Development and validation of a prognostic model for predicting 30-day mortality risk in medical patients in emergency department (ED)

© 2017 The Author(s). The primary aim of this prospective study is to develop and validate a new prognostic model for predicting the risk of mortality in Emergency Department (ED) patients. The study involved 1765 patients in the development cohort and 1728 in the validation cohort. The main outcome was mortality up to 30 days after admission. Potential risk factors included clinical characteristics, vital signs, and routine haematological and biochemistry tests. The Bayesian Model Averaging method within the Cox's regression model was used to identify independent risk factors for mortality. In the development cohort, the incidence of 30-day mortality was 9.8%, and the following factors were associated with a greater risk of mortality: male gender, increased respiratory rate and serum urea, decreased peripheral oxygen saturation and serum albumin, lower Glasgow Coma Score, and admission to intensive care unit. The area under the receiver operating characteristic curve for the model with the listed factors was 0.871 (95% CI, 0.844-0.898) in the development cohort and 0.783 (95% CI, 0.743-0.823) in the validation cohort. Calibration analysis found a close agreement between predicted and observed mortality risk. We conclude that the risk of mortality among ED patients could be accurately predicted by using common clinical signs and biochemical tests

Purification and characterization of a novel alginate lyase from a marine streptomyces species isolated from seaweed

Alginate, a natural polysaccharide derived from brown seaweed, is finding multiple applications in biomedicine via its transformation through chemical, physical, and, increasingly, enzymatic processes. In this study a novel alginate lyase, AlyDS44, was purified and characterized from a marine actinobacterium, Streptomyces luridiscabiei, which was isolated from decomposing seaweed. The purified enzyme had a specific activity of 108.6 U/mg, with a molecular weight of 28.6 kDa, and was composed of 260 amino acid residues. AlyDS44 is a bifunctional alginate lyase, active on both polyguluronate and polymannuronate, though it preferentially degrades polyguluronate. The optimal pH of this enzyme is 8.5 and the optimal temperature is 45¿C. It is a salt-tolerant alginate lyase with an optimal activity at 0.6 M NaCl. Metal ions Mn2+, Co2+, and Fe2+ increased the alginate degrading activity, but it was inhibited in the presence of Zn2+ and Cu2+. The highly conserved regions of its amino acid sequences indicated that AlyDS44 belongs to the polysaccharide lyase family 7. The main breakdown products of the enzyme on alginate were disaccharides, trisaccharides, and tetrasaccharides, which demonstrated that this enzyme acted as an endo-type alginate lyase. AlyDS44 is a novel enzyme, with the potential for efficient production of alginate oligosaccharides with low degrees of polymerization.T.N.T.N. would like to acknowledge the financial support provided by Flinders Research Scholarships, Flinders University, for offering the opportunity to complete her PhD project

Eco-friendly facile synthesis of Co3O4-Pt nanorods for ethylene detection towards fruit quality monitoring

Ethylene, a biomarker widely employed for evaluating fruit ripening during storage, exists at extremely low concentrations. Therefore a gas sensor with high sensitivity and a sub-ppm detection limit is needed. In this work, porous Co3O4 nanorods were synthesized through a hydrothermal method involving Co(NO3)2, Na2C2O4, H2O and ethylene glycol (EG), followed by annealing at 400 degrees C in air. The surface of the porous Co3O4 nanorods was functionalized with Pt nanoparticles to enhance the ethylene sensing performance. The effect of Co3O4 surface functionalisation with Pt nanoparticles was investigated by adding different amounts of nanoparticles. The sensor's outstanding performance at the optimum working temperature of 250 degrees C is attributed to the synergy between the high catalytic activity of Pt nanoparticles and the extensive surface area of the porous Co3O4 nanorods. Compared to pure Co3O4, the 0.031 wt% Pt sensor showed better ethylene sensing performance with a response 3.4 times that of pristine Co3O4. The device also demonstrated high selectivity, repeatability, long-term stability and a detection limit of 0.13 ppm for ethylene, which is adequate for fruit quality monitoring. The gas sensing mechanism of porous Co3O4 nanorods and the influence of Pt decoration on sensor performance are discussed

Chlorinated and brominated polycyclic aromatic hydrocarbons in ambient air: seasonal variation, profiles, potential sources, and size distribution

Chlorinated and brominated polycyclic aromatic hydrocarbons (ClPAHs and BrPAHs, respectively) are a new derivative group of PAHs. These halogenated PAHs (Halo-PAHs) have been reported to be carcinogenic and are considered emerging persistent organic pollutants. Gaining a clear understanding of the distribution and behavior of these ubiquitous organic pollutants is essential for the control and mitigation of their emission into the environment. However, research into the characteristics of Halo-PAHs in the atmosphere has been somewhat limited. This review paper thus aims to provide an overview of the seasonal patterns, profiles, potential sources, and particle-size distributions of atmospheric ClPAHs and BrPAHs with 3-5 rings. Most previous studies have focused on particulate Halo-PAHs and reported that their levels are higher during the cold season than during the warm season, with this seasonal variation more apparent for ClPAHs than for BrPAHs. In terms of their phase distribution, ClPAHs and BrPAHs share a similar trend, with their gaseous concentrations highest in summer and lowest in winter and their particulate concentrations exhibiting the opposite trend. Halo-PAH profiles have been shown to differ between sampling locations, possibly reflecting differences in the potential sources present at these sites, e.g., coal burning, traffic emissions, and industrial activity. The majority of Halo-PAHs tend to accumulate as ultrafine particles with an aerodynamic diameter of less than 1.0 mu m. Overall, a detailed understanding of the characteristics of Halo-PAHs in the atmosphere has yet to be achieved; hence, further research on atmospheric Halo-PAHs is necessary

Does female leadership matter in firm risk-taking and performance? Evidence from gender equality reforms in an emerging market

Our article examines the impact of board gender diversity and female leadership on firm risk-taking and firm performance in Vietnam under the implementation of the National Strategy on Gender Equality. We find that female CEOs are associated with lower firm risk-taking and an increase in firm accounting returns is attributed to a transition from male to female CEOs. Further, board gender diversity is independently identified to lower firm risk-taking and female leadership (i.e. female CEOs and chairwomen) generates higher accounting profit (measured by ROA) for their businesses under this reform agenda

A general network architecture for sound event localization and detection using transfer learning and recurrent neural network

Polyphonic sound event detection and localization (SELD) task is challenging because it is difficult to jointly optimize sound event detection (SED) and direction-of-arrival (DOA) estimation in the same network. We propose a general network architecture for SELD in which the SELD network comprises sub-networks that are pretrained to solve SED and DOA estimation independently, and a recurrent layer that combines the SED and DOA estimation outputs into SELD outputs. The recurrent layer does the alignment between the sound classes and DOAs of sound events while being unaware of how these outputs are produced by the upstream SED and DOA estimation algorithms. This simple network architecture is compatible with different existing SED and DOA estimation algorithms. It is highly practical since the sub-networks can be improved independently. The experimental results using the DCASE 2020 SELD dataset show that the performances of our proposed network architecture using different SED and DOA estimation algorithms and different audio formats are competitive with other state-of-the-art SELD algorithms. The source code for the proposed SELD network architecture is available at Github

Epidemiological features and risk factors of Salmonella gastroenteritis in children resident in Ho Chi Minh City, Vietnam.

Non-typhoidal Salmonella are an important but poorly characterized cause of paediatric diarrhoea in developing countries. We conducted a hospital-based case-control study in children aged 2 children (cases 20∙8%, controls 10∙2%; OR 2∙32, 95% CI 1∙2-4∙7). Our findings indicate that Salmonella are an important cause of paediatric gastroenteritis in this setting and we suggest that transmission may occur through direct human contact in the home

The value of daily platelet counts for predicting dengue shock syndrome: Results from a prospective observational study of 2301 Vietnamese children with dengue

BACKGROUND: Dengue is the most important mosquito-borne viral infection to affect humans. Although it usually manifests as a self-limited febrile illness, complications may occur as the fever subsides. A systemic vascular leak syndrome that sometimes progresses to life-threatening hypovolaemic shock is the most serious complication seen in children, typically accompanied by haemoconcentration and thrombocytopenia. Robust evidence on risk factors, especially features present early in the illness course, for progression to dengue shock syndrome (DSS) is lacking. Moreover, the potential value of incorporating serial haematocrit and platelet measurements in prediction models has never been assessed. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed data from a prospective observational study of Vietnamese children aged 5-15 years admitted with clinically suspected dengue to the Hospital for Tropical Diseases in Ho Chi Minh City between 2001 and 2009. The analysis population comprised all children with laboratory-confirmed dengue enrolled between days 1-4 of illness. Logistic regression was the main statistical model for all univariate and multivariable analyses. The prognostic value of daily haematocrit levels and platelet counts were assessed using graphs and separate regression models fitted on each day of illness. Among the 2301 children included in the analysis, 143 (6%) progressed to DSS. Significant baseline risk factors for DSS included a history of vomiting, higher temperature, a palpable liver, and a lower platelet count. Prediction models that included serial daily platelet counts demonstrated better ability to discriminate patients who developed DSS from others, than models based on enrolment information only. However inclusion of daily haematocrit values did not improve prediction of DSS. CONCLUSIONS/SIGNIFICANCE: Daily monitoring of platelet counts is important to help identify patients at high risk of DSS. Development of dynamic prediction models that incorporate signs, symptoms, and daily laboratory measurements, could improve DSS prediction and thereby reduce the burden on health services in endemic areas

Endemic fluoroquinolone-resistant Salmonellaenterica serovar Kentucky ST198 in Northern India

Salmonellaenterica serovar Kentucky is an emergent human pathogen. Human infection with ciprofloxacin-resistant S. enterica Kentucky ST198 has been reported in Europe and North America as a consequence of travel to Asia/the Middle East. This is, to the best of our knowledge, the first study reporting the identification of this epidemic clone in India and South Asia

Effect of the optimize heart failure care program on clinical and patient outcomes – The pilot implementation in Vietnam

Background: The Ho-Chi-Minh-city Heart Institute in Vietnam took part in the Optimize Heart Failure (OHF) Care Program, designed to improve outcomes following heart failure (HF) hospitalization by increasing patient awareness and optimizing HF treatment. Methods: HF patients hospitalized with left ventricular ejection-fraction (LVEF) <50% were included. Patients received guideline-recommended HF treatment and education. Clinical signs, treatments and outcomes were assessed at admission, discharge, 2 and 6 months (M2, M6). Patients’ knowledge and practice were assessed at M6 by telephone survey. Results: 257 patients were included. Between admission and M2 and M6, heart rate decreased significantly, and clinical symptoms improved significantly. LVEF increased significantly from admission to M6. 85% to 99% of patients received education. At M6, 45% to 78% of patients acquired knowledge and adhered to practice regarding diet, exercise, weight control, and detection of worsening symptoms. High use of renin-angiotensin-aldosterone-system inhibitors (91%), mineralocorticoid-receptor-antagonists (77%) and diuretics (85%) was noted at discharge. Beta-blocker and ivabradine use was less frequent at discharge but increased significantly at M6 (from 33% to 51% and from 9% to 20%, respectively, p < 0.001). There were no in-hospital deaths. Readmission rates at 30 and 60 days after discharge were 8.3% and 12.5%, respectively. Mortality rates at 30 days, 60 days and 6 months were 1.2%, 2.5% and 6.4%, respectively. Conclusions: The OHF Care Program could be implemented in Vietnam without difficulty and was associated with high usage of guideline-recommended drug therapy. Although education was delivered, patient knowledge and practice could be further improved at M6 after discharge