Extracellular vesicles-powered immunotherapy: Unleashing the potential for safer and more effective cancer treatment

Cancer treatment has seen significant advancements with the introduction of Onco-immunotherapies (OIMTs). Although some of these therapies have received approval for use, others are either undergoing testing or are still in the early stages of development. Challenges persist in making immunotherapy widely applicable to cancer treatment. To maximize the benefits of immunotherapy and minimize potential side effects, it's essential to improve response rates across different immunotherapy methods. A promising development in this area is the use of extracellular vesicles (EVs) as novel delivery systems. These small vesicles can effectively deliver immunotherapies, enhancing their effectiveness and reducing harmful side effects. This article discusses the importance of integrating nanomedicines into OIMTs, highlighting the challenges with current anti-OIMT methods. It also explores key considerations for designing nanomedicines tailored for OIMTs, aiming to improve upon existing immunotherapy techniques. Additionally, the article looks into innovative approaches like biomimicry and the use of natural biomaterial-based nanocarriers (NCs). These advancements have the potential to transform the delivery of immunotherapy. Lastly, the article addresses the challenges of moving OIMTs from theory to clinical practice, providing insights into the future of using advanced nanotechnology in cancer treatment.

Exosome-Based Macromolecular neurotherapeutic drug delivery approaches in overcoming the Blood-Brain barrier for treating brain disorders

Delivering drugs to the brain is a complex challenge in medical research, particularly for disorders like Alzheimer's and Parkinson's. The blood-brain barrier restricts the entry of many therapeutic molecules, hindering their effectiveness. Nanoparticles, a potential solution, face issues like toxicity and limited approvals. A new avenue explores the use of small extracellular vesicles (sEVs), i.e., exosomes, as natural carriers for drug delivery. sEVs, tiny structures below 150 nm, show promise due to their minimal immune response and ability to precisely deliver drugs. This review focuses on the potential of sEVs-based drug delivery systems for treating neurological disorders, brain cancers, and other brain-related issues. Notably, bioengineered sEVs-carrying therapeutic compounds exhibit promise in early studies. The unique features of sEVs, such as their small size and natural properties, position them as candidates to overcome challenges in drug delivery to the brain. Ongoing clinical trials and research into sEVs behavior within the body further highlight their potential for revolutionizing drug delivery and addressing complex brain conditions.

Exploring nanocarriers as innovative materials for advanced drug delivery strategies in onco-immunotherapies

In recent years, Onco-immunotherapies (OIMTs) have been shown to be a potential therapy option for cancer. Several immunotherapies have received regulatory approval, while many others are now undergoing clinical testing or are in the early stages of development. Despite this progress, a large number of challenges to the broad use of immunotherapies to treat cancer persists. To make immunotherapy more useful as a treatment while reducing its potentially harmful side effects, we need to know more about how to improve response rates to different types of immunotherapies. Nanocarriers (NCs) have the potential to harness immunotherapies efficiently, enhance the efficiency of these treatments, and reduce the severe adverse reactions that are associated with them. This article discusses the necessity to incorporate nanomedicines in OIMTs and the challenges we confront with current anti-OIMT approaches. In addition, it examines the most important considerations for building nanomedicines for OIMT, which may improve upon current immunotherapy methods. Finally, it highlights the applications and future scenarios of using nanotechnology.

Transforming Pharmaceutical Synthesis with Sein-E-B Nanocomposite Photocatalyst through 1,4-NAD(P)H Cofactor Regeneration and C-N Bond Activation

The need for sunlight chemical renewal and contemporary organic transformation has fostered the advancement of environmentally friendly photocatalytic techniques. For the first time, we report on the novel crafting of a bright future with selenium-infused Eosin-B (Sein-E-B) nanocomposite photocatalysts in this work. The Sein-E-B nanocomposite materials were created using a hydrothermal process for solar chemical regeneration and organic transformation under visible light. The synthesized samples were subjected to UV-DRS-visible spectroscopy, FT-IR, SEM, EDX, EIS and XRD analysis. The energy band gap of the Sein-E-B nanocomposite photocatalyst was measured using UV-DRS, and the result was around 2.06 eV. to investigate the generated Sein-E-B catalytic activity as a nanocomposite for 1,4-NADH/NADPH re-formation and C-N bond activation. This novel photocatalyst offers a promising alternative for the regeneration of solar chemicals and C-N bond creation between pyrrole and aryl halides.

Rete middle cerebral artery presenting with a ruptured aneurysm

ABSTRACT

The developmental anomaly of the middle cerebral artery (MCA) is a rare occurrence. Rete MCA, also known as "unfused," "twig-like," and aplastic MCA, is an even rarer anomaly. These immature rete vessels are prone to flow-related aneurysms which rupture themselves presenting with intraparenchymal hematoma. We here with present a case of rete MCA with a ruptured aneurysm and discuss its pathophysiology and management.

Isolated pancreatic injury following blunt trauma in a seven-year-old girl: A case report

INTRODUCTION AND IMPORTANCE

Isolated pancreatic injury following blunt abdominal trauma is rare, and the absence of definite clinical signs and symptoms may delay diagnosis and management.

CASE PRESENTATION

We present the case of a seven-year-old girl with a history of progressive, periumbilical abdominal pain and multiple episodes of non-bilious, non-blood mixed vomiting following a road traffic accident. Computed tomography (CT) imaging revealed an isolated grade three pancreatic injury managed conservatively.

CLINICAL DISCUSSION

The patient usually presents with epigastric tenderness with or without a rise in pancreatic enzyme levels. CT grading of injury correlates with and guides the management approach, and CT abdomen with contrast is the preferred investigation for diagnosis. Management depends on the grade of injury, the hemodynamic status of the children, and the co-existence of other injuries.

CONCLUSION

Isolated pancreatic injury, although rare, can go undiagnosed due to a lack of suspicion from the treating surgeon and may have dire consequences. Conservative management can be a suitable strategy for children with stable hemodynamic status.

Targeting Pathways and Integrated Approaches to Treat Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic symmetrical systemic disorder that not only affects joints but also other organs such as heart, lungs, kidney, and liver. Approximately there is 0.5%-1% of the total population affected by RA. RA pathogenesis still remains unclear due to which its appropriate treatment is a challenge. Further, multitudes of factors have been reported to affect its progression i.e. genetic factor, environmental factor, immune factor, and oxidative factor. Therapeutic approaches available for the treatment of RA include NSAIDs, DMARDs, enzymatic, hormonal, and gene therapies. But most of them provide the symptomatic relief without treating the core of the disease. This makes it obligatory to explore and reach the molecular targets for cure and long-term relief from RA. Herein, we attempt to provide extensive overlay of the new targets for RA treatment such as signaling pathways, proteins, and receptors affecting the progression of the disease and its severity. Precise modification in these targets such as suppressing the notch signaling pathway, SIRT 3 protein, Sphingosine-1-phosphate receptor and stimulating the neuronal signals particularly efferent vagus nerve and SIRT 1 protein may offer long term relief and potentially diminish the chronicity. To target or alter the novel molecules and signaling pathway a specific delivery system is required such as liposome, nanoparticles and micelles and many more. Present review paper discusses in detail about novel targets and delivery systems for treating RA.

Dacarbazine-primed carbon quantum dots coated with breast cancer cell-derived exosomes for improved breast cancer therapy

Imprecise targeting of chemotherapeutic drugs often leads to severe toxicity during breast cancer therapy. To address this issue, we have devised a strategy to load dacarbazine (DC) into fucose-based carbon quantum dots (CQDs), which are subsequently coated with exosomes (Ex-DC@CQDs) derived from breast cancer cells. Nanoparticle tracking analysis and western blotting revealed that Ex-DC@CQDs retained the structural and functional characteristics of exosomes. We found that exosomes facilitated the transport of DC@CQDs to cancer cells via heparan sulfate proteoglycan (HSPG) receptors, followed by an augmented depolarization of the mitochondrial membrane potential, ROS generation, and induction of apoptosis leading to cell death. In vivo imaging and pharmacokinetic studies demonstrated enhanced antitumor targeting and efficacy compared to free DC which we attribute to an improved pharmacokinetic profile, a greater tumor accumulation via exosome-mediated- HSPG receptor-driven cell uptake, and sustained release of the Ex-DC@CQDs. Our findings may pave the way for the further development of biologically sourced nanocarriers for breast cancer targeting.

Mechanistic insight on the role of iRhom2-TNF-α-BAFF signaling pathway in various autoimmune disorders

iRhom2 is a crucial cofactor involved in upregulation of TNF receptors (TNFRs) and the pro-inflammatory cytokine tumor necrosis factor (TNF-) from the cell surface by ADAM17. Tumor necrosis factor- α converting enzyme (TACE) is another name given to ADAM17. Many membrane attached biologically active molecules are cleaved by this enzyme which includes TNFRs and the pro-inflammatory cytokine tumor necrosis factor- α. The TNF receptors are of two types TNFR1 and TNFR2. iRhom2 belongs to the pseudo-protease class of rhomboid family, its abundance is observed in the immune cells. Biological activity of ADAM17 is affected in multiple levels by the iRhom2. ADAM17 is trafficked into the Golgi apparatus by the action of iRhom2, where it gets matured proteolytically and is stimulated to perform its function on the cell surface. This process of activation of ADAM17 results in the protection of the organism from the cascade of inflammatory reactions, as this activation blocks the TNF- α mediated secretion responsible for inflammatory responses produced. Present paper illustrates about the iRhom2-TNF-α-BAFF signaling pathway and its correlation with several autoimmune disorders such as Rheumatoid Arthritis, Systemic Lupus Erythematosus, Hemophilia Arthropathy, Alzheimer's disease and Tylosis with esophageal cancer etc.

Surface modification strategies in translocating nano-vesicles across different barriers and the role of bio-vesicles in improving anticancer therapy

Nanovesicles and bio-vesicles (BVs) have emerged as promising tools to achieve targeted cancer therapy due to their ability to overcome many of the key challenges currently being faced with conventional chemotherapy. These challenges include the diverse and often complex pathophysiology involving the progression of cancer, as well as the various biological barriers that circumvent therapeutic molecules reaching their target site in optimum concentration. The scientific evidence suggests that surface-functionalized nanovesicles and BVs camouflaged nano-carriers (NCs) both can bypass the established biological barriers and facilitate fourth-generation targeting for the improved regimen of treatment. In this review, we intend to emphasize the role of surface-functionalized nanovesicles and BVs camouflaged NCs through various approaches that lead to an improved internalization to achieve improved and targeted oncotherapy. We have explored various strategies that have been employed to surface-functionalize and biologically modify these vesicles, including the use of biomolecule functionalized target ligands such as peptides, antibodies, and aptamers, as well as the targeting of specific receptors on cancer cells. Further, the utility of BVs, which are made from the membranes of cells such as mesenchymal stem cells (MSCs), white blood cells (WBCs), red blood cells (RBCs), platelets (PLTs) as well as cancer cells also been investigated. Lastly, we have discussed the translational challenges and limitations that these NCs can encounter and still need to be overcome in order to fully realize the potential of nanovesicles and BVs for targeted cancer therapy. The fundamental challenges that currently prevent successful cancer therapy and the necessity of novel delivery systems are in the offing.

Care-Seeking Behavior of Families of North Indian Children Suffering From WHO-Defined Severe Community-Acquired Pneumonia: A Hospital-Based Prospective Study

Background Community-acquired pneumonia (CAP) is one of the leading causes of death in children under five. In developing countries, delayed treatment seeking has been associated with mortality and morbidity. There are only a few studies in India evaluating care-seeking behavior, particularly in children with CAP. Methods The present study was a hospital-based prospective semi-qualitative study. The study was conducted on parents or caregivers of consecutively hospitalized children under five (two to 59 months) with WHO-defined severe CAP along with radiological abnormalities consistent with CAP. Categorization of CAP and interpretation of chest X-rays (CXR) were done as per WHO criteria. Complicated CAP was categorized as severe pneumonia and had additional characteristics, including pleural effusion/empyema/pneumothorax requiring intercostal drainage, acute respiratory distress syndrome, or septic shock. Results After the screening of 420 consecutively hospitalized children under five with WHO-defined severe CAP along with radiological abnormalities consistent with it, 350 children were recruited in the present study. Among the recruited children, 58.6% experienced delayed care seeking, and among delayed care seekers, 94.6% presented with complications or developed complications during their hospital stay. The median delay in medical attention was three days. It also found that mothers with education levels below a high school had delayed care-seeking behavior. Mothers noticed the illness first in the majority of subjects (190, 54.3%), followed by fathers (78, 22.3%). Visiting traditional healers (46, 22.4%) and opting for home-bound remedies (44, 21.5%) were among the most common reasons for delayed care seeking. Fast breathing was the most concerning symptom among the parents and caregivers of the hospitalized children due to severe CAP followed by retractions, cough, and drowsiness. Retractions, drowsiness, and inability to feed were significantly recognized as alarming symptoms by the parents and caregivers in children with complicated CAP. Delayed care-seeking behavior was more prevalent in families from rural areas than in urban areas. If decision takers were in close relation with the sick child, chances of delayed care were less and vice versa. In urban areas, mothers can make decisions in significantly higher numbers than in rural areas, while grandmothers were more involved in decision-making in rural areas. Conclusion The delayed care-seeking behavior was significantly higher in children with complicated CAP. Delayed care-seeking behavior was more prevalent in families from rural areas than in urban areas. The most common reasons for delayed care-seeking behavior were home remedies and visiting traditional healers. Caregivers need to be more aware of the danger signs of CAP and the consequences of treatment delay.

Biomedical applications of nanomaterials in the advancement of nucleic acid therapy: Mechanistic challenges, delivery strategies, and therapeutic applications

In the past few decades, substantial advancement has been made in nucleic acid (NA)-based therapies. Promising treatments include mRNA, siRNA, miRNA, and anti-sense DNA for treating various clinical disorders by modifying the expression of DNA or RNA. However, their effectiveness is limited due to their concentrated negative charge, instability, large size, and host barriers, which make widespread application difficult. The effective delivery of these medicines requires safe vectors that are efficient & selective while having non-pathogenic qualities; thus, nanomaterials have become an attractive option with promising possibilities despite some potential setbacks. Nanomaterials possess ideal characteristics, allowing them to be tuned into functional bio-entity capable of targeted delivery. In this review, current breakthroughs in the non-viral strategy of delivering NAs are discussed with the goal of overcoming challenges that would otherwise be experienced by therapeutics. It offers insight into a wide variety of existing NA-based therapeutic modalities and techniques. In addition to this, it provides a rationale for the use of non-viral vectors and a variety of nanomaterials to accomplish efficient gene therapy. Further, it discusses the potential for biomedical application of nanomaterials-based gene therapy in various conditions, such as cancer therapy, tissue engineering, neurological disorders, and infections.

Preclinical study models of psoriasis: State-of-the-art techniques for testing pharmaceutical products in animal and nonanimal models

Local and systemic treatments exist for psoriasis, but none can do more than control its symptoms because of its numerous unknown mechanisms. The lack of validated testing models or a defined psoriatic phenotypic profile hinders antipsoriatic drug development. Despite their intricacy, immune-mediated diseases have no improved and precise treatment. The treatment actions may now be predicted for psoriasis and other chronic hyperproliferative skin illnesses using animal models. Their findings confirmed that a psoriasis animal model could mimic a few disease conditions. However, their ethical approval concerns and inability to resemble human psoriasis rightly offer to look for more alternatives. Hence, in this article, we have reported various cutting-edge techniques for the preclinical testing of pharmaceutical products for the treatment of psoriasis.

Novel Biotherapeutics Targeting Biomolecular and Cellular Approaches in Diabetic Wound Healing

Wound healing responses play a major role in chronic inflammation, which affects millions of people around the world. One of the daunting tasks of creating a wound-healing drug is finding equilibrium in the inflammatory cascade. In this study, the molecular and cellular mechanisms to regulate wound healing are explained, and recent research is addressed that demonstrates the molecular and cellular events during diabetic wound healing. Moreover, a range of factors or agents that facilitate wound healing have also been investigated as possible targets for successful treatment. It also summarises the various advances in research findings that have revealed promising molecular targets in the fields of therapy and diagnosis of cellular physiology and pathology of wound healing, such as neuropeptides, substance P, T cell immune response cDNA 7, miRNA, and treprostinil growth factors such as fibroblast growth factor, including thymosin beta 4, and immunomodulators as major therapeutic targets.

Mucocutaneous manifestations of COVID-19-associated mucormycosis: A retrospective cross-sectional study

Background Cutaneous mucormycosis has shown a significant upsurge during the COVID-19 pandemic. Due to the rapid progression and high mortality of cutaneous mucormycosis in this context, it is important to identify it early. However, very few studies report detailed clinical descriptions of cutaneous mucormycosis in COVID-19 patients. Objectives To describe mucocutaneous lesions of COVID-19-associated mucormycosis based on clinical morphology and attempt to correlate them with radiological changes. Methods A retrospective cross-sectional study was conducted at a tertiary care centre from 1st April to 31st July 2021. Eligibility criteria included hospitalised adult patients of COVID-19-associated mucormycosis with mucocutaneous lesions. Results All subjects were recently recovering COVID-19 patients diagnosed with cutaneous mucormycosis. One of fifty-three (2%) patients had primary cutaneous mucormycosis, and all of the rest had secondary cutaneous mucormycosis. Secondary cutaneous mucormycosis lesions presented as cutaneous-abscess in 25/52 (48%), nodulo-pustular lesions in 1/52 (2%), necrotic eschar in 1/52 (2%) and ulcero-necrotic in 1/52 (2%). Mucosal lesions were of three broad sub-types: ulcero-necrotic in 1/52 (2%), pustular in 2/52 (4%) and plaques in 1/52 (2%). Twenty out of fifty-two patients (38%) presented with simultaneous mucosal and cutaneous lesions belonging to the above categories. Magnetic resonance imaging of the face showed variable features of cutaneous and subcutaneous tissue involvement, viz. peripherally enhancing collection in the abscess group, "dot in circle sign" and heterogeneous contrast enhancement in the nodulo-pustular group; and fat stranding with infiltration of subcutaneous tissue in cases with necrotic eschar and ulcero-necrotic lesions. Limitations The morphological variety of cutaneous mucormycosis patients in a single-centre study like ours might not be very precise. Thus, there is a need to conduct multi-centric prospective studies with larger sample sizes in the future to substantiate our morphological and radiological findings. Conclusions COVID-19-associated mucormycosis patients in our study presented with a few specific types of mucocutaneous manifestations, with distinct magnetic resonance imaging findings. If corroborated by larger studies, these observations would be helpful in the early diagnosis of this serious illness.

Impact of atmospheric anthropogenic nitrogen on new production in the northern Indian Ocean: constrained based on satellite aerosol optical depth and particulate nitrogen levels

Aerosols are one of the significant external sources of soluble reactive nitrogen to the surface ocean and their deposition affects the primary productivity. Owing to rapid industrialization over South and Southeast Asia, an increasing trend in atmospheric pollutants was observed over the northern Indian Ocean (NIO). To assess the contribution of the aeolian supply of inorganic nitrogen to the NIO, the available compositional data of marine aerosols collected over this basin between 2001 and 2020 were compiled. Based on the observed relationship of mass load, and particulate nitrate and ammonium concentrations with the corresponding satellite-derived anthropogenic aerosol optical depth (AAOD), the temporal, spatial, and long-term variabilities were derived for the past two decades. In particular, high aerosol mass load, nitrate and ammonium levels were observed in the coastal aerosols of peninsular India during fall and winter and they were low in summer. The atmospheric input of inorganic nitrogen to the Arabian Sea is higher (AS; 1.7 TgN per year) compared to that of the Bay of Bengal (BoB; 0.9 TgN per year) and accounts for ∼30% of the total external sources of nitrogen to the NIO. The new production, supported by external sources of nitrogen, contributes to ∼23 and 53% of export production to the oxygen minimum zone (OMZ) in the AS and BoB respectively. A significant rate of increase in the aerosol mass load (0.05-1.67 μg per m³ per year), and nitrate (0.003-0.04 μg per m³ per year) and ammonium (0.006-0.11 μg per m³ per year) concentrations was observed between 2001 and 2020, likely because of the increased emission of anthropogenic pollutants over South and Southeast Asia and their subsequent long-range atmospheric transport to the NIO. Overall, these results suggest that an enhanced contribution of atmospheric nitrogen may potentially increase (1) the N/P ratio of the surface ocean that impacts phytoplankton composition, (2) export production to the OMZ leads to intensification, and (3) sequestration of atmospheric CO₂. A decrease in primary production due to global warming is reported due to a decrease in vertical nutrient supply; however, the increase in atmospheric deposition of nutrients may compensate for this. Therefore, ocean models must be coupled with atmospheric models to better constrain the oceanic response to climate change in the NIO.

Present scenarios and future prospects of herbal nanomedicine for antifungal therapy

The current COVID-19 epidemic is a sobering reminder that human susceptibility to infectious diseases remains even in our modern civilization. After all, infectious diseases are still the major reason of death globally. Healthcare authorities have often underestimated and ignored the threat posed by "microbial dangers," although they put millions of lives at risk every year. Overlooked developing diseases including fungal infections (FIs) contribute to roughly 1.7 million fatalities per year. As many as 150 million cases of severe and potentially life-threatening FIs are reported each year. In the last few years, the number of instances has steadily increased. Most of them are invasive fungal infections that require specialized treatment and hospital care. In recent years herbal antifungal compounds have been explored to acquire effective and safe therapy against fungal infections. However, potential therapeutic effects are hampered by the poor solubility, stability, and bioavailability of these important chemicals as well as the gastric degradation that occurs in the gastrointestinal tract. To get around this issue, researchers have turned to novel drug delivery systems such as nanoemulsions, ethosomes, metallic nanoparticles, liposomes, lipid nanoparticles, transferosomes, etc by improving their limits, nanocarriers can enhance the medicinal effects of herbal oils and extracts. The present review article focuses on the available antifungal agents and their characteristics, mechanism of antifungal drugs resistance, herbal oils and extract as antifungal agents, challenges in the delivery of herbal drugs, and application of nano-drug delivery systems for effective delivery of antifungal herbal compounds.

Decadal variations in natural and anthropogenic aerosol optical depth over the Bay of Bengal: the influence of pollutants from Indo-GangeticPlain

Perennial increase in atmospheric pollution over the Bay of Bengal (BoB) and South China Sea is reported due to increase in human population and industrial activity in South and Southeast Asia. Based on total aerosol optical depth (AOD) derived from MODIS (moderate resolution imaging resolution imaging spectroradiometer), natural and anthropogenic fractions were derived. The seasonality and spatial variability in rate of increase in total, natural, and anthropogenic AOD fractions were examined over the BoB using data collected between 2001 and 2019. Both total and anthropogenic AOD displayed statistically significant rate of increase in the northwest BoB (NWB) and western coastal BoB (WCB) regions during 2001 to 2019 whereas the long-term changes are insignificant in the other regions of BoB. Significant increase in AOD in the NWB and WCB regions is mainly contributed by dominant outflow of anthropogenic emissions from Indo-Gangetic Plain (IGP) area of Indian subcontinent. The magnitude of AOD decreased by half from northern BoB to equatorial region due to increase in distance from the source region. The contribution of anthropogenic AOD was >70% to total AOD with higher contribution during winter and lower during summer. The rate of increase in both total and anthropogenic AOD was close to 0.104 and 0.099 per decade in the NWB and 0.069 and 0.059 per decade in the WCB region between 2001 and 2019. The rate of increase in total and anthropogenic AOD decreased from 2001-2009 (0.164 and 0.115 per decade respectively) to 2010-2019 (0.068 and 0.076 per decade respectively) in the NWB region. Significant increase in anthropogenic AOD by 50 and 30% was observed during El Niño and La Niña periods respectively than normal year in both northwest BoB (NWB) and western coastal (WCB) regions due to change in strength and direction of winds. Although some fraction of anthropogenic AOD is found over the entire BoB, significant rate of increase in anthropogenic AOD is found only about 23% of the area of BoB than hitherto reported as entire BoB. The impact of atmospheric deposition of anthropogenic aerosols on biogeochemical processes, such as primary production and ocean acidification, needs further evaluation.

COVID-19: clinical presentation and detection methods

The unending outburst of COVID-19 has reinforced the necessity of SARS-CoV-2 identification approaches for the prevention of infection transmission and the proper care of severe and critical patients. As there is no cure, a prompt and reliable diagnosis of SARS-CoV2 is vital to counter the spread and to provide adequate care and treatment for the infection. Currently, RT-PCR is a gold standard detection method for the qualitative and quantitative detection of viral nucleic acids. Besides, enzyme-linked immunosorbent assay is also a primarily used method for qualitative estimation of viral load. However, almost all the detection methods have their pros and cons in terms of specificity, accuracy, sensitivity, cost, time consumption, the need for sophisticated laboratories, and the requirement of skilled technical experts to carry out the detection tests. Thus, it is suggested to integrate different techniques to enhance the detection efficiency and accurateness for SARS-CoV2. This review focuses on preliminary, pre-confirmatory, and confirmatory methods of detection such as imaging techniques (chest-X-ray and chest- computed tomography), nucleic acid detection methods, serological assay methods, and viral culture and identification methods that are currently being employed to detect the presence of SARS-CoV-2 infection along with recent detection method and applicability for COVID-19.

Novel archetype in psoriasis management bridging molecular dynamics in exploring novel therapies

Psoriasis is an autoimmune chronic inflammatory condition of skin affecting 125 million populaces around the globe. It is implicated as a result of multifaceted phenomena involving various cell and subcell activities with the aid of numerous cellular and molecular components including signaling aisle and regulatory proteins owing to the development of such hyperproliferative dermatological conditions. This involves a deeply complex and conflicting pathology owing to genetic and immunological deviations resulting from the unusual presentation of different signaling pathways and regulatory proteins. Explorations of these biomarkers and intervention of molecular and cellular processes in psoriasis are yet to be investigated and could be an exceptional aspect for understanding pathology with successful targeting of disease. In the presented study, we have integrated molecular insights, including signaling molecules, pathways, and proteins implicated in pathogenesis, and we have attempted to link this knowledge to the targeting of these phenomena in order to manage the conditions precisely. Further, therapeutic delivery approaches for targeting distinct layers of skin have also been investigated based on the application of different nanocarriers for successful psoriasis treatment.

Urine Extracellular Vesicle GATA2 mRNA Discriminates Biopsy Result in Men with Suspicion of Prostate Cancer

PURPOSE

Prostate specific antigen has limited performance in detecting prostate cancer. The transcription factor GATA2 is expressed in aggressive prostate cancer. We analyzed the predictive value of urine extracellular vesicle GATA2 mRNA alone and in combination with a multigene panel to improve detection of prostate cancer and high risk disease.

MATERIALS AND METHODS

GATA2 mRNA was analyzed in matched extracellular vesicles isolated from urines before and after prostatectomy (16) and paired urine and tissue prostatectomy samples (19). Extracellular vesicle GATA2 mRNA performance to distinguish prostate cancer and high grade disease was tested in training (52) and validation (165) cohorts. The predictive value of a multigene score including GATA2, PCA3 and TMPRSS2-ERG (GAPT-E) was tested in both cohorts.

RESULTS

Confirming its prostate origin, urine extracellular vesicle GATA2 mRNA levels decreased significantly after prostatectomy and correlated with prostate cancer tissue GATA2 mRNA levels. In the training and validation cohort GATA2 discriminated prostate cancer (AUC 0.74 and 0.66) and high grade disease (AUC 0.78 and 0.65), respectively. Notably, the GAPT-E score improved discrimination of prostate cancer (AUC 0.84 and 0.72) and high grade cancer (AUC 0.85 and 0.71) in both cohorts when compared with each biomarker alone and PT-E (PCA3 and TMPRSS2-ERG). A GAPT-E score for high grade prostate cancer would avoid 92.1% of unnecessary prostate biopsies, compared to 61.9% when a PT-E score is used.

CONCLUSIONS

Urine extracellular vesicle GATA2 mRNA analysis improves the detection of high risk prostate cancer and may reduce the number of unnecessary biopsies.

Spatial and temporal variability in concentration and characteristics of aerosols at Visakhapatnam (east) and Goa (west) coasts of India

Knowledge on the variability in quantity and compositions of various size groups of aerosols is important to understand their sources and their role in biogeochemical and climate processes. Here, we studied total suspended particles (TSP), PM₁₀ and PM_2.5 for their quantitative and water soluble compositional (F^-, Cl^-, SO₄^2-, NO₃^-, NH₄⁺, Na⁺, K⁺, Ca²⁺, and Mg²⁺) distributions, and to understand their nature and potential sources at Goa and Visakhapatnam on the west and east coasts, respectively, of India. While the mean concentrations of TSP were found to be 117 ± 44 and 85 ± 51 μg/m³ its maximal levels occurred in spring intermonsoon (SIM; 141 ± 52) and winter monsoon (WM; 155 ± 145 μg/m³) seasons at Goa and Visakhapatnam, respectively. PM₁₀ and PM_2.5 exhibited higher ranges at Visakhapatnam than Goa. The increase in PM_2.5 abundance from WM to SIM at Visakhapatnam seems to occur in coincidence with decrease in TSP favored by topography and ambient meteorological conditions. Locally released and seasonally transported (from land and sea) constituents contributed to the observed variability in aerosol compositions. Sulphate dominated the aerosol composition at both Goa (57-64%) and Visakhapatnam (43-55%) followed by NO₃^- (5-16% and 6-18%, respectively) where the former component was higher in PM₁₀ and PM_2.5. The NO₃^- was more in TSP. Relations between SO₄^2- and NH₄⁺ suggested possible presence of NH₄HSO₄. Examination of ionic ratios and balance suggested near neutrality in PM₁₀ and PM_2.5 while TSP was acidic at the both locations. Notable relations between Ca²⁺ and NO₃^-, particularly in PM₁₀ at Goa, indicated their release from mining related activities.

Spectroscopic (FTIR, UV-Vis and NMR), theoretical investigation and molecular docking of substituted 1,8-dioxodecahydroacridine derivatives

Recently, substituted 1,8-dioxodecahydroacridine derivatives have been investigated and found to possess a wide variety of biological and pharmacological activities. Two of these biologically relevant N-heterocyclic scaffolds, 2-(9-(4-methoxyphenyl)-3,3,6,6-tetramethyl-1,8-dioxo-1,2,3,4,5,6,7,8- -octahydroacridin-10(9H)-yl)succinic acid (MTDOSA) and 2-(3,3,6,6-tetramethyl- 9-(4-nitrophenyl)-1,8-dioxo-1,2,3,4,5,6,7,8-octahydroacridin-10(9H)-yl)- succinic acid (NTDOSA), have been studied in ground and first excited state using DFT method employing B3LYP/6-311++G(d,p) level of theory. Quantum chemical calculations of geometrical structure and vibrational wavenumbers of MTDOSA and NTDOSA were carried out using DFT method. The experimental FT-IR spectra of the compounds were recorded in the range 4000?400 cm-1 and comprehensively interpreted on the basis of potential energy distribution. The global reactivity descriptors are calculated and discussed. Moreover, 1H- and 13C-NMR spectral data have been calculated using the gauge independent atomic orbital method and compared with experimental spectra. The docking studies reveal that the compounds MTDOSA and NTDOSA have strong binding affinity toward the target protein 5KLH. Thus, the compounds have a possible use as an antileishmanial drug.

Promising Phytoactives Candidates for Efficacious Treatment of Psoriasis and Other Skin Disorders

Psoriasis is a complex multifactor red blistering autoimmune skin disorder depicted by T-cell inception, neighbourhood vascular changes, abnormal keratinocyte extension, and neutrophil activation. The fabricated meds used to treat it are having undesired indications and it has been seen that some the synthetic medications have brutal impact on psoriasis. All things considered, the herbal phytoactives are promising choice, which is highly effective and consistently amazing with no side effect as of natural origin. In the present review a few plant sources have been contemplated in based on traditional learning and reports of various phyto investigations.

Correlation of testicular ultrasonography, testicular biometry, serum testosterone levels and seminal attributes in pre and post-pubertal age for breeding soundness evaluation in Osmanabadi bucks

The present research work entitled "Correlation of testicular ultrasonography, testicular biometry, serum testosterone levels and seminal attributes in pre- and post-pubertal age for breeding soundness evaluation in Osmanabadi bucks" was undertaken in 18 healthy Osmanabadi bucks from the Instructional Livestock Farm Complex, Bombay Veterinary College, Mumbai, Maharashtra. The body weight (kg), scrotal circumference (cm) and testicular biometry (cm) of post-weaning 18 Osmanabadi male kids was recorded every 15 days from weaning, i.e., 120 ± 10 days along with serum testosterone (ng/ml) by radioimmunoassay method at monthly intervals for the next 6 months. Semen was collected six times on the seventh month onward during post-pubertal age at 15-day interval from 18 bucks. The semen was evaluated for macroscopic and microscopic tests. The body weight increased from 14.45 ± 0.67 to 19.57 ± 0.70 kg from four to nine and a half months of age. The average daily body weight gain was 31.27 g. Maximum body weight gain was 01.19 ± 0.16 kg from 5 to 6 followed by 01.15 ± 0.16 kg from 4 to 5 months of age. The scrotal circumference increased from 17.22 ± 0.56 to 19.03 ± 0.55 cm from four to nine and a half months of age with maximum increased between 4 and 5 followed by 6 and 7 months of age. The testicular length, width and thickness of right and left testicles were recorded by ultrasonography method. There was increase in mean right and left testicular length, width and thickness from 5.25 ± 0.19 to 5.84 ± 0.18 and 5.49 ± 0.21 to 6.16 ± 0.20; 2.99 ± 0.12 to 3.32 ± 0.12 and 3.10 ± 0.13 to 3.44 ± 0.12 and 2.97 ± 0.12 to 3.16 ± 0.12 and 3.06 ± 0.12 to 3.31 ± 0.11 cm, respectively by ultrasonography, between four to nine and a half months of age. Testicular length, width and thickness gain was at maximum in 5 to 6 months of age. Left testicular length was more than the right testis. Before puberty, there was sudden gain in body weight, testicular length and width. However, scrotal circumference showed significant increase after puberty. Body weight had highest correlation with ultrasonographic left testicular thickness (r = 1) followed by scrotal circumference, ultrasonographic right and left testicular width, left testicular length, right testicular length and thickness and least by right testicular thickness (r = 0.95). The semen was thin to thick in consistency and average semen density was 3.10 ± 0.05. Average semen volume was 0.81 ± 0.02 ml, mass activity, initial motility, live and dead sperm count, abnormal sperm count and sperm concentration were 3.45 ± 0.13, 76.16 ± 1.16 and 75.16 ± 1.28% and 24.84 ± 1.28, 12.30 ± 0.50% and 2631.04 ± 45.74 million/ml, respectively in 18 bucks in six collection at 15 days. There was significant rise in semen volume, mass activity, initial motility and concentration at 8.5 months and live count, density at 9 months of age which indicates the age of sexual maturity is 8.5 to 9 months in Osmanabadi bucks. The body weight had highest positive correlation with mass activity (r = 98) followed by initial motility, live sperm count and total sperm concentration, semen volume (r = 76). The scrotal circumference had highest positive correlation with initial motility (r = 98) followed by live sperm count, total sperm count, mass activity, semen volume (r = 86). On the other hand, body weight and scrotal circumference were negatively correlated with abnormal and dead sperm count. The mean testosterone concentration increased from 0.02 ± 0.004 to 5.75 ± 0.80 ng/ml between four and half to nine and half months of age, respectively. There was significant rise (p < 0.01) up to 1.38 ± 0.28 ng/ ml at 6.5 months, i.e., age of puberty and up to 5.75 ± 0.80 ng/ml at 9.5 months, i.e., age of sexual maturity. Testosterone had highest positive correlation with testicular length followed by testicular width, length, body weight and scrotal circumference, mass activity, live sperm count, initial motility, while it had highest negative correlation with dead and abnormal sperm count. From the present research work, it was concluded that the scrotal circumference, testicular length, width and thickness increased with increasing body weight. Before puberty, there was sudden gain in body weight, testicular length and width. However, scrotal circumference increased significantly at post-pubertal age. So testicular length, body weight, testicular width in pre pubertal age and scrotal circumference post-pubertal age can be used as indicator for selection of Osmanabadi bucks for breeding purpose. On the other hand, the semen parameters should consider only after 8.5 to 9 months of age for selection of Osmanabadi bucks for breeding.

Protein biomarker for psoriasis: A systematic review on their role in the pathomechanism, diagnosis, potential targets and treatment of psoriasis

Psoriasis is defined as a long-lasting multifactorial inflammatory autoimmune skin condition precisely characterized by delimited, erythematic papules with adherent shiny scales. The conditions are led by hyperproliferative responses of epidermis due to hyperactivation and immature keratinocytes production. The psoriatic skin consists of the thickened epidermal layer, in concurrence with inflammatory exudates in the dermis mainly of dendritic cells, neutrophils, T cells, and macrophages, contributing to the distinct manifestation of psoriatic lesions. It consents to multifaceted and discrete pathology due to the genetic and immunological alteration resulting from abnormal expression of various regulatory and structural proteins. These proteins are associated with various cellular and sub-cellular activities. Therefore, the presence of protein in a pathological cellular environment in the psoriatic lesions as well as in serum could be a great avenue for the insight of pathomechanism, anticipation and diagnosis of psoriasis. Research of protein biomarker in psoriasis is yet a developing realm to be explored by both fundamental and clinical researchers. This review is an attempt to assimilate the current discoveries and revelations of different proteins as a biomarker and their importance in pathogenesis, diagnosis, treatment, and anticipation of both the inflammatory and other dermatological aspects of psoriasis.

Cost-effective way to reduce stimulant-abuse among gay/bisexual men and transgender women: a randomized clinical trial with a cost comparison

OBJECTIVES

A randomized controlled study was conducted with 422 homeless, stimulant-using gay/bisexual (G/B) men and 29 transgender women (n = 451) to assess two community-based interventions to reduce substance abuse and improve health: (a) a nurse case-managed program combined with contingency management (NCM + CM) versus (b) standard education plus contingency management (SE + CM).

STUDY DESIGN

Hypotheses tested included: a) completion of hepatitis A/B vaccination series; b) reduction in stimulant use; and c) reduction in number of sexual partners.

METHODS

A deconstructive cost analysis approach was utilized to capture direct costs associated with the delivery of both interventions. Based on an analysis of activity logs and staff interviews, specific activities and the time required to complete each were analyzed as follows: a) NCM + CM only; b) SE + CM only; c) time to administer/record vaccines; and d) time to receive and record CM visits. Cost comparison of the interventions included only staffing costs and direct cash expenditures.

RESULTS

The study outcomes showed significant over time reductions in all measures of drug use and multiple sex partners, compared to baseline, although no significant between-group differences were detected. Cost analysis favored the simpler SE + CM intervention over the more labor-intensive NCM + CM approach. Because of the high levels of staffing required for the NCM relative to SE, costs associated with it were significantly higher.

CONCLUSIONS

Findings suggest that while both intervention strategies were equally effective in achieving desired health outcomes, the brief SE + CM appeared less expensive to deliver.

Intrapancreatic Splenule in a Pancreas Allograft: Case Report

A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae. No other abdominal trauma was identified, specifically to the pancreas, duodenum, or spleen. Our transplant center accepted the pancreas from this donor. During back-table inspection of the pancreas, a 1.5 × 1.5 cm dark purple rubbery mass was identified within the parenchyma of the pancreas in the tail. An incisional biopsy of the lesion was sent for frozen section, which yielded a mixed inflammatory infiltrate consisting of neutrophils and lymphocytes and an overlying fibrous capsule. The diagnosis of lymphoma or another neoplasm could not be definitely ruled out. Owing to uncertainty in diagnosis, the entire lesion was excised along with the distal pancreas with the use of a linear stapler. The staple line was oversewn with running 4-0 polypropylene suture, and the pancreas was transplanted. After surgery, the pancreas allograft functioned well with a small pancreatic leak, which had resolved by the first postoperative outpatient visit.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors: Present perspectives and future horizons

AIMS

Our comprehensive review highlights the drug development and pharmacogenomics leading to the recent approval of PCSK9 inhibitors. We also review the anticipated future advances into the uses of PCSK9 inhibition.

BACKGROUND

Despite the present advances in pharmacotherapy, atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality worldwide. Low density lipoprotein-cholesterol (LDL-C) lowering is the primary target for ASCVD risk reduction, showing demonstrable benefits in mortality. However, 70% of events occur even in the presence of statins. This residual risk may be approached with additional LDL-C reduction. Statin intolerance is a common clinical concern affecting adherence and the benefit with statins. There is also significant variation of individual lipid-lowering. Following rapid development, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have progressed from genetic observations, to mechanistic studies, to closer realization of the goal of CVD risk reduction. This review discusses the science behind PCSK9 inhibition, evidence of trials involving efficacy and safety, and reflections of its present and future role in clinical care, especially in high-risk patients with ASCVD, persons with suboptimal responses to statins and familial hyperlipidemia. Monoclonal antibodies have demonstrated LDL-C lowering of up to 57% as monotherapy and up to 73% when added to statins. Statins have limited efficacy in reduction of LDL-C due to an increased number of LDL-receptors. Elevated lipoprotein (a) levels may also be significantly lowered by PCSK9i. The journey from discovery to PSCK9 target validation took less than five years, and development and approval of therapeutic modalities for PCSK9 inhibitors happened over the next seven. This review highlights the drug development and pharmacogenomics leading to the recent approval of two agents, alirocumab and evolocumab, with a third bococizumab, and other novel approaches to the pathway pending.

DATA SYNTHESIS

We searched MEDLINE database via Pubmed for reviews, research publications and relevant trials available on PCSK9 inhibition.

CONCLUSION

Despite decades of medical advances, ASCVD remains one of the major causes of morbidity and mortality worldwide. Statin use has multiplied since the validation of LDL hypothesis, however, it is undeniable a more effective and well-tolerated agent is needed in significant number or patients. With the arrival of the era of unprecedented CV protection with PCSK9 inhibition, this exciting new therapy holds a pivotal promise as the future of lipid management. The data available already indicate safety, tolerability and superb efficacy of these agents, which are already changing contemporary cholesterol management. The rapid translation of innovative basic science research into drug development may lead to CV outcomes reduction and confirm that this pathway will become prominently utilized.

Typing of Plasmodium falciparum DNA from 2 years old Giemsa-stained dried blood spots using nested polymerase chain reaction assay

A panel of 129 Giemsa-stained thick blood spots (TBS) confirmed for Plasmodium falciparum infection having different levels of parasite density were collected from a malaria endemic area. DNA was extracted and nested polymerase chain reaction (PCR) assay was performed to amplify P. falciparum DNA. Nested PCR assay successfully amplified P. falciparum DNA at a very low parasitaemia of ~10 parasites/μl of blood. Current PCR assay is very simple and can be used retrospectively to monitor the invasion and prevalence of different Plasmodium species in endemic areas.

Effect of Fly Ash Disposal on Ground Water Quality near Parichha Thermal Power Plant, Jhansi: A Case Study

Thermal power plant generates a huge amount of fly ash on combustion of coal which is becoming a major environmental issue. Thermal power plants are greatly facing a fly ash management problem. Open dumping of fly ash can deteriorate the groundwater quality by runoff. In the present investigation, the ground water samples were collected from nearby areas of Parichha Thermal Power Plant at six locations during the period of Jan 2014 to May 2014. The samples were taken to the laboratory and analyzed for physico-chemical properties and heavy metal content. The physico-chemical analysis was done for the parameters like pH, Turbidity, Temperature, Electrical Conductivity, Alkalinity, Total Dissolved Solids, Total Hardness, Calcium Hardness and Magnesium Hardness. The concentration of Turbidity, EC and Alkalinity was exceeding the standard at all locations and shows that the groundwater of the area is not fit for drinking. The ground water samples were also analyzed for the presence of lead and cadmium and it was found that lead was exceeding the limit although cadmium was found within the limit.

Anti-C reactive protein antibodies in Indian patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is characterized by over production of autoantibodies. C-reactive protein (CRP) is a phylogenetically highly conserved plasma protein that participates in the systemic response to inflammation. Anti-CRP antibodies might have biological functions of pathogenetic interest in SLE. We evaluated anti-CRP antibodies in Indian SLE patients and their association with anti-dsDNA antibodies and complement levels (C3 and C4). One hundred SLE patients diagnosed according to the American College of Rheumatology criteria were included. Disease activity was assessed using SLE disease activity index (SLEDAI). Anti-CRP autoantibodies were detected by enzyme linked immunosorbent assay. Anti-dsDNA antibodies were detected by indirect immunofluroscence test (Euroimmun Lubeck, Germany). High sensitivity CRP and complement levels (C3, C4) were detected using a Nephelometer. (BN ProSpec, Dade Behring, Germany). Anti-CRP antibodies were detected in 26% of SLE patients. Mean age of disease onset among anti-CRP positives was 22.4 ± 7.5, and 26.6 ± 9.3 years among anti-CRP negatives (P > 0.05). Anti-dsDNA positivity was significantly higher among anti-CRP positives (32.7%) as compared to anti-CRP negatives (16%) (P = 0.00519). No statistically significant difference was observed in SLEDAI scores of anti-CRP positive group and anti-CRP negative group (P > 0.05). We observed a positive correlation between anti-CRP antibodies and anti-dsDNA antibodies.