A High Precision, Wide Dynamic Range Closed-Loop Neuromodulation IC With Rapid Stimulation Artifact Recovery

This article presents a high precision, wide dynamic range (DR) closed-loop neuromodulation (CLNM) system that can completely reject stimulation artifacts (SA) and achieve rapid SA recovery. In the recorder, a novel SA quick-blanking scheme is proposed for rail-to-rail SA rejection while minimizing SA recovery time. Besides, a new analog front-end (AFE) architecture based on a frequency-shaping (FS) technique is developed to extend DR intrinsically. In the stimulator, a stimulation driver implemented with a proposed redundant crossfire (RXF) technique is incorporated to improve the effective resolution of the stimulation current. The designed CLNM system is implemented in a 180 nm Bipolar-CMOS-DMOS (BCD) process. Measurement results show that the system is capable of tolerating rail-to-rail (5 V) SA and reducing the SA recovery time from 12 ms to 0.15 ms. The FS recorder extends the DR at low frequencies (LF) to 17.5 bits to enhance tolerance to LF interferences. The proposed stimulator adopting the 4-way RXF topology improves the effective resolution to 12.75 bits without consuming much extra area and power. Animal experiments demonstrate that the designed system can acquire high-fidelity neural signals immediately after stimulation onsets, thus supporting concurrent recording and stimulation.

Analytical validation and clinical utilization of K-4CARE™: a comprehensive genomic profiling assay with personalized MRD detection

Background: Biomarker testing has gradually become standard of care in precision oncology to help physicians select optimal treatment for patients. Compared to single-gene or small gene panel testing, comprehensive genomic profiling (CGP) has emerged as a more time- and tissue-efficient method. This study demonstrated in-depth analytical validation of K-4CARE, a CGP assay that integrates circulating tumor DNA (ctDNA) tracking for residual cancer surveillance. Methods: The assay utilized a panel of 473 cancer-relevant genes with a total length of 1.7 Mb. Reference standards were used to evaluate limit of detection (LOD), concordance, sensitivity, specificity and precision of the assay to detect single nucleotide variants (SNVs), small insertion/deletions (Indels), gene amplification and fusion, microsatellite instability (MSI) and tumor mutational burden (TMB). The assay was then benchmarked against orthogonal methods using 155 clinical samples from 10 cancer types. In selected cancers, top tumor-derived somatic mutations, as ranked by our proprietary algorithm, were used to detect ctDNA in the plasma. Results: For detection of somatic SNVs and Indels, gene fusion and amplification, the assay had sensitivity of >99%, 94% and >99% respectively, and specificity of >99%. Detection of germline variants also achieved sensitivity and specificity of >99%. For TMB measurement, the correlation coefficient between whole-exome sequencing and our targeted panel was 97%. MSI analysis when benchmarked against polymerase chain reaction method showed sensitivity of 94% and specificity of >99%. The concordance between our assay and the TruSight Oncology 500 assay for detection of somatic variants, TMB and MSI measurement was 100%, 89%, and 98% respectively. When CGP-informed mutations were used to personalize ctDNA tracking, the detection rate of ctDNA in liquid biopsy was 79%, and clinical utility in cancer surveillance was demonstrated in 2 case studies. Conclusion: K-4CARE™ assay provides comprehensive and reliable genomic information that fulfills all guideline-based biomarker testing for both targeted therapy and immunotherapy. Integration of ctDNA tracking helps clinicians to further monitor treatment response and ultimately provide well-rounded care to cancer patients.

An MRI Compatible Data Acquisition Device for Rat Brain Recording Inside 16.4T Magnet

Concurrent recording of neural activities and functional magnetic resonance imaging (fMRI) data is useful for studying the neurovascular coupling relationship. This article presents a low-noise, frequency-shaping based neural recorder chip that is insensitive to radio frequency (RF) pulses and gradient echo artifacts under strong magnetic environment. To support simultaneous recording of local field potentials (LFPs), extracellular spikes, and fMRI data, a magnetic resonance imaging (MRI) compatible data acquisition (DAQ) device based on the designed recorder chip is developed with multiple circuit optimization techniques. Bench-top measurement shows that the designed DAQ device has 4.5 μV input-referred noise integrated from 300 Hz to 3000 Hz, which is not greatly affected by electromagnetic interference (EMI) at ultrahigh magnetic field (UMF, 16.4 T). In animal experiments, the designed DAQ device has been demonstrated to be capable of acquiring both the LFPs and extracellular spikes from a rat's brain before, during, and after MRI scanning. Besides, no obvious artifacts are seen from the designed DAQ device at multiple typical MRI scanning modes, and the system recovery time after gradient artifacts is reduced from more than 25 ms to less than 5 ms. The proposed DAQ device architecture based on the frequency-shaping neural recorder chip is MRI compatible and can provide highly competitive performance for concurrent recording of neural activities and fMRI data.

Enhanced Photothermal Effect Assisted by Resonance Energy Transfer in Carbon/Covellite Core-Shell Nanoparticles toward a High-Performance Interfacial Water Evaporation Process

Carbon and semiconductor nanoparticles are promising photothermal materials for various solar-driven applications. Inevitable recombination of photoinduced charge carriers in a single constituent, however, hinders the realization of a greater photothermal effect. Core-shell heterostructures utilizing the donor-acceptor pair concept with high-quality interfaces can inhibit energy loss from the radiation relaxation of excited species, thereby enhancing the photothermal effect. Here, core-shell structures composed of a covellite (CuS) shell (acceptor) and spherical carbon nanoparticle (CP) core (donor) (abbreviated as CP/CuS) are proposed to augment the photothermal conversion efficiency via the Förster resonance energy transfer (FRET) mechanism. The close proximity and spectral overlap of the donor and acceptor trigger the FRET mechanism, where the electronic excitation relaxation energy of the CP reinforces the plasmonic resonance and near-infrared absorption in CuS, resulting in boosting the overall photothermal conversion efficiency. CP/CuS core-shell coated on polyurethane (PU) foam exhibits a total solar absorption of 97.1%, leading to an elevation in surface temperature of 61.6 °C in dry conditions under simulated solar illumination at a power density of 1 kW m-2 (i.e., 1 sun). Leveraging the enhanced photothermal conversion emanated from the energy transfer effect in the core-shell structure, CP/CuS-coated PU foam achieves an evaporation rate of 1.62 kg m-2 h-1 and an energy efficiency of 93.8%. Thus, amplifying photothermal energy generation in core-shell structures via resonance energy transfer can be promising in solar energy-driven applications and thus merits further exploration.

Fungal Depletion Bolsters Anti-Tumor Immune Response Elicited by Anti-PD1 Alone and in Combination with Radiation Therapy

PURPOSE/OBJECTIVE(S)

Pembrolizumab in combination with chemotherapy has become the standard of care treatment for both metastatic and early-stage triple negative breast cancer (TNBC). Clinical trials are currently underway investigating the use of pembrolizumab with radiation in the neoadjuvant setting in early TNBC. Several groups have described a link between the microbiome and the efficacy of chemotherapy and anti-PD1 immune checkpoint inhibitors (ICIs) in preclinical models. Recent work from our lab has shown that targeting commensal fungi in the microbiome enhances the radiation induced antitumor immune response. Therefore, we hypothesized that fungal depletion might positively impact anti-PD1 therapy and combination treatment with anti-PD1 and radiation therapy (RT).

MATERIALS/METHODS

This study utilized an orthotopic syngeneic breast tumor model in which the syngeneic cell line E0771 was injected into the mammary fat pad of female C57BL/6 mice. Tumor-bearing mice were then treated with and without the antifungal fluconazole, anti-PD1, and radiation (16 Gy single fraction) using the X-RAD SmART platform with CT guidance. Tumor volumes were compared using 2-way ANOVA and survival curves analyzed using log rank. In a separate set of experiments, tumor-infiltrating immune cells were isolated and analyzed by high-dimensional multiplex flow cytometry.

RESULTS

We found that fungal depletion with fluconazole prior to treatment with anti-PD1 reduced the tumor volume and significantly improved survival in comparison to those treated with anti-PD1 alone (P = 0.0016). To identify what changes in the tumor immune microenvironment is driving this increased anti-tumor response, we performed flow cytometry on immune cells isolated from the tumors. We found that the use of fluconazole prior to anti-PD1 treatment reduced the proportion of CD11b+F4/80+ tumor-associated macrophages (TAMs) (P = 0.01) and increased tumor infiltrating cytotoxic T cell population (P = 0.04) when compared with the use of anti-PD1 alone. We also evaluated the effect of fungal depletion on combination therapy with RT and anti-PD1. Strikingly, we found that mice depleted of fungi with fluconazole prior to radiation and anti-PD1 therapy, have decreased tumor burden and significantly increased survival when compared to their fungally-intact counterparts (P = 0.043).

CONCLUSION

Our data indicates that the depletion of the gut fungal populations induces an increased antitumor response following anti-PD1 alone and in combination with radiation. This increased antitumor immune response is associated with an increase in the cytotoxic CD8+ T cell compartment with concomitant decrease in immunosuppressive tumor associated macrophages.

Non-Redundant Mechanisms of Immune Resistance to Radiotherapy Converge on Innate Immunity

PURPOSE/OBJECTIVE(S)

Despite evidence of preclinical synergy between radiotherapy (RT) and immune checkpoint blockade (ICB), randomized trials of RT/ICB have demonstrated limited benefit in solid tumors. We performed single-cell RNA sequencing (scRNA-seq) and CITE-seq (cellular indexing of transcriptomes and epitopes) to address the discordance between preclinical and clinical data. We hypothesized that multiple orthogonal inhibitory immune pathways restrain the local and systemic efficacy of RT beyond T-cell oriented immune checkpoints.

MATERIALS/METHODS

We used the EO771 syngeneic murine model of breast cancer to characterize the immune tumor microenvironment following RT with or without ICB. RT (16 Gy x 1) was delivered using the X-RAD SmART platform with CT image guidance. Neutralizing antibodies (anti-PD-1/Ly6G/Gr-1/CD47) were delivered by intraperitoneal injections. scRNA-seq analysis were performed by Seurat and BBrowser (BioTuring).

RESULTS

We found that adaptive ICB (anti-PD-1) reprogrammed the immune response to RT by promoting an M1-like interferon-primed state (ISG15, CXCL10) in tumor associated macrophages (TAMs) and by increasing the late recruitment of intratumoral neutrophils. Given that neutrophils may drive resistance to RT in other models, we evaluated the effect of intratumoral neutrophil depletion using anti-Ly6G or anti-Gr-1 on the antitumor efficacy of RT/ICB. Both neutrophil depletion strategies led to enhanced tumor control and improved survival in advanced EO771 tumors compared to RT/ICB alone (P<0.001). In parallel to this approach, we found that TAMs upregulated several innate immune checkpoints including SIRPα in response to RT. Disruption of the SIRPα-CD47 interaction by anti-CD47 antibodies similarly enhanced the antitumor efficacy of RT/ICB by improving tumor control and survival (P<0.001). Using scRNA-seq and unbiased clustering, we found that anti-CD47 eliminated an entire cluster of chronically inflamed TAMs, characterized by pro-inflammatory markers (IL1A, NOS2) and chemokines (CCL3, CXCL1/2/3). Anti-CD47 also reduced intratumoral neutrophils by eliminating a cluster of pathologically activated neutrophils, termed myeloid-derived suppressor cells (PMN-MDSCs) that expressed several markers of ferroptosis (TFRC, PTGS2, SLC3A2). Consistent with the potent immunosuppressive capacity of PMN-MDSCs, we found that anti-CD47 increased tumor-infiltrating lymphocytes including central memory TCF7+ T cells and CD19+ B cells. Lastly, by inference and analysis of cell-cell communication (CellChat), we found that anti-CD47 strengthened the interactions between TAMs and CD8+ T cells compared to RT/ICB alone.

CONCLUSION

Our data collectively indicate that resistance to RT/ICB in the EO771 model Is driven by innate immune cells including neutrophils and chronically inflamed TAMs. Targeted disruption of the CD47-SIRPα axis is a promising approach to overcoming immune resistance by reprogramming TAMs and eliminating PMN-MDSCs.

Reshaping Macrophage Polarization Potential Enhances Antitumor Immune Response to Radiation Therapy

PURPOSE/OBJECTIVE(S)

Although radiation therapy (RT) remains a cornerstone in the treatment of breast cancer, many trials combining RT with immune checkpoint blockade (ICB) have failed to demonstrate benefit in solid tumors including breast cancer. Maximal efficacy of RT relies on the generation of antitumor immunity following treatment which largely consists of cytotoxic T cells and macrophages. Broad depletion of macrophages modestly enhances tumor responses to RT suggesting that they can shape RT-induced antitumor immunity. Although IL4 signaling through GATA-3 is known to polarize T cells into the protumor Th2 phenotype, such central drivers of macrophage polarization are not well established. Given that macrophages abundantly express IL4 receptor, we hypothesized that GATA-3 may direct the transition of macrophages to M2/alternative phase and that genetic ablation of GATA-3 in macrophages can enhance antitumor immunity by arresting macrophage transition to an M2-like pro-tumor state.

MATERIALS/METHODS

We generated a macrophage specific GATA-3 KO mouse model (mG3KO) driven by the LysM-Cre promoter. Using a syngeneic orthotopic murine model of breast cancer (EO771), we evaluated the differential effect of RT (16Gy x 1) in WT and mG3KO mice. Multiparametric flow cytometry was performed to investigate the immune changes within the tumor microenvironment on day 3, day 5 and day 10 after RT. T cell depletion was performed using antibodies to CD4 and CD8 by intraperitoneal injections to understand the role of adaptive immunity in the response to RT in WT and mG3KO mice.

RESULTS

We found that mG3KO mice bearing advanced EO771 tumors demonstrated significantly improved tumor regression compared to WT mice (p<0.001), which translated to increased overall survival. In vitro characterization of bone-marrow derived macrophages from mG3KO and WT mice suggest that macrophages with ablated GATA-3 expressed increased levels of iNOS and decreased levels of Arginase (Arg-1), consistent with an M1-like phenotype. Immune profiling of the tumors also revealed that mGATA-3 KO animals have significant enrichment of CD8+ T cells in the tumor milieu post RT and these CD8+ T cells express higher amounts of interferon gamma (p<0.001) and Granzyme B (p<0.0015) than their WT counterparts. Using neutralizing antibodies to deplete CD8+ T cells, we show that anti-tumor effects in the mG3KO mice were abolished, suggesting that mG3KO macrophages impact survival, at least, in part by enhancing cytotoxic CD8+T cells. Studies are currently ongoing to reveal the detailed mechanism of GATA-3 ablation in improving the efficacy of RT.

CONCLUSION

Our data indicates that GATA-3 is a central regulator of macrophage polarization in response to RT. Further, directed ablation of GATA-3 appears to drive macrophages towards an M1-like phenotype, which enhances T cell recruitment to irradiated tumors. These data suggest that the antitumor efficacy of RT can be prolonged by targeting GATA-3-dependent signaling within myeloid cells.

Feasibility and Acceptability of ChatGPT Generated Radiology Report Summaries for Cancer Patients

PURPOSE/OBJECTIVE(S)

Patients now have direct access to their diagnostic imaging reports. However, they can include complex terminology that can be difficult for patients to understand. ChatGPT (OpenAI, San Francisco, CA) is an artificial intelligence (AI) text-generating model that can simplify complex text and generate human-like responses. We assessed ChatGPT's ability to generate summarized MRI reports for patients with prostate cancer and evaluated physician satisfaction with providing patients with an AI-summarized report.

MATERIALS/METHODS

We used ChatGPT to summarize five prostate cancer MRI reports performed at our institution from 2021-2022. Using a standard prompt, we asked ChatGPT to summarize the full MRI reports into a patient letter at a 6th grade reading level. To account for variability in text output, we generated three different summarized reports per unique MRI report. Full MRI and summarized reports were assessed for readability using Flesch-Kincaid Grade Level (FK) score. Radiation oncologists at our institution were asked to evaluate the summarized reports with an anonymous questionnaire. Physicians were shown two full MRI reports and three summarized versions for each full report. For each summarized report, physicians were asked six questions assessing the following: factual correctness, ease of understanding, completeness, potential for harm, overall quality, and likelihood they would send the report to a patient. Qualitative responses were given on a 1-5 Likert-type scale.

RESULTS

A total of 15 summarized reports were generated from five full MRI reports using ChatGPT. The median FK score for the full MRI reports and summarized reports was 9.6 vs. 5.0, (p<0.05), respectively. 12 radiation oncologists responded to our questionnaire with experience levels of: resident (25%), attending <5 years (33%), attending 5-10 years (17%), and attending >10 years (25%). The mean [SD] rating across all six summarized reports for each of the questions were: factual correctness (4.0 [0.6], understanding 4.0 [0.7]), completeness (4.1 [0.5]), potential for harm (3.5 [0.9]), overall quality (3.4 [0.9]), and likelihood to send to patient (3.1 [1.1]). 89%, 78%, and 93% of respondents answered agree or strongly agree for correctness, ease of understanding, and completeness of the summarized reports. 51%, 53%, and 46% of respondents answered agree or strongly agree for potential for harm, overall quality, and likelihood to send to patient.

CONCLUSION

ChatGPT was able to summarize prostate MRI reports at a reading level appropriate for patients. Physicians were likely to be satisfied with the summarized reports with respect to factual correctness, ease of understanding, and completeness. They were less likely to be satisfied with respect to potential for harm, overall quality, and likelihood to send to patients. Further research is needed to optimize ChatGPT's ability to summarize radiology reports for patients and understand what factors influence physician trust in AI-summarized reports.

Intrathoracic herniation of retrosternal gastric conduit after thoracolaparoscopic esophagectomy causing gastric conduit obstruction: A case report

INTRODUCTION AND IMPORTANCE

Intrathoracic herniation of gastric conduit (IHGC) is a specific complication following esophagectomy with retrosternal gastric pull-up but is not well recognized. Diagnosis and management are challenging due to the lack of literature reviews.

CASE PRESENTATION

We report a 50-year-old man where a reconstructed gastric conduit hernia into the mediastinal pleural cavity after esophagectomy. The patient underwent minimally invasive esophagectomy with cervical anastomosis for middle esophageal carcinoma followed by retrosternal reconstruction; during the tunneling phase, the mediastinal pleura was injured. Subsequently, the patient developed progressive dysphagia postoperatively, and chest CT scans revealed that the dilating gastric tube had moved into the mediastinal pleural cavity.

CLINICAL DISCUSSION

After ruling out the pyloric stenosis by endoscopy, our diagnosis was severe gastric outlet obstruction due to gastric conduit herniation. We performed laparoscopic surgery to mobilize and straighten the redundant gastric conduit. No recurrence occurred throughout the follow-up for one year.

CONCLUSION

IHGC can cause gastric conduit obstruction, which requires reoperation to repair. The laparoscopic approach is an appropriate strategy with the advantages of being less invasive and effective in mobilizing and straightening the gastric conduit. To prevent mediastinal pleural injury - which affects the continuation of the reconstructions, the surgeon should use blunt dissection with direct observation during the route creation.

Deposition of Ultrathin MgB2 Films from a Suspension Using Cosolvent Marangoni Flow

Magnesium diboride (MgB₂) has demonstrated, theoretically and experimentally, promise as a candidate material for hydrogen storage and has thus attracted much contemporary research interest. To study hydrogen gas adsorption on MgB₂ thin films using a quartz crystal microbalance (QCM)─a workhorse apparatus for this specific experiment─MgB₂ must be deposited uniformly on the active surface of the QCM without damaging the quartz's performance. In work presented here, a wet-chemistry colloid synthesis and deposition process of a MgB₂ thin film on a gold (Au) surface was established to avoid the extreme conditions of conventional physical deposition methods. This process also counteracts the unwanted phenomena of drying droplets on a solid surface, particularly the coffee-ring effect. To verify the normal function of the QCM after MgB₂ deposition and its ability to obtain meaningful data, simple gas adsorption tests were conducted on the QCM, and the MgB₂ film on the QCM was characterized with X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM) for elemental analysis and surface roughness, respectively. To obtain information about the thickness and the involvement of the coffee-ring effect, the same synthesis route was applied on a similar gold substrate─an evaporated Au film on glass. XPS characterization of the film and its precursor suspension shows the potential existence of both MgB₂ and its oxide forms. The film's thickness on evaporated Au was measured by scanning transmission electron microscopy (STEM) to be 3.9 nm. The resulting samples show mitigation of the coffee-ring effect through roughness measurements with AFM at two scan sizes of 50 × 50 and 1 × 1 μm².

Oral Lichen Planus in Patients With Good's Syndrome: A Literature Review

Good's syndrome is defined as the association of a thymoma with an immune deficiency. Many patients with Good's syndrome also have oral lichen planus involvement, and some authors have even considered it to be one of the clinical signs of Good's syndrome. In the literature, to our knowledge, clinical forms of oral lichen planus associated with Good's syndrome have not been described. We therefore aimed to characterize the forms of oral lichen planus occurring in the context of Good's syndrome. To this end, we carried out a scoping review of the literature according to the Joanna Briggs Institute guide and included 17 articles on the theme of "the forms and clinical locations of oral lichen planus associated with Good's syndrome". A total of 17 articles were selected, and 19 patients with Good's syndrome including oral lichen planus were identified. Most of them were women aged 60 years with erosive oral lichen planus of the tongue and inner cheeks. The treatments used were thymectomy, to which immunoglobulin infusions were added in some cases. All these treatments resulted in improvement of the oral lichen planus in 70.6% of cases. The management of Good's syndrome allows the improvement of oral lichen. In patients over 50 years of age with acute erosive oral lichen planus refractory to conventional therapies, Good's syndrome should be investigated.

Real-Time Monitoring of Biofilm Formation Using a Noninvasive Impedance-Based Method

Biofilms are complex three-dimensional microbial communities that adhere to a variety of surfaces and interact with their surroundings. Because of the dynamic nature of biofilm formation, establishing a uniform technique for quantifying and monitoring biofilm volume, shape, and features in real-time is challenging. Herein, we describe a noninvasive electrochemical impedance approach for real-time monitoring of dental plaque-derived multispecies biofilm growth on a range of substrates. A working equation relating electrochemical impedance to live biofilm volume has been developed that is applicable to all three surfaces examined, including glass, dental filling resin, and Ca2+-releasing resin composites. Impedance changes of 2.5, 35, 50, and 65% correlated to biofilm volumes of 0.10 ± 0.01, 16.9 ± 2.2, 29.7 ± 2.3, and 38.6 ± 2.8 μm3/μm2, respectively. We discovered that glass, dental filling resin, and Ca2+-releasing dental composites required approximately 3.5, 4.5, and 6 days, respectively, to achieve a 50% change in impedance. The local pH change at the biofilm-substrate interfaces also monitored with potentiometry pH microsensor, and pH change varied according to biofilm volume. This impedance-based technique can be a useful analytical method for monitoring the growth of biofilms on a variety of substrates in real-time. Therefore, this technique may be beneficial for examining antibacterial properties of novel biomaterials.

Performances of Dried Blood Spots and Point-of-Care Devices to Identify Virological Failure in HIV-Infected Patients: A Systematic Review and Meta-Analysis

To broaden access to HIV viral load monitoring (VLM), the use of blood samples from dried blood spots (DBS) or point-of-care (POC) devices, could be of great help in settings where plasma is not easily accessible. The variety of assays available makes the choice complex. This systematic review and meta-analysis aims to estimate the sensitivity and specificity of DBS and POC devices to identify patients in virological failure using World Health Organization (WHO) recommendations (viral load ≥1000 copies/mL), compared with plasma, for the assays currently available. Four databases were searched for articles, and two reviewers independently identified articles reporting sensitivity and specificity of DBS and/or POC to identify patients in virological failure. We excluded articles that used other thresholds as well as articles with a total number of participants below 50 to avoid reporting bias. Heterogeneity and factors associated with assays' performances were assessed by I² statistics and metaregression. The protocol of this review follows the PRISMA guidelines. Out of 941 articles, 47 were included: 32 DBS evaluations and 16 POC evaluations. Overall, when using DBS, the Abbott RT HIV-1, Roche CAP-CTM, NucliSENS BioMerieux and Aptima assays presented sensitivity and specificity exceeding 85%, but reported results were highly heterogeneous. Factors associated with better performances were high volume of blood and the use of the same assay for DBS and plasma VLM. Regarding the POC devices, SAMBA I, SAMBA II, and GeneXpert devices presented high sensitivity and specificity exceeding 90%, with less heterogeneity. DBS is suitable VLM, but performances can vary greatly depending on the protocols, and should be performed in trained centers. POC is suitable for VLM with less risk of heterogeneity but is more intensive in costs and logistics.

An intervention pilot to facilitate harm reduction service decentralization in Vietnam

INTRODUCTION

Harm reduction services, including methadone maintenance therapy (MMT), have been decentralized to Vietnam's community health care settings. This study aims to pilot test an intervention to facilitate decentralized harm reduction service delivery in Vietnam.

METHODS

The research team conducted an intervention pilot between August 2020 and May 2021 with six community MMT distribution sites in Thai Nguyen Province of Vietnam. We recruited five commune health workers (CHW) from each center (N = 30). In-person intervention training included content to correct misconceptions about harm reduction and reduce stigmatizing attitudes toward patients who use drugs and teach CHWs to self-examine and improve their service provision process. The study team developed a web-based platform to streamline CHW's patient monitoring and referral efforts. The team assessed intervention outcomes at baseline, 3-, and 6-months. CHWs in the intervention group provided acceptability ratings and feedback on the intervention at 6-months.

RESULTS

CHWs in both intervention and control groups had similar background characteristics and outcome measures at baseline. CHWs in the intervention group, compared to those in the control group, showed a significantly higher level of improvement in adherence to service delivery protocol at 3-months. CHW in the intervention group had a significantly lower level of management-related stress compared to the control group at 6-months, although the intervention effect measured by the difference in change from baseline was not statistically significant. CHWs who participated in the final focus group reported high acceptability of the intervention.

CONCLUSION

This intervention pilot demonstrated acceptability and promising outcomes on community-based harm reduction service delivery. Similar intervention strategies can be applied to enhance the decentralization of other chronic disease treatment services.

Cystic pulmonary tuberculosis: A rare form of an ancient disease

Cystic pulmonary tuberculosis is a unique form of pulmonary tuberculosis (PTB) presenting with multiple reversible cysts of the lung. Unlike the other forms, this cystic lung disease can improve with prompt tuberculosis treatments. Here we report the case of a 15‐year‐old girl who presented with respiratory failure and severe lung damage at hospital admission. We diagnosed her with PTB based on her positive GeneXpert result test. The patient was treated with a standard tuberculosis regimen for 6 months and recovered completely.

Enhancing the electrical properties of graphite nanoflake through gamma-ray irradiation

Understanding changes in material properties through external stimuli is critical to validating the expected performance of materials as well as engineering material properties in a controlled manner. Here, we investigate a change in the c-axis electrical properties of graphite nanoflakes (GnFs) induced by gamma-ray irradiation, using conductive probe atomic force microscopy (CP-AFM). The fundamentals behind the change in their electrical properties are elucidated by analyzing the interlayer spacing, graphitization, and morphology. An increase in gamma-ray irradiation dose for GnFs leads to an exponential increase in the electrical conductance and a gradual decrease in the interlayer spacing, while accompanying indistinguishable changes in their morphology. Our experimental results suggest that the c-axis electrical conductance enhancement of GnFs with gamma-ray irradiation might be attributed to a reduction in interlayer spacing, though the created defects may also play a role. This study demonstrates that gamma-ray irradiation can be a promising route to tailor the electrical properties of GnFs.

Effects of gonadotropins, 11-ketotestosterone, and insulin-like growth factor-1 on target gene expression and growth of previtellogenic oocytes from shortfinned eels, Anguilla australis, in vitro

Pituitary gonadotropins, metabolic hormones, and sex steroids are known factors affecting the advanced stages of ovarian development in teleost fish. However, the effects of these hormones and of the interactions between them on the growth of previtellogenic ovarian follicles are not known. In order to address this void in understanding, previtellogenic ovarian fragments from eel, Anguilla australis, were incubated in vitro with recombinant Japanese eel follicle-stimulating hormone (rec-Fsh), human chorionic gonadotropin (hCG), or 11-ketotestosterone (11-KT) in the presence or absence of recombinant human insulin-like growth factor-1 (IGF1). The results of long-term in vitro culture (21 days) demonstrated that rec-Fsh and 11-KT, rather than hCG, caused significant increases in the diameter of previtellogenic oocytes. Meanwhile, only 11-KT induced a significant increase in lipid accumulation. Moreover, a greater effect on oocyte growth was observed when IGF1 supplementation was combined with 11-KT rather than with rec-Fsh or hCG. For short-term culture (24 h), treatment with 11-KT in the presence or absence of IGF1 had no significant effects on mRNA levels of target genes (lhr, cyp19, cyp11b, lpl, and ldr) except for upregulation of fshr. There were no significant effects of rec-Fsh on expression of any target gene, whereas hCG downregulated the expression of these genes. There was no evidence for any interaction between the gonadotropins and IGF1 that resulted in growth of previtellogenic oocytes. Taken together, these results suggest that hormones from both the reproductive and the metabolic axes regulate the growth of previtellogenic oocytes in Anguilla australis.

Phytochemicals, Antiinflammatory, and Analgesic Effects of the Ethanol Extract From the Leaves of Premna Flavescens Wall. ex C. B. Clarke

In the current study, the ethanol extract of Premna flavescens leaves (EPF) was evaluated for its in vivo antiinflammatory, analgesic potentials, and acute oral toxicity. The analgesic potential was assessed through the acetic acid-induced writhing test, and the antiinflammatory characteristic was determined through the carrageenan-induced paw edema test in mice. The analgesic experimental results indicated that at a dose of 750 mg/kg, EPF exhibited nearly the same effect as aspirin at a dose of 100 mg/kg. carrageenan-induced paw edema inflammation in experimental mice treated with EPF at a dose of 750 mg/kg was significantly reduced after 5 h of carrageenan injection. EPF did not show acute oral toxicity at the highest dose of 5 g/kg. Six compounds were isolated from EPF: friedelin (1), friedelinol (2), holoptelin B (3), ethyl p-methoxycinamate (4), 3β-hydroxy stigmast-5-en-7-one (5), and n-triacontanol (6). Compounds 1, 2, and 6 were isolated from P flavescens for the first time, while compounds 3, 4, and 5 were reported from the genus Premna for the first time. These findings give more scientific evidence for the traditional medicinal use of this plant to treat rheumatism and osteoarthritis.

Real-time monitoring of the pH microenvironment at the interface of multispecies biofilm and dental composites

Bacterial-mediated local pH change plays an important role in altering the integrity of resin dental composite materials in a dynamic environment such as the oral cavity. To address this, we developed a 300-μm-diameter, flexible, solid-state potentiometric pH microsensor capable of detecting and quantifying the local pH microenvironment at the interface of multispecies biofilm and dental resin in real time over 10 days. We used fluorinated poly(3,4-ethylenedioxythiophene) as the back contact in our newly developed pH sensor, along with a PVC-based ion-selective membrane and PTFE-AF coating. The high temporal resolution pH data demonstrated pH changes from 7 to 6 and 7 to 5.8 for the first 2 days and then fluctuated between 6.5 to 6 and 6 to 5.5 for the remaining 8 days with the resin composite or glass slide substrate respectively. We could observe the fluctuations in pH mediated by lactic acid production within the biofilm and the re-establishment of pH back to 7. However, acid production started to overwhelm buffering capacity with the continuous feed of sucrose cycles and reduced the local pH nearer to 5.5. No such changes or fluctuations were observed above the biofilm, as the pH remained at 7.0 ± 0.2 for 10 days. The localized real-time monitoring of the pH within the biofilm showed that the pH shift underneath the biofilm could lead to damage to the underlying material and their interface but cannot be sensed external to the biofilm.

Artificial Intelligence Enables Real-Time and Intuitive Control of Prostheses via Nerve Interface

OBJECTIVE

The next generation prosthetic hand that moves and feels like a real hand requires a robust neural interconnection between the human minds and machines.

METHODS

Here we present a neuroprosthetic system to demonstrate that principle by employing an artificial intelligence (AI) agent to translate the amputees movement intent through a peripheral nerve interface. The AI agent is designed based on the recurrent neural network (RNN) and could simultaneously decode six degree-of-freedom (DOF) from multichannel nerve data in real-time. The decoder's performance is characterized in motor decoding experiments with three human amputees.

RESULTS

First, we show the AI agent enables amputees to intuitively control a prosthetic hand with individual finger and wrist movements up to 97-98% accuracy. Second, we demonstrate the AI agent's real-time performance by measuring the reaction time and information throughput in a hand gesture matching task. Third, we investigate the AI agent's long-term uses and show the decoder's robust predictive performance over a 16-month implant duration. Conclusion & significance: Our study demonstrates the potential of AI-enabled nerve technology, underling the next generation of dexterous and intuitive prosthetic hands.

Emergence of amoxicillin resistance and identification of novel mutations of the pbp1A gene in Helicobacter pylori in Vietnam

Background

Amoxicillin-resistant Helicobacter pylori (H. pylori) strains seem to have increased over time in Vietnam. This threatens the effectiveness of H. pylori eradication therapies with this antibiotic. This study aimed to investigate the prevalence of primary resistance of H. pylori to amoxicillin and to assess its association with pbp1A point mutations in Vietnamese patients.

Materials and methods

Naive patients who presented with dyspepsia undergoing upper gastrointestinal endoscopy were recruited. Rapid urease tests and PCR assays were used to diagnose H. pylori infection. Amoxicillin susceptibility was examined by E-tests. Molecular detection of the mutant pbp1A gene conferring amoxicillin resistance was carried out by real-time PCR followed by direct sequencing of the PCR products. Phylogenetic analyses were performed using the Tamura-Nei genetic distance model and the neighbor-joining tree building method.

Results

There were 308 patients (46.1% men and 53.9% women, p = 0.190) with H. pylori infection. The mean age of the patients was 40.5 ± 11.4 years, ranging from 18 to 74 years old. The E-test was used to determine the susceptibility to amoxicillin (minimum inhibitory concentration (MIC) ≤ 0.125 μg/ml) in 101 isolates, among which the rate of primarily resistant strains to amoxicillin was 25.7%. Then, 270 sequences of pbp1A gene fragments were analysed. There were 77 amino acid substitution positions investigated, spanning amino acids 310–596, with the proportion varying from 0.4 to 100%. Seven amino acid changes were significantly different between amoxicillin-sensitive (Amox^S) and amoxicillin-resistant (Amox^R) samples, including Phe₃₆₆ to Leu (p <  0.001), Ser₄₁₄ to Arg (p <  0.001), Glu/Asn_464–465 (p = 0.009), Val₄₆₉ to Met (p = 0.021), Phe₄₇₃ to Val (p <  0.001), Asp₄₇₉ to Glu (p = 0.044), and Ser/Ala/Gly_595–596 (p = 0.001). Phylogenetic analyses suggested that other molecular mechanisms might contribute to amoxicillin resistance in H. pylori in addition to the alterations in PBP1A.

Conclusions

We reported the emergence of amoxicillin-resistant Helicobacter pylori strains in Vietnam and new mutations statistically associated with this antimicrobial resistance. Additional studies are necessary to identify the mechanisms contributing to this resistance in Vietnam.

What management for epidermal growth factor receptor-mutated non-small-cell lung cancer, with squamous cell transformation and T790M-acquired resistance mechanisms? A Case report and review of literature

Histological transformation into squamous cell carcinoma (SCC) is a rare mechanism of resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors. Its pathophysiology remains unclear and its management is particularly challenging. We report on tumor progression with SCC histological transformation associated with the T790M mutation in a patient with stage IV bronchial adenocarcinoma with an L858R mutation of the EGFR gene and treated with gefitinib. We will discuss the importance of liquid and tumor biopsy in the diagnostic management of resistance mechanisms as well as therapeutic management options.

Mathematical models to describe the growth curves of Vietnamese Ri chicken

Ri chicken is the most popular backyard chicken breed in Vietnam, but little is known about the growth curve of this breed. This study compared the performances of models with three parameters (Gompertz, Brody, and Logistic) and models containing four parameters (Richards, Bridges, and Janoschek) for describing the growth of Ri chicken. The bodyweight of Ri chicken was recorded weekly from week 1 to week 19. Growth models were fitted using minpack.lm package in R software and Akaike's information criterion (AIC), Bayesian information criterion (BIC), and root mean square error (RMSE) were used for model comparison. Based on these criteria, the models having four parameters showed better performance than the ones with three parameters, and the Richards model was the best one for males and females. The lowest and highest value of asymmetric weights (α) were obtained by Bridges and Brody models for each of sexes, respectively. Age and weight estimated by the Richard model were 8.46 and 7.51 weeks and 696.88 and 487.58 g for males and for females, respectively. Differences in the growth curves were observed between males and female chicken. Overall, the results suggested using the Richards model for describing the growth curve of Ri chickens. Further studies on the genetics and genomics of the obtained growth parameters are required before using them for the genetic improvement of Ri chickens.

Do inequalities exist in housing and working conditions among local and migrant industrial workers in Vietnam? Results from a multi-site survey

BACKGROUND

While internal migrants in Vietnam have been a key driving force in the country's rapid economic development, they also face many vulnerabilities. Our study seeks to explore possible inequalities in housing and working conditions between local and internal migrant industrial workers in Vietnam.

METHODS

Cross-sectional surveys were conducted with 1200 industrial workers in four regions of Vietnam. Dependent variables included housing conditions (satisfaction with convenience of accommodation, sanitation and water of accommodation, and accommodation in general) and working conditions (satisfaction with income, monthly income, number of hazardous working conditions, and work-related stress measured through the modified Effort-Reward Imbalance Questionnaire). The primary independent variable is migrant status. Covariates included region, gender, education, marital status, accommodation status, living arrangements, industry, age, monthly income, experience, and working hours.

RESULTS

Of the sample, 24.7% (n=296) were migrants. Overall, no differences were found regarding housing conditions by migrant status. In adjusted regression models, migrants reported higher numbers of hazardous working conditions (β=0.07, 95%CI=0.01-0.13, p=.01) and higher monthly income (β=0.05, 95%CI=0.01-0.09, p=.02).

DISCUSSION

Recent state-level changes in the Vietnamese household registration system may explain the lack of differences in housing conditions by migrant status. Future research should utilize longitudinal designs to examine impacts over time of state policy on migrants' housing conditions as well as well-being. Regarding working conditions, findings highlight the need for stronger social protection policy and better information channels on occupational health and safety for migrants. Further research, including qualitative studies, is needed to explore why migrants face more hazardous working conditions.

A portable, self-contained neuroprosthetic hand with deep learning-based finger control

Objective.Deep learning-based neural decoders have emerged as the prominent approach to enable dexterous and intuitive control of neuroprosthetic hands. Yet few studies have materialized the use of deep learning in clinical settings due to its high computational requirements.Approach.Recent advancements of edge computing devices bring the potential to alleviate this problem. Here we present the implementation of a neuroprosthetic hand with embedded deep learning-based control. The neural decoder is designed based on the recurrent neural network architecture and deployed on the NVIDIA Jetson Nano-a compacted yet powerful edge computing platform for deep learning inference. This enables the implementation of the neuroprosthetic hand as a portable and self-contained unit with real-time control of individual finger movements.Main results.A pilot study with a transradial amputee is conducted to evaluate the proposed system using peripheral nerve signals acquired from implanted intrafascicular microelectrodes. The preliminary experiment results show the system's capabilities of providing robust, high-accuracy (95%-99%) and low-latency (50-120 ms) control of individual finger movements in various laboratory and real-world environments.Conclusion.This work is a technological demonstration of modern edge computing platforms to enable the effective use of deep learning-based neural decoders for neuroprosthesis control as an autonomous system.Significance.The proposed system helps pioneer the deployment of deep neural networks in clinical applications underlying a new class of wearable biomedical devices with embedded artificial intelligence.Clinical trial registration: DExterous Hand Control Through Fascicular Targeting (DEFT). Identifier: NCT02994160.

Self-Assembly of Porphyrin Nanofibers on ZnO Nanoparticles for the Enhanced Photocatalytic Performance for Organic Dye Degradation

Synthesizing novel photocatalysts that can effectively harvest photon energy over a wide range of the solar spectrum for practical applications is vital. Porphyrin-derived nanostructures with properties similar to those of chlorophyll have emerged as promising candidates to meet this requirement. In this study, tetrakis(4-carboxyphenyl) porphyrin (TCPP) nanofibers were formed on the surface of ZnO nanoparticles using a simple self-assembly approach. The obtained ZnO/TCPP nanofiber composites were characterized via scanning electron microscopy, X-ray diffraction analysis, and ultraviolet-visible absorbance and reflectance measurements. The results demonstrated that the ZnO nanoparticles with an average size of approximately 37 nm were well integrated in the TCPP nanofiber matrix. The resultant composite showed photocatalytic activity of ZnO and TCPP nanofibers concomitantly, with band gap energies of 3.12 and 2.43 eV, respectively. The ZnO/TCPP photocatalyst exhibited remarkable photocatalytic performance for RhB degradation with a removal percentage of 97% after 180 min of irradiation under simulated sunlight because of the synergetic activity of ZnO and TCPP nanofibers. The dominant active species participating in the photocatalytic reaction were •O2 - and OH•, resulting in enhanced charge separation by exciton-coupled charge-transfer processes between the hybrid materials.

Biogeochemical functioning of an urbanized tropical estuary: Implementing the generic C-GEM (reactive transport) model

Estuaries are amongst the most productive ecosystems of the land ocean continuum, but they are also under high anthropic pressures due to coastal urbanization. Too sparse observations have hindered the understanding of complex interactions between water quality and estuarine hydrodynamics and biogeochemical transformations. Until now, estuarine modelling studies have mainly focused on temperate estuarine systems in industrialized countries. This study investigates the responses of a tropical estuary to pollution load from a megacity (Ho Chi Minh City, Southern Vietnam) by applying a one-dimensional, biogeochemical estuarine model (C-GEM). The Saigon River Estuary flows through the megacity of Ho Chi Minh (HCMC) and is subject to episodic hypoxia events due to wastewater inputs from urban discharges. Good agreements are found between simulation outputs and observations for tidal propagation, salinity, total suspended sediment, and water quality variables in dry season in Saigon River Estuary. C-GEM reproduces the increases in ammonium, total organic carbon, phytoplankton and dissolved oxygen depletion in the urban section of the Saigon River as an impact of untreated wastewaters from HCMC. The steady-state version of C-GEM also reveals the formation of a pollutant cloud (30-km stretch) resulting from the combined effects of tidal fluctuation and low flushing capacity during the dry season. Furthermore, the quantification of the reaction fluxes simulated by the model demonstrates that nitrification is the main process removing NH₄⁺ from the Saigon River. For the first time in such a type of environment, our study demonstrates the effectiveness of C-GEM at unraveling the complex interplay between biogeochemical reactions and transport in a tropical estuary with a minimized data requirement. This is significant for tropical estuaries in developing countries, where intensive monitoring programs are rare and have thus been rarely the object of modelling investigations.

Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020-2030 in four countries

Background

We aimed to estimate the disease burden of Tuberculosis (TB) and return on investment of TB care in selected high-burden countries of the Western Pacific Region (WPR) until 2030.

Methods

We projected the TB epidemic in Viet Nam and Lao People's Democratic Republic (PDR) 2020–2030 using a mathematical model under various scenarios: counterfactual (no TB care); baseline (TB care continues at current levels); and 12 different diagnosis and treatment interventions. We retrieved previous modeling results for China and the Philippines. We pooled the new and existing information on incidence and deaths in the four countries, covering >80% of the TB burden in WPR. We estimated the return on investment of TB care and interventions in Viet Nam and Lao PDR using a Solow model.

Findings

In the baseline scenario, TB incidence in the four countries decreased from 97•0/100,000/year (2019) to 90•1/100,000/year (2030), and TB deaths from 83,300/year (2019) to 71,100/year (2030). Active case finding (ACF) strategies (screening people not seeking care for respiratory symptoms) were the most effective single interventions. Return on investment (2020–2030) for TB care in Viet Nam and Lao PDR ranged US$4-US$49/dollar spent; additional interventions brought up to US$2•7/dollar spent.

Interpretation

In the modeled countries, TB incidence will only modestly decrease without additional interventions. Interventions that include ACF can reduce TB burden but achieving the End TB incidence and mortality targets will be difficult without new transformational tools (e.g. vaccine, new diagnostic tools, shorter treatment). However, TB care, even at its current level, can bring a multiple-fold return on investment.

Funding

World Health Organization Western Pacific Regional Office; Swiss National Science Foundation Grant 163878.

Observer-based deadbeat predictive speed controller for surface-mounted PM synchronous motor

This paper investigates an observer-based deadbeat predictive speed controller (DBPSC) for a prototype surface-mounted permanent magnet synchronous motor (SPMSM) drive system. Unlike the conventional deadbeat controllers which are mainly used for deadbeat current control in the inner loop in a cascaded control structure, the proposed deadbeat controller is designed by incorporating a speed controller with a load torque disturbance observer. Specifically the proposed deadbeat speed control law consists of a deadbeat stabilizing feedback control term and a compensation control term. The stability of the proposed closed-loop system is assured based on the former term by forcing all poles of the dynamic error vector toward the origin within a short transient time, which guarantees a fast transient response of the control system by using the solution of an optimal control problem. The latter term is proposed based on the predicted q-axis current to compensate for the model nonlinearities and parameter uncertainties. Next, the deadbeat load torque observer (DBLTO) is proposed to provide a precisely estimated load torque with a high estimation rate for the predicted q-axis current in the latter term, which helps the proposed scheme in obtaining a small steady-state error (SSE), a low total harmonic distortion (THD), and robustness against the parameter variations. In addition, the proposed scheme possesses a simple structure, so it reduces the computational burden for digital implementation. The Lyapunov theory is utilized in the stability proof process of the proposed observer-based method. Finally, the comparative studies between the proposed DBPSC and a conventional deadbeat speed controller (DBSC) are performed under the sudden changes of speed and load torque through simulations on MATLAB/Simulink and experiments on a prototype SPMSM drive using a TI TMS320F28335 DSP platform.

Changes in, and predictors of, quality of life among patients with unstable angina after percutaneous coronary intervention

RATIONALE, AIMS AND OBJECTIVES

Changes in, and predictors of, quality of life (QoL) among unstable angina patients are informative for both clinical and public health practice. However, there is little research on this topic, especially in health care settings with limited resources. This study aims to detect changes in QoL and its associated factors among patients with unstable angina after percutaneous coronary intervention.

METHODS

A longitudinal design was conducted with two repeated rounds of measurements, 1 and 3 months after intervention, using the generic SF-36 questionnaire, in 120 patients from Vietnam National Heart Institute. A linear mixed-effects model was used to assess changes in patient QoL over time while adjusting for other covariates.

RESULTS

Only two out of eight QoL subscales (social functioning and emotional well-being) declined after 1 month, but these tended to rise again after 3 months, while scores of all other QoL subscales increased. Adjusting for covariates, QoL increased slightly after 1 month of intervention (β = 0.65, 95%CI = -0.86 to 2.16) but improved by almost six QoL points after 3 months (β = 5.99, 95%CI = 4.48 to 7.50). Four confounders significantly associated with a decline in QoL were older age, being retired, living in rural areas, and having abnormal troponin level.

CONCLUSION

QoL of the patients with unstable angina improves significantly 3 months after intervention, rather than after 1 month. More attention should be given to patients, who are old, retired, live in rural areas and have abnormal troponin level.

Development of a rigid suspended micro-island device and robust measurement method for thermal transport measurements

One of the most versatile techniques to study thermal transport in low dimensional materials utilizes a suspended micro-island device integrated with resistance thermometers. Advancements in experimental techniques with suspended micro-island devices resulted in increasing capabilities such as enhancing temperature resolution and expanding a measurable range of sample thermal conductance. In this work, we further improve the suspended micro-island based technique. Specifically, we present a rigid structure of the suspended micro-island device and robust measurement method for sequential heating. The rigid structure enabled by T-shaped beams prevents the displacement of suspended micro-islands, thus increasing the success rates of sample transfer especially for samples with a large cross-sectional area and short length. Besides, thermal isolation of micro-islands is maintained at a similar level through the T-shaped beams compared to conventional flat beams. Next, we introduce an advanced experimental approach that enables sequential heating to measure sample thermal conductance. Sequential heating in micro-islands can be used either to measure accurate sample thermal conductance even under unexpected asymmetric supporting beam configuration or to study thermal transport dependence on heat flow directions. Using a switch matrix for sequential heating eliminates the need for experimental reconfigurations during the experiment. We demonstrate the experimental method with thermal conductivity measurements of the Si nanowire under both the ideal symmetric beam configuration and replicated asymmetric beam configuration scenarios. The results show that the developed experimental method effectively eliminates potential experimental errors that can arise from the asymmetry in beam configurations.

ER-resident oxidoreductases are glycosylated and trafficked to the cell surface to promote matrix degradation by tumour cells

Tumour growth and invasiveness require extracellular matrix (ECM) degradation and are stimulated by the GALA pathway, which induces protein O-glycosylation in the endoplasmic reticulum (ER). ECM degradation requires metalloproteases, but whether other enzymes are required is unclear. Here, we show that GALA induces the glycosylation of the ER-resident calnexin (Cnx) in breast and liver cancer. Glycosylated Cnx and its partner ERp57 are trafficked to invadosomes, which are sites of ECM degradation. We find that disulfide bridges are abundant in connective and liver ECM. Cell surface Cnx-ERp57 complexes reduce these extracellular disulfide bonds and are essential for ECM degradation. In vivo, liver cancer cells but not hepatocytes display cell surface Cnx. Liver tumour growth and lung metastasis of breast and liver cancer cells are inhibited by anti-Cnx antibodies. These findings uncover a moonlighting function of Cnx-ERp57 at the cell surface that is essential for ECM breakdown and tumour development.

A bioelectric neural interface towards intuitive prosthetic control for amputees

OBJECTIVE

While prosthetic hands with independently actuated digits have become commercially available, state-of-the-art human-machine interfaces (HMI) only permit control over a limited set of grasp patterns, which does not enable amputees to experience sufficient improvement in their daily activities to make an active prosthesis useful.

APPROACH

Here we present a technology platform combining fully-integrated bioelectronics, implantable intrafascicular microelectrodes and deep learning-based artificial intelligence (AI) to facilitate this missing bridge by tapping into the intricate motor control signals of peripheral nerves. The bioelectric neural interface includes an ultra-low-noise neural recording system to sense electroneurography (ENG) signals from microelectrode arrays implanted in the residual nerves, and AI models employing the recurrent neural network (RNN) architecture to decode the subject's motor intention.

MAIN RESULTS

A pilot human study has been carried out on a transradial amputee. We demonstrate that the information channel established by the proposed neural interface is sufficient to provide high accuracy control of a prosthetic hand up to 15 degrees of freedom (DOF). The interface is intuitive as it directly maps complex prosthesis movements to the patient's true intention.

SIGNIFICANCE

Our study layouts the foundation towards not only a robust and dexterous control strategy for modern neuroprostheses at a near-natural level approaching that of the able hand, but also an intuitive conduit for connecting human minds and machines through the peripheral neural pathways. (Clinical trial identifier: NCT02994160).

Noise Optimization Techniques for Switched-Capacitor Based Neural Interfaces

This paper presents the noise optimization of a novel switched-capacitor (SC) based neural interface architecture, and its circuit demonstration in a 0.13 [Formula: see text] CMOS process. To reduce thermal noise folding ratio, and suppress kT/C noise, several noise optimization techniques are developed in the proposed architecture. First, one parasitic capacitance suppression scheme is developed to block noise charge transfer from parasitic capacitors to amplifier output. Second, one recording path-splitting scheme is proposed in the input sampling stage to selectively record local field potentials (LFPs), extracellular spikes, or both for reducing input noise floor, and total power consumption. Third, an auto-zero noise cancellation scheme is developed to suppress kT/C noise in the neural amplifier stage. A prototype neural interface chip was fabricated, and also verified in both bench-top, and In-Vivo experiments. Bench-top testings show the input-referred noise of the designed chip is 4.8 [Formula: see text] from 1 [Formula: see text] to 300 [Formula: see text], and 2.3 [Formula: see text] from 300 [Formula: see text] to 8 kHz respectively, and In-Vivo experiments show the peak-to-peak amplitude of the total noise floor including neural activity, electrode interface noise, and the designed chip is only around 20 [Formula: see text]. In comparison with conventional architectures through both circuit measurement and animal experiments, it is well demonstrated that the proposed noise optimization techniques can effectively reduce circuit noise floor, thus extending the application range of switched-capacitor circuits.

Dataset on the effects of spacing and fruit truss limitation on the growth, yield and quality of open-field tomato plants

This article presents data on the effects of spacing and fruit truss limitation on tomato plant growth, yield and fruit quality. Plants with two, three, and four fruit trusses (T1-T3) were grown in four different spaces (S1-S4) to create 12 treatments. The experiment was conducted on an open field with a randomized complete block design and three replications. Data on fruit quantity, weight, and yield were collected to assess the effects of plant density and fruit truss limitation on tomato fruit produced and marketable fruit produced. This data could help develop a strategy for breeding new tomato cultivars for high density planting on the rice-based rotational crop systems in the Red River Delta of Vietnam and other similar sub-tropical regions.

Trade Shows and SME Internationalisation: Networking for Performance

Trade shows are a key vehicle where SMEs often develop networks, through which valuable resources for internationalisation can be acquired. However, there tends to be a scarcity of research on the performance outcomes of network development of international SMEs (ISMEs), particularly, in trade show forums. Adopting a network-based view, we investigate the influence of trade shows on the performance of ISMEs. Results from a survey of 229 Australian and New Zealand SMEs indicate that proactiveness is positively associated with the development of networks through trade shows, which, in turn, increases the firms’ operational performance, but not financial performance. In addition, the effect of trade shows is generally more beneficial for ISMEs in the service industry, compared to other industries.

HCV infection status and care seeking among people living with HIV who use drugs in Vietnam

HCV co-infection is widespread among people living with HIV who use drugs (PLHWUD). However, HCV testing was inconsistently implemented among PLHWUD. The low infection awareness and mental health challenges together impede PLHWUD's treatment-seeking. The study used baseline data of a randomized controlled trial conducted in Vietnam. HCV infection status was collected through self-report and medical record review. A linear mixed-effects regression model was used to examine the relationships between PLHWUD's perceived barriers to seeking healthcare, their depressive symptoms, and the consistencies in HCV status reports. Among the 181 PLHWUD in the study, one-third (64; 35.4%) had inconsistent self-reports and medical records of HIV infection status. The agreement between the two records was fair (Kappa statistics = 0.43). PLHWUD with consistent HCV infection confirmed by both medical records and self-reports perceived lower levels of healthcare-seeking barriers than those with discrepant HCV reports (estimated difference = -1.59, SE = 0.71, P = 0.027). Depressive symptoms were significantly correlated with healthcare-seeking barriers among those with discrepant HCV results (estimate = 0.17, SE = 0.06, P = 0.007). There is an urgent need to extend HCV screening efforts and increase HCV awareness among PLHWUD. Explicit HCV result notification and integrated mental health support are recommended to facilitate patients' access to needed care.

A Wide Dynamic Range Neural Data Acquisition System With High-Precision Delta-Sigma ADC and On-Chip EC-PC Spike Processor

A high-performance, wide dynamic range, fully-integrated neural interface is one key component for many advanced bidirectional neuromodulation technologies. In this paper, to complement the previously proposed frequency-shaping amplifier (FSA) and high-precision electrical microstimulator, we will present a proof-of-concept design of a neural data acquisition (DAQ) system that includes a 15-bit, low-power Delta-Sigma analog-to-digital converter (ADC) and a real-time spike processor based on one exponential component-polynomial component (EC-PC) algorithm. High-precision data conversion with low power consumption and small chip area is achieved by employing several techniques, such as opamp-sharing, multi-bit successive approximation (SAR) quantizer, two-step summation, and ultra-low distortion data weighted averaging (DWA). The on-chip EC-PC engine enables low latency, automatic detection, and extraction of spiking activities, thus supporting closed-loop control, real-time data compression and /or neural information decoding. The prototype chip was fabricated in a 0.13  μm CMOS process and verified in both bench-top and In-Vivo experiments. Bench-top measurement results indicate the designed ADC achieves a peak signal-to-noise and distortion ratio (SNDR) of 91.8 dB and a dynamic range of 93.0 dB over a 10 kHz bandwidth, where the total power consumption of the modulator is only 20  μW at 1.0 V supply, corresponding to a figure-of-merit (FOM) of 31.4fJ /conversion-step. In In-Vivo experiments, the proposed DAQ system has been demonstrated to obtain high-quality neural activities from a rat's motor cortex and also greatly reduce recovery time from system saturation due to electrical microstimulation.

Induction of oocyte development in previtellogenic eel, Anguilla australis

The role of gonadotropins during early ovarian development in fish remains little understood. Concentrations of gonadotropins were therefore experimentally elevated in vivo by administration of recombinant follicle-stimulating hormone (rec-Fsh) or human chorionic gonadotropin (hCG) and the effects on ovarian morphology, sex steroid levels and mRNA levels of genes expressed in pituitary and ovary examined. Hormones were injected thrice at weekly intervals in different doses (20, 100 or 500 µg/kg BW for rec-Fsh and 20, 100 or 500 IU/kg BW for hCG). All treatments, especially at the highest doses of either rec-Fsh or hCG, induced ovarian development, reflected in increased oocyte size and lipid uptake. Both gonadotropins up-regulated follicle-stimulating hormone receptor (fshr) mRNA levels and plasma levels of estradiol-17β (E2). Exogenous gonadotropins largely decreased the expression of follicle-stimulating hormone β-subunit (fshb) and had little effect on those of luteinizing hormone β-subunit (lhb) in the pituitary. It is proposed that the effects of hCG on ovarian development in previtellogenic eels could be indirect as a significant increase in plasma levels of 11-ketotestosterone (11-KT) was found in eels treated with hCG. Using rec-Fsh and hCG has potential for inducing puberty in eels in captivity, and indeed, in teleost fish at large.

Efficacy of camera traps in detecting primates in Hue Saola Nature Reserve

Camera trapping has been demonstrated to be an effective tool in surveying a suite of species, especially elusive mammals in rough terrains. The method has become increasingly common in primate surveys for both ground-dwelling and arboreal taxa in many tropical regions of the world. However, camera trapping has rarely been used to inventory primates in Vietnam, although many species are under severe threats and in critical need of surveying for improved conservation measures. In this study, we employed camera trapping to primarily investigate the possible continued presence of galliform species, but also to opportunistically record primate species, in Hue Saola Nature Reserve in central Vietnam. We documented five primate species, including the northern pig-tailed macaque Macaca leonina, the stump-tailed macaque Macaca arctoides, the rhesus macaque Macaca mulatta, the pygmy slow loris Nycticebus pygmaeus, and the red-shanked douc Pygathrix nemaeus, which represents a majority of primate diversity in the reserve. The results show that camera trapping may be an option for documenting primate diversity, and seasonal and daily activities of ground-dwelling taxa. Our data also suggest that although human disturbance is still rampant in the area, Hue Saola Nature Reserve appears to be reasonably well protected compared to other conservation areas in Indochina. In particular, it is home to several highly threatened primates, and it therefore plays a crucial role in primate conservation in Vietnam. However, these populations are in need of greater protection, such as more targeted patrols to remove snares and prevent other violations.

Depressive Symptoms, Suicidal Ideation, and Mental Health Service Use of Industrial Workers: Evidence from Vietnam

Background: Depressive symptoms and suicidal ideation substantially reduce industrial workers' productivity and performance. This study was performed to examine the prevalence of depressive symptoms and suicidal ideation and identify associated factors among industrial workers in different provinces of Vietnam. Materials and Methods: We performed a cross-sectional study in industrial zones of four provinces of Vietnam. The Patient Health Questionnaire (PHQ-9) was employed to screen depressive symptoms and suicidal ideation. Multivariate logistic regression was performed to determine factors related to depressive symptoms and suicidal ideation. Results: Of 1200 industrial workers, 30.5% and 33.6% industrial workers had positive depressive symptoms and suicidal ideation in the last two weeks, respectively. There were 38.3% ever using mental health services in the last 12 months. High school education (OR = 0.64, 95% CI = 0.44-0.95); living in dormitory (OR = 3.07, 95% CI = 1.51-6.24), living with siblings (OR = 2.98; 95% CI = 1.32-6.75), having two children or more (OR = 1.45, 95% CI = 1.03-2.03), high years of experience (OR = 0.94; 95% CI = 0.89-0.98), suffering from burnout, alcohol use disorder (OR = 2.38; 95% CI = 1.72-3.28), and smoking status (OR = 0.38, 95% CI = 0.23-0.61) were associated with positive depressive symptoms. Living with children, working in mechanical/metallurgy/electronics factories, completely exhausted and often thinking of quitting, and alcohol use disorder were positively related to suicidal ideation. Conclusions: This study found a high prevalence of depressive symptoms and suicidal ideation among industrial workers in Vietnam. Regular screening and detecting high-risk groups, along with interventions to reduce health risk behaviors, burnout and on-site medical service quality improvement, are recommended to alleviate the burden of depression in industrial workers.

HIV- and Drug Use-Related Stigma and Service Provision Among Community Health Workers in Vietnam

This study compared community health workers' (CHW) stigma towards people living with HIV (PLH) and people who use drugs (PWUD) and explored the relationship between stigma and CHWs' confidence level in providing HIV/drug-related services. Using two sets of identically worded questions, levels of stigma towards PWUD and PLH were measured among 120 CHW from 60 communes in Vietnam. The associations between CHWs' confidence in service provision and stigma towards PWUD and PLH were examined using a linear mixed-effects regression model. The majority of the CHW reported higher levels of stigma towards PWUD than towards PLH. Compared to the CHW reporting higher stigma towards PWUD, those with higher stigma towards PLH were significantly less confident in service provision. Social opprobrium attached to drug-using behaviors can be a major driver behind the overall HIV stigma. CHWs' fear of HIV infection should be tackled to boost their confidence in HIV/drug-related care provision.

Patterns of Risky Sexual Behaviors and Associated Factors among Youths and Adolescents in Vietnam

Youths and adolescents are vulnerable to HIV/STIs from unprotected sex. Promotion of young population's awareness about risky sexual behaviors is essential to develop contextualized interventions. A cross-sectional study was conducted in five Vietnamese provinces to document current attitudes and practices regarding sexual behaviors among youths. The information on sociodemographic characteristics, substance use, and sexual behaviors was collected via self-reported questionnaires. The factors associated with risky sexual behaviors were identified by the multivariate logistic regression. Among the 1200 participants, 73.5% reported having sex in their lifetime, and 48.1% used condoms at their latest sexual intercourse. Participants in urban areas were more likely not to intend to use condoms and had a higher unintended pregnancy rate than in rural areas. Older age was positively associated with not wanting to use and not using condoms. Substance-using participants were more likely to not use condoms. The participants taking alcohol or other stimulants before sex had a higher likelihood of unintended pregnancy. Respondents' attitudes and practices regarding sexual behaviors were associated with gender and employment. This study indicated that young population's awareness in Vietnam is high, however, risky sexual behaviors also remain common. Sex-related educational programs about the consequences of substance use, multiple sex partners, and unprotected sex should be developed.

Tumor cell capture from blood by flowing across antibody-coated surfaces

The load of circulating tumor cells (CTC) is related to poor outcomes in cancer patients. A sufficient number of these cells would enable a full characterization of the cancer. An approach to probe larger blood volumes, allowing for the detection of more of these very rare CTC, is the use of leukapheresis. Currently available techniques allow only the analysis of a small portion of leukapheresis products. Here, we present a method that uses flow rather than static conditions which allows processing of larger volumes. We evaluated the conditions needed to isolate tumor cells from blood while passing antibody coated surfaces. Results show that our set-up efficiently captures cancer cells from whole blood. Results show that the optimal velocity at which cells are captured from blood is 0.6 mm s-1. Also, it can be concluded that the VU1D9 antibody targeting the EpCAM antigen has very high capture efficiency. When using an antibody that does not capture 100% of all cells, combining multiple antibodies on the capture surface is very beneficial leading to an increase in cell capture and is therefore worthwhile considering in any cancer cell capture methodology.