Preliminary design and control of a soft exosuit for assisting elbow movements and hand grasping in activities of daily living

The development of a portable assistive device to aid patients affected by neuromuscular disorders has been the ultimategoal of assistive robots since the late 1960s. Despite significant advances in recent decades, traditional rigid exoskeletonsare constrained by limited portability, safety, ergonomics, autonomy and, most of all, cost. In this study, we present thedesign and control of a soft, textile-based exosuit for assisting elbow flexion/extension and hand open/close. We describea model-based design, characterisation and testing of two independent actuator modules for the elbow and hand,respectively. Both actuators drive a set of artificial tendons, routed through the exosuit along specific load paths, thatapply torques to the human joints by means of anchor points. Key features in our design are under-actuation and the useof electromagnetic clutches to unload the motors during static posture. These two aspects, along with the use of 3Dprinted components and off-the-shelf fabric materials, contribute to cut down the power requirements, mass and overallcost of the system, making it a more likely candidate for daily use and enlarging its target population. Low-level control isaccomplished by a computationally efficient machine learning algorithm that derives the system’s model from sensorydata, ensuring high tracking accuracy despite the uncertainties deriving from its soft architecture. The resulting system isa low-profile, low-cost and wearable exosuit designed to intuitively assist the wearer in activities of daily living

Antibiotic use and prescription and its effects on Enterobacteriaceae in the gut in children with mild respiratory infections in Ho Chi Minh City, Vietnam. A prospective observational outpatient study.

BACKGROUND AND OBJECTIVES: Treatment guidelines do not recommend antibiotic use for acute respiratory infections (ARI), except for streptococcal pharyngitis/tonsillitis and pneumonia. However, antibiotics are prescribed frequently for children with ARI, often in absence of evidence for bacterial infection. The objectives of this study were 1) to assess the appropriateness of antibiotic prescriptions for mild ARI in paediatric outpatients in relation to available guidelines and detected pathogens, 2) to assess antibiotic use on presentation using questionnaires and detection in urine 3) to assess the carriage rates and proportions of resistant intestinal Enterobacteriaceae before, during and after consultation. MATERIALS AND METHODS: Patients were prospectively enrolled in Children's Hospital 1, Ho Chi Minh City, Vietnam and diagnoses, prescribed therapy and outcome were recorded on first visit and on follow-up after 7 days. Respiratory bacterial and viral pathogens were detected using molecular assays. Antibiotic use before presentation was assessed using questionnaires and urine HPLC. The impact of antibiotic usage on intestinal Enterobacteriaceae was assessed with semi-quantitative culture on agar with and without antibiotics on presentation and after 7 and 28 days. RESULTS: A total of 563 patients were enrolled between February 2009 and February 2010. Antibiotics were prescribed for all except 2 of 563 patients. The majority were 2nd and 3rd generation oral cephalosporins and amoxicillin with or without clavulanic acid. Respiratory viruses were detected in respiratory specimens of 72.5% of patients. Antibiotic use was considered inappropriate in 90.1% and 67.5%, based on guidelines and detected pathogens, respectively. On presentation parents reported antibiotic use for 22% of patients, 41% of parents did not know and 37% denied antibiotic use. Among these three groups, six commonly used antibiotics were detected with HPLC in patients' urine in 49%, 40% and 14%, respectively. Temporary selection of 3rd generation cephalosporin resistant intestinal Enterobacteriaceae during antibiotic use was observed, with co-selection of resistance to aminoglycosides and fluoroquinolones. CONCLUSIONS: We report overuse and overprescription of antibiotics for uncomplicated ARI with selection of resistant intestinal Enterobacteriaceae, posing a risk for community transmission and persistence in a setting of a highly granular healthcare system and unrestricted access to antibiotics through private pharmacies. REGISTRATION: This study was registered at the International Standard Randomised Controlled Trials Number registry under number ISRCTN32862422: http://www.isrctn.com/ISRCTN32862422

Emerging Role of Circulating Tumor Cells in Gastric Cancer

With over 1 million incidence cases and more than 780,000 deaths in 2018, gastric cancer (GC) was ranked as the 5th most common cancer and the 3rd leading cause of cancer deaths worldwide. Though several biomarkers, including carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), and cancer antigen 72-4 (CA72-4), have been identified, their diagnostic accuracies were modest. Circulating tumor cells (CTCs), cells derived from tumors and present in body fluids, have recently emerged as promising biomarkers, diagnostically and prognostically, of cancers, including GC. In this review, we present the landscape of CTCs from migration, to the presence in circulation, biologic properties, and morphologic heterogeneities. We evaluated clinical implications of CTCs in GC patients, including diagnosis, prognosis, and therapeutic management, as well as their application in immunotherapy. On the one hand, major challenges in using CTCs in GC were analyzed, from the differences of cut-off values of CTC positivity, to techniques used for sampling, storage conditions, and CTC molecular markers, as well as the unavailability of relevant enrichment and detection techniques. On the other hand, we discussed future perspectives of using CTCs in GC management and research, including the use of circulating tumor microembolies; of CTC checkpoint blockade in immunotherapy; and of organoid models. Despite the fact that there are remaining challenges in techniques, CTCs have potential as novel biomarkers and/or a non-invasive method for diagnostics, prognostics, and treatment monitoring of GC, particularly in the era of precision medicine

Effect of food intake on pharmacokinetics of oral artemisinin in healthy Vietnamese subjects

The influence of food intake on the pharmacokinetics of artemisinin was studied with six healthy Vietnamese male subjects. In a crossover study, artemisinin capsules (500 mg) were administered with and without food after an overnight fast. Plasma samples were obtained up to 24 h after intake of each drug. Measurement of artemisinin concentrations was performed by high-performance liquid chromatography with electrochemical detection. Tolerance was evaluated according to subjective and objective findings, including repeated physical examinations, routine blood investigations, and electrocardiograms. Pharmacokinetics were analyzed with a noncompartmental method and with a one-compartment model. This model had either zero-order or first-order input. No statistically significant differences were found between the results of the two experimental conditions. Specifically, there were no consistent differences in parameters most likely to be affected by food intake, including absorption profile, absorption rate, bioavailability (f) (as reflected in area under the concentration time curve [AUC]), and drug clearance. Some mean +/- standard deviation parameters after food were as follows: maximum concentration of drug in serum (Cmax), 443 +/- 224 microg x liter(-1); time to Cmax, 1.78 +/- 1.2 h; AUC, 2,092 +/- 1,441 ng x ml(-1) x h, apparent clearance/f, 321 +/- 167 liter x h(-1); mean residence time, 4.42 +/- 1.31 h; and time at which half of the terminal value was reached, 0.97 +/- 0.68 h. The total amount of artemisinin excreted in urine was less than 1% of the dose. We conclude that food intake has no major effect on artemisinin pharmacokinetics. In addition, we conclude tentatively that artemisinin is cleared by the liver, that this clearance does not depend on liver blood flow (i.e., that artemisinin is a so-called low-clearance drug), and that absorption of the drug is not affected by food intak

Improvement of domestic and export markets for Vietnamese fruit through improved post-harvest and supply chain management

The fruit industry in Vietnam has a great potential and plays an important role in agricultural production. About 85% of Vietnamese households are involved in some way in vegetable, fruit and flower production. These people, especially the farmers, are experiencing dramatic changes in moving from a centrally-planned to a market-orientated economy (Nguyen Dinh Hung et al., 2004). Exports of fruit and vegetables in 2000 were US$213 million, in 2003 they fell to US$151 million, but in 2007 exports have now risen to US 283 million, in 2008 up to US$470 million,, and the first 5 months of 2009 is about US$ 240 million. Vietnam is experiencing difficulties in competing with other Asian nations in export markets and its own domestic market, especially with China and Thailand. This suggests that Vietnam's horticultural industries require substantial development to be globally and domestically competitive. With increasing living standards Vietnamese consumers are also demanding safer and higher quality fruit. This project mapped current domestic supply chains to determine customer and consumers preferences and needs. This information was then used to design training programs that focusing on the total supply chain to implement quality management and Good Agricultural Practices (GAP) systems that provide benefits to Vietnamese farmer, supply chain participants and ultimately the consumer. During project time, 572 farmers, 79 collectors and wholesalers have had training by this project in pre-and post-harvest GAP practices

VinDr-CXR: An open dataset of chest X-rays with radiologist’s annotations

Measurement(s) diseases and abnormal findings from chest X-ray scans Technology Type(s) AI is used to detect diseases and abnormal findings Sample Characteristic - Location Vietna

Prevalence and correlates of hyperglycemia in a rural population, Vietnam: implications from a cross–sectional study

<p>Abstract</p> <p>Background</p> <p>Despite the increasing prevalence of type 2 diabetes in urban areas, relatively little has been known about its actual prevalence and its associations in rural areas, Vietnam. The purpose of this study was to evaluate the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), diabetes and their risk factors in a rural province, Vietnam.</p> <p>Methods</p> <p>A cross–sectional study with a representative sample was designed to estimate the hyperglycemia prevalence, using 75–g oral glucose tolerance test. Potential risk factors for hyperglycemia were analyzed using multinomial logistic regression, taken into account influences of socio–economic status, anthropometric measures, and lifestyle–related factors.</p> <p>Results</p> <p>The age and sex–adjusted prevalence rates (95% CI) of isolated IFG, isolated IGT, combined IFG–IGT, and diabetes were 8.7 (7.0–10.5), 4.3 (3.2−5.4), 1.6 (0.9−2.3), and 3.7% (2.7–4.7%), respectively. There were still 73% of diabetic subjects without knowing the condition. Blood pressure, family history of diabetes, obesity–related measures (waist circumference, waist–hip ratio, body fat percentage, and abdominal obesity) were the independent risk factors for hyperglycemia (IFG, IGT, and diabetes).</p> <p>Conclusions</p> <p>The prevalence of hyperglycemia in rural areas has not been as sharply increased as that reported in urban cities, Vietnam. Blood pressure and obesity–related measures were the most significant predictors for hyperglycemia level and they can be taken into account in building prognosis models to early detection of diabetes in rural Vietnamese populations.</p