Congenital aneurysm of the muscular interventricular septum associated with bifascicular block

Isolated congenital aneurysm of the muscular interventricular septum is rare. We present a patient with congenital aneurysm of the basal muscular ventricular septum, who also develops conduction abnormalities with first-degree heart block, right bundle branch block, and left posterior fascicular block. The case details the natural history of the aneurysm over a 10-year period follow-up during which the patient remained asymptomatic with evidence of regression of the aneurysm. Given the aneurysm\u27s location close to the proximal right bundle and left posterior fascicle, we believe that the cause for the aneurysm also injured both fascicles resulting in bifascicular block. The diagnosis of bifascicular block was confirmed using the electrocardiogram-derived vectorcardiography loops. These conduction abnormalities have remained stable. The case illustrates the utility of vectorcardiography in diagnosing bundle branch conduction defects. The case also illustrates the importance of anatomical considerations when encountering congenital heart defects

Vietnamska konfucijanska diplomatska tradicija ter dopisovanje med zadnjimi predkolonialnimi odposlanci vladavine Nguyễn in Li Hongzhangom

The Vietnamese envoys’ records during their diplomatic journeys to Beijing, especially poems and prose, have attracted increasing academic attention, from both international and local scholars. Some studies have comprehensively examined the Vietnamese envoys’ routes when visiting China, literary works, diplomatic strategies, and Confucian beliefs, such as the Taiwanese scholar Chen Yiyuan’s (陳益源) journal paper, which specifically problematizes the absence of filial expression related to the envoys’ journey in Xiaogan (孝感), Hubei Province. The systematic works of Liam C. Kelley and Peng Qian (彭茜) chiefly delineate the harmonious and normal communication based upon the long-developed cultural congruity between Vietnam and China. Their studies and other relevant research show the sophisticated impact of Chinese Confucianism on the Vietnamese envoys. However, there is so far insufficient investigation into the official representatives’ transformation and violation of Confucian manners and thoughts at specific historical moments. Hence, this paper intends to specify the practices of Confucian discourses in the final negotiation between the states of the Nguyễn and the Qing in 1883, both of which encountered the military threat from France and other Western countries. Our findings suggest that although those last envoys, including Phạm Thận Duật and Nguyễn Thuật, utilised a Sinocentric and Confucian manner to bargain with the Chinese for military aid, overall the Nguyễn adopted a Machiavellian approach instead. This means there was a division between political utility and ritual ethics, and the Vietnamese envoys, as pragmatic politicians, prioritized national security while discussing military aid in terms of Confucian rhetoric and values.Mednarodna in domača akademska skupnost čedalje večjo pozornost posvečata zapisom vietnamskih odposlancev, še posebej poeziji in prozi, ki so nastajali med njihovimi diplomatskimi potovanji v Peking. Avtorji so se v posameznih študijah osredotočili na poti, po katerih so potovali vietnamski odposlanci po kitajskem ozemlju, različna literarna dela, diplomatske strategije in konfucijanske ideje. Te še posebej izpostavi tajvanski učenjak Chen Yiyuan (陳益源), ki v svoji razpravi problematizira odsotnost poslušnosti in spoštovanja starejših na potovanju odposlancev v Xiaogan (孝感) v provinci Hubei. Liam C. Kelley in Peng Qiang (彭茜) sistematično prikažeta običajno harmonično komunikacijo, temelječo na kulturni skladnosti med Vietnamom in Kitajsko, ki se je oblikovala v daljšem zgodovinskem obdobju. Tovrstne študije sicer podrobno prikažejo sofisticiran vpliv kitajskega konfucianizma na vietnamske odposlance, a hkrati je še vedno premalo raziskav o uradnih predstavnikih in njihovih transformacijah ter kršenju konfucijanskih načel in idej v specifičnih zgodovinskih trenutkih. Članek zato poskuša prikazati prakse konfucijanskega diskurza v zadnjih pogajanjih med vladavino Nguyễn in dinastijo Qing leta 1883, ko sta se obe državi soočali z vojaškimi grožnjami Francije in drugih zahodnih dežel. Kljub temu da so zadnji odposlanci, kot na primer Phạm Thận Duật in Nguyễn Thuật, sinocentrična in konfucijanska načela uporabili kot metodo za uspešno pogajanje s kitajsko stranjo za vojaško pomoč, je Nguyễn namesto tega raje prevzel machiavellistični pristop. To kaže na razcep med politično koristjo in ritualno etiko, pri čemer so vietnamski odposlanci kot pragmatični politiki v kontekstu konfucijanske retorike in vrednot pri pogajanjih o vojaški pomoči prednostno obravnavali nacionalno varnost

A Community Hospital Antimicrobial Stewardship Program’s Assessment of Prolonged Infusion Piperacillin-tazobactam for Pseudomonas Aeruginosa Pneumonia

Background: The study aim was to determine and compare the length of hospitalization, mortality, clinical stability, and time to clinical stability of a standard infusion (SI) and prolonged infusion (PI) piperacillin-tazobactam (TZP) in Pseudomonas aeruginosa ( PA) pneumonia patients. Methods: This retrospective study evaluated length of hospitalization, mortality, clinical stability, and time to clinical stability with either SI-TZP or PI-TZP therapy in hospitalized patients diagnosed with PA pneumonia between January 01, 2008 and June 30, 2014. Patients were included in the study if they received ≥2 days of TZP, were diagnosed with PA pneumonia, and had TZP therapy initiated within 3 days of the documented PA infection. Results: A similar proportion of patients achieved clinical stability between the PI (n=14, 70%) and SI (n=22, 67%) groups, (p=0.8). There was no statistically significant difference in the average time to clinical stability between the PI (mean=5.3±3.6) and SI (mean=5.8±6.8) groups, (p=0.77). The total length of stay in the PI group (mean=15.9±9.8) was shorter than in the SI group (mean=23.9±33) but did not achieve statistical significance, p=0.2. The 14-day all-cause mortality was similar between the two groups, PI (n=1, 5%) and SI (n=2, 6%). Conclusion: The use of PI TZP was equally effective as standard therapy. Further research is warranted to confirm these findings on the clinical benefits of prolonged infusion therapy

Deep Learning-Based Signal Detection for Dual-Mode Index Modulation 3D-OFDM

In this paper, we propose a deep learning-based signal detector called DuaIM-3DNet for dual-mode index modulation-based three-dimensional (3D) orthogonal frequency division multiplexing (DM-IM-3D-OFDM). Herein, DM-IM-3D- OFDM is a subcarrier index modulation scheme which conveys data bits via both dual-mode 3D constellation symbols and indices of active subcarriers. Thus, this scheme obtains better error performance than the existing IM schemes when using the conventional maximum likelihood (ML) detector, which, however, suffers from high computational complexity, especially when the system parameters increase. In order to address this fundamental issue, we propose the usage of a deep neural network (DNN) at the receiver to jointly and reliably detect both symbols and index bits of DM-IM-3D-OFDM under Rayleigh fading channels in a data-driven manner. Simulation results demonstrate that our proposed DNN detector achieves near-optimal performance at significantly lower runtime complexity compared to the ML detector

Electromagnetic form factor of pion from N_f=2+1 dynamical flavor QCD

We present a calculation of the electromagnetic form factor of the pion in $N_f=2+1$ flavor lattice QCD. Calculations are made on the PACS-CS gauge field configurations generated using Iwasaki gauge action and Wilson-clover quark action on a $32^3\times64$ lattice volume with the lattice spacing estimated as $a=0.0907(13)$ fm at the physical point. Measurements of the form factor are made using the technique of partially twisted boundary condition to reach small momentum transfer as well as periodic boundary condition with integer momenta. Additional improvements including random wall source techniques and a judicious choice of momenta carried by the incoming and outgoing quarks are employed for error reduction. Analyzing the form factor data for the pion mass at $M_\pi \approx 411$ MeV and 296 MeV, we find that the NNLO SU(2) chiral perturbation theory fit yields $=0.441 \pm 0.046 {\rm fm}^2$ for the pion charge radius at the physical pion mass. Albeit the error is quite large, this is consistent with the experimental value of $0.452\pm 0.011 {\rm fm}^2$. Below $M_\pi\approx 300$ MeV, we find that statistical fluctuations in the pion two- and three-point functions become too large to extract statistically meaningful averages on a $32^3$ spatial volume. We carry out a sample calculation on a $64^4$ lattice with the quark masses close to the physical point, which suggests that form factor calculations at the physical point become feasible by enlarging lattice sizes to $M_\pi L\approx 4$.Comment: 28 pages, 14 figure

Risk Factors of Streptococcus suis Infection in Vietnam. A Case-Control Study

Background: Streptococcus suis infection, an emerging zoonosis, is an increasing public health problem across South East Asia and the most common cause of acute bacterial meningitis in adults in Vietnam. Little is known of the risk factors underlying the disease. Methods and Findings: A case-control study with appropriate hospital and matched community controls for each patient was conducted between May 2006 and June 2009. Potential risk factors were assessed using a standardized questionnaire and investigation of throat and rectal S. suis carriage in cases, controls and their pigs, using real-time PCR and culture of swab samples. We recruited 101 cases of S. suis meningitis, 303 hospital controls and 300 community controls. By multivariate analysis, risk factors identified for S. suis infection as compared to either control group included eating "high risk" dishes, including such dishes as undercooked pig blood and pig intestine (OR1 = 2.22; 95% CI = [1.15-4.28] and OR2 = 4.44; 95% CI = [2.15-9.15]), occupations related to pigs (OR1 = 3.84; 95% CI = [1.32-11.11] and OR2 = 5.52; 95% CI = [1.49-20.39]), and exposures to pigs or pork in the presence of skin injuries (OR1 = 7.48; 95% CI = [1.97-28.44] and OR2 = 15.96; 95% CI = [2.97-85.72]). S. suis specific DNA was detected in rectal and throat swabs of 6 patients and was cultured from 2 rectal samples, but was not detected in such samples of 1522 healthy individuals or patients without S. suis infection. Conclusions: This case control study, the largest prospective epidemiological assessment of this disease, has identified the most important risk factors associated with S. suis bacterial meningitis to be eating 'high risk' dishes popular in parts of Asia, occupational exposure to pigs and pig products, and preparation of pork in the presence of skin lesions. These risk factors can be addressed in public health campaigns aimed at preventing S. suis infectio

Bamboo cellulose based single cell protein and nanocellulose by dilute sulfuric acid hydrolysis and fermentation

The novel and facile multi-stage method was used for the conversion of bamboo into nanocellulose and single cell protein. Firstly, the bamboo chips were treated with sodium hydroxide solution followed by hydrogen peroxide bleaching for obtaining cellulose pulp with a brightness of 80% ISO. In the second stage, the obtained bleached cellulosic pulp was achieved with a dilute sulfuric acid and hydrogen peroxide followed by filtration for obtaining the sugar solution, which than was treated and used for Candida utilis cultivation, and nanocellulose, which than was submerged purification and refining for obtaining nanocellulose fibers. The optimal conditions of the yeast cultivation were dertermined for obtaining the single cell protein with protein content of approx. 49.5 wt.%. For isolation of nanocellulose with fiber diameter < 100 nm were proposed: concentration of hydrogen peroxide 0.25 wt.%, the concentration of sulfuric acid 0.75 wt. %, liquor to cellulose ratio 8 to 1, temperature 140oC, time 120 min. The characteristics of nanocellulose were studied by SEM, FTIR, and XRD

Helicobacter pylori infection and gastroduodenal diseases in Vietnam: a cross-sectional, hospital-based study

<p>Abstract</p> <p>Background</p> <p>The rate of <it>H. pylori </it>infection in Vietnam is reportedly high, but the spectrum of <it>H. pylori</it>-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese <it>H. pylori </it>has also not been investigated in detail.</p> <p>Methods</p> <p>Individuals undergoing esophagogastroduodenoscopy were randomly recruited. <it>H. pylori </it>infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU) and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. <it>H. pylori </it>virulence factors were investigated by PCR and sequencing.</p> <p>Results</p> <p>Among the examined patients, 65.6% were infected with <it>H. pylori</it>. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all <it>H. pylori</it>-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of <it>vacA m1</it>, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among <it>H. pylori </it>isolates from Hanoi than among those from Ho Chi Minh.</p> <p>Conclusions</p> <p><it>H. pylori </it>infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. <it>vacA m1 </it>is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.</p