Relapse/refractory B-cell acute lymphoblastic leukaemia (r/r B-ALL) represents paediatric cancer with a challenging prognosis. CAR T-cell treatment, considered an advanced treatment, remains controversial due to high relapse rates and adverse events. This study assessed the efficacy and safety of CAR T-cell therapy for r/r B-ALL. The literature search was performed on four databases. Efficacy parameters included minimal residual disease negative complete remission (MRD-CR) and relapse rate (RR). Safety parameters constituted cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Anti-CD22 showed superior efficacy with the highest MRD-CR event rate and lowest RR, compared to anti-CD19. Combining CAR T-cell therapy with haploidentical stem cell transplantation improved RR. Safety-wise, bispecific anti-CD19/22 had the lowest CRS rate, and anti-CD22 showed the fewest ICANS. Analysis of the costimulatory receptors showed that adding CD28ζ to anti-CD19 CAR T-cell demonstrated superior efficacy in reducing relapses with favorable safety profiles. Choosing a more efficacious and safer CAR T-cell treatment is crucial for improving overall survival in acute leukaemia. Beyond the promising anti-CD22 CAR T-cell, exploring costimulatory domains and new CD targets could enhance treatment effectiveness for r/r B-ALL.

Enhalus arcoides is a highly beneficial type of seagrass. Prior studies have presented proof of the bioactivity of E. acoroides, suggesting its potential to combat cancer. Therefore, this study aims to delve deeper into E. acoroides bioactive molecule profiles and their direct biological anticancer activities potentials through the combination of in-silico and in-vitro studies. This study conducted metabolite profile analysis on E. acoroides utilizing HPLC-ESI-HRMS/MS analysis. Two extraction techniques, ethanol and hexane, were employed for the extraction process. Furthermore, the in-silico study was conducted using molecular docking simulations on the HER2, EGFR tyrosine kinase and HIF-1α protein receptor. Afterward, the antioxidant activity of E. acoroides metabolites was examined to ABTS, and the antiproliferative activity was tested using an MTT assay. An in-silico study revealed its ability to combat breast cancer by inhibiting the HER2/EGFR/HIF-1α pathway through molecular docking. In addition, the MTT assay demonstrated that higher dosages of metabolites from E. acoroides increased the effectiveness of toxicity against cancer cell lines. Additionally, the study demonstrated that the metabolites possess the ability to function as potent antioxidants, effectively inhibiting a series of carcinogenic mechanisms. Ultimately, this study showed a new approach to unveiling the E. acoroides metabolites’ anticancer activity through inhibiting HER2/EGFR/HIF-1α receptors, with great cytotoxicity and a potent antioxidant property to prevent a carcinogenic cascade.

Dysregulation of renin-angiotensin-aldosterone system (RAAS) often leads to hypertension and severe cardiorenal complications. Although RAAS-targeted therapies have proven effective, it remains yet optimal in reducing cardiovascular events. The aim of this study was to evaluate the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI) compared to control in patients with hypertension. The primary outcomes were systolic and diastolic blood pressure (BP) control, along with the incidence of adverse events. A systematic review and meta-analysis was conducted according following PRISMA guidelines. A comprehensive literature search was performed across five databases: PubMed, ScienceDirect, EBSCO, Cochrane, and ProQuest, with studies identified up until 3 October 2024. The study included nine clinical trials that met the predefined eligibility criteria: (1) randomized clinical trials; (2) adult patients diagnosed with hypertension; and (3) comparison of ARNI versus control, reporting either BP control or adverse events. Quality appraisal using RoB 2.0 revealed that eight studies had a low risk of bias, and one had a high risk of bias. The pooled analysis demonstrated that ARNI is significantly more efficacious in achieving targeted systolic BP as compared to the control group (OR: 1.80; 95%CI: 1.41-2.30; p<0.001; I²=0%), and there was no statistical difference for the efficacy on diastolic BP compared to control (OR: 0.92; 95%CI: 0.75–1.13; p=0.45; I²=75%). The incidence of adverse events was not associated with ARNI (OR: 1.07; 95%CI: 0.90–1.27; p=0.46; I²=72%). In conclusion, ARNI demonstrated a favorable outcome only in systolic BP, but in diastolic BP which could be associated with inadequate duration of observation. Further studies are warranted to assess BP-lowering effect and safety profile of ARNI in a longer observation time.

Introduction: Hypertension is the leading noncommunicable disease case affecting 1.28 billion individuals worldwide, with most cases located in low- and middle-income countries. While there are numerous techniques for treating mild to moderate hypertension, properly controlling severe or resistant hypertension poses substantial challenges. Ultrasound-based renal denervation (uRDN) has emerged as a promising non-pharmacological approach. This study aims to investigate the safety and efficacy of uRDN in hypertensive patients. Methods: The literature search across PubMed, ScienceDirect, BMJ Journals, ProQuest, and Springer databases yielded 419 articles. A total of 395 articles were filtered, leading to 24 articles assessed for eligibility and overall analysis, which resulted in eight included studies for quantitative synthesis. Quality appraisal used RoB 2.0, while meta-analysis used RevMan 5.4. Results: Our analysis results indicated significant improvements in 24-hour, daytime, and home ambulatory blood pressure measurements, favoring the uRDN over control. The mean difference (MD) for 24-hour measurements was -0.84 mmHg [95% CI -1.14, -0.55; p < 0.00001], for daytime measurements -1.27 mmHg [95% CI -1.59, -0.95; p < 0.00001], and for home measurements -1.98 mmHg [95% CI -2.32, -1.64; p < 0.00001], with moderate heterogeneity observed. Office ambulatory measurements also favored the uRDN with a significant MD of -1.51 mmHg [95% CI -1.91; -1.10; p < 0.00001]. Funnel plots revealed some outliers, indicating true heterogeneity among the studies. Conclusion: uRDN was associated with a significant reduction (-2.32 to -0.10 mmHg) in blood pressure of hypertensive patients.

Introduction Essential oil treatment has been explored as a potential alternative medicine, as these therapies can induce calming and sedative effects by acting on the neuro-limbic system and upregulating neurotransmitter synthesis. Objectives This paper aims to assess the impact of essential oil interventions on aggressive behavior in people with dementia. Methods The literature search was carried out through six databases. The outcomes of interest were the survival risk and post-treatment score of the Cohen-Mansfield Agitation Inventory (CMAI), Neuropsychiatric Inventory (NPI), and Quality of Life (QoL). Quality appraisal was done using RoB 2.0, while meta-analysis was done using RevMan 5.4. This systematic review has been registered to the PROSPERO database (CRD42023476844). Results We analyzed 11 included studies with 1,418 patients. RoB 2.0 analysis resulted in eight low-risk-of-bias and three high-risk-of-bias studies. This study suggests that essential oil interventions lead to statistically significant improvements in survival risk with moderate heterogeneity [OR = 0.63 (95% CI: 0.41, 0.98, p = 0.04; I2 = 74%)]. This study also found a significant improvement in NPI scores following the use of essential oils [SMD = -2.97 (95% CI = -5.61, -0.32, p = 0.03; I2 = 98%)], but no statistically significant improvements were found in CMAI scores [SMD = 0.17 (95% CI = 0.37, 0.71, p = 0.53; I2 = 74%)]. The QoL assessment showed a trend favoring the control group after implementing essential oil treatments [SMD = 4.89 (95% CI = 1.51, 8.27, p = 0.005; I2 = 98%)]. Conclusions Essential oil is a potential approach in alleviating the agitated behavior of dementia patients considering its survival risk and some parameters, such as NPI, CMAI, and QoL score. However, more studies regarding essential oils on these parameters should be done, especially studies with specific main ingredients of the essential oil.

Atrial fibrillation (AF), affects around 2% of the global population and is projected to rise over the next 50 years. Catheter ablation (CA) is the primary treatment for symptomatic AF resistant to drug therapy. Despite its widespread use, CA has a failure rate of 20% to 50%, often requiring repeat procedures, due to significant long-term recurrence rates. Combining CA with renal denervation (RDN) or ganglion plexus ablation (GPA) may effectively reduce the recurrence rates of AF. Quality assessment was done using the Cochrane ROB 2.0 tool, network meta-analysis using RStudio, and comparative meta-analysis using RevMan 5.4. A thorough search across seven databases resulted in 13 articles for analysis, with eight classified as low-risk and five as moderate-risk of bias. The network meta-analysis found that RDN + CA had the highest freedom from AF episodes at 12 and 24 months (OR 2.28 [1.34-3.86] and OR 1.61 [0.89-2.89]), followed by GPA + CA (OR 1.88 [0.91-3.89] and OR 1.36 [0.91-2.03]), compared to CA alone. RDN + CA also showed fewer procedure-related complications (OR 0.78 [0.30-2.02]), while GPA + CA was more prevalent (OR 3.60 [1.72-7.55]), compared to CA alone. Additionally, RDN + CA significantly reduced systolic blood pressure (SBP) (MD -5.22 [-9.91- -0.53]), diastolic blood pressure (DBP) (MD -3.61 [-7.98- -0.76]), and creatinine levels (MD -0.25 [-0.34- -0.15]), while increasing estimated glomerular filtration rate (eGFR) (MD 7.98 [-1.16-17.11]) compared to the control group. Remarkable success in preventing AF recurrence was observed when CA was combined with RDN or GPA. However, it is noteworthy that GPA + CA was associated with a higher incidence of procedural-related complications, while RDN + CA demonstrated additional advantages by improving blood pressure regulation and renal function.