Search

Louis Cantor,1 Dan Lindfield,2 Federico Ghinelli,3 Anna W Świder,3 Francesca Torelli,3 Carolyn Steeds,3 Jaime E Dickerson Jr,4,5 Dan Q Nguyen6 1Eugene and Marilyn Glick Eye Institute, Indiana School of Medicine, Indianapolis, IN, USA; 2Royal Surrey County Hospital, Guildford, England, UK; 3Valid Insight, Macclesfield, England, UK; 4Sight Sciences, Menlo Park, CA, USA; 5North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA; 6Mid-Cheshire Hospitals NHS Foundation Trust, Crewe, UKCorrespondence: Francesca Torelli, Valid Insight, Ropewalks, Newton St, Macclesfield, SK11 6QJ, UK, Tel +44 203 750 9833 Ext 703, Email ftorelli@validinsight.comIntroduction: Selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS) are increasingly used options for mild-to-moderate open-angle glaucoma (OAG) care. While most MIGS devices are indicated for use in combination with cataract surgery only, with phacoemulsification playing a role in lowering IOP, newer technologies can also be used as standalone glaucoma surgery.Methods: This systematic literature review (SLR) aimed to assess the clinical, economic, and humanistic outcomes of MIGS and SLT for the treatment of OAG and was conducted according to PRISMA guidelines. Studies that assessed MIGS or SLT in at least one treatment arm versus any other glaucoma treatment in adults with mild-to-moderate OAG were included. Clinical, humanistic (health-related quality of life [HRQoL] and patient burden), and economic data were extracted, and the methodological quality of included studies was evaluated.Results: A total of 2720 articles were screened, and 81 publications were included. Fifty-eight reported clinical outcomes. The majority assessed iStent or iStent inject (n=41), followed by OMNI (n=9), gonioscopy-assisted transluminal trabeculotomy (GATT) or the Kahook Dual Blade (KDB) (n=7), Hydrus (n=6), SLT (n=5), Xen Gel Stent (n=2), PreserFlo (n=1), and iTrack (n=1). IOP reduction was observed across prospective studies, varying from − 31% to − 13.7% at month 6 and from − 39% to − 11.4% at year 1 versus baseline. Most adverse events were transient and non-serious. Limited humanistic and economic data were identified.Conclusion: Given their established efficacy and safety, there is a rationale for wider use of MIGS in mild-to-moderate OAG. Of the MIGS devices, iStent and OMNI have the largest clinical evidence base supporting their sustained effectiveness.Keywords: intraocular pressure, IOP, iStent, MIGS, OMNI, SLT

Paediatric burn follow-up optimally follows a balance between complication detection and avoiding unnecessary hospital visits. In a long-term review, we assessed complication patterns in children with burns requiring surgery. Using the Welsh Burns Centre database, a retrospective note review of paediatric burns over 3 years from 1995 was performed, identifying all children undergoing surgery for their burns. 94 patients were identified with a median follow-up since injury of 13.6 years. Mean age was 5.27 (SD=4.9) years. TBSA ranged from <1 to 70%. 94% underwent split-skin grafting. 18% (n=17) developed contractures and 33% (n=31) developed hypertrophic scarring. Those developing contractures were younger, and suffered significantly greater TBSA burns (p<0.05) than those developing hypertrophic scarring or those without complications. All contractures developed within 1-13 months, and hypertrophic scarring within 1-17 months. All patients sustaining axillary burns developed contractures, whilst 75% of contractures developed around the upper limb. In conclusion, younger patients with larger TBSA burns in the upper limb were at higher risk for contractures and hypertrophic scarring, which all presented within 18 months. Therefore any patients that are complication-free 18 months after-injury can be safely discharged, allowing streamlining of follow-up for the benefit of patients, parents and hospital resources. [ABSTRACT FROM AUTHOR]

Aims: The MicraVR™ transcatheter pacing system (TPS) has been implemented into clinical routine for several years. The primary recipients are patients in need for VVI pacing due to bradycardia in the setting of atrial fibrillation (AF). Implantation safety and acute success have been proven in controlled studies and registries. So far only few long-term real-life data on TPS exist. We report indication, procedure and outcome data from two high-volume implanting German centers., Methods: Between 2016 and 2019, 188 (of 303) patients were included. During follow-up (FU), TPS interrogation was performed after 4 weeks and thereafter every 6 months., Results: Indication for TPS implantation in 159/188 (85%) patients was permanent or intermittent AV block III° in the setting of atrial fibrillation. The mean procedure duration was 50 min [35.0-70.0]. The average acute values after system release were: thresholds: 0.5V [0.38-0.74]/0.24ms; R-wave sensing: 10.0mV [8.1-13.5]; impedance: 650 Ohm [550-783]; RV-pacing demand: 16.9% [0.9-75.9]; and battery status: 3.15 V [3.12-3.16]. During FU of 723.4 ± 597.9 days, neither pacemaker failure nor infections were reported. Long-term FU revealed: thresholds: 0.5V [0.38-0.63]/0.24 ms; sensing: 12.3mV [8.9-17.2]; impedance: 570 Ohm [488-633]; RV-pacing demand: 87.1% [29.5-98.6]; and battery status 3.02 V [3.0-3.1]. Forty-three patients died from not-device-related causes., Conclusion: This to date largest German long-term dataset for MicraVR™ TPS implantation revealed stable device parameter. Foremost, battery longevity seems to fulfill predicted values despite a significant increase in RV-pacing demand over time and even in patients with consecutive AV-node ablation. Of note, no infections or system failure were observed., (© 2023. The Author(s).)

Objective: We described mortality and loss to follow-up (LTFU) in children and adolescents who were under care for more than 5 years following initiation of antiretroviral therapy (ART)., Methods: Patients were followed from 5 years after ART until the earlier of their 25th birthday, last visit, death, or LTFU. We used Cox regression to assess predictors of mortality and competing risk regression to assess factors associated with LTFU., Results: In total, 4488 children and adolescents initiating ART between 1997 and 2016 were included in the analysis, with a median follow-up time of 5.2 years. Of these, 107 (2.2%) died and 271 (6.0%) were LTFU. Mortality rate was 4.35 and LTFU rate 11.01 per 1000 person-years. Increased mortality was associated with AIDS diagnosis (adjusted hazard ratio [aHR] 1.71; 95% confidence interval [CI] 1.24-2.37), current CD4 count <350 cells/mm 3 compared with ≥500 (highest aHR 13.85; 95% CI 6.91-27.76 for CD4 <200), viral load ≥10 000 copies/mL compared with <400 (aHR 3.28; 95% CI 1.90-5.63), and exposure to more than one ART regimen (aHR 1.51; 95% CI 1.14-2.00). Factors associated with LTFU were male sex (adjusted subdistribution hazard ratio [asHR] 1.29; 95% CI 1.04-1.59), current viral load >1000 copies/mL compared with <400 (highest asHR 2.36; 95% CI 1.19-4.70 for viral load 1000-9999), and ART start after year 2005 compared with ≤2005 (highest asHR 5.96; 95% CI 1.98-17.91 for 2010-2016)., Conclusion: For children and adolescents surviving 5 years on ART, both current CD4 and viral load remained strong indicators that help to keep track of their treatment outcomes. More effort should be made to monitor patients who switch treatments., (© 2024 British HIV Association.)

Rationale: Skeletal dysplasias are a complex series of rare genetic disorders that cause irregular development of bones, joints, and cartilages in children. A total of 770 disorders associated with 41 groups of skeletal dysplasia have been documented, demonstrating a wide range of clinical manifestations and varying levels of severity. In addition to conventional methods, whole genome sequencing has emerged as a useful approach to pinpointing the underlying etiology of skeletal dysplasias., Patient Concerns: A 13-month-old female was admitted to the hospital due to the symptoms of jaundice and failure to thrive., Diagnoses: The child was subjected to blood tests and a radiographic assessment. The blood chemistries revealed elevated levels of total bilirubin (178 µmol/L), bile acids (198 µmol/L), and low levels of serum calcium (1.69 mmol/L) and phosphate (0.8 mmol/L), along with irregular skeletal development in the forearms and legs, considering rickets and cholestasis., Interventions: Whole exome sequencing data of the proband revealed a homozygous mutation of c.388dupA in the BAAT (bile acid-CoA: amino acid N-acyltransferase) gene sequence. This mutation caused a frameshift in the amino acid of the BAAT protein, resulting in the pR130Kfs*12 variant. This mutation has been identified as the underlying cause of skeletal dysplasia in the proband., Outcomes: A novel frameshift mutation in the BAAT gene of a Vietnamese female child diagnosed with skeletal dysplasia has been studied by whole exome sequencing analysis., Lessons: This research reported a case of skeletal dysplasia caused by a frameshift mutation in the BAAT gene. The results of this study contribute to our understanding of the diverse factors that influence irregular skeletal development in children and provide genetic data to support clinical practice., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Limited information is available on the safety and efficacy of cryoballoon ablation (CBA) in elderly patients with atrial fibrillation (AF). Moreover, global utilization of CBA in this population (≥ 80 years old) has not been reported. This study's objectives were to determine the use, efficacy, and safety of CBA to treat octogenarians suffering from AF., Methods: In this sub-analysis of the Cryo Global Registry, 12-month outcomes of treating AF via CBA in octogenarians were compared to patients < 80 years old. Efficacy was evaluated as time to a ≥ 30 s atrial arrhythmia (AA) recurrence. Healthcare utilization was determined via repeat ablations and hospitalizations. Improvement upon disease burden was evaluated through patient reporting of symptoms and the EQ-5D-3L quality of life (QoL) survey., Results: The octogenarian cohort (n = 101) had a higher prevalence of females (51.5% vs 35.7%) and CHA 2 DS 2 -VASc scores (4.2 ± 1.3 vs 2.0 ± 1.5) compared to the control cohort (n = 1573, both p < 0.01). Even when adjusting for baseline characteristics and antiarrhythmic drug usage, freedom from AA recurrence at 12 months (80.6% vs 78.9%, HR adj :0.97 [95% CI:0.59-1.58], p = 0.90) was comparable between octogenarians and control, respectively. Similar serious adverse event rates were observed between octogenarians (5.0%) and control (3.2%, p = 0.38). The groups did not differ in healthcare utilization nor reduction of AF-related symptoms from baseline to follow-up, but both experienced an improvement in QoL at 12 months., Conclusions: Despite more age-related comorbidities, CBA is a safe and effective treatment for AF in octogenarians, with efficacy and adverse events rates akin to ablations performed in younger patients., Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02752737., (© 2023. The Author(s).)

Introduction: This systematic review aims to evaluate the use of machine learning and artificial intelligence in hernia surgery., Methods: The PRISMA guidelines were followed throughout this systematic review. The ROBINS-I and Rob 2 tools were used to perform qualitative assessment of all studies included in this review. Recommendations were then summarized for the following pre-defined key items: protocol, research question, search strategy, study eligibility, data extraction, study design, risk of bias, publication bias, and statistical analysis., Results: A total of 13 articles were ultimately included for this review, describing the use of machine learning and deep learning for hernia surgery. All studies were published from 2020 to 2023. Articles varied regarding the population studied, type of machine learning or Deep Learning Model (DLM) used, and hernia type. Of the thirteen included studies, all included either inguinal, ventral, or incisional hernias. Four studies evaluated recognition of surgical steps during inguinal hernia repair videos. Two studies predicted outcomes using image-based DMLs. Seven studies developed and validated deep learning algorithms to predict outcomes and identify factors associated with postoperative complications., Conclusion: The use of ML for abdominal wall reconstruction has been shown to be a promising tool for predicting outcomes and identifying factors that could lead to postoperative complications., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Introduction and Importance: Chronic extra-articular infections of the tibial tunnel are rare, and there are only a few cases reported in the literature, so the diagnosis and management of these infections are still unclear., Case Presentation: We report a 36-year-old patient with chronic infection of the tibial tunnel after ACL reconstruction surgery. The patient was treated with arthroscopic debridement of the tibial tunnel and antibiotic cement filling. Seven months postoperative, there were no signs of infection at the surgical site and the knee joint. The patient has no pain, no joint instability, no limitation of range of motion, and no limitation in daily activities., Clinical Discussion: The definitive diagnosis of chronic infection of the tibial tunnel should be carefully based on clinical signs, blood tests, and imaging to rule out combined intra-articular infections. The arthroscopic technique can be a favorable method to control and debride the inflammatory tissue of the tibial tunnel, limiting the recurrence rate postoperatively., Conclusion: Arthroscopic debridement and antibiotic-loaded cement can be considered an alternative to traditional surgical methods in the treatment of chronic infection of the tibial bone tunnel after ACL reconstruction., Level of Evidence: A case report., Competing Interests: Conflict of interest statement The authors declare that they have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Current guidelines for secondary prevention of atherosclerotic cardiovascular disease (ASCVD) recommend targeting a low-density lipoprotein cholesterol (LDL-C) of < 70 mg/dL. However, temporal trends and racial/ethnic- and sex-differences in achievement of LDL-C targets are not well described. We assessed trends and racial/ethnic- and sex-differences in achievement of LDL-C < 70 mg/dL using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008 to 2017-March 2020., Methods: We combined NHANES cycles into 4 periods: 2005-2008, 2009-2012, 2013-2016, and 2017-March 2020 and included participants ≥ 40 years with self-reported ASCVD. We estimated LDL-C < 70 mg/dL prevalence over time and further stratified by sex and race/ethnicity. We used multivariable logistic regression adjusted for social determinants of health and clinical covariates to model LDL-C target attainment., Results: Among 1,826 NHANES participants representing 7,161,221 US adults with self-reported ASCVD (59.6% ≥ 65 years, 56.4% male, 74.8% White), LDL-C target attainment increased from 19.0% (95% CI, 15.3%-23.3%) in 2005-2008 to 26.3% (95% CI, 20.4%-33.1%) in 2017-March 2020 ( P = 0.012 for trend). Achievement of LDL-C < 70 mg/dL significantly rose among men from19.5% (95% CI, 15.1%-24.8%) to 29.4% (95% CI, 20.7%-29.9%) without significant change in women (from 18.3% [95% CI, 13.6%-24.2%] to 22.5% [95% CI, 13.0%-35.9%]; P = 0.241 for trend). Improvement in LDL-C target attainment was similar among White, Black, and Hispanic individuals (∼5-7% increase) and was greatest among individuals of other (non-White, Hispanic, or Black) race/ethnicity (23.1% increase). In our multivariable analysis, comorbid diabetes and ages 65-75 and > 75 years were associated with LDL-C target attainment., Conclusion: LDL-C control modestly improved between 2005 and 2008 and 2017-March 2020; however, only ∼1/4 of individuals met guideline-directed LDL-C treatment targets by 2017-March 2020. Women had lower LDL-C control and lesser magnitude of improvement in LDL-C control than men, highlighting a need for targeted interventions to improve lipid-lowering therapy utilization in this population., Competing Interests: We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome., (© 2024 The Authors. Published by Elsevier B.V.)

This study employed novel extraction methods with natural deep eutectic solvents (NADES) to extract bioactive compounds and proteins from Bacopa monnieri leaves. The conditional influence of ultrasonic-assisted extraction (UAE), microwave-assisted extraction (MAE), and enzymatic-assisted extraction (EAE) on the recovery efficiency of phenolics, proteins, flavonoids, and terpenoids was evaluated. The conditions of UAE were 50 mL/g LSR, 600W of ultrasonic power, and 30% water content with 40°C for 1 min to obtain the highest bioactive compounds and protein contents. The conditions of MAE were 40 mL/g LSR, 400W of microwave power with 30% water content for 3 min to reach the highest contents of biological compounds. The conditions of EAE were 30 mL/g of LSR, 20 U/g of enzyme concentration with L-Gly-Na molar ratio at 2:4:1, and 40% water content for 60 min to acquire the highest bioactive compound contents. Scanning electron microscopy (SEM) is employed to analyze the surface of Bacopa monnieri leaves before and after extraction. Comparing seven extraction methods was conducted to find the most favorable ones. The result showed that the UMEAE method was the most effective way to exploit the compounds. The study suggested that UMEAE effectively extracts phenolics, flavonoids, terpenoids, and protein from DBMP., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Vo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In this study, we synthesize nanostructured NdMn x Fe 1-x O 3 perovskites using a facile method to produce materials for the high-working-efficiency anodes of Li-ion batteries. A series of characterization assessments (e.g., X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and electron microscopy) were conducted, and the results confirmed the efficacious partial replacement of Fe ions with Mn ions in the NdFeO 3 perovskite structure, occurrence of both amorphous and crystalline structures, presence of oxygen vacancies (V O ), and interconnection between nanoparticles. The possibility of Mn ion replacement significantly affects the size, amount of V O , and ratio of amorphous phase in NdMn x Fe 1-x O 3 perovskites. The NdMn x Fe 1-x O 3 perovskite with x = 0.3 presents a notable electrochemical performance, including low charge transfer resistance, durable Coulombic efficiency, first-rate capacity reservation, high pseudo-behavior, and elongated 150-cycle service life, whereas no discernible capacity deterioration is observed. The reversible capacity of the anode after the 150th-cylcle was 713 mAh g -1 , which represents a high-capacity value. The outstanding electrochemical efficiency resulted from the optimum presence of V O , interconnection between the nanoparticles, and distinctive properties of the NdFeO 3 perovskite. The interconnection between nanoparticles was advantageous for forming a large electrolyte-electrode contact area, improving Li-ion diffusion rates, and enhancing pseudocapacitive effect. The attributes of perovskite crystals, coexistence of Mn and Fe throughout the charge/discharge process, and optimum V O precluded the electrode devastation that caused the Li 2 O-phase decomposition catalysis, enabling favorable reversible Li storage., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Il Tae Kim reports a relationship with Heliyon that includes: board membership., (© 2023 The Authors. Published by Elsevier Ltd.)

This study aimed to use oleic acid-based ultrasonic-assisted extraction (UAE) to recover carotenoids from carrot pomace and emulsify the enriched-carotenoid oleic acid using spontaneous and ultrasonic-assisted emulsification. The extraction performance of oleic acid was compared with traditional organic solvents, including hexane, acetone, and ethyl acetate. The one-factor experiments were employed to examine the impact of UAE conditions, including liquid-to-solid ratios, temperature, ultrasonic power, and time, on the extraction yield of carotenoids and to find the conditional ranges for the optimization process. The response surface methodology was employed to optimize the UAE process. The second-order extraction kinetic model was used to find the mechanism of oleic acid-based UAE. After that, the enriched-carotenoid oleic acid obtained at the optimal conditions of UAE was used to fabricate nanoemulsions using spontaneous emulsification (SE), ultrasonic-assisted emulsification (UE), and SE-UE. The effect of SE and UE conditions on the turbidity of nanoemulsion was determined. Then, the physiochemical attributes of the nanoemulsion from SE, UE, and spontaneous ultrasonic-assisted emulsification (SE-UE) were determined using the dynamic light scattering method. The extraction yield of carotenoids from carrot pomace by using sonication was the highest. The adjusted optimal conditions were 39 mL/g of LSR, 50 °C, 12.5 min, and 350 W of ultrasonic power. Under optimal conditions, the carotenoid content attained was approximately 163.43 ± 1.83 μg/g, with the anticipated value (166 μg/g). The particle sizes of nanoemulsion fabricated at the proper conditions of SE, UE, and SE-UE were 31.2 ± 0.83, 33.8 ± 0.52, and 109.7 ± 8.24 nm, respectively. The results showed that SE and UE are suitable methods for fabricating nanoemulsions. The research provided a green approach for extracting and emulsifying carotenoids from carrot pomace., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

This study deployed ultrasonic-assisted extraction (UAE), combined with natural deep eutectic solvents (NADES), to extract phenolics and flavonoids from the black mulberry fruit, and the antioxidant activity was examined. The extraction yields of NADES-based UAE were assessed based on the yields of phenolics and flavonoids extracted from the black mulberry fruit. This study selected the molar ratios of hydrogen bond acceptors (HBA) and hydrogen bond donors HBD at 1:2 from previous studies. Choline chloride-lactic acid showed the highest solubility with phenolics and flavonoids among NADES systems. One-factor experiments evaluated the effect of UAE conditions (liquid-to-solid ratio (LSR), water content in NADES, temperature, and time) on TPC, TFC, and antioxidant activity. The suitable NADES-based UAE conditions for extracting phenolics and flavonoids from the black mulberry fruit were 60 ml/g of LSR, 40% water content, 70 °C, and 15 min. Response surface methodology with the Box-Behnken design model optimized the NADES-based UAE process based on response (TPC, TFC, ABTS, OH, and DPPH). The optimal conditions for the NADES-based UAE process were 70 ml/g of LSR, 38.9% water content in NADES, 67.9 °C, and 24.2 min of extraction time. The predicted values of the Box-Behnken design were compatible with the experimental results. Moreover, scanning electron microscopy (SEM) was used to survey the surface of black mulberry fruit with and without sonication. SEM can assist in demonstrating the destructive effect of NADES and ultrasonic waves on material surfaces. SEM findings indicated the high surface destruction capacity of NADES, which partially contributed to a superior extraction yield of NADES than conventional organic solvents. The study proposes an efficient and green method for extracting bioactive compounds from black mulberry fruits. The black mulberry fruit extracts can be applied to meat preservation and beverages with high antioxidants., (© 2023. Springer Nature Switzerland AG.)

Despite improvements in HIV testing and earlier antiretroviral therapy (ART) initiation in children living with HIV through the years, a considerable proportion start treatment with advanced disease. We studied characteristics of children and adolescents living with HIV and their level of immunodeficiency at ART initiation using data from a multi-country Asian cohort. We included children and adolescents who were ART-naïve and <18 years of age at ART initiation from 2011 to 2020 at 17 HIV clinics in six countries. Incidence rates of opportunistic infections (OIs) in the first two years of triple-drug ART (≥3 antiretrovirals) was also reported. Competing risk regression analysis was performed to identify factors associated with first occurrence of OI. In 2,027 children and adolescents (54% males), median age at ART initiation increased from 4.5 years in 2011-2013 to 6.7 in 2017-2020, median CD4 count doubled from 237 cells/μl to 466 cells/μl, and proportion of children who initiated ART as severely immunodeficient decreased from 70% to 45%. During follow-up, 275 (14%) children who received triple-drug ART as first treatment and had at least one clinic visit, developed at least one OI in the first two years of treatment (9.40 per 100 person-years). The incidence rate of any first OI declined from 12.52 to 7.58 per 100 person-years during 2011-2013 and 2017-2020. Lower hazard of OIs were found in those with age at first ART 2-14 years, current CD4 ≥200 cells/μl, and receiving ART between 2017 and 2020. The analysis demonstrated increasing number of children and adolescents starting ART with high CD4 count at ART start. The rate of first OI markedly decreased in children who started ART in more recent years. There remains a clear need for improvement in HIV control strategies in children, by promoting earlier diagnosis and timely treatment., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: AHS receives grants to her institution from ViiV Healthcare. All other authors report no potential conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Sornillo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study optimized the ultrasonic-assisted extraction (UAE) and microwave-assisted extraction (MAE) processes to acquire phenolics and flavonoids from passion fruit peels using a mixture of ethanol, acetone, and water. An augmented simplex-centroid design was employed to find the suitable volume ratio among solvent ingredients to attain the highest extraction yield of phenolics and flavonoids. One-factor experiments were conducted to investigate the influence of UAE and MAE parameters on the recovery yield of phenolics and flavonoids before the two processes were optimized using Box-Behnken Design (BBD) models. The optimal UAE conditions for recovering phenolics and flavonoids from passion fruit peel powder (PFP) were 28 mL/g of liquid-to-solid ratio (LSR), 608 W of ultrasonic power, and 63 °C for 20 min to acquire total phenolic content (TPC) and total flavonoid content (TFC) at 39.38 mg of gallic acid equivalents per gram of dried basis (mg GAE/g db) and 25.79 mg of rutin equivalents per gram of dried basis (mg RE/g db), respectively. MAE conditions for attaining phenolics and flavonoids from PFP were 26 mL/g of LSR and 606 W of microwave power for 2 min to recover TPC and TFC at 17.74 mg GAE/g db and 8.11 mg RE/g db, respectively. The second-order kinetic model was employed to determine the UAE and MAE mechanism of TPC and TFC and the thermodynamic parameters of the extraction processes. The antioxidant activities of passion fruit peel extracts at optimal conditions were examined to compare the efficiency of UAE and MAE. This study establishes an effective approach for obtaining phenolics and flavonoids from passion fruit peels., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

This research extracted phenolics and terpenoids from Abelmoschus sagittifolius (Kurz) Merr roots using natural deep eutectic solvent-based novel extraction techniques. Twelve natural deep eutectic solvents (NADESs) were produced for recovering phenolics and terpenoids. Citric acid/glucose and lactic acid/glucose, with a molar ratio of 2:1, were determined as the most appropriate NADESs for extracting phenolics and terpenoids, respectively. Afterward, the proper conditions for NADES-based ultrasonic-assisted and microwave-assisted extraction were investigated. Then, the time and liquid-to-solid ratios of ultrasonic- and microwave-combined extraction methods and the sequence of ultrasound and microwave treatments were examined. The conditions of ultrasonic-assisted extraction were 40 mL/g liquid-to-solid ratio, 40% water content, 30°C, 5 min, and 600 W ultrasonic power for the highest terpenoid recovery at 69 ± 2 mg UA/g dw, while 150 W ultrasonic power was suitable for phenolic recovery at 9.56 ± 0.17 mg GAE/g dw. The conditions of microwave-assisted extraction were 50 mL/g liquid-to-solid ratio, 20% water content, 400 W microwave power, and 2 min to acquire the highest phenolics and terpenoids at 22.13 ± 0.75 mg GAE/g dw and 90 ± 1 mg UA/g dw, respectively. Under appropriate conditions, the biological activities, phenolic content, and terpenoid content of obtained extracts from four extraction methods, including ultrasonic-assisted, microwave-assisted, ultrasonic-microwave-assisted, and microwave-ultrasonic-assisted extraction, were compared to select the most proper method. The conditions of ultrasonic-microwave-assisted extraction were 40 mL/g liquid-to-solid ratio, 5 min sonication, and 1 min microwave irradiation to obtain the highest phenolic and terpenoid contents (27.07 ± 0.27 mg GAE/g dw and 111 ± 3 mg UA/g dw, respectively). Ultrasonic-microwave-assisted extraction showed the highest phenolic content, terpenoid content, and biological activities among the four extraction techniques. The changes in the surface morphology were determined using scanning electron microscopy. This study demonstrated that ultrasonic-microwave-assisted extraction was an effective and sustainable method in food and pharmaceutical industries for recovering phenolics and terpenoids from Abelmoschus sagittifolius (Kurz) Merr., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

This study aimed to produce bacterial cellulose from paper waste sludge (PWS) as a method of utilizing the cellulose source from the remaining pulp in the material. Initially, PWS was hydrolyzed by sulfuric acid to create an enriched-reducing sugar hydrolysate. One-factor experiments were conducted with a fixed amount of PWS (5 g) to investigate the influence of hydrolysis conditions, including water, sulfuric acid addition, temperature, and retention time, on the production yield of reducing sugars. Based on these results, the Box-Behnken model was designed to optimize the hydrolysis reaction. The optimal hydrolysis conditions were 10 ml/g of the sulfuric acid solution (30.9%) at 105.5 °C for 90 min of retention time 0.81 (gGE/g PWS), corresponding to a conversion yield of 40.5%). Subsequently, 100 ml of the filtered and neutralized PWS hydrolysate was used as the culture to produce the bacterial cellulose (BC) using Acetobacter xylinum , which produced 12 g/L of bacterial cellulose. The conversion yield of bacterial cellulose calculated as the ratio of the weight of produced bacterial cellulose to that of cellulose in PWS reached 33.3%. The structure of the obtained BC was analyzed using scanning electron microscopy (SEM) and X-ray diffraction (XRD) to indicate the formation of nano-cellulose fiber networks. This research proposed a combined method to convert paper waste sludge into bacterial cellulose, demonstrating the potential for waste utilization and sustainable production of paper industries for added-value products., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

Organic compounds are widespread pollutants in wastewater, causing significant risks for living organisms. In terms of advanced oxidation processes, photocatalysis is known as an effective technology for the oxidation and mineralization of numerous non-biodegradable organic contaminants. The underlying mechanisms of photocatalytic degradation can be explored through kinetic studies. In previous works, Langmuir-Hinshelwood and pseudo-first-order models were commonly applied to fit batch-mode experimental data, revealing critical kinetic parameters. However, the application or combination conditions of these models were inconsistent or ignored. This paper briefly reviews kinetic models and various factors influencing the kinetics of photocatalytic degradation. In this review, kinetic models are also systemized by a new approach to establish a general concept of a kinetic model for the photocatalytic degradation of organic compounds in an aqueous solution., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Lead (Pb), cadmium (Cd), arsenic (As), chromium (Cr), and nickel (Ni) are poisonous, widely distributed, persistent, and transferable to crops, posing potential health risks. This study aims to assess the potential health risks of those elements in rice collected from North-Central Vietnam: Thanh Hoa, Nghe An, and Ha Tinh provinces. Element analysis was performed on rice harvested in November 2020 by ICP-MS. The estimated daily intake (EDI), target hazard quotient (THQ), non-carcinogenic hazard index (HI), and target carcinogenic risk (TR) were used to assess potential health risks for different population groups. The highest element levels (mg kg -1 dry weight) were observed for Cr (0.30 ± 0.11), As (0.17 ± 0.025) and for Pb (0.24 ± 0.013) in Thanh Hoa, and for Cd (0.088 ± 0.015) in Ha Tinh. Strong links were observed between geological formations, mining activities and Cr in rice (Thanh Hoa), or industrial activities and Ni accumulation in rice (Hung Nguyen and Ky Anh districts). Children had greater EDIs than adults, with As having a higher EDI than RfD. Rice THQs indicated a risk trend: Thanh Hoa > Ha Tinh > Nghe An, with As being a significant contributor to HIs. Cr and Cd were significant risk factors and HIs in female children were 1.5 times higher than in other groups. Based on TR values for Ni and Pb, a potential carcinogenic risk to rice eaters was observed, particularly Ni. The data revealed a significant human health risk (both non-carcinogenic and carcinogenic) connected with rice consumption. Therefore, crops and foods from North-Central Vietnam should be strictly regulated., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Towards hepatitis C elimination among people who inject drugs (PWID), we assessed the effectiveness of a strategy consisting of a community-based respondent-driven sampling (RDS) as wide screening, a simplified and integrated hospital-based care, and prevention of reinfection supported by community-based organisations (CBO), in Hai Phong, Vietnam., Methods: Adults who injected heroin were enrolled in a RDS survey implemented in two CBO premises. Rapid HIV and HCV tests were done on site, and blood was taken for HCV RNA testing. Those with detectable HCV RNA were referred with CBO support to three public hospitals for 12-week sofosbuvir/daclatasvir, plus ribavirin for patients with cirrhosis. Participants were followed-up 12 weeks post-treatment (SVR12) and 48 weeks after enrolment. The primary endpoint was the rate of undetectable HCV RNA participants at 48 weeks., Findings: Among the 1444 RDS survey participants, 875 had hepatitis C. Their median age was 41 years (IQR 36-47), 96% were males, 36% were HIV-coinfected. Overall, 686 (78.4%) started sofosbuvir/daclatasvirs, and 629 of the 647 (97.2%) patients tested at SVR12 were cured. At week 48 (581/608) 95.6% had undetectable HCV RNA, representing 66.4% of all PWID identified with hepatitis C. The reinfection rate after SVR12 was 4/100 person-years (95% CI: 2-7)., Interpretation: Our strategy, involving CBO and addressing all steps from wide HCV screening to prevention of reinfection, stands as a promising approach to eliminate HCV among PWID in low and middle-income countries., Funding: France ANRS|MIE (#ANRS12380). The RDS survey was implemented with grants from the NIDA (#R01DA041978) and ANRS|MIE (#ANRS12353)., Competing Interests: ML received fees from Cepheid and Gilead US, as well as consultancy fees from Gilead US, outside the submitted work. KL received grants or contracts from MSD, honoraria from Janssen and Gilead, and travel support from Gilead, outside the submitted work. DDJ received grants and contracts from U.S. Centers for Disease Control, outside the submitted work. PV grants and contracts from Gilead medical Sciences outside the submitted work. Other authors declare no competing interest., (© 2023 The Author(s).)

Rice is the second-most important primary crop in the world and one of the most susceptible crops to salt stress. Soil salinization hinders seedling growth and decreases crop yield by inducing ionic and osmotic imbalances, photosynthesis disturbances, cell wall alterations, and gene expression inhibition. Plants have developed a range of defense mechanisms to adapt to salt stress. One of the most effective means is to make use of plant microRNAs (miRNAs) as post-transcriptional regulators to regulate the expression of developmental genes in order to mitigate the detrimental effects of salt stress. In this study, the miRNA sequencing data between two contrasting rice cultivars, salt-tolerant Doc Phung (DP) and salt-sensitive IR28 seedlings, were compared under control and salt stress (150 mM NaCl) conditions to determine the salt stress-responsive miRNAs. Comparative analysis of miRNA sequencing data detected a total of 69 differentially expressed miRNAs in response to salt stress treatment. Among them, 18 miRNAs from 13 gene families, MIR156, MIR164, MIR167, MIR168, MIR171, MIR396, MIR398, MIR1432, MIR1846, MIR1857, MIR1861, MIR3979, and MIR5508, were identified to be specifically and significantly expressed in the shoot and root tissues of DP seedlings. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses further revealed that these detected miRNAs regulate a range of essential biological and stress response processes, including gene transcription, osmotic homeostasis, root formation, ROS scavenger synthesis, and auxin and abscisic acid signaling pathways. Our findings provide more insight into the miRNA-mediated responsive mechanisms of rice under salt stress and should benefit the improvement of salt stress tolerance in rice., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Nguyen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management and outcome are sparse., Methods and Results: This international multicenter registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. A total of 553,729 catheter ablation procedures (radiofrequency: 62.9%, cryoballoon: 36.2%, other modalities: 0.9%) were performed at 214 centers in 35 countries. In 78 centers 138 patients (0.025%, radiofrequency: 0.038%, cryoballoon: 0.0015% (p<0.0001)) were diagnosed with an oesophageal fistula. Periprocedural data were available for 118 patients (85.5%). Following catheter ablation, the median time to symptoms and the median time to diagnosis were 18 (7.75, 25; range: 0-60) days and 21 (15, 29.5; range: 2-63) days, respectively. The median time from symptom onset to oesophageal fistula diagnosis was 3 (1, 9; range: 0-42) days. The most common initial symptom was fever (59.3%). The diagnosis was established by chest computed tomography in 80.2% of patients. Oesophageal surgery was performed in 47.4% and direct endoscopic treatment in 19.8%, and conservative treatment in 32.8% of patients. The overall mortality was 65.8%. Mortality following surgical (51.9%) or endoscopic treatment (56.5%) was significantly lower as compared to conservative management (89.5%) (odds ratio 7.463 (2.414, 23.072) p<0.001)., Conclusions: Oesophageal fistula after catheter ablation of atrial fibrillation is rare and occurs mostly with the use of radiofrequency energy rather than cryoenergy. Mortality without surgical or endoscopic intervention is exceedingly high., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Background: Androgens and androgen receptor (AR) are critical regulators of the masculinization process in male sexual development. The absence of a functioning AR results in the development of the androgen insensitivity syndrome (AIS), a rare disorder of sexual development (DSD) characterized by the external genitalia feminization, gynecomastia, and impaired spermatogenesis., Objective: To determine the AR gene mutations associated with male DSD in four unrelated Vietnamese patients., Methods: To detect the disease-causing mutations, whole exome sequencing (WES) was performed on four patients diagnosed with AIS. Sanger sequencing was then used for validation of the identified mutations. Finally, 12 web-based tools, three-dimensional protein modeling software, and the guidelines issued by the American College of Medical Genetics and Genomics were used to assess the potential pathogenicity of these mutations., Results: Four distinct novel mutations, namely c.1834T > A (p.Cys612Ser), c.2122 C > G (p.Leu708Val), c.2630T > G (p.Phe877Cys), and c.2641 C > A (p.Leu881Met) in the AR gene, were identified in four AIS patients using WES. The in silico analysis results revealed that the Cys612, Leu708, Phe877, and Leu881 sites are important for an appropriate response to androgens of the AR, and mutation at these sites can have adverse effects on the AR functions, androgen-AR interaction, and AR signaling pathway., Conclusions: WES and in silico analyses strongly suggested that four novel AR mutations are pathogenic and have led to the development of AIS in the four Vietnamese patients under consideration., (© 2022. The Author(s) under exclusive licence to The Genetics Society of Korea.)

This research combined ultrasonic-assisted extraction (UAE) and natural deep eutectic solvent (NADES) to recover phenolic and flavonoid components from mangosteen rind. The antioxidant activities were determined using DPPH, ABTS + , and hydroxyl assays. NADES prepared from lactic and 1,2-propanediol had the highest extraction efficiency based on the total flavonoid content (TFC) and phenolic contents (TPC). Single-factor experiments were employed to assess the influence of UAE conditions (liquid-to-solid ratio, temperature, water content in NADES, and time) on TFC, TPC, and antioxidant activities. NADES-based UAE conditions were optimized using response surface methodology with the Box-Behnken design model on five dependent responses (TPC, TFC, DPPH, ABTS, and OH). The optimal conditions for the lactic-1,2-Propanediol-based UAE process were 76.7 ml liquid/g solid with 30.3% of water content at 57.5 °C for 9.1 min. Scanning electron microscopy (SEM) was applied to examine the surface morphology of mangosteen rind before and after sonication. This study proposes an efficient, green, and practical approach for recovering phenolics and flavonoids from mangosteen rinds., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Breast cancer is the leading cause of cancer death in Vietnamese women, but its mutational landscape and actionable alterations for targeted therapies remain unknown. After treatment, a sensitive biomarker to complement conventional imaging to monitor patients is also lacking. In this prospective multi-center study, 134 early-stage breast cancer patients eligible for curative-intent surgery were recruited. Genomic DNA from tumor tissues and paired white blood cells were sequenced to profile all tumor-derived mutations in 95 cancer-associated genes. Our bioinformatic algorithm was then utilized to identify top mutations for individual patients. Serial plasma samples were collected before surgery and at scheduled visits after surgery. Personalized assay tracking the selected mutations were performed to detect circulating tumor DNA (ctDNA) in the plasma. We found that the mutational landscape of the Vietnamese was largely similar to other Asian cohorts, showing higher TP53 mutation frequency than in Caucasians. Alterations in PIK3CA and PI3K signaling were dominant, particularly in our triple-negative subgroup. Using top-ranked mutations, we detected ctDNA in pre-operative plasma in 24.6-43.5% of the hormone-receptor-positive groups and 76.9-80.8% of the hormone-receptor-negative groups. The detection rate was associated with breast cancer subtypes and clinicopathological features that increased the risk of relapse. Interim analysis after a 15-month follow-up revealed post-operative detection of ctDNA in all three patients that had recurrence, with a lead time of 7-13 months ahead of clinical diagnosis. Our personalized assay is streamlined and affordable with promising clinical utility in residual cancer surveillance. We also generated the first somatic variant dataset for Vietnamese breast cancer women that could lay the foundation for precision cancer medicine in Vietnam., (© 2022 Gene Solutions JSC and The Authors. Molecular Oncology published by John Wiley & Sons Ltd on behalf of Federation of European Biochemical Societies.)

We demonstrated previously that the hypothalamic supraoptic nucleus (SON) undergoes an axonal sprouting response following a unilateral lesion of the hypothalamo-neurohypophysial tract in a 35-day-old rat to repopulate the partially denervated neural lobe (NL). However, no sprouting occurs following the same injury in a 125-day-old rat. We previously reported a significant increase in Thy-1 protein in the SON of a 125-day-old rat compared to a 35-day-old rat in the absence of injury. Thy-1 is a cell surface glycoprotein shown to inhibit axonal outgrowth following injury; however, we did not look at axotomy's effect on Thy-1 in the SON. Therefore, we sought to determine the integrin ligands that bind Thy-1 in the SON and how axotomy impacts Thy-1. Like what others have shown, the co-immunoprecipitation analysis demonstrated that Thy-1 interacts with α v ß 3 and α v ß 5 integrin dimers in the SON. We used western blot analysis to examine protein levels of Thy-1 and integrin subunits following injury in the 35- and 125-day-old rat SON and NL. Our results demonstrated that Thy-1 protein levels increase in the lesion SON in a 35-day-old rat. The quantitative dual-fluorescent analysis showed that the increase in Thy-1 in the lesion SON occurred in astrocytes. There was no change in Thy-1 or integrin protein levels following injury in the 125-day-old following injury. Furthermore, the axotomy significantly decreased Thy-1 protein levels in the NL of both 35- and 125-day-old rats. These results provide evidence that Thy-1 protein levels are injury dependent in the magnocellular neurosecretory system., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: This study aimed to evaluate the effects of dialysis on change of QT interval in pre-dialysis, 1 h after dialysis initiation, and post-dialysis period in patients on maintenance dialysis (MHD)., Methods: An observational prospective study was conducted, including 61 patients, on thrice-weekly MHD ≥3 months, and without acute diseases, at the Nephrology-Dialysis Department of a tertiary hospital in Vietnam. The exclusive criteria were atrial fibrillation, atrial flutter, branch block, prolonged QT recorded in medical history, and taking antiarrhythmic drugs lengthening QT interval before entering the study. Twelve-lead electrocardiographs and blood chemistries were done simultaneously before, 1 h after initiation, and after the dialysis session., Results: The proportion of patients with prolonged QT interval increased significantly from 44.3% in pre-dialysis to 77% 1 h after dialysis initiation and 86.9% in post-dialysis session. Immediately after dialysis, the QT and QTc intervals on all 12 leads were significantly longer. Post-dialysis levels of potassium, chloride, magnesium, and urea decreased significantly from 3.97 (0.7), 98.6 (4.7), 1.04 (0.2), and 21.4 (6.1) to 2.78 (0.4), 96.6 (2.5), 0.87 (0.2), and 6.33 (2.8) mmol/L, respectively, whereas the calcium increased significantly from 2.19 (0.2) to 2.57 (0.2) mmol/L. There were significant differences in the potassium level at the dialysis initiation and its speed of reduction between the group without and with prolonged QT interval., Conclusions: There was an increased risk of prolonged QT interval in MHD patients regardless of the absence of the previous abnormal QT interval. Notably, this risk increased rapidly 1 h after the initiation of dialysis., (© 2023 S. Karger AG, Basel.)

Background: Colorectal cancer (CRC) is the fifth most common cancer with rising prevalence in Vietnam. However, there is no data about the mutational landscape and actionable alterations in the Vietnamese patients. During post-operative surveillance, clinical tools are limited to stratify risk of recurrence and detect residual disease., Method: In this prospective multi-center study, 103 CRC patients eligible for curative-intent surgery were recruited. Genomic DNA from tumor tissue and paired white blood cells were sequenced to profile all tumor-derived somatic mutations in 95 cancer-associated genes. Our bioinformatic algorithm identified top mutations unique for individual patient, which were then used to monitor the presence of circulating tumor DNA (ctDNA) in serial plasma samples., Results: The top mutated genes in our cohort were APC , TP53 and KRAS . 41.7% of the patients harbored KRAS and NRAS mutations predictive of resistance to Cetuximab and Panitumumab respectively; 41.7% had mutations targeted by either approved or experimental drugs. Using a personalized subset of top ranked mutations, we detected ctDNA in 90.5% of the pre-operative plasma samples, whereas carcinoembryonic antigen (CEA) was elevated in only 41.3% of them. Interim analysis after 16-month follow-up revealed post-operative detection of ctDNA in two patients that had recurrence, with the lead time of 4-10.5 months ahead of clinical diagnosis. CEA failed to predict recurrence in both cases., Conclusion: Our assay showed promising dual clinical utilities in residual cancer surveillance and actionable mutation profiling for targeted therapies in CRC patients. This could lay foundation to empower precision cancer medicine in Vietnam and other developing countries., Competing Interests: V-AH, T-AT, TH, DQN, Y-TL, H-NN, HG and LT are current employees of Gene Solutions, Vietnam. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nguyen, Nguyen, Nguyen Hoang, Tran, Le Trinh, Le, Nguyen Tran, Pham, Dinh, Nguyen, Nguyen The, Mai, Chu, Pham, Nguyen, Ngo Ha, Nguyen, Nguyen, Lu, Do Thi, Truong, Nguyen, Nguyen, Giang and Tu.)

Objective: The aim of this study was to investigate the impact of left atrial diverticula (LADs), left sided septal pouches (LSSPs) and middle right pulmonary veins (MRPVs) on recurrent atrial fibrillation (rAF) in patients undergoing laser pulmonary vein isolation procedure (PVI)., Material and Methods: This retrospective study enrolled 139 patients with pre-procedural multiple detector computed tomography (MDCT) imaging and 12 months follow-up examination. LADs, LSSPs and MRPV were identified by two radiologists on a dedicated workstation using multiplanar reconstructions and volume rendering technique. Univariate and bivariate regression analyses with patient demographics and cardiovascular risk factors as covariates were performed to reveal independent factors associated with rAF., Results: LADs were recorded in 41 patients (29%), LSSPs in 20 (14%) and MRPVs in 15 (11%). The right anterosuperior wall of the left atrium was the most prevalent location of LADs (68%). rAF occured in 20 patients, thereof, 15 exhibited an outpouching structure of the left atrium (LAD: 9, LSSP: 2 and MRPV: 3). Presence of an LAD (HR: 2.7, 95%CI: 1.0-8.4, p = 0.04) and permanent AF (HR: 4.8, 95%CI: 1.5-16.3, p = 0.01) were independently associated with rAF., Conclusions: LAD, LSSP and MRPV were common findings on pre-procedural cardiac computed tomography. LADs were revealed as potential independent risk factor of rAF, which might be considered for treatment planning and post-treatment observation., Competing Interests: The authors have declared that no competing interests exist.

This context presents the study of ultrasonic-assisted extraction (UAE) to obtain phenolic and flavonoid compounds from watermelon rind powder (WRP). The antioxidant activity of the extracts was investigated using DPPH and ABTS + assays. One-factor experiments were conducted to examine the effect of each factor (solid-to-liquid ratio (SLR), acetone concentration (AC), temperature, and time) on the UAE of WRP. Box-Behnken Design (BDD) model was employed to optimize the UAE conditions based on total phenolic contents (TPC), total flavonoid content (TFC), and their antioxidant activities. The optimal conditions were 1:30.50 SLR, 70.71% AC, 29.78 °C, and 10.65 min extraction time. There were no significant differences between predicted and experimental results (less than 6.0%), recommending a feasible and innovative process of deploying UAE to extract phenolics and flavonoids effectively from watermelon rind., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Published by Elsevier B.V.)

Toxic metal pollution influences the lives of diverse aquatic organisms and humans who consume contaminated aquatic products. However, its potential impacts on aquatic organism health and, thus, ecological health, have been neglected in many regions. This research was carried out to contribute to filling that knowledge gap. Three freshwater fish species in the Nhue−Day River basin, Vietnam, have been chosen to study the bioaccumulation of metals (Zn, Cu, Pb, and Cd) in the tissues (livers, kidneys, gills) and their effects on fish physiological health (changes in the oxidative-GST activity, and physiological biomarkers-energy reserves, respectively) from 2013 to 2017. The extensive results revealed significant spatial and temporal variations in metal concentrations in tissues of common carp (Cyprinus carpio), silver carp (Hypothalmic molitrix), and tilapia (Oreochromis niloticus), and well correlated to their concentration in the water (p < 0.05). Fish bioaccumulated metals in the following order: Zn > Cu > Pb > Cd, with more in the kidneys and livers (spring and summer) than in other tissues. Metal accumulation in O. niloticus and C. carpio was higher than in H. molitrix. Biomarker responses (except for glycogen variation) were also higher during warm seasons. Changes in metal levels in water and fish tissues caused variations in biomarkers in the respective fish tissues, particularly in the livers, as demonstrated by significant correlations of metal concentrations in water and fish tissues to biochemical and physiological responses (p < 0.05). The findings suggest that metal pollution in the river basin adversely impacts the physiological health of both wild and cultured fish. Seasonal shifts in the levels of metal accumulation and biomarkers could be connected to species-specific differences in physiology and the levels of metals in environments. This biomarker set is simple but effective in assessing the impact of metal pollution on fish health and, hence, the aquatic ecosystem. This is one of the first biomonitoring studies to assist in designing better water management strategies for the Nhue−Day River basin.

Deoiled coconut cake powder (DCCP) was hydrolyzed to reduce the ratio of insoluble/soluble dietary fiber (RIS) by partially converting insoluble dietary fiber to soluble using Celluclast 1.5 L, a commercial cellulase preparation in citrate buffer medium. Firstly, the influence of citrate buffer amount, enzyme concentration, pH, and retention time on the enzymatic hydrolysis efficiency was investigated. Then, response surface methodology (RSM) was employed to optimize the process in which the insoluble and soluble dietary fiber contents were the responses. The results revealed that 10.3 g buffer/g of materials, 3.7 U/g of the materials, and 60 min of retention time were the optimal conditions for the enzymatic hydrolysis to obtain the insoluble and soluble contents of 68.21%db and 8.18%db, respectively. Finally, DCCP or hydrolyzed DCCP (HDCCP) was partially substituted for wheat flour at different replacement ratios in a cookie recipe at 0, 10, 20, 30, and 40%. The cookies with a 10% replacement ratio of hydrolyzed deoiled coconut cake powders had a lower RIS by more than two folds those of DCCP and had the same sensorial score as the control sample. This study proposed that Celluclast 1.5 L effectively reduced RIS by partially converting insoluble to soluble dietary fiber, improving the soluble dietary fiber content in fiber-enriched cookies.

Background: In most low-to-middle-income countries, HIV control at the population level among people who inject drugs (PWID) remains a major challenge. We aimed to demonstrate that an innovative intervention can identify HIV-positive PWID in the community who are not treated efficiently, and get them treated efficiently., Methods: Between 2016 and 2020, we implemented an intervention consisting of mass HIV screening of PWID using three annual respondent-driven sampling surveys (RDSS) and a post-intervention evaluation RDSS in community-based organisation (CBO) sites, coupled with peer support to facilitate/improve access to antiretroviral and methadone therapy in Haiphong, Vietnam. The primary outcome was the proportion of identified uncontrolled HIV-positive PWID who achieved viral control. We also estimated the potential effect of the intervention on the proportion of PWID with HIV RNA >1000 copies/mL among all PWID during the study period., Findings: Over the three RDSS, 3150 different PWID were screened, i.e. two-thirds of the estimated population size. They all injected heroin, their median age was of 39 years, 95% were male, 26.5% were HIV-infected, and 78.6% of the latter had HIV RNA ≤1000 copies/mL. Among the 177 PWID identified with an unsuppressed viral load, 73 (41.2%) achieved viral suppression at the final visit. HIV viremia decreased from 7.2% at baseline to 2.9% at the final RDSS ( p <0.001). Up to 42% of this observed reduction may be explained by the intervention, in the absence of any external intervention targeting PWID during the study period., Interpretation: Mass community-based screening using RDSS coupled with CBO support is a powerful tool to rapidly identify untreated HIV-positive PWID and (re)link them to care., Funding: NIDA (USA) and ANRS (France)., Competing Interests: The authors declare no competing interest., (© 2022 The Author(s).)

In this article, we propose a soft eel robot design using soft pneumatic actuators that mimic eel muscles. Four pairs of soft actuators are used to construct the eel robot body. Pulse signals with suitable shifting phases are utilized to control delivery of compressed air to the actuators in sequence to create a sinusoidal wave from head to tail of the robot body. A model of hydrodynamic forces acting on an anguilliform swimmer when moving in fluid was built to estimate the thrust force generated by the robot at different tail beat frequencies. Experimental data revealed that the generated thrust force was positively correlated with the beat frequency. Measured data showed that swimming efficiency depended on both generated thrust force and body posture in situ . At the beat frequency of 1.25 Hz, and air pressure at three segments from head to tail of 65, 50, and 30 kPa, respectively, the eel robot body showed the best cost of transport (COT) of 19.21 with velocity of 10.5 cm/s (or 0.198 body length per second [BL/s]), compared to the other's values of operation frequency and air pressure. We also found that control shifting phase strongly affects the swimming speed and COT. The robot body reached the highest velocity at around 19 cm/s (0.36 BL/s) with the COT of 10.72. Obtained result in this research would contribute to development of soft elongated swimming robot and enhance the knowledge on swimming performance of both robot and natural eels.

From the end of 2019, one of the most serious and largest spread pandemics occurred in Wuhan (China) named Coronavirus (COVID-19). As reported by the World Health Organization, there are currently more than 100 million infectious cases with an average mortality rate of about five percent all over the world. To avoid serious consequences on people's lives and the economy, policies and actions need to be suitably made in time. To do that, the authorities need to know the future trend in the development process of this pandemic. This is the reason why forecasting models play an important role in controlling the pandemic situation. However, the behavior of this pandemic is extremely complicated and difficult to be analyzed, so that an effective model is not only considered on accurate forecasting results but also the explainable capability for human experts to take action pro-actively. With the recent advancement of Artificial Intelligence (AI) techniques, the emerging Deep Learning (DL) models have been proving highly effective when forecasting this pandemic future from the huge historical data. However, the main weakness of DL models is lacking the explanation capabilities. To overcome this limitation, we introduce a novel combination of the Susceptible-Infectious-Recovered-Deceased (SIRD) compartmental model and Variational Autoencoder (VAE) neural network known as BeCaked. With pandemic data provided by the Johns Hopkins University Center for Systems Science and Engineering, our model achieves 0.98 [Formula: see text] and 0.012 MAPE at world level with 31-step forecast and up to 0.99 [Formula: see text] and 0.0026 MAPE at country level with 15-step forecast on predicting daily infectious cases. Not only enjoying high accuracy, but BeCaked also offers useful justifications for its results based on the parameters of the SIRD model. Therefore, BeCaked can be used as a reference for authorities or medical experts to make on time right decisions., (© 2022. The Author(s).)

Multinational studies have reported monogenic etiologies in 25%-30% of children with steroid-resistant nephrotic syndrome. Such large studies are lacking in Asia. We established Deciphering Diversities: Renal Asian Genetics Network (DRAGoN) and aimed to describe the genetic and clinical spectrums in Asians. We prospectively studied a cohort of 183 probands with suspected genetic glomerulopathies from South and Southeast Asia, of whom 17% had positive family history. Using multi-gene panel sequencing, we detected pathogenic variants in 26 (14%) probands, of whom one-third had COL4A4 or COL4A5 variants (n = 9, 5%). Of those with COL4A5 defects, only 25% had features suggestive of Alport syndrome. Besides traditional predictors for genetic disease (positive family history and extrarenal malformations), we identified novel predictors, namely older age (6.2 vs. 2.4 years; p = 0.001), hematuria (OR 5.6; 95% CI 2.1-14.8; p < 0.001), and proteinuria in the absence of nephrotic syndrome (OR 4.6; 95% CI 1.8-11.8; p = 0.001) at first manifestation. Among patients who first presented with proteinuria without nephrotic syndrome, the genetic diagnostic rates were >60% when a second risk factor (positive family history or extrarenal manifestation) co-existed. The genetic spectrum of glomerulopathies appears different in Asia. Collagen IV genes may be included in sequencing panels even when suggestive clinical features are absent., (© 2022 John Wiley & Sons A/S . Published by John Wiley & Sons Ltd.)

Introduction and Importance: Fabella syndrome is a rare cause of posterolateral knee pain. The definitive diagnosis and management of this syndrome remain unclear., Case Presentation: We report a case of a 19-year-old patient who is a Vietnamese professional football player. He presented with persistent pain in the posterolateral aspect of the knee joint for 12 months that was unrelated to trauma. He was treated conservatively for 6 months without any improvement in the previous hospital. He was diagnosed with fabella syndrome and underwent open surgery to remove the bone. Evaluation after surgery 12 weeks revealed the symptoms disappeared and he was able to return to practice., Clinical Discussion: In order to diagnose fabella syndrome, the clinicians need to be vigilant and base on the clinical signs as well as imaging to exclude other causes of posterolateral knee pain. Conservative therapy is always the first choice of treatment although the recurrence rate is high, especially in professional athletes. If the initial conservative therapies failed, the fabella surgical removal surgery should be made in athletes., Conclusion: Fabella syndrome is a rare cause of posterolateral knee pain in professional athletes. The definitive diagnosis and management of this syndrome remain unclear. Our case shows that surgical removal of the bone fragments can be considered if failure after the initial conservative therapies., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: The COVID-19 outbreak disproportionally affects vulnerable populations including people who inject drugs (PWID). Social distancing and stay-at-home orders might result in a lack of access to medical and social services, poorer mental health, and financial precariousness, and thus, increases in HIV and HCV risk behaviors. This article explores how the HIV/HCV risk behaviors of PWID in Haiphong, a city with high harm reduction service coverage in Vietnam, changed during the early phase of the COVID-19 pandemic, and what shaped such changes, using the risk environment framework., Method: We conducted three focus group discussions with peer outreach workers in May 2020 at the very end of the first lockdown, and 30 in-depth interviews with PWID between September and October 2020, after the second wave of infection in Vietnam. Discussions and interviews centered on the impact of the COVID-19 pandemic on their lives, and how their drug use and sexual behaviors changed as a result of the pandemic., Results: The national shutdown of nonessential businesses due to the COVID-19 epidemic caused substantial economic challenges to participants, who mostly were in a precarious financial situation before the start of the epidemic. Unsafe injection is no longer an issue among our sample of PWID in Haiphong thanks to a combination of different factors, including high awareness of injection-related HIV/HCV risk and the availability of methadone treatment. However, group methamphetamine use as a means to cope with the boredom and stress related to COVID-19 was common during the lockdown. Sharing of smoking equipment was a standard practice. Female sex workers, especially those who were active heroin users, suffered most from COVID-related financial pressure and may have engaged in unsafe sex., Conclusion: While unsafe drug injection might no longer be an issue, group methamphetamine use and unsafe sex were the two most worrisome HIV/HCV risk behaviors of PWID in Haiphong during the social distancing and lockdown periods. These elevated risks could continue beyond the enforced lockdown periods, given PWID in general, and PWID who are also sex workers in particular, have been disproportionately affected during the global crisis., (© 2022. The Author(s).)