Joint Asian Pacific Association of Gastroenterology (APAGE)-Asian Pacific Society of Digestive Endoscopy (APSDE) clinical practice guidelines on the use of non-invasive biomarkers for diagnosis of colorectal neoplasia

Screening for colorectal cancer (CRC) is effective in reducing CRC related mortality. Current screening methods include endoscopy based and biomarker based approaches. This guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society of Digestive Endoscopy (APSDE), developed in response to the increasing use of, and accumulating supportive evidence for the role of, non-invasive biomarkers for the diagnosis of CRC and its precursor lesions. A systematic review of 678 publications and a two stage Delphi consensus process involving 16 clinicians in various disciplines was undertaken to develop 32 evidence based and expert opinion based recommendations for the use of faecal immunochemical tests, faecal based tumour biomarkers or microbial biomarkers, and blood based tumour biomarkers for the detection of CRC and adenoma. Comprehensive up-to-date guidance is provided on indications, patient selection and strengths and limitations of each screening tool. Future research to inform clinical applications are discussed alongside objective measurement of research priorities. This joint APAGE-APSDE practice guideline is intended to provide an up-to-date guide to assist clinicians worldwide in utilising non-invasive biomarkers for CRC screening; it has particular salience for clinicians in the Asia-Pacific region

The influence of human genetic variation on early transcriptional responses and protective immunity following immunization with Rotarix vaccine in infants in Ho Chi Minh City in Vietnam : a study protocol for an open single-arm interventional trial [awaiting peer review]

Background: Rotavirus (RoV) remains the leading cause of acute gastroenteritis in infants and children aged under five years in both high- and low-middle-income countries (LMICs). In LMICs, RoV infections are associated with substantial mortality. Two RoV vaccines (Rotarix and Rotateq) are widely available for use in infants, both of which have been shown to be highly efficacious in Europe and North America. However, for unknown reasons, these RoV vaccines have markedly lower efficacy in LMICs. We hypothesize that poor RoV vaccine efficacy across in certain regions may be associated with genetic heritability or gene expression in the human host. Methods/design: We designed an open-label single-arm interventional trial with the Rotarix RoV vaccine to identify genetic and transcriptomic markers associated with generating a protective immune response against RoV. Overall, 1,000 infants will be recruited prior to Expanded Program on Immunization (EPI) vaccinations at two months of age and vaccinated with oral Rotarix vaccine at two and three months, after which the infants will be followed-up for diarrheal disease until 18 months of age. Blood sampling for genetics, transcriptomics, and immunological analysis will be conducted before each Rotarix vaccination, 2-3 days post-vaccination, and at each follow-up visit (i.e. 6, 12 and 18 months of age). Stool samples will be collected during each diarrheal episode to identify RoV infection. The primary outcome will be Rotarix vaccine failure events (i.e. symptomatic RoV infection despite vaccination), secondary outcomes will be antibody responses and genotypic characterization of the infection virus in Rotarix failure events. Discussion: This study will be the largest and best powered study of its kind to be conducted to date in infants, and will be critical for our understanding of RoV immunity, human genetics in the Vietnam population, and mechanisms determining RoV vaccine-mediated protection. Registration: ClinicalTrials.gov, ID: NCT03587389. Registered on 16 July 2018

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Neutralized Micro-Droplet Generated by On-Chip Electrohydrodynamic

A new conceptual design of electrospray has been developed to generate neutralized micro-droplet using on-chip electro-hydrodynamic. A prototype of a bipolar electrostatic atomization with chambered nozzle tips has been carried out to demonstrate the capability of spaying viable, safe, neutral and alternative droplets which can be applied in micro/nano-encapsulation, bio-scaffold production and also the polymeric micro/nanoparticle fabrication over conventional fabrication techniques as well as the direct current electro-spraying/electrospinning. Several initially experimental results as presented through this work have shown the potential application of the present device in drug delivery

Threshold level of Peptest in diagnosing gastroesophageal reflux disease with extraesophageal symptoms: Evidence from Vietnam

Abstract Background and Aim We aimed to evaluate the application of Peptest, a novel technique to detect pepsin in the saliva, and identify its threshold level for the diagnosis of gastroesophageal reflux disease (GERD) with extraesophageal symptoms. Methods A cross‐sectional study was conducted in two groups: patients with extraesophageal GERD symptoms (symptomatic group divided into GERD and non‐GERD groups according to 24‐h esophageal pH‐impedance monitoring [pH‐I] results) and healthy controls. For the symptomatic group, endoscopy, pH 24 h, high‐resolution manometry (HRM), and salivary Peptest were performed. For the healthy control group, only Peptest was done. The accuracy of Peptest was compared with that of pH‐I by the Lyon consensus criteria. Results Chronic laryngitis was the most frequent extraesophageal symptom. On saliva testing, the GERD group had a higher prevalence of positive samples and pepsin concentration than the control group. Between GERD and non‐GERD groups, the optimal threshold level was 31.2 ng/mL, with a sensitivity of 86.7% and specificity of 27.5%. The optimal threshold level was 31.4 ng/mL to differentiate GERD from healthy controls, with a sensitivity of 86.7% and specificity of 66.0%. Age, number of total refluxes, DeMeester score, post‐reflux swallow‐induced peristaltic wave (PSPW) index, and mean nocturnal baseline impedence (MNBI) were associated with pepsin concentration. Regarding HRM metrics, there was no significant difference of pepsin concentration between low/normal upper esophageal sphincter (UES) resting pressure, low/normal lower esophageal sphincter (LES) resting pressure, low/normal 4‐s integrated relaxation pressure (IRP4s), and hypomotility/normal motility. Conclusion Patients with extraesophageal symptoms had a higher prevalence of positive Peptest. The optimum threshold level of 31.4 ng/mL had high sensitivity and moderate specificity to differentiate between patients with GERD and healthy controls

In-air particle generation by on-chip electrohydrodynamics

Electrohydrodynamic atomization has been emerging as a powerful approach for respiratory treatment, including the generation and delivery of micro/nanoparticles as carriers for drugs and antigens. In this work, we present a new conceptual design in which two nozzles facilitate dual electrospray coexisting with ionic wind at chamfered tips by a direct current power source. Experimental results by a prototype have demonstrated the capability of simultaneously generating-and-delivering a stream of charged reduced particles. The concept can be beneficial to pulmonary nano-medicine delivery since the mist of nanoparticles is migrated without any restriction of either the collector or the assistance of external flow, but is pretty simple in designing and manufacturing devices

Electric Field-Enhanced Electrohydrodynamic Process For Fabrication of Highly Sensitive Piezoelectric Sensor

We introduce the use of a 55° chamfered nozzle in an electrohydrodynamic (EHD) system to control single-jet mode’s stability and enhance the product’s quality. This nozzle can reduce the critical voltage, broaden stable mode’s voltage range, and promote homogeneity in fabricated fibers. The findings demonstrated in generating highly uniform poly(vinylidene fluoride-cotrifluoroethylene) (PVDF-TrFE) fibers for a flexible piezoelectric sensor. Owing to the fibers’ excellent quality, the sensor shows high sensitivity and ability to detect the drops of a metal bead, or a water droplet from 20 cm height. This shows potential use of modified chamfered nozzle in practical EHD fabrication processes

Enhanced electro-hydrodynamics for electrospinning a highly sensitive flexible fiber-based piezoelectric sensor

The single-jet mode in an electro-hydrodynamic (EHD) system is the most desirable mode for generating uniform droplets and fibers and has many applications in numerous fields. Several studies have been carried out to enhance the performance of the EHD process focusing on this mode. In this paper, we introduce the use of a chamfered nozzle in an EHD system to greatly extend the single-jet mode’s voltage range, and generally, to enhance the EHD process in terms of control capability and product quality. We carried out simulations and experiments to compare the performance of a chamfered nozzle and conventional flat-end nozzle. Both theoretical analysis and experiments demonstrate that the chamfered nozzle in an EHD system reduces the critical voltage, broadens the voltage range for the single-jet mode, and enhances homogeneity in particle and fiber generation. Furthermore, the chamfered nozzle’s advantages were demonstrated in fabricating highly uniform polyvinylidene fluoride-co-trifluoroethylene (PVDF-TrFE) fibers for piezoelectric sensor development. Owing to the fibers’ excellent quality, the sensor shows high sensitivity that can detect and differentiate between the drops of a metal bead, a water droplet, and an oil droplet. The use of a chamfered nozzle with its advantages shows potential for development of better EHD-based devices