Unveiling the potential of gene editing techniques in revolutionizing Cancer treatment: A comprehensive overview

Gene editing techniques have emerged as powerful tools in biomedical research, offering precise manipulation of genetic material with the potential to revolutionize cancer treatment strategies. This review provides a comprehensive overview of the current landscape of gene editing technologies, including CRISPR-Cas systems, base editing, prime editing, and synthetic gene circuits, highlighting their applications and potential in cancer therapy. It discusses the mechanisms, advantages, and limitations of each gene editing approach, emphasizing their transformative impact on targeting oncogenes, tumor suppressor genes, and drug resistance mechanisms in various cancer types. The review delves into population-level interventions and precision prevention strategies enabled by gene editing technologies, including gene drives, synthetic gene circuits, and precision prevention tools, for controlling cancer-causing genes, targeting pre-cancerous lesions, and implementing personalized preventive measures. Ethical considerations, regulatory challenges, and future directions in gene editing research for cancer treatment are also addressed. This review highlights how gene editing could revolutionize precision medicine by enhancing patient care and advancing cancer treatments with targeted, personalized methods. For these benefits to be fully realized, collaboration among researchers, doctors, regulators, and patient advocates is crucial in fighting cancer and meeting clinical needs.

Enhanced biocidal efficacy of alcohol based disinfectants with salt additives

Surfaces contaminated with pathogens pose a significant risk of disease transmission and infection. Alcohol-based disinfectants are widely utilized to decontaminate high-touch areas across various settings. However, their limited antimicrobial activity and the emergence of alcohol-tolerant strains necessitate the development of highly efficient disinfectant formulations. In this work we test the broad-spectrum antimicrobial activities of the salt-incorporated alcohol solution disinfectant against enveloped and non-enveloped viruses, spore-forming and non-spore-forming bacteria, and mold and yeast fungi. Specifically, the disinfection capability of the isopropanol (IPA) and ethanol (EtOH) solutions containing NaCl salts was evaluated by measuring (1) antibacterial activity against Gram-positive bacteria (methicillin-resistant Staphylococcus aureus), Gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli), and an alcohol-tolerant strain of E. coli; (2) sporicidal activity against Clostridioides difficile; (3) the antiviral activity against enveloped A/PR8/34 H1N1 influenza virus and non-enveloped adenovirus VR-5; and (4) the antifungal efficacy against Aspergillus niger and Cryptococcus neoformans from the time-dependent viability assays. Additionally, the biocidal activity of the disinfectant formulation was tested by spraying it on the biocontaminated surfaces, including plastics, stainless steel, and glass. Overall, the inclusion of salt in alcohol solutions significantly enhanced their disinfection activities, positioning these solutions as promising candidates for long-term disinfection and maintenance of hygienic environments. This method, which employs mild salt instead of toxic materials, offers a simpler, more cost-effective, and safer alternative to conventional alcohol-based disinfectants. This research is expected to significantly impact on disease prevention and contribute greatly to public health and safety.

Uncovering the Binding Mechanism of Mutated Omicron Variants via Computational Strategies

The COVID-19 pandemic, triggered by the SARS-CoV-2 virus, has resulted in nearly 630 million cases and 6.60 million fatalities globally, as of November 2022. SARS-CoV-2, a species of the Coronaviridae family, has a single-stranded positive-sense RNA genome as well as four main structural proteins (S, E, M, and N) required for viral entrance into target cells. The spike protein (S) influences this entry through interactions with human angiotensin-converting enzyme 2 (hACE2) receptor. The World Health Organization (WHO) recognized numerous variants of concern (VOCs) that involve Alpha, Beta, Gamma, Delta, and Omicron, having multiple mutations within the spike protein, altering infection rates and immunity evasion. The Omicron variant, featuring 50 mutations, mainly within the spike protein's receptor-binding domain (RBD), has a higher transmission rate as compared to other variants. This study focused on two recent Omicron subvariants, XBB.1.5 and CH.1.1, which are known for their high affinity for the human ACE2 receptor. Utilizing an in silico strategy, a total of 1.65 μs molecular dynamics (MD) simulations were performed to assess the stability as well as binding details of these subvariants along with the wild-type Omicron variants. The comprehensive structural stability of the spike protein-hACE2 complexes was evaluated by using numerous parameters including root-mean-square deviation (RMSD), root-mean-square fluctuation (RMSF), radius of gyration (R g), and principal component analysis (PCA). Moreover, the binding free energies have been determined using the MM-GBSA approach to provide insights into the binding affinities of these variants. Evaluation revealed that the unbound mutant frameworks (SM and TM) displayed higher degrees of instability in comparison to the wild-type (WT) Omicron variant. In contrast, the WT-hACE2 of the Omicron variant complex was less stable than the subvariants, SM-hACE2 and TM-hACE2 complexes. Binding free energy calculations employing MM-PBSA disclosed higher binding energy values for the SM-hACE2 and TM-hACE2 complexes, suggesting a more stable and ordered binding interaction. The observed increase in transmissibility of the new XBB.1.5 and CH.1.1 subvariants, in comparison to the wild-type Omicron, appears to be due to this greater stability and ordered binding.

Interrelationships Between Plasma Levels of Brain Natriuretic Peptide and Prolonged Symptoms Due to Long COVID

Objectives: Evidence for the usefulness of biomarkers that aid in diagnosis, assessment of severity, and prediction of prognosis in patients with long COVID is limited. The aim of this study was to clarify the characteristics of brain natriuretic peptide (BNP) in long COVID. Methods: We conducted a retrospective observational study of patients who visited the COVID-19 aftercare outpatient clinic at Okayama University Hospital from February 2021 to April 2024. Results: A total of 428 patients were enrolled in this study, and the patients were divided into a group with normal BNP (n = 314, ≤18.4 pg/mL) and a group with increased BNP (n = 114, >18.4 pg/mL). The long COVID group with increased BNP had a higher proportion of females (44.3% vs. 73.7%, p < 0.01) and an older median age (38 vs. 51 years, p < 0.01). Fatigue and brain fog were commonly manifested in both groups, while dyspnea was a more frequent complaint in the group with increased BNP. Various symptoms including fatigue, palpitations, and taste and/or olfactory disorders were associated with elevated BNP (23 to 24 pg/mL). Memory impairment was also linked to higher BNP (OR: 2.36, p = 0.05). In long COVID patients, plasma BNP elevation appears to be more pronounced in females and is often related to cardiogenic factors, in which inflammatory responses are also involved. Conclusions: Plasma BNP measurement may be useful for evaluating the severity of long COVID, especially in female patients and those with respiratory symptoms and/or memory impairment.

Structural and topological analysis of thiosemicarbazone-based metal complexes: computational and experimental study of bacterial biofilm inhibition and antioxidant activity

The structural and electronic behavior of thiosemicarbazone (TSC)-based metal complexes of Mn (II), Fe (II), and Ni (II) have been investigated. The synthesized metal complexes were characterized using elemental analysis, magnetic susceptibility, molar conductivity, FTIR, and UV-Vis spectroscopy, the computational path helped with further structural investigation. The solubility test on the TSC and its complexes revealed their solubility in most organic solvents. DFT computational analysis was performed, and quantum reactivity parameters of the octahedral optimized complexes were calculated to describe the reactivity via the stability states of the synthesized complexes. FMOs map was generated to confirm similar findings and MEP analysis was applied to elaborate the important electrophilic and nucleophilic sites on the studied surfaces. Also, other important topological analyses such as electron localization function and reduced density gradient, to establish the favorable noncovalent interactions, were studied. In silico molecular docking approach was studied against the gram-positive bacteria Bacillus cereus to predict the potent inhibition behavior of the studied complexes. The findings summarized the inhibition prediction of the most interactive [NiL2Cl2], then [FeL2Cl2] complexes as confirmed by the binding energy values (- 7.1 kacl/mol and - 6.4 kacl/mol, respectively). Another In silico results, with gram-positive bacteria (S. aureus), estimated similar results of the experimental finding, where [MnL2Cl2] (- 9.2 kcal/mol) is the more effective predicted antibacterial inhibitor. Fluorescence microscopy was used to examine the inhibition of bacterial biofilm, and the DPPH assay was used to measure antioxidant activity, followed by an understanding of the behavior of the current complexes toward free radicals' removal. The findings observed less aggregated bacterial strains covered with the studied complexes leading to less dense biofilm covering.

Potential Applications of Rare Earth Metal Nanoparticles in Biomedicine

In recent years, the world scientific community has shown increasing interest in rare earth metals in general and their nanoparticles in particular. Medicine and pharmaceuticals are no exception in this matter. In this review, we have considered the main opportunities and potential applications of rare earth metal (gadolinium, europium, ytterbium, holmium, lutetium, dysprosium, erbium, terbium, thulium, scandium, yttrium, lanthanum, europium, neodymium, promethium, samarium, praseodymium, cerium) nanoparticles in biomedicine, with data ranging from single reports of effects found in vitro to numerous independent in vivo studies, as well as a number of challenges to their potential for wider application. The main areas of application of rare earth metals, including in the future, are diagnosis and treatment of malignant neoplasms, therapy of infections, as well as the use of antioxidant and regenerative properties of a number of nanoparticles. These applications are determined both by the properties of rare earth metal nanoparticles themselves and the need to search for new approaches to solve a number of urgent biomedical and public health problems. Oxide forms of lanthanides are most often used in biomedicine due to their greatest biocompatibility and nanoscale size, providing penetration through biological membranes. However, the existing contradictory or insufficient data on acute and chronic toxicity of lanthanides still make their widespread use difficult. There are various modification methods (addition of excipients, creation of nanocomposites, and changing the morphology of particles) that can reduce these effects. At the same time, despite the use of some representatives of lanthanides in clinical practice, further studies to establish the full range of pharmacological and toxic effects, as well as the search for approaches to modify nanoparticles remain relevant.

Chronic inflammation in post-acute sequelae of COVID-19 modulates gut microbiome: a review of literature on COVID-19 sequelae and gut dysbiosis

BACKGROUND

Long COVID or Post-acute sequelae of COVID-19 is an emerging syndrome, recognized in COVID-19 patients who suffer from mild to severe illness and do not recover completely. Most studies define Long COVID, through symptoms like fatigue, brain fog, joint pain, and headache prevailing four or more weeks post-initial infection. Global variations in Long COVID presentation and symptoms make it challenging to standardize features of Long COVID. Long COVID appears to be accompanied by an auto-immune multi-faceted syndrome where the virus or viral antigen persistence causes continuous stimulation of the immune response, resulting in multi-organ immune dysregulation.

MAIN TEXT

This review is focused on understanding the risk factors of Long COVID with a special emphasis on the dysregulation of the gut-brain axis. Two proposed mechanisms are discussed here. The first mechanism is related to the dysfunction of angiotensin-converting enzyme 2 receptor due to Severe Acute Respiratory Syndrome Corona Virus 2 infection, leading to impaired mTOR pathway activation, reduced AMP secretion, and causing dysbiotic changes in the gut. Secondly, gut-brain axis dysregulation accompanied by decreased production of short-chain fatty acids, impaired enteroendocrine cell function, and increased leakiness of the gut, which favors translocation of pathogens or lipopolysaccharide in circulation causing the release of pro-inflammatory cytokines. The altered Hypothalamic-Pituitary-Adrenal axis is accompanied by the reduced level of neurotransmitter, and decreased stimulation of the vagus nerve, which may cause neuroinflammation and dysregulation of serum cortisol levels. The dysbiotic microbiome in Long COVID patients is characterized by a decrease in beneficial short chain fatty acid-producing bacteria (Faecalibacterium, Ruminococcus, Dorea, and Bifidobacterium) and an increase in opportunistic bacteria (Corynebacterium, Streptococcus, Enterococcus). This dysbiosis is transient and may be impacted by interventions including probiotics, and dietary supplements.

CONCLUSIONS

Further studies are required to understand the geographic variation, racial and ethnic differences in phenotypes of Long COVID, the influence of viral strains on existing and emerging phenotypes, to explore long-term effects of gut dysbiosis, and gut-brain axis dysregulation, as well as the potential role of diet and probiotics in alleviating those symptoms.

Evaluating spill kits in infection control: perspectives of nurses and health professionals

BACKGROUND

The burden of hospital-acquired infections (HAIs) equates to 3.5 million cases, resulting in more than 90 000 deaths and 2.5 million disability-adjusted life years (DALYs) across Europe. Biological spills pose infection and safety risks for both patients and staff, so spill management is of strategic importance for containment. There is limited evidence as to the efficacy of spill kits currently in use with regard to infection control management.

AIM

To understand the perceptions of health professionals when using different spill kit systems. Data collection involved videos and interviews with simulated patients and health professionals (n=24). Simulated spills/scenarios were used to compare the use of both two standard (incumbent) and BIOPERL+ spill kit interventions. Data analysis was iterative and informed by the Framework Method of Analysis.

FINDINGS

The BIOPERL+ kit facilitates rapid identification of the appropriate spill kit to use; locating and understanding instructions in both kit types highlight how individuals learn and absorb information; there were positive views on the efficacy of the granules to absorb blood, urine, faeces and vomit of both kit types; the larger scoop of the BIOPERL+ kit was seen as a benefit, facilitating ease of use; concerns were raised over potential cross-contamination and the environmental impact of plastic components used in the kits.

CONCLUSION

The 'one size fits all' of the BIOPERL+ kit identified it as the spill kit to use for all biological spills, whereas choice of the two incumbent kits depended on spill type. Locating and understanding instructions in both kit types highlighted how individuals learn and absorb information differently, which may have implications for clinical practice. Participants perceived that all kits had minimal to strong odour, yet the incumbent kits emitted a chlorine-type odour, potentially posing a health risk. The BIOPERL+ large scoop size was seen as more efficacious for spillage containment compared with the smaller plastic scoop of the incumbent kits. Participants also perceived that the incumbent kits could be a source of potential cross-contamination when reusing component parts. The cardboard materials used in the BIOPERL+ kit were perceived as a benefit, potentially having less of an impact on the environment. The study identified that the BIOPERL+ kit is an effective, safe novel intervention that is both appropriate for managing human spills and environmentally friendly.

Correlation Between Inflammatory Markers and Pathogenic Bacteria in Children's Winter Respiratory Infections in Xinjiang

Background

This study examines the distribution characteristics of pathogenic bacteria in respiratory infections and their relationship with inflammatory markers to guide clinical drug use.

Methods

We selected 120 patients with lower respiratory tract infection in the electronic medical record system of Xinjiang Provincial People's Hospital from March 2019 to March 2023 for a case-control study. Using Indirect Immunofluorescence Antibody test(IFA), blood routine, C-reactive Protein (CRP), and High-sensitivity C-reactive Protein(hsCRP), we detected nine respiratory pathogens (Respiratory syncytial virus; Influenza A virus; Influenza B virus; Parainfluenza virus; Adenovirus; Mycoplasma pneumoniae; Chlamydia pneumoniae; Legionella pneumophila type 1; Rickettsia Q) in all patients and analyzed their distribution and correlation. The patients were divided into three groups [Respiratory Syncytial Virus Immunoglobulin M(RSV-IgM) positive group A, Mycoplasma Immunoglobulin M(MP - IgM) positive group B, antibody - negative group with elevated hsCRP, 40 patients each]. We compared differences in hsCRP, platelet count, White Blood Cells(WBC), and Neutrophil(NE) among the groups.

Results

We conducted a systematic sorting and analysis of variables exhibiting significant differences. The results of the multivariate logistic regression analysis indicated that inflammatory markers, including white blood cell count (WBC) (OR 3.85, 95% CI: 1.116-1.623), neutrophils (NE) (OR 2.26, 95% CI: 1.091-1.312), high-sensitivity C-reactive protein (HsCRP) (OR 1.95, 95% CI: 1.068-14.640), lymphocytes (OR 1.30, 95% CI: 1.045-1.134), platelet count (OR 1.34, 95% CI: 1.625-2.760), and C-reactive protein (CRP) (OR 3.80, 95% CI: 1.232-2.379), were significantly associated with the presence of pathogenic bacteria.

Conclusion

There was significant correlation between inflammatory markers and pathogenic bacteria in patients with lower respiratory tract infection in Xinjiang region.

The evolutionary journey to a new normal for learning and capacity building of healthcare workers to prepare and respond to health emergencies across Africa

Background

Faced with the COVID-19 mobility restrictions, the WHO AFRO EPR program pioneered a collaborative initiative with Project ECHO to virtually educate health workers across Africa at scale. This initiative has evolved into a transformative learning journey. This paper aims to present the lessons learned.

Results

From April 2020 to February 2024, 287 virtual learning sessions were conducted with over 125,816 attendances from 173 countries and regions. This marked a significant increase compared to pre-pandemic face-to-face training, which targeted fewer than 2,000 participants annually. Survey responses (n = 43,221) indicated high relevance and applicability, with 97% of respondents planning to use the information in their work and 89% finding the sessions very or extremely relevant. Self-reported knowledge levels increased from 28 to 74% post-session.

Discussion

Integrating digital learning into WHO AFRO's education and training toolkit has facilitated immediate emergency responses and enhanced long-term resilience, adaptability, and equity among healthcare workers, especially in under-resourced regions. This initiative has reached more health professionals than pre-pandemic in-person training, facilitating more equitable access to essential knowledge and best practices.

Conclusion

The WHO AFRO and Project ECHO partnership navigated a variety of challenges, while establishing a paradigm shift in learning strategies. Emphasizing a digital learning first approach, while retaining in-person elements, this collaborative initiative offers insights for future healthcare education, highlighting adaptability, cost-efficiency, equity, and new technologies in addressing global health challenges. However, to sustain this momentum and further expand access to critical knowledge, stakeholders must commit to continued investment in digital learning infrastructure, training, and technology.

The burden of group A Streptococcus (GAS) infections: The challenge continues in the twenty-first century

Streptococcus pyogenes is a Gram-positive bacterium, also known as Group A Streptococcus (GAS), that has become a significant threat to the healthcare system, infecting more than 18 million people and resulting in more than 500,000 deaths annually worldwide. GAS infection rates decreased gradually during the 20th century in Western countries, largely due to improved living conditions and access to antibiotics. However, post-COVID-19, the situation has led to a steep increase in GAS infection rates in Europe, the United States, Australia, and New Zealand, which triggers a global concern. GAS infections are normally moderate, with symptoms of fever, pharyngitis, and pyoderma; nevertheless, if left untreated or with continued exposure to GAS or with recurring infections it can result in fatal outcomes. GAS produces a variety of virulence factors and exotoxins that can lead to deadly infections such as necrotizing fasciitis, impetigo, cellulitis, pneumonia, empyema, streptococcal toxic shock syndrome, bacteremia, and puerperal sepsis. In addition, post-immune mediated disorders such as post-streptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease contribute to extremely high death rates in developing nations. Despite substantial research on GAS infections, it is still unclear what molecular pathways are responsible for their emergence and how to best manage them. This review thus provides insights into the most recent research on the pathogenesis, virulence, resistance, and host interaction mechanisms of GAS, as well as novel management options to assist scientific communities in combating GAS infections.

CRISPR/Cas12a-based method coupled with isothermal amplification to identify Alternaria spp. isolated from wheat grain samples

Alternaria fungal species are considered major plant pathogens, infecting various crops and resulting in significant agricultural losses. Additionally, these species can contaminate grain with multiple mycotoxins that are harmful to humans and animals. Efficient pest management relies on timely detection and identification of phytopathogens in plant and grain samples, facilitating prompt selection of a crop protection strategy. Conventional identification tools, such as morphological characterization and identification based on polymerase chain reaction (PCR)-based methods, are time-consuming and laboratory-bound, limiting their implementation for on-site diagnostics essential in the agricultural industry. Isothermal amplification methods, including nucleic acid sequence-based amplification (NASBA), loop-mediated isothermal amplification (LAMP), and recombinase polymerase amplification (RPA), enable nucleic acid amplification at constant temperatures, making them ideal for point-of-care diagnostics without the need for thermal cycling equipment. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 12a (Cas12a)-based identification, coupled with such isothermal amplification methods, represents an emerging nucleic acid-based technology for detecting plant pathogens at high accuracy and sensitivity. This study aimed to develop a CRISPR/Cas12a-based method integrated with RPA amplification for specific detection of Alternaria spp. isolated from wheat grain samples. The developed method targeted the β-tubulin gene was successfully identified Alternaria strains within a 20-min RPA amplification followed by a 30-min CRISPR/Cas12a reaction and visualization of results. Specificity test included pathogenic fungal species commonly hosted wheat grain, such as Fusarium spp. Bipolaris sorokiniana, and Nigrospora oryzae revealed high specificity of the method for Alternaria species. Furthermore, the method exhibited high sensitivity, detecting Alternaria DNA down to 100 copies, validated by real-time fluorescence readout. A fluorescence assay was employed to visualize the results of RPA and CRISPR/Cas12a reaction, demonstrating substantial implementation potential of the method in point-of-care detection of Alternaria spp. In conclusion, we present the CRISPR/Cas12a-based method as a potentially sustainable approach for the rapid, precise, and specific nucleic-acid-based identification of Alternaria species in grain samples.

Comparison of cardiovascular risk prediction models developed using machine learning based on data from a Sri Lankan cohort with World Health Organization risk charts for predicting cardiovascular risk among Sri Lankans: a cohort study

INTRODUCTION

Models derived from non-Sri Lankan cohorts are used for cardiovascular (CV) risk stratification of Sri Lankans.

OBJECTIVE

To develop a CV risk prediction model using machine learning (ML) based on data from a Sri Lankan cohort followed up for 10 years, and to compare the predictions with WHO risk charts.

DESIGN

Cohort study.

SETTING

The Ragama Health Study (RHS), an ongoing, prospective, population-based cohort study of patients randomly selected from the Ragama Medical Office of Heath area, Sri Lanka, focusing on the epidemiology of non-communicable diseases, was used to develop the model. The external validation cohort included patients admitted to Colombo North Teaching Hospital (CNTH), a tertiary care hospital in Sri Lanka, from January 2019 through August 2020.

PARTICIPANTS

All RHS participants, aged 40-64 years in 2007, without cardiovascular disease (CVD) at baseline, who had complete data of 10-year outcome by 2017, were used for model development. Patients aged 40-74 years admitted to CNTH during the study period with incident CV events or a disease other than an acute CV event (CVE) with complete data for CVD risk calculation were used for external validation of the model.

METHODS

Using the follow-up data of the cohort, we developed two ML models for predicting 10-year CV risk using six conventional CV risk variables (age, gender, smoking status, systolic blood pressure, history of diabetes, and total cholesterol level) and all available variables (n=75). The ML models were derived using classification algorithms of the supervised learning technique. We compared the predictive performance of our ML models with WHO risk charts (2019, Southeast Asia) using area under the receiver operating characteristic curves (AUC-ROC) and calibration plots. We validated the 6-variable model in an external hospital-based cohort.

RESULTS

Of the 2596 participants in the baseline cohort, 179 incident CVEs were observed over 10 years. WHO risk charts predicted only 10 CVEs (AUC-ROC: 0.51, 95% CI 0.42 to 0.60), while the new 6-variable ML model predicted 125 CVEs (AUC-ROC: 0.72, 95% CI 0.66 to 0.78) and the 75-variable ML model predicted 124 CVEs (AUC-ROC: 0.74, 95% CI 0.68 to 0.80). Calibration results (Hosmer-Lemeshow test) for the 6-variable ML model and the WHO risk charts were χ2=12.85 (p=0.12) and χ2=15.58 (p=0.05), respectively. In the external validation cohort, the sensitivity, specificity, positive predictive value, negative predictive value, and calibration of the 6-variable ML model and the WHO risk charts, respectively, were: 70.3%, 94.9%, 87.3%, 86.6%, χ2=8.22, p=0.41 and 23.7%, 79.0%, 35.8%, 67.7%, χ2=81.94, p<0.0001.

CONCLUSIONS

ML-based models derived from a cohort of Sri Lankans improved the overall accuracy of CV-risk prediction compared with the WHO risk charts for this cohort of Southeast Asians.

Generation of a genetically engineered porcine melanoma model featuring oncogenic control through conditional Cre recombination

Melanoma is a serious type of skin cancer that originates from melanocytes. Rodent melanoma models have provided valuable insights into melanoma pathology; however, they often lack applicability to humans owing to genetic, anatomical, physiological, and metabolic differences. Herein, we developed a transgenic porcine melanoma model that closely resembles humans via somatic cell nuclear transfer (SCNT). Our model features the conditional oncogenes cassettes, TP53R167H and human BRAFV600E, controlled by melanocyte-specific CreER recombinase. After SCNT, transgenic embryos developed normally, with the capacity to develop porcine embryonic stem cells. Seven transgenic piglets with oncogene cassettes were born through embryo transfer. We demonstrated that Cre recombination-mediated oncogene activation remarkably triggered the mitogen-activated protein kinase pathway in vitro. Notably, intradermal injection of 4-hydroxytamoxifen activated oncogene cassettes in vivo, resulting in melanocytic lesions resembling hyperpigmented nevi with increased proliferative properties similar to early human melanomas. This melanoma-inducing system, heritably transmitted to offspring, supports large-scale studies. The novel porcine model provides a valuable tool for elucidating melanoma development and metastasis mechanism, advancing translational medicine, and facilitating preclinical evaluation of new anticancer drugs.

Robustly detecting mpox and non-mpox using a deep learning framework based on image inpainting

Due to the lack of efficient mpox diagnostic technology, mpox cases continue to increase. Recently, the great potential of deep learning models in detecting mpox and non-mpox has been proven. However, existing methods are susceptible to interference from various noises in real-world settings, require diverse non-mpox images, and fail to detect abnormal input, which makes them unsuitable for practical deployment and application. To address these challenges, we proposed a novel strategy based on image inpainting called "Mask, Inpainting, and Measure" (MIM). In MIM's pipeline, a generative adversarial network learns feature representations of mpox images by inpainting the masked mpox images. On this basis, MIM measure the similarity between the inpainted image and the original image to detect mpox and non-mpox. Compared with multi-class classification models, MIM can handle unknown categories and abnormal inputs more effectively. We used the recognized mpox dataset (MSLD) and a dataset containing 18 categories of non-mpox skin diseases to verify the effectiveness and robustness of MIM. Experimental results show that the average AUROC of MIM achieves 0.8237. In addition, external clinical testing further demonstrates the robustness of MIM. Importantly, we developed a free smartphone app to help the public and healthcare professionals detect mpox more conveniently.

Importance of benzoyltransferase GcnE and lysine benzoylation of alcohol dehydrogenase AdhB in pathogenesis and aflatoxin production in Aspergillus flavus

Lysine benzoylation (Kbz) is a newly identified post-translational modification associated with active transcription and metabolism in eukaryotes. However, whether Kbz exists in pathogenic fungi and its function remains unknown. Here, we demonstrated for the first time that Kbz is present in Aspergillus flavus and identified 60 benzoylated sites on 46 benzoylated proteins by global benzoylome analysis. Our data demonstrated that alcohol dehydrogenase B (AdhB) is regulated by benzoylation on lysine 321 (K321), and mutations of Kbz site in AdhB significantly reduced the alcohol dehydrogenase activity in vivo and in vitro. Both adhB deletion mutant and benzoylated site mutants (K321R and K321A) exhibited similar phenotype, including decreased conidiation and seed colonization, increased sclerotia formation and aflatoxin production, and more sensitive to cell wall damage stress. We also found that GcnE has benzoyltransferase activity in vitro and in vivo, and its repression leads to decreased Kbz level and enzymatic activity of AdhB. The catalytic site E139 is important for the benzoyltransferase function of GcnE. Our study uncovers a previously unknown mechanism by which benzoylation regulates AdhB activity to affect the development, secondary metabolism, pathogenicity, and stress response of A. flavus. Meanwhile, it points out the important role of Kbz in the pathogenicity of pathogenic fungi.IMPORTANCEAspergillus flavus is a ubiquitous opportunistic pathogen of plants and animals, which produces carcinogenic and toxic secondary metabolite aflatoxin. A. flavus and aflatoxin contamination have emerged as a global food safety concern. Currently, post-translational modification plays crucial modulatory roles in the fungal development and virulence, but the role of benzoylation in fungal pathogenicity remains undetermined, which limits the development of prevention and control technique. Here, we first identified 46 benzoylated proteins in A. flavus, and found that benzoyltransferase GcnE exerted effects on pathogenicity and aflatoxin production by regulating the benzoylation of AdhB. This finding not only provided valuable information for prevention and control of A. flavus contamination, but also offered basic knowledge for investigation of the regulation mechanism of secondary metabolism in other fungi.

Prospective clinical performance of CoVarScan in identifying SARS-CoV-2 Omicron subvariants

The purpose of this work was to evaluate the performance of CoVarScan, a multiplex fragment analysis approach, in identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of the Omicron lineage rapidly and accurately. The ability to identify variants with high fidelity and low turnaround time is important both epidemiologically and clinically for pandemic monitoring and therapeutic monoclonal antibody (mAb) selection. Currently, the gold-standard test for this task is whole-genome sequencing (WGS), which is prohibitively expensive and/or inaccessible due to equipment requirements for many laboratories. Omicron variants have been closely related, so the ability of genotyping tests to differentiate them is an important, outstanding question. CoVarScan uses PCR targeting eight SARS-CoV-2 mutational hot spots. In total, 4,918 SARS-CoV-2-positive cases between 17 December 2021 and 31 January 2024 were included in the analysis. CoVarScan achieved 96.5% concordance with WGS and could detect unique mutational signatures for BA.1, BA.2, BA.2.12.1, BA.4/BA.5, BA.2.75, XBB, and BA.2.86. These are the major variants of concern (VOCs) that have dominated since Omicron originally appeared in December 2021. Lastly, based on panel design, we predict a unique mutational pattern for the newly emergent, highly mutated variant BA.2.87. CoVarScan can rapidly, accurately, and cost-effectively identify all Omicron variants in a scalable manner. Furthermore, CoVarScan does not require design alterations to detect new VOCs. CoVarScan performs as accurately as WGS with higher sensitivity, allowing its use as a tool to quickly identify variants for epidemiological surveillance and clinical decision-making in the selection of effective therapeutic mAbs.IMPORTANCEAlmost 5 years since the start of the pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern continue to emerge, with mutations conferring new properties like increased transmissibility and resistance to therapeutic monoclonal antibodies and vaccines. Conventionally, whole-genome sequencing (WGS) has characterized new SARS-CoV-2 variants, but results come too late for clinical actionability. WGS suffers from high failure rates for samples with low viral RNA and is inaccessible for lower-resource laboratories. As new variants like Omicron appear, it is necessary to develop rapid and accurate testing to distinguish between variants. Fast and accurate identification of sensitive viral lineages would allow tailored use of monoclonal antibodies that may otherwise have been pulled from the market due to rising overall resistance. Rapid results also allow public health officials to make policy decisions in time to reduce morbidity and mortality for sensitive populations such as patients who are immunocompromised or have significant medical comorbidities.

Monkeypox-related knowledge and vaccination willingness among HIV-diagnosed and -suspected males: a cross-sectional survey in Changsha

Objective

This study aimed to update baseline data on monkeypox (mpox)-related knowledge and vaccination willingness among human immunodeficiency virus (HIV) diagnosed and suspected males.

Methods

The cross-sectional survey was conducted in Changsha, a provincial capital in China, during 5 JULY to 5 SEPTEMBER 2023. Among the three study groups, the participants in the "previously diagnosed" group were recruited from a cohort of HIV-infected patients. The "newly diagnosed" and the "suspected" groups were recruited from the outpatients and grouped according to their confirmatory test results. The the exploratory factor analysis was firstly applied to capture the latent structure of participants' response to the questionnaire about monkeypox. The component and factor scores were compared between groups using the Kruskal-Wallis H tests. The chi-square test was then used to assess the difference of mpox vaccination willingness between MSM and non-MSM in each group. Finally, multivariate logistic regression analysis was performed to identify the determinants of vaccination willingness.

Results

A total of 481 males were included in the final analysis. The results revealed that there was a gap in knowledge about monkeypox between the three participant groups. The vaccination willingness rate of HIV-infected participants was above 90%, while the rate in the HIV-suspected group was 72.60%. Multivariate logistic regression analysis revealed that the previously diagnosed group (adjusted odds ratio [aOR] = 0.314, 95% confidence interval [CI]: 0.105-0.940) and the suspected group (aOR = 0.111, 95% CI: 0.034-0.363) had a lower level of vaccination willingness and they were referred to the newly diagnosed group. Participants in the age groups ranging 25-34 (aOR = 0.287, 95% CI: 0.086-0.959) and 35-44 (aOR = 0.136, 95% CI: 0.039-0.478) years showed a lower level of vaccination willingness, referred to the 15-24 year age group. A better knowledge about monkeypox was associated with a higher level of vaccination willingness (aOR = 1.701, 95% CI: 1.165-2.483). Additionally, a considerable percentage of heterosexual individuals in each group indicated their acceptance of monkeypox vaccines.

Conclusion

An overall high level of vaccination willingness was observed among HIV-infected and-suspected male individuals with disparities noted among those with different HIV infection status, knowledge levels of monkeypox, and age. Addressing the existing knowledge gap and engaging people with persistent risks-regardless of their sexual orientation-for a timely HIV diagnosis may facilitate vaccine-based mitigation measures against monkeypox.

Exploring the antifungal potential of Cannabis sativa-derived stilbenoids and cannabinoids against novel targets through in silico protein interaction profiling

Cannabinoid and stilbenoid compounds derived from Cannabis sativa were screened against eight specific fungal protein targets to identify potential antifungal agents. The proteins investigated included Glycosylphosphatidylinositol (GPI), Enolase, Mannitol-2-dehydrogenase, GMP synthase, Dihydroorotate dehydrogenase (DHODH), Heat shock protein 90 homolog (Hsp90), Chitin Synthase 2 (CaChs2), and Mannitol-1-phosphate 5-dehydrogenase (M1P5DH), all of which play crucial roles in fungal survival and pathogenicity. This research evaluates the binding affinities and interaction profiles of selected cannabinoids and stilbenoids with these eight proteins using molecular docking and molecular dynamics simulations. The ligands with the highest binding affinities were identified, and their pharmacokinetic profiles were analyzed using ADMET analysis. The results indicate that GMP synthase exhibited the highest binding affinity with Cannabistilbene I (-9.1 kcal/mol), suggesting hydrophobic solid interactions and multiple hydrogen bonds. Similarly, Chitin Synthase 2 demonstrated significant binding with Cannabistilbene I (-9.1 kcal/mol). In contrast, ligands such as Cannabinolic acid and 8-hydroxycannabinolic acid exhibited moderate binding affinities, underscoring the variability in interaction strengths among different proteins. Despite promising in silico results, experimental validation is necessary to confirm therapeutic potential. This research lays a crucial foundation for future studies, emphasizing the importance of evaluating binding affinities, pharmacokinetic properties, and multi-target interactions to identify promising antifungal agents.

An updated review summarizing the anticancer potential of flavonoids via targeting NF-kB pathway

Nuclear factor-κB (NF-κB) cell signaling pathway is essential for the progression and development of numerous human disorders, including cancer. NF-κB signaling pathway regulates a wide range of physiological processes, such as cell survival, growth, and migration. Deregulated NF-kB signaling resulted in unregulated cell proliferation, viability, movement, and invasion, thus promoting tumor development. Recent findings have increasingly shown that plant derived phytochemicals that inhibit NF-κB signaling have the potential to be employed in cancer therapeutics. Flavonoids are a group of polyphenolic natural compounds present in various plants and their fruits, vegetables, and leaves. These compounds have numerous medicinal properties owing to their antioxidant, anti-inflammatory, antiviral, and antitumor characteristics. The main mechanism by which these flavonoids exhibit their anticancer potential is via potent antioxidative and immunomodulatory actions. Current research reports have demonstrated that these flavonoids exhibited their anticancer effects via suppressing the NF-κB signaling. Based on these facts, we have comprehensively outlined the cancer promoting role of NF-κB pathway in various processes including tumor progression, drug resistance, angiogenesis and metastasis. In addition to these, we also summarize the anticancer potential of flavonoids by specifically targeting the NF-κB pathway in various types of cancers.

The role of gene copy number variation in antimicrobial resistance in human fungal pathogens

Faced with the burden of increasing resistance to antifungals in many fungal pathogens and the constant emergence of new drug-resistant strains, it is essential to assess the importance of various resistance mechanisms. Fungi have relatively plastic genomes and can tolerate genomic copy number variation (CNV) caused by aneuploidy and gene amplification or deletion. In many cases, these genomic changes lead to adaptation to stressful conditions, including those caused by antifungal drugs. Here, we specifically examine the contribution of CNVs to antifungal resistance. We undertook a thorough literature search, collecting reports of antifungal resistance caused by a CNV, and classifying the examples of CNV-conferred resistance into four main mechanisms. We find that in human fungal pathogens, there is little evidence that gene copy number plays a major role in the emergence of antifungal resistance compared to other types of mutations. We discuss why we might be underestimating their importance and new approaches being used to study them.

Binding ability of Delta and Omicron towards the angiotensin-converting enzyme 2 receptor and antibodies: a computational study

The COVID-19 pandemic posed a threat to global society. Delta and Omicron are concerning variants due to the risk of increasing human-to-human transmissibility and immune evasion. This study aims to evaluate the binding ability of these variants toward the angiotensin-converting enzyme 2 receptor and antibodies using a computational approach. The receptor-binding domain (RBD) of the two variants was created by CHARMM-GUI and then docked to the hACE2 receptor and two antibodies (REGN10933 and REGN10987). These complexes were also subjected to molecular dynamics simulation within 100 ns. As a result, the two variants, Omicron and Delta, exhibited stronger interaction with the hACE2 receptor than the wild type. The mutations in the RBD region also facilitated the virus's escape from antibody neutralization.

Exploring pyrazolines as potential inhibitors of NSP3-macrodomain of SARS-CoV-2: synthesis and in silico analysis

COVID-19 has proved to be a global health crisis during the pandemic, and the emerging JN.1 variant is a potential threat. Therefore, finding alternative antivirals is of utmost priority. In the current report, we present the synthesis of new and potential anti-viral pyrazoline compounds. Here we report a chemical scheme where β-aryl β-anilino ketones react with phenyl hydrazine in potassium hydroxide to give the corresponding 3,5-diarylpyrazoline. The protocol is applicable to a variety of β-amino ketones and tolerates several functional groups. This method is efficient and proceeds regioselectivity since the β-Anilino group acts as a protecting group for alkenes of chalcones. We identified the NSP3-microdomain (Mac-1) of SARS-CoV-2 as a putative target for newly synthesized triaryl-2-pyrazoline compounds. The molecular dynamics simulation-based free energy estimation suggests compounds 7a, 7d, 7 g, 7i, 7k, and 7 L as promising Mac-1 inhibitors. The detailed structural inspection of MD simulation trajectories sheds light on the structural and functional dynamics involved in the SARS-CoV-2 Mac-1. The data presented here is expected to guide the design and development of better anti-SARS-CoV-2 therapies.

Who Can Help Me? Citizens' Help-Seeking on Weibo During the Shanghai Lockdown

OBJECTIVE

In the context of the Omicron-induced lockdown in Shanghai, this paper investigated the appeals for assistance by citizens on Weibo, aiming to understand their principal challenges and immediate needs.

METHODS

This paper collected Weibo posts (N = 1040) containing the keyword "Shanghai Anti-epidemic Help" during the citywide lockdown. The online help requests from Shanghai citizens were analyzed across 7 dimensions, including the help sought, level of urgency, help recipient, the intended beneficiary of the help, expression, position, and emotion.

RESULTS

The study found that the most common requests for assistance were related to social isolation, specifically in the areas of home and community (34.81%), isolation (10.86%), and personal freedom (7.31%). Of all help requests, 11.83% were deemed very urgent. Most of the Weibo posts sent out a plea for help to Internet users (56.06%), primarily requesting help for themselves (26.25%) or their families (27.60%).

CONCLUSIONS

The study found that personal freedom, food, and medical care were the most frequently sought help from the public, and most of the public's positions and emotions were pessimistic. The relevant findings revealed the public's needs and status during the city closure, providing a reference for emergency preparedness in public health events or emergencies.

Influence of cytokines on the recovery trajectory of HIV patients on antiretroviral therapy: A review

Cytokines, critical signaling molecules in the immune system, significantly influence the pathophysiology of Human Immunodeficiency Virus (HIV) infection and the effectiveness of antiretroviral therapy (ART). Dysregulated cytokine production, characterized by elevated pro-inflammatory and anti-inflammatory cytokines, plays a pivotal role in chronic inflammation and immune activation in untreated HIV patients. ART initiation leads to changes in cytokine levels, typically resulting in decreased systemic inflammation, though the extent and persistence of these changes vary among individuals. Despite successful viral suppression with ART, many HIV patients experience persistent immune activation and inflammation, driven by ongoing cytokine dysregulation. This persistent inflammatory state is associated with adverse clinical outcomes, including cardiovascular disease, neurocognitive impairment, and non-AIDS-related cancers. Understanding the specific cytokine profiles that contribute to these outcomes is crucial for developing targeted therapeutic interventions to improve long-term health. Cytokine modulation presents a promising avenue for enhancing immune recovery and reducing chronic inflammation in HIV patients on ART. Identifying cytokine patterns that serve as biomarkers for disease progression and treatment response can help tailor individualized treatment strategies. Future research should focus on adjunctive therapies that target cytokine activity to mitigate residual inflammation, thereby improving the overall health and quality of life for HIV patients.

A Case of Primary Lung Adenocarcinoma With Recurrent Brain Metastasis due to Transformation to Small Cell Carcinoma During Adjuvant Atezolizumab Therapy

Histologic transformation from non-small cell to small cell lung cancer (SCLC) is a resistance mechanism to immune checkpoint inhibitors. We report herein a case of lung adenocarcinoma who developed liver and brain metastases during adjuvant atezolizumab therapy. The patient underwent a craniotomy to resect a brain metastasis, which was pathologically diagnosed as SCLC. He subsequently received platinum-based chemotherapy with durvalumab, resulting in sustained regression of the liver metastases. This case demonstrates a metastatic brain tumor-acquired resistance to atezolizumab through histologic transformation from adenocarcinoma to SCLC. Therefore, rebiopsy is needed if recurrent disease appears during immune checkpoint inhibitor treatment in patients with non-small cell lung cancer.

Targeting H3N2 influenza: advancements in treatment and vaccine strategies

INTRODUCTION

The emergence of the H3N2 influenza virus in 1968 marked a significant event as it crossed the species barrier. This shift led to a pandemic, resulting in the deaths of one million people globally and highlighting the virus's severe impact on older individuals due to antigenic drift.

AREA COVERED

This review comprehensively examines the virological characteristics, evolutionary trends, and global epidemiology of the Influenza A (H3N2) virus. It delves into vaccination strategies, antiviral interventions, and emerging diagnostic approaches. The impact of antigenic variation on vaccine design and effectiveness, seasonal outbreak patterns, and pandemic potential are explored. Additionally, the interplay between viral factors and host immune responses is assessed. Researchers are actively investigating innovative strategies to enhance vaccine efficacy against H3N2 mutations, such as precise antigenic material administration, controlled release patterns, understanding immune system mechanisms, and glycan engineering.

EXPERT OPINION

The ongoing mutational dynamics of the H3N2 virus necessitate regular vaccine updates, as advocated by the WHO. Research in the Western Pacific region underscores the need for heightened awareness and effective control strategies. Evaluating antiviral therapies and addressing drug resistance requires multidisciplinary approaches involving researchers, healthcare professionals, and policymakers. This comprehensive understanding of H3N2 is vital for improving public health interventions and preparing for future influenza challenges.

Association of haloacid dehydrogenase and alcohol dehydrogenase with vegetative growth, virulence and stress tolerance during tea plant infection by Didymella segeticola

Tea leaf spot, caused by the fungus Didymella segeticola, occurs in the high-mountain tea plantations of Southwest China. Due to a limited understanding of the disease's epidemiology and the lack of comprehensive control measures, it has a significant negative impact on tea yield and quality. In this study, we revealed that D. segeticola infection begins when conidia germinate to form a germ tube on the leaf surface. The fungus then grows in the intercellular spaces of the leaf epidermal cells, invading tea tissue and causing necrotic lesions. This infection leads to significant alterations in the cell walls of spongy and palisade mesophyll cells, severely damaging chloroplasts. We employed transcriptomic and metabolomic analyses based on an in vitro infection model using matcha powder to uncover two key genes of D. segeticola: DsHAD (encoding holoacid dehydrogenase) and DsADH (encoding alcohol dehydrogenase). These genes are associated with conidiation, virulence, and sensitivity to oxidative stress. DsHAD regulates the virulence of D. segeticola by modulating glutamate homeostasis. Our results elucidate the infection strategy of D. segeticola on tea leaves and provide valuable data for future research on control measures for tea leaf spot.

Expanding the therapeutic arsenal against cancer: a computational investigation of hybrid xanthone derivatives as selective Topoisomerase 2α ATPase inhibitors

The DNA topoisomerase II (topo II) enzyme plays an important role in the replication, recombination, and repair of DNA. Despite their widespread applications in cancer therapy, new, selective, and potent topo II inhibitors with better pharmaceutical profiles are needed to handle drug resistance and severe adverse effects. In this respect, an array of 36 new anticancer compounds was designed based on a Xanthone core tethered to multifunctional Pyridine-amines and Imidazole scaffold via alkyl chain linkers. An integrated in silico approach was used to understand the structural basis and mechanism of inhibition of the hybrid xanthone derivatives. In this study, we established an initial virtual screening workflow based on pharmacophore mapping, docking, and cancer target association to validate the target selection process. Next, a simulation-based docking was conducted along with pharmacokinetic analysis to filter out the five best compounds (7, 10, 25, 27, and 30) having binding energies within the range of -60.45 to -40.97 kcal/mol. The screened compounds were further subjected to molecular dynamics simulation for 200 ns followed by MM-GBSA and ligand properties analysis to assess the stability and binding affinity to hTOP2α. The top-ranking hits 3,7-bis(3-(2-aminopyridin-3-ylhydroxy)propoxy)-1-hydroxy-9H-xanthen-9-one (ligand 7) and 3,8-bis(3-(2-aminopyridin-3-ylhydroxy)propoxy)-1-hydroxy-9H-xanthen-9-one (ligand 25) were found to have no toxicity, optimum pharmacokinetic and, DFT properties and stable intermolecular interactions with the active site of hTopo IIα protein. In conclusion, further in vitro and in vivo experimental validation of the identified lead molecules is warranted for the discovery of new human Topoisomerase 2 alpha inhibitors.Communicated by Ramaswamy H. Sarma.

Latin America's Dengue Outbreak Poses a Global Health Threat

Dengue fever, caused by the dengue virus (DENV), poses a significant global health challenge, particularly in tropical and subtropical regions. Recent increases in indigenous DENV cases in Europe are concerning, reflecting rising incidence linked to climate change and the spread of Aedes albopictus mosquitoes. These vectors thrive under environmental conditions like temperature and humidity, which are increasingly influenced by climate change. Additionally, global travel accelerates the cross-border spread of mosquito-borne diseases. DENV manifests clinically in a spectrum from asymptomatic cases to severe conditions like dengue hemorrhagic fever and dengue shock syndrome, influenced by viral serotype and host factors. In 2024, Brazil experienced a fourfold increase in dengue cases compared to 2023, accompanied by higher mortality. Conventional control measures, such as vector control, community engagement, and vaccination, proved insufficient as climate change exacerbated mosquito proliferation, challenging containment efforts. In this regard, our review analyzes prevention measures and therapeutic protocols during the outbreak while addressing DENV transmission dynamics, clinical presentations, and epidemiological shifts. It also evaluates diagnostic strategies combining clinical assessment with serological and molecular testing, providing information to improve diagnostic and preventive measures. The global expansion of dengue-endemic regions, including outbreaks in Europe, highlights the urgent need for enhanced surveillance, proactive interventions, and international collaboration to mitigate the growing threat of Dengue and other arboviruses like West Nile, Zika, Chikungunya, Oropouche, and Yellow Fever viruses.

Immunobiology of MPox Infection and Its Management: Experience From Developing Nations

PURPOSE

As humanity grapples with the COVID-19 pandemic caused by the novel SARS-CoV-2 virus, the rising threats of the MPox virus (MPXV) in 2022 and 2024 have shown signs of global transmission and the potential to spark another pandemic. Though MPXV has been present for over 5 decades, with cases traditionally confined to endemic regions in West and Central Africa, recent outbreaks have occurred in multiple non-endemic regions, declaring itself as a Public Health Emergency of International Concern. This study aims to examine the patterns of MPXV transmission, its zoonotic potential, associated complications, and viable strategies to control its spread.

METHODS

The study examines recent outbreak data, case reports, and literature on MPXV transmission, emphasising zoonotic pathways and healthcare-associated cases. A bibliometric analysis has also been performed to deepen the understanding and identify emerging research trends.

RESULTS

The findings suggest that while MPXV has traditionally been endemic in certain regions of Africa, recent outbreaks indicate an increased transmission risk in non-endemic countries, raising concerns about potential global spread. Data reveals that much of the transmission has occurred within healthcare settings. Additionally, global research on the outbreak remains limited and requires further exploration from various perspectives, emphasising the need for prompt intervention.

CONCLUSION

Containing MPXV's spread is essential to prevent another potential pandemic. Effective management and control strategies, including enhanced surveillance, public health interventions, and targeted education within at-risk communities, are critical to mitigate the spread and impact of MPXV globally. This study advocates for a proactive approach to MPXV control to avoid its escalation into a widespread health crisis.

The Significance of Mono- and Dual-Effective Agents in the Development of New Antifungal Strategies

Invasive fungal infections (IFIs) pose significant challenges in clinical settings, particularly due to their high morbidity and mortality rates. The rising incidence of these infections, coupled with increasing antifungal resistance, underscores the urgent need for novel therapeutic strategies. Current antifungal drugs target the fungal cell membrane, cell wall, or intracellular components, but resistance mechanisms such as altered drug-target interactions, enhanced efflux, and adaptive cellular responses have diminished their efficacy. Recent research has highlighted the potential of dual inhibitors that simultaneously target multiple pathways or enzymes involved in fungal growth and survival. Combining pharmacophores, such as lanosterol 14α-demethylase (CYP51), heat shock protein 90 (HSP90), histone deacetylase (HDAC), and squalene epoxidase (SE) inhibitors, has led to the development of compounds with enhanced antifungal activity and reduced resistance. This dual-target approach, along with novel chemical scaffolds, not only represents a promising strategy for combating antifungal resistance but is also being utilized in the development of anticancer agents. This review explores the development of new antifungal agents that employ mono-, dual-, or multi-target strategies to combat IFIs. We discuss emerging antifungal targets, resistance mechanisms, and innovative therapeutic approaches that offer hope in managing these challenging infections.

Development of a Recombinant Omicron BA.1 Subunit Vaccine Candidate in Pichia pastoris

Low-cost and safe vaccines are needed to fill the vaccine inequity gap for future pandemics. Pichia pastoris is an ideal expression system for recombinant protein production due to its cost-effective and easy-to-scale-up process. Here, we developed a next-generation SARS-CoV2 Omicron BA.1-based recombinant vaccine candidate expressed in P. pastoris. The receptor binding domain of Omicron BA.1 spike protein (RBD-Omicron) was produced at 0.35 g/L in supernatant. With a 60% recovery after two-step purification, RBD-Omicron showed 99% purity. After in vitro characterisation of purified RBD-Omicron via chromatography, mass spectrometry, calorimetry and surface plasmon resonance-based methods, it was injected into mice for immunization studies. Three different doses of Alum and CpG adjuvanted RBD-Omicron were investigated and 10 μg RBD-Omicron gave the highest antigenicity. After two doses of vaccination, IgG titers in mice serum reached to more than 106. These serum antibodies also recognized earlier (Delta Plus: B.1.617.2) and later (Eris: EG.5, Pirola: BA.2.86) SARS-CoV2 variants. The long-term immunological response in mice was measured by analyzing serum antibody titers and T-cell response of splenocytes after 60 weeks. Interestingly, IgG titers and Th1 response were significantly high even after a year. Omicron subvariants are dominantly circulating in the world, so Omicron sub-lineage-based vaccines can be used for future pandemics. The RBD-Omicron-based vaccine candidate developed in this study is suitable for technology transfer and transition into the clinic.

Therapeutic Potential of Neutralizing Monoclonal Antibodies (nMAbs) against SARS-CoV-2 Omicron Variant

BACKGROUND

The COVID-19 pandemic has spurred significant endeavors to devise treatments to combat SARS-CoV-2. A limited array of small-molecule antiviral drugs, specifically monoclonal antibodies and interferon therapy, have been sanctioned to treat COVID-19. These treatments typically necessitate administration within ten days of symptom onset. There have been reported reductions in the effectiveness of these medications due to mutations in non-structural protein genes, particularly against Omicron subvariants. This underscores the pressing requirement for healthcare systems to continually monitor pathogen variability and its impact on the efficacy of prevention and treatments.

AIM

This review aimed to comprehend the therapeutic benefits and recent progress of nMAbs for preventing and treating the Omicron variant of SARS-CoV-2.

RESULTS AND DISCUSSION

Neutralizing monoclonal antibodies (nMAbs) provide a treatment avenue for severely affected individuals, especially those at high risk for whom vaccination is not viable. With their specific epitope affinity, they pose no significant risk of severe adverse effects. The degree of reduction in neutralization varies significantly across different monoclonal antibodies and variant combinations. For instance, Sotrovimab maintained its neutralization effectiveness against Omicron BA.1, but exhibited diminished efficacy against BA.2, BA.4, BA.5, and BA.2.12.1.

CONCLUSION

Bebtelovimab has been observed to preserve its efficacy against all subtypes of the Omicron variant. Subsequently, WKS13, mAb-39, 19n01, F61-d2 cocktail, etc., have become effective. This review has highlighted the therapeutic implications of nMAbs in SARS-CoV-2 Omicron treatment and the progress of COVID-19 drug discovery.

Fortifying defenses: Tactical safety protocols for COVID-19 sub-variant JN.1 in healthcare and laboratory settings

Introduction

Primary care physicians are crucial in fighting COVID-19, especially with the emergence of the new JN.1 sub-variant.

Measures to Reduce Risk

Given your direct exposure to infected patients, it is imperative to establish a protocol for triaging patients with respiratory symptoms and to uphold a minimum distance of 2 meters between patients and primary care physicians. Patients suspected or diagnosed with the JN.1 sub-variant should be advised to wear surgical masks for their protection and others protection. Primary care physicians must also use personal protective equipment (PPE) and maintain strict hand hygiene practices when dealing with these patients. Patient samples should be treated as high risk for contamination, and laboratory procedures should be meticulously evaluated for potential hazards. PPE should be tailored to the procedure.

Conclusion

To protect the health and well-being of primary care physicians, who play a critical role in addressing the challenges, it is essential to strictly adhere to infection control measures.

Advances in Cysteine Protease B Inhibitors for Leishmaniasis Treatment

The expression and release of cysteine proteases by Leishmania spp. and their virulence factors significantly influence the modulation of host immune responses and metabolism, rendering cysteine proteases intriguing targets for drug development. This review article explores the substantial role of cysteine protease B (CPB) in medicinal chemistry from 2001 to 2024, particularly concerning combatting Leishmania parasites. We delve into contemporary advancements and potential prospects associated with targeting cysteine proteases for therapeutic interventions against leishmaniasis, emphasizing drug discovery in this context. Computational analysis using the pkCSM tool assessed the physicochemical properties of compounds, providing valuable insights into their molecular characteristics and drug-like potential, enriching our understanding of the pharmacological profiles, and aiding rational inhibitor design. Our investigation highlights that while nonpeptidic compounds constitute the majority (69.2%, 36 compounds) of the dataset, peptidomimetic- based derivatives (30.8%, 16 compounds) also hold promise in medicinal chemistry. Evaluating the most promising compounds based on dissociation constant (Ki) and half maximal inhibitory concentration (IC50) values revealed notable potency, with 41.7% and 80.0% of nonpeptidic compounds exhibiting values < 1 μM, respectively. On the other hand, all peptidic compounds evaluated for Ki (43.8%) and IC50 (31.3%) obtained values < 1 μM, respectively. Further analysis identified specific compounds within both categories (nonpeptidic: 1, 2, and 4; peptidic: 48-52) as particularly promising, warranting deeper investigation into their structure-activity relationships. These findings underscore the diverse landscape of inhibitors in medicinal chemistry and highlight the potential of both nonpeptidic and peptide-based compounds as valuable assets in therapeutic development against leishmaniasis.

Monkeypox Global Research: A Comprehensive Analysis from Emergence to Present (1961-2023) for innovative prevention and control approaches

The current study aims to identify research hotspots and trends in Monkeypox (MPX). A total of 2655 MPX-related articles published from 1961 to 2023 were extracted from the Scopus database. Data were analyzed using Scopus Analytics, Microsoft Excel, Bibliometrix, and VOSviewer. The number of MPX papers has been increasing annually, particularly since the most recent outbreak. The United States and India have been productive in this area. The most cited and productive scholar in the field is Inger K. Damon. The MPX research theme map shows clusters with various centralities and densities, focusing on deep learning, molecular docking, and orthopoxviruses. Over the last decade, key terms include "transmission," "pandemic," "deep learning," "docking," "Democratic Republic of Congo," "Ebola," "virulence," "modified vaccinia Ankara," and "orthopoxvirus." Researchers can utilize existing findings to steer future research on this illness, prepare for potential pandemics, and address bioterrorist threats.

Assessment of clinical characteristics and mortality in patients hospitalized with SARS-CoV-2 from January 2022 to November 2022, when Omicron variants were predominant in the United States

OBJECTIVE

To describe the demographic/clinical characteristics, treatment patterns, and mortality among patients hospitalized with COVID-19 during Omicron predominance by immunocompromised and high-risk status.

METHODS

Retrospective observational study of patients hospitalized with COVID-19 between January 1, 2022 and November 30, 2022, using data from the Optum de-identified Clinformatics Data Mart Database. Patient demographic/clinical characteristics, treatments, mortality and costs, were assessed, during the emergence of BA.1 BA.4, BA.5, BA.2.12.1, BA.2.75, BQ.1, XBB Omicron viral subvariants.

RESULTS

Overall, 43,123 patients were included, with a mean (standard deviation [SD]) age of 75.5 (12.4) years, 51.8% were female. Immunocompromised patients accounted for 36% of hospitalized patients while only 5.8% received any outpatient COVID-19 treatment within 30 days of hospital admission. The mean (SD) hospital length of stay was 7.9 (7.5) days with 15.5% mortality within 30 days of admission. Mean (SD) hospital costs were $33,975 ($26,392), and 30-day all-cause readmission was 15.1%. Patients with immunocompromised status and those with a higher number of high-risk conditions proceeded to have an elevated proportion of hospital readmissions and mortality within 30 days. Moreover, a higher proportion of mortality was observed during the BA.1 period (20.1%) relative to other variant periods (11.0%).

CONCLUSION

COVID-19 imposed a large healthcare burden, particularly among immunocompromised patients and those with underlying high-risk conditions during Omicron period. Low utilization of outpatient COVID-19 treatments was observed in these high-risk populations eligible for treatment. Continued surveillance and research regarding COVID-19 variants and the impact of outpatient treatment options on high-risk patients is crucial to inform and guide public health action.

Oral Immunisation With Non-GMO Surface Displayed SARS-CoV-2 Spike Epitopes on Bacteria-Like Particles Provokes Robust Humoral and Cellular Immune Responses, and Modulated the Gut Microbiome in Mice

The coronavirus disease 2019 (COVID-19) is a fatal disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). To date, several vaccines have been developed to combat the spread of this virus. Mucosal vaccines using food-grade bacteria, such as Lactobacillus spp., are promising strategies for developing safe and effective vaccines against SARS-CoV-2. In this study, we designed a non-GMO surface-displayed SARS-CoV-2 spike S1 epitope on Limosilactobacillus fermentum-derived bacteria-like particles (BLPs). After that, we evaluated its efficacy to induce immune responses in immunocompetent mice. Moreover, we examined the influence of oral immunisation on the gut microbiome and microbiota metabolites. Twenty-eight 6-week-old male C57BL/6 mice were orally immunised with the following: PBS (control), Lm. fermentum-derived BLPs only, BLPs displaying SARS-CoV-2 spike S1-2, or BLPs displaying SARS-CoV-2 spike S1-3 epitopes. Our results showed that mucosal immunisation of mice with surface-displayed SARS-CoV-2 spike epitopes provoked high-level secretory IgA and systemic IgG production. Moreover, the immunisation exhibited a Th1-like immune response, characterised by an elevated IgG2a-to-IgG1 ratio and high antiviral IFN-γ production. In addition, we observed gut microbiome modulation and increased butyrate production in immunised mice. Overall, the use of Lm. fermentum-derived BLPs and the anchor CshA to display SARS-CoV-2 spike S1epitopes is a promising novel strategy in developing a cost-effective, non-GMO mucosal vaccine alternative against SARS-CoV-2.

A Comprehensive Review on Immunoregulatory Effects of Phytochemicals

An efficient immune system in the host body plays a crucial role in the preservation of normal biological and immune reactions and processes, as well as the intrinsic environment. This is because the immune system is responsible for fighting off foreign invaders. A healthy immune system strengthens the body's defense against infections, illnesses, and other unwelcome pathogens, thereby reducing the risk of allergic reactions and autoimmune diseases. Innate immune cells and acquired immune system components interact in a corrective fashion to produce optimal immune responses. In recent years, researchers have begun to focus on the immune system as a potential primary target of toxicity from chemical, pharmacological, and environmental exposure. Sex, age, stress, malnutrition, alcohol, genetic variability, lifestyles, environmental pollutants, and chemotherapy are just a few of the many elements that might modify the host's immunological responses. The production, amplification, attenuation, or suppression of immunological responses are all examples of immunomodulation. There are a wide variety of synthetic and traditional treatments available, and many of them cause major side effects and develop pathogenic resistance very quickly. Natural substances called phytochemicals play a crucial role in regulating the body's immune system. Risk factors for immune response changes are discussed, as is the immunomodulatory action of phytochemicals like glycosides, alkaloids, phenolic acids, flavonoids, saponins, tannins, sterols, and steroids.

The dual role of toll-like receptors in COVID-19: Balancing protective immunity and immunopathogenesis

Toll-like receptors (TLRs) of human are considered as the most critical immunological mediators of inflammatory pathogenesis of COVID-19. These immunoregulatory glycoproteins are located on the surface and/or intracellular compartment act as innate immune sensors. Upon binding with distinct SARS-CoV-2 ligand(s), TLRs signal activation of different transcription factors that induce expression of the proinflammatory mediators that collectively induce 'cytokine storm'. Similarly, TLR activation is also pivotal in conferring protection to infection and invasion as well as upregulating the tissue repair pathways. This dual role of the human TLRs in deciding the fate of SARS-CoV-2 has made these receptor proteins as the critical mediators of immunoprotective and immunopathogenic consequences associated with COVID-19. Herein, pathbreaking discoveries exploring the immunobiological importance of the TLRs in COVID-19 and developing TLR-directed therapeutic intervention have been reviewed by accessing the up-to-date literatures available in the public domain/databases. In accordance with our knowledge in association with the importance of TLRs' role against viruses and identification of viral particles, they have been recognized as suitable candidates with high potential as vaccine adjuvants. In this regard, the agonists of TLR4 and TLR9 have effective potential in vaccine technology while the others need further investigations. This comprehensive review suggests that basal level expression of TLRs can act as friends to keep our body safe from strangers but act as a foe via overexpression. Therefore, selective inhibition of the overexpressed TLRs appears to be a solution to counteract the cytokine storm while TLR-agonists as vaccine adjuvants could lessen the risk of infection in the naïve population.

Hypoalbuminemia as a predictor of severe dengue: a systematic review and meta-analysis

INTRODUCTION

Dengue fever is a significant health concern globally, especially in tropical regions. Identifying reliable markers for severe dengue, such as hypoalbuminemia, is crucial for early diagnosis and treatment.

METHODS

This review systematically explores the association between hypoalbuminemia and severe dengue. We searched databases including PubMed, Embase, Scopus, Cochrane, and Web of Science until 28 December 2023, focusing on studies that reported albumin levels in dengue patients. Our selection criteria aimed at observational studies, from which data extraction and quality assessment were performed using Nested- Knowledge and the Newcastle-Ottawa Scale.

RESULTS

A meta-analysis of 17 studies involving 974 severe and 18,496 non-severe dengue patients identified a standardized mean difference (SMD) in albumin levels of -1.625 g/dL (95% CI: -3.618 to -0.369). Subgroup analysis indicated more pronounced hypoalbuminemia in pediatric patients, with a pooled SMD of -1.08 g/dL (95% CI: -1.71 to -0.45). Our analysis demonstrated the link between hypoalbuminemia and severe dengue, indicating a significant pooled relative risk of 2.286, within 95% CI 1.308 to 3.996.

CONCLUSIONS

The study confirms hypoalbuminemia as a significant predictor of severe dengue. Recognizing hypoalbuminemia in dengue patients can aid clinicians in forecasting the severity, potentially improving patient outcomes through targeted therapeutic strategies.

Preparation, Characterization, In Vitro Biological Evaluation, DFT Calculations, and Molecular Docking Investigations of 1H-Imidazole-2-Carboxylic acid and Histidine-Based Mixed-Ligand Complexes

Mixed-ligand complexes incorporating 1H-Imidazole-2-Carboxylic acid (IMCA) and Histidine (LHIS) show promise for biomedical and biotechnological applications. This study synthesizes and characterizes FeIMCALHIS, CoIMCALHIS, and NiIMCALHIS coordination compounds using metal chloride salts (FeCl3.6H2O, CoCl2.6H2O, NiCl2.6H2O) in ethanolic solutions. The complexes are characterized by spectroscopic methods (IR, UV-vis, and mass spectra), elemental analysis, conductivity, magnetic, and thermal analysis. Molar conductivity indicates their non-electrolytic nature. UV-vis spectra reveal absorption bands with pathochromic shifts, and electronic spectra show characteristic metal-ligand transitions, indicating their structural configuration and coordination geometry. 3D geometry optimization shows six-coordination around Fe(III) and Co(II) in FeIMCALHIS and CoIMCALHIS, and four-coordination around Ni(II) in NiIMCALHIS. Analysis of the highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) suggests decreased electron donation ability upon coordination. Electronic structure parameters (HOMO, LUMO, ionization potential, energy gap, electron affinity, chemical potentials, and electronegativity) provide further insights into stability and reactivity. The metal complexes exhibit enhanced antimicrobial, antioxidant, and anti-inflammatory activity compared to individual ligands, with FeIMCALHIS showing notable antimicrobial activity. Molecular docking analysis reveals strong binding interactions with target proteins, highlighting their potential therapeutic applications.

The Emergence of Nanotechnology in the Prognosis and Treatment of Myocardial Infarctions

Myocardial infarction (MI), commonly known as a heart attack, is a critical cardiovascular condition associated with high morbidity and mortality rates worldwide. Despite significant advancements in traditional treatment modalities, there remains a need for innovative approaches to improve the prognosis and treatment outcomes of MI. The emergence of nanotechnology has provided a promising avenue for revolutionizing the management of this life-threatening condition. This manuscript aims to explore the role of nanotechnology in the prognosis and treatment of myocardial infarctions. Nanotechnology offers unique advantages in the field of cardiovascular medicine, including targeted drug delivery, precise imaging and diagnosis, regenerative medicine approaches, biosensors and monitoring, and the integration of therapy and diagnostics (theragnostic). One of the key advantages of nanotechnology is the ability to deliver therapeutic agents directly to the affected site. Nanoparticles can be engineered to carry drugs specifically to damaged heart tissue, enhancing their efficacy while minimizing off-target effects. Additionally, nanoparticles can serve as contrast agents, facilitating high-resolution imaging and accurate diagnosis of infarcted heart tissue. Furthermore, nanotechnology-based regenerative approaches show promise in promoting tissue healing and regeneration after MI. Nanomaterials can provide scaffolding structures or release growth factors to stimulate the growth of new blood vessels and support tissue repair. This regenerative potential holds significant implications for restoring cardiac function and minimizing long-term complications. Nanotechnology also enables real-time monitoring of critical parameters within the heart, such as oxygen levels, pH, and electrical activity, through the utilization of nanoscale devices and sensors. This capability allows for the early detection of complications and facilitates timely interventions. Moreover, the integration of therapy and diagnostics through nanotechnology- based platforms, known as theragnostic, holds tremendous potential. Nanoparticles can simultaneously deliver therapeutic agents while providing imaging capabilities, enabling personalized treatment strategies tailored to individual patients. This manuscript will review the recent advancements, clinical trials, and patents in nanotechnology for the prognosis and treatment of myocardial infarctions. By leveraging nanotechnology's unique properties and applications, researchers and clinicians can develop innovative therapeutic approaches that enhance patient outcomes, improve prognosis, and ultimately revolutionize the management of myocardial infarctions.

Knowledge, willingness to provide service and preparedness for monkeypox infection among medical practitioners working in Bangladesh: a multicentred cross-sectional study

Background

The resurfaced zoonotic disease, Monkeypox, has become a global public health concern recently. Therefore, the objective of this study was to assess the current knowledge, willingness to provide service during an outbreak and preparedness about human monkeypox among medical practitioners in Bangladesh.

Methods

This cross-sectional study was conducted among registered physicians at the three medical college hospitals in Dhaka, Bangladesh. Knowledge about monkeypox was assessed by 20 questions, collected through a self-answered paper-based structured questionnaire. Good knowledge was defined by 70% of correct responses among the asked questions. Willingness and preparedness to treat during the monkeypox outbreak were also assessed. Multivariate logistic regression analysis was performed to assess the predictors of good knowledge of monkeypox infection. Statistical analysis was done with SPSS V.25.0.

Result

Out of 385 physicians, two-thirds (63%) were male, and between 31 and 50 years of age (58%). A majority (91.4%) knew monkeypox is transmitted human-to-human, followed by sexual (55.1%) and vertical transmission (34.8%), but only 19.5% were aware of vaccine availability. Overall, about half of the respondents (57%) showed a good knowledge of monkeypox and the remainder (43%) had poor knowledge. Older age, higher education and having a higher job designation were found to be associated with good knowledge. However, only 30.1% expressed willingness to provide care, and just 22.3% believed their hospitals were prepared for a potential outbreak.

Conclusion

The present study highlighted that physicians in Bangladesh possess a relatively good level of knowledge, with a lack of practical preparedness and willingness to serve in managing monkeypox cases during an outbreak.

In vitro and silico activity of piperlongumine against azole-susceptible/resistant Aspergillus fumigatus and terbinafine-susceptible/resistant Trichophyton species

In recent years, the widespread emergence of drug resistance in yeasts and filamentous fungi to existing antifungal armamentariums has become a severe threat to global health. There is also concern regarding increased rates of azole resistance in Aspergillus fumigatus and Terbinafine resistance in Trichophyton species. To overcome this concern of resistance to regular therapies, new antifungal drugs with novel and effective mechanisms are crucially needed. Herbal remedies may be promising strategies for the treatment of resistant infections. We aimed to investigate the in vitro and silico activity of piperlongumine against clinical azole susceptible/resistant A. fumigatus and terbinafine-susceptible/resistant Trichophyton species. In the current study, piperlongumine demonstrated potent antifungal activity, with minimum inhibitory concentrations (MICs) ranging from 0.016-4 μg/mL against Trichophyton isolates and 0.25-2 μg/mL for A. fumigatus isolates. Additionally, molecular docking studies indicated that piperlongumine has a strong binding affinity to the active sites of squalene epoxidase and sterol 14-alpha demethylase. However, further studies are warranted to correlate these findings with clinical outcomes and provide the basis for further investigations to pave the way for developing novel antifungal agents.

Enhanced immunity against SARS-CoV-2 in returning Chinese individuals

Global COVID-19 vaccination programs effectively contained the fast spread of SARS-CoV-2. Characterizing the immunity status of returned populations will favor understanding the achievement of herd immunity and long-term management of COVID-19 in China. Individuals were recruited from 7 quarantine stations in Guangzhou, China. Blood and throat swab specimens were collected from participants, and their immunity status was determined through competitive ELISA, microneutralization assay and enzyme-linked FluoroSpot assay. A total of 272 subjects were involved in the questionnaire survey, of whom 235 (86.4%) were returning Chinese individuals and 37 (13.6%) were foreigners. Blood and throat swab specimens were collected from 108 returning Chinese individuals. Neutralizing antibodies against SARS-CoV-2 were detected in ~90% of returning Chinese individuals, either in the primary or the homologous and heterologous booster vaccination group. The serum NAb titers were significantly decreased against SARS-CoV-2 Omicron BA.5, BF.7, BQ.1 and XBB.1 compared with the prototype virus. However, memory T-cell responses, including specific IFN-γ and IL-2 responses, were not different in either group. Smoking, alcohol consumption, SARS-CoV-2 infection, COVID-19 vaccination, and the time interval between last vaccination and sampling were independent influencing factors for NAb titers against prototype SARS-CoV-2 and variants of concern. The vaccine dose was the unique common influencing factor for Omicron subvariants. Enhanced immunity against SARS-CoV-2 was established in returning Chinese individuals who were exposed to reinfection and vaccination. Domestic residents will benefit from booster homologous or heterologous COVID-19 vaccination after reopening of China, which is also useful against breakthrough infection.