Recent advances in cold atmospheric plasma (CAP) for breast cancer therapy.

The serious problems of conventional breast cancer therapy strategies such as drug resistance, severe side effects, and lack of selectivity prompted the development of various cold atmospheric plasma (CAP) devices. Due to its advanced technology, CAP can produce a unique environment rich in reactive oxygen and nitrogen species (RONS), photons, charged ions, and an electric field, making it a promising revolutionary platform for cancer therapy. Despite substantial technological successes, CAP-based therapeutic systems are encounter with distinct limitations, including low control of the generated RONS, poor knowledge about its anticancer mechanisms, and challenges concerning designing, manufacturing, clinical translation, and commercialization, which must be resolved. The latest developments in CAP-based therapeutic systems for breast cancer treatment are discussed in this review. More significantly, the integration of CAP-based medicine approaches with other breast cancer therapies, including chemo- and nanotherapy is thoroughly addressed.

Effects of Health Literacy Promotion Programs for Preventing Opisthorchiasis and Cholangiocarcinoma: a Systematic Review and Meta-analysis.

Cholangiocarcinoma (CCA), caused mainly by Opisthorchis viverrini (OV) infection, is a public health issue. Health literacy can play a significant role in preventing OV and CCA and adopting preventive behaviors. Therefore, this study aimed to evaluate, summarize, and synthesize the current evidence on health literacy programs for preventing OV and CCA.A systematic literature search, with Thai and English languages, was performed using electronic databases through PubMed, Google Scholar, ThaiJo, ThaiLis, and Embase to identify studies examining health literacy programs to prevent OV and CCA. We followed PRISMA 2020 guidelines. In addition, we used the RevMan software to perform a meta-analysis to analyze effect sizes using a fixed-effects model and measures of heterogeneity using Cochran's Q and I2. This meta-analysis included seven studies that met the criteria. The results showed that the people who received a program had an increased health literacy overall and in each aspect with a statistically significant (p < 0.001). So, health literacy programs can assist people in understanding their health and gaining access to health information and services. Additionally, the effect of programs (communication abilities, self-management, media and information literacy, and decision-making in practice) can help prevent OV and CCA. As a result, multi-disciplinary healthcare teams are crucial to developing preventive programs to prevent OV and CCA. Further studies need to be done and applied to these programs to modify behavior to avoid other diseases.

The Effect of Melatonin on Analgesia, Anxiety, and Intraocular Pressure (IOP) in Cataract Surgery Under Topical Anesthesia.

PURPOSE: This study investigated the effect of oral melatonin as a premedication before cataract surgery on pain score, anxiety, surgical conditions, and intraocular pressure (IOP) during cataract surgery with phacoemulsification under topical anesthesia. DESIGN: This randomized, double-blind prospective study was conducted among 120 patients aged 50 to 80. METHODS: Patients were randomly assigned to receive either sublingual melatonin 3 mg or placebo 60 min before surgery. Verbal anxiety and pain scores, heart rate, systolic and diastolic blood pressure, intraocular pressure, and quality of surgical conditions were recorded. The results were analyzed using SPSS 23 software, and statistical analysis consisted of χ2 test and t-test, and a P value less than .05 was considered significant. FINDINGS: There was a significant difference between the two groups regarding pain after the surgery before being discharged from the recovery room. The mean pain score in the melatonin group was lower than the placebo group in T4 (in the postoperative ward) (P < .05). The anxiety score of patients was lower in the melatonin group in T3 and T4 (during surgery and in the postoperative ward, respectively) (P < .05). IOP was significantly lower in the case group at the end of the surgery after receiving premedication (P = .021). CONCLUSIONS: This study showed that 3 mg Sublingual melatonin premedication for patients undergoing cataract surgery under topical anesthesia reduced patients' anxiety scores, pain score, and IOP.

Potential of chimeric antigen receptor (CAR)-redirected immune cells in breast cancer therapies: Recent advances.

Despite substantial developments in conventional treatments such as surgery, chemotherapy, radiotherapy, endocrine therapy, and molecular-targeted therapy, breast cancer remains the leading cause of cancer mortality in women. Currently, chimeric antigen receptor (CAR)-redirected immune cell therapy has emerged as an innovative immunotherapeutic approach to ameliorate survival rates of breast cancer patients by eliciting cytotoxic activity against cognate tumour-associated antigens expressing tumour cells. As a crucial component of adaptive immunity, T cells and NK cells, as the central innate immune cells, are two types of pivotal candidates for CAR engineering in treating solid malignancies. However, the biological distinctions between NK cells- and T cells lead to differences in cancer immunotherapy outcomes. Likewise, optimal breast cancer removal via CAR-redirected immune cells requires detecting safe target antigens, improving CAR structure for ideal immune cell functions, promoting CAR-redirected immune cells filtration to the tumour microenvironment (TME), and increasing the ability of these engineered cells to persist and retain within the immunosuppressive TME. This review provides a concise overview of breast cancer pathogenesis and its hostile TME. We focus on the CAR-T and CAR-NK cells and discuss their significant differences. Finally, we deliver a summary based on recent advancements in the therapeutic capability of CAR-T and CAR-NK cells in treating breast cancer.

A comprehensive review of IL-26 to pave a new way for a profound understanding of the pathobiology of cancer, inflammatory diseases and infections.

Cytokines are considered vital mediators of the immune system. Down- or upregulation of these mediators is linked to several inflammatory and pathologic situations. IL-26 is referred to as an identified member of the IL-10 family and IL-20 subfamily. Due to having a unique cationic structure, IL-26 exerts diverse functions in several diseases. Since IL-26 is mainly secreted from Th17, it is primarily considered a pro-inflammatory cytokine. Upon binding to its receptor complex (IL-10R1/IL-20R2), IL-26 activates multiple signalling mediators, especially STAT1/STAT3. In cancer, IL-26 induces IL-22-producing cells, which consequently decrease cytotoxic T-cell functions and promote tumour growth through activating anti-apoptotic proteins. In hypersensitivity conditions such as rheumatoid arthritis, multiple sclerosis, psoriasis and allergic disease, this cytokine functions primarily as the disease-promoting mediator and might be considered a biomarker for disease prognosis. Although IL-26 exerts antimicrobial function in infections such as hepatitis, tuberculosis and leprosy, it has also been shown that IL-26 might be involved in the pathogenesis and exacerbation of sepsis. Besides, the involvement of IL-26 has been confirmed in other conditions, including graft-versus-host disease and chronic obstructive pulmonary disease. Therefore, due to the multifarious function of this cytokine, it is proposed that the underlying mechanism regarding IL-26 function should be elucidated. Collectively, it is hoped that the examination of IL-26 in several contexts might be promising in predicting disease prognosis and might introduce novel approaches in the treatment of various diseases.

Does CCL19 act as a double-edged sword in cancer development?

Cancer is considered a life-threatening disease, and several factors are involved in its development. Chemokines are small proteins that physiologically exert pivotal roles in lymphoid and non-lymphoid tissues. The imbalance or dysregulation of chemokines has contributed to the development of several diseases, especially cancer. CCL19 is one of the homeostatic chemokines that is abundantly expressed in the thymus and lymph nodes. This chemokine, which primarily regulates immune cell trafficking, is involved in cancer development. Through the induction of anti-tumor immune responses and inhibition of angiogenesis, CCL19 exerts tumor-suppressive functions. In contrast, CCL19 also acts as a tumor-supportive factor by inducing inflammation, cell growth, and metastasis. Moreover, CCL19 dysregulation in several cancers, including colorectal, breast, pancreatic, and lung cancers, has been considered a tumor biomarker for diagnosis and prognosis. Using CCL19-based therapeutic approaches has also been proposed to overcome cancer development. This review will shed more light on the multifarious function of CCL19 in cancer and elucidate its application in diagnosis, prognosis, and even therapy. It is expected that the study of CCL19 in cancer might be promising to broaden our knowledge of cancer development and might introduce novel approaches in cancer management.

Optical-based biosensor for detection of oncomarker CA 125, recent progress and current status.

Ovarian cancer (OV) is the second most mortal gynecological malignancy. The oncomarker CA125 has been used as the main ovarian cancer marker for diagnosing and screening ovarian cancer in stages I and II. Therefore, sensitive and real-time detection of CA 125 is critical in ovarian cancer monitoring. Various tests are used to diagnose the CA 125. In recent years, modern methods such as biosensor technology have replaced the old tests for rapid, sensitive and specific detection of CA 125. Various types of biosensors are being developed, among which Surface Plasmon resonance (SPR) biosensors are one of the most important and remarkable types. Considering the importance of SPR biosensors in the diagnosis of enocomarker CA 125, the main focus of the present study is to consolidate the research work from the past two decade to the present. Also, the advantages and challenges in SPR biosensors development have been considered in the detection of CA 125 oncomarker.

Various types of electrochemical biosensors for leukemia detection and therapeutic approaches.

Leukemia often initiates following dysfunctions in hematopoietic stem cells lineages. Various types of leukemia, including acute lymphoblastic leukemia (ALL), chronic myelogenous leukemia (CML), acute promyelocytic leukemia (APL), and human T-cell leukemia/lymphoma virus type 1 (HTLV-1) can thus call for different diagnosis and treatment options. One of the most important subjects in leukemia is the early detection of the disease for effective therapeutic purposes. In this respect, biosensors detecting the molecules of deoxyribonucleic acid (DNA) as analytes are called genosensors or DNA biosensors. Electrochemical sensors, as the most significant approach, also involve reacting of chemical solutions with sensors to generate electrical signals proportional to analyte concentrations. Biosensors can further help detect cancer cells in the early stages of the disease. Moreover, electrochemical biosensors, developed based on various nanomaterials (NMs), can increase sensitivity to the detection of leukemia-related genes, e.g., BCR/ABL as a fusion gene and promyelocytic leukemia/retinoic acid receptor alpha (PML/RARα). Therefore, the present review reflects on previous studies recruiting different NMs for leukemia detection.

Cancer combination therapies by angiogenesis inhibitors; a comprehensive review.

Abnormal vasculature is one of the most conspicuous traits of tumor tissue, largely contributing to tumor immune evasion. The deregulation mainly arises from the potentiated pro-angiogenic factors secretion and can also target immune cells' biological events, such as migration and activation. Owing to this fact, angiogenesis blockade therapy was established to fight cancer by eliminating the nutrient and oxygen supply to the malignant cells by impairing the vascular network. Given the dominant role of vascular-endothelium growth factor (VEGF) in the angiogenesis process, the well-known anti-angiogenic agents mainly depend on the targeting of its actions. However, cancer cells mainly show resistance to anti-angiogenic agents by several mechanisms, and also potentiated local invasiveness and also distant metastasis have been observed following their administration. Herein, we will focus on clinical developments of angiogenesis blockade therapy, more particular, in combination with other conventional treatments, such as immunotherapy, chemoradiotherapy, targeted therapy, and also cancer vaccines. Video abstract.

Tumor immunotherapies by immune checkpoint inhibitors (ICIs); the pros and cons.

The main breakthrough in tumor immunotherapy was the discovery of immune checkpoint (IC) proteins, which act as a potent suppressor of the immune system by a myriad of mechanisms. After that, scientists focused on the immune checkpoint molecules mainly. Thereby, much effort was spent to progress novel strategies for suppressing these inhibitory axes, resulting in the evolution of immune checkpoint inhibitors (ICIs). Then, ICIs have become a promising approach and shaped a paradigm shift in tumor immunotherapies. CTLA-4 plays an influential role in attenuation of the induction of naïve and memory T cells by engagement with its responding ligands like B7-1 (CD80) and B7-2 (CD86). Besides, PD-1 is predominantly implicated in adjusting T cell function in peripheral tissues through its interaction with programmed death-ligand 1 (PD-L1) and PD-L2. Given their suppressive effects on anti-tumor immunity, it has firmly been documented that ICIs based therapies can be practical and rational therapeutic approaches to treat cancer patients. Nonetheless, tumor inherent or acquired resistance to ICI and some treatment-related toxicities restrict their application in the clinic. The current review will deliver a comprehensive overview of the ICI application to treat human tumors alone or in combination with other modalities to support more desired outcomes and lower toxicities in cancer patients. Video Abstract.

Bone morphogenetic protein (BMP)-modified graphene oxide-reinforced polycaprolactone-gelatin nanofiber scaffolds for application in bone tissue engineering.

In this study, blend nanofibrous scaffolds were electrospun from polycaprolactone/gelatin (PCL/Gel) blend solutions reinforced by bone morphogenetic protein (BMP)-modified graphene oxide (GO). SEM results showed that uniform and bead-less nanofibers with 270 nm average diameter were obtained from electrospun of PCL/Gel blend solutions. Tensile strength test and contact angle measurement demonstrated that addition of PCL led to higher mechanical and physical properties of the resulting nanofibers. The addition of PCL as well as GO in the blend supports the suitable mechanical strength in the body media. The loading of BMP-modified graphene in the Gel/PCL structure caused the formation of nanofibrous substrate with great resemblance to bone tissue. Gel/PCL-G hybrid nanofibers revealed good biocompatibility in the presence of human osteosarcoma cells, and no trace of cellular toxicity was observed. The cells grown on the scaffolds exhibited a spindle-like and broad morphology and almost uniformly covered the entire nanofiber scaffold. Gel/PCL nanofibers reinforced by graphene oxide-immobilized bone morphogenetic protein was prepared as a promising safe and biocompatible nanofiber with high antibacterial activity for bone tissue engineering.

Intimate partner violence against pregnant women during the COVID-19 pandemic: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to estimate the pooled prevalence of (intimate partner violence) IPV against pregnant women in the COVID-19 pandemic. A literature search was conducted in PubMed, Web of Science, and Scopus for observational studies regarding the prevalence of IPV against pregnant women during the COVID-19 pandemic. The search was performed with the following keywords: intimate partner violence, domestic violence, battered women, wife assault, partner assault, wife abuse, partner abuse, femicide, domestic homicide, pregnancy, gestation, pregnant women, COVID-19, SARS-CoV-2, 2019-nCoV, Coronavirus Disease-19, 2019 Novel Coronavirus, Wuhan Coronavirus, SARS Coronavirus 2, Wuhan Seafood Market Pneumonia Virus. Heterogeneity between the studies was assessed using Cochran's Q test and I2 index. In addition, a random-effects model was used to estimate the prevalence of IPV. Data analysis was performed in Stata software version 16. Six articles met our inclusion criteria, which were conducted on 2213 pregnant women. The pooled prevalence of total IPV was estimated at 22 percent (95 percent Confidence Interval [CI]: 4-40 percent). Moreover, the pooled prevalence of psychological, physical, and sexual violence was reported to be 24 percent (95 percent CI: 13-35 percent), 14 percent (95 percent CI: 7-20 percent), and 6 percent (95 percent CI: 4-9 percent), respectively. Publication bias was significant (P = .01). According to the results, IPV against pregnant women has been relatively prevalent during the COVID-19 pandemic. Therefore, identifying the women who are at the risk of IPV is essential to preventing the consequences of maternal-fetal abuse and designing strategies to facilitate the reporting of violence during pandemics.

Asymmetric impact of temperature on COVID-19 spread in India: Evidence from quantile-on-quantile regression approach.

The emergence of new coronavirus (SARS-CoV-2) has become a significant public health issue worldwide. Some researchers have identified a positive link between temperature and COVID-19 cases. However, no detailed research has highlighted the impact of temperature on COVID-19 spread in India. This study aims to fill this research gap by investigating the impact of temperature on COVID-19 spread in the five most affected Indian states. Quantile-on-Quantile regression (QQR) approach is employed to examine in what manner the quantiles of temperature influence the quantiles of COVID-19 cases. Empirical results confirm an asymmetric and heterogenous impact of temperature on COVID-19 spread across lower and higher quantiles of both variables. The results indicate a significant positive impact of temperature on COVID-19 spread in the three Indian states (Maharashtra, Andhra Pradesh, and Karnataka), predominantly in both low and high quantiles. Whereas, the other two states (Tamil Nadu and Uttar Pradesh) exhibit a mixed trend, as the lower quantiles in both states have a negative effect. However, this negative effect becomes weak at middle and higher quantiles. These research findings offer valuable policy recommendations.

A paradigm shift in cell-free approach: the emerging role of MSCs-derived exosomes in regenerative medicine.

Recently, mesenchymal stem/stromal cells (MSCs) due to their pro-angiogenic, anti-apoptotic, and immunoregulatory competencies along with fewer ethical issues are presented as a rational strategy for regenerative medicine. Current reports have signified that the pleiotropic effects of MSCs are not related to their differentiation potentials, but rather are exerted through the release of soluble paracrine molecules. Being nano-sized, non-toxic, biocompatible, barely immunogenic, and owning targeting capability and organotropism, exosomes are considered nanocarriers for their possible use in diagnosis and therapy. Exosomes convey functional molecules such as long non-coding RNAs (lncRNAs) and micro-RNAs (miRNAs), proteins (e.g., chemokine and cytokine), and lipids from MSCs to the target cells. They participate in intercellular interaction procedures and enable the repair of damaged or diseased tissues and organs. Findings have evidenced that exosomes alone are liable for the beneficial influences of MSCs in a myriad of experimental models, suggesting that MSC- exosomes can be utilized to establish a novel cell-free therapeutic strategy for the treatment of varied human disorders, encompassing myocardial infarction (MI), CNS-related disorders, musculoskeletal disorders (e.g. arthritis), kidney diseases, liver diseases, lung diseases, as well as cutaneous wounds. Importantly, compared with MSCs, MSC- exosomes serve more steady entities and reduced safety risks concerning the injection of live cells, such as microvasculature occlusion risk. In the current review, we will discuss the therapeutic potential of MSC- exosomes as an innovative approach in the context of regenerative medicine and highlight the recent knowledge on MSC- exosomes in translational medicine, focusing on in vivo researches.

Examining the Impact of a Behavior Modification Program on Disease Prevention Behaviors among Individuals at Risk of Diabetes: A Quasi-Experimental Investigation.

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM.

Organoid Models of Heart Diseases: Find a New Channel in Improvements of Cardiac Regenerative Medicine.

We are experiencing a revolution in regenerative medicine. Recent developments in organoid technology have provided unique opportunities for studying human biology and diseases. Indeed, organoid models have revolutionized the in vitro culture tools for biomedical research by creating robust three-dimensional (3D) architecture to recapitulate the primary tissues' cellular heterogeneity, structure, and functions. Such organoid technology enables researchers to re-create human organs and diseases model in a culture dish. It thus holds excellent promises for many translational applications such as regenerative medicine, drug discovery, and precision medicine. This review summarizes the current knowledge on the progression and promotion of organoid models, particularly with the heart disease approach. We discuss the usefulness of clinical applications of cardiac organoids and ultimately highlight the currently advanced therapeutic strategies in vitro model of organoids aimed at personalizing heart disease treatment.

Mind-Body Interventions in Patients With Heart Failure: State of the Science.

Complementary and alternative medicine are broadly considered mind-body interventions (MBIs) that support physical and mental wellness in patients with heart failure (HF). The aims of this review were to integrate and summarize current evidence from MBIs in patients with HF and to identify gaps for future research. We used PRISMA guideline and conducted a literature search through six databases. Fifteen publications met the criteria, published between 2013 and 2021. This review stipulated that MBIs included yoga, Tai Chi, meditation, reflexology, massage, relaxation, and breathing interventions. The findings emphasized that MBIs could reduce physical and psychological symptoms and improve health outcomes in patients with HF. MBIs had encouraging results for patients with HF on selected physiological and behavioral outcomes. Despite the early state of the evidence in this field, it seems that MBIs will play an essential role in the future for alleviating the symptoms of patients with HF.

Health-Promoting Behaviors among Older Adults with Noncommunicable Diseases in Rural and Urban Areas during the New Normal Post-COVID-19 Era: A Structural Equation Modeling Analysis.

This study aimed to develop and test a causal relationship among perceived self-efficacy (PSE), health literacy (HL), access to COVID-19 preventive material (ACPM), social networks (SN), and health-promoting behaviors (HPBs). Multistage stratified random sampling was used to recruit 250 older adults with noncommunicable diseases (NCDs) from Thai urban and rural communities. The data were collected with self-reported questionnaires. Data analyses used descriptive statistics and structural equation modeling. The results indicated that participants in urban communities had higher PSE, ACPM, HL, SN, and HPBs than rural participants. The fitness parameters of the modified model (χ2 = 71.936, df = 58, p-value = 0.103, χ2/df = 1.240; root mean square error of approximation (RMSEA) = 0.031; standardized root mean square residual (SRMR) = 0.042; goodness of fit index (GFI) = 0.964; normed-fit index (NFI) = 0.964; comparative fit index (CFI) = 0.993) indicated its suitability as the research model. HPBs were directly positively influenced by PSE (ß = 0.40, p < 0.001), ACPM (ß = 0.24, p < 0.001), HL (ß = 0.19, p < 0.01), and SN (ß = 0.01, p < 0.05). Therefore, taking all predicting variables together could explain 81.0% of the variance in HPBs. Multidisciplinary healthcare teams could use these findings to establish proper interventions or healthcare activities to increase HPBs among older adults, particularly in this era of the "new normal".

The relationships between stress, stress-coping behaviors, and suicidal risk among Thais who had become unemployed due to the COVID-19 pandemic: A cross-sectional study.

Background: The COVID-19 pandemic has resulted in severe mental health problems worldwide. Thus, in addition to the high number of people who have died from infection with complications, some have committed suicide. Objective: This study aimed to determine the relationships between stress, stress-coping behaviors, and suicidal risk among those who had become unemployed in Thailand due to the COVID-19 pandemic. Methods: This study had a cross-sectional correlational design and included 447 unemployed Thais at least 18 years of age who had become unemployed due to the COVID-19 pandemic. The participants were selected through multistage sampling. A self-administered questionnaire was used for data collection. The data were then analyzed using frequency, percentage, and Spearman's correlation coefficient. Results: Most participants had moderate-level stress (73.16%) and stress-coping behaviors (71.81%). Almost all the participants had no suicidal risk (76.73%). The stress level and overall stress-coping behavior were positively correlated with suicidal risk (r = 0.305, p <0.01 and r = 0.352, p <0.01, respectively). Conclusion: Stress and stress-coping behaviors were associated with suicidal risk among Thais who had become unemployed due to the COVID-19 pandemic. Hence, nurses must screen patients with psychological problems, especially those who have become unemployed due to the COVID-19 pandemic, for suicide risk. Developing interventions to reduce such patients' stress and promote appropriate stress-coping behaviors is essential.

Factors Influencing Access to Health Services among Chronically Ill Older Adults with Physical Disabilities in the Era of the COVID-19 Outbreak.

Chronically ill older adults with physical disabilities frequently face difficulties in their daily lives and require essential health service access, especially in the COVID-19 context. This study aimed to examine the association between social support, perception of benefits due to disability and access to health services among chronically ill older adults with physical disabilities during this crisis in Thailand. A total of 276 chronically ill older adults with physical disabilities were included in this cross-sectional study. Self-reported questionnaires were assessed through multi-stage random sampling. Correlations between the independent variables and health service access were examined using multiple regression analysis. Of the respondents, 159 were female (59.6%). Most participants perceived benefits (58.8%) and access to health services (56.2%) at good levels, while social support was at a moderate level (47.9%). Stepwise multiple regression analysis showed that social support (ß = 0.351), perception of benefits (ß = 0.257) and age (ß = 0.167) were positively correlated with health service access. The findings are relevant for health care providers and multi-professional teams, who should enhance older adults' social support and perception of benefits to improve their access to health services, particularly among chronically ill older adults with physical disabilities, in the era of COVID-19.