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Manzar Ashtari,1– 3 Mikhail Lipin,1,2 Michelle Duong,4 Gui-Shuang Ying,5 Yinxi Yu,5 Albert Maguire,1,2 Jean Bennett1,2 1Department of Ophthalmology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA; 2Department of Ophthalmology, Center for Advanced Retinal & Ocular Therapeutics (CAROT) at the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA; 3Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA; 4Emergency Department, Mainline Health, Bryn Mawr, PA, USA; 5Department of Ophthalmology, Center for Preventative Ophthalmology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USACorrespondence: Manzar Ashtari, University of Pennsylvania, Perelman School of Medicine, Room 201 Anatomy/Chemistry Building, Philadelphia, PA, 19102, USA, Tel +1 215– 746-8259, Email ashtari@pennmedicine.upenn.eduIntroduction: Previous works on experience-dependent brain plasticity have been limited to the cortical structures, overlooking subcortical visual structures such as the lateral geniculate nucleus (LGN). Animal studies have shown substantial experience dependent plasticity and using fMRI, human studies have demonstrated similar properties in patients with cataract surgery. However, in neither animal nor human studies LGN has not been directly assessed, mainly due to its small size, tissue heterogeneity, low contrast/noise ratio, and low spatial resolution.Methods: Utilizing a new algorithm that markedly improves the LGN visibility, LGN was evaluated in a group of low vision patients before and after retinal intervention to reinstate vision and normal sighted matched controls.Results: Between and within groups comparisons showed that patients had significantly smaller left (p< 0.0001) and right (p < 0.00002) LGN volumes at baseline as compared to the one-year follow-up volumes. The same baseline and one year comparison in controls was not significant. Significant positive correlations were observed between the incremental volume increase after gene therapy of the left LGN and the incremental increase in the right (r = 0.71, p < 0.02) and left (r = 0.72, p = 0.018) visual fields. Incremental volume increase of the right LGN also showed a similar positive slope but did not reach significance.Discussion: These results show that despite significantly less volume at baseline, retinal gene therapy promotes robust expansion and increase in LGN volume. Reinstating vision may have facilitated the establishment of new connections between the retina and the LGN and/or unmasking of the dormant connections. The exact trajectory of the structural changes taking place in LGN is unclear but our data shows that even after years of low vision, the LGN in RPE65 patients has the potential for plasticity and expansion to a nearly normal volume one year after gene therapy administration.Keywords: brain plasticity, retinal gene therapy, lateral geniculate nucleus, image processing, brain morphometry

Although much is known regarding the physiology, ecology and life history of Macrocystis pyrifera, there is little accessible information for establishing robust and reliable culturing practices to support aquaculture and habitat restoration. Naturally occurring kelp forests formed by M. pyrifera support productive coastal ecosystems, and because it is one of the fastest growing macroalgal species, its high biomass production, and high affinity for nutrients and significant polysaccharide content makes it a species of considerable interest for aquaculture. This species has undergone substantial decline throughout its biogeographic range and is threatened by local and global stressors. Here, we synthesize the current knowledge on culturing of M. pyrifera and discuss approaches to stock collection, preservation of diversity and applications for experimental studies. It is crucial to preserve the current genetic diversity of this species immediately and long-term culture storage approaches such as germplasm banking and cryopreservation provide the tools to allow this. A concerted effort is also needed to better understand the physiological attributes of M. pyrifera in order to select strains for aquaculture and restorative applications that may provide resilience to future environmental stressors. Finally, attention must be given to developing effective in situ restoration approaches whereby large-scale stock production can be optimized and out-planting strategies developed to ensure restoration success.

Rising ocean temperature is a major driver of kelp forest decline worldwide and one that threatens to intensify over the coming decades. What is not particularly well understood are the mechanisms that drive loss and how they operate at differing life stages. This study aimed to establish an understanding of the effects of increasing temperature on the early developmental stages of the giant kelp, Macrocystis pyrifera. Sporulation was carried out across 10 temperature treatments from 9.5 to 26.2°C ± 0.2°C at approximately 2°C intervals. Spores were then incubated at these temperatures under a 20.3±1.7 μmol photons m-2 s-1, 16L:8D photoperiod for 5 days. Results indicate that spore release was positively correlated with increasing temperature, whereas an inverse trend was observed between temperature and the growth of germ-tube. The thermal threshold for spore and germling development was determined to be between 21.7°C and 23.8°C. Spore settlement was the most drastically effected developmental phase by increasing temperature. This study highlights the vulnerability of early life stages of M. pyrifera development to rising ocean temperature and has implications for modelling future distribution of this valuable ecosystem engineer in a changing ocean.

Ambient ammonia gas (NH3(g)) was continuously measured for one year, from March 2018 to February 2019, using a passive sampling method in a source-specific monitoring campaign in Hanoi, Vietnam, providing an unprecedented picture of the spatiotemporal characteristics of NH3(g) in this city. The four survey sites (three urban and one rural) were representative of a typical downtown area, a polluted river, a crossroad, and a rural area. Regarding spatial distribution, a distinctly high concentration (79.8 ± 61.2 ppb) was indicated at the polluted river, an important source unheard of in urban areas, followed by the crossroad (38.6 ± 18.8 ppb) and the downtown (36.5 ± 20.0 ppb); the lowest concentration (35.6 ± 36.0 ppb) was observed in the rural area. Seasonal variation was thoroughly discussed, together with meteorological parameters as driving factors. The strong dependence of NH3(g) concentration on the change in temperature and relative humidity at polluted river and rural area due to the strong impact of these meteorological factors on the volatilization of NH3(g) from wastewater and agriculture, respectively, causes the highest concentration in summer at these sites. The NH3(g) intensely emitted from the polluted river in summer was, furthermore, transferred to the surrounding area under the impact of the local wind direction. However, basically, in downtown, the concentration was higher in the cooler seasons than in the warmer seasons, which was found different compared with the conventional results in most of former studies, suggesting the major impact of vehicular emission on the rise of NH3(g) in urban area. [ABSTRACT FROM AUTHOR]

Background: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources , community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. Objective: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. Designs: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test–retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland–Altman plots). Results: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test–retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5–0.7), demonstrating that the instrument has an acceptable level of stability. Conclusions: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

Background: In almost 30 years since economic reforms or ‘renovation’ (Doimoi) were launched, Vietnam has achieved remarkably good health results, in many cases matching those in much higher income countries. This study explores the contribution made by Universal Health Insurance (UHI) policies, focusing on the past 15 years. We conducted a mixed method study to describe and assess the policy process relating to health insurance, from agenda setting through implementation and evaluation. Design: The qualitative research methods implemented in this study were 30 in-depth interviews, 4 focus group discussions, expert consultancy, and 420 secondary data review. The data were analyzed by NVivo 7.0. Results: Health insurance in Vietnam was introduced in 1992 and has been elaborated over a 20-year time frame. These processes relate to moving from a contingent to a gradually expanded target population, expanding the scope of the benefit package, and reducing the financial contribution from the insured. The target groups expanded to include 66.8% of the population by 2012. We characterized the policy process relating to UHI as incremental with a learning-by-doing approach, with an emphasis on increasing coverage rather than ensuring a basic service package and financial protection. There was limited involvement of civil society organizations and users in all policy processes. Intertwined political economy factors influenced the policy processes. Conclusions: Incremental policy processes, characterized by a learning-by-doing approach, is appropriate for countries attempting to introduce new health institutions, such as health insurance in Vietnam. Vietnam should continue to mobilize resources in sustainable and viable ways to support the target groups. The country should also adopt a multi-pronged approach to achieving universal access to health services, beyond health insurance.

Shay Phillips,1 Maja Gift,2 Shyam Gelot,3 Minh Duong,2 Hazel Tapp1 1Carolinas Medical Center, Department of Family Medicine, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA; 2Department of Pharmacy Services, Tampa General Hospital, Tampa, FL, USA; 3University of South Florida College of Pharmacy, Tampa, FL, USA Purpose: The primary assessment tool used by hospitals to measure the outcomes of pain management programs is the 0–10 numerical pain rating scale. However, it is unclear if this assessment should be used as the sole indicator of positive outcomes by pain management programs. Although it is assumed that pain intensity scores would be correlated with patient satisfaction, few studies have evaluated the association between pain intensity scores and patient satisfaction. Methods: In this pilot study, we investigated the relationship between pain intensity and patient satisfaction by evaluating 88 patients who received opioid analgesics at a 1018-bed acute care institution. A 14-question survey was adapted from a questionnaire developed by the American Pain Society to assess patient pain control and overall satisfaction with our institution's pain management strategies. Results: This study found no association between pain intensity score and patient satisfaction with overall pain management (Spearman's rank correlation coefficient = −0.31; 95% confidence interval = −0.79 to 0.39). The majority of the surveyed patients were satisfied or very satisfied with their overall pain management, regardless of their pain intensity score. Conclusion: These findings contribute to the general understanding that institutions should use pain intensity scores together with a measure of patient pain satisfaction when assessing regulatory and quality control programs. Keywords: pain management, pain assessment, pain intensity scores, perception, measurement, HCAHPS survey

Background: in endemic areas, neurocysticercosis appears mainly as a single, large, spherical and non-enhancing intracranial cyst. Case presentation: an atypical case of neurocysticercosis (NCC) in a French Caucasian, without history of travel to endemic areas, was confirmed by histology and molecular speciation. Imaging was atypical, showing several hook-bearing scolices visible in the cyst, while the serology employed was non-contributary. Conclusions: NCC should be considered when multiple taeniid scolices are observed within the same cystic lesion.

Rising ocean temperature is a major driver of kelp forest decline worldwide and one that threatens to intensify over the coming decades. What is not particularly well understood are the mechanisms that drive loss and how they operate at differing life stages. This study aimed to establish an understanding of the effects of increasing temperature on the early developmental stages of the giant kelp, Macrocystis pyrifera. Sporulation was carried out across 10 temperature treatments from 9.5 to 26.2°C ± 0.2°C at approximately 2°C intervals. Spores were then incubated at these temperatures under a 20.3±1.7 μmol photons m-2 s-1, 16L:8D photoperiod for 5 days. Results indicate that spore release was positively correlated with increasing temperature, whereas an inverse trend was observed between temperature and the growth of germ-tube. The thermal threshold for spore and germling development was determined to be between 21.7°C and 23.8°C. Spore settlement was the most drastically effected developmental phase by increasing temperature. This study highlights the vulnerability of early life stages of M. pyrifera development to rising ocean temperature and has implications for modelling future distribution of this valuable ecosystem engineer in a changing ocean. [ABSTRACT FROM AUTHOR]

BackgroundFacilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam.Methods and findingsIn a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]).ConclusionsA randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period.

The preferences of the deer mouse (Peromyscus maniculatus (Wagner, 1845)), southern red-backed vole (Myodes gapperi (Vigors, 1830)), heather vole (Phenacomys intermedius Merriam, 1889), long-tailed vole (Microtus longicaudus (Merriam, 1888)), and meadow vole (Microtus pennsylvanicus (Ord, 1851)) for lodgepole pine (Pinus contorta Dougl. ex Loud.), white spruce (Picea glauca (Moench.) Voss), and subalpine fir (Abies lasiocarpa (Hook.) Nutt.) seeds were investigated using cafeteria-style feeding experiments. Seed selection by P. maniculatus and M. gapperi in the field was also studied. Peromyscus maniculatus, M. gapperi, M. longicaudus, and M. pennsylvanicus showed a distinct preference for lodgepole pine seeds and avoidance of subalpine fir seeds, and consumed the different species of seeds in similar relative proportions. Phenacomys intermedius behaved very differently from the other rodent species in that it did not show a preference among seed species, and consumed very few seeds in total. Findings from the field seed selection trials were consistent with laboratory results. We suggest that postdispersal seed predation by small mammals could limit the recruitment success of lodgepole pine and white spruce, but would not be a major problem in the regeneration of subalpine fir stands. This could provide an advantage for subalpine fir over neighbouring competitive species. A l'aide d'experiences d'alimentation a choix multiples, nous avons determine les preferences des souris sylvestres (Peromyscus maniculatus (Wagner, 1845)), des campagnols a dos roux de Gapper (Myodes gapperi (Vigors, 1830)), des campagnols des bruyeres (Phenacomys intermedius Merriam, 1889), des campagnols a longue queue (Microtus longicaudus (Merriam, 1888)) et des campagnols de Pennsylvanie (Microtus pennsylvanicus (Ord, 1851)) pour les graines de pin vrille (Pinus contorta Dougl. ex Loud.), d'epinette blanche (Picea glauca (Moench.) Voss) et de sapin subalpin (Abies lasiocarpa (Hook.) Nutt.). Nous avons aussi etudie la selection de graines de P. maniculatus et de M. gapperi en nature. Peromyscus maniculatus, M. gapperi, M. longicaudus et M. pennsylvanicus montrent une nette preference pour les graines du pin vrille et un evitement des graines du sapin subalpin et ils consomment les differentes especes de graines dans des proportions relatives semblables. Phenacomys intermedius se comporte de facon tres differente des autres especes de rongeurs en ce qu'il ne montre pas de preference pour aucune des especes de graines et qu'il consomme au total tres peu de graines. Les resultats des essais de selection de graines en nature concordent avec les resultats du laboratoire. Nous croyons que la predation des graines apres leur dispersion par les petits mammiferes pourrait limiter le succes du recrutement des pins vrilles et de l'epinette blanche, mais ne devrait pas poser de probleme majeur pour la regeneration des parcelles de sapins subalpins. Cela pourrait s'averer un avantage pour le sapin subalpin par rapport aux especes competitrices voisines. [Traduit par la Redaction], Introduction Seed predation by small mammals destroys a significant proportion of the annual seed crop of forest trees and has substantial negative effects on the regeneration of coniferous forests (Abbott [...]

OBJECTIVE: Our objective is to identify the prevalence of depression among inpatients with heart failure (HF), and to ascertain the factors associated with the depression from a wide spectrum of sociodemographic variables. MATERIALS AND METHODS: We conducted a hospital-based cross-sectional survey of prospectively collected data in inpatients with a diagnosis of HF at Vietnam National Heart Institute, Bach Mai Hospital (Hanoi, Vietnam) from July 2020 to July 2021. A sample size of 128 inpatients with HF was finally included. Primary outcome variable was depression ICD-10. RESULTS: The mean age was 62.34 (SD = 14.76). The sex ratio was 66 males to 62 females. The overall prevalence of depression ICD-10 was 46.88% among HF inpatients. The proportion of the depressed patients fluctuated between 37.21% and 83.33% by NYHA heart failure classification. Compared to the depressive prevalence among patients with NYHA class II, the odds were 8.43 times higher for those with NYHA class IV (OR univariate 8.43; 95% CI 1.63-43.46). Patient's age was significantly associated with increased prevalence of depression (OR multivariate 1.07; 95% CI 1.003-1.14). It was significantly higher odds of depression in HF patients who felt sadness after a diagnosis of an illness (OR multivariate 18.02, 95% CI: 4.21-77.08). Individuals with higher household economic status were less likely to be diagnosed with depression compared to those with lower household economic status (OR multivariate 0.15, 95% CI: 0.02-0.92). The odds of depression were significantly higher in HF patients who reported with family conflict (OR multivariate 23.45, 95% CI: 1.29-423.55), and in those having the loss of a close family member (OR multivariate 38.62, 95% CI: 1.41-1055.98). CONCLUSIONS: The prevalence of depression by ICD-10 was relatively high. Age of patient, sadness after a diagnosis of an illness, household economic status, family conflict and loss of a close family member were significantly associated with the depression among HF inpatients. Present results suggest a need for a disease management program addressing both psychological and HF aspects with the aim of improving health outcomes for the inpatients in Vietnam health facilities. [ABSTRACT FROM AUTHOR]

Research has been conducted on the bipodal dihydroxamic acids that contain an apical C atom and amide linkages. The synthesis of these acids has been investigated and the results indicate the significance of the acids' Fe(III) chelation characteristics.

Research was conducted to examine Gd(DOTA)- and Gd(DTPA)2- complexes in the crystalline state and aqueous solutions for various pH values at room temperature and other temperatures using X-ray absorption fine structure analysis. Results demonstrate that the complexes are very rigid. The experimental Fourier transforms of the complexes studied as crystals and in aqueous solutions can be easily explained by mass spectrometric calculations.

Environmental research indicates that greenhouse-gas emission targets should influence early action in reducing harmful carbon dioxide emissions to minimize future damage to the environment. Deferred action will also damage economic prospects for developing nations due to the added cost of socioeconomic inertia in energy systems. The characteristics of optimal global emissions scenarios and strategies are given.