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Triple negative breast carcinoma (TNBC) is a rapid progressive tumor and has a poor overall survival. Therefore, it is crucial to find out effective molecular targets and develop optimal therapeutic strategies for TNBC. In this study, immunohistochemical staining was used to detect expressions of programmed death-ligand 1 (PD-L1) and phosphatase and tensin homolog (PTEN) in 136 breast carcinomas including 50 TNBC. The effect of PTEN on regulation of PD-L1 expression was assessed in vitro in the PTEN knockdown TNBC cells. We found that PD-L1(SP142) positive rate in TNBC (48.0%) was significantly higher than non-TNBC (23.3%). PTEN negative rate was 42% in TNBC. The inverse correlation between PTEN and PD-L1(SP142) expression in TNBC was statistically significant (P<0.05). After PTEN knockdown, PD-L1 expression in TNBC cells increased significantly, and the expression level of AKT increased simultaneously. PTEN knockdown promoted cell proliferation, viability and G1/S switch of TNBC cells. These results suggested that PTEN may involve in regulation of PD-L1 expression, because PTEN loss can upregulate PD-L1 expression in TNBC. Antitumor immunity of PD-L1 could be enhanced in TNBC when targeting PTEN at the same time.Full article

MUP (medically unexplained pain) is a pain whose cause cannot be determined by diagnostic imaging, blood test, physical examination and past medical history, etc. Many departments have independently created the concept, definition, and diagnostic criterion in MUP. This leads to an abnormal situation in which each department has different disease concepts and diagnostic criteria. It is out-of-the-ordinary that physicians from the different departments make different diagnoses in the same patient. MUP has caused confusion in clinical practice. The medical community should make the unified disease concept, definition, and diagnostic criterion of MUP. For this purpose, the various scientific organizations involved in MUP need to discuss. In this case, the first priority should not be the majority vote, but the treatment outcomes. The solution to a medical controversy is to choose a medical theory or treatment method that produces better long-term results.Full article

Since the first outbreak of SARS-CoV2, Severe Acute Respiratory Syndrome Coronavirus-2 in Wuhan, China in the December 2019, the world continues to be in state of fear, uncertainty, tension and anxiety till date and this state might continue because of emerging mutants. The vaccination drive all over the world is continuing, still the new variants are cause of concern, with the aim to prevent the spread of the virus, focus should be on techniques and processes which helps in strengthening our defense mechanism, the immune system. It has becoming clear from several studies that the immune system is greatly impacted by the COVID-19 infection through several inflammatory reactions. The role of balanced diet full of nutrients cannot be overlooked in controlling infectious diseases. A balanced diet which should include plant foods, vitamins and micronutrients and this review wants to emphasize on the preventive role played by the plant foods, vitamins and minerals in COVID-19 infections, to reduce the mortality rate as well as the morbidity in patients who are infected.Full article

Proper and effective management of obstructive sleep apnea (OSA) in elderly patients represents an important yet under-researched therapeutic target. Therefore, the main purpose of our research was to employ age stratification to analyse sleep quality and sleep fragmentation, the daily sleepiness, OSA severity and CPAP compliance in elderly. Conforming to the inclusion criteria of minimum 70 years of age at the time of polysomnography and CPAP titration night a total number of 162 elderly patients was included, median age 73,00±4 (MED±IQR). The comparison group consisted of 448 adult subjects under the age of 70 years old, median age 54,00±14,00 (MED±IQR). Sleep fragmentation in elderly was promoted to suboptimal CPAP adherence, as the probability of CPAP use ≥ 4 hours per day was less than 20%. Overall CPAP compliance hours in the elderly group achieved 3,991±3,804 hours/day with bigger variation in between the subjects versus 5,547±3,465 hours/day for the controls, (MED±IQR, p<0,001). Despite naturally occurring sleep fragmentation worsened by OSA, less than 30% of elderly patients would score ≥ 10 points on Epworth sleepiness scale. The study emphasizes acute need for standardized age-specific diagnostic tools to address different perception of daily drowsiness and sleepiness by older people. Further, it underlines the importance of early recognition of possible comorbid OSA and insomnia and suggest paying more attention to “non-obese phenotype” in the subgroup of elderly patients with suspected OSA. Elderly patients might also need development of more flexible CPAP compliance criteria; however, those must be standardized and objective. Full article

Currently, the world is facing the COVID-19 epidemic, a disease caused by SARS-CoV-2. Emerging body of molecular evidences suggested a similar path to SARS and MERS viruses. A viral particles cascade enters into the human body through eyes, nose, and mouth, few of these viral particles reaches to the lower respiratory tract through breathing and here their spike protein act like a key and lock into epithelial cells which are the air sacs in lungs. SARS-CoV-2 is undetectable for a longer period of time than many other flu and coronaviruses. Once they entered inside body, they overtake the cell’s machinery, replicate, multiply and infect the adjoining cells. All the viruses have a tell-tale signature on the surface known as antigens, identifying these antigens is what activate the immune system by producing the antibodies. Researchers have shown that a wide range of immune cells that react to SARS-CoV-2 and helps in recovery could be helpful in the development of potential vaccines.Full article

Patients with comorbid neurotic and anxiety disorders are more receptive of the discomfort accompanying continuous positive airway pressure therapy than average obstructive sleep apnea patients. The purpose of the study was to analyze short-term and long-term continuous positive airway pressure therapy adherence data of patients with obstructive sleep apnea and comorbid anxiety and stress-related dyssomnias, as this group of disorders is expected to rise in the post-covid era. Study retrospectively analyzed clinical outcomes of obstructive sleep apnea patients. All subjects with obstructive sleep apnea were diagnosed based on in-lab video polysomnography, further referred to CPAP titration and were invited for regular follow-up visits. The results showed that subjects with comorbid obstructive sleep apnea and anxiety-related disorders used ventilation therapy more hours per day (6,690 hours/day vs. 5,000 hours/day, ****p<0,0001, anxiety (n=19) vs. controls (n=60)). Patients from the anxiety group remained longer in our therapy program (7,086 years vs. 2,905 years, ****p<0,0001) and had markedly better control over their weight, as the body-mass index of the control group increased by +1,065 kg/m2 per year and the body-mass index in the examination group increased only by +0,296 kg/m2 every year. Our data document that obstructive sleep apnea patients on ventilation therapy, who do not have enough control over their increasing body weight might highly benefit from therapy approaches similar to patients with anxiety-related dyssomnias and that management of obstructive sleep apnea is not an obstacle in concomitant treatment of neurotic and anxiety-related dyssomnias.Full article

Emerging smart medical instruments combined with advanced smart industrial equipment facilitate the collection of vast volumes of critical data. This data not only enables significantly more accurate and cost-effective diagnosis and maintenance but also enriches the datasets available for AI algorithms, leading to improved insights and outcomes. The integration of high-speed and ultra-reliable telecommunications infrastructure is crucial, as it supports the cloud model. This model allows for off-device aggregation in the cloud, which effectively offloads infrastructure demands and provides an extended runway for future technological improvements before the deployment of the next generation of devices. However, in certain scenarios, latency and bandwidth limitations present significant challenges. These limitations require that a substantial amount of AI and machine learning processing is conducted directly on the transmitted data, which places rigorous demands on both the processing subsystems and the communications links themselves. The current project directly addresses the accelerator side of this multifaceted issue. It will carry out comprehensive end-to-end demonstrations leveraging pilot 5G networks and telemedicine facilities, collaborating closely with major industry participants to showcase the capabilities and potential of this innovative technology. This collaborative effort is essential to pushing the boundaries of what is possible in smart medical instruments and industrial applications [1].Full article