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Introduction: Our research aims to evaluate the effectiveness of thromboprophylaxis using enoxaparin in patients undergoing hip replacement. Methods: A retrospective cohort study was conducted based on medical records of patients aged 40 years and older undergoing hip replacement. Exclusion criteria included patients who had used anticoagulants to prevent other diseases, patients with a history of chronic renal failure, liver failure, cancer or allergy to anticoagulants, and patients with indicated mechanical prophylaxis. In our study, 65 patients were randomized into 2 groups - the control group and the venous thromboembolism (VTE) prophylaxis group (receiving subcutaneous enoxaparin 40 mg daily for 7 - 14 days). Preventive effectiveness was evaluated based on the comparison of VTE incidence after surgery between the groups. Results: In our study, most of the patients were over 60 years old (79.2%). No case of pulmonary embolism was recorded. There were 11 patients in the control group (17.2%) who developed deep venous thrombosis (DVT) versus 2 patients in the prophylaxis group (3.1%). After adjusting for postoperative hospital stay, use of enoxaparin reduced the risk of DVT by 89.7% (OR 0.103, 95% confidence interval 0.019-0.569, p=0.009), especially in patients over 60 years old (OR 0.147, 95% confidence interval 0.026 - 0.822, p = 0.029). Conclusion: This study demonstrates that using enoxaparin significantly reduces the incidence of DVT in patients undergoing hip replacement, especially in patients over 60 years old.

Platinum(IV) was extracted from chloride solution using kerosene solution of trioctyl ammonium chloride, methyltrioctylammonium chloride, and tetraoctyl ammonium chloride ionic liquids as solvents in high yields. To increase the Pt(IV) recovery and heterogenize the process for easy handling at industrial scale, these three ionic liquids were directly impregnated on some solid carriers, such as silica gel-60, silica gel-100, Amberlite XAD-7 ion-exchange resin, and Amberlite XAD-7 ion-exchange resin to form sorbents in nature of supported ionic liquid phase. The influence of some factors, such as ionic liquid and solid carrier structure, IL/Pt molar ratio, and ionic liquid loading as well as sorption isotherms, was investigated. The stripping and desorption of Pt(IV) using different eluents and reusability of ionic liquids and supported ionic liquid phases were also evaluated.

BackgroundLittle is known about the natural history of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.MethodsWe conducted a prospective study at a quarantine center for coronavirus disease 2019 in Ho Chi Minh City, Vietnam. We enrolled quarantined people with reverse-transcription polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 infection, collecting clinical data, travel and contact history, and saliva at enrollment and daily nasopharyngeal/throat swabs (NTSs) for RT-PCR testing. We compared the natural history and transmission potential of asymptomatic and symptomatic individuals.ResultsBetween 10 March and 4 April 2020, 14 000 quarantined people were tested for SARS-CoV-2; 49 were positive. Of these, 30 participated in the study: 13 (43%) never had symptoms and 17 (57%) were symptomatic. Seventeen (57%) participants imported cases. Compared with symptomatic individuals, asymptomatic people were less likely to have detectable SARS-CoV-2 in NTS collected at enrollment (8/13 [62%] vs 17/17 [100%]; P = .02). SARS-CoV-2 RNA was detected in 20 of 27 (74%) available saliva samples (7 of 11 [64%] in the asymptomatic group and 13 of 16 [81%] in the symptomatic group; P = .56). Analysis of RT-PCR positivity probability showed that asymptomatic participants had faster viral clearance than symptomatic participants (P ConclusionsAsymptomatic SARS-CoV-2 infection is common and can be detected by analysis of saliva or NTSs. The NTS viral loads fall faster in asymptomatic individuals, but these individuals appear able to transmit the virus to others.

Background Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. Methods This retrospective study included 2266 patients who initiated MDR-TB treatment between 2011 and 2015 in HCMC. Treatment outcomes were available for 2240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. Results Among 2266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011 to 2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1 kg/m2 of BMI for patients with BMI Conclusion The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011 and 2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome.

This study describes clinical and subclinical features of 30 patients with airway foreign body at the Endoscopy Department, National Otorhinolaryngology Hospital of Vietnam from August 2018 to February 2020. The study results show that airway foreign body was commonly found in patients aged over 18 (43.33%); male-female ratio was 1.7:1; cough and shortness of breath were two common symptoms with 96.67% and 73.33%, respectively; penetration syndrome was the common clinical symptom with 93.33%; 20% of the airway foreign body cases were detected by X-ray; 100% of the airway foreign body cases were diagnosed by endoscopy; 53.33% of the cases were cured in one day; and 93.33% of the cases showed good treatment results. The study concludes that airway foreign bodies can be detected in all ages with more men than women; penetration syndrome with cough and shortness of breath suggests symptoms of airway foreign bodies; and endoscopy of bronchial airways is the leading method to diagnose and remove airway foreign bodies. Keywords Airway foreign body, clinical, subclinical. References [1] V.T. Quang, Otorhinorarynology Textbook, Vietnam National University Press, Hanoi, 2017 (in Vietnamese).[2] A.M. Salih, M. Alfaki and D.M. Alam-Elhuda, Airway foreign bodies: A critical review for a common pediatric emergency, National Central for Biotechnology Information, 2016, 7: 5-12. http://doi.org/10.5847/wjem.j.1920 8642.2016.01.001 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786499/[3] D.D. Tuoc, Forgotten airway foreign body, The Second Degree Specialist Graduation Thesis, Hanoi Medical University, 1978 (in Vietnamese).[4] N.D. Khang, N.N. Lien, Airway foreign body cases in National Otorhinolarygology Hospital of Vietnam from 1998 to 2001, The Second Degree Specialist Graduation Thesis, Hanoi Medical University, 2001 (in Vietnamese).[5] V.L. Phuoc, Airway foreign bodies in Otorhinorarygology Department at Hue Central Hospital, The Second Degree Specialist Graduation Thesis, Hue University of Medicine and Pharmacy, 2003 (in Vietnamese). [6] L.S. Can, P.K. Hoa, Airway foreign body, in: L.S. Can, Otorhinorarynology Emergency, Medical Publishing House, Hanoi, 1991, pp 32-38 (in Vietnamese).[7] C.Y. Chiu, K.S. Wong, S.H. Lai, S.H. Hsia, C.T.Wu. Factors predicting early diagnosis of foreign body aspiration in children. Polish Journal of Otolaryngology 21 (2005) 161–164. https://doi.org/10.5604/00306657.1184544

Objective: describe the clinical features in chronic sinusitis in adults in National Otorhinorarynology Hospital of Vietnam. Subjects and research methods: use the transverse descriptive method to describe the clinical features in chronic sinusitis in adults in the inpatient department - National otolaryngology hospital of Viet Nam. Results: the study involved 58 patients aged 18 and over suffering from chronic sinusitis in the inpatient department - National Otorhinorarynology Hospital of Vietnam from August 2019 to December 2019. The average age of the patients is 47,17 ± 15,32, with a male to female ratio of 1.1:1; most of the reason for being hospitalized is runny nose (72,4%) and stuffy nose (87,9%). Symptoms encountered in chronic sinusitis are runny nose, stuffy nose, headache, smell disorders and cough, in addition, with systemic symptoms such as fever, fatigue, weakness. Conclusion: on the clinical characteristics of chronic sinusitis in adults, the common symptoms in chronic sinusitis are runny nose, stuffy nose, headache, smell disorders and cough, duration of illness lasts from 6 months to many years, in both men and women.

GC-MS was applied to identify 24 main substances in Melaleuca cajuputi essential oil (TA) extracted from fresh cajeput leaves through steam distilling. The inhibitory capability of active compounds in the TA from Thua Thien Hue, Vietnam over the Angiotensin-Converting Enzyme 2 (ACE2) protein in human body - the host receptor for SARS-CoV-2 and the main protease (PDB6LU7) of the SARS-CoV-2 using docking simulation has been studied herein. The results indicate that the ACE2 and PDB6LU7 proteins were strongly inhibited by 10 out of 24 compounds accounting for 70.9% in the TA. The most powerful anticoronavirus activity is expressed in the order: Terpineol (TA2) ≈ Guaiol (TA5) ≈ Linalool (TA19) > Cineol (TA1) > β-Selinenol (TA3) > α-Eudesmol (TA4) > γ-Eudesmol (TA7). Interestingly, the synergistic interactions of these 10 substances of the TA exhibit excellent inhibition into the ACE2 and PDB6LU7 proteins. The docking results orient that the natural Melaleuca cajuputi essential oil is considered as a valuable resource for preventing SARS-CoV-2 invasion into human body.

Metagenomics could detect SARS-CoV-2 in all eight nasopharyngeal/throat swabs with high/low viral loads, and rhinovirus in a co-infected patient. The sequenced viruses belonged to lineage B1. Because metagenomics could detect novel pathogen and co-infection, and generate sequence data for epidemiological investigation, it is an attractive approach for infectious-disease diagnosis.

Background Identification of germline and somatic BRCA1/2 mutations in ovarian cancer is important for genetic counseling and treatment decision making with poly ADP ribose polymerase inhibitors. Unfortunately, data on the frequency of BRCA1/2 mutations in Vietnamese patients are scare. Methods We aim to explore the occurrence of BRCA1/2 mutations in 101 Vietnamese patients with ovarian cancer including serous (n = 58), endometrioid (n = 14), mucinous (n = 24), and clear cell (n = 5) carcinomas. BRCA1/2 mutations were detected from formalin-fixed parafin-embedded tumor samples using the OncomineTM BRCA Research Assay on Personal Genome Machine Platform with Ion Reporter Software for sequencing data analysis. The presence of pathogenic mutations was confirmed by Sanger sequencing. Results We found no BRCA2 mutation in the entire cohort. Four types of pathogenic mutations in BRCA1 (Ser454Ter, Gln541Ter, Arg1751Ter, and Gln1779AsnfsTer14) were detected in 8 unrelated patients (7.9%) belonging to serous and endometrioid carcinoma groups. Except for the c.1360_1361delAG (Ser454Ter) mutation in BRCA1 exon 11 that was somatic, the other mutations in exons 11, 20, and 22 were germline. Interestingly, the recurrent Arg1751Ter mutation in BRCA1 exon 20 appeared in 4 patients, suggesting that this is a founder mutation in Vietnamese patients. Conclusion Mutational analysis of tumor tissue using next generation sequencing allowed the detection of both germline and somatic BRCA1/2 mutations. .

BackgroundLittle is known about the natural history of asymptomatic SARS-CoV-2 infection or its contribution to infection transmission.MethodsWe conducted a prospective study at a quarantine centre for COVID-19 in Ho Chi Minh City, Vietnam. We enrolled quarantined people with RT-PCR-confirmed SARS-CoV-2 infection, collecting clinical data, travel and contact history, and saliva at enrolment and daily nasopharyngeal throat swabs (NTS) for RT-PCR testing. We compared the natural history and transmission potential of asymptomatic and symptomatic individuals.ResultsBetween March 10th and April 4th, 2020, 14,000 quarantined people were tested for SARS-CoV-2; 49 were positive. Of these, 30 participated in the study: 13(43%) never had symptoms and 17(57%) were symptomatic. 17(57%) participants acquired their infection outside Vietnam. Compared with symptomatic individuals, asymptomatic people were less likely to have detectable SARS-CoV-2 in NTS samples collected at enrolment (8/13 (62%) vs. 17/17 (100%) P=0.02). SARS-CoV-2 RNA was detected in 20/27 (74%) available saliva; 7/11 (64%) in the asymptomatic and 13/16 (81%) in the symptomatic group (P=0.56). Analysis of the probability of RT-PCR positivity showed asymptomatic participants had faster viral clearance than symptomatic participants (PConclusionsAsymptomatic SARS-CoV-2 infection is common and can be detected by analysis of saliva or NTS. NTS viral loads fall faster in asymptomatic individuals, but they appear able to transmit the virus to others.

Eighteen active substances, including 17 organosulfur compounds found in garlic essential oil (T), were identified by GC-MS analysis. For the first time, using the molecular docking technique, we report the inhibitory effect of the considered compounds on the host receptor angiotensin-converting enzyme 2 (ACE2) protein in the human body that leads to a crucial foundation about coronavirus resistance of individual compounds on the main protease (PDB6LU7) protein of SARS-CoV-2. The results show that the 17 organosulfur compounds, accounting for 99.4% contents of the garlic essential oil, have strong interactions with the amino acids of the ACE2 protein and the main protease PDB6LU7 of SARS-CoV-2. The strongest anticoronavirus activity is expressed in allyl disulfide and allyl trisulfide, which account for the highest content in the garlic essential oil (51.3%). Interestingly, docking results indicate the synergistic interactions of the 17 substances, which exhibit good inhibition of the ACE2 and PDB6LU7 proteins. The results suggest that the garlic essential oil is a valuable natural antivirus source, which contributes to preventing the invasion of coronavirus into the human body.

INTRODUCTION The discrimination of leukemia lymphoblasts (LB) in diagnosis and follow-up of B-cell progenitor acute lymphoblastic leukemia (BCP-ALL) by multiparameter flow cytometry (MFC) may be difficult due to the presence of hematogones (HG). The aim of this study was to compare lymphoblasts of BCP-ALL and HG for the expression of the most discriminating antigens. METHODS A total of 82 bone marrow samples (39 BCP-ALL and 43 patients with HG) were analyzed using MFC. Mean fluorescence intensity (MFI) was measured for ten markers commonly used in hematology laboratories: CD45, CD19, CD10, CD34, CD38, CD20, CD22, CD58, CD81, and CD123. Statistical comparison of the MFI between LB and HG was performed. The presence on LB of aberrant expression of myeloid and/or T-cell markers was also investigated. RESULTS Qualitative pattern expression of antigens showed overexpression on LB of CD58, CD22, CD34, CD10 and underexpression of CD81, CD45, CD38 when compared to HG. Expression of CD123 was positive in 34% of BCP-ALL LB and always absent on HG. Aberrant antigen expression (myeloid and/or T-cell marker) including CD123 was observed in 58% of BCP-ALL patients. The use of a MFI antigen ratio of the most discriminating markers (CD81/CD58) (analysis of variance, P

Background Allergic diseases are on the rise in many parts of the world, including the Asia–Pacific (APAC) region. Second-generation antihistamines are the first-line treatment option in the management of allergic rhinitis and urticaria. International guidelines describe the management of these conditions; however, clinicians perceive the additional need to tailor treatment according to patient profiles. This study serves as a consensus of experts from several countries in APAC (Hong Kong, Malaysia, the Philippines, Singapore, Thailand, Vietnam), which aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal second-generation antihistamines for patients with allergic rhinitis and/or urticaria. Methods Specialists from allergology, dermatology, and otorhinolaryngology were surveyed on practical considerations and key decision points when treating patients with allergic rhinitis and/or urticaria. Results Clinicians felt the need for additional tools for diagnosis of these diseases and a single drug with all preferred features of an antihistamine. Challenges in treatment include lack of clinician and patient awareness and compliance, financial constraints, and treatment for special patient populations such as those with concomitant disease. Selection of optimal second-generation antihistamines depends on many factors, particularly drug safety and efficacy, impact on psychomotor abilities, and sedation. Country-specific considerations include drug availability and cost-effectiveness. Survey results reveal bilastine as a preferred choice due to its high efficacy and safety, suitability for special patient populations, and the lack of sedative effects. Conclusions Compliance to the international guidelines is present among allergists, dermatologists and otorhinolaryngologists; however, this is lower amongst general practitioners (GPs). To increase awareness, allergy education programs targeted at GPs and patients may be beneficial. Updates to the existing international guidelines are suggested in APAC to reflect appropriate management for different patient profiles and varying symptoms of allergic rhinitis and urticaria. Electronic supplementary material The online version of this article (doi:10.1186/s12948-017-0074-3) contains supplementary material, which is available to authorized users.

We present here emissions estimated from a newly developed emission model for residential wood combustion (RWC) at high spatial and temporal resolution, which we name the MetVed model. The model estimates hourly emissions resolved on a 250 m grid resolution for several compounds, including particulate matter (PM), black carbon (BC) and polycyclic aromatic hydrocarbons (PAHs) in Norway for a 12-year period. The model uses novel input data and calculation methods that combine databases built with an unprecedented high level of detail and near-national coverage. The model establishes wood burning potential at the grid based on the dependencies between variables that influence emissions: i.e. outdoor temperature, number of and type and size of dwellings, type of available heating technologies, distribution of wood-based heating installations and their associated emission factors. RWC activity with a 1 h temporal profile was produced by combining heating degree day and hourly and weekday activity profiles reported by wood consumers in official statistics. This approach results in an improved characterisation of the spatio-temporal distribution of wood use, and subsequently of emissions, required for urban air quality assessments. Whereas most variables are calculated based on bottom-up approaches on a 250 m spatial grid, the MetVed model is set up to use official wood consumption at the county level and then distributes consumption to individual grids proportional to the physical traits of the residences within it. MetVed combines consumption with official emission factors that makes the emissions also upward scalable from the 250 m grid to the national level. The MetVed spatial distribution obtained was compared at the urban scale to other existing emissions at the same scale. The annual urban emissions, developed according to different spatial proxies, were found to have differences up to an order of magnitude. The MetVed total annual PM2.5 emissions in the urban domains compare well to emissions adjusted based on concentration measurements. In addition, hourly PM2.5 concentrations estimated by an Eulerian dispersion model using MetVed emissions were compared to measurements at air quality stations. Both hourly daily profiles and the seasonality of PM2.5 show a slight overestimation of PM2.5 levels. However, a comparison with black carbon from biomass burning and benzo(a)pyrene measurements indicates higher emissions during winter than that obtained by MetVed. The accuracy of urban emissions from RWC relies on the accuracy of the wood consumption (activity data), emission factors and the spatio-temporal distribution. While there are still knowledge gaps regarding emissions, MetVed represents a vast improvement in the spatial and temporal distribution of RWC.

In many practical applications, the electrical drive system, which is composed of a motor connected to a load machine through a shaft, is regarded as a two-mass system with flexible shaft, i.e., when long shaft and large load side mass are used. In this case, the oscillation caused by the finite stiffness and damping coefficients of the shaft may degrade the performance of the drive system. Hence, this paper focuses on control design for two-mass systems using induction motor drive fed by a voltage source inverter. By using flatness-based controller and utilizing the deadbeat response of the stator current loop, the performance of the drive system is improved not only in nominal speed range but also in field weakening range. The validity and effectiveness of the proposed method are verified by simulations.

β-Amino alcohol and diamine ligands were prepared from isosorbide as a chiral renewable resource. The efficiencies of these ligands were evaluated for the metal-catalyzed enantioselective ethylation of aldehydes and the alkynylation of aldimines.

Annona squamosa Linn. (custard apple) has been used extensively in India traditional medicine for treatment of dysentery, cardiac problems, fainting, worm infections, constipation, hemorrhage, dysuria, fever. This study assessed the phytochemicals present in the leaves of A. squamosa. The phytochemical was extracted separately with distilled water and 96% ethanol. A wide variety of pharmacologically active compounds such as alkaloids, coumarins, tannins, cardiac glycosides, flavonoids, carbohydrates, phenols, and saponins were found to present in the leaves of A. squamosa. However, terpenoids and phlobatannins were absent in this plant. This study also assessed the contents of phenolics and flavonoids for their in vitro antioxidant activity. The total polyphenol content of ethanol extract of A. squamosa measured by Folin-Ciocalteau reagent in terms of gallic acid equivalent achieved 242.88±6.13 mg GAE/g. The flavonoid content of the plant sample as quercetin equivalent achieved 82,61±0.82 mg QE/g. The antioxidant activity of the ethanol extract of A. squamosa was correlated with total phenolic and flavonoid content with values IC50 of 132.96±1.33 μg/ml, 64.74±0.52 μg/ml for DPPH and ABTS scavenging activity, respectively.

Emerging evidence indicates that migrants from Plasmodium falciparum endemic regions are at risk of delayed presentation of P. falciparum malaria. We report three cases of P. falciparum malaria occurring years after arrival in Europe. All patients were originally from Sub-Saharan Africa. Two subjects had controlled human immunodeficiency virus infection and one was a pregnant woman. We performed a literature review of all published cases of delayed presentation of P. falciparum in migrants and identified 32 additional cases. All cases but one originate from sub-Saharan Africa. There was a median time of 36 months between the last visit to a malaria-endemic country and clinical malaria (range: 3 months to 10 years). Pregnancy was the most frequently reported risk factor (11/35 or 31.4%). Parasitemia was ≤ 0.1% in 38% of cases (11/29 reported), and no death was reported. The underlying possible mechanisms for this delayed presentation in migrants from an endemic area probably include the persistence of submicroscopic parasitemia combined with decaying P. falciparum-specific immunity. Suspicion of P. falciparum delayed malaria should remain high in migrants, mainly from sub-Saharan Africa, even without a recent travel history, especially in those presenting risk factors for impaired parasite clearance or distinct immune responses such as pregnancy and HIV infection. In these patients, new prevention and screening strategies should be studied and blood safety policies adapted.

Synthesis of triazolo-cyclobutane nucleosides analogs is reported. These molecules have been obtained by a short and efficient sequence involving a click azide-alkyne cycloaddition following by cis-hydroxylation in the key step.

Dengue is a viral disease for which there is currently no therapeutic agent. We investigated the potential of lovastatin in the treatment of dengue. Lovastatin was safe and well tolerated, but did not demonstrate a therapeutic benefit., Background. Dengue endangers billions of people in the tropical world, yet no therapeutic is currently available. In part, the severe manifestations of dengue reflect inflammatory processes affecting the vascular endothelium. In addition to lipid lowering, statins have pleiotropic effects that improve endothelial function, and epidemiological studies suggest that outcomes from a range of acute inflammatory syndromes are improved in patients already on statin therapy. Methods. Following satisfactory review of a short pilot phase (40 mg lovastatin vs placebo in 30 cases), we performed a randomized, double-blind, placebo-controlled trial of 5 days of 80 mg lovastatin vs placebo in 300 Vietnamese adults with a positive dengue NS1 rapid test presenting within 72 hours of fever onset. The primary outcome was safety. Secondary outcomes included comparisons of disease progression rates, fever clearance times, and measures of plasma viremia and quality of life between the treatment arms. Results. Adverse events occurred with similar frequency in both groups (97/151 [64%] placebo vs 82/149 [55%] lovastatin; P = .13), and were in keeping with the characteristic clinical and laboratory features of acute dengue. We also observed no difference in serious adverse events or any of the secondary outcome measures. Conclusions. We found lovastatin to be safe and well tolerated in adults with dengue. However, although the study was not powered to address efficacy, we found no evidence of a beneficial effect on any of the clinical manifestations or on dengue viremia. Continuing established statin therapy in patients who develop dengue is safe. Chinese Clinical Trials Registration. ISRCTN03147572.

An efficient procedure for the synthesis of functionalized chiral ammonium, imidazolium, and pyridinium-based ionic liquids derived from (1R, 2S)-ephedrine using solvent-free microwave activation has been described. Good yields were obtained in very short reaction time. These chiral ionic liquids were used as chiral reaction media for the asymmetric Michael addition, giving good yields and moderate enantioselectivities.

A new class of β-amino alcohol and diamine ligands was prepared from isosorbide as a chiral renewable resource. The original wedge-shaped structure of isosorbide offers an interesting chiral pocket to promote the metal-catalyzed enantioselective reduction of ketones by transfer hydrogenation.

Many patients with acute coronary syndrome (ACS) in Asia undergo PCI but long-term antithrombotic management patterns (AMPs) and real-world clinical outcomes remain unclear. This analysis described AMPs and long-term outcomes of patients with ACS (unstable angina [UA], non-ST segment elevation MI [

PURPOSE Across Hong Kong, Malaysia, the Philippines, Singapore, Thailand and Vietnam, (referred to as Asia) approximately 30-53 million individuals of the 151 million employed suffer from allergic rhinitis (AR) and urticaria. It is estimated that approximately 90% of patients with these allergic conditions are insufficiently treated, impacting the socioeconomic burden in terms of absence from work and decreased productivity. This study aims to estimate the socioeconomic burden of allergies in Asia and the cost savings that their adequate management can provide. Due to the limited availability of regional data, this study focused AR and urticaria in selected countries. METHODS Published literature, information from statistical bureaus, clinician surveys and extrapolation of selected data from the European Union were used to determine the socioeconomic costs of AR and urticaria. RESULTS Many patients in Asia suffer from perennial allergies and experience symptoms of AR and urticaria for up to 298 days per year. An estimate of the indirect costs of patients insufficiently treated for AR and urticaria amounts to USD 105.4 billion a year, which equates to USD 1,137-2,195 per patient due to absenteeism and presenteeism. Adherence to guideline-approved treatment can lead to estimated savings of up to USD 104 billion. CONCLUSIONS The current study suggests that within Asia, the socioeconomic impact of AR and urticaria is similar to that seen in the European Union in spite of the lower wages in Asia. This is due to the mainly perennial allergens prevailing in Asia, whereas the sensitization patterns observed in the European Union are dominated by seasonal exposure to pollen. These results underline the need for governmental initiatives to increase public awareness on the prevention and treatment of these and other allergic diseases as well as greater research funding and large-scale studies to reduce their growing socioeconomic burden in coming years.

A novel family of chiral imidazolium-based ionic liquids containing a chiral moiety and a free hydroxyl function has been designed and synthesized using isosorbide as a biorenewable substrate. These chiral ionic liquids were found to catalyze the aza Diels–Alder reaction to give good yields and moderate diastereoselectivities. Chiral ionic liquids are recycled while their efficiency is preserved.

A new class of monophosphine ligands has been prepared from natural chirality renewable source, 1,4:3,6-dianhydrohexitol compounds, via a nucleophilic substitution process, or a hydrophosphination reaction involving microwave activation. These ligands have been evaluated for the rhodium-catalyzed enantioselective hydrogenation of olefins giving good conversion and enantioselectivity up to 95% and 96% ee, respectively.

Although many studies have made efforts to define and assess medical professionalism, few have addressed issues of construct validity.The purpose of this article is to explore further construct validity of medical professionalism employing exploratory and confirmatory factor analysis.The 32-item instrument by the American Board of Internal Medicine (ABIM) was adapted to assess the perceptions on medical professionalism of Vietnamese medical students. A sample of 1,196 (487 first-year, 341 third-year, 368 sixth-year) medical students participated voluntarily in the completion of the instrument. The data were randomly divided into three samples to assess the construct validity of medical professionalism by empirically deriving and confirming a model of professionalism.Exploratory and confirmatory factor analytic techniques resulted in a six-factor well-fitting model with a comparative fit index of .963 and root mean square error approximation of .029, 90% confidence interval [016, .039]: integrity, social responsibility, professional practice habits, ensuring quality care, altruism, and self-awareness. Social responsibility was perceived least important, and self-awareness was perceived most important by Vietnamese medical students. These constructs of medical professionalism were relatively similar with those found in Taiwanese medical students and the ABIM definitions but with some Vietnamese cultural differences.Although the results confirm that medical professionalism is a somewhat culturally sensitive construct, it nonetheless has many elements of medical professionalism that are universal. Future research should be conducted to test the generalizability of our six-factor model of professionalism with various samples (e.g., residents, physicians), cultures, and language groups.

The synthesis of 15 N-labelled nornicotine 2 and 15 N-labelled nicotine 1 is described via the reductive aminocyclization of a 1,4-ketoaldehyde with a corresponding amine in the presence of sodium cyanoborohydride. Yields of 30% and 26%, respectively, were obtained from 3-bromopyridine. The 15 N-label has been easily introduced from ammonium- 15 N-labelled chloride as an inexpensive label source. As far as we are aware, this is the first synthesis of 15 N-labelled nicotine.

Ligand (I) and its endo isomer are prepared via different approaches and tested in the title reaction.

A variety of isosorbide-derived amino alcohols as well as diamines such as (I) is prepared and tested as ligands in the Ru-catalyzed asymmetric transfer hydrogenation of aromatic ketones.

Anti-sheep Fab fragment antisera were produced in rabbits using sheep digoxin-specific Fab fragments (Digidot) as immunogen. These antisera were used for the development of a radioimmunoassay (RIA) of sheep Fab fragments in human plasma and urine using 125I-labeled Fab fragments. Interference in the assays by digoxin, human proteins, and antibodies from different species was insignificant, but cross-reactivity between anti-sheep Fab antisera and goat IgG or Fab fragments was 22 to 67%. The limit of detection was 0.1 µg/mL and the assay was linear over a 0.6–28 µg/mL range of Fab fragments. Intra- and interassay coefficients of variation were less than 6.9 and 10.5%, respectively. Accuracy of plasma and urine assays at various Fab fragment levels ranged from 96 to 106%. RIA was applied to the pharmacokinetic study of sheep digoxin-specific Fab fragments in one patient acutely intoxicated by digitoxin and treated with Digidot. The Fab elimination half-life was 12.1 hr. Steady-state volume of distribution and total-body clearance were 10.8 L and 23.4 mL/min, respectively. Unchanged Fab fragments (50 kD) and degradation products (25 kD) isolated by gel filtration chromatography of a urine sample cross-reacted with the anti-Fab antiserum.

Tat is a regulatory HIV-1 protein, which has the particularity to be secreted very early by HIV-infected cells. The extra cellular roles of Tat are suspected to be the main cause of the maintenance of reservoirs of HIV-infected cells and the failure of actual AIDS therapies to eradicate HIV. This study describes the rationale used to design molecules that bind to a target area containing an hydrophobic pocket identified in the 2D-NMR structure of Tat. Molecules were synthesized and the derivative named TDS2 was shown to be a Tat inhibitor. Fluorescence revealed that TDS2 binds in the target area, which is conserved across five different Tat variants representative of the main HIV-1 subtypes. TDS2 inhibitedin vitroHIV-1 replication in human T-cells. Further chemical modifications remain necessary to enhance affinity to Tat and reduce cytotoxicity.

To assess the in vivo sensitivity of Plasmodium falciparum to mefloquine and artesunate in a hyperendemic area of southern Viet Nam, we studied 41 children and 21 adults from a remote commune who had uncomplicated falciparum malaria without previous treatment. Patients were randomly allocated to artesunate (4 mg/kg on day 0 and 2 mg/kg on days 1-4) or mefloquine (10 mg/kg followed by 5 mg/kg at 6 h). Serial assessments were performed over 28 days. Of 31 patients allocated artesunate, nine (29%) redeveloped parasitaemia during follow-up compared with 23% (seven of 30) who received mefloquine. Of the 41 children, 15 (37%) had recrudescence/re-infection compared with only one of 20 adults (5%; p < 0.001). Significantly more children than adults failed on mefloquine treatment (37% vs 0%; p = 0.021) and one case showed RIII resistance. There was no significant difference in the case of artesunate. In regression analysis, parasitaemia was an independent predictor of recrudescence/re-infection after mefloquine (p = 0.02). These data support the use of combination therapy such as artesunate plus mefloquine for falciparum malaria in a hyperendemic area of Viet Nam. Primarily because of their greater parasite densities, children should be given higher doses of mefloquine (e.g. 25 mg/kg).

A new class of β-amino alcohol and diamine ligands has been prepared from isosorbide as a chiral renewable source. The efficiency of these ligands has been evaluated for the metal-catalyzed enantioselective reduction of aromatic ketones by transfer hydrogenation, giving excellent conversion and good enantioselectivity.

A novel class of chiral ammonium and imidazolium-based ionic liquids has been designed and synthesized using isosorbide as a biorenewable substrate. These chiral ionic liquids were found to catalyze the aza Diels–Alder reaction to give good yields and moderate diastereoselectivitives.

Quinolones can be prepared in a three step procedure from triethylorthoformate and activated methylene derivatives leading to alkoxymethylenemalonates followed by reaction with aromatic amines and finally a cyclization. All the reactions were carried out under solvent-free conditions possibly under microwave activation with benefits for the first step.

Sudden changes in the elastic stiffness constants of single crystalline calcite at the transition calcite I-calcite II (Vo Thanh and Lacam) are interpreted in terms of the interaction between pressure induced elastic strains and the rotational mode of CO 3 = groups. The latter is softened at the critical pressure, causing the transition. Our theoretical analysis explains qualitatively the experimental observations and data.

Background Despite marked global differences in the prevalence of rheumatic heart disease, little is known about geographic variations in the characteristics of patients with severe mitral stenosis. Aim To determine if differences in rheumatic fever epidemiology influence the characteristics of patients with mitral stenosis and the immediate results of percutaneous mitral commissurotomy (PMC). Methods We compared 350 patients (mean age: 41 ± 17 years, 81% women) scheduled for PMC in five non-Western and two Western countries. Fifty consecutive patients were included in each centre. All presented a mitral valve area less than 1.5 cm2 and were in New York Heart Association (NYHA) functional class greater or equal to II, with no contraindications to PMC. Results The 250 patients from non-Western countries were younger than the 100 patients from Western countries (35 ± 12 vs 57 ± 15 years, p