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Introduction: Patients experiencing an out-of-hospital cardiac arrest (OHCA) frequently do not receive bystander cardiopulmonary resuscitation (CPR), especially in low- and middle-income countries (LMIC). In this study we sought to determine the prevalence of OHCA patients in Vietnam who received bystander CPR and its effects on survival outcomes.Methods: We performed a multicenter, retrospective observational study of patients (≥18 years) presenting with OHCA at three major hospitals in an LMIC from February 2014–December 2018. We collected data on the hospital and patient characteristics, the cardiac arrest events, the emergency medical services (EMS) system, the therapy methods, and the outcomes and compared these data, before and after pairwise 1:1 propensity score matching, between patients who received bystander CPR and those who did not. Upon admission, we assessed factors associated with good neurological survival at hospital discharge in univariable and multivariable logistic models.Results: Of 521 patients, 388 (74.5%) were men, and the mean age was 56.7 years (SD 17.3). Although most cardiac arrests (68.7%, 358/521) occurred at home and 78.8% (410/520) were witnessed, a low proportion (22.1%, 115/521) of these patients received bystander CPR. Only half of the patients were brought by EMS (8.1%, 42/521) or private ambulance (42.8%, 223/521), 50.8% (133/262) of whom had resuscitation attempts. Before matching, there was a significant difference in good neurological survival between patients who received bystander CPR (12.2%, 14/115) and patients who did not (4.7%, 19/406; P < .001). After matching, good neurological survival was absent in all OHCA patients who did not receive CPR from a bystander. The multivariable analysis showed that bystander CPR (adjusted odds ratio: 3.624; 95% confidence interval 1.629–8.063) was an independent predictor of good neurological survival.Conclusion: In our study, only 22.1% of total OHCA patients received bystander CPR, which contributed significantly to a low rate of good neurological survival in Vietnam. To improve the chances of survival with good neurological functions of OHCA patients, more people should be trained to perform bystander CPR and teach others as well. A standard program for emergency first-aid training is necessary for this purpose.

Despite the importance of soil moisture (SM) in various applications and the need to validate satellite SM products, the current in situ SM network is still inadequate, even for developed country such as the United States. Recently, SM2RAIN (Soil Moisture to Rain) algorithm has prominently emerged as a bottom-up approach to derive rainfall data from SM. In this study, we evaluated whether SM2RAIN algorithm and rain gauges, which are more abundant and readily available than in situ SM, can be used to validate satellite-based SMAP SM estimates. Since errors in SMAP SM propagate to SMAP-derived rainfall, the skills of SM2RAIN might be able to provide insights on the accuracy of SMAP SM observations. While the correlation between SM2RAIN skills and SMAP SM skills was found to be statistically significant, the strength of the correlation varied among different climate zones and annual rainfall classes. Specifically, weaker correlations were observed in arid and lower rainfall regions (median R value of 0.12), while stronger correlations were found in temperate and higher rainfall regions (median R value of 0.54). In term of over/under-estimation tendencies, 56% of the stations had the same tendencies (SM2RAIN skills and satellite SM skills both have positive or negative PBIAS value). [ABSTRACT FROM AUTHOR]

Objective To investigate factors associated with survival after out-of-hospital cardiac arrest in Viet Nam. Methods We did a multicentre prospective observational study of people (> 18 years) presenting with out-of-hospital cardiac arrest (not caused by trauma) to three tertiary hospitals in Viet Nam from February 2014 to December 2018. We collected data on characteristics, management and outcomes of patients with out-of-hospital cardiac arrest and compared these data by type of transportation to hospital and survival to hospital admission. We assessed factors associated with survival to admission to and discharge from hospital using logistic regression analysis. Findings Of 590 eligible people with out-of-hospital cardiac arrest, 440 (74.6%) were male and the mean age was 56.1 years (standard deviation: 17.2). Only 24.2% (143/590) of these people survived to hospital admission and 14.1% (83/590) survived to hospital discharge. Most cardiac arrests (67.8%; 400/590) occurred at home, 79.4% (444/559) were witnessed by bystanders and 22.3% (124/555) were given cardiopulmonary resuscitation by a bystander. Only 8.6% (51/590) of the people were taken to hospital by the emergency medical services and 32.2% (49/152) received pre-hospital defibrillation. Pre-hospital defibrillation (odds ratio, OR: 3.90; 95% confidence interval, CI: 1.54-9.90) and return of spontaneous circulation in the emergency department (OR: 2.89; 95% CI: 1.03-8.12) were associated with survival to hospital admission. Hypothermia therapy during post-resuscitation care was associated with survival to discharge (OR: 5.44; 95% CI: 2.33-12.74). Conclusion Improvements are needed in the emergency medical services in Viet Nam such as increasing bystander cardiopulmonary resuscitation and public access defibrillation, and improving ambulance and post-resuscitation care. Objectif Examiner les facteurs associes a la survie apres un arret cardiaque hors hopital au Viet Nam. Methodes Nous avons mene une etude d'observation prospective multicentrique sur des personnes (> 18 ans) ayant subi un arret cardiaque hors hopital (non traumatique) et admis dans trois hopitaux tertiaires au Viet Nam entre fevrier 2014 et decembre 2018. Nous avons recolte des donnees sur les caracteristiques, la gestion et l'issue de ces patients, puis les avons compares en fonction du moyen de transport vers l'hopital et de la survie apres leur admission. Enfin, nous avons mesure des facteurs associes a la survie lors de l'admission et de la sortie de l'etablissement a l'aide d'une analyse de regression logistique. Resultats Sur les 590 patients eligibles ayant subi un arret cardiaque hors hopital, 440 (74,6%) etaient des hommes et l'age moyen s'elevait a 56,1 ans (ecart type: 17.2). Seulement 24,2% (143/590) d'entre eux ont survecu a leur admission a l'hopital, et 14,1% (83/590) a leur sortie. La plupart des arrets cardiaques (67,8%; 400/590) ont eu lieu a domicile, 79,4% (444/559) se sont deroules en presence de passants et 22,3% (124/555) ont fait l'objet d'une reanimation cardiopulmonaire pratiquee par un temoin. A peine 8,6% (51/590) des patients ont ete emmenes a l'hopital par les services medicaux d'urgence, et 32,2% (49/152) ont recu une defibrillation avant d'arriver a l'hopital. La defibrillation prehospitaliere (odds ratio, OR: 3,90; intervalle de confiance de 95%, IC: 1,54-9,90) et le retablissement d'une circulation spontanee aux urgences (OR: 2,89; IC de 95%: 1,03-8,12) allaient de pair avec la survie apres admission. Lhypothermie therapeutique administree durant les soins post-reanimation etait liee a un meilleur taux de survie au moment de la sortie (OR: 5,44; IC de 95%: 2,33-12,74). Conclusion Des amenagements sont requis en matiere de services medicaux d'urgence au Viet Nam, notamment pour encourager la pratique de la reanimation cardiopulmonaire aupres de la population, garantir l'acces a des defibrillateurs publics, mais aussi ameliorer les soins en ambulance et en post-reanimation. Objetivo Investigar los factores relacionados con la supervivencia despues de un paro cardiaco extrahospitalario en Vietnam. Metodos Se realizo un estudio observacional prospectivo multicentrico de personas (>18 anos) que sufrieron un paro cardiaco extrahospitalario (no causado por traumatismo) en tres hospitales terciarios de Vietnam entre febrero de 2014 y diciembre de 2018. Se recopilaron los datos sobre las caracteristicas, el tratamiento y los resultados de los pacientes con paro cardiaco extrahospitalario y se compararon segun el tipo de transporte hasta el hospital y la supervivencia hasta el ingreso en el hospital. Se evaluaron los factores de supervivencia hasta el ingreso y el alta hospitalaria mediante un analisis de regresion logistica. Resultados De las 590 personas que cumplian los requisitos y sufrieron un paro cardiaco extrahospitalario, 440 (74,6 %) eran hombres, cuya edad media era de 56,1 anos (desviacion estandar: 17,2). Solo el 24,2 % (143/590) de estas personas sobrevivieron al ingreso en el hospital y el 14,1 % (83/590) sobrevivieron al alta hospitalaria. La mayoria de los paros cardiacos (67,8 %; 400/590) ocurrieron en el hogar, el 79,4 % (444/559) fueron presenciados por transeuntes y el 22,3 % (124/555) recibieron reanimacion cardiopulmonar por un transeunte. Solo el 8,6 % (51/590) de las personas fueron trasladadas al hospital por los servicios medicos de emergencia y el 32,2 % (49/152) recibieron desfibrilacion prehospitalaria. La desfibrilacion prehospitalaria (oportunidad relativa, OR: 3,90; intervalo de confianza del 95 %, IC: 1,54-9,90) y la recuperacion de la circulacion espontanea en el servicio de urgencias (OR: 2,89; IC del 95 %: 1,03-8,12) se asociaron a la supervivencia hasta el ingreso hospitalario. La hipotermia terapeutica durante la atencion posterior a la reanimacion se asocio a la supervivencia hasta el alta (OR: 5,44; IC del 95 %: 2,33-12,74). Conclusion Se necesitan mejoras en los servicios medicos de emergencia de Vietnam, como el aumento de las intervenciones de reanimacion cardiopulmonar para transeuntes y de desfibrilacion de acceso publico, asi como el mejoramiento de la atencion en las ambulancias y de los cuidados posteriores a la reanimacion. [phrase omitted], Introduction Out-of-hospital cardiac arrest is one of the leading causes of death and disability worldwide [1,2] and contributes to as much as 10% of the total mortality in low- and [...]

Background & aimsChronic hepatitis B virus (HBV) infection is an important cause of cirrhosis and hepatocellular carcinoma worldwide; populations that migrate to the United States and Canada might be affected disproportionately. The Hepatitis B Research Network (HBRN) is a cooperative network of investigators from the United States and Canada, created to facilitate clinical, therapeutic, and translational research in adults and children with hepatitis B. We describe the structure of the network and baseline characteristics of adults with hepatitis B enrolled in the network.MethodsThe HBRN collected data on the clinical characteristics of 1625 adults with chronic HBV infection who are not receiving antiviral therapy from 21 clinical centers in North America.ResultsHalf of the subjects in the HBRN are men, and the median age is 42 years; 72% are Asian, 15% are black, and 11% are white; with 82% born outside of North America. The most common HBV genotype was B (39%); 74% of subjects were negative for the hepatitis B e antigen. The median serum level of HBV DNA when the study began was 3.6 log10 IU/mL; 68% of male subjects and 67% of female subjects had alanine aminotransferase levels higher than the normal range.ConclusionsThe HBRN cohort is used to address important clinical and therapeutic questions for North Americans infected with chronic HBV and to guide health policies on HBV prevention and management in North America.

A series of thioureas 7a–k containing pyrimidine and a D -glucose moiety were synthesized through the reaction between substituted 2-aminopyrimidines 3a–k and tetra-O-acetyl-β- D -glucopyranosyl isothiocyanate 6. The yields achieved were 55–77%. Compounds 7a–k were screened for their anticancer activity against breast adenocarcinoma MCF-7, hepatocellular carcinoma HepG2, cervical cancer HeLa, and lung adenocarcinoma SK-LU-1 cell lines. The compounds that exhibited the highest potential inhibitory activity included 7b (IC50 = 1.16 ± 0.22 μM and 1.22 ± 0.41 μM against MCF-7 and SK-LU-1 cells, respectively), 7e (IC50 = 1.12 ± 0.13 μM against HeLa cells), and 7h (IC50 = 1.12 ± 0.11 μM against HepG2 cells). Compounds 7h and 7k exhibited EGFR inhibitory activity with IC50 values of 12.23 ± 0.21 nM and 24.16 ± 0.23 nM, respectively. They also exhibited VEGFR-2 inhibitory activity with IC50 values of 19.13 ± 1.12 nM and 25.62 ± 1.32 nM, respectively, in comparison with sorafenib. Induced-fit docking simulation for the most active inhibitor 7h was carried out on the enzyme 4HJO in order to elucidate its inhibitory potential. The obtained results showed that compound 7h was compatible with the active site of the EGFR tyrosine kinase domain of 4HJO with residues Lys692, Lys704, Met769, and Cys773. Molecular dynamics simulation in a water solvent system showed that the active interactions with these residues played an important role in stabilizing complex 7h/ 4HJO in the active pocket. [ABSTRACT FROM AUTHOR]

Summary: Background: Data on patients switched to tenofovir alafenamide (TAF) from nucleos(t)ide analogues (NUCs) other than tenofovir disoproxil fumarate are limited. Aims: To assess the treatment and renal/bone safety outcomes following the switch to TAF. Methods: We prospectively enrolled adult patients with chronic hepatitis B (CHB) who switched from any NUC to TAF at 14 centres in Japan, Korea, Taiwan and the U.S. Study outcomes were viral suppression (VR; HBV DNA < 20 IU/mL), biochemical response (BR; alanine aminotransferase normalisation), and changes in estimated glomerular filtration rate (eGFR) and T‐scores (L‐spine) by bone absorptiometry by 24 months after switch to TAF. Results: We enrolled 270 eligible patients. Mean age was 58.1; 58.2% were male; 12.2% had cirrhosis and 73.3% previously received entecavir monotherapy. VR rate increased significantly from 95.2% to 98.8% by 24 months after the switch to TAF (p = 0.014). Between the switch and 24 months later, the mean spine T‐score improved significantly from −1.43 ± 1.36 to −1.17 ± 1.38 (p < 0.0001), while there was no significant change in mean eGFR (88.4 ± 16.9–89.5 ± 16.3 mL/min/1.73 m2, p = 0.13). On multivariable analysis adjusted for age, sex, baseline spine T‐score and prior TDF or adefovir dipivoxil use, male sex was significantly associated with lower risk of worsening spine T‐score (odds ratio: 0.29, p = 0.020), while age was significantly associated with a higher risk of worsening chronic kidney disease stage (OR: 1.07, p = 0.019). Conclusions: At 24 months after the switch to TAF, VR rates and spine bone density improved significantly while renal function remained stable. [ABSTRACT FROM AUTHOR]