Multiple Recurrent Acute Ischemic Strokes Treated by Thrombectomy in a Patient with Acute Pulmonary Embolism

BACKGROUND: Thrombectomy is recommended to treat for an acute ischemic stroke (AIS) patient with anterior large vessel occlusion. However, there were neither detailed guidelines nor systematic reviews of acute ischemic stroke patients having multiple times or re-occluded arteries. CASE REPORT: In our case report, we struggled a multiple (4-times) AIS patient underwent by one intravenous r-tpA and 3 remaining of endovascular treatment of thrombectomy. Especially, the finding of both pulmonary embolism and cerebral arteries occlusion in this patient made us difficult to decide the appropriate treatment plan. The patient was considered having multiple cardiac thrombi pumping out to the brain and pulmonary vessels even in treatment with NOAC (New Oral Anticoagulant). Our priority, normally, was to recanalize the brain vessels compared to the pulmonary arteries. CONCLUSION: In conclusion, based on this noticed case study, we want to share our experiences on the diagnosis of ischemic stroke, the strategy in treatment and prevention with anticoagulant therapy

Identification of tuberculosis-associated proteins in whole blood supernatant

<p>Abstract</p> <p>Background</p> <p>Biological parameters are useful tools for understanding and monitoring complicated disease processes. In this study, we attempted to identify proteins associated with active pulmonary tuberculosis (TB) using a proteomic approach.</p> <p>Methods</p> <p>To assess TB-associated changes in the composition of human proteins, whole blood supernatants were collected from patients with active TB and healthy control subjects. Two-dimensional difference gel electrophoresis (2D-DIGE) was performed to analyze proteins with high molecular weights (approximately >20 kDa). Baseline protein levels were initially compared between patients with active TB and control subjects. Possible changes of protein patterns in active TB were also compared <it>ex vivo </it>between whole blood samples incubated with <it>Mycobacterium tuberculosis </it>(<it>Mtb</it>)-specific antigens (stimulated condition) and under unstimulated conditions. Immunoblot and enzyme-linked immunosorbent assays (ELISA) were performed to confirm differences in identified proteins.</p> <p>Results</p> <p>Under the baseline condition, we found that the levels of retinol-binding protein 4 (RBP4), fetuin-A (also called α-HS-glycoprotein), and vitamin D-binding protein differed between patients with active TB and control subjects on 2D gels. Immunoblotting results confirmed differential expression of RBP4 and fetuin-A. ELISA results further confirmed significantly lower levels of these two proteins in samples from patients with active TB than in control subjects (<it>P </it>< 0.0001). <it>Mtb</it>-specific antigen stimulation <it>ex vivo </it>altered clusterin expression in whole blood samples collected from patients with active TB.</p> <p>Conclusions</p> <p>We identified TB-associated proteins in whole blood supernatants. The dynamics of protein expression during disease progression may improve our understanding of the pathogenesis of TB.</p

Prevalence and Risk Factors for Tuberculosis Infection among Hospital Workers in Hanoi, Viet Nam

BACKGROUND: Transmission of tuberculosis (TB) to health care workers (HCWs) is a global issue. Although effective infection control measures are expected to reduce nosocomial TB, HCWs' infection has not been assessed enough in TB high burden countries. We conducted a cross-sectional study to determine the prevalence of TB infection and its risk factors among HCWs in Hanoi, Viet Nam. METHODOLOGY/PRINCIPAL FINDINGS: A total of 300 HCWs including all staff members in a municipal TB referral hospital received an interferon-gamma release assay (IGRA), QuantiFERON-TB Gold In-Tube(TM), followed by one- and two-step tuberculin skin test (TST) and a questionnaire-based interview. Agreement between the tests was evaluated by kappa statistics. Risk factors for TB infection were analyzed using a logistic regression model. Among the participants aged from 20 to 58 years (median = 40), prevalence of TB infection estimated by IGRA, one- and two-step TST was 47.3%, 61.1% and 66.3% respectively. Although the levels of overall agreement between IGRA and TST were moderate, the degree of agreement was low in the group with BCG history (kappa = 0.29). Working in TB hospital was associated with twofold increase in odds of TB infection estimated by IGRA. Increased age, low educational level and the high body mass index also demonstrated high odds ratios of IGRA positivity. CONCLUSIONS/SIGNIFICANCE: Prevalence of TB infection estimated by either IGRA or TST is high among HCWs in the hospital environment for TB care in Viet Nam and an infection control program should be reinforced. In communities with heterogeneous history of BCG vaccination, IGRA seems to estimate TB infection more accurately than any other criteria using TST

Circulating Levels of Adiponectin, Leptin, Fetuin-A and Retinol-Binding Protein in Patients with Tuberculosis: Markers of Metabolism and Inflammation

BACKGROUND: Wasting is known as a prominent feature of tuberculosis (TB). To monitor the disease state, markers of metabolism and inflammation are potentially useful. We thus analyzed two major adipokines, adiponectin and leptin, and two other metabolic markers, fetuin-A and retinol-binding protein 4 (RBP4). METHODS: The plasma levels of these markers were measured using enzyme-linked immunosorbent assays in 84 apparently healthy individuals (=no-symptom group) and 46 patients with active pulmonary TB around the time of treatment, including at the midpoint evaluation (=active-disease group) and compared them with body mass index (BMI), C-reactive protein (CRP), chest radiographs and TB-antigen specific response by interferon-γ release assay (IGRA). RESULTS: In the no-symptom group, adiponectin and leptin showed negative and positive correlation with BMI respectively. In the active-disease group, at the time of diagnosis, leptin, fetuin-A and RBP4 levels were lower than in the no-symptom group [adjusted means 2.01 versus 4.50 ng/ml, P<0.0001; 185.58 versus 252.27 µg/ml, P<0.0001; 23.88 versus 43.79 µg/ml, P<0.0001, respectively]. High adiponectin and low leptin levels were associated with large infiltrates on chest radiographs even after adjustment for BMI and other covariates (P=0.0033 and P=0.0020). During treatment, adiponectin levels increased further and then decreased. Leptin levels remained low. Initial low levels of fetuin-A and RBP4 almost returned to the normal reference range in concert with reduced CRP. CONCLUSIONS: Our data and recent literature suggest that low fat store and underlying inflammation may regulate these metabolic markers in TB in a different way. Decreased leptin, increased adiponectin, or this ratio may be a promising marker for severity of the disease independent of BMI. We should further investigate pathological roles of the balance between these adipokines

Measuring Efficiency of Generating Electric Processes

Electric energy sources are the foundation for supporting for the industrialization and modernization; however, the processes of electricity generation increase CO2 emissions. This study integrates the Holt–Winters model in number cruncher statistical system (NCSS) to estimate the forecasting data and the undesirable model in data envelopment analysis (DEA) to calculate the efficiency of electricity production in 14 countries all over the world from past to future. The Holt–Winters model is utilized to estimate the future; then, the actual and forecasting data are applied into the undesirable model to compute the performance. From the principle of an undesirable model, the study determines the input and output factors as follows nonrenewable and renewable fuels (inputs), electricity generation (desirable output), and CO2 emissions (undesirable output). The empirical results exhibit efficient/inefficient terms over the period from 2011–2021 while converting these fuels into electricity energy and CO2 emissions. The efficiency reveals the environmental effect level from the electricity generation. The analysis scores recommend a direction for improving the inefficient terms via the principle of inputs and undesirable outputs excess and desirable outputs shortfalls in an undesirable model

Estimating Relative Efficiency of Electricity Consumption in 42 Countries during the Period of 2008–2017

Augmentation of electrical equipment is pushing for an increase in energy supply sources all over the world, as electricity consumption (EC) typically rises with growing populations. The value of EC reveals economic development and degree of emissions. Therefore, this research uses the undesirable outputs model in data envelopment analysis (DEA) for estimating relative efficiency of electricity consumption in 42 countries from 2008 to 2017. According to the principle of an undesirable outputs model and studied objectives, variables are selected that included population and EC as inputs, gross domestic product (GDP) as desirable output, and carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) as undesirable outputs. The empirical results indicate that 420 terms of 42 countries during the period of 2008&#8315;2017 have 102 efficient and 310 inefficient terms. Moreover, the interplay level between input and output factors every year is presented via scores. The study suggests the effect of EC to human life and propounds the emission status to look for directions to overcome inefficient terms

Integrating the Additive Seasonal Model and Super-SBM Model to Compute the Efficiency of Port Logistics Companies in Vietnam

The growing trade process is pushing the importing and exporting ratio of products at ports in Vietnam. The total amount of goods is determined by analyzing the effectiveness of products that are delivered at ports. Thus, this research presents a whole performance picture of the port logistics operation process at two airports and six seaport logistics companies in Vietnam to describe exchanging products by utilizing additive trend methods to formulate the efficiency and rank them from previous periods to future terms. Based on the prediction analysis, the best accuracy result is calculated by the additive Holt Winters method when the mean absolute percentage error (MAPE) indicators remain at the standard level, and its average qualification is also the lowest. Combining the actual and prediction values, the ranking of all ports accordingly by year during the past, current, and future time periods from 2011&ndash;2022 is obtained after calculating the final efficiency via the super-SBM model. The empirical result of the current and estimated efficiency denotes that Da Nang port logistics is always selected as the best port logistics company and maintained the first ranking with consistently high scores on the basis of the performance qualification. The empirical analysis result proposes the status quo of port logistics companies in Vietnam from the past to future to describe the amount of exchanging goods

Assessing Bank Performance Using Dynamic SBM Model

Global economic growth has led banks to expand their operations all over the world. The purpose of this research was to understand the efficiency of 18 large bank from all over the world during the period from 2013 to 2017. The performance was estimated by a dynamic slacks-based measure (SBM) model in data envelopment analysis (DEA). This model could be solved using inputs, outputs, and links. The banks variables were considered as follows: Assets, capitalization, and liabilities as inputs; revenue as output; and net interest income as a good link. The final empirical results exhibit the efficiency for each term, and the overall score. The data analysis recommends a feasible solution to refine inefficient terms based on the projections (slacks). This study visually observed the proficiency of the banking industry to equip enterprises with the best choice for their finances

The adsorption kinetic and isotherm studies of metal ions (Co2+, Sr2+, Cs+) on Fe3O4 nanoparticle of radioactive importance

The release of radionuclide elements from nuclear, medical, research, and defense fields has become a serious environmental problem. Hence, the investigation of the adsorption kinetic and isotherm of metal ions (Co2+, Sr2+, and Cs+) which are commonly found in radioactive waste has been considered essential for radioactive contaminant removal process from aqueous environment. In this paper, the adsorption kinetic of three metal ions on Fe3O4 nanoparticle (Fe3O4 NPs) have been described by the pseudo-first-order, pseudo-second-order, Elovich, and Intra-particle diffusion models, while the adsorption isotherm have been described by the Langmuir, Freundlich, Dubinin-Radushkevich model, and Tempkin isotherm models. Comparing the correction coefficients (R2) of four adsorption kinetic models and four isothermal adsorption models, the adsorption kinetic of three ions fitted well to the pseudo-second-order model with R2 > 0.9913. Meanwhile, the adsorption isotherm of three metal ions indicate that the Langmuir model was best fit the isothermal adsorptions with R2 > 0.9799. The maximum adsorption capacities of Co2+, Sr2+, and Cs+ were found to be 30.488, 34.843, and 33.223 mg/g, respectively. Based on the data of the present investigation, the Fe3O4 NPs being eco-friendly and low-cost adsorbent might be a suitable alternative for the elimination of radioactive waste from environmental and industrial wastes

Prioritization of Factors Impacting Lecturer Research Productivity Using an Improved Fuzzy Analytic Hierarchy Process Approach

Improving the scientific research productivity of lecturers is an important strategy contributing to improving the reputation of universities, attracting external funding sources, and improving the credibility of both domestic and international students. This study was carried out with the aim of determining the priority of the university’s governance factors that affect lecturers’ scientific research productivity. Six university governance factors were considered, including (i) research objectives and strategies, (ii) decentralization, (iii) leadership, (iv) support for research activities, (v) policy towards lecturers, and (vi) resources for research activities. In this study, an improved analytic hierarchy process method using generalized triangular fuzzy numbers and a centroid index was proposed. The research data were collected via in-depth interviews with experts and administrators at Vietnam National University, Hanoi (VNU). The results indicate that “resources for research activities” constitute the most important factor affecting the research productivity of lecturers at VNU, followed by research objectives and strategies and leadership