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Vascular malformations, including lymphatic-venous malformations (LVMs), are complex and can lead to significant morbidity. This case report details the management of a rare multifocal, combined LVM in a 3-month-old male, misdiagnosed as a right inguinal hernia prenatally. Postnatal imaging revealed multiloculated cystic masses extending from the mons pubis to the right groin, scrotum, and thigh. Doppler ultrasound and MRI demonstrated the extent of the masses, with the largest cyst measuring 4 × 4 × 2 cm. Initial surgical excision and debulking were performed; however, the lesion recurred 6 months later. Given the complexity and involvement of truncal vessels, complete excision was not feasible, and sclerotherapy with intralesional Bleomycin injections was initiated. After the first Bleomycin injection, a significant reduction in lesion size was observed. However, 6 months later, the lesion recurred and enlarged, necessitating a second Bleomycin injection. Subsequent follow-ups showed further reduction in lesion size. Unfortunately, 2 years later, the patient experienced diffuse cystic infiltration of the pelvis and right lower extremity due to treatment delays caused by the COVID-19 pandemic. Imaging at this stage revealed a cystic mass in the right pelvic cavity measuring 10 × 6 × 5 cm. Two additional sessions of Bleomycin injections were performed, resulting in a successful resolution of the cystic masses. Regular follow-ups have shown that the LVMs remain under control, with no symptoms and no concerns from the family. This case underscores the complexities involved in diagnosing and managing multifocal, combined LVMs. It suggests that Bleomycin sclerotherapy can be a valuable, minimally invasive alternative to more extensive surgical procedures, particularly when critical structures are involved. The patient’s condition has been successfully managed with a combination of surgical and sclerotherapy interventions, ultimately resulting in symptomatic relief and cosmetic improvement.

Eosinophilic gastroenteritis poses a significant diagnostic challenge, particularly in developing countries, where the awareness of this condition may be limited. Here, the case of a patient in her early 30s, who presented with recurrent episodes of abdominal pain and diarrhea, is reported. Initial standard laboratory investigations revealed normal complete blood counts and elevated total serum immunoglobulin E levels. Upper and lower endoscopic evaluations with systemic biopsies did not reveal any significant abnormalities. However, computed tomography revealed a thickened small intestine wall, halo signs, and mild ascites. Analysis of the ascitic fluid confirmed eosinophilia. These findings prompted a diagnosis of eosinophilic gastroenteritis. The patient responded well to a targeted elimination diet, corticosteroids, and antileukotriene medication. The present case emphasizes the importance of considering eosinophilic gastroenteritis in the differential diagnosis of patients who present with abdominal pain and eosinophilic ascites.

Introduction: Lymphatic malformations (LMs) or lymphangiomas are rare congenital anomalies affecting the lymphatic system. They are predominantly found in the head and neck, with less common occurrences in abdominal cavity or scrotum. Bleomycin is among the sclerotic agents used, capable of inducing a non-specific inflammatory process leading to thrombosis and fibrosis of the cyst. However, there is limited literature regarding the efficacy of Bleomycin as a standalone treatment for large and mixed types of cystic LMs. Case presentation: A 17-year-old male presented with swelling in the right inguinal and scrotal regions, without tenderness. Ultrasound and contrast-enhanced computed tomography scan (CT scan) revealed a large, well-defined multiloculated cystic lesion measuring 7x8x8cm in the pelvic region, extending into the left inguinoscrotal region (15x6x8cm), consistent with LMs. Treatment comprised aspiration of cystic fluid followed by Bleomycin injection, administered at a maximum dosage of 0.5 IU/kg body weight under general anesthesia. A sequence of five sclerotherapy sessions of Bleomycin injections was carried out, with each session spaced one month apart. Following 15 months of observation, no intra-abdominal cystic masses were identified, and scrotal ultrasound displayed near-complete resolution. Only a fibrotic tissue measuring 1.5 × 1cm in size was identified in the scrotum, and it remained stable across three consecutive scans, indicating that no further intervention was required. Conclusion: Based on this case study, sclerotherapy using intralesional Bleomycin injection for large, complex LMs in children appears to be safe and effective. This scarless approach seems to provide good cosmetic outcomes and poses a minimal risk of neurovascular injury.

Background: Food allergy (FA), which is a condition that has no effective cure and can result in severe life-threatening allergic reactions, remains a global public health concern; however, little is known about how FAs are currently managed in the Asia-Pacific region. Objective: The main objective of this survey was to evaluate the epidemiology of FA, as well as the availability of resources and practices for management of FA and anaphylaxis by health care providers across Asia. Methods: From June 2022 to September 2022, a questionnaire-based survey comprising 66 questions was electronically sent to member societies of the Asia Pacific Association of Allergy Asthma and Clinical Immunology by using Survey Monkey. Results: A total of 20 responses were received from 15 member countries and territories. Compared with the pediatric data, there was a lack of prevalence data for FA in adults. Except for Australia and Japan, most regions had between 0.1 and 0.5 allergists per 100,000 population and some had fewer than 0.1 allergists per 100,000 population. The perceived rate of FA in regions with a short supply of allergists was high. Although specific IgE tests and oral food challenges were available in all regions, the median wait time for oral food challenges at government facilities was 37 days (interquartile range = 10.5-60 days). Seven regions still relied on prescriptions of ampules and syringes of injectable adrenaline, and adrenaline autoinjectors were not accessible in 4 regions. Oral immunotherapy as FA treatment was available in half of the surveyed countries and territories. Conclusions: Our study offers a cross-sectional evaluation of the management practices for FA in each Asia Pacific Association of Allergy Asthma and Clinical Immunology member country or territory. Urgent actions are required to enhance allergy services, improve the accessibility and affordability of adrenaline autoinjectors, and conduct robust epidemiologic studies.

Abstract Background Previous case series have reported idiopathic eosinophilic vasculitis as a potential manifestation of hypereosinophilic syndrome (HES). This condition is characterized by digital necrotizing, systemic vasculitis that affects varying-sized blood vessels. This report presents our experience in treating a patient with eosinophilic vasculitis. Case presentation We describe the case of a 23-year-old man who presented with idiopathic HES, which manifested as digital ulcers and peripheral ischemia in both the upper and lower limbs, without the involvement of other organ systems. After ruling out primary and secondary causes of eosinophilia, a diagnosis of HES was established. Our patient has shown a positive response to corticosteroid therapy. Conclusions Our case contributes to the existing evidence about diagnosing idiopathic eosinophilic vasculitis in patients with HES. We observed a favorable response to corticosteroid treatment in our patient.

Background: Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions and can cause death. Given the prevalence of anaphylaxis within healthcare systems, it is a high priority public health issue. However, management of anaphylaxis – both acute and preventative – varies by region. Methods: The World Allergy Organization (WAO) Anaphylaxis Committee and the WAO Junior Members Steering Group undertook a global online survey to evaluate local practice in the diagnosis and management of anaphylaxis across regions. Results: Responses were received from WAO members in 66 countries. While intramuscular epinephrine (adrenaline) is first-line treatment for anaphylaxis, some countries continue to recommend alternative routes in contrast to guidelines. Epinephrine auto-injector (EAI) devices, prescribed to individuals at ongoing risk of anaphylaxis in the community setting, are only available in 60% of countries surveyed, mainly in high-income countries. Many countries in South America, Africa/Middle-East and Asian-Pacific regions do not have EAI available, or depend on individual importation. In countries where EAIs are commercially available, national policies regarding the availability of EAIs in public settings are limited to few countries (16%). There is no consensus regarding the time patients should be observed following emergency treatment of anaphylaxis. Conclusion: This survey provides a global snapshot view of the current management of anaphylaxis, and highlights key unmet needs including the global availability of epinephrine for self-injection as a key component of anaphylaxis management.

Asthma is a prevalent non-communicable disease that affects both children and adults. Many patients with severe, uncontrolled asthma could not achieve total control despite using anti-asthmatic drugs. There is increasing evidence that allergy to environmental allergens, including both indoor and outdoor allergens, is associated with asthma symptoms and severe asthma. Frequently reported sensitized allergens were dust mites, cockroaches, grass pollens, molds, pets, and rodents in allergic asthma patients, although the patterns of widespread allergens differed from each country. Allergen avoidance is the cornerstone of asthma management, especially in sensitized subjects. This review summarizes environmental allergen avoidance and clarifies their effects on asthma control. Despite contrasting results about the impact of allergen exposure reduction on asthma control, several studies supported the beneficial effects of reducing asthma-related symptoms or risk of exacerbations as a nondrug therapy. Identifying environmental allergens is helpful for asthma patients, and further studies on clinically effective avoidance methods are required.

CeO2-supported Pt single atoms with different coordination environments exhibit distinct behaviors in reactant adsorption/activation and product desorption, thus showing different catalytic performance for various catalytic oxidation reactions.

Abstract The advent of two-dimensional (2D) crystals has led to numerous scientific breakthroughs. Conventional 2D systems have in-plane covalent bonds and a weak out-of-plane van-der-Waals bond. Here we report a new type of 2D material composed of discrete magnetic molecules, where anisotropic van-der-Waals interactions bond the molecules into a 2D packing. Through mechanical exfoliation, we can obtain single-crystalline molecular monolayers, which can be readily integrated into other 2D systems. Optical spectroscopy suggests the few-layered molecules preserve the temperature-induced spin-crossover switching observed in the bulk form but show a drastic increase in thermal hysteresis unique to these thin 2D molecule assemblies. The trapping of spin bistability with decreasing layer number can arise from domain wall dynamics in reduced dimensions. Our results establish molecular solids with strong anisotropy of intermolecular interactions as precursors to a new class of 2D materials, affording possibilities to control molecular functionalities through substrate and interlayer interactions.

Glycosmis stenocarpa is a species of shrub found in the Northern provinces of Vietnam. Its roots contain different carbazolic derivatives, mainly Murrayafoline A (Mu-A), which exhibits valuable biological activities. In this study, we performed an extraction of Mu-A from the roots of G. stenocarpa and optimized this process using response surface methodology (RSM) according to a central composite design, with three independent parameters including extraction time (min), extraction temperature (°C), and solvent/material ratio (mL/g). Two dependent variables were the Mu-A content (mg/g raw materials) and extraction efficiency (%). The optimal conditions to extract Mu-A were found to be as follows: extraction temperature, 67°C; extraction time, 165 min; and solvent/material ratio, 5:1. Under these conditions, the Mu-A content and extraction efficiency were 38.94 ± 1.31 mg/g raw materials and 34.98 ± 1.18%, respectively. Mu-A exhibited antiproliferation and antitumor-promoting activity against the HepG-2 cell line. The present optimization work of Mu-A extraction from G. stenocarpa roots contributed to the attempt of designing a large-scale extraction process for the compound and further exploitation of its potential in vivo applications.

Abstract Background Emergence of cross-resistance to current anti-malarial drugs has led to an urgent need for identification of potential compounds with novel modes of action and anti-malarial activity against the resistant strains. One of the most promising therapeutic targets of anti-malarial agents related to food vacuole of malaria parasite is haemozoin, a product formed by the parasite through haemoglobin degradation. Methods With this in mind, this study developed two-dimensional-quantitative structure–activity relationships (QSAR) models of a series of 21 haemozoin inhibitors to explore the useful physicochemical parameters of the active compounds for estimation of anti-malarial activities. The 2D-QSAR model with good statistical quality using partial least square method was generated after removing the outliers. Results Five two-dimensional descriptors of the training set were selected: atom count (a_ICM); adjacency and distance matrix descriptor (GCUT_SLOGP_2: the third GCUT descriptor using atomic contribution to logP); average total charge sum (h_pavgQ) in pKa prediction (pH = 7); a very low negative partial charge, including aromatic carbons which have a heteroatom-substitution in “ortho” position (PEOE_VSA-0) and molecular descriptor (rsynth: estimating the synthesizability of molecules as the fraction of heavy atoms that can be traced back to starting material fragments resulting from retrosynthetic rules), respectively. The model suggests that the anti-malarial activity of haemozoin inhibitors increases with molecules that have higher average total charge sum in pKa prediction (pH = 7). QSAR model also highlights that the descriptor using atomic contribution to logP or the distance matrix descriptor (GCUT_SLOGP_2), and structural component of the molecules, including topological descriptors does make for better anti-malarial activity. Conclusions The model is capable of predicting the anti-malarial activities of anti-haemozoin compounds. In addition, the selected molecular descriptors in this QSAR model are helpful in designing more efficient compounds against the P. falciparum 3D7A strain.

New therapeutic strategies to reduce sepsis-related mortality are urgently needed, as sepsis accounts for one in five deaths worldwide. Since hematopoietic stem and progenitor cells (HSPCs) are responsible for producing blood and immune cells, including in response to immunological stress, we explored their potential for treating sepsis. In a mouse model of Group A Streptococcus (GAS)-induced sepsis, severe immunological stress was associated with significant depletion of bone marrow HSPCs and mortality within approximately 5–7 days. We hypothesized that the inflammatory environment of GAS infection drives rapid HSPC differentiation and depletion that can be rescued by infusion of donor HSPCs. Indeed, infusion of 10,000 naïve HSPCs into GAS-infected mice resulted in rapid myelopoiesis and a 50–60% increase in overall survival. Surprisingly, mice receiving donor HSPCs displayed a similar pathogen load compared to untreated mice. Flow cytometric analysis revealed a significantly increased number of myeloid-derived suppressor cells in HSPC-infused mice, which correlated with reduced inflammatory cytokine levels and restored HSPC levels. These findings suggest that HSPCs play an essential immunomodulatory role that may translate into new therapeutic strategies for sepsis.

To develop a lead-free solder with high strength and ductility, a novel interface was designed between the tetra-needle-like ZnO whisker (T-ZnOw) and Sn1.0Ag0.5Cu solder matrix. First, surface modification of T-ZnOw was conducted using a pyrolysis method based on self-assembly to deposit NiO nanoparticles densely and evenly on the whisker surface. The interfacial relationship between T-ZnOw (100) and NiO (101) planes was semi-coherent with a misfit of 0.145. In-situ transmission electron microscopy was used to explore the surface modification mechanism. Next, a composite solder of 0.3mass% NiO/T-ZnOw reinforced Sn1.0Ag0.5Cu was prepared with ultrasonic agitation, and the introduced reinforcement was uniformly distributed in the solder matrix. A thin NiO transition layer existed between the reinforcement and matrix, indicating the formation of the Sn1.0Ag0.5Cu/NiO/T-ZnOw sandwich structure interface. No gaps, pores, or new phases were formed at the interface, and atomic interdiffusion occurred at the interface to form effective bonding. The composite solder shows improved wettability compared with plain solder. The ultimate tensile strength (UTS) and elongation of the composite solder were 32.5 MPa and 28.1%, respectively, being 19.0% and 35.1% higher than those of the plain Sn1.0Ag0.5Cu solder. The strengthening-ductility mechanisms primarily included load transfer, grain refinement, and misfit dislocation effects.

Abstract Aims Dozens of causative genes and their mechanisms of nonsyndromic cleft lip with or without cleft palate (NSCL/P) were revealed through genome‐wide association and linkage studies. Results were, however, not always replicated in different populations or methodologies. This study used case–control and family based approaches to investigate the etiology of NSCL/P and its two subtypes: nonsyndromic cleft lip only (NSCLO) and nonsyndromic cleft lip and palate (NSCLP) among the Vietnamese population. Methods Two hundred and seventeen NSCL/P case‐parent trios (one affected child and two parents), including 105 NSCLO and 112 NSCLP were involved for a family based design; and 273 ethnic and region‐matched healthy controls with no cleft history in their families were recruited for a case–control design. Three SNPs consisting of TFAP2A (rs1675414 and rs303048) and 8q24 (rs987525) were genotyped using the TaqMan SNP genotyping assay. Results TFAP2A rs1675414 was associated with NSCLO, replicated by both case‐control and family based tests. Other SNPs yielded no evidence of susceptibility to NSCL/P or two subtypes. Conclusion The current investigation suggests an intriguing role of TFAP2A in the etiology of NSCLO among the Vietnamese population.

In microfluidic studies of improved oil recovery, mostly pore networks with uniform depth and surface chemistry are used. To better mimic the multiple porosity length scales and surface heterogeneity of carbonate reservoirs, we coated a 2.5D glass microchannel with calcite particles. After aging with formation water and crude oil (CRO), high-salinity Water (HSW) was flooded at varying temperatures and durations. Time-resolved microscopy revealed the CRO displacements. Precise quantification of residual oil presented some challenges due to calcite-induced optical heterogeneity and brine–oil coexistence at (sub)micron length scales. Both issues were addressed using pixel-wise intensity calibration. During waterflooding, most of the ultimately produced oil gets liberated within the first pore volume (similar to glass micromodels). Increasing temperature from 22 °C to 60 °C and 90 °C produced some more oil. Waterflooding initiated directly at 90 °C produced significantly more oil than at 22 °C. Continuing HSW exposure at 90 °C for 8 days does not release additional oil; although, a spectacular growth of aqueous droplets is observed. The effect of calcite particles on CRO retention is weak on flat surfaces, where the coverage is ~20%. The calcite-rich pore edges retain significantly more oil suggesting that, in our micromodel wall roughness is a stronger determinant for oil retention than surface chemistry.

Asthma: Traps to target for treatment Controlling the formation of mesh-like structures of DNA and protein which induce airway damage in asthma could offer new therapeutic opportunities, especially for patients who do not respond well to conventional treatments. The structures are produced by activated cells as part of the immune response in asthma. They are known as eosinophil extracellular traps (EETs) since they are most prominently released by the activity of white blood cells called eosinophils. Hae-Sim Park and colleagues at Ajou University in South Korea studied the involvement of EETs in patients with severe asthma. Their results suggest eosinophils are more activated to create damaging EETs in patients with severe asthma than in those with less severe forms of the disease. Searching for ways to control EET formation could be a fruitful approach to helping patients with severe eosinophilic asthma.

Abstract Background The approaches to the diagnosis and treatment of chronic spontaneous urticaria (CSU) differ in various parts of the world. We sought to determine the adherence to international and national urticaria guidelines as well as the motives to deviate from the guidelines among physicians worldwide. Methods A web-based questionnaire was created and launched via e-mail by the World Allergy Organization (WAO) to representatives of all WAO Member Societies, the members of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the members of the WAO Junior Members Group (JMG), regardless of the specialty, affiliation, or nationality in March 2017. Results We received 1140 completed surveys from participating physicians from 99 countries. Virtually all participants (96%) were aware of at least one urticaria guideline and reported that they follow a guideline. However, one in five physicians who follow a guideline (22%) reported to deviate from it. Reliance on own clinical experience is the most frequent reason for deviation from guidelines or not following them (44%). Young (

Abstract Type 2-immunity represents the typical adaptive response to allergen exposure in atopic individuals. It mainly involves Th2 cells and immunoglobulin E, as the main orchestrators of type 2-inflammation. Recently, it has been highlighted that allergens may be responsible for a Th2 response beside specific IgE activation and that a number of other environmental stimuli, such as viruses and pollutants, can trigger the same pattern of inflammation beyond atopy. Emerging data sustain a substantial role of the so-called epithelial dysfunction in asthma pathogenesis, both from anatomic and functional point of view. Furthermore an increasing amount of evidence demonstrates the relevance of innate immunity in polarizing a Th2 impaired response in asthmatic patients. Under this perspective, the complex cross-talking between airway epithelium, innate and adaptive immunity is emerging as a major determinant of type 2-inflammation beyond allergens. This review will include an update on the relevance of dysregulation of innate and adaptive type 2-immunity in asthma pathogenesis, particularly severe asthma, and on the role of the allergens that are associated with severe asthma. Type 2-immunity also will be reviewed in the light of the current and upcoming targeted treatments for severe asthma.

The low melting temperature In-48Sn alloy is a promising candidate for flexible devices. However, the joint strength of the In-48Sn alloy on the Cu substrate was low due to the rapid diffusion of Cu into the In-rich alloy. In this study, the effect of the addition of xCu (x = 2.0 and 8.0 wt.%) on wettability, interfacial reaction, and mechanical strength of the In-Sn-xCu/Cu joint is analyzed. The results demonstrate that both the In-48Sn and In-Sn-xCu alloys exhibit good wettability on the Cu substrate and that the contact angle increases with an increase in the Cu content. Furthermore, fine grains are observed in the alloy matrix of the In-Sn-xCu/Cu joint and the interfacial intermetallic compound (IMC) comprising the Cu-rich Cu6(In,Sn)5 near the Cu substrate and the Cu-deficient Cu(In,Sn)2 near the solder side. The In-Sn-2.0Cu/Cu joint with fine microstructure and a small amount of IMC in the alloy matrix shows the highest average shear strength of 16.5 MPa. Although the In-Sn-8.0Cu/Cu joint also exhibits fine grains, the presence of large number of voids and rough interfacial IMC layer causes the formation of additional stress concentration points, thereby reducing the average shear strength of the joint.

Abstract Increased filaggrin expression was found to be correlated with severity scores in chronic spontaneous urticaria (CSU); however, the role of filaggrin breakdown products (FBPs) in CSU has not been studied. We collected stratum corneum (SC) specimens from the volar forearms of 10 CSU patients, 10 AD patients, and 10 healthy normal controls (NCs) and measured contents of FBPs (pyrrolidone carboxylic acid [PCA] and urocanic acid [UCA]) using UPLC-MS/MS, transepidermal water loss (TEWL) and epidermal pH. Compared to NCs, cis-UCA level was increased in CSU lesions (P

Diseases caused by flaviviruses, including dengue fever and Japanese encephalitis, are major health problems in Vietnam. This cross-sectional study explored the feasibility of domestic dogs as sentinels to better understand risks of mosquito-borne diseases in Hanoi city. A total of 475 dogs serum samples from 221 households in six districts of Hanoi were analyzed by a competitive enzyme-linked immunosorbent assay (cELISA) for antibodies to the pr-E protein of West Nile virus and other flaviviruses due to cross-reactivity. The overall flavivirus seroprevalence in the dog population was 70.7% (95% CI = 66.4–74.8%). At the animal level, significant associations between seropositive dogs and district location, age, breed and keeping practice were determined. At the household level, the major risk factors were rural and peri-urban locations, presence of pigs, coil burning and households without mosquito-borne disease experience (p < 0.05). Mosquito control by using larvicides or electric traps could lower seropositivity, but other measures did not contribute to significant risk mitigation of flavivirus exposure in dogs. These results will support better control of mosquito-borne diseases in Hanoi, and they indicate that dogs can be used as sentinels for flavivirus exposure.

Rice is a staple food in Vietnam, and the concern about rice is much greater than that for other foods. Preventing fraud against this product has become increasingly important in order to protect producers and consumers from possible economic losses. The possible adulteration of this product is done by mixing, or even replacing, high-quality rice with cheaper rice. This highlights the need for analytical methodologies suitable for its authentication. Given this scenario, the present work aims at testing a rapid and non-destructive approach to detect adulterated rice samples. To fulfill this purpose, 200 rice samples (72 authentic and 128 adulterated samples) were analyzed by near infrared (NIR) spectroscopy coupled, with partial least squares-discriminant analysis (PLS-DA) and soft independent modeling of class analogies (SIMCA). The two approaches provided different results; while PLS-DA analysis was a suitable approach for the purpose of the work, SIMCA was unable to solve the investigated problem. The PLS-DA approach provided satisfactory results in discriminating authentic and adulterated samples (both 5% and 10% counterfeits). Focusing on authentic and 10%-adulterated samples, the accuracy of the approach was even better (with a total classification rate of 82.6% and 82.4%, for authentic and adulterated samples, respectively).