Clinical Research Research Articles

Transrectal Ultrasound in Cervical Cancer: A Systematic Review of its Current Application.

The use of transrectal ultrasound (TRUS) is established in prostate cancer but remains limited in cervical cancer. This systematic review aims to aggregate and describe the current use and advancements of TRUS in cervical cancer to identify gaps in the literature. This study follows a protocol registered in the PROSPERO database (CRD42024520099). It includes cervical cancer patients confirmed by histopathological analysis, where TRUS was used for diagnosis or as an adjunct to therapeutic procedures. Cross-sectional, case-control, cohort, or randomized controlled trials published in any language were included. The risk of bias was assessed using the Newcastle Ottawa Scale (NOS). From an initial pool of 3380 articles, 50 duplicates were removed, leaving 3330 unique articles. After screening titles and abstracts, 2932 articles were excluded, resulting in 31 studies included in the review. These studies involved 1635 women with cervical cancers, with a mean age of 52.9years. Histopathologically, 81.2% were squamous cell carcinoma (SCC), and 39.6% were at FIGO stage IIB. Nineteen studies were prospective, five retrospective, and fourteen used consecutive sampling. Only 10 articles had a fair rating, while the rest received poor ratings. Complications from post-TRUS included pain (N = 106), haemorrhage (N = 59), and perforations (N = 10). TRUS was used in seven areas, including cancer extension and pre-operative assessment. It showed a strong correlation with MRI but had lower sensitivity. TRUS was useful in staging, diagnosis, and guiding brachytherapy, demonstrating comparable accuracy to MRI in several instances. The recommended use of TRUS in cervical cancer is still limited in formal guidelines, and clinical research remains insufficient. The online version contains supplementary material available at 10.1007/s13224-024-02047-8.

A training protocol compliance of 13% was observed in a research study of clinical research professionals

ObjectiveWe attempted to conduct a randomized controlled trial of three different informed consent training formats to evaluate their effectiveness. We recruited 503 clinical research professionals, who received $50 for participation. Incidental findings showed unexpectedly low rates of compliance with completing the study training protocols, resulting in insufficient statistical power to test our original hypotheses. In this report, we conducted a secondary analysis of the data in which we characterize and evaluate the observed low compliance. This involved using literature on average reading times, speed-reading times, and video play speeds to calculate the timeframes required to complete the three training formats.ResultsOnly 13% of participants completed the training in a reasonable timeframe. Furthermore, only 46% of participants completed the training in the minimum possible timeframe. These findings lead us to ask whether online research training is effective, since no training can be effective if participants do not actually complete the training. Given extensive requirements for educational training among clinical research professionals, we feel the burden of proof is on training programs to demonstrate that they have positive effects.

The State of Stroke Research in Malawi: Results from a Mapping Review Study.

Stroke is one of the leading causes of death and disability globally, and low-income countries such as Malawi bear a heavy burden. Tailored, high-quality research is essential for bridging existing gaps and improving the healthcare provided in low-resource settings while maximizing available resources. This mapping study aimed to synthesize the current state of stroke research in Malawi. Six databases were thoroughly searched: CINAHL complete, Ovid MEDLINE and EMBASE, Web of Science Core Collection, PubMed, and Google Scholar. The search retrieved 598 references and identified 20 studies published between 2005 and 2023. Of these, 70% were conducted at Queen Elizabeth Central Hospital only; open-access journals published 95% of the studies. Cross-sectional studies were the most common (50%), followed by case-control studies (20%). The Malawi-Liverpool-Wellcome Trust Clinical Research Program authors contributed the most articles as main authors (25%). The number of citations per article ranged from 0 to 168 on Google Scholar, and the number of authors per article ranged from 1 to 15. Authors from thirty-five different institutions from 11 other countries partnered with Malawi on stroke articles, and England contributed 45.7% of the institutions. Most articles focused on pathophysiology (30%), followed by diagnosis (20%) and stroke management (15%). The highest number of participants included in the analysis was 739 and the highest number of stroke participants was 222. The identified challenges included the need for more infrastructure and under-utilization of available services. The Wellcome Trust has emerged as the primary funding agency for stroke research in Malawi. The study found limited collaboration among local institutions in Malawi, with most research focused in Blantyre District. There is a critical need for increased interdisciplinary teamwork to boost nationwide research.

New non-contrast MRI of endolymphatic hydrops in Ménière's disease considering inversion time.

Three-tesla MRI with gadolinium-based contrast agents is important in diagnosing Ménière's disease. However, contrast agents cannot be used in some patients. By using the compositional difference between the inner ear endolymph and perilymph, we performed basic and clinical research focused on potassium ions and protein to find the optimal parameters for visualizing endolymphatic hydrops on MRI without contrast. We then examined the relationship between severity stage and visualization rate of endolymphatic hydrops. In phantom experiments simulating the endolymph and perilymph, we explored MRI parameters that could be used to separate endolymph from perilymph by gradually changing the inversion time. We then used these parameters to perform both new non-contrast MRI and contrast MRI on the same day in Ménière's disease patients, and we compared the visualization rates of endolymphatic hydrops under the two modalities. Fifty patients were selected from 478 patients with Ménière's disease of different severity stages; 12 patients had asthma and allergy to contrast agents. The higher the disease stage, the higher the endolymphatic hydrops visualization rate. The new non-contrast MRI gave significantly higher (p < .01) visualization rates of endolymphatic hydrops on the affected side in patients at Stage 3 or above than in Stages 1 and 2 combined. New non-contrast MRI with parameters focusing on the endolymph-perilymph difference in the density of protons surrounding the potassium ions and protein can produce images consistent with endolymphatic hydrops. We believe that this groundbreaking method will be useful for diagnosing Ménière's disease in patients. Clinical studies are at evidence level 3 in non-randomized controlled trials.

Development of hepatic fibrosis in common variable immunodeficiency-related porto-sinusoidal vascular disorder.

Liver involvement is an increasingly recognised complication of common variable immunodeficiency (CVID). Nodular regenerative hyperplasia (NRH), a subgroup of porto-sinusoidal vascular disorder, and manifestations of portal hypertension (PH) unrelated to cirrhosis are the most common findings. Nonetheless, the evolution of liver disease over time remains unknown. Retrospective review of patients followed at the National Institutes of Health with CVID-related liver disease and liver biopsy from 1990 to 2020. Clinical, imaging and histological follow-up were recorded as part of clinical research protocols. Forty patients were included, with a median age of 37.5 years at initial biopsy, 73% presenting with clear evidence of NRH, and a median fibrosis stage of 1. At biopsy, median platelet count was 100 × 109/L, spleen size 19.5 cm, hepatic venous pressure gradient 9.5 mmHg and 37.5% of patients had signs of PH. Cumulative incidence of PH was 65% at 5 years. In a subgroup of 16 patients, a follow-up liver biopsy, performed at a median time of 3 years after the index biopsy, revealed an increase in fibrosis by ≥2 stages in 31% of cases and an increase to an overall stage of 2.2 (p = 0.001). No clinical or histological factors were associated with progression of fibrosis. In this CVID cohort, NRH is the most common initial histological finding; however, unexpectedly fibrosis progresses over time in a subgroup of patients. A better understanding of the underlying causal process of liver disease CVID might lead to improved outcomes.

Progress in the Utilization of Nanobody CAR-T Cell in Cancer Immunotherapy

Chimeric antigen receptor-modified T cells (CAR-T cells) therapy is a groundbreaking cancer immunotherapy that has demonstrated remarkable therapeutic results. CAR-T cells typically utilize single-chain variable fragments (scFv) from monoclonal antibodies (mAb) as their primary structural component for targeting antigens. Recently, scientists have discovered that nanobody (Nb), which possesses the advantages of low molecular weight, strong stability, high affinity, and low immunogenicity, can be utilized to target structural domains to develop novel therapies. In preclinical and clinical trials, Nb CAR-T cell therapy has shown effects comparable to those of conventional CAR-T cell therapy. The main focus of this study is to provide an overview of Nb CAR-T cell target selection, use, and advancements in clinical research for the immunotherapy of hematological and solid malignancies.

Herbal and Natural Supplements for Improving Sleep: A Literature Review.

Herbal and natural supplements have gained popularity as alternative treatments to insomnia and sleep disorders due to their perceived safety and potential effectiveness. This literature review summarizes the current evidence on the efficacy, safety, and mechanisms of action of commonly used supplements for sleep, including valerian, hops, kava, German chamomile, cherry, tryptophan, theanine, melatonin, magnesium, and zinc. We conducted literature review of clinical research on herbal and supplements for sleep reported to date. We summarized key findings and reviewed outcomes related to clinical efficacy and side effects. Findings suggest that certain supplements, particularly valerian, hops, and melatonin, could be effective in improving sleep quality and reducing insomnia symptoms through modulation of neurotransmitter systems and regulation of sleep-wake cycles. However, the strength of the evidence varies with unestablished optimal dosages, formulations, and treatment durations. Although generally considered safe, these supplements are not without risks, such as rare but serious adverse effects associated with kava and potential interactions with prescription medications. The quality and purity of supplements also vary widely due to a lack of strict regulations. Healthcare providers should remain informed about the latest research and work closely with patients to develop personalized treatment plans. Herbal and natural supplements may offer promising alternatives or adjunct treatments for insomnia and sleep disorders, but their use should be guided by the best available evidence and individual patient requirements. Larger, well-designed clinical trials are needed to establish the efficacy and safety of these supplements for clinical decision-making.

Trends in the treatment of human papillomavirus-associated oropharyngeal carcinoma in Slovakia.

The optimal treatment of oropharyngeal cancer (OPC) associated with human papillomavirus (HPV) is currently a subject of clinical research. This questionnaire study investigated current trends in the treatment of HPV-associated (HPV+) OPC in Slovakia with the incorporation of deintensification of oncological treatment into routine clinical practice outside of clinical trials. The Slovak Cooperative Head and Neck Cancer Group (SCHNCG) developed a questionnaire aimed at identifying trends in the oncological treatment of HPV+ OPC intended for all radiation oncology (RO) facilities in Slovakia. Specialists in the field of RO responded to general questions about the character of their individual institutions as well as to 4 theoretical clinical scenarios (case reports) regarding the treatment of HPV+ OPC, focusing primarily on the applied dose of radiotherapy (RT), the extent of target volumes, and the type of concurrent chemotherapy (CHT). The questionnaire study involved 35 RO specialists from 14 institutions in Slovakia. Regarding primary chemoradiotherapy (CRT) in T1N1M0 HPV+ OPC, 16 respondents (45.7%) would consider de-escalation of the RT dose to <70 Gy. In the case of postoperative RT in pT1pN1M0 HPV+ OPC with negative resection margins (R0) and absent extracapsular extension (ECE), 4 physicians (11.4%) would consider de-escalation of the RT dose to <60 Gy in the tumor bed area, while the majority of the treating specialists (n=19, 54.3%) would omit concurrent CHT. In the case of primary RT in elderly patient with T2N1M0 HPV+ OPC, the same number of physicians (n=16, 45.7%) would consider de-escalation of the RT dose to <70 Gy, and 14 respondents (40.0%) would completely omit CHT. In a high-risk patient with T2N3M0 HPV+ OPC with a complete response after 3 cycles of induction chemotherapy (iCHT), none of the respondents would indicate a reduction in the RT dose to the area of the original tumor and lymphadenopathy to <60 Gy. The doses and extent of irradiated volumes in the treatment of HPV+ OPC in Slovakia vary among different institutions. The tendency to de-escalate RT doses and reduce doses of concurrent systemic therapy in Slovakia is high and there was also an observed trend to reduce the extent of radiation treatment fields.

An Effective Algorithm Based on Sequence and Property Information for N4-methylcytosine Identification in Multiple Species

Abstract: N4-methylcytosine (4mC) is one of the most important epigenetic modifications, which plays a significant role in biological progress and helps explain biological functions. Although biological experiments can identify potential 4mC sites, they are limited due to the experimental environment and labor-intensive process. Therefore, it is crucial to construct a computational model to identify the 4mC sites. Some computational methods have been proposed to identify the 4mC sites, but some problems should not be ignored, such as those presented as follows: (1) a more accurate algorithm is required to improve the prediction, especially for Matthew’s correlation coefficient (MCC); (2) easier method is needed for clinical research to design medicine or treat disease. Considering these aspects, an effective algorithm using comprehensible encoding in multiple species was proposed in this study. Since nucleotide arrangement and its property information could reflect the sequence structure and function, several feature vectors have been developed based on nucleotide energy information, trinucleotide energy information, and nucleotide chemical property information. Besides, feature effect has been analyzed to select the optimal feature vectors for multiple species. Finally, the optimal feature vectors were inputted into the CatBoost algorithm to construct the identification model. The evaluation results showed that our study obtained the highest MCC, i.e., 2.5%~11.1%, 1.4%~17.8%, 1.1%~7.6%, and 2.3%~18.0% higher than previous models for the A. thaliana, C. elegans, D. melanogaster, and E. coli datasets, respectively. These satisfactory results reflect that the proposed method is available to identify 4mC sites in multiple species, especially for MCC. It could provide a reasonable supplement for biological research.

Association between nurses' personal, professional and work characteristics, and engagement in hospital-based clinical research.

The purpose of this study was to assess the associations between demographic, professional and other personal nurse characteristics, social support factors and comfort in conducting research with nurses' level of active participation in clinical research. A prospective, cross-sectional, correlational design was used. Clinical nurses working in a multihospital healthcare system were recruited by email to complete an anonymous survey that used multiple valid and reliable scales to assess demographic and professional work characteristics, curiosity, grit, locus of control, perceived social support (for research activities), comfort in conducting research, and level of being research-active. Univariate and multivariable analyses were completed. Of 310 participants, 274 (88.4%) were female and mean (SD) age was 42.9 (13.1) years. After condensing 11 levels of research activity to four categories, 179 (57.7%) were not research-active, and 91 (29.4%), 26 (8.3%) and 14 (4.5%) were engaged at low, moderate, and high levels, respectively. Of 78 factors, 69 (88.5%) were associated with being research-active in univariate analyses. In multivariable analysis that adjusted for age, personal experience as a patient, years as a nurse and hours in direct patient care, professionalism characteristics, higher curiosity, internal locus of control, grit perseverance, support of a nurse scientist and nurse friends, and comfort in conducting research remained associated with higher levels of being research-active (all p < 0.01). Research-active nurses were more likely to be engaged professionally in hospital-based activities beyond their work roles and displayed higher levels of positive psychological characteristics and mentorship that supported research capacity. Research-active nurses were more likely to have internal factors and external resources that promoted higher levels of being research-active. A strong professional governance model may enhance clinical nurses research activities.

When are You Recovered? Defining Cutoff Points Using the Acute Respiratory Tract Infection Questionnaire

ObjectivesAcute respiratory tract infections (ARTIs) are a heterogenous group of diseases. Often, it is difficult to obtain a precise diagnosis in general practice but also difficult to determine when the patient is recovered. The lack of a precise definition of recovery after ARTI complicates scientific research aiming to optimize diagnostics and compare treatments. The study aimed to define cutoff points to determine the end of an ARTI as a proxy for recovery in patients diagnosed with ARTI in general practice using a validated patient-reported outcome instrument; The ARTI Questionnaire (ARTIQ). MethodsA total of 259 participants was divided in 2 groups—1 with ARTI and 1 without. Histograms and area under the curve were calculated for each of the 5 dimensions within the ARTIQ to evaluate the discriminative effect. For the most discriminative dimensions receiver operating comparison curves were performed to determine relevant cutoff points for having or not having ARTI symptoms and serve as a proxy for recovery in clinical research. ResultsThe highest discriminative effect was found in 2 dimensions: “physical—upper airways” and “physical—lower airways.” When combining these dimensions, the area under the curve was 0.97. Sensitivity, specificity, and predictive values were calculated for selected cutoff points. ConclusionCutoff points serving as proxy for recovery from ARTI using a patient-reported outcome were identified. The specific cutoff point for a certain research project must be selected considering the specific clinical situation of interest.

Nebulized Glutathione as a Key Antioxidant for the Treatment of Oxidative Stress in Neurodegenerative Conditions.

Glutathione (GSH), a tripeptide synthesized intracellularly, serves as a pivotal antioxidant, neutralizing reactive oxygen species (ROS) and reactive nitrogen species (RNS) while maintaining redox homeostasis and detoxifying xenobiotics. Its potent antioxidant properties, particularly attributed to the sulfhydryl group (-SH) in cysteine, are crucial for cellular health across various organelles. The glutathione-glutathione disulfide (GSH-GSSG) cycle is facilitated by enzymes like glutathione peroxidase (GPx) and glutathione reductase (GR), thus aiding in detoxification processes and mitigating oxidative damage and inflammation. Mitochondria, being primary sources of reactive oxygen species, benefit significantly from GSH, which regulates metal homeostasis and supports autophagy, apoptosis, and ferroptosis, playing a fundamental role in neuroprotection. The vulnerability of the brain to oxidative stress underscores the importance of GSH in neurological disorders and regenerative medicine. Nebulization of glutathione presents a novel and promising approach to delivering this antioxidant directly to the central nervous system (CNS), potentially enhancing its bioavailability and therapeutic efficacy. This method may offer significant advantages in mitigating neurodegeneration by enhancing nuclear factor erythroid 2-related factor 2 (NRF2) pathway signaling and mitochondrial function, thereby providing direct neuroprotection. By addressing oxidative stress and its detrimental effects on neuronal health, nebulized GSH could play a crucial role in managing and potentially ameliorating conditions such as Parkinson's Disease (PD) and Alzheimer's Disease (AD). Further clinical research is warranted to elucidate the therapeutic potential of nebulized GSH in preserving mitochondrial health, enhancing CNS function, and combating neurodegenerative conditions, aiming to improve outcomes for individuals affected by brain diseases characterized by oxidative stress and neuroinflammation.

The mediating role of chronic low-grade inflammation participation in the relationship between obesity and type 2 diabetes: findings from the NHANES

BackgroundChronic low-grade inflammation may mediate the relationship between obesity and diabetes, yet clinical research in this area remains scarce. Thus, this study aimed to explore the mediating role of chronic low-grade inflammation in this relationship using the National Health and Nutrition Examination Survey (NHANES).MethodsThis study involved 2,482 participants enrolled in the NHANES between 2005 and 2016. Based on the complex sampling survey weights of NHANES, logistic regression models were fitted, adjusting for various covariates to investigate the relationship between BMI, INFLA score, and diabetes. Moreover, weighted quantile sum (WQS) regression models were fitted to analyze the proportional contribution of individual components within the INFLA score. Finally, mediation analysis was conducted to quantitatively assess the magnitude of the mediating effect of the INFLA score on the relationship between BMI and diabetes.ResultsAfter adjusting for all potential confounding factors, a significant positive correlation was noted between INFLA score and diabetes [OR (95% CI), 1.038(1.003–1.075), p = 0.035]. Additionally, a significant positive correlation was observed between the high INFLA group and diabetes compared to the low INFLA group [OR (95% CI), 1.599(1.031–2.481), p = 0.037]. WQS regression models revealed that the proportional contributions of C-reactive protein, white blood cell count, platelet count, and neutrophil-to-lymphocyte ratio (NLR) were 55.5%, 34.8%, 8.46%, and 1.19%, respectively. Finally, the results of the mediation analysis indicated that the indirect effect of the INFLA score accounted for 10.20%.ConclusionsChronic low-grade inflammation was associated with diabetes and partially mediates the relationship between obesity and diabetes.

Applications of machine learning to electronic health record data in liver-related disease

Electronic Health Records (EHRs) has gained its increasing significance in modern healthcare as its promising prospects in the application of machine learning. The accumulation of vast clinical data holds potential for repurposing in clinical research such as prediction, diagnosis and prognosis. However, the collection and preparation of EHR data present challenges, primarily due to the inherent incompleteness of the data and the associated privacy and security concerns. To address the issue, text-mining tools based on domain-specific lexicons, data sharing and multiple de-identification methods have been suggested. In terms of methodologies, various machine learning models and algorithms used in EHR data analysis are analyzed, including logistic regression, decision trees, random forests, and natural language processing, each with its unique application scenarios in the healthcare domain. Liver related diseases, including HAV, HBV, HCV and especially Liver Cancer, has affected hundreds of millions of people around the world. The incidence and mortality rates for these diseases are still rising continually. With recent advancements of Machine Learning techniques, such as the attention mechanism and BERT-based embedding, which have shown exceptional results in EHR analysis when applying to liver diseases. While EHRs offer a treasure trove of data for clinical research, the challenges associated with their collection, processing, and analysis cannot be ignored. It underscores the need for robust methodologies and tools to harness the full potential of EHRs while ensuring data integrity and patient privacy. In this paper, we will gather and review the existing application in the realm of liver-related diseases.

The contemporary issues related to conventional treatment of acne and the way forward

Background: People perceive acne as a minority disorder (not a major health concern), but it has a significant impact and burden on the victims. Although conventional drugs are available for its treatment, which are applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid etc. or formulationAcne vulgaris is a common skin condition that can have a significant impact on individuals, yet conventional treatments often come with various contemporary issues. This paper discusses the contemporary issues related to the conventional treatment of acne and explores a way forward. Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit, with a high prevalence globally and in Nigeria. Although conventional drugs are available for treatment, there are several contemporary issues related to their usage that need to be addressed. Method: Relevant literature, including stakeholder reports and studies conducted globally and locally, were searched and reviewed to identify the contemporary issues related to conventional acne treatment. The key contemporary issues identified include economic, environmental, emotional, social, and spiritual concerns. Findings: The economic burden of costly conventional medications makes them inaccessible for many. Environmental issues arise from the use of potentially harmful chemicals that can pollute water sources and contribute to climate change. Acne can also lead to emotional distress, social stigma, and spiritual conflicts, especially due to the side effects of conventional treatments. Given the limitations of conventional treatments, the article recommends the use of scientifically-proven herbal remedies as a promising alternative strategy. Herbs such as tea tree oil, green tea, chasteberry, black seed, and spikeweed have demonstrated antibacterial, anti-inflammatory, and anti-androgenic properties that can effectively manage acne without the adverse effects of conventional drugs. Conclusion: The use of evidence-based herbal medicines offers a way forward in the treatment of acne, addressing the contemporary issues associated with conventional approaches. Further clinical research and regulatory approval are necessary to integrate these herbal remedies into conventional acne management and ensure their widespread and safe use. Novelty/Originality of this article: This study proposes an integrated acne treatment framework that combines conventional therapies with evidence-based herbal medicine. This approach addresses contemporary issues in acne treatment by considering economic, environmental, and socio-cultural aspects.

Simple tape-stripping method for highly reliable and quantitative analysis of skin microbiome.

The composition of human skin microbiome profoundly impacts host skin health and disease. However, the relationship between skin homeostasis or the development of skin diseases and daily changes in skin microbial composition is poorly understood. Longitudinal samplings at more frequent intervals would address this issue, while conventional sampling methods have technical difficulties, leading to limitations in sampling opportunities. Here, we developed a simple and stable tape-stripping method regardless of the operator's skill. Our method enables skin microbial sampling within 30 seconds and taking multiple skin microbial samples from the same body site. The amount of microbial DNA among multiple sampling sites could be measured within 13.5%. The sequencing results of multiple sampling showed high consistency, Pearson's correlation coefficient between multiple samples of 0.98. Furthermore, these results were comparable to those collected by the conventional swabbing method. These results demonstrate that our tape-stripping method enables simple microbiome collection and highly reliable quantitative skin microbiome analysis. These features of our method would lead to a further understanding of skin disease development or diagnosis of skin conditions in clinical research by increasing the opportunities for microbial sampling.

DNA Nanotechnology Targeting Mitochondria: From Subcellular Molecular Imaging to Tailor-Made Therapeutics.

Mitochondria, one of the most important organelles, represent a crucial subcellular target for fundamental research and biomedical applications. Despite significant advances in the design of DNA nanotechnologies for a variety of bio-applications, the dearth of strategies that enable mitochondria targeting for subcellular molecular imaging and therapy remains an outstanding challenge in this field. In this Minireview, we summarize the recent progresses on the emerging design and application of DNA nanotechnology for mitochondria-targeted molecular imaging and tumor treatment. We first highlight the engineering of mitochondria-localized DNA nanosensors for in situ detection and imaging of diverse key molecules that are essential to maintain mitochondrial functions, including mitochondrial DNA and microRNA, enzymes, small molecules, and metal ions. Then, we compile the developments of DNA nanotechnologies for mitochondria-targeted anti-tumor therapy, including modularly designed DNA nanodevices for subcellular delivery of therapeutic agents, and programmed DNA assembly for mitochondrial interference. We will place an emphasis on clarification of the chemical principles of how DNA nanobiotechnology can be designed to target mitochondria for various biomedical applications. Finally, the remaining challenges and future directions in this emerging field will be discussed, hoping to inspire further development of advanced DNA toolkits for both academic and clinical research regarding mitochondria.

Status and hotspot analysis of Qingfei Paidu Decoction for the prevention and treatment of COVID-19 based on bibliometric analysis.

Qingfei Paidu Decoction (QFPDD) has played an important role in the prevention and treatment of COVID-19 infection in China. The present study aims to perform an econometric analysis and visualization of the literature on the treatment of COVID-19 with QFPDD in the Chinese databases and English databases. Six databases including such as Chinese databases CNKI, VIP, CBM, WANFANG as well as English databases PubMed, Web of Science were searched for publications related to the prevention and treatment of COVID-19 with QFPDD. The institutions, authors, keywords of each publication were cisualized using the software of CiteSpace. A total of 187 literature on the prevention and treatment of novel coronavirus infection with QFPDD were included, of which 145 (77.5%) were in Chinese and 42 (22.5%) were in English. Those publications were written by 926 authors from 383 institutions. There were 78 theoretical studies (41.7%), 63 clinical studies (33.7%), and 46 basic studies (24.6%). The cooperative institutions with the core of "Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences" and "Shanghai University of Chinese Medicine Cross Academy of Science" have been formed, and two core teams with "Wang Yanping" and "Zhang Weidong" have been formed. The keyword analysis showed that the research mainly focuses on pathologic pathogenesis, clinical efficacy, adverse reactions, integrated Chinese and western medicine therapy, network pharmacology research. QFPDD has attracted worldwide attention, mechanism research and clinical research may become a future development trend. Therefore, in-depth basic research and clinical studies with large samples and multi-center cooperation should be carried out to provide high-level evidence-based evidence for the prevention and treatment of COVID-19 with QFPDD.

Comprehensive Review of the Use of Plant-Derived Antioxidants in the Management of Non-Alcoholic Liver Toxicity

ABSTRACT With its rising incidence, non-alcoholic fatty liver disease (NAFLD) has become a global health problem. Hepatic lipid buildup, inflammation, and oxidative stress are the results of complex interactions between metabolic, genetic, and environmental variables in the development of nonalcoholic fatty liver disease. The potential significance of antioxidants generated from phytochemicals in alleviating non-alcoholic liver damage has garnered substantial interest among the many treatment methods. The goal of this thorough review is to summarize and assess the body of research on the application of antioxidants derived from phytochemicals in the treatment of non-alcoholic fatty liver disease. A comprehensive examination of peer-reviewed research from many databases demonstrates a wide variety of phytochemicals with antioxidant characteristics and their possible effects on oxidative stress, inflammation, and hepatic lipid metabolism. Prominent phytochemicals such as curcumin, resveratrol, quercetin, silymarin, and green tea catechins are among those whose antioxidative processes are included in the review. Preclinical and clinical research on these substances have revealed encouraging results, suggesting that they may be able to lessen inflammation and hepatic steatosis while also enhancing liver function. We investigate the molecular mechanisms underlying their protective benefits, including reduction of pro-inflammatory cytokines and modification of nuclear factor-erythroid 2-related factor 2 (Nrf2). The study also discusses the shortcomings and difficulties in the existing research, highlighting the necessity of more clinical trials, standardized dosing schedules, and research into the possible synergistic effects of mixing several phytochemicals. To present a fair picture of the therapeutic application of phytochemical antioxidants, safety issues and possible negative effects are also included. This review emphasizes the potential use of phytochemical-derived antioxidants in the treatment of non-alcoholic hepatic damage. Including these organic substances in all-encompassing lifestyle interventions might be a good way to both prevent and cure NAFLD. Keywords: Phytochemicals, Non-alcoholic fatty liver disease (NAFLD), Anti-oxidants, Non-alcoholic steatohepatitis (NASH), Toxicity.

DNA Nanotechnology Targeting Mitochondria: From Subcellular Molecular Imaging to Tailor‐Made Therapeutics

AbstractMitochondria, one of the most important organelles, represent a crucial subcellular target for fundamental research and biomedical applications. Despite significant advances in the design of DNA nanotechnologies for a variety of bio‐applications, the dearth of strategies that enable mitochondria targeting for subcellular molecular imaging and therapy remains an outstanding challenge in this field. In this Minireview, we summarize the recent progresses on the emerging design and application of DNA nanotechnology for mitochondria‐targeted molecular imaging and tumor treatment. We first highlight the engineering of mitochondria‐localized DNA nanosensors for in situ detection and imaging of diverse key molecules that are essential to maintain mitochondrial functions, including mitochondrial DNA and microRNA, enzymes, small molecules, and metal ions. Then, we compile the developments of DNA nanotechnologies for mitochondria‐targeted anti‐tumor therapy, including modularly designed DNA nanodevices for subcellular delivery of therapeutic agents, and programmed DNA assembly for mitochondrial interference. We will place an emphasis on clarification of the chemical principles of how DNA nanobiotechnology can be designed to target mitochondria for various biomedical applications. Finally, the remaining challenges and future directions in this emerging field will be discussed, hoping to inspire further development of advanced DNA toolkits for both academic and clinical research regarding mitochondria.