Surgical interventions for intractable migraine: a systematic review and meta-analysis

BACKGROUND

Migraine affects approximately 14-15% of the global population, contributing to nearly 5% of the world's health burden. When drug treatments prove ineffective for intractable migraines, highly specific surgical interventions emerge as potential solutions. We aimed to analyze surgical approaches for these refractory or intractable migraines through a systematic review and meta-analysis.

METHODS

We conducted a literature search across databases such as PubMed, Scopus, Web of Science, and Embase, focusing on studies related to migraines and surgical outcomes. We considered clinical trials or observational studies that included any surgical intervention for refractory or intractable migraines, emphasizing key outcomes such as reductions in migraine intensity, Migraine Disability Assessment scores (MIDAS), and 50% Migraine Headache Index (MHI) reduction rates. Statistical analyses were performed using R version 4.3.

RESULTS

Eleven studies were included in the systematic review. A meta-analysis of four studies involving overall 95 patients showed a significant reduction in mean migraine intensity scores using ONS (-2.27, 95% CI: -3.92 to -0.63, P=0.021). Three studies with 85 patients showed an average MIDAS score reduction of -52.3, though this was not statistically significant (95% CI: -136.85 to 32.19, P=0.116). Two additional studies corroborated these reductions in MIDAS scores. Nerve decompression surgery showed a substantial decrease in the average migraine intensity (from 8.31 down to 4.06). Median MIDAS score dropped from 57 to 20. Two studies indicated a success rate of 40% and 82%, respectively, in achieving a 50% reduction in the Migraine MHI through nerve decompression. Findings from two studies suggest that septorhinoplasty and sinus surgery effectively decrease migraine intensity scores.

CONCLUSION

The existing evidence emphasizes the potential advantages of surgical interventions as a promising approach to managing intractable or refractory migraines. However, robust and comprehensive research is crucial to refine and solidify the efficacy of these surgical methods, aiming for widespread benefits for patients, considering cost-effectiveness factors.

Current approaches in smart nano-inspired drug delivery: A narrative review

Background and Aim

The traditional drug delivery approach involves systemic administration of a drug that could be nonspecific in targeting, low on efficacy, and with severe side-effects. To address such challenges, the field of smart drug delivery has emerged aiming at designing and developing delivery systems that can target specific cells, tissues, and organs and have minimal off-target side-effects.

Methods

A literature search was done to collate papers and reports about the currently available various strategies for smart nano-inspired drug delivery. The databases searched were PubMed, Scopus, and Google Scholar. Based on selection criteria, the most pertinent and recent items were included.

Results

Smart drug delivery is a cutting-edge revolutionary intervention in modern medicines to ensure effective and safe administration of therapeutics to target sites. These hold great promise for targeted and controlled delivery of therapeutic agents to improve the efficacy with reduced side-effects as compared to the conventional drug delivery approaches. Current smart drug delivery approaches include nanoparticles, liposomes, micelles, and hydrogels, each with its own advantages and limitations. The success of these delivery systems lies in engineering and designing them, and optimizing their pharmacokinetics and pharmacodynamics properties.

Conclusion

Development of drug delivery systems that can get beyond various physiological and clinical barriers, as observed in conventionally administered chemotherapeutics, has been possible through recent advancements. Using multifunctional targeting methodologies, smart drug delivery tries to localize therapy to the target location, reduces cytotoxicity, and improves the therapeutic index. Rapid advancements in research and development in smart drug delivery provide wider and more promising avenues to guarantee a better healthcare system, improve patient outcomes, and achieve higher levels of effective medical interventions like personalized medicine.

Recurring food source-based Listeria outbreaks in the United States: An unsolved puzzle of concern?

Recurring Listeria outbreaks in the United States is a growing public healthcare concern. Although no associated reported death, 17 were hospitalized out of the 18 reported illnesses in the recent outbreak in 15 US states. The United States has experienced about 30 Listeria outbreaks in the last decade with 524 Listeriosis cases and 80 deaths. The identified origin were ice cream, leafy greens, mushroom, meat slice, dairy products like cheese, packaged salads, cooked chicken, hard-boiled egg, pork product, frozen vegetable, raw milk, packaged caramel apple, bean sprout and soya products. Although rare, Listeria may lead to serious illness (invasive listeriosis) or death. Listeriosis is critically harmful and medically complicated, especially in the pregnant, the old above 65 years and in the immunocompromised. It could cause premature birth, miscarriage or even neonatal death. Hospitalization is often necessary in the geriatric, being fatal at times. Among Listeria sp., Listeria monocytogenes is often human infection-associated. It is a gram-positive, non-sporulating, motile bacillus opportunistic pathogen. Food-borne listeriosis is often associated with frozen foods due to its ability to thrive at low temperatures. Hypervirulent strains of L. monocytogenes with an ability to infect the respiratory system (the lungs) was recently reported in the coronavirus disease-19 patients during the pandemic. L. monocytogenes seemed to have developed antimicrobial resistance to ciprofloxacin and meropenem, possibly acquired through the food chain. An early onset of listeriosis in the newborn is evident in the first 7 days postparturition. As the bacteria colonize the genitourinary tract, majority of such cases result from teratogenic transfer during vaginal delivery. Premature newborns, neonates born outside healthcare facilities and low-birth-weight babies were increasingly predisposed to an early onset of listeriosis. Listeria outbreaks were earlier reported in South Africa, Australia and Europe, with an unclear origin of the outbreaks. Social media updates about such outbreaks, the most likely food source, and measures to self-protect are suggested as preventive measures. The article deals on various such aspects related to listeriosis primarily originating from food, to ensure better public healthcare and human wellness.

Erratum: Licorice (Glycyrrhiza Glabra L.)-Derived Phytochemicals Target Multiple Signaling Pathways to Confer Oncopreventive and Oncotherapeutic Effects [Corrigendum]

[This corrects the article DOI: 10.2147/OTT.S366630.].

Global health concern on the rising dengue and chikungunya cases in the American regions: Countermeasures and preparedness

Background and Aim

Severe morbidity and mortality due to seasonal infectious diseases are common global public health issues. Vector-borne viral illnesses like dengue and chikungunya overload the healthcare systems leading to critical financial burden to manage them. There is no effective drug or vaccine currently available to control these two diseases.

Methods

The review was formulated by incorporating relevant reports on chikungunya and dengue in the Americas regions through a comprehensive search of literature that were available on dedicated scientific publication portals such as PubMed, ScienceDirect, and Web of Science.

Results

The strategies of public health administrations to control largely the mosquito vectors during tropical monsoon seem to be effective. Yet, it seems practically impossible to completely eliminate them. The mosquito vector disseminates the virus via transovarian route thereby internalising the virus through generations, a reason behind reappearing and recurring outbreaks. The numerous factors associated with industrialisation, urbanisation, population density, and easy transboundary movements appear to have contributed to the spread of vectors from an endemic region to elsewhere.

Conclusion

The article made a state-of-affair comprehensive analysis of the rising dengue and chikungunya cases in the tropics, particularly the tropical Americas, as a human health concern, the countermeasures undertaken and the overall preparedness. The viral transmission is a hard situation to tackle as the vector survives in diverse temperature and ecology, is resistant to insecticides, and the unavailability of drugs. Better vector-control measures and improved understanding of the reemerging arboviral infections could offer an extended reaction time to counter outbreaks, and minimise associated morbidity/mortality.

Pooled rates and demographics of POTS following SARS-CoV-2 infection versus COVID-19 vaccination: Systematic review and meta-analysis

PURPOSE

To address recent concerns of postural orthostatic tachycardia syndrome (POTS) occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination.

METHODS

We searched PubMed, Web of Science, and Scopus as of 1st June 2023. We performed a systematic review and meta-analysis of pooled POTS rate in SARS-CoV-2-infected and COVID-19-vaccinated groups from epidemiological studies, followed by subgroup analyses by characteristic. Meta-analysis of risk ratio was conducted to compare POTS rate in infected versus uninfected groups. Meta-analysis of demographics was also performed to compare cases of post-infection and post-vaccination POTS from case reports and series.

RESULTS

We estimated the pooled POTS rate of 107.75 (95 % CI: 9.73 to 273.52) and 3.94 (95 % CI: 0 to 16.39) cases per 10,000 (i.e., 1.08 % and 0.039 %) in infected and vaccinated individuals based on 5 and 2 studies, respectively. Meta-regression revealed age as a significant variable influencing 86.2 % variance of the pooled POTS rate in infected population (P < 0.05). Moreover, POTS was 2.12-fold more likely to occur in infected than uninfected individuals (RR = 2.12, 95 % CI: 1.71 to 2.62, P < 0.001). Meta-analyzed demographics for cases of post-infection (n = 43) and post-vaccination (n = 17) POTS found no significant differences in several variables between groups, except that the time from exposure to symptom onset was shorter for cases of post-vaccination POTS (P < 0.05).

CONCLUSION

Although evidence is limited for post-vaccination POTS, our study showed that POTS occur more frequently following SARS-CoV-2 infection than COVID-19 vaccination.

Alarming Rise in Global Rabies Cases Calls for Urgent Attention: Current Vaccination Status and Suggested Key Countermeasures

In the wake of rising rabies cases worldwide, especially after the COVID-19 pandemic, it is time to understand the scenario better and suggest technically sound and plausible countermeasures. This article is an attempt at this perspective. Although a critical zoonotic viral disease, rabies is preventable. Medico-legally, the ailment is classified as furious rabies and paralytic rabies. The four world bodies, namely, the World Health Organisation (WHO), the Food and Agriculture Organisation (FAO), the World Organisation for Animal Health (OIE), and the Global Alliance for Rabies Control (GARC) endorsed framing a global support system to eradicate human death from dog-mediated rabies under the 'Zero by 30' framework. The framework calls for extending the vaccination of dogs to reduce the risk of human rabies. Stray dogs became aggressive primarily due to their food shortage during the pandemic lockdown. As many adopted stray dogs were disowned post-pandemic, decreased human-dog interactions increased the aggressiveness among dogs. As a result, 'dog-bite' cases rose, with a sudden spike in rabies cases and dog-bite-induced deaths in India and elsewhere. Jeopardising the 'Zero by 30' plan is certainly a public health concern. Stray dog sterilisation through the irreversible ductal occlusion technique and reversible inhibition of sperm under guidance (RISUG) are other suggested interventions to control rabies. Importantly, wildlife like foxes, raccoons, skunks, and bats could also be rabid. Three out of the four WHO-pre-qualified human vaccines against rabies are intradermally administered as post-exposure prophylaxis, while the intramuscular one is more popular. Even though 'Zero by 30' may not be achieved within the set timeframe, it is time for a concerted and planned strategy by global agencies to curb the globally rising rabies cases and manage the disease better. The 'One Health' model seems to be a plausible guideline and the ultimate countermeasure to achieve this.

Ethnomedicinal values of Boerhaavia diffusa L. as a panacea against multiple human ailments: a state of art review

Ethnopharmacological relevance: Therapeutic botanicals (plants and derivatives) are in use since antiquity for various health ailments. The ethnic community is the repository of the information, the multifactorial therapeutic applications of which may often need scientific validation. The spreading hogweed or Boerhaavia diffusa L., also known as Punarnava, is a reassuring medicinal herb with diverse pharmacological benefits. It is used in Ayurveda in Asia and Africa as a rejuvenator or "Rasayan" for its excellent antiaging and antioxidant properties. Aim: The study aimed at compiling the state-of-art knowledge of the medicinal benefits of Boerhaavia diffusa L. and unraveling the unexplored commercially useful bioactive constituents by establishing their possible pharmacological benefits. Methods: The data from published literature, confined to pharmacological manifestations of various phytocomponents of Boerhaavia diffusa L. or its parts like root, leaf and stem were extracted from scientific databases, Google, Science Direct, PubMed, etc. using its antifungal, antibacterial, anticancer, anti-inflammatory, antidiabetic, hepatoprotective, cardioprotective, renoprotective, antifertility benefits and molecular docking study as search strings and keywords. Further, the reported in silico studies for bioactivity and bioavailability are detailed. Results: The botanicals possess numerous bioactive compounds, the most widely reported ones being phenolic (punarnavoside, trans-caftaric acid, boerhavic acid), rotenoid (boeravinones A-J), flavonoid (borhaavone, quercetin, kaempferol), isoflavonoid (2'-O-methyl abronisoflavone), alkaloid (punarnavine), steroid (boerhavisterol, β-Ecdysone), anthracenes and lignans (liriodendrin, syringaresinol mono-β-D-glucoside). Some of the reported reassuring benefits of their purified forms or even the crude extracts are antidiabetic, antimicrobial, anticancer, antioxidant, anti-inflammatory, hepatoprotective, renoprotective, cardioprotective, antifertility, etc. Conclusion: The article provides an extensive study on such pharmacological utility to support the ethnomedicinal use of Boerhaavia diffusa L. and propose possible mechanism of the various bioactive compounds in optimising metabolic dysfunctions, healing and protecting vital body organs, often related to the magnificent antioxidant property of this ayurvedic panacea. Further, establishing specific roles of its yet-to-explore bioactive constituents for diverse pharmacological applications is suggested.

The neglected continuously emerging Marburg virus disease in Africa: A global public health threat

Background and Aim

Severe viral hemorrhagic fever (VHF) is caused by Marburg virus which is a member of the Filoviridae (filovirus) family. Many Marburg virus disease (MVD) outbreaks are reported in five decades. A major notable outbreak with substantial reported cases of infections and deaths was in 2022 in Uganda. The World Health Organisation (WHO) reported MVD outbreak in Ghana in July 2022 following the detection of two probable VHF patients there. Further, the virus was reported from two other African countries, the Equatorial Guinea (February 2023) and Tanzania (March 2023). There have been 35 deaths out of 40 reported cases in Equatorial Guinea, and six of the nine confirmed cases in Tanzania so far.

Methods

Data particularly on the several MVD outbreaks as reported from the African countries were searched on various databases including the Pubmed, Scopus, and Web-of-science. Also, the primary data and reports from health agencies like the WHO and the Centers for Disease Control and Prevention CDC) were evaluated and the efficacy reviewed.

Results

Chiroptera in general and bat species like Rousettus aegyptiacus and Hipposideros caffer in particular are natural reservoirs of the Marburg virus. MVD-infected nonhuman primate African fruit-bat and the MVD-infected humans pose significant risk in human infections. Cross-border viral transmission and its potential further international ramification concerns raise the risk of its rapid spread and a potential outbreak. Occurrence of MVD is becoming more frequent in Africa with higher case fatality rates. Effective prophylactic and therapeutic interventions to counter this deadly virus are suggested.

Conclusion

In the face of the lack of effective therapeutics and preventives against MVD, supportive care is the only available option which contributes to the growing concern and disease severity. In view of the preventive approaches involving effective surveillance and monitoring system following the "One Health" model is extremely beneficial to ensure a healthy world for all, this article aims at emphasizing several MVD outbreaks, epidemiology, zoonosis of the virus, current treatment strategies, risk assessments, and the mitigation strategies against MVD.

SARS-CoV-2 Variants BA.2.86 and EG.5.1 Alongside Scrub Typhus and Nipah in India During the Ongoing Cricket World Cup 2023: Threat Perceptions and Countermeasures

The United States (US), the United Kingdom (UK), and China witnessed rising cases of coronavirus disease 2019 (COVID-19) in 2023. Concerns about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) novel strains amid the sudden surge of COVID cases are growing. Recently, BA.2.86 (Pirola) poses a much greater risk due to its higher transmission rate and spreading across regions. Pirola variant has mutations that set it apart from all earlier known SARS-CoV-2 variants. This variant was designated a variant of interest by the World Health Organization (WHO). Another SARS-CoV-2 variant named "Eris" (EG.5.1) was detected in India and started picking up in the US and the UK. The WHO listed EG.5.1 (variant) as a variant under monitoring. Therefore, it is important to remain vigilant. Further, multiple Nipah virus infections and scrub typhus cases are spreading among humans in India currently. In this situation, the 13th edition of the International Cricket Council (ICC) Men's Cricket World Cup is being held in India this year. With global reach, this big sporting carnival attracts millions of cricket fans from several countries. In light of the multiple public health concerns encountered currently, this gala global sports event needs additional preventive measures.

A systematic review and meta-analysis of food handling practices in Ghana vis-a-vis the associated factors among food handlers during 2009 and 2022

Foodborne diseases (FBDs) are a major public health concern, especially in Sub-Saharan African (SSA) countries, such as Ghana, where poor food handling practices (FHPs) are prevalent. To estimate the pooled proportion of good FHPs and the associated factors among Ghanaian food handlers, this systematic review and meta-analysis was conducted to aid scholars, practitioners and policymakers in devising FBD-preventable interventions. The scientific databases PubMed, Google Scholar, Science Direct, African Journals Online, ProQuest, and Directory of Open Access Journals were systematically searched until April 19, 2023, for relevant literature. Observational studies meeting the inclusion criteria of reported good FHPs among food handlers were included. Three authors independently searched the database, assessed the risks of bias and extracted the data from the shortlisted articles. A random-effects model with the DerSimonian and Laird model was used to estimate the pooled effect size of FHPs and the pooled odds ratio (POR) of FHP-associated factors. Out of the 2019 records collated, 33 with a total sample size of 6095 food handlers met the inclusion criteria for meta-analysis. The pooled proportion of good FHPs among Ghanaian food handlers was 55.8% [95% Cl (48.7, 62.8%); I2 = 97.4%; p < 0.001]. Lack of food safety training [POR = 0.10; 95% CI (0.03, 0.35); p = 0.001] and inadequate knowledge of food hygiene [POR = 0.36; 95% CI (0.01, 10.19); p < 0.001] were identified as the critical good FHP-associated factors. The study showed that the proportion of good FHPs among Ghanaian food handlers was 55.8%. To increase knowledge of food hygiene among food handlers, the Ghanaian Food and Drugs Authority (FDA) is recommended to provide regular training on food safety for the well-being of the general public.

Photophysical properties of four-membered BN3 heterocyclic compounds: theoretical insights

CONTEXT

Understanding the photochemistry of boron nitrogen (BN)-containing compounds is an important aspect to enhance the various optical and electronic applications. In this work, we have explored the structure, bonding, reactivity, electronic absorption (UV-Vis), and light harvesting efficiency (LHE) of a series of BN3 ring and open-chain systems. The frontier molecular orbitals (FMO) analysis found that ring systems have a low HOMO-LUMO energy gap as compared to the open-chain systems which insinuates the feasibility of ring systems in the optoelectronic materials. Also, the molecular electrostatic potential (MEP) maps have been computed to pursue the electrophilic and nucleophilic sites available at the surface of the compound. Interestingly, we have found that the open-chain compounds show more molecular charge distribution range rather than the ring compounds. The investigation of photophysical properties showed that the UV-Vis absorption significantly red-shifted in BN3 ring systems as compared to open-chain counterparts. Furthermore, light harvesting efficiency (LHE) was also found higher in the ring systems as compared to the BN3 open-chain systems. Moreover, the computed structural parameters are found well corroborated with the available X-ray data.

METHODS

Structures of all compounds were optimized by using density functional theory (DFT) method, with M06-2X/6-31G(d,p) level. All the calculations in this work are carried out in Gaussian 16 program package. GaussView6.1 software was used for the modeling of initial geometries and for the plotting of MEP plots. To account the solvent effect on geometries the polarized continuum model (PCM) was used and tetrahydrofuran (THF) taken as solvent. The NBO6.0 program (incorporated in G16 software) was used for the exploration of bonding nature and stabilization energies of B-N bond. The absorption spectra were simulated by using ORCA 4.2 program.

Analyzing the emerging patterns of SARS-CoV-2 Omicron subvariants for the development of next-gen vaccine: An observational study

Background and Aim

Understanding the prevalence and impact of SARS-CoV-2 variants has assumed paramount importance. This study statistically analyzed to effectively track the emergence and spread of the variants and highlights the importance of such investigations in developing potential next-gen vaccine to combat the continuously emerging Omicron subvariants.

Methods

Transmission fitness advantage and effective reproductive number (R e) of epidemiologically relevant SARS-CoV-2 sublineages through time during the study period based on the GISAID data were estimated.

Results

The analyses covered the period from January to June 2023 around an array of sequenced samples. The dominance of the XBB variant strain, accounting for approximately 57.63% of the cases, was identified during the timeframe. XBB.1.5 exhibited 37.95% prevalence rate from March to June 2023. Multiple variants showed considerable global influence throughout the study, as sporadically documented. Notably, the XBB variant demonstrated an estimated relative 28% weekly growth advantage compared with others. Numerous variants were resistant to the over-the-counter vaccines and breakthrough infections were reported. Similarly, the efficacy of mAB-based therapy appeared limited. However, it's important to underscore the perceived benefits of these preventive and therapeutic measures were restricted to specific variants.

Conclusion

Given the observed trends, a comprehensive next-gen vaccine coupled with an advanced vaccination strategy could be a potential panacea in the fight against the pandemic. The findings suggest that targeted vaccine development could be an effective strategy to prevent infections. The study also highlights the need of global collaborations to rapidly develop and distribute the vaccines to ensure global human health.

Role of available COVID-19 vaccines in reducing deaths and perspective for next generation vaccines and therapies to counter emerging viral variants: an update

The COVID-19 disease wreaked havoc all over the world causing more than 6 million deaths out of over 519 million confirmed cases. It not only disturbed the human race health-wise but also caused huge economic losses and social disturbances. The utmost urgency to counter pandemic was to develop effective vaccines as well as treatments that could reduce the incidences of infection, hospitalization and deaths. The most known vaccines that could help in managing these parameters are Oxford-AstraZeneca (AZD1222), Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273) and Johnson & Johnson (Ad26.COV2.S). The effectiveness of AZD1222 vaccine in reducing deaths is 88% in the age group 40-59 years, touching 100% in the age group 16-44 years & 65-84 years. BNT162b2 vaccine also did well in reducing deaths due to COVID-19 (95% in the age group 40-49 years and 100% in the age group 16-44 years. Similarly, mRNA-1273 vaccine showed potential in reducing COVID-19 deaths with effectiveness ranging from 80.3 to 100% depending upon age group of the vaccinated individuals. Ad26.COV2.S vaccine was also 100% effective in reducing COVID-19 deaths. The SARS-CoV-2 emerging variants have emphasized the need of booster vaccine doses to enhance protective immunity in vaccinated individuals. Additionally, therapeutic effectiveness of Molnupiravir, Paxlovid and Evusheld are also providing resistance against the spread of COVID-19 disease as well as may be effective against emerging variants. This review highlights the progress in developing COVID-19 vaccines, their protective efficacies, advances being made to design more efficacious vaccines, and presents an overview on advancements in developing potent drugs and monoclonal antibodies for countering COVID-19 and emerging variants of SARS-CoV-2 including the most recently emerged and highly mutated Omicron variant.

Application of CRISPR-Cas System to Mitigate Superbug Infections

Multidrug resistance in bacterial strains known as superbugs is estimated to cause fatal infections worldwide. Migration and urbanization have resulted in overcrowding and inadequate sanitation, contributing to a high risk of superbug infections within and between different communities. The CRISPR-Cas system, mainly type II, has been projected as a robust tool to precisely edit drug-resistant bacterial genomes to combat antibiotic-resistant bacterial strains effectively. To entirely opt for its potential, advanced development in the CRISPR-Cas system is needed to reduce toxicity and promote efficacy in gene-editing applications. This might involve base-editing techniques used to produce point mutations. These methods employ designed Cas9 variations, such as the adenine base editor (ABE) and the cytidine base editor (CBE), to directly edit single base pairs without causing DSBs. The CBE and ABE could change a target base pair into a different one (for example, G-C to A-T or C-G to A-T). In this review, we addressed the limitations of the CRISPR/Cas system and explored strategies for circumventing these limitations by applying diverse base-editing techniques. Furthermore, we also discussed recent research showcasing the ability of base editors to eliminate drug-resistant microbes.

Deep and Transfer Learning Approaches for Automated Early Detection of Monkeypox (Mpox) Alongside Other Similar Skin Lesions and Their Classification

The world faces multiple public health emergencies simultaneously, such as COVID-19 and Monkeypox (mpox). mpox, from being a neglected disease, has emerged as a global threat that has spread to more than 100 nonendemic countries, even as COVID-19 has been spreading for more than 3 years now. The general mpox symptoms are similar to chickenpox and measles, thus leading to a possible misdiagnosis. This study aimed at facilitating a rapid and high-brevity mpox diagnosis. Reportedly, mpox circulates among particular groups, such as sexually promiscuous gay and bisexuals. Hence, selectively vaccinating, isolating, and treating them seems difficult due to the associated social stigma. Deep learning (DL) has great promise in image-based diagnosis and could help in error-free bulk diagnosis. The novelty proposed, the system adopted, and the methods and approaches are discussed in the article. The present work proposes the use of DL models for automated early mpox diagnosis. The performances of the proposed algorithms were evaluated using the data set available in public domain. The data set adopted for the study was meant for both training and testing, the details of which are elaborated. The performances of CNN, VGG19, ResNet 50, Inception v3, and Autoencoder algorithms were compared. It was concluded that CNN, VGG19, and Inception v3 could help in early detection of mpox skin lesions, and Inception v3 returned the best (96.56%) classification accuracy.

Current Surge of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Variants in China Could Be Threatening as the Asian Games 2023 Flags Off in September: Foolproof Cautionary Measures Are Suggested

Despite normalcy having almost returned in the lives of people throughout the world post-coronavirus disease-19 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the danger still looms over the fears of development and propagation of a newer SARS-CoV-2 variant. The movement of people globally has reached the pre-pandemic level, and this augmentation increased surveillance regarding the emergence of lethal SARS-CoV-2 variants. International sports events are among the potential avenues where the virus could cause serious impact. Therefore, the organization of such events should be planned and executed meticulously to avoid viral transmission and minimize the health effects of infections on the sportspersons and the local people. Additionally, there could be dissemination of the infections to the native countries of the participants and visitors while they return to their homes. Through this editorial, we prompt caution to the organizers and the event-hosting nation's administration regarding the potential threat and suggest measures to avoid any medical emergencies related to COVID-19.

COVID-19 vaccines and their underbelly: Are we going the right way?

Background

Historically, a critical aetiological agent of health concern stays till eternity after its discovery, so shall it be with the COVID-19 outbreak. It has transformed human life to a 'new normal' with huge tolls on the social, psychological, intellectual and financial spheres.

Aim

This perspective aimed to collate numerous reported COVID-19 vaccine-associated adverse events and the predisposing factors. It focussed on the efficacy of mix-n-match (cocktail) vaccines to effectively counter COVID-19 infection to facilitate future research and possible interventions.

Material and Methods

Databases like Scopus, Pubmed and the Web-of-science were searched for published literature on 'adverse events associated with COVID-19 vaccine'. The reports and updates from health agencies like the WHO and CDC were also considered for the purpose. The details with respect to the adverse events associated with COVID-19 vaccination and the predisposing factors were compiled to obtain insights and suggest possible future directions in vaccine research.

Results

India stood strong to manage its health resources in time and turned into a dominant global vaccine supplier at a time when healthcare infrastructure of many countries was still significantly challenged. Developing indigenous vaccines and the vaccination drive in India were its major achievements during the second and the subsequent COVID-19 waves. The fully indigenous Covaxin vaccine, primarily as an emergency intervention, was successfully rapidly launched. Similar such vaccines for emergency use were developed elsewhere as well. However, all of these reached the marketplace with a 'emergency use only' tag, without formal clinical trials and other associated formalities to validate and verify them as these would require much longer incubation time before they are available for human use.

Discussion

Many adverse events associated with either the first or the second/booster vaccination doses were reported. Evidently, these associated adverse events were considered as 'usually rare' or were often underreported. Without the additional financial or ethical burden on the vaccine companies, fortunately, the Phase IV (human) clinical trials of their manufactured vaccines are occurring by default as the human population receives these under the tag 'emergency use'. Thus, focused and collaborative strategies to unveil the molecular mechanisms in vaccine-related adverse events in a time-bound manner are suggested.

Conclusion

Reliable data particularly on the safety of children is lacking as majority of the current over-the-counter COVID-19 vaccines were for emergency use. Many of these were still in their Phase III and Phase IV trials. The need for a mutant-proof, next-gen COVID-19 vaccine in the face of vaccine-associated adverse events is opined.

Nanoadjuvants: Promising Bioinspired and Biomimetic Approaches in Vaccine Innovation

Adjuvants are the important part of vaccine manufacturing as they elicit the vaccination effect and enhance the durability of the immune response through controlled release. In light of this, nanoadjuvants have shown unique broad spectrum advantages. As nanoparticles (NPs) based vaccines are fast-acting and better in terms of safety and usability parameters as compared to traditional vaccines, they have attracted the attention of researchers. A vaccine nanocarrier is another interesting and promising area for the development of next-generation vaccines for prophylaxis. This review looks at the various nanoadjuvants and their structure-function relationships. It compiles the state-of-art literature on numerous nanoadjuvants to help domain researchers orient their understanding and extend their endeavors in vaccines research and development.

Rift valley fever (RVF) viral zoonotic disease steadily circulates in the Mauritanian animals and humans: A narrative review

Background and Aim

Rift valley fever (RVF) virus (RVFV) is reportedly steadily circulating in Mauritania being repeated in 1987, 2010, 2012, 2015, and 2020. Mauritania seems a preferred niche for RVF virus due to its persistent outbreak there. Lately, nine Mauritanian wilayas confirmed 47 (23 fatalities with 49% CFR) human cases between August 30 and October 17, 2022. Most of the cases were largely among livestock breeders associated with animal husbandry activities. The review aimed at understanding the origin, cause, and measures to counter the virus.

Methods

The facts and figures from the various published articles sourced from databases including Pubmed, Web of Science, and the Scopus as also some primary data from health agencies like WHO, CDC, and so forth were evaluated and the efficacy of countermeasures reviewed.

Results

Among the reported confirmed cases, it was found that 3-70 year age-group males outnumbered the females. Deaths after fever occurred primarily due to acute hemorrhagic thrombocytopenia. Human infections often occurred through zoonotic transmission mainly through mosquitoes in the population contiguous to cattle outbreak, a conducive site for local RVFV transmission. Many transmission cases were through direct or indirect contact with blood or organs of the infected animal.

Conclusion

RVFV infection was predominant in the Mauritanian regions bordering Mali, Senegal, and Algeria. High human and domesticated animal density as also the existing zoonotic vectors further contributed to RVF virus circulation. Mauritanian RVF infection data confirmed that RVFV was zoonotic that included small ruminants, cattle, and camel. This observation hints at the role of transborder animal mobility in RVFV transmission. In light of this, preventive approaches with effective surveillance and monitoring system following the One Health model is extremely beneficial for a free and fair healthy world for all.

Anti-tubercular activity evaluation of natural compounds by targeting Mycobacterium tuberculosis resuscitation promoting factor B inhibition: An in silico study

Tuberculosis (TB), an infectious disease caused by the Mycobacterium tuberculosis (Mtb), has been responsible for the deaths of millions of individuals around the globe. A vital protein in viral pathogenesis known as resuscitation promoting factor (RpfB) has been identified as a potential therapeutic target of anti-tuberculosis drugs. This study offered an in silico process to examine possible RpfB inhibitors employing a computational drug design pipeline. In this study, a total of 1228 phytomolecules were virtually tested against the RpfB of Mtb. These phytomolecules were sourced from the NP-lib database of the MTi-OpenScreen server, and five top hits (ZINC000044404209, ZINC000059779788, ZINC000001562130, ZINC000014766825, and ZINC000043552589) were prioritized for compute intensive docking with dock score ≤ - 8.5 kcal/mole. Later, molecular dynamics (MD) simulation and principal component analysis (PCA) were used to validate these top five hits. In the list of these top five hits, the ligands ZINC000044404209, ZINC000059779788, and ZINC000043552589 showed hydrogen bond formation with the functional residue Glu²⁹² of the RpfB protein suggesting biological significance of the binding. The RMSD study showed stable protein-ligand complexes and higher conformational consistency for the ligands ZINC000014766825, and ZINC000043552589 with RMSD 3-4 Å during 100 ns MD simulation. The overall analysis performed in the study suggested promising binding of these compounds with the RpfB protein of the Mtb at its functional site, further experimental investigation is needed to validate the computational finding.

Potential Strategies to Control the Risk of Antifungal Resistance in Humans: A Comprehensive Review

Fungal infections are becoming one of the main causes of morbidity and mortality in people with weakened immune systems. Mycoses are becoming more common, despite greater knowledge and better treatment methods, due to the regular emergence of resistance to the antifungal medications used in clinical settings. Antifungal therapy is the mainstay of patient management for acute and chronic mycoses. However, the limited availability of antifungal drug classes limits the range of available treatments. Additionally, several drawbacks to treating mycoses include unfavourable side effects, a limited activity spectrum, a paucity of targets, and fungal resistance, all of which continue to be significant issues in developing antifungal drugs. The emergence of antifungal drug resistance has eliminated accessible drug classes as treatment choices, which significantly compromises the clinical management of fungal illnesses. In some situations, the emergence of strains resistant to many antifungal medications is a major concern. Although new medications have been developed to address this issue, antifungal drug resistance has grown more pronounced, particularly in patients who need long-term care or are undergoing antifungal prophylaxis. Moreover, the mechanisms that cause resistance must be well understood, including modifications in drug target affinities and abundances, along with biofilms and efflux pumps that diminish intracellular drug levels, to find novel antifungal drugs and drug targets. In this review, different classes of antifungal agents, and their resistance mechanisms, have been discussed. The latter part of the review focuses on the strategies by which we can overcome this serious issue of antifungal resistance in humans.

X-ray radiation shielding and microscopic studies of flexible and moldable bandage by in situ synthesized cerium oxide nanoparticles/MWCNTS nanocomposite for healthcare applications

This research reports a robust method for developing advanced flexible and moldable X-ray shielding bandages by harnessing an in situ synthesized polygonal cerium oxide nanoparticles/MWCNTs nanocomposite. The developed advanced hybrid nanocomposite was thoroughly blended with silicone rubber, namely polydimethylsiloxane (PDMS) to form an advanced hybrid gel which was then coated on a conventional cotton bandage to develop an advanced flexible, moldable X-ray shielding bandage. The combined effects were analyzed to determine their unique X-ray reduction properties and were very effective. The linear attenuation value of the developed bandage (untreated cotton bandage coated with CeO₂/MWCNT/PDMS), varied from 1.274 m^-1 to 0.549 m^-1 and the mass attenuation values from 0.823 m² kg^-1 to 0.354 m² kg^-1 for kVp 40 to 100 respectively. The improved features of high density and efficiency of protection are because of the binary protective effect of CeO₂ nanoparticles and MWCNT. The morphological features of the developed material were characterized using various techniques such as TEM, SEM, XRD, and EDXA. The developed bandage is an entirely lead-free product, thin and light, has high shielding performance, flexibility, durability, good mechanical strength, doesn't crack easily (no crack), and can be washed in water. It may therefore be useful in various fields, including diagnostic radiology, cardiology, urology, and neurology treatments, attenuating emergency radiation leakages in CT scanner rooms or via medical equipment, and safeguarding complex shielding machinery in public areas.

Inflammatory and vascular biomarkers in post-COVID-19 syndrome: A systematic review and meta-analysis of over 20 biomarkers

Severe acute respiratory syndrome coronavirus 2 may inflict a post-viral condition known as post-COVID-19 syndrome (PCS) or long-COVID. Studies measuring levels of inflammatory and vascular biomarkers in blood, serum, or plasma of COVID-19 survivors with PCS versus non-PCS controls have produced mixed findings. Our review sought to meta-analyse those studies. A systematic literature search was performed across five databases until 25 June 2022, with an updated search on 1 November 2022. Data analyses were performed with Review Manager and R Studio statistical software. Twenty-four biomarkers from 23 studies were meta-analysed. Higher levels of C-reactive protein (Standardized mean difference (SMD) = 0.20; 95% CI: 0.02-0.39), D-dimer (SMD = 0.27; 95% CI: 0.09-0.46), lactate dehydrogenase (SMD = 0.30; 95% CI: 0.05-0.54), and leukocytes (SMD = 0.34; 95% CI: 0.02-0.66) were found in COVID-19 survivors with PCS than in those without PCS. After sensitivity analyses, lymphocytes (SMD = 0.30; 95% CI: 0.12-0.48) and interleukin-6 (SMD = 0.30; 95% CI: 0.12-0.49) were also significantly higher in PCS than non-PCS cases. No significant differences were noted in the remaining biomarkers investigated (e.g., ferritin, platelets, troponin, and fibrinogen). Subgroup analyses suggested the biomarker changes were mainly driven by PCS cases diagnosed via manifestation of organ abnormalities rather than symptomatic persistence, as well as PCS cases with duration of <6 than ≥6 months. In conclusion, our review pinpointed certain inflammatory and vascular biomarkers associated with PCS, which may shed light on potential new approaches to understanding, diagnosing, and treating PCS.

Immunotherapeutics in lung cancers: from mechanistic insight to clinical implications and synergistic perspectives

BACKGROUND

Lung cancer is one of the highly lethal forms of cancer whose incidence has worldwide rapidly increased over the past few decades. About 80-85% of all lung cancer cases constitute non-small cell lung cancer (NSCLC), with adenocarcinoma, squamous cell carcinoma and large cell carcinoma as the main subtypes. Immune checkpoint inhibitors have led to significant advances in the treatment of a variety of solid tumors, significantly improving cancer patient survival rates.

METHODS AND RESULTS

The cytotoxic drugs in combination with anti-PD-(L)1 antibodies is a new method that aims to reduce the activation of immunosuppressive and cancer cell prosurvival responses while also improving direct cancer cell death. The most commonly utilized immune checkpoint inhibitors for patients with non-small cell lung cancer are monoclonal antibodies (Atezolizumab, Cemiplimab, Ipilimumab, Pembrolizumab etc.) against PD-1, PD-L1, and CTLA-4. Among them, Atezolizumab (TECENTRIQ) and Cemiplimab (Libtayo) are engineered monoclonal anti programmed death ligand 1 (PD-L1) antibodies that inhibit binding of PD-L1 to PD-1 and B7.1. As a result, T-cell proliferation and cytokine synthesis are inhibited leading to restoring the immune homeostasis to fight cancer cells.

CONCLUSIONS

In this review article, the path leading to the introduction of immunotherapeutic options in lung cancer treatment is described, with analyzing the benefits and shortages of the current immunotherapeutic drugs. In addition, possibilities to co-administer immunotherapeutic agents with standard cancer treatment modalities are also considered.

Application of CRISPR/Cas9 Technology in Cancer Treatment: A Future Direction

Gene editing, especially with clustered regularly interspaced short palindromic repeats associated protein 9 (CRISPR-Cas9), has advanced gene function science. Gene editing's rapid advancement has increased its medical/clinical value. Due to its great specificity and efficiency, CRISPR/Cas9 can accurately and swiftly screen the whole genome. This simplifies disease-specific gene therapy. To study tumor origins, development, and metastasis, CRISPR/Cas9 can change genomes. In recent years, tumor treatment research has increasingly employed this method. CRISPR/Cas9 can treat cancer by removing genes or correcting mutations. Numerous preliminary tumor treatment studies have been conducted in relevant fields. CRISPR/Cas9 may treat gene-level tumors. CRISPR/Cas9-based personalized and targeted medicines may shape tumor treatment. This review examines CRISPR/Cas9 for tumor therapy research, which will be helpful in providing references for future studies on the pathogenesis of malignancy and its treatment.