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A 9-year-old girl presented with a recent history of shortness of breath, fatigue, visual disturbances, and gastrointestinal symptoms. Echocardiography demonstrated three large intracardiac masses in the right and left atria protruding into the mitral and tricuspid valve orifices causing bilateral inflow obstruction. She underwent urgent surgical excision of the masses. Histology revealed rare intracardiac Burkitt's Lymphoma.

This paper analyses the impacts of the national Payment for Forest Environmental Services (PFES) policy in A Luoi district, Thua Thien Hue province, Viet Nam. There are mixed impacts of PFES in A Luoi district. While some surveyed households have experienced increases in income since PFES, for many other incomes have fallen. Our findings show PFES impacts on local communities and individuals are limited because most forest areas are managed by state agencies, leaving only 17.9% of PFES payments being channeled to these groups, while the rest goes to state government agencies and commune people’s committees. This disparity in PFES payments has further widened the income gap between state agencies and local households. PFES payments currently contribute little to household incomes, averaging only 2.64% of total earnings. PFES has little impact and additionality in advancing land tenure security and reducing natural forest product exploitation for generating income as impacts are similar to those found in non-PFES villages. PFES poverty reduction impacts vary from village to village, but in general, percentages of poor households receiving PFES payments range from 1% to 59%.

STUDY QUESTION Do ovarian hormone changes influence the levels of cell-free or circulating microRNA (cf-miRNA) across the menstrual cycle? SUMMARY ANSWER This exploratory study suggests that fluctuations in hormonal levels throughout the menstrual cycle may alter cf-miRNAs levels. WHAT IS KNOWN ALREADY cf-miRNA levels vary with numerous pathological and physiological conditions in both males and females and are regulated by exogenous and endogenous factors, including hormones. STUDY DESIGN, SIZE, DURATION A prospective, monocentric study was conducted between March and November 2021. Since this was a pilot study, the sample size was based on feasibility as well as previous similar human studies conducted in different tissues. A total of 20 participants were recruited for the study. PARTICIPANTS/MATERIALS, SETTING, METHODS We conducted an exploratory study where blood samples were collected from 16 eumenorrheic females in the early follicular phase, the ovulation phase and the mid-luteal phase of the menstrual cycle. The levels of oestrogen, progesterone, LH and FSH were measured in serum by electrochemiluminescence. The levels of 174 plasma-enriched miRNAs were profiled using a PCR-based panel, including stringent internal and external controls to account for the potential differences in RNA extraction and reverse-transcription stemming from low-RNA input samples. MAIN RESULTS AND THE ROLE OF CHANCE This exploratory study suggests that cf-miRNAs may play an active role in the regulation of the female cycle by mediating the expression of genes during fluctuating hormonal changes. Linear mixed-models, adjusted for the relevant variables, showed associations between phases of the menstrual cycle, ovarian hormones and plasma cf-miRNA levels. Validated gene targets of the cf-miRNAs varying with the menstrual cycle were enriched within female reproductive tissues and are primarily involved in cell proliferation and apoptosis. LARGE SCALE DATA All relevant data are available from the Mendeley database: LEGER, Bertrand (2022), ‘MiRNA and menstrual cycle’, Mendeley Data, V1, doi: 10.17632/2br3zp79m3.1. LIMITATIONS, REASONS FOR CAUTION Our study was conducted on a small participant cohort. However, it was tightly controlled for endogenous and exogenous confounders, which is critical to ensure robust and reproducible cf-miRNA research. Both adjusted and non-adjusted P-values are presented throughout the article. WIDER IMPLICATIONS OF THE FINDINGS Measures of ovarian hormones should be rigorously included in future studies assessing cf-miRNA levels in females and used as time-varying confounders. Our results reinforce the importance of accounting for female-specific biological processes in physiology research by implementing practical or statistical mitigation strategies during data collection and analysis. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Clinique romande de réadaptation, Sion, Switzerland. S.L. was supported by an Australian Research Council (ARC) Future Fellowship (FT10100278). D.H. was supported by an Executive Dean’s Postdoctoral Research Fellowship from Deakin University. The authors declare no competing interests.

We were synthesized CdSe nanocrystals (NC) at a temperature of 260 oC and controlling their growth kinetics follows different reaction times from 1 minute to 180 minutes. Base on their optical properties and estimated size to track their growth kinetics follow the Lamer model. Structure and morphology characterized were investigated by XRD pattern and transmission electron microscopy (TEM). All samples show cubic zinc blende type structures. The average NCs size can be calculated by absorption spectra, XRD and TEM, these results lie in close vicinity with each other. The energies of photoluminescence (PL) peaks and band gap of CdSe NCs can be tuned within the regions of 1.99 eV to 2.13 eV and 1.92 eV to 2.12 eV with increasing reaction time. The Stokes shifts and PL emission peaks are narrow, thus confirming the formation of uniformly distributed NCs.

Background Persistent left superior vena cava (LSVC) with connection to the left atrium (LA) is a rare anomaly with serious clinical implications. Depending on the direction of flow through the intracardiac shunt, clinical presentation varies from cyanosis or paradoxical embolism to overt right heart failure. Case summary A 26-year-old man with repaired ventricular septal defect (VSD) during infancy presented with symptoms of progressive exercise intolerance. Cardiac imaging revealed a large defect at the posterior wall of the LSVC above its entry to the coronary sinus (CS), connecting the LSVC with the LA and resulting in diversion of pulmonary venous return to the CS. All pulmonary veins connect normally to the LA. The large left-to-right intracardiac shunt led to significant right ventricular dilation and tricuspid regurgitation. He underwent successful anatomical repair with transcatheter implantation of covered stent from LSVC to the CS, redirecting pulmonary venous return to the LA. At 1 year follow up, his exercise capacity had improved, and cardiac imaging showed complete seal of the LSVC defect without obstruction to pulmonary venous return. Discussion Our case is the first to our knowledge to report this unusual anatomic variant of LSVC to LA connection, and complete repair by transcatheter treatment. Previous case reports of other forms of LSVC to LA connection were treated with surgery or device occlusion without reconnection of LSVC. This case highlights the efficacy and safety of innovative percutaneous techniques in the management of complex congenital heart lesions. Meticulous procedural planning through 3D modelling and simulation is vital to mitigate the risks of these innovative procedures.

Purpose To compare the prevalence of psychiatric comorbidity between patients with complex regional pain syndrome (CRPS) of the hand and non-CRPS patients and to assess the association between biopsychosocial (BPS) complexity profiles and psychiatric comorbidity in a comparative study. Patients and methods We included a total of 103 patients with CRPS of the hand and 290 patients with chronic hand impairments but without CRPS. Psychiatric comorbidities were diagnosed by a psychiatrist, and BPS complexity was measured by means of the INTERMED. The odds ratios (OR) of having psychiatric comorbidities according to BPS complexity were calculated with multiple logistic regression (adjusted for age, sex, and pain). Results Prevalence of psychiatric comorbidity was 29% in CRPS patients, which was not significantly higher than in non-CRPS patients (21%, relative risk=1.38, 95% CI: 0.95 to 2.01 p=0.10). The median total scores of the INTERMED were the same in both groups (23 points). INTERMED total scores (0-60 points) were related to an increased risk of having psychiatric comorbidity in CRPS patients (OR=1.46; 95% CI: 1.23-1.73) and in non-CRPS patients (OR=1.21; 95% CI: 1.13-1.30). The four INTERMED subscales (biological, psychological, social, and health care) were correlated with a higher risk of having psychiatric comorbidity in both groups. The differences in the OR of having psychiatric comorbidity in relation to INTERMED total and subscale scores were not statistically different between the two groups. Conclusion The total scores, as well as all four dimensions of BPS complexity measured by the INTERMED, were associated with psychiatric comorbidity, with comparable magnitudes of association between the CRPS and non-CRPS groups. The INTERMED was useful in screening for psychological vulnerability in the two groups.

Purposes Acetabular fractures are more and more common in the elderly. Open reduction and internal fixation (ORIF) may lead to poor outcomes and high revision rates. Primary total hip arthroplasty (THA) combined with internal fixation, also known as the combined hip procedure (CHP), associated with dual mobility cup (DM-CHP) could be an efficient procedure in selected elderly patients. The aim of this study is to compare functional and radiological outcomes between ORIF and DM-CHP. Methods Between 2007 and 2018, 51 patients older than 65 years were surgically treated for acetabular fractures. Twenty-six patients were treated by DM-CHP and 25 by ORIF. Each group was divided into two subgroups regarding a single or combined approach. Hospital stay, surgical time, intraoperative blood loss, and complications were documented. The Harris Hip Score (HHS) was used for measuring the functional outcome. Radiological analysis was used to assess the centre of rotation in the DM-CHP group. Results Median surgery time and intra-operative blood loss were higher in DM-CHP than those in ORIF. Early medical complication rate was higher for a combined approach as compared with a single posterior approach in DM-CHP (p = 0.003). Dislocation rate was 7.7% in DM-CHP. Revision rate was higher in ORIF (20% versus 7.7%). HHS was similar in both groups. Conclusions DM-CHP leads to similar functional outcomes and less revision than ORIF. This study strengthens the practice of using only the posterior approach for primary THA in the elderly. Dual mobility is a valid therapeutic option for acetabular fractures in elderly patients.

Cardiac MRI and CT are increasingly used in the diagnosis and management of patients with congenital heart disease as an imaging adjunct to echocardiography. The benefits and limitations of both modalities are highlighted, with a focus on the anatomical, functional and haemodynamic information that can be gained from the different modalities. Deciding on the imaging modality of choice must also take into account patient factors such as age, compliance, the type of congenital heart disease, and previous procedures. Future developments in CT and MRI are also discussed.

Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients.Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults.Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002].Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.

Background: To examinate the property of skin irritation of MECAMIX herbal cream on experimental rabbit, thenceforward, evaluating the test steps to commercialize research product for the community. Materials and method: MECAMIX herbal cream is manufactured and supplied by Vietnam Medical Sciences Application Company (VMSA). Laboratory research, cross-sectional and experimental design in controlled animals. Results: About skin irritation, the irritant point of Mecamix K < 0.07; qualified within the point limit of [0 - 0.5], corresponding to negligible skin irritation. Conclusion: MECAMIX herbal cream is perfectly satisfactory in terms of skin irritation standards as stipulated by the Ministry of Health in Decision 3113/1999 /QĐ-BYT dated on October 11th, 1999 of the Minister of Health. Key words: Mecamix, herbal cream, skin irritation

Two-dimensional covalent organic frameworks (2D-COFs) have been of increasing interest in the past decade due to their potentially ordered porous structures. One of the most common routes to these polymers relies on Schiff-base chemistry, i.e. the condensation reaction between a carbonyl and an amine. However, the judicious choice of these two building blocks is critical given that many COF forming reactions can lead to an inherent disorder if such a pathway is available. Examples of disorder in 2D-COFs due to both inherent growth mechanisms and reaction pathways will be given and their influence on ion sieving membranes will be discussed. A 2D-COF with negatively charged carboxylated pores, where disorder is minimized, has been shown to be highly charge and size selective for ion conductivity for a series of tetraalkyl ammonium cations. Progress on membranes for desalinization and small ion separations such as Li ion separation from brines using negatively charged, positively charged and zwitterion pores will also be presented.

Overlapping clinical features promoted the discussion of whether Kawasaki disease (KD) and PIMS-TS share pathophysiological features and disease outcomes. Medical records from English patients with KD (2015-02/20, N = 27) and PIMS-TS (02/2020-21, N = 34) were accessed to extract information. Children with PIMS-TS were older and more frequently of minority ethnicity background. They patients more commonly exhibited cytopenias and hyperferritinemia, which associated with diffuse cardiac involvement and functional impairment. In some PIMS-TS cases, cardiac pathology developed late, but outcomes were more favorable. In both, KD and PIMS-TS, baseline coronary diameter was a predictor of outcomes. PIMS-TS treatment more frequently included respiratory and cardiovascular support, and corticosteroids with IVIG. Cardiac involvement in PIMS-TS may be the result of a cytokine storm. Though more severe and diffuse when compared to KD, cardiac involvement of PIMS-TS has a more favorable prognosis, which may, after recovery, mitigate the need for long-term follow up.

Background: The aim of the study was to document cardiovascular clinical findings, cardiac imaging and laboratory markers in children presenting with the novel multisystemic inflammatory syndrome associated with COVID-19. Methods: A real-time internet based survey was sent via the member mailing database for Association for European Paediatric and Congenital Cardiologists (AEPC) working groups for Cardiac Imaging and Cardiovascular Intensive Care member. Inclusion criteria was children 0-18 years admitted to hospital between March 1 and June 6, 2020 with diagnosis of an inflammatory syndrome and acute cardiovascular complications. Findings: A total of 286 children from 55 centres from 17 European countries were included. The median age was 8·4 years (IQR 3·8-12·4 years) and 67% were males. Most common cardiovascular complications were shock (40%), cardiac arrhythmias (35%), pericardial effusion (28%) and coronary artery dilatation (24%). Reduced left ventricular ejection fraction was present in 52% of patients and 93% had raised cardiac troponin (cTnT). The biochemical markers of inflammation were raised in majority of patients on admission: elevated CRP (99%), ferritin (79%), procalcitonin (96%), NT-proBNP (93%), IL-6 level (88%) and D-dimers (90%). There was a statistically significant correlation between degree of elevation in cardiac and biochemical parameters and need of intensive care support (p

This study aimed to access the sustainable potential of inedible vegetable oil-based biodiesel systems in Northern Viet Nam by employing a life cycle sustainability assessment index so-called Triple I. Simultaneously, different feedstocks for biodiesel production were investigated, including Vernicia montana, Hibiscus sabdariffa, and Pongamia pinnata followed by the application of four biodiesel blend systems, which are B5, B10, B20, and B100. Subsequently, the influence of various changes in, for instance, crop yield, fuel price, distribution distance, coproduct prices, biodiesel production technology was also discussed. Findings of this study were used to propose feasible options and implications for biodiesel policies toward sustainable development of inedible vegetable oil-based biodiesel in Northern Viet Nam.

Superior sinus venosus atrial septal defect is a communication between the two atria located above the upper margin of the oval fossa, immediately caudal to the junction of the superior vena cava and the right atrium. Commonly, it is associated with partial anomalous pulmonary venous drainage, particularly of the right upper pulmonary vein. Surgical repair has been the gold-standard approach to close this congenital anomaly, with excellent results. However, some recent studies have shown promising results from a trans-catheter approach by placing a covered stent in the superior vena cava to close the defect and redirect the anomalous pulmonary venous return posterior to the stent and into the left atrium. This procedure has proven effective and feasible in selected patients. Additionally, the development of a percutaneous approach has opened the possibility of treating patients with contraindications to surgical correction. Procedural planning using 3D printed models, simulation, holographic augmented reality, and interrogation of the superior vena cava with a balloon has made it possible to increase the effectiveness and safety of the transcatheter correction of this type of atrial septal defects. Based on our experience and literature data, transcatheter correction of sinus venosus atrial septal defect with partial anomalous pulmonary venous drainage may be an alternative to surgery in adult patients and would reduce the need for cardiopulmonary bypass. The short and medium-term results are promising, but longer follow-up studies on the use of this technique are needed to validate the procedure.

Management of adults with failing Fontan physiology poses many challenges, especially as transplantation offers the only realistic alternative to palliative care. We present the first combined heart and liver transplant performed in Europe, for a late survivor of single ventricle palliation with the Fontan circulation. In addition to the conventional medical and surgical challenges posed, we highlight the management of the associated multi-organ failure with focus on the liver and novel strategies for assessment and optimization.

Retrograde systolic flow in the main pulmonary artery (PA) is a hallmark echocardiographic sign of patent ductus arteriosus. We describe a case of PA aneurysm mimicking patent ductus arteriosus flow. Using 4-dimensional flow cardiac magnetic resonance imaging, this echocardiographic feature is explained and altered flow dynamics in the aneurysmal PA are visualized. (Level of Difficulty: Intermediate.), Graphical abstract, Retrograde systolic flow in the main pulmonary artery (PA) is a hallmark echocardiographic sign of patent ductus arteriosus. We describe a case of PA…

Background The superior sinus venosus atrial septal defect (SVASD) is characterized by deficiency of the common wall between the superior vena cava (SVC) and the right upper pulmonary vein (RUPV), which is no longer committed to the left atrium. Objectives This study sought to evaluate the potential for redirecting the SVC and RUPV flow to the right and left atria, respectively, by implantation of a covered stent in the SVC. Methods Review of 48 consecutive adult SVASD patients undergoing assessment for correction. Pre-procedural evaluation included cross-sectional imaging and ex vivo simulation using printed or virtual 3-dimensional models. Results Transcatheter correction was performed in 25 patients, with a further 6 awaiting stent implantation. Only 8 patients were deemed technically unsuitable. The procedure involved balloon test inflation in the anticipated stent landing zone with simultaneous transesophageal echocardiography and pulmonary venography to confirm defect closure and unobstructed pulmonary venous drainage, followed by deployment of a 10-zig covered Cheatham platinum stent. Stents of lengths between 5 and 8 cm were implanted. A second, uncovered stent was used for anchoring in 9 patients. The RUPV was protected with a high-pressure balloon during stent implantation to prevent pulmonary venous obstruction in 4 patients. The median follow-up period was 1.4 (interquartile range: 0.8 to 1.7) years, with no mortality. Stent embolization occurred in 1 patient; another required drainage of hemopericardium. Cardiac computed tomography after 3 months confirmed unobstructed pulmonary venous return. At latest follow-up, a residual shunt was present in 1 patient. Conclusions Transcatheter correction of SVASD may be considered as an alternative to surgery in a substantial proportion of patients.

This paper presents the comparative simulation results of applying Genetic Algorithm (GA) for funding the position of the node and the value of the reactive power for compensation that is the best optimization for the stability of voltage to all nodes in a standard IEEE 14-bus power system For improving the stability of the studied system in normal and short-circuit working conditions, a GA which is useful for optimization is applied to this system by MATLAB software. It can be concluded from the simulation results of a case study based on the power system that the GA can figure out the bus position and optimal value that meet the qualifications of the studied system under severe operating.

The optimal method for monitoring antiplatelet therapy in children supported with ventricular assist devices (VADs) is unknown. We conducted a retrospective study to compare Thromboelastography Platelet Mapping (TEG/PM) with multiple electrode platelet aggregometry (MEA) on a Multiplate analyzer (Roche Diagnostics, Mannheim, Germany). We analyzed data from 66 paired blood samples from 9 patients

The main criteria used for deciding on surgery in children with presumed antenatally detected pelviureteric junction obstruction (PPUJO) are the level of hydronephrosis (ultrasonography), the level of differential renal function (DRF) and the quality of renal drainage after a furosemide challenge (renography), the importance of each factor being far from generally agreed. Can we predict, on the basis of ultrasound parameters, the patient in whom radionuclide renography can be avoided?We retrospectively analysed the medical charts of 81 consecutive children with presumed unilateral PPUJO detected antenatally. Ultrasound and renographic studies performed at the same time were compared. Anteroposterior pelvic diameter (APD) and calyceal size were both divided into three levels of dilatation. Parenchymal thickness was considered either normal or significantly decreased. Acquisition of renograms under furosemide stimulation provided quantification of DRF, quality of renal drainage and cortical transit.The percentages of patients with low DRF and poor drainage were significantly higher among those with major hydronephrosis, severe calyceal dilatation or parenchymal thinning. Moreover, impaired cortical transit, which is a major risk factor for functional decline, was seen more frequently among those with very severe calyceal dilatation. However, none of the structural parameters obtained by ultrasound examination was able to predict whether the level of renal function or the quality of drainage was normal or abnormal. Alternatively, an APD30 mm, a calyceal dilatation of10 mm and a normal parenchymal thickness were associated with a low probability of decreased renal function or poor renal drainage.In the management strategy of patients with prenatally detected PPUJO, nuclear medicine examinations may be postponed in those with an APD30 mm, a calyceal dilatation of10 mm and a normal parenchymal thickness. On the contrary, precise estimation of DRF and renal cortical transit should be performed in patients with APD30 mm, major calyceal dilatation and/or parenchymal thinning.

Imaging of the heart during exercise can improve detection and treatment of heart diseases but is challenging using current clinically applied cardiac MRI (cMRI) techniques. Real-time (RT) imaging strategies have recently been proposed for exercise cMRI, but respiratory motion and unreliable cardiac gating introduce significant errors in quantification of cardiac function. Self-navigated cMRI sequences are currently not routinely available in a clinical environment. We aim to establish a method for cardiac and respiratory gated cine exercise cMRI that can be applied in a clinical cMRI setting. We developed a retrospective, image-based cardiac and respiratory gating and reconstruction framework based on widely available highly accelerated dynamic imaging. From the acquired dynamic images, respiratory motion was estimated using manifold learning. Cardiac periodicity was obtained by identifying local maxima in the temporal frequency spectrum of the spatial means of the images. We then binned the dynamic images in respiratory and cardiac phases and subsequently registered and averaged them to reconstruct a respiratory and cardiac gated cine stack. We evaluated our method in healthy volunteers and patients with heart diseases and demonstrate good agreement with existing RT acquisitions (R = .82). We show that our reconstruction pipeline yields better image quality and has lower inter- and intra-observer variability compared to RT imaging. Subsequently, we demonstrate that our method is able to detect a pathological response to exercise in patients with heart diseases, illustrating its potential benefit in cardiac diagnostic and prognostic assessment.

Biodiesel that is produced from renewable resources has been rising as a promising candidate to replace conventional energy. Vietnam, with a large amount of land used in agriculture or forestry, has advantaged conditions to produce and develop renewable energy from biomass resources. However, developing biodiesel from agricultural product may affect food security significantly. Therefore, Jatropha that is inedible and waste cooking oil (WCO) could be suitable to biodiesel production. One of the most important aims of using biodiesel to replace fossil diesel is to reduce environmental impacts, particularly impact on Climate Change. It is necessary to analyze the environmental performance of biodiesel through the entire life cycle. In this paper, life cycle assessment of biodiesel production and use was applied to measure the environmental performance of biodiesel produced from jatropha oil and WCO under Vietnam conditions. Some main emissions, such as CO2, NOx, PM, CH4, VOC and land use, were computed through a cradle-to-grave analysis. The result shows that when using Jatropha biodiesel to replace diesel, global warming potential (GWP) and photochemical oxidant formation potential (POFP) could be improved, but some other impacts, such as acidification potential (AP) and eutrophication potential (EP), could tend to increase. The environmental impacts of WCO biodiesel are all reduced in comparison with fossil diesel.

The main purposes of this study are to demonstrate the synergistic anticancer drug systems with the combined doxorubicin (D) and paclitaxel (P) via the aid of cell penetrating and cell targeting moieties for enhancing the cancer therapeutic effect. Firstly, the synergistic effect of combined free drugs (D/P) was investigated to obtain the suitable dose combination for subsequent studies. The combination of free drugs D/P at molar ratio of 1/0.2 shows synergistic therapeutic effect compared with the treatment of a free single drug D or P. Secondly, sustainable release systems of two single drug-loaded micelles, (i) co-delivered D-FOL micelle & P-FOL micelle system and (ii) co-delivered D-TAT/FOL micelle & P-TAT/FOL micelle system, at D/P molar ratio of 1/0.2 were investigated. The results show synergistic effect with the higher efficacy of the TAT/FOL system compared to FOL only system. Finally, a dual D/P-loaded system with sustainable release rate, synergistic drug interaction, selective targeting to cancer cells and high cell penetrating ability was designed. The D/P-TAT/FOL micelles exhibit an IC50 value of 0.172 μM D/0.043 μM P, which is much lower than the IC50 values of the single drug-loaded micelles without functionalization (3.873 μM for D-micelles and 0.790 μM for P-micelles). Overall, this newly developed dual encapsulation of D and P in the multifunctional carrier would be a promising technology for cancer treatment.

Seawater desalination and water reuse using membrane technology can provide a sustainable water supply to the world if such processes can be more energy-efficient. To harness the highly efficient water transport used by nature, it is proposed to incorporate trans-membrane water channel, AquaporinZ (AqpZ), into biomimetic membranes. However, the biomimetic membranes are intrinsically too fragile to be used in water purification. Here, we report a robust vesicular biomimetic membrane design and the synthesis route. The membrane is formed by cross-linking AqpZ-embedded block copolymer vesicles, followed by immobilizing vesicles on the membrane support via covalent binding, and then stabilizing through an optimized layer-by-layer polydopamine (PDA)–histidine (His) coating process. As compared with commercially available HTI membranes, the AqpZ-embedded vesicular membrane shows an order-of-magnitude increment in water flux (17.6 L/m 2 /h) with high salt retention (91.8%) when using 6000 ppm NaCl as the feed and 0.8 M sucrose as the draw solute in the forward osmosis operation. Thus, the vesicular membrane design may provide new insights into the design and fabrication of Aqp-embedded biomimetic membranes.

Aim Data on arrhythmia outcome following device closure of atrial septal defect (ASD) are lacking. This study provides medium-term follow-up data on atrial arrhythmias in patients who were ≥40 years of age at the time of transcatheter ASD closure. Methods and results It is a retrospective review. Mean age of the 159 patients was 57 years. Median follow-up was 3.6 years (range 6 months–10.9 years). Patients were classified, according to arrhythmia status prior to ASD closure, into Group I, no history of atrial arrhythmia ( n = 119, mean age 55.5 years); Group II, paroxysmal atrial arrhythmia ( n = 18, mean age 55.7 years); and Group III, persistent atrial fibrillation ( n = 22, mean age 65.7 years). Group III patients were significantly older, had larger left atrial size, and had higher mean pulmonary arterial pressure than Group I and II patients ( P < 0.001). Prior to closure, radiofrequency ablation was carried out in 12/18 (66%) of Group II and 3/22 (14%) of Group III. After device closure, 7 patients (6%) of Group I developed new atrial fibrillation. Fifty per cent (9/18) of Group II but only 9% (2/22) of Group III were in sinus rhythm on follow-up. Conclusion Device closure alone in patients with persistent atrial arrhythmia is not likely to restore sinus rhythm in the medium term. New atrial arrhythmia occurred in 6% of patients who were in sinus rhythm prior to device closure. At least 50% of the patients with paroxysmal atrial arrhythmia continue to have significant atrial arrhythmia following device closure, and the role of ablation prior to closure in patients with a history of arrhythmia requires refinement.

Folate has been applied as a targeting moiety for various anticancer drug-delivery agents to avoid non-specific attack of normal tissues as well as to increase cellular uptake at the target tumor cells. Polymer micelles made of poly[(D,L-lactide)-co-glycolide)]-poly(ethylene glycol)-folate (PLGA-PEG-FOL) was fabricated as a tumor targeting carrier for encapsulating the anticancer drug doxorubicin. To accelerate the drug release in the endosome after folate-mediated cellular uptake, pH-sensitive poly(β-amino ester)-PEG-FOL (PAE-PEG-FOL) was added together with PLGA-PEG-FOL to form mixed micelles. The results showed that the drug release can be triggered at different pH due to the ionization of PAE. The IC 50 of PLGA-PEG-FOL micelles is 0.46 x 10 -6 M. With 20% PAE in the mixed micelles (20:80 mixed micelles), the IC 50 decreases to 0.34 x 10 -6 M, which is comparable to that of pure PAE-PEG-FOL micelles at pH 7.4. As a result of the pH sensitivity, the PAE-PEG-FOL micelles are not stable at pH 6.5 or lower, and the drug may be released from the micelles into the extracellular environment before uptake by the cells. The 20:80 mixed micelles are relatively stable at this condition. As a result, the micelles retain more drug in the micelles for a higher degree of cellular uptake by folate receptor-mediated endocytosis, and exhibit higher cytotoxicity.

Background Mechanical circulatory support in the pediatric population is currently limited to pulsatile ventricular assist devices (VAD). In recent years, the use of durable, newer generation, continuous flow devices have increased substantially among adults with end-stage heart failure. We examined the extended role of this device in the pediatric population (aged less than 18 years). Methods Between 2010 and 2015, 12 patients (median age 7.1 years; range, 3.7 to 17.0; one third of patients were aged 5 years or less) received a HeartWare ventricular assist device (HVAD; HeartWare, Framingham, MA), 11 for cardiomyopathy and 1 for posttransplant rejection. Right VAD support (n = 5; 42%) was provided by a short-term device (Levitronix, Zurich, Switzerland). Results Overall, 1 patient died (day 638), 8 patients (67%) underwent transplantation, 1 patient (8.3%) recovered, and 2 patients (17%) remain on HVAD. The mean length of support was 150 days (range, 16 to 638). Four patients (33.3%) were discharged home (all left VAD). In the left VAD group (n = 7), 3 patients subsequently received transplants (days 185, 201, and 234, respectively), 1 recovered (day 149), 1 died (day 638), 1 remained on HVAD (day 198), and 1 needed conversion to biventricular assist device (BIVAD [day 73]). In the BIVAD group (n = 5), right VAD was weaned in 3 (60%), all subsequently received transplants, and 2 remained on BIVAD support until transplant (days 16 and 17, respectively). One BIVAD patient required conversion to central cannulation for longer-term support. Four BIVAD patients (80%) were in Interagency Registry for Mechanically Assisted Circulatory Support level 1 before VAD compared with 2 (29%) in the left VAD group ( p = not significant). The actuarial survival rate was 100% at 1 year with no neurologic events. Conclusions The third-generation, continuous flow device can provide durable support in the pediatric population. The selection strategy for patients who benefit most from the device continues to evolve. It is anticipated that a smaller design in the future will benefit an even wider pediatric population with heart failure.

Objective: When taking into account the Society of Nuclear Medicine (SNM) and European Association of Nuclear Medicine (EANM) guidelines on diuretic renography in children, we see important divergences in the preparation, acquisition, processing, and interpretation of the results. In this study, we estimated the quality of renal drainage according to these two guidelines. Patients and methods: Ninety kidneys with hydronephrosis or severe vesicorenal reflux were processed and analyzed according to the SNM (estimation of the T1/2 of the washout curve and conclusions about the possible existence of obstruction) and EANM guidelines (estimation of normalized residual activity or NORA, and output efficiency or OE on the late postmicturition images, without any conclusion about the possible existence of obstruction). Among the 90 kidneys, 39, 20, and 31 were considered to have normal, equivocal, or poor drainage (obstruction), respectively, when the SNM guidelines were used. Results: All 39 kidneys with good drainage according to SNM were also considered as normal using the EANM guidelines. Among the 20 equivocal cases based on T1/2, concordance between the two guidelines was obtained in only 35 and 0% when using NORA and OE (OE was considered normal in all 20 cases), respectively. Among the 31 cases defined as obstructed by SNM, only five were classified as 'poor drainage' using NORA and no single case was classified thus using OE. Conclusion: This limited study demonstrates that the use of different guidelines can lead to different interpretations of the results. This is unacceptable, and an agreement between both pediatric task groups of the SNM and EANM is urgently required.

Folate has been applied as a targeting moiety for various anticancer drug-delivery agents to avoid non-specific attack of normal tissues as well as to increase cellular uptake at the target tumor cells. Polymer micelles made of poly[(D,L-lactide)-co-glycolide)]-poly(ethylene glycol)-folate (PLGA-PEG-FOL) was fabricated as a tumor targeting carrier for encapsulating the anticancer drug doxorubicin. To accelerate the drug release in the endosome after folate-mediated cellular uptake, pH-sensitive poly(β-amino ester)-PEG-FOL (PAE-PEG-FOL) was added together with PLGA-PEG-FOL to form mixed micelles. The results showed that the drug release can be triggered at different pH due to the ionization of PAE. The IC(50) of PLGA-PEG-FOL micelles is 0.46 × 10(-6) M. With 20% PAE in the mixed micelles (20:80 mixed micelles), the IC(50) decreases to 0.34 × 10(-6) M, which is comparable to that of pure PAE-PEG-FOL micelles at pH 7.4. As a result of the pH sensitivity, the PAE-PEG-FOL micelles are not stable at pH 6.5 or lower, and the drug may be released from the micelles into the extracellular environment before uptake by the cells. The 20:80 mixed micelles are relatively stable at this condition. As a result, the micelles retain more drug in the micelles for a higher degree of cellular uptake by folate receptor-mediated endocytosis, and exhibit higher cytotoxicity.

Background We describe our current unit approach and report interstage results in the HLHS with Intact atrial septum (IAS) or highly restrictive interatrial communication (HRIC). Method A retrospective review of the institutional HLHS programme (2005–2014). Advances in fetal diagnosis lead to delivery planning in hybrid theatre: median sternotomy and interventional defect creation/enlargement. Results 9 neonates (4 IAS and 5 HRIC) and 5 required immediate intervention postnatally. Delayed/insufficient septostomy in 3 HRIC resulted in death before stage I Norwood even with ECMO support in 2/3. Of the other 6, 2 had trans-atrial stent placement and 1 trans-atrial balloon septostomy (3 had surgical septectomy). 5/6 underwent concomitant bilateral pulmonary artery banding. All the 6 patients reached the Norwood procedure after 27 ± 21 days and 50% required ECMO postoperatively. Trans-atrial stenting resulted in less pre Norwood morbidities. There was no stent-related complications. There was no hospital mortality after Norwood and current inter-stage survival is 100%: 5 patients underwent successfully second-stage palliation, 1 of them had the Fontan completion and subsequently transplanted. Conclusion Together with advanced fetal diagnosis, effective left atrial decompression especially with trans-atrial stunting using hybrid technique and availability of mechanical support can improve the outcome of HLHS/IAS/HRIC with low interstage morbidity and excellent survival.

Objective To investigate the outcome of orthotopic heart transplant (OHT) in adult population for failing atrial switch operation in childhood. Methods Between 2001 and March 2013, 230 OHT were performed at our institution. Of these twenty patients (8.7%) had undergone previous atrial inversion procedures (7 Senning, 13 Mustard) for simple Transposition of Great Arteries (TGA) or TGA with ventricular septal defect (VSD) Mean age of atrial switch procedure was 22.9 ± 24.3 months. Two patients were mechanically supported to OHT with Heartware HVAD. Mean age at OHT was 27.2 ± 9.6 years, medium time from atrial switch was 25.3 years. Donor ischaemic time and CPB were 192.4 ± 50 and 207.2 ± 88.5 min respectively. Lenght of stay in ITU was 6.5 days (1–25 days). Four patients required renal replacement therapy (CVVH) and one needed tracheostomy. Median follow up is 4.7 ± 3.6 years. Five deaths occurred (25%): 3 early deaths (one cerebro-vascular accident and 2 acute rejections), 2 late deaths (a EBV-related lymphoproliferative disorder and a late rejection). All deaths occurred before 2003. Conclusions Heart transplantation in patients with failing systemic ventricle following atrial switch procedure is associated with a medium and long term good outcome in the modern era. However the recent development of mechanical cardiac support has allowed us to bridge more efficiently these patients to OHT with better selection of donors and improved outcome.

Dear Sir, The joint SNMMI and EANM guideline for small-bowel and colon transit [1], the subject of a recent editorial, is an important step towards long-awaited standardization. We hope for similar efforts in other areas in nuclear medicine. One area that urgently requires unequivocal guidelines is diuretic renography in children, the approaches of the SNM [2] and the EANM [3] currently being different and often contradictory. The recommendations of the SNM guidelines include the following. Intravenous or oral hydration and a maximal furosemide dose of 40 mg should be administered. A bladder catheter should be placed “when necessary”. Acquisition should be performed using serial 15-s to 30-s frames with a 64 × 64 or 128 × 128 matrix for 30 – 60 min. Low priority is given to late post-erect, post-micturition images. The background area remains undefined. The presence or absence of obstruction is based on either the T1⁄2 calculated from the descending slope of the diuretic curve (only on the F+20 study) or from the percentage of tracer activity that remains 20 min after injection of the diuretic, in relation to the activity at the time of diuretic injection. The recommendations of the EANM guidelines include the following. Oral hydration in most patients and a maximal furosemide dose of 20 mg should be administered. Bladder catheterization is rarely if ever advised and can be replaced by a late post-micturition and post-erect acquisition. A zoom adapted to the size of the child is recommended, as well as an acquisition using 10-s frames. Background correction using the perirenal area is considered the best compromise. The T1⁄2 of the furosemide curve is not acceptable for evaluating washout: drainage should be evaluated, whatever the timing of furosemide injection, by means of quantitative parameters such as output efficiency and/or normalized residual activity. Poor drainage does not mean obstruction. Joint guidelines would most likely clarify the discrepancies between the two approaches.

Soybean cultivar MTD10 cultivated on a moderate acid paddy soil of the Mekong Delta responded well to a multistrain inoculation and to chemical nitrogen fertilizer. However, the efficiency of chemical nitrogen uptake by the uninoculated plants decreased with increasing nitrogen application rate. Inoculation improved all examined agronomic characteristics of plants. Inoculated plants produced grain yield 10 times greater than the uninoculated controls and 2.5 times greater than the uninoculated plants receiving 80 kg/ha of chemical nitrogen. Inoculation was superior to chemical nitrogen fertilization in all parameters of importance to market-oriented farmers.

Nitrogen fixation as measured by acetylene conversion to ethylene was found to be common for duckweed blooms on ponds, lakes, and streams in Michigan. Twenty-six of 29 sites with duckweed sampled over a 2-year period showed acetylene reduction activity (ARA). These activities corresponded to N inputs of 3.7–7.5 kg N∙ha−1 per annual cycle for typical blooms but dense Lemna trisulca blooms could be 10 times greater. The ARA was stimulated five- to six-fold by light, was not removed when plants were shaken in water, and was usually associated with the leaves and not the roots. Colonies of heterocyst-bearing cyanobacteria of the genera Nostoc, Gloeotrichia, Anabaena, Calothrix, and Cylindrospermum were observed attached to the lower epidermis or in the reproductive pockets of leaves of Spirodela and Lemna plants but not on Wolffia plants. The ARA correlated reasonably well with the density of cyanobacterial colonies observed. The duckweed appeared to provide a more favorable environment for the cyanobacteria which should result in enhanced nitrogen inputs to aquatic and sediment environments harboring duckweed. The N2 fixation was not sufficient, however, to meet all the nitrogen needs of the duckweed bloom.