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The messenger RNA (mRNA) platform emerged at the forefront of vaccine development during the COVID-19 pandemic, with two mRNA COVID-19 vaccines being among the first authorized globally. These vaccines were developed rapidly. Informed by decades of laboratory research, and proved to be safe and efficacious tools for mitigating the global impact of the COVID-19 pandemic. The mRNA platform holds promise for a broader medical application beyond COVID-19. Herein, we provide an overview of this platform and describe lessons learned from the COVID-19 pandemic to help formulate strategies toward enhancing uptake of future mRNA-based interventions. We identify several strategies as vital for acceptance of an expanding array of mRNA-based vaccines and therapeutics, including education, accurate and transparent information sharing, targeted engagement campaigns, continued investment in vaccine safety surveillance, inclusion of diverse participant pools in clinical trials, and addressing deep-rooted inequalities in access to healthcare. We present findings from the Global Listening Project (GLP) initiative, which draws on quantitative and qualitative approaches to capture perceptions and experiences during the COVID-19 pandemic to help design concrete action plans for improving societal preparedness for future emergencies. The GLP survey (>70,000 respondents in 70 countries) revealed tremendous disparities across countries and sociodemographic groups regarding willingness to accept novel mRNA vaccines and medicines. The comfort in innovations in mRNA medicines was generally low (35%) and was marginally lower among women (33%). The GLP survey and lessons learnt from the COVID-19 pandemic provide actionable insights into designing effective strategies to enhance uptake of future mRNA-based medicines.

Background: No head-to-head studies are currently available comparing pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) with 13-valent pneumococcal conjugate vaccine (PCV-13). This study explored the feasibility of using network meta-analysis (NMA) to conduct an indirect comparison of the relative efficacy or effectiveness of the two vaccines. Methods: A systematic literature search was conducted for published randomized controlled trials (RCTs) and non-RCT studies reporting data on vaccine efficacy or effectiveness against invasive pneumococcal disease in children aged

Objective: The current study was designed to explore the relationship of TIMI and SYNTAX risk score to predict the CAD extent and severity in STEMI patients. Methods: For this cross-sectional study, 304 STEMI patients undergoing PPCI were enrolled at Department of Interventional Cardiology NICVD Karachi from September 2021 to January 2022. and the TIMI risk score was determined at enrolment. Based on these scorings, the patients were grouped as low, intermediate, and high risk, i.e., a score of ≤ 3, 4 to 7, and ≥ 8, respectively. The SYNTAX scores were utilized to assess the extent of CAD. Results: Statistically significant difference was found in symptoms to balloon time (p=0.001), history of diabetes (p=0.006), angina (p=0.011), obesity (p=0.048), STEMI type (p=0.003), Killip classes (p=0.000), Infarct-Related Artery (p=0.006), number of diseased vessels (p<0.01), LMS > 50% (p=0.000), PCI type (p<0.01), collateral circulation (p<0.01), In-hospital mortality (p<0.01), LV support (p<0.01), and post-procedural TIMI flow (p=0.013), among the three TIMI risk groups. Significant correlation was found among TIMI risk score and SYNTAX score. Conclusion: It is observed that the TIMI risk scores are highly correlated with the SYNTAX Score in predicting the CAD severity in STEMI patients. [ABSTRACT FROM AUTHOR]

Abstract Cryptococcal meningoencephalitis can occur in both previously healthy and immunocompromised hosts. Here, we describe a 55 year-old HIV-negative male with no known prior medical problems, who presented with three months of worsening headaches, confusion, and memory changes without fever. Magnetic resonance imaging of the brain demonstrated bilateral enlargement/enhancement of the choroid plexi, with hydrocephalus, temporal and occipital horn entrapments, as well as marked periventricular transependymal cerebrospinal fluid (CSF) seepage. CSF analysis yielded a lymphocytic pleocytosis and cryptococcal antigen titer of 1:160 but sterile fungal cultures. Despite standard antifungal therapy and CSF drainage, the patient had worsening confusion and persistently elevated intracranial pressures. External ventricular drainage led to improved mental status but only with valve settings at negative values. Ventriculoperitoneal shunt placement could thus not be considered due to a requirement for drainage into the positive pressure venous system. Due to this persistent CSF inflammation and cerebral circulation obstruction, the patient required transfer to the National Institute of Health. He was treated for cryptococcal post-infectious inflammatory response syndrome with pulse-taper corticosteroid therapy, with resultant reductions in CSF pressures along with decreased protein and obstructive material, allowing successful shunt placement. After tapering of corticosteroids, the patient recovered without sequelae. This case highlights (1) the necessity to consider cryptococcal meningitis as a rare cause of neurological deterioration in the absence of fever even in apparently immunocompetent individuals and (2) the potential for obstructive phenomena from inflammatory sequelae and the prompt response to corticosteroid therapy.

Genotype, environment and their interactions are important determinant of crop phenotypes. In present study, oat genotypes including advanced lines (candidate varieties), approved cultivars, obsolete cultivars and germplasm accessions were evaluated at three sites under terminal phase heat stress to study the response of heat resistant elite advanced oat lines. Genotype + Genotype × Environment was used to select better genotype across three experimental sites. Advanced lines such as "Sgd-1", "Sgd-oat-2011" and "Fsd-oat" were selected for better yield under the terminal heat stress which had better green fodder yield (GFY) and also showed stable performance when compared at three locations. These advanced lines provided a yield advantage of 10% when compared with standard checks under heat stress. Among the yield components, plant height (PH) had positive association with GFY at all locations and this trait may be prioritized for the selection of high yielding genotypes. "S-2000" showed better performance for leaf area, "Sgd-oat-2011" and "CK-1" had been stable for tiller number and "Fsd-Oat" showed stable performance for stem thickness at all three locations. The results showed that candidate variety "Sgd-1" found to be superior cultivar for general cultivation due to its higher GFY, tiller number and PH. Moreover, Sgd-1 was heat tolerant cultivar and can be recommended for general cultivation subjected to terminal phase heat stress. [ABSTRACT FROM AUTHOR]

Abstract Background The COVID-19 pandemic has led to disruptions in elective and outpatient procedures. Guidance from the Centers for Medicare and Medicaid Services provided a framework for gradual reopening of outpatient clinical operations. As the infrastructure to restart endoscopy has been more clearly described, patient concerns regarding viral transmission during the procedure have been identified. Moreover, the efficacy of the measures in preventing transmission have not been clearly delineated. Methods We identified patients with pandemic-related procedure cancellations from 3/16/2020 to 4/20/2020. Patients were stratified into tier groups (1–4) by urgency. Procedures were performed using our hospital risk mitigation strategies to minimize transmission risk. Patients who subsequently developed symptoms or tested for COVID-19 were recorded. Results Among patients requiring emergent procedures, 57.14% could be scheduled at their originally intended interval. COVID-19 concerns represented the most common rescheduling barrier. No patients who underwent post-procedure testing were positive for COVID-19. No cases of endoscopy staff transmission were identified. Conclusions Non-COVID-19 related patient care during the pandemic is a challenging process that evolved with the spread of infection, requiring dynamic monitoring and protocol optimization. We describe our successful model for reopening endoscopy suites using a tier-based system for safe reintroduction of elective procedures while minimizing transmission to patients and staff. Important barriers included financial and transmission concerns that need to be addressed to enable the return to pre-pandemic utilization of elective endoscopic procedures.

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Sewage water is causing a potential threat to agriculture sector due to industrial effluents having heavy metals. Present investigation was carried to study the role of ethylenediaminetetraacetic acid (EDTA) or aqueous extracts of Hyacinth and Hedychium on soil quality and growth of spinach and turnip plants irrigated with sewage water (SW). Treatment of plants with SW resulted in an increment of catalase (CAT), peroxidase (POD) and polyphenol oxidase (PPO) activities. However, EDTA or plant extracts further enhanced their activities. At both stages of development of the tested crops, a substantial increase was found in the content of proline and total phenols, indicating the strengthening of the antioxidant protection mechanism to boost the oxidative effects of SW stress. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) studies revealed considerable variation in the protein profile among the different treatments, with an expression of some unique proteins obvious with other treatments. SW treatments increased heavy metals (HM) content in soil and plants; however, EDTA or plant extracts greatly decreased the levels of HMs in both shoots and roots and soils. The present study results suggest that the application of EDTA or aqueous plant extracts can be a useful strategy for phytoextraction in areas irrigated with sewage water.

Seizures after liver transplantation were previously thought to be a reliable harbinger of catastrophe, but more recent studies have found seizure activity to be relatively common, and most cases do not result in a poor outcome. Generalized seizures are the most common, and they typically occur de novo within the first two weeks after transplantation. The underlying cause for seizure activity in these patients may be complex, with potential etiologies including metabolic, infectious, cerebrovascular, and medication-induced causes. Identification of the underlying cause and the use of antiepileptic drugs (AEDs) is crucial for minimizing risk to the patient’s neurologic and overall health. In this report, we present the case of a patient with refractory seizures unresponsive to conventional treatment, requiring prolonged barbiturate burst suppression with ventilator support. Seizure activity eventually ceased, and the patient made a full recovery.

Fresh forages are the cheapest source of animal feed in world. Small grain cereals (SGC) are the most commonly used fresh forages or ensiled forage. Clovers are the perennial legumes that offer quality forage but their initial dry matter (DM) yield is low. Usually, SGC and clover are sown in mixtures to draw benefits from greater Cut-1 DM yield of cereals and biological nitrogen (N) fixation of clovers. However, mixtures are difficult to manage, compared to monoculture owing to differences in their growth pattern, temporal, spatial and physical requirements. In this review, SGC-clover mixtures are analyzed for their potential herbage DM yield and quality of the produce. Effect of various management factors on the productivity of forage mixtures are well documented. Decisions in managing mixtures, like choice of cereal and cutting time and how they affect the value of the final produce is reviewed. Besides decision, effect of relative proportion and spatial arrangement of intercrops is also deliberated. Special attention is paid to the competition between SGC and clovers and its impact on clover suppression in mixture. At the end conclusions are drawn to optimize production from mixtures. [ABSTRACT FROM AUTHOR]

Water scarcity and land degradation are emerging threats to global food production. The dry land regions of world are affected by climate change to a greater extent and facing food insecurity. The current pattern of food production has been estimated to be inadequate to meet demands of growing population and required around 38% increase to meet world`s food demands by 2025. Food insecurity in erosion hit dry land regions of Pakistan also demands development of resource-efficient cropping systems to meet the food needs of population growing. The research studies involved different cropping patterns such as fallow-wheat, mungbeanwheat, sorghum-wheat, fallow-lentil, mungbean-lentil, sorghum-lentil, fallowbarley, mungbean-barley and sorghumbarley. The organic amendments involved farmyard manure, NPK, poultry manure, compost and inoculation by phosphorus solubilizing microbes. The effect of cropping systems and soil amendments were evaluated at field scale in terms of water use efficiency measured in terms of economic terms. The results of the studies revealed that double cropping (mungbean-lentil and mungbean-barley) was feasible option in the dryland regions of Pakistan if integrated with the use of poultry manure as alternate environmental-friendly strategy to cut down the use of mineral fertilizers and eliminate summer fallowing. [ABSTRACT FROM AUTHOR]

Salinity causes decrease in maize growth and production. Maize occupies an important position in fodder and food crops of Pakistan. Recently, maize has been designated as silicon (Si) accumulator which can alleviate the salinity damage, a major constraint to agricultural crop production. With the objective to combat salinity stress in maize by Si applications using silicic acid Si(OH)4, an experiments was conducted on two contrasting maize genotypes (salt sensitive; Pak-Afgoee and salt tolerant; Ev-5098), under normal and saline conditions. Three different levels of Si (0, 1 and 3 mM) were optimized for salinity tolerance on the basis of plant morphological characters especially dry weight in hydroponics. These Si-level was further used to investigate its effect on maize in hydroponic (0 mM NaCl) and saline (100 mM NaCl). The evaluation was done on the basis of various morphological, physiological, biochemical and growth traits during the experiments. Silicon supplementation into the solution culture significantly improved the K+: Na+ with reduced Na+ and increased K+ uptake. Plant water relations with higher water potential, increase in chlorophyll fractions and its ratios, enhanced stomatal conductance. It was concluded that Ev-5098 is better than Pak-Afgoee under salt stress and silicon inclusion into the any growth medium is beneficial for maize and can improve crop growth by maintaining plant water status, better K+: Na+ and recovering the plant defense system adversely influenced by salt stress. [ABSTRACT FROM AUTHOR]