Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on post-anesthetic shivering in adult patients undergoing surgery under general or neuraxial anesthesia.Methods:PubMed, Web of Science, Embase, the Cochrane Library, and China National Knowledge Infrastructure databases were searched for randomized controlled trials (RCTs) comparing TEAS with placebo and reporting on shivering. The primary outcome was the incidence of post-anesthetic shivering. Secondary outcomes included the incidence of postoperative nausea (PON), postoperative vomiting (POV), and postoperative nausea and vomiting (PONV). Trial sequential analysis (TSA) was also carried out to test the robustness of our results.Results:This meta-analysis included a total of 10 RCTs comparing TEAS to placebo with 445 and 444 patients, respectively. TEAS reduced the incidence of post-anesthetic shivering from 25% to 10% [risk ratio (RR) 0.41; 95% confidence interval (95% CI) 0.30–0.55; P < 0.05; I2 = 0%] in comparison with placebo, without significant publication bias. Besides, the incidence of PON (RR = 0.37, 95% CI = 0.19–0.74; P < 0.05), POV (RR = 0.15, 95% CI = 0.06–0.38; P < 0.05), and PONV (RR = 0.24, 95% CI = 0.15–0.38; P < 0.05) was lower in the TEAS groups versus placebo. In addition, TSA indicated that there was enough evidence for these outcomes and further studies are unlikely to alter the conclusions regarding the incidence of post-anesthetic shivering and PONV.Conclusion:This meta-analysis suggested that TEAS can effectively reduce the incidence of post-anesthetic shivering and PONV, and further studies are unlikely to alter the conclusions.

Mpox, a zoonotic Orthopoxvirus infection, was historically endemic to West and Central Africa. In 2022, it sparked a significant global outbreak, raising concerns about its spread beyond traditional regions. Notably, the emergence of Clade IIb and Ib strains has alarmed the global health community due to their increased transmission among humans. This paper examines mpox viruses and their general characteristics, their evolution, and the emergence of novel clades with unique features. Clade IIb stands out for its unique genetic mutations, which may enhance its transmissibility. Clinically, infections often present with fewer anogenital lesions and milder symptoms, which can complicate diagnosis. PCR testing remains the most reliable diagnostic tool, although emerging point-of-care tests show promise. Treatments such as tecovirimat and immune-based therapies (e.g., VIGIV) have demonstrated success, despite limitations. The MVA vaccine provides partial protection, although its efficacy against Clade IIb requires further validation. The emergence of Clades IIb and Ib, with distinct transmission dynamics, especially among specific population groups, underscores the need for targeted public health responses. This review highlights critical surveillance challenges in endemic African regions, where underreporting and limited diagnostic infrastructure hinder early detection. By analyzing the evolution and spread of newer clades, this review provides unique insights into mpox’s shifting epidemiology and outlines implications for global preparedness, including the urgent need for strengthened surveillance systems, equitable access to vaccines, and coordinated international efforts focusing on research and preparedness to help mitigate future risks.

Background:Ewing sarcoma (ES) is a neoplasm of neuroectodermal origin arising from bone or soft tissue. The annual incidence of ES is 2.93 per 1, 000, 000. Acute myeloid leukemia (AML) is one of the most described second malignancies as a complication of primary cancer therapy. There is a lack of recent studies elaborating on the incidence rates of such complications. So, the aim was to quantify the risk of developing AML as a second primary malignancy (SPM) in ES patients and to provide an updated evidence to the literature.Methods:We extracted the data from the Surveillance, Epidemiology and End Results (SEER) program statistical analysis software package (SEER*Stat, version 8.4.1.2). We used an MP-SIR session to identify patients diagnosed with AML as an SPM after ES as a first primary malignancy between 2000 and 2020. We assessed the SIR as Observed/Expected(O/E) and Excess Absolute Risk (EAR) per 10, 000 with a 95% confidence interval (CI) and statistical significance at 0.05.Results:A total of 2631 patients with ES were recorded in the SEER database, with a median follow-up of 120 + months. Patients with ES had an increased risk of developing AML with an O/E of 145.98 (P < 0.05, EAR = 21.79). Gender played a role in AL development; both males (O/E = 52.94, P < 0.05, 95% CI: 31.87–82.670) and females (O/E = 105.62, P < 0.05) had a high risk of AL SPM. About 35 patients developed acute non-lymphocytic leukemia with an O/E 130.92 (P < 0.05, 95% CI: 91.19−182.08, EAR 21.77). There was a significantly increased risk of developing SPMs in different sites among ES patients (O/E = 5.85, P < 0.05)Conclusion:Patients treated for a primary ES have a significant risk of developing AML, among other second primary malignancies. Thus, we recommend screening for AML from 2 to 11 months after the diagnosis of ES for early detection and better management outcomes.

Engineered food-borne probiotics represent an emerging food-oncomicrobiology strategy that unites synthetic biology, nutrition, and cancer immunotherapy. Preclinical models demonstrate potent antitumor effects: Lactococcus lactis secreting soluble CD80-reduced tumor growth by 64%; Escherichia coli Nissle 1917 producing PD-L1 nanobodies achieved complete regression in 50% of treated mice with a two-fold rise in CD8⁺IFNγ⁺TNFα⁺ T-cell infiltration; and Lactobacillus plantarum delivering IL-2 enhanced NK-cell activity 2.5-fold and extended survival by 30%. Clinical meta-analyses reveal that gut-microbiome diversity increases checkpoint-inhibitor response by 40% and median progression-free survival by 12 months. A phase I trial in Non-Small Cell Lung Cancer (NSCLC) showed reduced immune-related colitis (from 14% to 6%) and higher response rates (36% vs 21%) with probiotic co-therapy. Remaining challenges in colonization and biosafety, together with advances in controllable genetic circuits, make edible biologics a promising, low-toxicity immunotherapeutic platform.

Implantable biosensors are emerging as transformative tools for real-time sepsis surveillance in postoperative patients. By continuously monitoring key inflammatory biomarkers such as cytokines and endotoxins, these systems can enable earlier diagnosis and intervention than traditional intermittent testing. Technological advances such as active-reset DNA-aptamer biosensors for cytokine tracking and electrochemical lipopolysaccharide sensors achieving attogram-level sensitivity illustrate rapid progress in the field. Research across the United States, Europe, and Asia highlights the growing global commitment to integrating biosensors into perioperative monitoring. Their application across surgical specialties may fundamentally shift postoperative care from reactive to predictive management, reducing sepsis-related morbidity and mortality. Ongoing research into wireless communication, long-term biocompatibility, and multiplexed sensing will be pivotal to clinical translation and adoption in both high- and low-resource healthcare systems.