Nipah virus (NiV), a pathogen with pandemic potential, lacks approved treatments or vaccines, highlighting the urgent need for research on immune-targeted antigenic determinants. A significant gap persists in NiV research, as studies on the fusion (F) protein critical for viral entry as well as the B cells epitopes, have primarily focused on computational prediction rather than experimental validation of immunogenic epitopes obtained through immunoinformatics approach. This study focused on the conserved F protein across NiV human isolates and employed an immunoinformatics approach to predict linear B-cell epitopes capable of direct immune activation. Predicted epitopes were screened for antigenicity, toxicity, and allergenicity. Molecular docking analysis was performed to evaluate its binding affinity with B-cell receptors (BCRs). To validate its immunogenicity, the LF6 peptide was synthesized and used in an indirect ELISA to test sera from cohort previously infected with NiV as well as with negative cohort. Epitope LF6 (LISNIEIGFCL) was identified as a strong candidate based on its immunogenic properties. Molecular docking showed favorable binding of LF6 with BCR. ELISA results revealed that one sera from the survival cohort showed positive response which is an IgG antibody response 2-fold higher (0.343) than the cut-off value (0.0171). This study provides the first reported evidence linking computational predictions with functional immune reactivity for a B-cell epitope of NiV. The findings suggest that LF6 has the potential to elicit specific immune responses. However, given the small sample size, further validation in larger cohorts is essential to confirm LF6’s vaccine relevance.

Fragaria indica stem, leaf, and root extract was used to assess the antimicrobial activity against bla-TEM beta-lactamase producing Shigella flexneri, Salmonella typhi, and Escherichia coli. Ethanolic extracts of F. indica leaves exhibited a maximum zone of inhibition of 20 ± 1.2 mm (p < 0.001), 18 ± 1.4 mm (p < 0.001), and 16 ± 1.5 mm (p < 0.001) against E. coli, S. flexneri, and S. typhi, respectively. To identify different compounds, the bioactive ethanolic leaf extracts were further processed for HPLC, GC-MS, ADMET, and docking analysis. In the ethanolic leaf extract, 19 phenolic compounds were identified in HPLC analysis. Three phenolic compounds, including Isorhamnetin-3-rutinoside, 5, 7-Dihydroxy-4’ -methoxyflavone, and Luteolin, were for the first time reported in F. indica. In GC-MS analysis, sixteen compounds were identified. From the literature search, among the identified compounds, AlphaHimachalene, 1,3-Diphenyl-1-((trimethylsilyl)oxy)-1(Z)-heptene, 1H-Benzocycloheptene, Bicyclo[5.2.0] nonane, cis-1,1,3,4-Tetramethylcyclopentane, Bicyclo[2.2.2]octane-cis-2,3-diyl Carbonate, BetaHimachalene and 2-methylene-4,8,8-trimethyl-4-vinyl were reported for the first time in F. indica. Two compounds, including Alpha-Himachalene and Bicyclo[2.2.2]octane-cis-2,3-diyl carbonate, having good water solubility, drug likeness, and medicinal characteristics, were selected for docking analysis. Docking of Alpha-Himachalene and Bicyclo[2.2.2]octane-cis-2,3-diyl carbonate showed interaction with Pro-26, Phe-22, and Ala-23 residues of bacterial bla-TEM beta-lactamase. Similarly, Bicyclo[2.2.2] octane-cis-2,3-diyl carbonate interacts with amino acid residues of Ala-235 and Ser-233 of bla-TEM beta-lactamase. Further studies will help to characterize the anti-infective compounds against bla-TEM producing foodborne bacterial pathogens.

This systematic review and meta-analysis aimed to examine the effect of the antioxidant alpha-lipoic acid (ALA) on various cardiometabolic risk factors and hormonal parameters in patients with polycystic ovary syndrome (PCOS). We searched PubMed, EMBASE, SCOPUS, Cochrane Library, and Web of Science databases without language restrictions until May 2023 to find randomized controlled trials (RCTs) that assessed the impact of ALA supplementation on anthropometric, glycemic, lipid, oxidative stress, and hormonal parameters in women with PCOS. Outcomes were summarized using the standardized mean difference (SMD) and 95% confidence interval (CI) in a random-effects model. An I2 statistic of >60% established significant between-study heterogeneity. The overall certainty of the evidence for each outcome was determined using the grading of recommendations, assessment, development, and evaluations system. Seven RCTs met the inclusion criteria. The ALA group had significant reductions in fasting blood sugar (fasting blood sugar (FBS), n=7 RCTs, SMD, -0.60; 95% CI, -1.10 to -0.10; I2=63.54%, moderate certainty of evidence) and homeostatic model assessment for insulin resistance (homeostatic model assessment of insulin resistance (HOMA-IR), n=4 RCTs, SMD, -2.03; 95% CI, -3.85 to -0.20; I2=96.32%, low certainty of evidence) compared with the control group. However, significant differences were observed between the groups in body mass index, insulin, estrogen, follicle-stimulating hormone, luteinizing hormone, testosterone, low-density lipoprotein, highdensity lipoprotein, triglyceride, total cholesterol, malondialdehyde, or total antioxidant capacity profiles. ALA supplementation improves FBS and HOMA-IR levels in women with PCOS. ALA consumption is an effective complementary therapy for the management of women with PCOS.

Wound healing is a dynamic process that involves a series of molecular and cellular events aimed at replacing devitalized and missing cellular components and/or tissue layers. Recently, extracellular vesicles (EVs), naturally cell-secreted lipid membrane-bound vesicles laden with biological cargos including proteins, lipids, and nucleic acids, have drawn wide attention due to their ability to promote wound healing and tissue regeneration. However, current exploitation of EVs as therapeutic agents is limited by their low isolation yields and tedious isolation processes. To circumvent these challenges, bioinspired cell-derived nanovesicles (CDNs) that mimic EVs were obtained by shearing mesenchymal stem cells (MSCs) through membranes with different pore sizes. Physical characterisations and high-throughput proteomics confirmed that MSC-CDNs mimicked MSC-EVs. Moreover, these MSC-CDNs were efficiently uptaken by human dermal fibroblasts and demonstrated a dose-dependent activation of MAPK signalling pathway, resulting in enhancement of cell proliferation, cell migration, secretion of growth factors and extracellular matrix proteins, which all promoted tissue regeneration. Of note, MSC-CDNs enhanced angiogenesis in human dermal microvascular endothelial cells in a 3D PEG-fibrin scaffold and animal model, accelerating wound healing in vitro and in vivo. These findings suggest that MSC-CDNs could replace both whole cells and EVs in promoting wound healing and tissue regeneration.

Antibody cross-reactivity among flaviviruses is a major limitation in understanding the prevalence without vector control measures. In this study, we investigated the presence of Zika virus (ZIKV)-specific antibodies and the significance of their cross-reactivity with other flaviviruses, which could affect the serological specificity in both symptomatic and asymptomatic pregnant women. Among the results obtained from 217 serum samples tested for ZIKV-specific IgM and IgG, no specific predictions regarding seropositivity or exposure due to extensive cross-reactivity with dengue virus (DENV) serology could be made. Clear-cut positivity was observed in 1.8% (n = 4) and 1.0% (n = 2) for ZIKV IgM and IgG, respectively. The same samples assessed for DENV showed 1.3% (n = 3) seropositivity each for IgM and IgG levels. None of the samples were positive for ZIKV and DENV IgM or IgG. However, one sample (0.4%) tested positive for ZIKV and DENV IgM. No significant correlation was observed between DENV IgM and IgG when comparing the overlapped serotiters. On the other hand, the ZIKV IgG-positive sample showed higher serotiters for DENV IgG, indicating cross-reactivity with ZIKV but without statistical significance. Therefore, screening for the incidence of ZIKV becomes particularly challenging in a population where the presence or pre-exposure to DENV is observed. Our observations further suggest that unless flavivirus prevalence is properly addressed, determining the prevalence of ZIKV antibodies, which may be confounded with other uninvestigated flaviviruses, will be complicated.

This study delves into the realm of sports psychology, aiming to investigate the intricate relationship between family dynamics and athlete nutrition within the context of the Saudi youth national team. Employing a descriptive research approach, a comprehensive questionnaire was administered, comprising three core dimensions: dietary intake assessment, the psychological impact of family dynamics, and individual beliefs regarding their influence on athlete nutrition. The questionnaire encompassed 28 statements and was administered to a sample of 90 players selected from the Saudi youth national team. From a sports psychology perspective, the study uncovers valuable insights. Firstly, it highlights the moderate impact of family dynamics as a social system on the dietary habits of Saudi youth national team players. It is evident that designated mealtimes serve as a crucial social gathering, wherein the family underscores the significance of adequate water consumption and the selection of nutritious foods. Remarkably, this study discerns no statistically significant differences at the 0.05 level concerning the relationship between family dynamics and sports nutrition, even when considering variables such as age and economic status among the Saudi youth national team players. In light of these sports psychology-oriented findings, it is recommended that future research endeavors within this domain explore the psychological aspects of how families support and influence athletes in maintaining their health, fitness, and physique through specific dietary regimens. This may include examining the familial dynamics and their psychological impact on athletes’ adherence to nutritional guidelines. Moreover, it is imperative to consider the role of familial support in mitigating psychological stressors related to nutrition and its impact on athletic performance. The integration of sports psychology principles into nutritional counseling and education for athletes and their families could prove highly beneficial. By enhancing understanding and communication within the family unit, athletes may better navigate the challenges of adhering to optimal nutrition strategies. Consequently, this approach has the potential to bolster not only athletic performance but also the overall psychological well- being of athletes, ensuring they are better equipped to handle the pressures of competitive sports.

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, the impact of varicocele repair (VR) on conventional semen parameters remains controversial. Only a few systematic reviews and meta-analyses (SRMAs) have evaluated the impact of VR on sperm concentration, total motility, and progressive motility, mostly using a before-after analytic approach. No SRMA to date has evaluated the change in conventional semen parameters after VR compared to untreated controls. This study aimed to evaluate the effect of VR on conventional semen parameters in infertile patients with clinical varicocele compared to untreated controls. Materials and Methods: A literature search was performed using Scopus, PubMed, Embase, and Cochrane databases following the Population Intervention Comparison Outcome (PICOS) model (Population: infertile patients with clinical varicocele; Intervention: VR [any technique]; Comparison: infertile patients with clinical varicocele that were untreated; Outcome: sperm concentration, sperm total count, progressive sperm motility, total sperm motility, sperm morphology, and semen volume; Study type: randomized controlled trials and observational studies). Results: A total of 1,632 abstracts were initially assessed for eligibility. Sixteen studies were finally included with a total of 2,420 infertile men with clinical varicocele (1,424 patients treated with VR vs. 996 untreated controls). The analysis showed significantly improved post-operative semen parameters in patients compared to controls with regards to sperm concentration (standardized mean difference [SMD] 1.739; 95% CI 1.129 to 2.349; p<0.001; I2=97.6%), total sperm count (SMD 1.894; 95% CI 0.566 to 3.222; p<0.05; I2=97.8%), progressive sperm motility (SMD 3.301; 95% CI 2.164 to 4.437; p<0.01; I2=98.5%), total sperm motility (SMD 0.887; 95% CI 0.036 to 1.738; p=0.04; I2=97.3%) and normal sperm morphology (SMD 1.673; 95% CI 0.876 to 2.470; p<0.05; I2=98.5%). All the outcomes showed a high inter-study heterogeneity, but the sensitivity analysis showed that no study was sensitive enough to change these results. Publication bias was present only in the analysis of the sperm concentration and progressive motility. No significant difference was found for the semen volume (SMD 0.313; 95% CI -0.242 to 0.868; I2=89.7%). Conclusions This study provides a high level of evidence in favor of a positive effect of VR to improve conventional semen parameters in infertile men with clinical varicocele. To the best of our knowledge, this is the first SRMA to compare changes in conventional semen parameters after VR with changes in parameters of a control group over the same period. This is in contrast to other SRMAs which have compared semen parameters before and after VR, without reference to a control group. Our findings strengthen the available evidence and have a potential to upgrade professional societies’ practice recommendations favoring VR to improve conventional semen parameters in infertile men.

Background: Diabetes is a risk factor for postoperative complications. Previous meta-analyses have shown that elevated glycated hemoglobin (HbA1c) levels are associated with postoperative complications in various surgical populations. However, this is the first meta-analysis to investigate the association between preoperative HbA1c levels and postoperative complications in patients undergoing elective major abdominal surgery. Methods: PRISMA guidelines were adhered to for this study. Six databases were searched up to April 1, 2020. Primary studies investigating the effect of HbA1c levels on postoperative complications after elective major abdominal surgery were included. Risk of bias and quality of evidence assessments were performed. Data were pooled using a random effects model. Meta-regression was performed to evaluate different HbA1c cut-off values. Results: Twelve observational studies (25,036 patients) were included. Most studies received a ‘good’ and ‘moderate quality’ score using the NOS and GRADE, respectively. Patients with a high HbA1c had a greater risk of anastomotic leaks (odds ratio [OR]: 2.80, 95% CI [1.63, 4.83], P < 0.001), wound infections (OR: 1.21, 95% CI [1.08, 1.36], P = 0.001), major complications defined as Clavien-Dindo [CD] 3–5 (OR: 2.16, 95% CI [1.54, 3.01], P < 0.001), and overall complications defined as CD 1–5 (OR: 2.12, 95% CI [1.48, 3.04], P < 0.001). Conclusions An HbA1c between 6% and 7% is associated with higher risks of anastomotic leaks, wound infections, major complications, and overall postoperative complications. Therefore, guidelines with an HbA1c threshold > 7% may be putting pre-optimized patients at risk. Future randomized controlled trials are needed to explore causation before policy changes are made.

Varicoceles adversely impact semen quality and sperm DNA fragmentation, which typically improve with surgical repair. Some men with varicoceles have ipsilateral testicular atrophy due to damage from the varicocele. This study assessed semen quality and the sperm DNA fragmentation index (DFI) response to varicocele repair in men with ipsilateral testicular atrophy (TA) versus men with no testicular atrophy (NTA). Semen parameter values and DFI in both groups were compared preoperatively and postoperatively. The Mann-Whitney U test and the Wilcoxon signed-rank test were used where appropriate. There were 20 men in the TA group and 121 men in the NTA group with no difference in age, varicocele grade, or preoperative semen parameter values between the two groups. The NTA group had a higher preoperative DFI than the TA group. Both groups showed improvement in semen quality postoperatively, only the TA group showed a significant improvement in DFI, whereas the NTA group showed significant improvements in several parameter values and DFI. The change from preoperative to postoperative parameter values when comparing the two groups revealed a difference in total sperm motile count and DFI, with a larger mean improvement in the NTA group than in the TA group. Both TA and NTA groups showed improved semen quality and DFI after varicocele repair, but the NTA group had more improvement than the TA group. However, only total motile count (TMC) and DFI had a significantly greater mean change in preoperative to postoperative response in the NTA group than in the TA group.

Comparison between Surgeon Administered Intraoperative Transverse Abdominis Plane Block with Wound Site Local Anesthetic Infiltration in Patients Undergoing Open Appendicectomy: A Prospective Double-Blinded Randomised Control Trial Transversus abdominis plane (TAP) block is a defined technique for managing postoperative pain. In particular, the use of surgeon-administered TAP blocks needs more comprehensive research. Therefore, our objective was to record the pain relief needed in patients who underwent surgical administered TAP blocks followed with an open appendectomy in comparison to those who received local anaesthetic infiltration at the wound site. Additionally, we aimed to assess the time until the first postoperative analgesic application and compare tramadol requirements in the postoperative period for these two groups. We conducted a controlled, prospective, randomised, double-blind study involving patients who underwent open appendicectomy at Hospital Sultanah Aminah Johor Bahru from April 2017 to October 2017. Of 61 patients, 31 were in the intervention group, and 30 were in the control group. Both groups of patients received a dose of 10cc of 0.25% levobupivacaine. Patients in the intervention group experienced a longer interval before requiring their first rescue analgesia (2.6 hours versus 1.17 hours; p=0.02, SD=1.66-2.97). The total tramadol dose needed over the first 24 hours in the intervention group was slightly lower at 115.8mg compared to the control group, which used 136.7mg (p=0.32, sd=72.42-89.96). Notably, patients in the intervention group also had a significantly shorter hospital stay (1.39 versus 1.68 days, p=0.02). It was worth noting that none of our patients experienced any adverse events during the study. Considering our study's effectiveness and safety profile, we recommended the routine use of surgeon-administered TAP blocks in open appendicectomy. This approach not only enhanced patient postoperative analgesia but also reduced the duration of hospitalisation.