Impact of Education and Network for Avian Influenza H5N1 in Human: Knowledge, Clinical Practice, and Motivation on Medical Providers in Vietnam

BACKGROUND: Knowledge, clinical practice, and professional motivation of medical providers relating to H5N1 infection have an important influence on care for H5N1 patients who require early diagnosis and early medical intervention. METHODS/PRINCIPAL FINDINGS: Novel educational programs including training and workshops for medical providers relating to H5N1 infection in Vietnam were originally created and implemented in 18 provincial hospitals in northern Vietnam between 2008 and 2010. A self-administered, structured questionnaire survey was conducted in 8 provincial hospitals where both educational training and workshops were previously provided. A total of 326 medical providers, including physicians, nurses, and laboratory technicians who attended or did not attend original programs were enrolled in the survey. Knowledge, clinical attitudes and practice (KAP), including motivation surrounding caring for H5N1 patients, were evaluated. The study indicated a high level of knowledge and motivation in all professional groups, with especially high levels in laboratory technicians. Conferences and educational programs were evaluated to be the main scientific information resources for physicians, along with information from colleagues. The chest radiographs and the initiation of antiviral treatment in the absence of RT-PCR result were identified as gaps in education. Factors possibly influencing professional motivation for caring for H5N1 patients included healthcare profession, the hospital where the respondents worked, age group, attendance at original educational programs and at educational programs which were conducted by international health-related organizations. CONCLUSIONS: Educational programs provide high knowledge and motivation for medical providers in Vietnam caring for H5N1 patients. Additional educational programs related to chest radiographs and an initiation of treatment in the absence of RT-PCR are needed. Networking is also necessary for sharing updated scientific information and practical experiences. These enhanced KAPs by educational programs and integrated systems among hospitals should result in appropriate care for H5N1 patients and may reduce morbidity and mortality

Ordered Mesoporous Carbons as Novel and Efficient Adsorbent for Dye Removal from Aqueous Solution

Ordered mesoporous carbons (OMCs) were successfully synthesized by using hard template and soft template methods. These materials were characterized by XRD, TEM, and N2 adsorption-desorption Brunauer-Emmett-Teller (BET). From the obtained results, it is revealed that the obtained OMCs samples showed high surface area (>1000 m2/g) with high pore volume, mainly mesopore volume (1.2–2.4 cm3/g). Moreover, OMCs samples had similar structure of the SBA-15 silica and exhibited high MB adsorption capacity with qm of 398 mg·g−1 for OMCs synthesis with hard template and 476 mg·g−1 for OMCs synthesis with soft template, respectively. From kinetics investigation, it is confirmed that MB adsorption from aqueous solution obeys the pseudo-second-order kinetic equation

Drug-Related Problems in Coronary Artery Diseases

Coronary artery disease (CAD) remains the leading cause of mortality among cardiovascular diseases, responsible for 16% of the world’s total deaths. According to a statistical report published in 2020, the global prevalence of CAD was estimated at 1655 per 100,000 people and is predicted to exceed 1845 by 2030. Annually, in the United States, CAD accounts for approximately 610,000 deaths and costs more than 200 billion dollars for healthcare services. Most patients with CAD need to be treated over long periods with a combination of drugs. Therefore, the inappropriate use of drugs, or drug-related problems (DRPs), can lead to many consequences that affect these patients’ health, including decreased quality of life, increased hospitalization rates, prolonged hospital stays, increased overall health care costs, and even increased risk of morbidity and mortality. DRPs are common in CAD patients, with a prevalence of over 60%. DRPs must therefore be noticed and recognized by healthcare professionals. This chapter describes common types and determinants of DRPs in CAD patients and recommends interventions to limit their prevalence

Correlation and high-resolution timing for Paleo-tethys Permian-Triassic boundary exposures in Vietnam and Slovenia using geochemical, geophysical and biostratigraphic data sets

Two Permian-Triassic boundary (PTB) successions, Lung Cam in Vietnam, and Lukač in Slovenia, have been sampled for high-resolution magnetic susceptibility, stable isotope and elemental chemistry, and biostratigraphic analyses. These successions are located on the eastern (Lung Cam section) and western margins (Lukač section) of the Paleo-Tethys Ocean during PTB time. Lung Cam, lying along the eastern margin of the Paleo-Tethys Ocean provides an excellent proxy for correlation back to the GSSP and out to other Paleo-Tethyan successions. This proxy is tested herein by correlating the Lung Cam section in Vietnam to the Lukač section in Slovenia, which was deposited along the western margin of the Paleo-Tethys Ocean during the PTB interval. It is shown herein that both the Lung Cam and Lukač sections can be correlated and exhibit similar characteristics through the PTB interval. Using time-series analysis of magnetic susceptibility data, high-resolution ages are obtained for both successions, thus allowing relative ages, relative to the PTB age at ~252 Ma, to be assigned. Evaluation of climate variability along the western and eastern margins of the Paleo-Tethys Ocean through the PTB interval, using d18O values indicates generally cooler climate in the west, below the PTB, changing to generally warmer climates above the boundary. A unique Black Carbon layer (elemental carbon present by agglutinated foraminifers in their test) below the boundary exhibits colder temperatures in the eastern and warmer temperatures in the western Paleo-Tethys Ocean.ReferencesBalsam W., Arimoto R., Ji J., Shen Z, 2007. Aeolian dust in sediment: a re-examination of methods for identification and dispersal assessed by diffuse reflectance spectrophotometry. International Journal of Environment and Health, 1, 374-402.Balsam W.L., Otto-Bliesner B.L., Deaton B.C., 1995. 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IL-7 Promotes CD95-Induced Apoptosis in B Cells via the IFN-γ/STAT1 Pathway

Interleukin-7 (IL-7) concentrations are increased in the blood of CD4+ T cell depleted individuals, including HIV-1 infected patients. High IL-7 levels might stimulate T cell activation and, as we have shown earlier, IL-7 can prime resting T cell to CD95 induced apoptosis as well. HIV-1 infection leads to B cell abnormalities including increased apoptosis via the CD95 (Fas) death receptor pathway and loss of memory B cells. Peripheral B cells are not sensitive for IL-7, due to the lack of IL-7Ra expression on their surface; however, here we demonstrate that high IL-7 concentration can prime resting B cells to CD95-mediated apoptosis via an indirect mechanism. T cells cultured with IL-7 induced high CD95 expression on resting B cells together with an increased sensitivity to CD95 mediated apoptosis. As the mediator molecule responsible for B cell priming to CD95 mediated apoptosis we identified the cytokine IFN-γ that T cells secreted in high amounts in response to IL-7. These results suggest that the lymphopenia induced cytokine IL-7 can contribute to the increased B cell apoptosis observed in HIV-1 infected individuals

CD27− B-Cells Produce Class Switched and Somatically Hyper-Mutated Antibodies during Chronic HIV-1 Infection

Class switch recombination and somatic hypermutation occur in mature B-cells in response to antigen stimulation. These processes are crucial for the generation of functional antibodies. During HIV-1 infection, loss of memory B-cells, together with an altered differentiation of naïve B-cells result in production of low quality antibodies, which may be due to impaired immunoglobulin affinity maturation. In the current study, we evaluated the effect of HIV-1 infection on class switch recombination and somatic hypermutation by studying the expression of activation-induced cytidine deaminase (AID) in peripheral B-cells from a cohort of chronically HIV-1 infected patients as compared to a group of healthy controls. In parallel, we also characterized the phenotype of B-cells and their ability to produce immunoglobulins in vitro. Cells from HIV-1 infected patients showed higher baseline levels of AID expression and increased IgA production measured ex-vivo and upon CD40 and TLR9 stimulation in vitro. Moreover, the percentage of CD27−IgA+ and CD27−IgG+ B-cells in blood was significantly increased in HIV-1 infected patients as compared to controls. Interestingly, our results showed a significantly increased number of somatic hypermutations in the VH genes in CD27− cells from patients. Taken together, these results show that during HIV-1 infection, CD27− B-cells can also produce class switched and somatically hypermutated antibodies. Our data add important information for the understanding of the mechanisms underlying the loss of specific antibody production observed during HIV-1 infection