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Hydrogen peroxidase-inactivated vaccines have recently developed in controlling infectious diseases in aquaculture. The present study aimed to compare the efficacy of the hydrogen peroxidase-inactivated Streptococcus agalactiae vaccine via different delivery routes (injection, immersion, and oral administration) in red tilapia (Oreochromis sp.) without using adjuvant. Fish were randomly divided into 4 groups including G1: Control treatment (without vaccine), G2: vaccine-based diet (oral administration), G3: vaccinated by immersion and G4: vaccinated by injection. After 6 weeks of the experiment, fish were intraperitoneally injected with S. agalactiae and the mortality was recorded in 14 days. The results showed that lysozyme activity was differentially increased according to the delivery routes of vaccine, organs and time of sampling. However, the specific antibody levels in all vaccinated groups were only increased in week 6 post-vaccination. After the challenge test with S. agalactiae, the serum lysozyme levels in G3 and G4 were significantly higher than the control group (G1), while the total white blood cells and specific antibody levels were significantly increased in G2 and G4 compared to the control (G1). Similarly, the hydrogen peroxidase-inactivated vaccine statistically reduced the cumulative mortality in G2 (35.29%) and G4 (28.95%) compared to G1 (44.12%) after injected with the S. agalactiae. These results showed that the vaccine delivery routes by oral administration or injection may decrease the pathogen and show better protection for red tilapia than the immersion method. Further studies will be investigated to improve the efficacy of hydrogen peroxidaseinactivated vaccine via using different adjuvants.

BACKGROUND: Coronary artery fistulae are abnormal communications of coronary arteries with systemic vasculature, pulmonary vasculature, or cardiac chambers. Use of multimodality imaging can be paramount to understanding anatomical and functional features of these complex vascular lesions, therefore optimizing success of potential curative interventions. CASE SUMMARY: We present two patients with incidentally discovered giant aneurysmal coronary arteries with distal fistulous connections to the coronary sinus, which were successfully closed percutaneously with Amplatzer Septal Occluders using the assistance of three-dimensional (3D) printed heart models. CONCLUSION: Computed tomography-guided reconstruction with 3D multiplanar, multicolour printed models can help augment visuospatial understanding of the size, origin, course, and drainage of giant aneurysmal coronary artery-to-coronary sinus fistulae, and with manual bench testing can assist with choosing accurately sized and shaped devices for closure.

Progressive dilation of the infrarenal aortic diameter is a consequence of the ageing process and is considered the main determinant of abdominal aortic aneurysm (AAA). We aimed to investigate the genetic and clinical determinants of abdominal aortic diameter (AAD). We conducted a meta-analysis of genome-wide association studies in 10 cohorts (n = 13 542) imputed to the 1000 Genome Project reference panel including 12 815 subjects in the discovery phase and 727 subjects [Partners Biobank cohort 1 (PBIO)] as replication. Maximum anterior-posterior diameter of the infrarenal aorta was used as AAD. We also included exome array data (n = 14 480) from seven epidemiologic studies. Single-variant and gene-based associations were done using SeqMeta package. A Mendelian randomization analysis was applied to investigate the causal effect of a number of clinical risk factors on AAD. In genome-wide association study (GWAS) on AAD, rs74448815 in the intronic region of LDLRAD4 reached genome-wide significance (beta = -0.02, SE = 0.004, P-value = 2.10 × 10-8). The association replicated in the PBIO1 cohort (P-value = 8.19 × 10-4). In exome-array single-variant analysis (P-value threshold = 9 × 10-7), the lowest P-value was found for rs239259 located in SLC22A20 (beta = 0.007, P-value = 1.2 × 10-5). In the gene-based analysis (P-value threshold = 1.85 × 10-6), PCSK5 showed an association with AAD (P-value = 8.03 × 10-7). Furthermore, in Mendelian randomization analyses, we found evidence for genetic association of pulse pressure (beta = -0.003, P-value = 0.02), triglycerides (beta = -0.16, P-value = 0.008) and height (beta = 0.03, P-value

BackgroundOptimal management of patients with stable chest pain relies on the prognostic information provided by noninvasive cardiovascular testing, but there are limited data from randomized trials comparing anatomic with functional testing.MethodsIn the PROMISE trial (Prospective Multicenter Imaging Study for Evaluation of Chest Pain), patients with stable chest pain and intermediate pretest probability for obstructive coronary artery disease (CAD) were randomly assigned to functional testing (exercise electrocardiography, nuclear stress, or stress echocardiography) or coronary computed tomography angiography (CTA). Site-based diagnostic test reports were classified as normal or mildly, moderately, or severely abnormal. The primary end point was death, myocardial infarction, or unstable angina hospitalizations over a median follow-up of 26.1 months.ResultsBoth the prevalence of normal test results and incidence rate of events in these patients were significantly lower among 4500 patients randomly assigned to CTA in comparison with 4602 patients randomly assigned to functional testing (33.4% versus 78.0%, and 0.9% versus 2.1%, respectively; both P10%) who had a normal functional test were reclassified as being mildly abnormal, the discriminatory capacity improved to 0.69 (95% CI, 0.64-0.74).ConclusionsCoronary CTA, by identifying patients at risk because of nonobstructive CAD, provides better prognostic information than functional testing in contemporary patients who have stable chest pain with a low burden of obstructive CAD, myocardial ischemia, and events.Clinical trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01174550.

Aims: Diabetes is known to increase morbidity and mortality after major surgery. However, literature is conflicting on whether elevated preoperative haemoglobin A1c (HbA1c) levels are associated with worse outcomes following major noncardiac surgery. We aimed to investigate the effect of incremental preoperative HbA1c levels on postoperative outcomes in adults who had undergone major noncardiac surgery. Methods: We systematically searched PubMed, EMBASE and the Cochrane Library databases for eligible studies published between January 2012 and July 2023. Randomised controlled trials and observational studies (cohort and case–control studies) which measured HbA1c within 6 months before surgery and compared outcomes between at least three incremental subgroups or analysed HbA1c as a continuous variable were included. The systematic review protocol was registered with PROSPERO (CRD42023391946). Results: Twenty observational studies investigating outcomes across multiple surgical types were included. Higher preoperative HbA1c levels were associated with increased odds of overall postoperative complications, postoperative acute kidney injury, anastomotic leak, surgical site infections and increased length of stay. Each 1% increase in preoperative HbA1c was associated with increased odds of these complications. No association with reoperations and 30‐day mortality was identified. The literature was highly variable with respect to composite major complications, perioperative cardiovascular events, hospital readmissions, postoperative pneumonia and systemic thromboembolism. Conclusions: Current evidence suggested that higher preoperative HbA1c levels were associated with increased odds of postoperative complications and extended length of stay in adults undergoing major noncardiac surgery. Further high‐quality studies would be needed to quantify the risks posed and determine whether early intervention improves outcomes. [ABSTRACT FROM AUTHOR]

Background: The short Synacthen test (SST) is widely used to investigate adrenal insufficiency, but it can be time‐consuming, costly and labour‐intensive to perform and is not without risk of adverse events. Aim: To review SST requesting patterns and practices across public hospitals in Queensland. Methods: The electronic medical records of patients who underwent a SST with Pathology Queensland between January 2020 and December 2020 were reviewed to collect data regarding the indication for the test, the requesting speciality, SST results and any adverse events. Results: Six hundred and fifty‐two SSTs were identified, of which 363 individual patients were included in the analysis. The majority of the tests (n = 198, 54.5%) were performed in the inpatient setting. Endocrinology most commonly ordered SSTs (n = 188, 51.8%). The suspected aetiology of adrenal insufficiency was unclear in a large proportion of requests (n = 167, 46.0%). Static testing of morning cortisol prior to SST was performed in only 249 (68.6%) patients. Of 140 inpatients data, 17.9% (n = 25) showed a robust static cortisol of ≥400 nmol/L and were treated as having normal adrenal function, suggesting SST was unnecessary in these patients. Twenty‐two (6.1%) patients had a documented adverse event occurring during or after the SST. Conclusions: There was wide variability in requesting patterns and practices for SSTs across Queensland. More than one in six SSTs could have been avoided if a static morning cortisol had been performed prior. Clinician education and the adoption of a structured referral form may improve testing practices. [ABSTRACT FROM AUTHOR]

The editorial discusses the importance of advancing psychiatry training in low and middle-income countries, focusing on the case of Vietnam. It highlights the challenges faced by LMICs in mental health care due to a shortage of trained professionals and limited resources. The article emphasizes the need to develop high-standard mental health training and psychiatry residency programs in Vietnam through partnerships, structured curricula, and local research opportunities to address the growing demand for mental health services in the country. [Extracted from the article]

This study aimed to screen the in vitro antioxidant and antimicrobial activities of ethanolic extracts from 20 plants and three herbal commercial products empirically used for aquaculture improvement in Vietnam. The results of 2,2-diphenyl-1-pycrylhydrazyl (DPPH) radical scavenging assays showed that Phyllanthus amarus extract was the strongest antioxidant, followed by four extracts in the subsequent order: Piper betle > Psidium guajava > Euphorbia hirta > Mimosa pudica. These five plant extracts were very active in a DPPH radical scavenging assay with concentrations needed to scavenge half of the DPPH (IC50) below 30 µg/mL. Seven plant extracts showed an IC50 ranging from 31.9 to 59.7 µg/mL, while eleven extracts showed an IC50 above 70 µg/mL. A positive association was found between phenolic content (expressed as gallic acid equivalents) and antioxidant activity of the plant extracts. Concerning in vitro antimicrobial activities, P. amarus extract showed the highest activity against two different strains of Aeromonas hydrophila as demonstrated by its low minimal inhibitory concentration (MIC) of 156 and 625 µg/mL, respectively; whereas, P. betle displayed a moderate activity against Edwardsiella ictaluri with a MIC value of 625 µg/mL. Tannins were observed as significant factors contributing to antioxidant and antimicrobial properties of the plant extracts tested.

BackgroundA significant minority of patients receiving cardiac resynchronization therapy (CRT) remain nonresponsive to this intervention.ObjectiveThis study aimed to determine whether coronary sinus (CS) or baseline peripheral venous (PV) levels of established and emerging heart failure (HF) biomarkers are predictive of CRT outcomes.MethodsIn 73 patients (aged 68 ± 12 years; 83% men; ejection fraction 27% ± 7%) with CS and PV blood samples drawn simultaneously at the time of CRT device implantation, we measured amino-terminal pro-B-type natriuretic peptide (NT-proBNP), galectin-3 (gal-3), and soluble ST2 (sST2) levels. NT-proBNP concentrations >2000 pg/mL, gal-3 concentrations >25.9 ng/mL, and sST2 concentrations >35 ng/mL were considered positive on the basis of established PV cut points for identifying "high-risk" individuals with HF. CRT response was adjudicated by the HF Clinical Composite Score. A major adverse cardiovascular event (MACE) was defined as the composite end point of death, cardiac transplant, left ventricular assist device, and HF hospitalization at 2 years.ResultsNT-proBNP concentrations were 20% higher in the CS than in the periphery, while gal-3 and sST2 concentrations were 10% higher in the periphery than in the CS (all P < .001). There were 45% CRT nonresponders at 6 months and 16 (22%) patients with MACE. Triple-positive CS values yielded the highest specificity of 95% for predicting CRT nonresponse. Consistently, CS strategies identified patients at higher risk of developing MACE, with >11-fold adjusted increase for triple-positive CS patients compared to triple-negative patients (all P ≤ .04). PV strategies were not predictive of MACE.ConclusionOur findings suggest that CS sampling of HF biomarkers may be better than PV sampling for predicting CRT outcomes. Larger studies are needed to confirm our findings.