Search Results (29)

Background: Chemotherapy-induced nausea and vomiting (CINV) is a common treatment-related side effect that has a detrimental effect on the quality of life of patients with cancer and may lead to dose reductions or discontinuation of chemotherapy. This meta-analysis aims to explore the efficacy and safety of olanzapine plus triple antiemetic therapy for prevention of delayed-phase platinum-based CINV. Methods: Electronic databases (five English databases: (I) PubMed, (II) ScienceDirect, (III) The Cochrane Library, (IV) Scopus, and (V) EMBASE, and two Chinese databases: China National Knowledge Infrastructure and Wanfang Database) were searched for trials that evaluated the effectiveness and safety of olanzapine plus triple antiemetic in preventing platinum-based CINV. Efficacy was no nausea, complete control, and complete response (CR) rates in the acute, delayed, and overall phases after chemotherapy. Data were analyzed using the random effects model and fixed effects model. Results: A total of 18 trials involving 3110 patients were identified, including 9 controlled trials and 9 single-arm trials. The meta-analysis of nine studies, which showed significant heterogeneity (p = 0.002, I² = 67%), demonstrated that the olanzapine (OLN) group had a significantly higher rate of delayed CR compared to the control group (OR: 2.33, 95% CI: 1.57–3.46, p < 0.00001). Compared with the Without OLN group, the With OLN group had a significant overall CR (OR: 2.18, 95% CI: 1.80–2.63, p < 0.00001, heterogeneity: p < 0.00001, I² = 69%), and a significant acute CR (OR: 2.28, 95% CI: 1.45–3.58, p < 0.00001, heterogeneity: p = 0.04, I² = 51%). The meta-analysis revealed that the With OLN group could significantly increase the risk of dry mouth compared to the Without OLN group (OR  =  2.60, 95% CI: 1.73–3.91). In terms of insomnia, the odds ratio for the With OLN group was significantly lower than that for the Without OLN group (OR = 0.60; 95% CI 0.41–0.89). Conclusions: The results of this meta-analysis provide robust evidence that adding olanzapine to standard triple therapy significantly improves the prevention of platinum-based delayed-phase CINV, a setting where current antiemetic regimens often prove suboptimal. However, it also increases the risk of certain adverse events, especially dry mouth. Clinical decisions should be made based on a thorough assessment of the therapeutic benefits and safety risks. Full article

Automatic radiology report generation (ARRG) has emerged as a promising application of deep learning (DL) with the potential to alleviate reporting workload and improve diagnostic consistency. However, despite rapid methodological advances, the field remains technically fragmented and not yet mature for routine clinical adoption. This scoping review maps the current ARRG research landscape by examining DL architectures, multimodal integration strategies, and evaluation practices from 2015 to April 2025. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, a comprehensive literature search identified 89 eligible studies, revealing a marked predominance of chest radiography datasets (87.6%), primarily driven by their public availability and the accelerated development of automated tools during the COVID-19 pandemic. Most models employed hybrid architectures (73%), particularly CNN–Transformer pairings, reflecting a shift toward systems that combine local feature extraction with global contextual reasoning. Although these approaches have achieved measurable gains in textual and semantic coherence, several challenges persist, including limited anatomical diversity, weak alignment with radiological rationale, and evaluation metrics that insufficiently reflect diagnostic adequacy or clinical impact. Overall, the findings indicate a rapidly evolving but clinically immature field, underscoring the need for validation frameworks that more closely reflect radiological practice and support future deployment in real-world settings. Full article

As a typical sucrose-accumulating fruit, longan commonly experiences sugar receding during on-tree preservation, leading to quality deterioration. To investigate the mechanism of sucrose degradation in longan fruit, we conducted genome-wide identification and analysis of key genes involved in sucrose synthesis and catabolism based on the ‘Shixia’ (SX) genome. The results revealed that longan contained 8 sucrose synthases (SUSs), 4 sucrose phosphate synthases (SPSs), and 26 invertases (INVs). Notably, members of the longan SUS, SPS, and cell wall invertase (CWINV) families all contained the motif 10 sequence, while cytoplasmic invertase (CINV) members exhibited diverse motif combinations. Similarity analysis revealed that sequence similarity was reliable only when the sequence lengths of the compared genes were comparable. Cis-acting elements and miRNA prediction showed that these genes were enriched in MYB elements and regulated by miR156/827/171. Additionally, the expansion of SUS, SPS, and INV genes was driven by segmental duplication events under purifying selection. Furthermore, the ‘Chuliang’ (CL) cultivar exhibited slower on-tree sucrose degradation than SX, with sucrose accounting for 72.2% of total sugars at maturity, which is 33.4% higher than SX. Enzyme activity assay during the sucrose decline stage revealed that SUS, SPS, and INV activities were generally higher in SX pulp than in CL. Furthermore, correlation analysis showed that the activities of AINV and A/N-INV were both significantly negatively correlated with TSS and sucrose content, respectively. Additionally, the expression of DlCWINV10 exhibited a negative correlation with TSS (p < 0.05) and sucrose content (r = −0.6, p = 0.07), suggesting that DlCWINV10 may play an important role in the sucrose degradation process. In summary, this study elucidates the characteristics of SUS, SPS, and INV gene families in longan and their potential roles in sucrose metabolism, providing a theoretical foundation for understanding the on-tree sucrose degradation mechanism. Full article

Background: Nausea and vomiting frequently occur during postoperative recovery, chemotherapy, and pregnancy. While peppermint oil is traditionally used to relieve these symptoms, its efficacy remains uncertain. This systematic review and meta-analysis evaluates the efficacy of peppermint oil inhalation for postoperative (PONV), chemotherapy-induced (CINV), and pregnancy-related nausea and vomiting (NVP). Methods: Following PRISMA guidelines, we searched five databases (Scopus, Embase, the Cochrane Central Register of Controlled Trials, MEDLINE, and Web of Science) in November 2022, with an update in December 2024. Randomised controlled trials were included, comparing peppermint oil inhalation to a control in patients with PONV, CINV, and NVP. Separate meta-analyses were conducted for each patient group using R, focusing on the severity of the nausea and vomiting. Results: Nineteen RCTs were included. In three PONV studies, peppermint oil inhalation was associated with a reduction in nausea 2 to 6 h after the intervention (MD: −0.60 points, 95% confidence interval (CI): −0.77 to −0.44, p = 0.004). In three NVP studies, daily peppermint oil treatment was linked to lower symptom severity at 48 h (MD: −0.51, 95% CI: −0.78 to −0.24, p = 0.015) and 96 h (MD: −0.68, 95% CI: −1.09 to −0.27, p = 0.019). In three CINV studies, peppermint oil inhalation appeared to reduce symptoms at all time points, with the most notable reduction at 48 h (MD: −2.23, 95% CI: −3.13 to −1.34, p < 0.001) and 72 h (MD: −2.41, 95% CI: −3.96 to −0.86, p = 0.010). Conclusions: Peppermint oil inhalation may be a promising complementary therapy for reducing nausea and vomiting in postoperative, chemotherapy, and pregnancy settings. Full article

The area postrema (AP) is a circumventricular organ (CVO) at the base of the fourth ventricle. It has a crucial role in regulating nausea and vomiting due to its unique blood–brain barrier (BBB)-permeability and extensive neural connectivity. Here, we present two cases of area postrema syndrome (APS), a rare condition of intractable nausea and vomiting resulting from direct AP injury. Our cases each occurred in the context of infratentorial neoplasms or their treatment. Using these cases as a framework, we review the literature on central emetic pathways and propose a treatment algorithm for managing refractory nausea and vomiting of central origin. We also highlight other targets beyond conventional serotonergic, dopaminergic, or histaminergic blockade and their roles in central hyperemesis. Our literature review suggests that APS is due to the disruption of the baseline inhibitory tone of outgoing AP signals. When other options fail, our algorithm culminates in the off-label use of combined serotonergic and neurokinin-1 blockade, which is otherwise used to manage chemotherapy-induced nausea and vomiting (CINV). We believe multimodal CNS receptor blockade is efficacious in APS because it addresses the underlying central neural dysregulation, rather than solely targeting peripheral emetic triggers. Full article

The management of chemotherapy-induced nausea and vomiting (CINV) in children remains challenging due to differences in the chemotherapy regimens, their relative emetogenicity compared to that in adults and differences in drug metabolism and the available formulations. The common four classes of anti-emetics used for the treatment and prophylaxis of CINV in children include dexamethasone, neurokinin-1 receptor antagonists, 5-hydroxytryptamine-3 receptor antagonists (5HT3RAs), and olanzapine. The appropriate dose of dexamethasone for CINV prophylaxis in children is unknown, with a significant variability in dosage ranging between 6 and 32 mg/m²/day. The dose of dexamethasone is decreased by 30% when this drug is combined with (fos)aprepitant in children, in contrast to a decrease of 50% required in adults. The use of aprepitant in younger children (<12 years) is often hampered by the non-availability of oral suspension formulations in many countries; alternatively, 80 mg capsules are administered for 1–3 days in certain institutes to children weighing between 15 and 40 kg. Among the different 5HT3RAs, palonosetron is comparatively metabolized faster in children than in adults, requiring a higher dosage for similar efficacy to that achieved in adults. Olanzapine is a newer agent, used in doses between 0.1 and 0.14 mg/kg/day in children, with good anti-emetic efficacy, but has sedation and hyperglycemia as concerning adverse effects. Drug interactions between anti-emetics and between anti-emetics and chemotherapy/supportive agents (azole antifungals, cyclosporine, arsenic trioxide), especially QTc prolongation, should be considered during prescription. Full article

Auricular acupuncture (AA) has been used to manage chemotherapy-induced nausea and vomiting (CINV). However, the application of the technique varies widely among the clinical trials that test its effectiveness. The aim of the present study was to develop and clinically validate an AA protocol for the management of CINV in cancer patients. This study was carried out in two stages: (1) development of the AA protocol for the management of CINV and (2) clinical validation of the protocol. The content validity of the protocol was determined by a panel of specialists, with an agreement rate ranging from 85.7% to 100%. In the clinical validation, when administered to cancer patients, the protocol developed has been shown to reduce the incidence, frequency, severity, and length of nausea and vomiting following chemotherapy, as well as the severity of nausea and anticipatory nausea following chemotherapy. This protocol needs to be tested in future studies, including a pilot study with a sham group and a randomized clinical trial, in order to further evaluate its feasibility, acceptability, safety, and clinical usefulness for the management of CINV. Full article

Sugarcane (Saccharum spp. hybrid) is the chief source of sugar and biofuel globally and is prominent among cash crops. Sucrose is the main required product in sugarcane, and many studies have been performed to understand the phenomena of sucrose synthesis, metabolism, and accumulation in sugarcane. However, none of the studies concluded that a single gene is responsible for the sucrose content. Instead, a complex mechanism consisting of several genes, such as sucrose phosphate synthase genes (SPS1, SPS2, SPS4, SPS5), sucrose synthase genes (SuSy1, SuSy2, SuSy4), invertase genes (INV, CWIN, NIN1, CINV2), and phytohormone, trehalose, transcription factor (TF), protein kinase, and sugar transporter genes are working spatiotemporally in sugarcane. Currently, omics approaches like transcriptomics, proteomics, and metabolomics are also being used to explore the sugar metabolism in sugarcane, but integrated transcriptomic, proteomic, and metabolomic studies have been less reported. The results obtained from the integrated analysis of transcriptomics, proteomics, and metabolomics are more reliable because the strong gene expression, received in the form of abundant mRNA, does not guarantee the plentiful existence of associated proteins or their particular activity in the target cells or tissues, which discloses the restraint of single interpretation and stresses the significance of the integrated analysis of transcriptomics, proteomics, and metabolomics. This review highlights different genes and molecules contributing to sugar metabolism at different stages and the significance of omics approaches in explaining sucrose metabolism, especially sucrose accumulation in sugarcane. It is also a vital source of knowledge for sugarcane breeders, particularly associated with sucrose content improvement and bioethanol energy production. Full article

Background: In addition to pharmacological prevention, chemotherapy-induced nausea and vomiting (CINV) can be mitigated through patient education; written supporting materials can be beneficial. Methods: This is a randomized, controlled trial which randomly assigned patients undergoing first chemotherapy cycle to receive oral information regarding CINV prevention and management (control arm) or oral information plus an informative booklet (experimental arm). Overall, 384 cancer patients fulfilling the following inclusion criteria were enrolled: age ≥18 years; life expectancy ≥6 months; no cognitive impairment; written informed consent. After the first cycle, CINV occurrence and its impact on daily activities were assessed using the Functional Living Index Emesis (FLIE). Results: Severe nausea was self-reported by 3.0% and 10.8% of patients in the experimental and control group, respectively (difference: 7.8%; 95% confidence interval: 2.3% to 13.1%). Moderate/high impact of nausea on daily activities was lower in patients also receiving the booklet than in the control group (4.2% and 10.1%, respectively; difference: 5.9%; 95% confidence interval: 0.3% to 11.5%). Vomiting was not statistically different between study arms. Conclusions: This integrated nursing approach was effective in aiding cancer patients in CINV self-management. Although the beneficial effect was moderate, this intervention demands minimal resources in terms of costs and time. Full article

Epilepsy is a chronic condition characterized by recurrent spontaneous seizures. The interaction between astrocytes and neurons has been suggested to play a role in the abnormal neuronal activity observed in epilepsy. However, the exact way astrocytes influence neuronal activity in the epileptogenic brain remains unclear. Here, using the PTZ-induced kindling mouse model, we evaluated the interaction between astrocyte and synaptic function by measuring astrocytic Ca²⁺ activity, neuronal excitability, and the excitatory/inhibitory balance in the hippocampus. Compared to control mice, hippocampal slices from PTZ-kindled mice displayed an increase in glial fibrillary acidic protein (GFAP) levels and an abnormal pattern of intracellular Ca²⁺-oscillations, characterized by an increased frequency of prolonged spontaneous transients. PTZ-kindled hippocampal slices also showed an increase in the E/I ratio towards excitation, likely resulting from an augmented release probability of excitatory inputs without affecting inhibitory synapses. Notably, the alterations in the release probability seen in PTZ-kindled slices can be recovered by reducing astrocyte hyperactivity with the reversible toxin fluorocitrate. This suggests that astroglial hyper-reactivity enhances excitatory synaptic transmission, thereby impacting the E/I balance in the hippocampus. Altogether, our findings support the notion that abnormal astrocyte–neuron interactions are pivotal mechanisms in epileptogenesis. Full article

Strawberry anthracnose is a serious disease, and fungicides are currently widely used by farmers. Thus, biological control is a good alternative. This study aims to identify the species of endophytic Streptomyces CINv1 that was previously isolated from Cinnamomum verum J. Presl. and to evaluate its properties as a biocontrol agent, plant growth promoter, and plant colonizing endophyte. This strain was identified by analysis of its 16S rRNA gene sequences, and the result shows 100% similarity to Streptomyces albus CINv1. The CINv1 strain displayed high resistance (81.83%) against Colletotrichum sp. isolate CA0110, as tested by the dual culture technique. Additionally, inhibited pathogen growth on IMA-2 agar was observed under a compound microscope. The results demonstrated swelling, bulbousness, and cytoplasmic aggregation of abnormal hyphal, which were confirmed by SEM as well. Furthermore, the functional media used to evaluate plant growth-promoting properties, including nitrogen fixation, phosphate solubilization, and siderophore production, yielded positive results. Analyses of plant hormones by HPLC found their ability to produce indole-3-acetic acid (IAA). Thus, a biological control trial in greenhouse conditions was conducted by spraying a spore suspension of the strain onto strawberry seedlings once a week, which showed a significant reduction in disease severity. After the seventh spraying, the assessment of the number of leaves and canopy height of the seedling showed significant promotion. In addition, the CINv1 strain established a mutualistic interaction with the plant cells through colonization inter-and intracellularly in strawberry roots, leaves, and petioles. Moreover, using LC-MS/MS to analyze the secondary metabolites of this strain, various groups of compounds were found that could potentially benefit pharmaceutical and agricultural uses. Full article

Diabetic retinopathy causes progressive and irreversible damage to the retina through activation of inflammatory processes, overproduction of oxidative species, and glial reactivity, leading to changes in neuronal function and finally ischemia, edema, and hemorrhages. Current treatments are invasive and mostly applied at advanced stages, stressing the need for alternatives. To this end, we tested two unconventional and potentially complementary non-invasive treatment options: Photobiomodulation, the stimulation with near-infrared light, has shown promising results in ameliorating retinal pathologies and insults in several studies but remains controversial. Boldine, on the other hand, is a potent natural antioxidant and potentially useful to prevent free radical-induced oxidative stress. To establish a baseline, we first evaluated the effects of diabetic conditions on the retina with immunofluorescence, histological, and ultrastructural analysis in two diabetes model systems, obese LepR^db/db mice and organotypic retinal explants, and then tested the potential benefits of photobiomodulation and boldine treatment in vitro on retinal explants subjected to high glucose concentrations, mimicking diabetic conditions. Our results suggest that the principal subcellular structures affected by these conditions were mitochondria in the inner segment of photoreceptors, which displayed morphological changes in both model systems. In retinal explants, lactate metabolism, assayed as an indicator of mitochondrial function, was altered, and decreased photoreceptor viability was observed, presumably as a consequence of increased oxidative-nitrosative stress. The latter was reduced by boldine treatment in vitro, while photobiomodulation improved mitochondrial metabolism but was insufficient to prevent retinal structural damage caused by high glucose. These results warrant further research into alternative and complementary treatment options for diabetic retinopathy. Full article

BK channels are large conductance potassium channels characterized by four pore-forming α subunits, often co-assembled with auxiliary β and γ subunits to regulate Ca²⁺ sensitivity, voltage dependence and gating properties. BK channels are abundantly expressed throughout the brain and in different compartments within a single neuron, including axons, synaptic terminals, dendritic arbors, and spines. Their activation produces a massive efflux of K⁺ ions that hyperpolarizes the cellular membrane. Together with their ability to detect changes in intracellular Ca²⁺ concentration, BK channels control neuronal excitability and synaptic communication through diverse mechanisms. Moreover, increasing evidence indicates that dysfunction of BK channel-mediated effects on neuronal excitability and synaptic function has been implicated in several neurological disorders, including epilepsy, fragile X syndrome, mental retardation, and autism, as well as in motor and cognitive behavior. Here, we discuss current evidence highlighting the physiological importance of this ubiquitous channel in regulating brain function and its role in the pathophysiology of different neurological disorders. Full article

Chemotherapy-induced nausea and vomiting (CINV) negatively impact cancer patients’ quality of life and treatment outcomes. This study evaluated the achievement of complete response to CINV prophylaxis during the first five days after chemotherapy in adult outpatient cancer clinics with solid malignant tumours receiving Moderate or Highly Emetogenic Chemotherapy (MEC or HEC) in Portugal. During the study, patients completed three evaluations, and nausea severity and CINV impact on patients’ daily life was assessed. A complete response (no emetic episodes, no use of rescue antiemetic medication, and no more than mild nausea) was observed in 72% of the cycles (N = 161) throughout the five days after chemotherapy. Amongst the patient population, 25% classified their CINV episodes as severe. Though more than half of the patients achieved a complete response, suggesting that a therapeutic effort is being made to minimise this side effect, the overall scenario is barely optimistic. Significantly, new CINV-control measures in MEC/HEC patients should be adopted, specifically avoiding the single use of dexamethasone and 5-HT3 and raising awareness of using NK1-RAs. Thus, it is critical to improve CINV prophylactic treatment and implement practical international antiemetic guidelines in Portuguese clinical practice, envisaging the improvement of supportive care for cancer patients. Full article

Nausea and vomiting are the most common side effects of chemotherapy. They must be managed because they can increase the risk of malnutrition in patients, which can adversely affect treatment. The objective of this study was to evaluate the effect of ginger supplementation as an adjuvant treatment for alleviating chemo We checked. therapy-induced nausea and vomiting (CINV). This study searched for randomized controlled trials (RCTs) related to ginger supplement intake for CINV in three electronic databases (i.e., Medline (PubMed), Embase, and Web of Science). The search period ranged from each database’s first date of service to 5 November 2021. Two investigators independently performed abstract screenings, full-text screenings, data extraction, and risk of bias analyses (ROB). The Cochrane ROB tool was used for the assessment of ROB. This study systematically reviewed 23 RCTs. The effects of ginger supplementation were compared to those of placebo or antiemetic agents. This study conducted a meta-analysis after classifying the effects of ginger supplementation on acute and delayed CINV into subgroups due to the clinical heterogeneity between these RCTs. The results showed that the incidence of acute nausea (p = 0.53), the incidence of delayed nausea (p = 0.31), the incidence of acute vomiting (p = 0.09), and the incidence of delayed vomiting (p = 0.89) were not significantly different between the ginger supplement intake group and the control group. However, it was found that the ginger supplement intake group, which took not more than 1 g of ginger supplementation per day for above four days, had significantly less acute vomiting than the control group (OR 0.30; 95% CI 0.12 to 0.79; p = 0.02; I2 = 36%). Ginger supplementation may reduce the incidence of acute chemotherapy-induced vomiting. However, this study could not confirm the effects of ginger supplementation on the incidence of chemotherapy-induced nausea and delayed vomiting. Therefore, it will be necessary to conduct additional studies with sufficient sample sizes using high-quality RCTs to evaluate the effects of ginger supplementations based on the results of this study. Full article