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Abstract Liver injury with marked elevation of aspartate aminotransferase enzyme (AST) is commonly observed in dengue infection. To understand the pathogenesis of this liver damage, we compared the plasma levels of hepatic specific, centrilobular predominant enzymes (glutamate dehydrogenase, GLDH; glutathione S transferase-α, αGST), periportal enriched 4-hydroxyphenylpyruvate dioxygenase (HPPD), periportal predominant arginase-1 (ARG-1), and other non-specific biomarkers (paraoxonase-1, PON-1) in patients with different outcomes of dengue infection. This hospital-based study enrolled 87 adult dengue patients, stratified into three groups based on plasma AST levels ( 400 U/L) in a 1:1:1 ratio (n = 40, n = 40, n = 40, respectively. The new liver enzymes in the blood samples from the 4th to 6th days of their illness were measured by commercial enzyme-linked immunosorbent assay (ELISA) or colorimetric kits. Based on the diagnosis at discharge days, our patients were classified as 40 (46%) dengue without warning signs (D), 35 (40.2%) dengue with warning signs (DWS), and 11 (12.6%) severe dengue (SD) with either shock (two patients) or AST level over 1000 U/L (nine patients), using the 2009 WHO classification. The group of high AST (> 400 U/L) also had higher ALT, GLDH, ARG-1, and HPPD than the other groups, while the high (> 400 U/L) and moderate (80–400 U/L) AST groups had higher ALT, αGST, ARG-1, and HPPD than the low AST group (

Using conversation analysis as the research approach, this study explores how L2 learners utilize their task-related identities during task interactions and how those identities are used as resources for task management. Eight students in an ESL academic reading class formed two groups while they did their reading circle task for six rounds. In each round, the students took turns to be in charge of a specific role in the discussion session (i.e., discussion leader, notetaker, vocabulary definer, and contextualizer). Data was collected from all rounds and analyzed for emerging patterns. Results showed that (a) the participants used each other's assigned identities skillfully to orient the group to the institutional goal, and (b) the participants used their own existing obligations to problematize the task interactions. By providing insights on those dynamic task-related identities, this study broadens our understanding of interactions happening at the task implementation stage and suggests pedagogical implications.

As online learning becomes a recurrent component of higher education, there have been growing interests in the interaction between students and educational resources within digital environments so as to understand and facilitate students' initiative in managing those resources. The present study is an explorative inquiry into the relationships between students' self-reported preferences of study materials, their actual usage of those materials and their learning performances in online learning. It focuses on analysing the learning management system's log files, test results and students' responses to an evaluative survey of a bachelor business course at a large Belgian university, which was a blended course turned fully online due to the pandemic circumstance. The first research question concerns how preferences relate to the usage of materials. A cluster analysis was conducted to classify students based on their perceived interest and actual access to learning resources. The results show three clusters of students with different preferences and levels of usage towards the four types of study materials provided in the course. However, the majority showed strong favour for multimedia online learning, with Web lectures being prioritised both in perception and access behaviour, while discussion boards receive mixed opinions and the lowest actual participation. The second question follows these up by linking the preference-usage patterns with academic performances. A multivariate analysis of variance was conducted to compare the learning performances of students with different preference-usage patterns. The results show no significant differences, which means the students' preferences and/or usage of study materials has little to no impact on their learning performances in the online course.

Patients with relapsed and refractory multiple myeloma (RRMM) who are triple-class exposed (to an immunomodulatory agent, proteasome inhibitor, and anti-CD38 antibody) have limited treatment options and there is no standard of care. Idecabtagene vicleucel (ide-cel, bb2121), a BCMA-directed CAR T-cell therapy, demonstrated efficacy in triple-class exposed RRMM patients in the KarMMa trial (NCT03361748). In this retrospective study (KarMMa-RW), patient-level data from triple-class exposed RRMM patients were merged into a single data model and compared with KarMMa using trimmed stabilized inverse probability of treatment weighting. Endpoints included overall response rate (ORR; primary), rate of very good partial response or better (≥VGPR), progression-free survival (PFS), and overall survival (OS). Of 1949 real-world triple-class exposed RRMM patients, 190 received subsequent (index) line of therapy and met KarMMa eligibility criteria (Eligible RRMM cohort). With a median follow-up of 13.3 months in KarMMa and 10.2 months in Eligible RRMM, ORR, and ≥VGPR were significantly improved in KarMMa versus Eligible RRMM (ORR, 76.4% vs 32.2%; ≥VGPR, 57.9% vs 13.7%; both P

The use of batteries in electric cars comes with inherent risks. As the crucial component of these vehicles, batteries must possess a highly dependable safety system to ensure the safety of users. To establish such a reliable safety system, a comprehensive analysis of potential battery failures is carried out. This research examines various failure modes and their effects, investigates the causes behind them, and quantifies the associated risks. The failure modes and effect analysis (FMEA) method is employed to classify these failures based on priority numbers. By studying 28 accident reports involving electric vehicles, data is collected to identify potential failure modes and evaluate their risks. The results obtained from the FMEA assessment are used to propose safety measures, considering the importance of the potential failure modes as indicated by their risk priority number (RPN). The design incorporates safeguards against mechanical stress, external short circuits, and thermal runaway incidents. The findings of this study enhance our understanding of electric vehicle (EV) battery safety and offer valuable insights to EV manufacturers, regulators, and policymakers, aiding them in the development of safer and more reliable electric vehicles.

Purpose – This paper aims to examine the impact of competition on firm performance using a data set of 352 firms listed on Vietnam’s stock exchanges from 2015 to 2019. Design/methodology/approach – The two-step system generalized method of moments is used to estimate this impact. Findings – The findings reveal an inverted U-shaped relationship between competition and firm performance. Competition improves firm performance if its intensity is moderate. However, if the competition intensity exceeds the optimal level, the performance deteriorates accordingly. Research limitations/implications – The authors only studied Vietnamese firms due to the limited ability in data collection. It would be better to validate the findings using data from other transition economies. Practical implications – The non-linear relationship between competition and performance implies that government should pay more attention to retaining competition at an appropriate level. Social implications – Firms contribute a lot to the prosperity of Vietnam. Therefore, the findings have a meaningful implication for Vietnam’s government to moderate competition to improve its firms’ performance. Originality/value – This paper contributes to the extant literature by providing firsthand evidence of the impact of competition on firm performance in Vietnam – a transition economy.

Background and Aims: The prevalence of coexistence of HBsAg and anti-HBs in chronic hepatitis B virus (HBV)–infected patients is different between studies. The mutations on the S gene were proved as the cause of this coexistence. This study determined the frequency and factors associated with coexistence of HBsAg and anti-HBs in chronic HBV-infected patients. Methods: This cross-sectional study was conducted at University Medical Center at Ho Chi Minh City, Vietnam, from April 2014 to December 2020. HBeAg, HBsAg, and anti-HBs were measured by chemiluminescent immunoassay. Mutations on the HBV small S gene from amino acids 1–227 were detected using Sanger sequencing on 177 patients. Results: A total of 521 chronic HBV-infected patients were enrolled, including 350 males (62.7%), 17.1% with hepatic fibrosis of ≥ F3 and 9.8% with hepatocellular carcinoma (HCC). The coexistence of HBsAg and anti-HBs was detected in 9.8%, with 17.9% among genotype C compared to 7.4% in genotype B, P = .001. The coexistence group had lower levels of HBsAg titers (P = .052). There were significantly higher rates of coexistence in the group with HCC (19.6% vs 8.7%, P = .013). The existence of point mutations on the major hydrophilic region and the “a” determinant region of HBV was more frequently detected in the HBsAg and anti-HBs coexistence group (P = .043 and P = .008, respectively). Conclusion: The coexistence of HBsAg and anti-HBs was detected more frequently in the HBV genotype C group. The coexistence status was related to lower HBsAg titers, mutations on the major hydrophilic region, and/or the “a” determinant and exposed significant relation with HCC.

Abstract The arrangement of objects in scenes follows certain rules (“Scene Grammar”), which we exploit to perceive and interact efficiently with our environment. We have proposed that Scene Grammar is hierarchically organized: scenes are divided into clusters of objects (“phrases”, e.g., the sink phrase); within every phrase, one object (“anchor”, e.g., the sink) holds strong predictions about identity and position of other objects (“local objects”, e.g., a toothbrush). To investigate if this hierarchy is reflected in the mental representations of objects, we collected pairwise similarity judgments for everyday object pictures and for the corresponding words. Similarity judgments were stronger not only for object pairs appearing in the same scene, but also object pairs appearing within the same phrase of the same scene as opposed to appearing in different phrases of the same scene. Besides, object pairs with the same status in the scenes (i.e., being both anchors or both local objects) were judged as more similar than pairs of different status. Comparing effects between pictures and words, we found similar, significant impact of scene hierarchy on the organization of mental representation of objects, independent of stimulus modality. We conclude that the hierarchical structure of visual environment is incorporated into abstract, domain general mental representations of the world.

Across the adult lifespan memory processes are subject to pronounced changes. Prior knowledge and expectations might critically shape functional differences; however, corresponding findings have remained ambiguous so far. Here, we chose a tailored approach to scrutinize how schema (in-)congruencies affect older and younger adults’ memory for objects embedded in real-world scenes, a scenario close to everyday life memory demands. A sample of 23 older (52–81 years) and 23 younger adults (18–38 years) freely viewed 60 photographs of scenes in which target objects were included that were either congruent or incongruent with the given context information. After a delay, recognition performance for those objects was determined. In addition, recognized objects had to be matched to the scene context in which they were previously presented. While we found schema violations beneficial for object recognition across age groups, the advantage was significantly less pronounced in older adults. We moreover observed an age-related congruency bias for matching objects to their original scene context. Our findings support a critical role of predictive processes for age-related memory differences and indicate enhanced weighting of predictions with age. We suggest that recent predictive processing theories provide a particularly useful framework to elaborate on age-related functional vulnerabilities as well as stability.