Fractional flow reserve in assessment of intermediate non-culprit lesions in acute myocardial infarction

Context: Percutaneous coronary intervention (PCI) of intermediate non-culprit arteries can reduce death or heart attack risk in patients with acute myocardial infarction and multivessel coronary artery disease. Aims: To compare the effectiveness of fractional flow reserve (FFR)-guided PCI with angiography-guided PCI for intermediate non-culprit lesions in patients with acute myocardial infarction and multivessel coronary artery disease. Methods: In this cohort study, acute myocardial infarction patients with multivessel coronary artery disease who had successful percutaneous coronary intervention of the culprit artery were divided into group of patients receiving FFR-guided PCI (FFR≤0.80, n = 31) and group of patients receiving angiography-guided PCI (diameter stenosis of 50-90%, n = 62) for lesions in non-culprit arteries. These two groups were followed for at least 1 year for major adverse cardiovascular events. Results: There was no statistically significant difference in major cardiovascular events between FFR-guided percutaneous coronary intervention group and angiography-guided percutaneous coronary intervention group. However, FFR-guided percutaneous coronary intervention group had a lower mortality rate compared to the angiography-guided percutaneous coronary intervention group (3.2% vs. 4.8%). Additionally, there were no reported cases of myocardial infarction in angiography-guided PCI group, while angiography-guided PCI group had a rate of 1.6%. Conclusions: This study found that it remains uncertain whether FFR-guided PCI is superior than angiography-guided PCI for intermediate non-culprit lesions in patients with acute myocardial infarction and multivessel coronary artery disease

Multifunctional nanocarriers of Fe3O4@PLA-PEG/curcumin for MRI, magnetic hyperthermia and drug delivery

Background: Despite medicinal advances, cancer is still a big problem requiring better diagnostic and treatment tools. Magnetic nanoparticle (MNP)-based nanosystems for multiple-purpose applications were developed for these unmet needs. Methods: This study fabricated novel trifunctional MNPs of Fe3O4@PLA-PEG for drug release, MRI and magnetic fluid hyperthermia. Result: The MNPs provided a significant loading of curcumin (∼11%) with controllable release ability, a high specific absorption rate of 82.2 W/g and significantly increased transverse relaxivity (r2 = 364.75 mM-1 s-1). The in vivo study confirmed that the MNPs enhanced MRI contrast in tumor observation and low-field magnetic fluid hyperthermia could effectively reduce the tumor size in mice bearing sarcoma 180. Conclusion: The nanocarrier has potential for drug release, cancer treatment monitoring and therapy.The authors are grateful for the financial support by AOARD under award FA2386-17-1-4042. The Spanish government is acknowledged for the “Nanotechnology in translational hyperthermia (HIPERNANO)” research network (RED2018102626-T) and for funding under the project number MAT2017-83631-C3. NTK Thanh thanks EPSRC (EP/M015157/1). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed

Validation and utilization of an internally controlled multiplex Real-time RT-PCR assay for simultaneous detection of enteroviruses and enterovirus A71 associated with hand foot and mouth disease

Background: Hand foot and mouth disease (HFMD) is a disease of public health importance across the Asia-Pacific region. The disease is caused by enteroviruses (EVs), in particular enterovirus A71 (EV-A71). In EV-A71-associated HFMD, the infection is sometimes associated with severe manifestations including neurological involvement and fatal outcome. The availability of a robust diagnostic assay to distinguish EV-A71 from other EVs is important for patient management and outbreak response. Methods: We developed and validated an internally controlled one-step single-tube real-time RT-PCR in terms of sensitivity, linearity, precision, and specificity for simultaneous detection of EVs and EV-A71. Subsequently, the assay was then applied on throat and rectal swabs sampled from 434 HFMD patients. Results: The assay was evaluated using both plasmid DNA and viral RNA and has shown to be reproducible with a maximum assay variation of 4.41 % and sensitive with a limit of detection less than 10 copies of target template per reaction, while cross-reactivity with other EV serotypes was not observed. When compared against a published VP1 nested RT-PCR using 112 diagnostic throat and rectal swabs from 112 children with a clinical diagnosis of HFMD during 2014, the multiplex assay had a higher sensitivity and 100 % concordance with sequencing results which showed EVs in 77/112 (68.8 %) and EV-A71 in 7/112 (6.3 %). When applied to clinical diagnostics for 322 children, the assay detected EVs in throat swabs of 257/322 (79.8 %) of which EV-A71 was detected in 36/322 (11.2 %) children. The detection rate increased to 93.5 % (301/322) and 13.4 % (43/322) for EVs and EV-A71, respectively, when rectal swabs from 65 throat-negative children were further analyzed. Conclusion: We have successfully developed and validated a sensitive internally controlled multiplex assay for rapid detection of EVs and EV-A71, which is useful for clinical management and outbreak control of HFMD. Keywords: Hand foot and mouth disease, Enteroviruses, Enterovirus A71, Real-time RT-PCR, Diagnosi

A generic assay for whole-genome amplification and deep sequencing of enterovirus A71

Enterovirus A71 (EV-A71) has emerged as the most important cause of large outbreaks of severe and sometimes fatal hand, foot and mouth disease (HFMD) across the Asia-Pacific region. EV-A71 outbreaks have been associated with (sub)genogroup switches, sometimes accompanied by recombination events. Understanding EV-A71 population dynamics is therefore essential for understanding this emerging infection, and may provide pivotal information for vaccine development. Despite the public health burden of EV-A71, relatively few EV-A71 complete-genome sequences are available for analysis and from limited geographical localities. The availability of an efficient procedure for whole-genome sequencing would stimulate effort to generate more viral sequence data. Herein, we report for the first time the development of a next-generation sequencing based protocol for whole-genome sequencing of EV-A71 directly from clinical specimens. We were able to sequence viruses of subgenogroup C4 and B5, while RNA from culture materials of diverse EV-A71 subgenogroups belonging to both genogroup B and C was successfully amplified. The nature of intra-host genetic diversity was explored in 22 clinical samples, revealing 107 positions carrying minor variants (ranging from 0 to 15 variants per sample). Our analysis of EV-A71 strains sampled in 2013 showed that they all belonged to subgenogroup B5, representing the first report of this subgenogroup in Vietnam. In conclusion, we have successfully developed a high-throughput next-generation sequencing-based assay for whole-genome sequencing of EV-A71 from clinical samples

Validation and utilization of an internally controlled multiplex Real-time RT-PCR assay for simultaneous detection of enteroviruses and enterovirus A71 associated with hand foot and mouth disease

BACKGROUND: Hand foot and mouth disease (HFMD) is a disease of public health importance across the Asia-Pacific region. The disease is caused by enteroviruses (EVs), in particular enterovirus A71 (EV-A71). In EV-A71-associated HFMD, the infection is sometimes associated with severe manifestations including neurological involvement and fatal outcome. The availability of a robust diagnostic assay to distinguish EV-A71 from other EVs is important for patient management and outbreak response. METHODS: We developed and validated an internally controlled one-step single-tube real-time RT-PCR in terms of sensitivity, linearity, precision, and specificity for simultaneous detection of EVs and EV-A71. Subsequently, the assay was then applied on throat and rectal swabs sampled from 434 HFMD patients. RESULTS: The assay was evaluated using both plasmid DNA and viral RNA and has shown to be reproducible with a maximum assay variation of 4.41 % and sensitive with a limit of detection less than 10 copies of target template per reaction, while cross-reactivity with other EV serotypes was not observed. When compared against a published VP1 nested RT-PCR using 112 diagnostic throat and rectal swabs from 112 children with a clinical diagnosis of HFMD during 2014, the multiplex assay had a higher sensitivity and 100 % concordance with sequencing results which showed EVs in 77/112 (68.8 %) and EV-A71 in 7/112 (6.3 %). When applied to clinical diagnostics for 322 children, the assay detected EVs in throat swabs of 257/322 (79.8 %) of which EV-A71 was detected in 36/322 (11.2 %) children. The detection rate increased to 93.5 % (301/322) and 13.4 % (43/322) for EVs and EV-A71, respectively, when rectal swabs from 65 throat-negative children were further analyzed. CONCLUSION: We have successfully developed and validated a sensitive internally controlled multiplex assay for rapid detection of EVs and EV-A71, which is useful for clinical management and outbreak control of HFMD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12985-015-0316-2) contains supplementary material, which is available to authorized users

Rare Complication of Strongyloidiasis in Vietnam: A Case of Venous Thromboembolism and Duodenal Obstruction

Strongyloidiasis, a chronic helminth infection caused by the parasitic nematode Strongyloides stercoralis, has various clinical manifestations. Although rare, duodenal obstructions and venous thromboembolism are possible complications of strongyloidiasis. This paper presents the case of a 47-year-old Vietnamese male with a history of right lower limb edema, anorexia, nausea, vomiting, diarrhea, and abdominal discomfort lasting for four months. Venous Doppler ultrasound detected a thrombus in the right femoral vein, while an abdominal CT scan revealed a mass lesion suggestive of a lower bile duct tumor. Esophageogastroduodenoscopy showed a friable duodenal cap mucosa with multiple ulcers and edematous mucosa of the second part of the duodenum that caused a partial lumen obstruction. The final histological examination of the biopsy specimen revealed chronic duodenitis with larvae consistent with Strongyloides stercoralis. The patient was treated with Ivermectin for two weeks and anticoagulation therapy for three months. After treatment and a six-month follow-up, the patient's gastrointestinal symptoms and leg swelling resolved completely. This is the first documented case of a patient in Vietnam with strongyloidiasis who presented with venous thromboembolism and duodenal obstruction

Towards an explanation of age-related difficulties in crossing a two-way street

Crossing a two-way street is a complex task that involves visual, cognitive and motor abilities, all of which are known to decline with ageing. In particular, older pedestrians may experience difficulties when crossing two-way streets because of incorrect gap acceptance choices and impossible or unperceived evasive actions. To understand the overrepresentation of older pedestrians in crash statistics, several experimental studies have sought to identify traffic-related factors as well as those related to the abilities of the individuals themselves. However, none of these studies has required participants to actually walk across an experimental two-way street with curbs, which is a particularly challenging situation for older pedestrians. To fill this research gap, a quasi- experiment was conducted in a simulator including a total of 58 healthy aged participants (25 younger-old [age 60 - 72] and 33 older-old [age 72 - 92]) and 25 young adults (aged 18 - 25 years). Participants carried out a street-crossing task in a simulated two-way traffic environment; curbs were present on both sides of the experimental street. Participants also undertook a battery of tests to assess their visual and cognitive abilities. In addition, during the experiment, the participants' gait parameters were recorded. In line with earlier findings, the older-old group of participants made a higher number of decisions that led to collisions with approaching cars compared with the other groups. The two groups of older participants experienced specific difficulties when vehicles were in the far lane or when they approached rapidly. A regression analysis identified visual acuity, speed of processing (assessed using the UFOV® test), and step length as significant predictors of collisions. Our results have implications for understanding the difficulties experienced by older pedestrians and allow to draw up several recommendations for improving their safety

Engineering functionalized Zr-MOFs as facile removal of indole: Experimental studies and first-principles modeling

Zr-based metal-organic frameworks (Zr-MOFs) are emerging as potential adsorbents for removing nitrogen contaminants in fuel and wastewater. Functionalized Zr-MOFs exhibited superior indole (IND) adsorption capacity than the original MOF, but the activity of the multiple adsorption sites has not been discussed. Through experiment measurement and Density Functional Theory (DFT) calculations, this research investigated the IND adsorption mechanism at various sites on Zr-BDC-NH2 and Zr-BDC-NO2. Based on the adsorption isotherm, the adhesion of IND with Zr-MOFs was determined via the Freundlich model. DFT results suggest that the IND adsorption occurred at highly active sites such as O-linker, μ3-O-cluster, N-amine, and O-nitro via hydrogen and π-hydrogen bonds. Furthermore, the binding energy at each adsorption site in Zr-BDC-NH2 is higher than in Zr-BDC-NO2. In addition to the hydrogen acceptor bond, the π-hydrogen bond has also been analyzed through the electron density difference

Producing bacterial cellulose from industrial recycling paper waste sludge

This study aimed to produce bacterial cellulose from paper waste sludge (PWS) as a method of utilizing the cellulose source from the remaining pulp in the material. Initially, PWS was hydrolyzed by sulfuric acid to create an enriched-reducing sugar hydrolysate. One-factor experiments were conducted with a fixed amount of PWS (5 g) to investigate the influence of hydrolysis conditions, including water, sulfuric acid addition, temperature, and retention time, on the production yield of reducing sugars. Based on these results, the Box-Behnken model was designed to optimize the hydrolysis reaction. The optimal hydrolysis conditions were 10 ml/g of the sulfuric acid solution (30.9%) at 105.5 °C for 90 min of retention time 0.81 (gGE/g PWS), corresponding to a conversion yield of 40.5%). Subsequently, 100 ml of the filtered and neutralized PWS hydrolysate was used as the culture to produce the bacterial cellulose (BC) using Acetobacter xylinum, which produced 12 g/L of bacterial cellulose. The conversion yield of bacterial cellulose calculated as the ratio of the weight of produced bacterial cellulose to that of cellulose in PWS reached 33.3%. The structure of the obtained BC was analyzed using scanning electron microscopy (SEM) and X-ray diffraction (XRD) to indicate the formation of nano-cellulose fiber networks. This research proposed a combined method to convert paper waste sludge into bacterial cellulose, demonstrating the potential for waste utilization and sustainable production of paper industries for added-value products

A Novel Approach Combining Particle Swarm Optimization and Deep Learning for Flash Flood Detection from Satellite Images

Flood is one of the deadliest natural hazards worldwide, with the population affected being more than 2 billion between 1998–2017 with a lack of warning systems according to WHO. Especially, flash floods have the potential to generate fatal damages due to their rapid evolution and the limited warning and response time. An effective Early Warning Systems (EWS) could support detection and recognition of flash floods. Information about a flash flood can be mainly provided from observations of hydrology and from satellite images taken before the flash flood happens. Then, predictions from satellite images can be integrated with predictions based on sensors’ information to improve the accuracy of a forecasting system and subsequently trigger warning systems. The existing Deep Learning models such as UNET has been effectively used to segment the flash flood with high performance, but there are no ways to determine the most suitable model architecture with the proper number of layers showing the best performance in the task. In this paper, we propose a novel Deep Learning architecture, namely PSO-UNET, which combines Particle Swarm Optimization (PSO) with UNET to seek the best number of layers and the parameters of layers in the UNET based architecture; thereby improving the performance of flash flood segmentation from satellite images. Since the original UNET has a symmetrical architecture, the evolutionary computation is performed by paying attention to the contracting path and the expanding path is synchronized with the following layers in the contracting path. The UNET convolutional process is performed four times. Indeed, we consider each process as a block of the convolution having two convolutional layers in the original architecture. Training of inputs and hyper-parameters is performed by executing the PSO algorithm. In practice, the value of Dice Coefficient of our proposed model exceeds 79.75% (8.59% higher than that of the original UNET model). Experimental results on various satellite images prove the advantages and superiority of the PSO-UNET approach