FEE) of Markhamia lutea were assessed. The antioxidant activity of LEE and FEE was evaluated using 2,2-diphenyl-1-picryl-hydrazyl-hydrate, oxygen radical absorbance capacity and ferrozine iron metal chelation assays. Additionally, their total flavonoids and total phenolics were determined. The phytochemicals of LEE were analysed using LC–MS/Q-TOF in both positive and negative modes. Also, molecular docking was done for phytochemicals identified in LEE. Result LEE exhibited higher antioxidant and anti-Alzheimer activities in all techniques due to its high flavonoids content. LEE showed better activity than donepezil in case of anti-butyryl cholinesterase than both donepezil and rivastigmine in case of Aβ-amyloid-42 inhibition. A total of 62 compounds were tentatively identified using Ultra-performance Liquid Chromatography-Electrospray Ionization-Quadrupole Time-of-Flight Mass Spectrometry (UHPLC–ESI–TOF–MS), viz. 35 flavonoids, 11 phenolic acids, 2 terpenoids, 2 phenylpropanoids derivatives, 7 polyphenols, 3 coumarins and 2 organic acids. The molecular docking of some constituents showed that isorhamnetin-O-rutinoside, sissotrin, 3,5,7-trihydroxy-4'-methoxyflavone (diosmetin), rosmarinic acid, kaempferol hexoside, kampferol-7-neohesperoside, acacetin, taxifolin and apigenin-O-hexoside exert a promising activity as anti-Alzheimer drugs. Conclusion The LEE of Markhamia lutea contains secondary metabolites that is promising to act as natural antioxidants, acetylcholinesterase, butyryl cholinesterase and Aβ-amyloid-42 inhibition inhibitors, which can aid in the treatment of Alzheimer’s. Graphical Abstract

Abstract Background Type II diabetes mellitus is posing a severe health threat throughout the globe due to its associated pathophysiological risks and high mortality rate. Carbohydrate catabolic enzymes, including α-amylase, α-glucosidase and aldose reductase, play an important role in the development of diabetes. The natural or synthetic inhibitors of these enzymes are crucial in reducing diabetes and its related complications. Tinospora cordifolia is a plant of great significance in Ayurveda due to its unique biological activities, including anti-diabetic properties. The present study aims to identify the active constituents of T. cordifolia leaves and evaluate the in vitro inhibitory potential of its ethanol extract constituents against α-amylase, α-glucosidase and aldose reductase activities. Results The ethanolic leaf extract of T. cordifolia inhibited the activities of α-amylase, α-glucosidase and aldose reductase in a dose-dependent manner. It was on par with the standard inhibitors acarbose and quercetin. At 5 mg/ml, the noted % inhibition values of extract were 69.27 ± 0.17, 67.8 ± 0.26 and 62.55 ± 0.24, respectively, for α-amylase, α-glucosidase and aldose reductase. Using GC-MS analysis, neophytadiene, γ-sitosterol, phytol, phytyl palmitate, and phytyl acetate were identified as prominent constituents of the ethanolic extract. Based on molecular docking and ADME analysis, γ-sitosterol was found as the major reactive phytoconstituent, which showed the highest inhibitory potential against α-amylase, α-glucosidase and aldose reductase activities. Conclusions The present study identified γ-sitosterol as triplet inhibitor of α-amylase, α-glucosidase and aldose reductase and affirmed the ethno-medicinal significance of T. cordifolia leaves in the development of new anti-diabetic leads.

Abstract Background Trifarotene is effective for treating acne and other skin issues. To ensure its quality and meet regulatory standards, a reverse phase liquid chromatography (RP-LC) stability-indicating method was developed and validated for its quantification in pure and topical dosage forms. An isocratic elution chromatographic method was employed, using an octadecylsilyl silica gel-packed column (150 mm × 4.6 mm, 3 µm particle size). The mobile phase was a mixture of phosphate buffer and acetonitrile (40:60 v/v). Chromatographic conditions included a flow rate of 0.5 mL/min, column temperature of 40 °C, detection at 265 nm, and injection volume of 20 µL. Results The developed analytical method reports the retention time of trifarotene 11.2 min, higher theoretical plate count, asymmetric peak, and good resolution between the peaks of trifarotene, phenoxyethanol, and environmentally generated impurities. Conclusion The analytical method has been found to be linear, accurate, robust, specific, and selective for impurities produced during forced degradation studies. The proposed analytical method can be utilized for routine pharmaceutical analysis of trifarotene to judge its quality and safety.

Abstract Background Community-acquired pneumonia remains a major health concern, characterized by significant morbidity and mortality. The underlying pathophysiology of community-acquired pneumonia involves substantial oxidative stress and inflammation, which contribute to lung tissue damage and impaired immune function. Main body Variations in oxidative metabolism contribute to the inflammatory cascade which triggers pneumonia to commence and evolve, whereas oxidative stress as well as inflammatory processes is strongly related. Understanding the underlying immunological dysregulation and unbalanced redox that heighten vulnerability to a variety of illnesses has improved over the past several decades attributable to research. One of the key strategies for addressing oxidative stress is to lower the reactive oxygen species creation in the mitochondrion which is one of the main sites of their generation by using antioxidants, where they prevent oxidants from transferring electrons to other molecules. Consequently, antioxidants either directly or indirectly reduce the risk of damage and preserve the redox equilibrium. Therefore, antioxidants, due to their ability to neutralize reactive oxygen species and modulate inflammatory processes, have been explored as potential adjuvant therapies to enhance the treatment outcomes of community-acquired pneumonia. Where recent research has explored the potential of antioxidants as adjuvant therapy in the treatment of community-acquired pneumonia, aiming to mitigate these detrimental effects. Antioxidants such as N-acetylcystein, vitamin C, vitamin E, astaxanthin, and zinc have shown promising results in both preclinical and clinical studies. Conclusion Outcomes of several in vitro as well as in vivo antioxidant studies have demonstrated the antioxidants' promising potential as an adjunct pneumonia therapy. For an assessment of its effectiveness in this therapeutic context, more research involving humans will be required.

Abstract Background Vaginal dysbiosis, a change in the beneficial vaginal microbiome, leads to a significant depletion in the essential lactobacilli thus increasing the possibility of vaginal infections such as bacterial vaginosis. Probiotics have gained more attention as a means of delivering exogenous lactobacilli but one of the challenges in delivery strategies is maintaining and improving their viability. The objective of this study is to enhance the viability of Lactobacillus spp., via encapsulation in hyaluronic acid/polyvinyl alcohol hybrid electrospun nanofibers. Polyvinyl alcohol (PVA) and hyaluronic acid (HA) composite nanofibers integrated with Lactobacillus spp. were fabricated by electrospinning. The survival of Lactobacillus spp. after its immobilization in electrospun nanofibers with polyvinyl alcohol and hyaluronic acid was evaluated. Results Scanning electron microscopy indicated larger average diameters in PVA/HA nanofibers with Lactobacillus spp. encapsulation (0.189 ± 0.041 µm to 0.231 ± 0.061 µm between D3 and D4, and 0.177 ± 0.043 µm to 0.212 ± 0.041 µm between D5 and D6) which showed that the nanofibers had the bacterial cells successfully enclosed in them. The viability of the lactic acid bacteria enclosed in the PVA/HA nanofibers was observed to decrease by more than 2-log units. Conclusion The electrospun nanofiber-based delivery system is promising for the encapsulation and delivery of lactic acid bacteria to the vagina to combat recurrent vaginal infections such as bacterial vaginosis.

Abstract Background Tuberculosis (TB), a major cause of disease and antimicrobial resistance, is spread via aerosols. Aerosols have diagnostic potential and airborne-microbes other than Mycobacterium tuberculosis complex (MTBC) may influence transmission. We evaluated whether PneumoniaCheck (PMC), a commercial aerosol collection device, captures MTBC and the aeromicrobiome of people with TB. Methods PMC was done in sputum culture-positive people (≥ 30 forced coughs each, n = 16) pre-treatment and PMC air reservoir (bag, corresponding to upper airways) and filter (lower airways) washes underwent Xpert MTB/RIF Ultra (Ultra) and 16S rRNA gene sequencing (sequencing also done on sputum). In a subset (n = 6), PMC microbiota (bag, filter) was compared to oral washes and bronchoalveolar lavage fluid (BALF). Findings 54% (7/13) bags and 46% (6/14) filters were Ultra-positive. Sequencing read counts and microbial diversity did not differ across bags, filters, and sputum. However, microbial composition in bags (Sphingobium-, Corynebacterium-, Novosphingobium-enriched) and filters (Mycobacterium-, Sphingobium-, Corynebacterium-enriched) each differed vs. sputum. Furthermore, sequencing only detected Mycobacterium in bags and filters but not sputum. In the subset, bag and filter microbial diversity did not differ vs. oral washes or BALF but microbial composition differed. Bags vs. BALF were Sphingobium-enriched and Mycobacterium-, Streptococcus-, and Anaerosinus-depleted (Anaerosinus also depleted in filters vs. BALF). Compared to BALF, none of the aerosol-enriched taxa were enriched in oral washes or sputum. Interpretation PMC captures aerosols with Ultra-detectable MTBC and MTBC is more detectable in aerosols than sputum by sequencing. The aeromicrobiome is distinct from sputum, oral washes and BALF and contains differentially-enriched lower respiratory tract microbes.

Abstract Background Whole-genome sequencing (WGS)-based prediction of drug resistance in Mycobacterium tuberculosis has the potential to guide clinical decisions in the design of optimal treatment regimens. Methods We utilized WGS to investigate drug resistance mutations in a 32-year-old Tanzanian male admitted to Kibong’oto Infectious Diseases Hospital with a history of interrupted multidrug-resistant tuberculosis treatment for more than three years. Before admission, he received various all-oral bedaquiline-based multidrug-resistant tuberculosis treatment regimens with unfavourable outcomes. Results Drug susceptibility testing of serial M. tuberculosis isolates using Mycobacterium Growth Incubator Tubes culture and WGS revealed resistance to first-line anti-TB drugs, bedaquiline, and fluoroquinolones but susceptibility to linezolid, clofazimine, and delamanid. WGS of serial cultured isolates revealed that the Beijing (Lineage 2.2.2) strain was resistant to bedaquiline, with mutations in the mmpR5 gene (Rv0678. This study also revealed the emergence of two distinct subpopulations of bedaquiline-resistant tuberculosis strains with Asp47f and Glu49fs frameshift mutations in the mmpR5 gene, which might be the underlying cause of prolonged resistance. An individualized regimen comprising bedaquiline, delamanid, pyrazinamide, ethionamide, and para-aminosalicylic acid was designed. The patient was discharged home at month 8 and is currently in the ninth month of treatment. He reported no cough, chest pain, fever, or chest tightness but still experienced numbness in his lower limbs. Conclusion We propose the incorporation of WGS in the diagnostic framework for the optimal management of patients with drug-resistant and extensively drug-resistant tuberculosis.

Abstract Introduction Blood cultures have low sensitivity for candidemia. Sensitivity can be improved by the culture-independent system T2 Magnetic Resonance (T2). SeptiCyte RAPID is a host response assay quantifying the risk of infection-related inflammation through a scoring system (SeptiScore). We investigate the performance of SeptiScore in detecting persistent candidemia as defined by conventional cultures and T2. Methods This is a prospective multicentre observational study on patients with candidemia. Blood cultures and blood samples for assessment by T2 and SeptiCyte were collected for 4 consecutive days after the index culture. The performance of SeptiScore was explored to predict persistent candidemia as defined by (1) positive follow-up blood culture (2) either positive follow-up blood culture or T2 sample. Results 10 patients were enrolled including 34 blood collections assessed with the 3 methods. Overall, 4/34 (12%) follow-up blood cultures and 6/34 (18%) T2 samples were positive. A mixed model showed significantly higher SeptiScores associated with persistent candidemia when this was defined as either a positive follow-up blood culture or T2 sample (0.82, 95%CI 0.06 to 1.58) but not when this was defined as a positive follow-up blood culture only (-0.57, 95%CI -1.28 to 0.14). ROC curve for detection of persistent candidemia by SeptiScore at day 1 follow-up showed an AUC of 0.85 (95%CI 0.52-1.00) when candidemia was defined by positive follow-up blood culture, and an AUC of 1.00 (95%CI 1.00–1.00) when candidemia was defined according to both methods. Conclusion Integrating transcriptome profiling with culture-independent systems and conventional cultures may increase our ability to diagnose persistent candidemia.

Abstract Purpose Bone and joint tuberculosis (BJTB) is a distinct variant of tuberculosis in which clinical diagnosis often leads to relative misdiagnosis and missed diagnoses. This study aimed to evaluate the diagnostic accuracy of the targeted nanopore sequencing (TNPseq) assay for BJTB patients in China. Method The study enrolled a cohort of 163 patients with suspected BJTB. Diagnostic testing was performed using the TNPseq assay on samples including punctured tissue, pus, and blood. The diagnostic accuracy of the TNPseq assay was then compared with that of the T-SPOT and Xpert MTB/RIF assays. Result TNPseq exhibited superior performance in terms of accuracy, demonstrating a sensitivity of 76.3% (95% CI: 71.0-81.6%) and a specificity of 98.8% (95% CI: 93.5–100%) in clinical diagnosis. When evaluated against a composite reference standard, TNPseq demonstrated a sensitivity of 74.4% (95% CI: 69.3–79.5%) and a specificity of 98.8% (95% CI: 93.7–100%). These results exceed the performance of both the T-SPOT and Xpert MTB/RIF tests. Notably, TNPseq demonstrated high specificity and accuracy in puncture specimens, with a sensitivity of 75.0% (95% CI: 70.2–79.8%) and a specificity of 98.3% (95% CI: 92.7–100%), as well as in pus samples, with a sensitivity of 83.3% (95% CI: 78.6–88.1%) and a specificity of 100% (95% CI: 100–100%). Additionally, TNPseq facilitated the detection of mixed infection scenarios, identifying 20 cases of bacterial-fungal co-infection, 17 cases of bacterial-viral co-infection, and two cases of simultaneous bacterial-fungal-viral co-infection. Conclusion TNPseq demonstrated great potential in the diagnosis of BJTB due to its high sensitivity and specificity. The ability of TNPseq to diagnose pathogens and detect drug resistance genes can also guide subsequent treatment. Expanding the application scenarios and scope of TNPseq will enable it to benefit more clinical treatments.

Abstract Background Klebsiella pneumoniae is the most commonly encountered pathogen in clinical practice. Widespread use of broad-spectrum antibiotics has led to the current global dissemination of carbapenem-resistant K. pneumoniae, which poses a significant threat to antibacterial treatment efficacy and public health. Outer membrane vesicles (OMVs) have been identified as carriers capable of facilitating the transfer of virulence and resistance genes. However, the role of OMVs in carbapenem-resistant K. pneumoniae under external pressures such as antibiotic and phage treatments remains unclear. Methods To isolate and purify OMVs under the pressure of phages and tigecycline, we subjected K. pneumoniae 0692 harboring plasmid-mediated bla NDM-1 and bla KPC-2 genes to density gradient separation. The double-layer plate method was used to isolate MJ1, which efficiently lysed K. pneumoniae 0692 cells. Transmission electron microscopy (TEM) was used to characterize the isolated phages and extract OMV groups for relevant morphological identification. Determination of protein content of each OMV group was conducted through bicinchoninic acid assay (BCA) and proteomic analysis. Results K. pneumoniae 0692 released OMVs in response to different environmental stimuli, which were characterized through TEM as having the typical structure and particle size of OMVs. Phage or tigecycline treatment alone resulted in a slight increase in the mean protein concentration of OMVs secreted by K. pneumoniae 0692 compared to that in the untreated group. However, when phage treatment was combined with tigecycline, there was a significant reduction in the average protein concentration of OMVs compared to tigecycline treatment alone. Proteomics showed that OMVs encapsulated numerous functional proteins and that under different external stresses of phages and tigecycline, the proteins carried by K. pneumoniae 0692-derived OMVs were significantly upregulated or downregulated compared with those in the untreated group. Conclusions This study confirmed the ability of OMVs to carry abundant proteins and highlighted the important role of OMV-associated proteins in bacterial responses to phages and tigecycline, representing an important advancement in microbial resistance research.

Abstract Background Due to the increasing emergence of antibiotic resistance in Enterococcus faecalis (E. faecalis), it indicated as potentially opportunistic pathogen causing various healthcare-associated and life-threatening diseases around the world. Objective The aim of this meta-analysis was to evaluate the weighted pooled resistance rates in clinical E. faecalis isolates based on over time, areas, antimicrobial susceptibility testing (AST), and infection source. Methods We searched the studies in PubMed, Scopus, and Web of Science (November 30, 2022). All statistical analyses were carried out using the statistical package R. Results The analysis encompassed a total of 74 studies conducted in 28 countries. According to the meta-regression, the chloramphenicol, fosfomycin, imipenem, linezolid, minocycline, norfloxacin, quinupristin-dalfopristin, and tetracycline resistance rate increased over time. Analysis revealed statistically significant differences in antibiotic resistance rates for ampicillin, chloramphenicol, erythromycin, gentamicin, penicillin, rifampicin, teicoplanin, tetracycline, and vancomycin across various countries. Conclusions Globally, the prevalence of drug resistant E. faecalis strains are on the increase over time. Daptomycin and tigecycline can be an effective agent for the treatment of clinical E. faecalis infections. Considering the low prevalence of antibiotic resistance in continents of Europe and Australia, it is suggested to take advantage of their preventive strategies in order to obtain efficient results in other places with high prevalence of resistance.

Abstract Objectives The aim of this work was to assess dynamic cytokine profiles associated with bloodstream infection (BSI) caused by Klebsiella pneumoniae (Kpn) and investigate the clinical features associated with mortality. Methods A total of 114 patients with positive BSI-Kpn and 12 sepsis individuals without blood positive bacteria culture were followed up. Cytokine profiles were analyzed by multiplex immunoassay on the first, third, seventh and fourteenth day after diagnosis. The test cytokines included arginase, interferon-gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-12 (p70), and IL-23. The minimum inhibitory concentration (MIC) of 24 antibiotics were tested for BSI-Kpn. Risk factors associated with the 30-day mortality and 120-day mortality were evaluated using logistic analyses and nomogram. Results There were 55 out of 114 patients with BSI-Kpn were included. All isolates showed high susceptibility rate to novel avibactam combinations. The level of arginase was the highest in carbapenem-resistant Kpn (CRKP) patients. The AUCs of arginase, TNF-α and IL-4 reached 0.726, 0.495, and 0.549, respectively, whereas the AUC for the combination of these three cytokines was 0.805. Notably, 120-day mortality in patients with CRKP was higher than carbapenem-sensitive K. pneumoniae (CSKP). Furthermore, the long-term and high levels of IL-6 and IL-10 were associated with death. Conclusions High expression of arginase is correlated with CRKP. In addition, BSI-CRKP could result in indolent clinic course but poor long-term prognosis. Continuous increase of IL-6 and IL-10 were associated with mortality.

Abstract Background Cefiderocol is a siderophore-conjugated cephalosporin increasingly used in the management of Achromobacter infections. Testing for cefiderocol susceptibility is challenging with distinct recommendations depending on the pathogens. Objectives We evaluated the performance of commercial tests for testing cefiderocol susceptibility in the Achromobacter genus and reviewed the literature. Methods Diffusion (disks, MIC gradient test strips [MTS], Liofilchem) and broth microdilution (BMD) methods (ComASP™, Liofilchem; UMIC®, Bruker) were compared with the BMD reference method according to the EUCAST guidelines on 143 Achromobacter strains from 14 species with MIC50/90 of ≤ 0.015/0.5 mg/L. A literature search was conducted regardless of method or species. Results None of the methods tested fulfilled an acceptable essential agreement (EA). MTS displayed the lowest EA (30.8%) after UMIC® (49%) and ComASP™ (76.9%). All methods achieved an acceptable bias, with MICs either underestimated using MTS (-1.3%) and ComASP™ (-14.2%) or overestimated with UMIC® (+ 9.1%). Inhibition zone diameters ranged from 6 to 38 mm (IZD50/90=33/30 mm). UMIC® and ComASP™ failed to categorize one or the two cefiderocol-resistant strains of this study as resistant unlike the diffusion-based methods. The literature review highlighted distinct performance of the available methods according to pathogens and testing conditions. Conclusions The use of MTS is discouraged for Achromobacter spp. Disk diffusion can be used to screen for susceptible strains by setting a threshold diameter of 30 mm. UMIC® and ComASP™ should not be used as the sole method but have to be systematically associated with disk diffusion to detect the yet rarely described cefiderocol-resistant Achromobacter sp. strains.

Abstract Background Cognitive dysfunction caused by infection frequently emerges as a complication in sepsis survivor patients. However, a comprehensive understanding of its pathogenesis remains elusive. Methods In our in vivo experiments, an animal model of endotoxemia was employed, utilizing the Novel Object Recognition Test and Morris Water Maze Test to assess cognitive function. Various techniques, including immunofluorescent staining, Western blotting, blood‒brain barrier permeability assessment, Limulus Amebocyte Lysate (LAL) assay, and Proximity-ligation assay, were employed to identify brain pathological injury and neuroinflammation. To discern the role of Caspase-11 (Casp11) in hematopoietic or non-hematopoietic cells in endotoxemia-induced cognitive decline, bone marrow chimeras were generated through bone marrow transplantation (BMT) using wild-type (WT) and Casp11-deficient mice. In vitro studies involved treating BV2 cells with E. coli-derived outer membrane vesicles to mimic in vivo conditions. Results Our findings indicate that the deficiency of Casp11-GSDMD signaling pathways reverses infection-induced cognitive dysfunction. Moreover, cognitive dysfunction can be ameliorated by blocking the IL-1 effect. Mechanistically, the absence of Casp11 signaling significantly mitigated blood‒brain barrier leakage, microglial activation, and synaptic damage in the hippocampal CA3 region, ultimately leading to improved cognitive function. Conclusion This study unveils the crucial contribution of Casp11 and GSDMD to cognitive impairments and spatial memory loss in a murine sepsis model. Targeting Casp11 signaling emerges as a promising strategy for preventing or treating cognitive dysfunction in patients with severe infections.

Abstract Background Tissue fibrosis is a common pathway to failure in many organ systems and is the cellular and molecular driver of myriad chronic diseases that are incompletely understood and lack effective treatment. Recent studies suggest that gut microbe-dependent metabolites might be involved in the initiation and progression of fibrosis in multiple organ systems. Main body of the manuscript In a meta-organismal pathway that begins in the gut, gut microbiota convert dietary precursors such as choline, phosphatidylcholine, and L-carnitine into trimethylamine (TMA), which is absorbed and subsequently converted to trimethylamine N-oxide (TMAO) via the host enzyme flavin-containing monooxygenase 3 (FMO3) in the liver. Chronic exposure to elevated TMAO appears to be associated with vascular injury and enhanced fibrosis propensity in diverse conditions, including chronic kidney disease, heart failure, metabolic dysfunction-associated steatotic liver disease, and systemic sclerosis. Conclusion Despite the high prevalence of fibrosis, little is known to date about the role of gut dysbiosis and of microbe-dependent metabolites in its pathogenesis. This review summarizes recent important advances in the understanding of the complex metabolism and functional role of TMAO in pathologic fibrosis and highlights unanswered questions.

Abstract Mitochondria, responsible for cellular energy synthesis and signal transduction, intricately regulate diverse metabolic processes, mediating fundamental biological phenomena such as cell growth, aging, and apoptosis. Tumor invasion and metastasis, key characteristics of malignancies, significantly impact patient prognosis. Tumor cells frequently exhibit metabolic abnormalities in mitochondria, including alterations in metabolic dynamics and changes in the expression of relevant metabolic genes and associated signal transduction pathways. Recent investigations unveil further insights into mitochondrial metabolic abnormalities, revealing their active involvement in tumor cell proliferation, resistance to chemotherapy, and a crucial role in tumor cell invasion and metastasis. This paper comprehensively outlines the latest research advancements in mitochondrial structure and metabolic function. Emphasis is placed on summarizing the role of mitochondrial metabolic abnormalities in tumor invasion and metastasis, including alterations in the mitochondrial genome (mutations), activation of mitochondrial-to-nuclear signaling, and dynamics within the mitochondria, all intricately linked to the processes of tumor invasion and metastasis. In conclusion, the paper discusses unresolved scientific questions in this field, aiming to provide a theoretical foundation and novel perspectives for developing innovative strategies targeting tumor invasion and metastasis based on mitochondrial biology. Graphical Abstract

Abstract Background Vascular calcification is a common vascular lesion associated with high morbidity and mortality from cardiovascular events. Antibiotics can disrupt the gut microbiota (GM) and have been shown to exacerbate or attenuate several human diseases. However, whether antibiotic-induced GM disruption affects vascular calcification remains unclear. Methods Antibiotic cocktail (ABX) treatment was utilized to test the potential effects of antibiotics on vascular calcification. The effects of antibiotics on GM and serum short-chain fatty acids (SCFAs) in vascular calcification mice were analyzed using 16 S rRNA gene sequencing and targeted metabolomics, respectively. Further, the effects of acetate, propionate and butyrate on vascular calcification were evaluated. Finally, the potential mechanism by which acetate inhibits osteogenic transformation of VSMCs was explored by proteomics. Results ABX and vancomycin exacerbated vascular calcification. 16 S rRNA gene sequencing and targeted metabolomics analyses showed that ABX and vancomycin treatments resulted in decreased abundance of Bacteroidetes in the fecal microbiota of the mice and decreased serum levels of SCFAs. In addition, supplementation with acetate was found to reduce calcium salt deposition in the aorta of mice and inhibit osteogenic transformation in VSMCs. Finally, using proteomics, we found that the inhibition of osteogenic transformation of VSMCs by acetate may be related to glutathione metabolism and ubiquitin-mediated proteolysis. After adding the glutathione inhibitor Buthionine sulfoximine (BSO) and the ubiquitination inhibitor MG132, we found that the inhibitory effect of acetate on VSMC osteogenic differentiation was weakened by the intervention of BSO, but MG132 had no effect. Conclusion ABX exacerbates vascular calcification, possibly by depleting the abundance of Bacteroidetes and SCFAs in the intestine. Supplementation with acetate has the potential to alleviate vascular calcification, which may be an important target for future treatment of vascular calcification.

Abstract Purpose Pre-existing hypertension is reportedly a major risk factor for bevacizumab-induced proteinuria. However, few studies have focused on the effects of blood pressure (BP) control on proteinuria during bevacizumab treatment. We report a retrospective study of the association between poor BP control and the risk of developing proteinuria in patients with colorectal cancer (CRC). Methods Data for CRC patients who received bevacizumab between April 2015 and March 2022 were retrospectively collected. Patients were categorized into two groups based on average systolic blood pressure (SBP) during treatment: normal SBP (

Abstract Targeted therapies, such as small molecule kinase inhibitors, have made significant progress in the treatment of hematologic malignancies by directly modulating protein activity. However, issues such as drug toxicity, drug resistance due to target mutations, and the absence of key active sites limit the therapeutic efficacy of these drugs. Targeted protein degradation (TPD) presents an emergent and rapidly evolving therapeutic approach that selectively targets proteins of interest (POI) based on endogenous degradation processes. With an event-driven pharmacology of action, TPD achieves efficacy with catalytic amounts, avoiding drug-related toxicity. Furthermore, TPD has the unique mode of degrading the entire POI, such that resistance derived from mutations in the targeted protein has less impact on its degradation function. Proteolysis-targeting chimeras (PROTACs) and molecular glue degraders (MGDs) are the most maturely developed TPD techniques. In this review, we focus on both preclinical experiments and clinical trials to provide a comprehensive summary of the safety and clinical effectiveness of PROTACs and MGDs in hematologic malignancies over the past two decades. In addition, we also delineate the challenges and opportunities associated with these burgeoning degradation techniques. TPD, as an approach to the precise degradation of specific proteins, provides an important impetus for its future application in the treatment of patients with hematologic malignancies.

Abstract With the advent of adoptive cellular therapy, chimeric antigen receptor (CAR)-T cell therapy has gained widespread application in cancer treatment and has demonstrated significant efficacy against certain hematologic malignancies. However, due to the limitations of CAR-T cell therapy in treating solid tumors, other immune cells are being modified with CAR to address this issue. Macrophages have emerged as a promising option, owing to their extensive immune functions, which include antigen presentation, powerful tumor phagocytosis, and particularly active trafficking to the tumor microenvironment. Leveraging their unique advantages, CAR-macrophages (CAR-M) are expected to enhance the effectiveness of solid tumor treatments as a novel form of immunotherapy, potentially overcoming major challenges associated with CAR-T/NK therapy. This review outlines the primary mechanism underlying CAR-M and recent progressions in CAR-M therapy, while also discussing their further applications.

Abstract Background This study aimed to develop a novel positron emission tomography (PET) tracer, [68Ga]Ga-TD-01, for CXCR4 imaging. To achieve this goal, the molecular scaffold of TIQ15 was tuned by conjugation with the DOTA chelator to make it suitable for 68Ga radiolabeling. Methods A bifunctional chelator was prepared by conjugating the amine group of TIQ15 with p-NCS-Bz-DOTA, yielding TD-01, with a high yield (68.92%). TD-01 was then radiolabeled with 68Ga using 0.1 M ammonium acetate at 60 °C for 10 min. A 1-h dynamic small animal PET/MRI study of the labeled compound in GL261-luc2 tumor-bearing mice was performed, and brain tumor uptake was assessed. Blocking studies involved pre-administration of TIQ15 (10 mg/kg) 10 min before the PET procedure started. Results [68Ga]Ga-TD-01 exhibited a radiochemical yield (RCY) of 36.33 ± 1.50% (EOS), with a radiochemical purity > 99% and a molar activity of 55.79 ± 1.96 GBq/µmol (EOS). The radiotracer showed in vitro stability in PBS and human plasma for over 4 h. Biodistribution studies in healthy animals revealed favorable kinetics for subsequent PET pharmacokinetic modeling with low uptake in the brain and moderate uptake in lungs, intestines and spleen. Elimination could be assigned to a renal-hepatic pathway as showed by high uptake in kidneys, liver, and urinary bladder. Importantly, [68Ga]Ga-TD-01 uptake in glioblastoma (GBM)-bearing mice significantly decreased upon competition with TIQ15, with a baseline tumor-to-background ratios > 2.5 (20 min p.i.), indicating high specificity. Conclusion The newly developed CXCR4 PET tracer, [68Ga]Ga-TD-01, exhibited a high binding inhibition for CXCR4, excellent in vitro stability, and favorable pharmacokinetics, suggesting that the compound is a promising candidate for full in vivo characterization of CXCR4 expression in GBM, with potential for further development as a tool in cancer diagnosis.

Abstract Background Prostate Cancer (PCa) is the second most diagnosed urological cancer among men worldwide. Conventional methods used for diagnosis of PCa have several pitfalls which include lack of sensitivity and specificity. On the other hand, traditional treatment of PCa poses challenges such as long-term side effects and the development of multidrug resistance (MDR). Main body Hence, there is a need for novel PCa agents with the potential to lessen the burden of these adverse effects on patients. Nanotechnology has emerged as a promising approach to support both early diagnosis and effective treatment of tumours by ensuring precise delivery of the drug to the targeted site of the disease. Most cancer-related biological processes occur on the nanoscale hence application of nanotechnology has been greatly appreciated and implemented in the management and therapeutics of cancer. Nuclear medicine plays a significant role in the non-invasive diagnosis and treatment of PCa using appropriate radiopharmaceuticals. This review aims to explore the different radiolabelled nanomaterials to enhance the specific delivery of imaging and therapeutic agents to cancer cells. Thereafter, the review appraises the advantages and disadvantages of these modalities and then discusses and outlines the benefits of radiolabelled nanomaterials in targeting cancerous prostatic tumours. Moreover, the nanoradiotheranostic approaches currently developed for PCa are discussed and finally the prospects of combining radiopharmaceuticals with nanotechnology in improving PCa outcomes will be highlighted. Conclusion Nanomaterials have great potential, but safety and biocompatibility issues remain. Notwithstanding, the combination of nanomaterials with radiotherapeutics may improve patient outcomes and quality of life.

Xiao Xiao, Chunfang Gao Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of ChinaCorrespondence: Chunfang Gao, Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China, Tel +86-21-65161782-1210, Email gaocf1115@163.com; gaocf1115@shutcm.edu.cnAbstract: Saikosaponins (SS), which are major bioactive compounds in Radix Bupleuri, have long been used clinically for multicomponent, multitarget, and multipathway therapeutic strategies. Programmed cell death (PCD) induction is among the multiple mechanisms of SS and mediates the anticancer efficacy of this drug family. Although SS show promise for anticancer therapy, the available data to explain how SS mediate their key anticancer effects through PCD (apoptosis, autophagy, ferroptosis, and pyroptosis) remain limited and piecemeal. This review offers an extensive analysis of the key pathways and mechanisms involved in PCD and explores the importance of SS in cancer. We believe that high-quality clinical trials and a deeper understanding of the pharmacological targets involved in the signalling cascades that govern tumour initiation and progression are needed to facilitate the development of innovative SS-based treatments. Elucidating the specific anticancer pathways activated by SS and further clarifying how comprehensive therapies lead to cross-link among the different types of cell death will inspire the clinical translation of SS as cancer treatments. Keywords: apoptosis, autophagy, ferroptosis, pyroptosis