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Nguyen Van An,1 Hai Thi Nguyen,2 Van Nguyen Le,1 Ha Thi Thu Van,1 Nguyen Minh Hai,1 Vu Huy Luong,3,4 Vinh Thi Ha Nguyen,4,5 Hoa Quynh Pham,6 Hung Van Le,4,6 Dinh Viet Hung,7 Hoang Trung Kien,8 Minh Nhat Le,9,10 Nguyen Hoang Viet,11 Luong Cong Thuc,12 Ta Ba Thang,13 Tran Viet Tien,14 Le Huy Hoang,15 Nguyen Thuy Tram,15 Tuan Dinh Le,16 Nguyen Tien Son,16 Hai Ha Long Le17,18 1Department of Microbiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Central Laboratory, Bac Ninh Provincial General Hospital, Bac Ninh, Vietnam; 3Department of Laser and Skincare, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 4Department of Dermatology and Venereology, Hanoi Medical University, Hanoi, Vietnam; 5Department of General Planning, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 6Department of Microbiology, Mycology and Parasitology, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 7Department of Psychiatry, Military Medical 103, Vietnam Military Medical University, Hanoi, Vietnam; 8Department of Immunology, Vietnam Military Medical University, Hanoi, Vietnam; 9Tay Nguyen Institute of Science Research, Vietnam Academy of Science and Technology, VAST, Hanoi, Vietnam; 10Antimicrobial Resistance Research Center, National Institute of Infectious Disease, Tokyo, Japan; 11Molecular Pathology Department, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 12Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 13Respiratory Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 14Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 15Department of Bacteriology, National of Hygiene and Epidemiology, Hanoi, Vietnam; 16Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 17Department of Clinical Microbiology and Parasitology, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 18Department of Biochemistry, Hematology and Immunology, National Hospital of Dermatology and Venereology, Hanoi, VietnamCorrespondence: Hai Ha Long Le, Department of Clinical Microbiology and Parasitology, Faculty of Medical Technology, Hanoi Medical University, Hanoi, 100000, Vietnam, Tel +84978520055, Email lehalonghai@gmail.comPurpose: Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA) strain, can become resistant to all classes of clinically available antibiotics and causes skin infections and severe infections in the lungs, heart, and bloodstream. The study aimed to evaluate antimicrobial susceptibility patterns and MRSA exhibiting multidrug resistance obtained through a microbiological culture of clinical specimens at Bac Ninh Provincial General Hospital in Bac Ninh Province, Vietnam.Methods: We employed a cross-sectional analysis at Bac Ninh Provincial General Hospital in Vietnam. 15,232 clinical samples from inpatients were examined. S. aureus isolates were identified using established protocols and tested for MRSA and antibiotic susceptibility. Data was analyzed using R software, with statistical calculations to assess associations between variables.Results: Staphylococcus aureus was isolated from 417 samples (2.7%), with 77.2% being MRSA and 22.8% methicillin-susceptible Staphylococcus aureus (MSSA). Significant sources of MRSA were wounds (64.6%) and the surgical unit (50%) according to sample types and hospital wards, respectively. S. aureus showed high resistance rates, the highest being azithromycin (83.2%), and was fully susceptible to vancomycin. Among 294 multidrug-resistant (MDR) strains, the prevalence was 82.0% in MRSA and 18.0% in MSSA.Conclusion: The study highlights widespread antimicrobial resistance among MRSA isolates from a provincial hospital in Vietnam, emphasizing the urgent need for antibiotic surveillance, formulation of antibiotic policies, and preventive measures to tackle the increasing prevalence of multidrug-resistant MRSA.Keywords: Staphylococcus aureus, antibiotic resistance, MRSA, MDR, Vietnam

Introduction: Deformities of the spine and thorax in adolescent idiopathic scoliosis affect appearance. They are a cause of inferiority, affecting psychological well-being and the social life of the patients. To contribute to curve evaluation, planning in curve correction, and improving the post-operative aesthetics, many studies on the correlation between appearance and radiography in the assessment of shoulder and neck balance have been reported recently. In general, these studies did not clarify which indices are required to evaluate shoulder and neck balance. This study aimed to learn about indices to assess shoulder and neck balance in adolescent idiopathic scoliosis in correlation between clinical appearance and radiography. Materials and methods: This observational study recruited 50 patients with adolescent idiopathic scoliosis who were 12 to 18 years of age with Cobb angle >10°. Based on Pearson correlation coefficient, radiographic parameters such as coracoid height difference (CHD), clavicle rib intersection distance (CRID), clavicle angle (CA), clavicle chest cage angle difference (CCAD), and T1 tilt angle were evaluated in correlation with clinical shoulder and neck balance by difference of inner shoulder height (SHi), difference of outer shoulder height (SHo), and neck tilt angle. Results: SHi was moderately correlated with T1 tilt angle (r [hereafter] = 0.45), CA (0.47), and CHD (0.57), high-moderately correlated with CRID (0.64), very-highly correlated with CCAD (0.84). SHo was moderately correlated with T1 tilt angle (0.43), highly correlated with CHD (0.60), CA (0.63), and CRID (0.72), and very-highly correlated with CCAD (0.89). T1 tilt angle was high-moderately correlated with neck tilt angle (0.76). The correlation coefficients between clinical and radiographic shoulder and neck balance according to sex, BMI, type of main curve, severity of main curve did not change significantly. Conclusion: There was a very high correlation between SHo (shoulder tilt) and CCAD (0.89); the correlation between SHo and CRID was high-moderate (0.72), but CRID is easier than CCAD to evaluate on radiographs. On the other hand, T1 tilt angle, which is the easiest radiographic parameter to evaluate, had a high-moderate correlation with neck tilt angle (0.76) but a moderate correlation with SHo (0.43).

Huan Thanh Nguyen,1,2 Huong Thanh Do,2 Hai Van Be Nguyen,2 Tan Van Nguyen1,3 1Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 2Department of Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam; 3Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, VietnamCorrespondence: Huan Thanh Nguyen, Department of Geriatrics and Gerontology University of Medicine and Pharmacy at Ho Chi Minh City, 17 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam, Tel +84-909097849, Email huannguyen@ump.edu.vnPurpose: To investigate the prevalence and factors associated with frailty and impact of frailty on hospitalization due to any cause in elderly patients with chronic coronary syndrome (CCS).Patients and Methods: We conducted a study wherein we assessed frailty using Fried frailty phenotype for outpatients aged ≥ 60 years with CCS. Logistic regression analysis was performed to assess the factors associated with frailty. Frailty was adjusted for demographic and geriatric variables and comorbidities to assess its impact on hospitalization.Results: Overall, 420 patients (median age 70 years [interquartile range, 65– 77]; men, 74.5%) who completed the 3-month follow-up period were analyzed. Coronary revascularization for > 1 year was the most common clinical scenario for CCS (59.8%; n = 251). The prevalence of non-frail, pre-frail, and frail patients were 22.4% (n = 94), 49.7% (n = 209), and 27.9% (n = 117), respectively. In the adjusted model, three factors associated with frailty were age ≥ 75 years (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.39– 3.75, P = 0.001), limitations in instrumental activity of daily living (OR 3.89, 95% CI 2.33– 6.48, P < 0.001), and heart failure (OR 2.30, 95% CI 1.32– 4.02, P = 0.003). The overall 3-month hospitalization rate was higher in frail patients than in non-frail patients (23.9% vs 13.5%, P = 0.012). Frailty was associated with hospitalization (OR 1.85, 95% CI 1.04– 3.30, P = 0.037) but in a weak strength of association (r = 0.126).Conclusion: The prevalence of frailty was 27.9% in the elderly patients with CCS. Age ≥ 75 years, limitations in functional status, and heart failure were associated with increased odds of frailty. Frailty was a predictor of 3-month all-cause hospitalization in these patients.Keywords: frailty, chronic coronary syndrome, elderly

Nam Quang Tran,1,2 Bao Hoang Le,1 Chi Khanh Hoang,1 Huu-Thinh Nguyen,3 Truc Thanh Thai4 1Department of Endocrinology, University Medical Center at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 2Department of Endocrinology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 3Department of Health Checkup, University Medical Center at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 4Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamCorrespondence: Truc Thanh Thai, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam, Tel +84 908 381 266, Email thaithanhtruc@ump.edu.vnBackground: Thyroid nodule is a common disorder normally detected by ultrasound. However, little is known about the population prevalence of thyroid nodules in a Vietnamese population. This study aimed to estimate the prevalence of thyroid nodules, its characteristics, and associated factors in a large number of people undergoing annual health checkups.Methods: A retrospective, cross-sectional descriptive study was conducted, based on electronic medical records of people undergoing health checkups at the Health Checkup Department, University Medical Center at Ho Chi Minh City. All of the participants underwent thyroid ultrasonography, anthropometric measurements, and serum examinations.Results: A total of 16,784 participants (mean age: 40.4 ± 12.7 years, 45.1% female) were included in this study. The overall prevalence of thyroid nodules was 48.4%. The mean diameter of nodules was 7.2 ± 5.8 mm. The prevalence of nodules with malignant characteristics was 36.9%. Women had a significantly higher prevalence of thyroid nodules than men (55.2% vs 42.9%, p< 0.001). Advanced age, hypertension, and hyperglycemia were significantly associated with thyroid nodules in both genders. In men, significant factors also included increased body mass index. In women, these included increased total cholesterol and LDLc, hypertriglyceridemia, and hyperuricemia.Conclusion: This study showed a high prevalence of TNs in Vietnamese people undergoing general health checkups. Importantly, the proportion of TNs with malignant risk was quite high. Therefore, screening for TNs should be added to annual health checkups to improve early detection of TNs, targeting those who have a high-risk profile based on factors identified in this study.Keywords: thyroid nodules, malignant thyroid nodules, thyroid ultrasound, general health checkup

Long Doan,1 Huong T Nguyen,2 Thao TP Nguyen,3 Thi Thuy Linh Phan,4 Le Duc Huy,4 Thi Thuy Hang Nguyen,4 Thuoc Phuoc Doan2 1Internal Medicine Department, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam; 2Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam; 3Institute of Health Community Research, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam; 4Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, VietnamCorrespondence: Thuoc Phuoc Doan, Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, 53000, Vietnam, Tel +84 914932577, Email dpthuoc@hueuni.edu.vnPurpose: Our study aims to evaluate the risk of developing type 2 diabetes mellitus in the next 10 years using ModAsian FINDRISC and additionally explore associated factors among the Vietnam population.Participants and Methods: A cross-sectional study was conducted on 2258 participants aged 25 years old or above in Thua Thien Hue Province, Vietnam. The sample size is calculated based on the estimated sensitivity, and participants were randomly selected from different geographical and socio-economic areas. All participants were thoroughly medically examined, taking blood lipid profile and fasting blood glucose, taking blood pressure, anthropometric indexes, 12-lead electrocardiogram, and behavioral factors were investigated using the Vietnamese version of the WHO STEPS toolkit. The risk of developing T2DM was made based on the ModAsian FINDRISC.Results: The incidence of developing type 2 diabetes mellitus among the study population was 4.21%. The group with a high or very high risk of developing type 2 diabetes mellitus in the next 10 years accounted for 2.52%. Body mass index (AUC = 0.840, 95% CI: 0.792– 0.888), waist circumference (AUC = 0.824, 95% CI: 0.777– 0.871), family history of diabetes mellitus (AUC = 0.751, 95% CI = 0.668– 0.833), and history of antihypertensive medication use regularly (AUC = 0.708, 95% CI: 0.632– 0.784) are the most associated factors of the ModAsian FINDRISC. Residential location (OR = 5.62, 95% CI: 1.91– 16.54) and occupational status (OR = 0.35, 95% CI: 0.20– 0.62) were significant factors associated with a high and very high risk of developing type 2 diabetes mellitus in the next 10 year.Conclusion: Screening for the risk of type 2 diabetes mellitus and implementing intervention programs focusing on controlling weight, waist circumference, and blood pressure are essential for reducing type 2 diabetes mellitus incidence and burden in Vietnam.Keywords: type 2 diabetes mellitus, Vietnam, noncommunicable diseases, ModAsian FINDRISC

Hieu Trong Nguyen,1 Kien Hung Do,2 Nguyen Ba Le,3 Thang Tran4 1Department of Medical Oncology 2, Hanoi Oncology Hospital, Hanoi, Vietnam; 2Department of Medical Oncology 1, National Cancer Hospital of Vietnam, Hanoi, Vietnam; 3Ha Thanh Hospital, Hanoi, Vietnam; 4Department of Medical Oncology 4, National Cancer Hospital of Vietnam, Hanoi, VietnamCorrespondence: Hieu Trong Nguyen, Department of Medical Oncology 2, Hanoi Oncology Hospital, 42A Thanh Nhan, Thanh Nhan, Hai Ba Trung, Hanoi, Vietnam, Tel +84 983230112, Email hieunt@bvubhn.vnObjective: To evaluate the outcome and safety of the paclitaxel, carboplatin, and capecitabine (TCX) regimen in patients with advanced gastric cancer.Methods: Advanced gastric cancer patients received the TCX regimen for up to six cycles, which were 3 weeks apart. Paclitaxel (175 mg/m2) was given over a 3-hour infusion, followed by carboplatin in a 1-hour infusion on day 1. Capecitabine (850 mg/m2) was given orally twice daily from day 1 to day 14. Primary endpoints were progression-free survival (PFS) and overall survival (OS).Results: Among 83 patients at stage IVa and IVb, the median PFS was 9.3 months; 6-month, 1-year, and 2-year PFS were 74.6%, 32.5%, and 14.4%, respectively. The median OS was 17.0 months; 6-month, 1-year, and 2-year OS were 97.5%, 68.7%, and 21.7%, respectively. In the multivariable Cox regression model, higher CEA was associated with poor OS. Common adverse events included hand-food syndrome (77.9%), peripheral neuropathy (63.2%), fatigue (68.7%), and nausea (54.2%).Conclusion: The TCX regimen provided good survival and a better safety profile. More clinical trials are needed to confirm its treatment efficacy and safety, especially in comparison with other triplet regimens.Keywords: paclitaxel, carboplatin, capecitabine, advanced gastric cancer, efficacy

Huan Thanh Nguyen, Chanh Cong Nguyen, Thien Le Hoang Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh city, VietnamCorrespondence: Huan Thanh Nguyen, Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam, Tel +84-909097849, Email huannguyen@ump.edu.vnPurpose: We aimed to investigate the prevalence and factors associated with falls in older adult outpatients during the coronavirus disease (COVID-19) pandemic in Vietnam.Patients and Methods: From February 2022 to June 2022, this cross-sectional study included 814 patients (aged ≥ 60 years; mean age 71.8 ± 7.3 years; women, 65.2%) attending three geriatric clinics for a comprehensive geriatric assessment. Self-reported fall events in the past 12 months and post-COVID-19 falls were assessed. Factors associated with falls were determined using logistic regression analysis.Results: In total, 188 patients (23.1%) had falls (single fall, 75.5%; recurrent falls, 24.5%). The most frequent location, time, and circumstance of falls were the bedroom (43.1%), morning (54.3%), and dizziness (34.6%), respectively. Most patients experienced health issues after falls (bruise/grazes, 53.7%; fracture, 12.8%; immobility, 9.6%; hospital admission, 14.9%). In the adjusted model, factors associated with falls were being underweight (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.37– 4.56, P = 0.003), limitations in instrumental activities of daily living (OR 2.03, 95% CI 1.05– 3.95, P = 0.036), poor sleep quality (OR 1.83, 95% CI 1.10– 3.05, P = 0.020), and fear of falling (OR 3.45, 95% CI 2.23– 5.33, P < 0.001). Among 357 COVID-19 infected patients, post-COVID-19 falls occurred in 35 patients (9.8%) and were associated with fear of falling (OR 3.14, 95% CI 1.18– 8.40, P = 0.023) and post-COVID-19 lower limb weakness (OR 2.55, 95% CI 1.07– 6.10, P = 0.035).Conclusion: Our study found a substantial prevalence of falls among older outpatients during the COVID-19 pandemic in Vietnam. Management of factors associated with falls may be needed to reduce the burden of falls in the older population.Keywords: falls, prevalence, Vietnam, COVID-19

Huong Thi Le,1 Thao Thi Phuong Nguyen,2,3 Corey Jacinto,4 Cuong Tat Nguyen,2,3 Linh Gia Vu,2,3 Hien Thu Nguyen,2,3 Minh Ngoc Le Vu,5 Xuan Thi Thanh Le,1 Thao Thanh Nguyen,1 Quan Thi Pham,1 Nhung Thi Kim Ta,1 Quynh Thi Nguyen,1 Carl A Latkin,6 Cyrus SH Ho,7,8 Roger CM Ho7,9 1Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 2Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 3Faculty of Medicine, Duy Tan University, Da Nang, Vietnam; 4Department of Health Policy & Management, University of California, Los Angeles, CA, USA; 5Institute of Health Economics and Technology, Hanoi, Vietnam; 6Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 7Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 8Department of Psychological Medicine, National University Health System, Singapore; 9Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, SingaporeCorrespondence: Cuong Tat Nguyen, Duy Tan University, 254 Nguyen Van Linh Street, Da Nang, 550000, Vietnam, Tel +84 35 8705177, Email nguyentatcuong@duytan.edu.vnPurpose: New COVID-19 variants pose great challenges in protecting the success of vaccination programs. Awareness of community becomes an important component to prevent the spread of COVID-19. This study aims to analyze people’s awareness of COVID-19 and identify the implications for optimal risk communication in Vietnam.Study Methods and Materials: A total of 341 individuals participated in an online cross-sectional study. Community awareness on COVID-19 was examined by using a structured questionnaire. Multivariable Tobit regression was used to examine associated factors with community awareness.Results: Our results indicated high levels of awareness of local COVID-19 situation, transmission risks, and preventive behavioral practices during the first week of social isolation. Higher awareness of local pandemic situation was associated with female respondents (Coef.: 6.19; 95% CI: 0.51; 11.87) and larger family sizes of above 5 people (Coef.: 9.00; − 1.00; 19.00). Respondents between 35– 44 years old were shown to be less aware of preventive behavioral practices than other age groups, including the group of participants above 44 years old (Coef.: − 0.34; 95% CI: − 0.67; − 0.02). Lastly, participants who were “fairly satisfied” with information resources had awareness levels of preventive behavioral practices lower than that of “unsatisfied” respondents (Coef.: − 0.45; 95% CI: 0.74; − 0.16).Conclusion: This study offers crucial insights into the pandemic awareness of citizens and risk communication effectiveness during COVID-19 in Vietnam. The study findings shall serve the development of policies and interventions aimed at empowering individuals in the local and global fight against coronavirus.Keywords: COVID-19 epidemic, risk communication, awareness generation, preventive measures, Vietnam

Hong The Nguyen,1,2 Ngoc Dong Pham,3 Tung Quoc Mai,2 Hang Thi Thuy Do,3 Duong Thi Nga Nguyen,3 Peter McCluskey,4 Trong Van Pham2 1Department of Ophthalmology, 108 Military Central Hospital, Hanoi, Vietnam; 2Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam; 3Department of Cornea, Vietnam National Eye Hospital, Hanoi, Vietnam; 4Department of Ophthalmology, University of Sydney, Sydney, NSW, AustraliaCorrespondence: Tung Quoc MaiDepartment of Ophthalmology, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, 100000, VietnamTel +84 915644181Email maiquoctung@hmu.edu.vnPurpose: To evaluate the result of tectonic deep anterior lamellar keratoplasty (DALK) for keratitis with perforation and descemetocele.Patients and Methods: A prospective clinical study of 36 patients (36 eyes) treated with tectonic DALK for corneal perforation or descemetocele from microbial keratitis managed at the Vietnam National Eye Hospital over a two-year period. The surgical technique was manual lamellar dissection. The grafts were harvested from the anterior corneal cap of pre-cut donor tissues used for DSAEK or donor corneas with a low endothelial cell count.Results: A mean age was 55.36 ± 13.98 years (ranged from 25 to 75 years). Female gender represented 52%. causative agents were herpes simplex virus (58.3%), bacteria (22.2%), fungi (13.9%) and microsporidia (5.6%). There were 24 eyes with descemetocele (66.7%) and 12 with perforation (33.3%). There were 33 successful cases (91.7%) and 3 failed cases (8.3%). Best corrected visual acuity (BCVA) improved in 28 eyes (84.8%). The range of post-operative BCVA was from hand motions to 20/70. Eleven eyes (33.3%) attained vision 20/200 and higher. Clear graft was obtained in 15 eyes (45.5%), while mild or severe graft opacity was observed in 14 eyes (42.4%), and 4 eyes (12.1%), respectively. Surgical complications included descemet rupture (20.8%), pseudo anterior chamber (41.6%), persistent corneal epithelial defects (8.3%), reinfection (11.1%), glaucoma or ocular hypertension (5.6%) and cataract (8.3%).Conclusion: The study demonstrates that DALK is an effective procedure to treat corneal descemetocele, especially when an urgent penetrating keratoplasty (PKP) cannot be performed.Keywords: deep anterior lamellar keratoplasty, DALK, descemetocele, corneal perforation, corneal transplantation

Tuan Dinh Le, 1,* Nga Phi Thi Nguyen, 2, 3,* Son Tien Nguyen, 2, 3 Hien Thi Nguyen, 4 Hoa Thanh Thi Tran, 5 Thi Ho Lan Nguyen, 6 Cuong Duy Nguyen, 7 Giang Thi Nguyen, 6 Xuan Thanh Nguyen, 8 Bac Duy Nguyen, 9 Son The Trinh, 10 Tuan Anh Ngo, 11 Binh Nhu Do, 12, 13 Thuc Cong Luong 8, 14 1Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 2Department of Endocrinology, Military Hospital 103, Ha Noi, Vietnam; 3Department of Rheumatology and Endocrinology, Vietnam Military Medical University, Ha Noi, Vietnam; 4Department of Physiology, Thai Binh university of Medicine and Pharmacy, Thai Binh, Vietnam; 5Department of Intensive Care Unit, National Hospital of Endocrinology, Ha Noi, Vietnam; 6Department of Internal Medicine, National Hospital of Endocrinology, Ha Noi, Vietnam; 7Department of Intensive Care Unit, Thai Binh university of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of Vascular Cardiology, Military Hospital 103, Ha Noi, Vietnam; 9Department of Anatomy, Vietnam Military Medical University, Ha Noi, Vietnam; 10Military Institute of ClinicalEmbryology and Histology, Vietnam Military Medical University, Ha Noi, Vietnam; 11Department of Health Economic, Vietnam Military Medical University, Ha Noi, Vietnam; 12Department of Infectious Disease, Vietnam Military Medical University, Ha Noi, Vietnam; 13Division of Military Science, Military Hospital 103, Ha Noi, Vietnam; 14Director Office, Military Hospital 103, Ha Noi, Vietnam*These authors contributed equally to this workCorrespondence: Thuc Cong Luong; Son The Trinh Email lcthuc@gmail.com; trinhtheson@vmmu.edu.vnIntroduction: Endothelium dysfunction and decrease of incretin effects occur early in type 2 diabetes mellitus and these changes contribute to diabetic cardiovascular complications such as atherosclerosis, thick intima-media, coronary, and peripheral arterial diseases. In patients with diabetes, the femoral artery is a site of a high incidence of injury in peripheral vascular diseases, and atherosclerotic changes may appear earlier in the femoral artery compared to the carotid artery. This study was conducted to determine the prevalence of increased femoral artery intima-media thickness (IMT) and atherosclerotic plaque and their correlation with serum glucagon-like peptide-1 (GLP-1) levels in newly-diagnosed patients with type 2 diabetes mellitus.Materials and Methods: A cross-sectional study was conducted on 332 patients with nT2D in the National Endocrinology Hospital, Vietnam from January 2015 to May 2018. IMT was measured by Doppler ultrasound and GLP-1 by enzyme-linked immunosorbent assay (ELISA). All data were analyzed with SPSS version 26 for Windows (SPSS Inc, Chicago, IL).Results: Prevalence of thick femoral artery IMT and atherosclerotic plaque was 38.2 and 22.3%, respectively. There was a relationship between IMT and age, waist to hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting GLP-1, high sensitive CRP (hsCRP) and 24-hour microalbuminuria secretion (24-h MAUS). The fasting serum GLP-1 (fGLP-1) levels were reduced significantly in patients with thickness and atherosclerosis femoral artery (p = 0.001). After adjusting with other related factors, namely, DBP and estimated glomerular filtration rate (eGFR), whilst hsCRP and 24-h MAUS showed a significantly positive correlation to IMT (Standardized B and p of 0.242, 0.004 and 0.178, 0.043, respectively), fGLP-1 showed a significantly negative correlation to IMT (Standardized B = − 0.288, p = 0.001).Conclusion: Among n2TD, the percentage for femoral artery thick IMT and atherosclerosis was 38.2% and 22.3% respectively, and serum GLP-1 was negatively correlated with thick IMT and atherosclerosis.Keywords: newly diagnosed type 2 diabetes mellitus, intima-media thickness and atherosclerotic plaque, femoral artery, serum glucagon-like peptide-1 levels

Nguyen Thao Phan,1 Huy The Nguyen,1 Tran-Thuy Nguyen,1,2 Ngoc Duc Ly,1 Ngoc-Thanh Le1,2 1Department of Cardiovascular and Thoracic Surgery, Cardiovascular Center, E Hospital, Hanoi, Vietnam; 2School of Medicine and Pharmacy, Vietnam National University (VNU), Hanoi, VietnamCorrespondence: Tran-Thuy NguyenDepartment of Cardiovascular and Thoracic Surgery, Cardiovascular Center, E Hospital, 87–89 Tran Cung, Cau Giay, Hanoi, VietnamEmail drtranthuyvd@gmail.comAbstract: A single coronary artery (SCA) is a rare congenital anomaly that occurs in isolation without associated structural heart disease. Reports of a SCA with acute myocardial infarction are very rare in medical literature. This case study examines a patient with a right coronary artery that originated as a branch of the distal left circumflex artery, which had a total occlusion.Keywords: single coronary artery, coronary congenital anomaly, coronary intervention, myocardial infarction

Ha Thanh Nguyen,1,2 Peter F Collins,1,3 Toby G Pavey,1 Nhung Viet Nguyen,4 Tuong Duy Pham,2 Danielle L Gallegos1 1School of Exercise and Nutrition Sciences, Faculty of Health Queensland University of Technology, Kelvin Grove, QLD, Australia; 2Department of Nutrition and Food Safety, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 3Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia; 4National Lung Hospital, Hanoi, Vietnam Background: Malnutrition is common in patients with COPD; however, little is known about its impacts on health-related quality of life (QoL) among patients with COPD. This study aimed to explore the nutritional status and dietary intake among outpatients with COPD in Vietnam and its possible associations with QoL.Methods: A cross-sectional study was carried out in COPD outpatients visiting the COPD management unit at the National Lung Hospital, Hanoi, Vietnam between May 2017 and July 2017. Consecutive outpatients with a confirmed diagnosis of COPD were recruited with written inform consent. The nutritional status of participants was assessed using Subjective Global Assessment (SGA), and dietary intake via a 24-hour recall interview. The St George Respiratory Questionnaire (SGRQ) for COPD was used to investigate the participants’ QoL. Sociodemographic and clinical data were extracted from hospital records.Results: Of 168 COPD outpatients involved in the study, three-quarters (74.4%) were diagnosed as malnourished (SGA B/C) and 81.5% reported unintentional weight loss. Most of the patients did not meet their estimated energy and protein requirements (85.7% and 89.9%, respectively). Malnutrition was significantly associated with disease severity (P=0.039) and ratio of protein intake to estimated requirement (P=0.005). QoL was low for all levels of malnutrition or disease severity, with well-nourished participants and those with less disease severity having better QoL (P=0.006 and P

Thang Thanh Phan,1 Toan Trong Ho,1 Hue Thi Nguyen,1 Hang Thuy Nguyen,2 Thu Bich Tran,3 Son Truong Nguyen1 1Laboratory D Unit, Clinical Cancer Center, Cho Ray Hospital, Ho Chi Minh City, Vietnam; 2Pathology Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam; 3Faculty of Biology and Biotechnology, University of Science, VNU-HCM, Ho Chi Minh City, Vietnam Purpose: To identify and clarify the roles of inflammatory markers in prognosis for advanced non-small cell lung cancer (NSCLC) patients treated with EGFR tyrosine kinase inhibitor (TKI). Patients and methods: One hundred and twelve adenocarcinoma, clinical stage IV, NSCLC patients with either EGFR exon 19 deletion (E19del) or EGFR exon 21 L858R substitution mutation (L858R) were selected for this study. The blood cell count at different stages of treatment was used to calculate the inflammatory markers. The Kaplan–Meier statistics and Cox regression model were used to test the differences of progression-free survival (PFS) between groups by the optimal cutoff point of biomarkers. Results: The median values of white blood cell (WBC), neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR) in NSCLC patients tended to be reduced after 3 months treated with EGFR TKI and increased conversely when the disease develops progression (P3cm) and the high level of pretreatment NLR were associated with the shortening of PFS (HR=2.24, 95% CI: 1.04–4.83, P=0.039 and HR=2.67, 95% CI: 1.41–5.03, P=0.006, respectively). Multivariate analysis has shown that the elevated NLR is an independent prognostic marker for worse PFS of NSCLC patients treated with EGFR TKI (HR=2.15, 95% CI: 1.15–3.99, P=0.016). Conclusion: NLR and MLR are valuable markers in response evaluation for NSCLC patients treated with EGFR TKI. The elevated NLR is also an independent prognostic factor for worse survival. Keywords: neutrophil to lymphocyte ratio, NLR, NSCLC, EGFR TKI

Saïd C Azoury,1 Norma Elizabeth Farrow,2 Qing L Hu,2 Kevin C Soares,1 Caitlin W Hicks,1 Faris Azar,1 Nelson Rodriguez-Unda,3 Katherine E Poruk,1 Peter Cornell,1 Karen K Burce,1 Carisa M Cooney,3 Hien T Nguyen,1 Frederic E Eckhauser1 1Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; 2School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 3Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA Abstract: Surgical site infections (SSIs) complicate the postoperative course of a significant proportion of general abdominal surgical patients and are associated with excessive health care costs. SSIs increase postoperative morbidity and mortality, and may require hospital admission, intravenous antibiotics, and even surgical reintervention. Risks associated with SSIs are related to both host and perioperative factors. However, a vast majority of these infections are preventable. More recently, quality initiative programs such as American College of Surgeons National Surgical Quality Improvement Program are expanding their roles to help better monitor adherence to improvement measures. Indeed, standardizing preoperative antibiotic prophylaxis timing is perhaps the most persuasive example and this has been integral to reducing postoperative SSI rates. Herein, the authors provide an update on the epidemiology, risk factors, identification, and management of wound infections following abdominal surgery. Keywords: surgical site infection, diagnosis, treatment, prevention

Tuan Hiep Tran,1 Thiruganesh Ramasamy,1 Ju Yeon Choi,1 Hanh Thuy Nguyen,1 Thanh Tung Pham,1 Jee-Heon Jeong,1 Sae Kwang Ku,2 Han-Gon Choi,3 Chul Soon Yong,1 Jong Oh Kim11College of Pharmacy, Yeungnam University, Dae-Dong, 2College of Korean Medicine, Daegu Haany University, Gyeongsan, 3College of Pharmacy, Hanyang University, Hanyangdaehak-ro, Sangnok-gu, Ansan, South KoreaAbstract: The attachment of polyethylene glycol (PEG) increases the circulation time of drug-containing nanoparticles; however, this also negatively affects cellular uptake. To overcome this problem, unique lipid polymer hybrid (LPH) nanoparticles were developed with a pH-responsive PEG layer that detached prior to cell uptake. Docetaxel (DTX) was incorporated into the lipid core of the nanoparticles, which was then shielded with the pH-responsive block co-polymer polyethylene glycol-b-polyaspartic acid (PEG-b-PAsp) using a modified emulsion method. The optimized LPH nanoparticles were ~200 nm and had a narrow size distribution. Drug release from DTX-loaded LPH (DTX-LPH) nanoparticles was pH-sensitive, which is beneficial for tumor targeting. More importantly, DTX-LPH nanoparticles were able to effectively induce apoptosis in cancer cells. The negative surface charge and PEG shell of vehicle remarkably enhanced the blood circulation and physiological activity of DTX-LPH nanoparticles compared with that of free DTX. The nanoparticles were also found to reduce the size of tumors in tumor-bearing xenograft mice. The in vivo anticancer effect of DTX-LPH nanoparticles was further confirmed by the elevated levels of caspase-3 and poly ADP ribose polymerase found in the tumors after treatment. Thus, the results suggest that this novel LPH system could be an effective new treatment for cancer.Keywords: docetaxel, polyaspartic acid, drug delivery systems, antitumor, pH-sensitive

Fluctuations in the intensity and polarization of the cosmic microwave background (CMB) and the large-scale distribution of matter in the universe each contain clues about the nature of the earliest moments of time. The next generation of CMB and large-scale structure (LSS) experiments are poised to test the leading paradigm for these earliest moments-the theory of cosmic inflation-and to detect the imprints of the inflationary epoch, thereby dramatically increasing our understanding of fundamental physics and the early universe. A future CMB experiment with sufficient angular resolution and frequency coverage that surveys at least 1% of the sky to a depth of 1 uK-arcmin can deliver a constraint on the tensor-to-scalar ratio that will either result in a 5σ measurement of the energy scale of inflation or rule out all large-field inflation models, even in the presence of foregrounds and the gravitational lensing B-mode signal. LSS experiments, particularly spectroscopic surveys such as the Dark Energy Spectroscopic Instrument, will complement the CMB effort by improving current constraints on running of the spectral index by up to a factor of four, improving constraints on curvature by a factor of ten, and providing non-Gaussianity constraints that are competitive with the current CMB bounds.

This is a report on the status and prospects of the quantification of neutrino properties through the cosmological neutrino background for the Cosmic Frontier of the Division of Particles and Fields Community Summer Study long-term planning exercise. Experiments planned and underway are prepared to study the cosmological neutrino background in detail via its influence on distance-redshift relations and the growth of structure. The program for the next decade described in this document, including upcoming spectroscopic galaxy surveys eBOSS and DESI and a new Stage-IV CMB polarization experiment CMB-S4, will achieve σ(σmν) = 16 meV and σ(Neff) = 0.020. Such a mass measurement will produce a high significance detection of non-zero σmν, whose lower bound derived from atmospheric and solar neutrino oscillation data is about 58 meV. If neutrinos have a minimal normal mass hierarchy, this measurement will definitively rule out the inverted neutrino mass hierarchy, shedding light on one of the most puzzling aspects of the Standard Model of particle physics - the origin of mass. This precise a measurement of Neff will allow for high sensitivity to any light and dark degrees of freedom produced in the big bang and a precision test of the standard cosmological model prediction that Neff = 3.046.

© 2014 Le et al.Background: The National Hospital of Pediatrics in Vietnam performed >200 exchange transfusions annually (2006-08), often on infants presenting encephalopathic from lower-level hospitals. As factors delaying care-seeking are not known, we

We present a method for selecting z > 4 dusty, star-forming galaxies (DSFGs) using Herschel/Spectral and Photometric Imaging Receiver 250/350/500 μm flux densities to search for red sources. We apply this method to 21 deg2 of data from the HerMES survey to produce a catalog of 38 high-z candidates. Follow-up of the first five of these sources confirms that this method is efficient at selecting high-z DSFGs, with 4/5 at z = 4.3-6.3 (and the remaining source at z = 3.4), and that they are some of the most luminous dusty sources known. Comparison with previous DSFG samples, mostly selected at longer wavelengths (e.g., 850 μm) and in single-band surveys, shows that our method is much more efficient at selecting high-z DSFGs, in the sense that a much larger fraction are at z > 3. Correcting for the selection completeness and purity, we find that the number of bright (S 500 μm ≥ 30 mJy), red Herschel sources is 3.3 ± 0.8 deg-2. This is much higher than the number predicted by current models, suggesting that the DSFG population extends to higher redshifts than previously believed. If the shape of the luminosity function for high-z DSFGs is similar to that at z ∼ 2, rest-frame UV based studies may be missing a significant component of the star formation density at z = 4-6, even after correction for extinction. © 2014. The American Astronomical Society. All rights reserved.

We present observations of SPT-S J053816-5030.8, a gravitationally lensed dusty star-forming galaxy (DSFG) at z = 2.7817 that was first discovered at millimeter wavelengths by the South Pole Telescope. SPT 0538-50 is typical of the brightest sources found by wide-field millimeter-wavelength surveys, being lensed by an intervening galaxy at moderate redshift (in this instance, at z = 0.441). We present a wide array of multi-wavelength spectroscopic and photometric data on SPT 0538-50, including data from ALMA, Herschel PACS and SPIRE, Hubble, Spitzer, the Very Large Telescope, ATCA, APEX, and the Submillimeter Array. We use high-resolution imaging from the Hubble Space Telescope to de-blend SPT 0538-50, separating DSFG emission from that of the foreground lens. Combined with a source model derived from ALMA imaging (which suggests a magnification factor of 21 ± 4), we derive the intrinsic properties of SPT 0538-50, including the stellar mass, far-IR luminosity, star formation rate, molecular gas mass, and - using molecular line fluxes - the excitation conditions within the interstellar medium. The derived physical properties argue that we are witnessing compact, merger-driven star formation in SPT 0538-50 similar to local starburst galaxies and unlike that seen in some other DSFGs at this epoch. © 2013. The American Astronomical Society. All rights reserved..

We present observations of SPT-S J053816-5030.8, a gravitationally lensed dusty star-forming galaxy (DSFG) at z = 2.7817 that was first discovered at millimeter wavelengths by the South Pole Telescope. SPT 0538-50 is typical of the brightest sources found by wide-field millimeter-wavelength surveys, being lensed by an intervening galaxy at moderate redshift (in this instance, at z = 0.441). We present a wide array of multi-wavelength spectroscopic and photometric data on SPT 0538-50, including data from ALMA, Herschel PACS and SPIRE, Hubble, Spitzer, the Very Large Telescope, ATCA, APEX, and the Submillimeter Array. We use high-resolution imaging from the Hubble Space Telescope to de-blend SPT 0538-50, separating DSFG emission from that of the foreground lens. Combined with a source model derived from ALMA imaging (which suggests a magnification factor of 21 ± 4), we derive the intrinsic properties of SPT 0538-50, including the stellar mass, far-IR luminosity, star formation rate, molecular gas mass, and - using molecular line fluxes - the excitation conditions within the interstellar medium. The derived physical properties argue that we are witnessing compact, merger-driven star formation in SPT 0538-50 similar to local starburst galaxies and unlike that seen in some other DSFGs at this epoch. © 2013. The American Astronomical Society. All rights reserved..

The US Wheat Genome Project, funded by the National Science Foundation, developed the first large public Triticeae expressed sequence tag (EST) resource. Altogether, 116,272 ESTs were produced, comprising 100,674 5' ESTs and 15 598 3' ESTs. These ESTs were derived from 42 cDNA libraries, which were created from hexaploid bread wheat (Triticum aestivum L.) and its close relatives, including diploid wheat (T. monococcum L. and Aegilops speltoides L.), tetraploid wheat (T. turgidum L.), and rye (Secale cereale L.), using tissues collected from various stages of plant growth and development and under diverse regimes of abiotic and biotic stress treatments. ESTs were assembled into 18,876 contigs and 23,034 singletons, or 41,910 wheat unigenes. Over 90% of the contigs contained fewer than 10 EST members, implying that the ESTs represented a diverse selection of genes and that genes expressed at low and moderate to high levels were well sampled. Statistical methods were used to study the correlation of gene expression patterns, based on the ESTs clustered in the 1536 contigs that contained at least 10 5' EST members and thus representing the most abundant genes expressed in wheat. Analysis further identified genes in wheat that were significantly upregulated (p < 0.05) in tissues under various abiotic stresses when compared with control tissues. Though the function annotation cannot be assigned for many of these genes, it is likely that they play a role associated with the stress response. This study predicted the possible functionality for 4% of total wheat unigenes, which leaves the remaining 96% with their functional roles and expression patterns largely unknown. Nonetheless, the EST data generated in this project provide a diverse and rich source for gene discovery in wheat.

A total of 37 original cDNA libraries and 9 derivative libraries enriched for rare sequences were produced from Chinese Spring wheat (Triticum aestivum L.), five other hexaploid wheat genotypes (Cheyenne, Brevor, TAM W101, BH1146, Butte 86), tetraploid durum wheat (T. turgidum L.), diploid wheat (T. monococcum L.), and two other diploid members of the grass tribe Triticeae (Aegilops speltoides Tausch and Secale cereale L.). The emphasis in the choice of plant materials for library construction was reproductive development subjected to environmental factors that ultimately affect grain quality and yield, but roots and other tissues were also included. Partial cDNA expressed sequence tags (ESTs) were examined by various measures to assess the quality of these libraries. All ESTs were processed to remove cloning system sequences and contaminants and then assembled using CAP3. Following these processing steps, this assembly yielded 101,107 sequences derived from 89,043 clones, which defined 16,740 contigs and 33,213 singletons, a total of 49,953 "unigenes." Analysis of the distribution of these unigenes among the libraries led to the conclusion that the enrichment methods were effective in reducing the most abundant unigenes and to the observation that the most diverse libraries were from tissues exposed to environmental stresses including heat, drought, salinity, or low temperature.

The focus of this study was to analyze the content, distribution, and comparative genome relationships of 996 chromosome bin-mapped expressed sequence tags (ESTs) accounting for 2266 restriction fragments (loci) on the homoeologous group 3 chromosomes of hexaploid wheat (Triticum aestivum L.). Of these loci, 634, 884, and 748 were mapped on chromosomes 3A, 3B, and 3D, respectively. The individual chromosome bin maps revealed bins with a high density of mapped ESTs in the distal region and bins of low density in the proximal region of the chromosome arms, with the exception of 3DS and 3DL. These distributions were more localized on the higher-resolution group 3 consensus map with intermediate regions of high-mapped-EST density on both chromosome arms. Gene ontology (GO) classification of mapped ESTs was not significantly different for homoeologous group 3 chromosomes compared to the other groups. A combined analysis of the individual bin maps using 537 of the mapped ESTs revealed rearrangements between the group 3 chromosomes. Approximately 232 (44%) of the consensus mapped ESTs matched sequences on rice chromosome 1 and revealed large- and small-scale differences in gene order. Of the group 3 mapped EST unigenes approximately 21 and 32% matched the Arabidopsis coding regions and proteins, respectively, but no chromosome-level gene order conservation was detected.

Because of the huge size of the common wheat (Triticum aestivum L., 2n = 6x = 42, AABBDD) genome of 17,300 Mb, sequencing and mapping of the expressed portion is a logical first step for gene discovery. Here we report mapping of 7104 expressed sequence tag (EST) unigenes by Southern hybridization into a chromosome bin map using a set of wheat aneuploids and deletion stocks. Each EST detected a mean of 4.8 restriction fragments and 2.8 loci. More loci were mapped in the B genome (5774) than in the A (5173) or D (5146) genomes. The EST density was significantly higher for the D genome than for the A or B. In general, EST density increased relative to the physical distance from the centromere. The majority of EST-dense regions are in the distal parts of chromosomes. Most of the agronomically important genes are located in EST-dense regions. The chromosome bin map of ESTs is a unique resource for SNP analysis, comparative mapping, structural and functional analysis, and polyploid evolution, as well as providing a framework for constructing a sequence-ready, BAC-contig map of the wheat genome.

A total of 1918 loci, detected by the hybridization of 938 expressed sequence tag unigenes (ESTs) from 26 Triticeae cDNA libraries, were mapped to wheat (Triticum aestivum L.) homoeologous group 4 chromosomes using a set of deletion, ditelosomic, and nulli-tetrasomic lines. The 1918 EST loci were not distributed uniformly among the three group 4 chromosomes; 41, 28, and 31% mapped to chromosomes 4A, 4B, and 4D, respectively. This pattern is in contrast to the cumulative results of EST mapping in all homoeologous groups, as reported elsewhere, that found the highest proportion of loci mapped to the B genome. Sixty-five percent of these 1918 loci mapped to the long arms of homoeologous group 4 chromosomes, while 35% mapped to the short arms. The distal regions of chromosome arms showed higher numbers of loci than the proximal regions, with the exception of 4DL. This study confirmed the complex structure of chromosome 4A that contains two reciprocal translocations and two inversions, previously identified. An additional inversion in the centromeric region of 4A was revealed. A consensus map for homoeologous group 4 was developed from 119 ESTs unique to group 4. Forty-nine percent of these ESTs were found to be homoeologous to sequences on rice chromosome 3, 12% had matches with sequences on other rice chromosomes, and 39% had no matches with rice sequences at all. Limited homology (only 26 of the 119 consensus ESTs) was found between wheat ESTs on homoeologous group 4 and the Arabidopsis genome. Forty-two percent of the homoeologous group 4 ESTs could be classified into functional categories on the basis of blastX searches against all protein databases.

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid (2n = 6x = 42) wheat genome (Triticum aestivum L.). Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags (ESTs) representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection (113,220 ESTs). Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of ESTs into contigs. These contigs plus singletons (unassembled ESTs) were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5' and 3' sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics.

To localize wheat (Triticum aestivum L.) ESTs on chromosomes, 882 homoeologous group 6-specific ESTs were identified by physically mapping 7965 singletons from 37 cDNA libraries on 146 chromosome, arm, and sub-arm aneuploid and deletion stocks. The 882 ESTs were physically mapped to 25 regions (bins) flanked by 23 deletion breakpoints. Of the 5154 restriction fragments detected by 882 ESTs, 2043 (loci) were localized to group 6 chromosomes and 806 were mapped on other chromosome groups. The number of loci mapped was greatest on chromosome 6B and least on 6D. The 264 ESTs that detected orthologous loci on all three homoeologs using one restriction enzyme were used to construct a consensus physical map. The physical distribution of ESTs was uneven on chromosomes with a tendency toward higher densities in the distal halves of chromosome arms. About 43% of the wheat group 6 ESTs identified rice homologs upon comparisons of genome sequences. Fifty-eight percent of these ESTs were present on rice chromosome 2 and the remaining were on other rice chromosomes. Even within the group 6 bins, rice chromosomal blocks identified by 1-6 wheat ESTs were homologous to up to 11 rice chromosomes. These rice-block contigs were used to resolve the order of wheat ESTs within each bin.

We constructed high-density deletion bin maps of wheat chromosomes 5A, 5B, and 5D, including 2338 loci mapped with 1052 EST probes and 217 previously mapped loci (total 2555 loci). This information was combined to construct a consensus chromosome bin map of group 5 including 24 bins. A relatively higher number of loci were mapped on chromosome 5B (38%) compared to 5A (34%) and 5D (28%). Differences in the levels of polymorphism among the three chromosomes were partially responsible for these differences. A higher number of duplicated loci was found on chromosome 5B (42%). Three times more loci were mapped on the long arms than on the short arms, and a significantly higher number of probes, loci, and duplicated loci were mapped on the distal halves than on the proximal halves of the chromosome arms. Good overall colinearity was observed among the three homoeologous group 5 chromosomes, except for the previously known 5AL/4AL translocation and a putative small pericentric inversion in chromosome 5A. Statistically significant colinearity was observed between low-copy-number ESTs from wheat homoeologous group 5 and rice chromosomes 12 (88 ESTs), 9 (72 ESTs), and 3 (84 ESTs).

A total of 944 expressed sequence tags (ESTs) generated 2212 EST loci mapped to homoeologous group 1 chromosomes in hexaploid wheat (Triticum aestivum L.). EST deletion maps and the consensus map of group 1 chromosomes were constructed to show EST distribution. EST loci were unevenly distributed among chromosomes 1A, 1B, and 1D with 660, 826, and 726, respectively. The number of EST loci was greater on the long arms than on the short arms for all three chromosomes. The distribution of ESTs along chromosome arms was nonrandom with EST clusters occurring in the distal regions of short arms and middle regions of long arms. Duplications of group 1 ESTs in other homoeologous groups occurred at a rate of 35.5%. Seventy-five percent of wheat chromosome 1 ESTs had significant matches with rice sequences (E < or = e(-10)), where large regions of conservation occurred between wheat consensus chromosome 1 and rice chromosome 5 and between the proximal portion of the long arm of wheat consensus chromosome 1 and rice chromosome 10. Only 9.5% of group 1 ESTs showed significant matches to Arabidopsis genome sequences. The results presented are useful for gene mapping and evolutionary and comparative genomics of grasses.

The objectives of this study were to develop a high-density chromosome bin map of homoeologous group 7 in hexaploid wheat (Triticum aestivum L.), to identify gene distribution in these chromosomes, and to perform comparative studies of wheat with rice and barley. We mapped 2148 loci from 919 EST clones onto group 7 chromosomes of wheat. In the majority of cases the numbers of loci were significantly lower in the centromeric regions and tended to increase in the distal regions. The level of duplicated loci in this group was 24% with most of these loci being localized toward the distal regions. One hundred nineteen EST probes that hybridized to three fragments and mapped to the three group 7 chromosomes were designated landmark probes and were used to construct a consensus homoeologous group 7 map. An additional 49 probes that mapped to 7AS, 7DS, and the ancestral translocated segment involving 7BS also were designated landmarks. Landmark probe orders and comparative maps of wheat, rice, and barley were produced on the basis of corresponding rice BAC/PAC and genetic markers that mapped on chromosomes 6 and 8 of rice. Identification of landmark ESTs and development of consensus maps may provide a framework of conserved coding regions predating the evolution of wheat genomes.

The complex hexaploid wheat genome offers many challenges for genomics research. Expressed sequence tags facilitate the analysis of gene-coding regions and provide a rich source of molecular markers for mapping and comparison with model organisms. The objectives of this study were to construct a high-density EST chromosome bin map of wheat homoeologous group 2 chromosomes to determine the distribution of ESTs, construct a consensus map of group 2 ESTs, investigate synteny, examine patterns of duplication, and assess the colinearity with rice of ESTs assigned to the group 2 consensus bin map. A total of 2600 loci generated from 1110 ESTs were mapped to group 2 chromosomes by Southern hybridization onto wheat aneuploid chromosome and deletion stocks. A consensus map was constructed of 552 ESTs mapping to more than one group 2 chromosome. Regions of high gene density in distal bins and low gene density in proximal bins were found. Two interstitial gene-rich islands flanked by relatively gene-poor regions on both the short and long arms and having good synteny with rice were discovered. The map locations of two ESTs indicated the possible presence of a small pericentric inversion on chromosome 2B. Wheat chromosome group 2 was shown to share syntenous blocks with rice chromosomes 4 and 7.

Subacute sclerosing panencephalitis (SSPE) is related to "defective" measles virus or vaccination, though an association with parainfluenza viruses has been reported. SSPE is characterized by a slow, erratic course and elevated cerebrospinal fluid measles titers. An immunocompetent, vaccinated infant, with onset of symptoms in parainfluenza virus season and a catastrophic course is described. Cerebrospinal fluid titers were negative, but postmortem brain had typical SSPE lesions. Patient brain-derived RNA, subjected to reverse transcription followed by polymerase chain reaction yielded polymerase chain reaction products with measles virus but not parainfluenza virus genes. The sequenced fragment revealed multiple mutations, typical for SSPE. SSPE can thus present in infants, with short latency and no cerebrospinal fluid antibodies. Viral genomic analysis may be diagnostic, permitting early therapy.