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Cremin E, Ladd CJT, Balke T, Banerjee S, Bui LH, Ghosh T, Large A, Thi Van Le H, Nguyen KV, Nguyen LX, Nguyen TTN, Nguyen V, Pal I, Szabo S, Tran H, Sebesvari Z, Khan SA, Renaud FG. Causes and consequences of tipping points in river delta social-ecological systems. Ambio 2024:10.1007/s13280-023-01978-2. [PMID: 38613747 DOI: 10.1007/s13280-023-01978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/30/2023] [Accepted: 12/26/2023] [Indexed: 04/15/2024]
Abstract
The sustainability of social-ecological systems within river deltas globally is in question as rapid development and environmental change trigger "negative" or "positive" tipping points depending on actors' perspectives, e.g. regime shift from abundant sediment deposition to sediment shortage, agricultural sustainability to agricultural collapse or shift from rural to urban land use. Using a systematic review of the literature, we show how cascading effects across anthropogenic, ecological, and geophysical processes have triggered numerous tipping points in the governance, hydrological, and land-use management of the world's river deltas. Crossing tipping points had both positive and negative effects that generally enhanced economic development to the detriment of the environment. Assessment of deltas that featured prominently in the review revealed how outcomes of tipping points can inform the long-term trajectory of deltas towards sustainability or collapse. Management of key drivers at the delta scale can trigger positive tipping points to place social-ecological systems on a pathway towards sustainable development.
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Affiliation(s)
- Emilie Cremin
- School of Social and Environmental Studies, The University of Glasgow, Dumfries Campus, Rutherford/McCowan Building, Crichton University Campus, Dumfries, DG1 4ZL, Scotland, UK.
| | - Cai J T Ladd
- School of Geography and Earth Science, University of Glasgow, Glasgow, UK
- University of Swansea, Swansea, UK
| | - Thorsten Balke
- School of Geography and Earth Science, University of Glasgow, Glasgow, UK
| | - Sumana Banerjee
- School of Oceanographic Studies, Jadavpur University, Kolkata, India
| | - Ly H Bui
- VNU-Central Institute for Natural Resources and Environmental Studies (VNU-CRES), Vietnam National University (VNU), Hanoi, Vietnam
| | - Tuhin Ghosh
- School of Oceanographic Studies, Jadavpur University, Kolkata, India
| | - Andy Large
- School of Geography, Politics and Sociology, Newcastle University, Newcastle upon Tyne, UK
| | - Hue Thi Van Le
- VNU-Central Institute for Natural Resources and Environmental Studies (VNU-CRES), Vietnam National University (VNU), Hanoi, Vietnam
| | | | - Lan X Nguyen
- Research Center for Rural Development, An Giang University, An Giang, Vietnam
| | - Tanh T N Nguyen
- Research Center for Rural Development, An Giang University, An Giang, Vietnam
| | - Vinh Nguyen
- VNU-Central Institute for Natural Resources and Environmental Studies (VNU-CRES), Vietnam National University (VNU), Hanoi, Vietnam
| | - Indrajit Pal
- Disaster Preparedness, Mitigation and Management, Asian Institute of Technology, Pathum Thani, Thailand
| | - Sylvia Szabo
- Bangladesh University of Engineering and Technology, Dhaka, Bangladesh
- Department of Development and Sustainability, Dongguk University, Seoul, South Korea
- Ostrom Center for the Advanced Study in Natural-Resource-Governance, Pathum Thani, Thailand
| | - Ha Tran
- Can Tho University, Can Tho, Vietnam
| | - Zita Sebesvari
- United Nations University, Institute for Environment and Human Security, Bonn, Germany
| | - Shah Alam Khan
- Bangladesh University of Engineering and Technology, Dhaka, Bangladesh
| | - Fabrice G Renaud
- School of Social and Environmental Studies, The University of Glasgow, Dumfries Campus, Rutherford/McCowan Building, Crichton University Campus, Dumfries, DG1 4ZL, Scotland, UK
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Shu B, Wilson MM, Keller MW, Tran H, Sokol T, Lee G, Rambo‐Martin BL, Kirby MK, Hassell N, Haydel D, Hand J, Wentworth DE, Barnes JR. In-field detection and characterization of B/Victoria lineage deletion variant viruses causing early influenza activity and an outbreak in Louisiana, 2019. Influenza Other Respir Viruses 2024; 18:e13246. [PMID: 38188372 PMCID: PMC10767671 DOI: 10.1111/irv.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 01/09/2024] Open
Abstract
Background In 2019, the Louisiana Department of Health reported an early influenza B/Victoria (B/VIC) virus outbreak. Method As it was an atypically large outbreak, we deployed to Louisiana to investigate it using genomics and a triplex real-time RT-PCR assay to detect three antigenically distinct B/VIC lineage variant viruses. Results The investigation indicated that B/VIC V1A.3 subclade, containing a three amino acid deletion in the hemagglutinin and known to be antigenically distinct to the B/Colorado/06/2017 vaccine virus, was the most prevalent circulating virus within the specimens evaluated (86/88 in real-time RT-PCR). Conclusion This work underscores the value of portable platforms for rapid, onsite pathogen characterization.
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Affiliation(s)
- Bo Shu
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Malania M. Wilson
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Matthew W. Keller
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Ha Tran
- Louisiana Department of HealthOffice of Public Health LaboratoryBaton RougeLouisianaUSA
| | - Theresa Sokol
- Louisiana Department of HealthOffice of Public Health, Infectious Disease EpidemiologyNew OrleansLouisianaUSA
| | - Grace Lee
- Louisiana Department of HealthOffice of Public Health, Infectious Disease EpidemiologyNew OrleansLouisianaUSA
| | - Benjamin L. Rambo‐Martin
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Marie K. Kirby
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Norman Hassell
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Danielle Haydel
- Louisiana Department of HealthOffice of Public Health LaboratoryBaton RougeLouisianaUSA
| | - Julie Hand
- Louisiana Department of HealthOffice of Public Health, Infectious Disease EpidemiologyNew OrleansLouisianaUSA
| | - David E. Wentworth
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - John R. Barnes
- Virology, Surveillance and Diagnosis Branch, Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
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Rogers RT, Tran H, Belnap SC, Starosciak AK. Cerebrovascular Events and Hospital Discharge Outcomes Associated With Drug Use: A Retrospective Case-Matched Study. Cureus 2023; 15:e50190. [PMID: 38192948 PMCID: PMC10771966 DOI: 10.7759/cureus.50190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Individuals using cocaine, methamphetamines, cannabis, and other mood-altering drugs (MADs) have been reported to have greater stroke risk when compared to individuals who do not use these drugs. Yet, the impact that MAD use has on stroke outcomes has not been adequately explored, with existing research not agreeing on the extent to which the use of these drugs influences stroke outcomes. This study aimed to determine the impact that the use of common MADs has on stroke outcome factors such as length of stay (LOS), discharge modified Rankin Scale (mRS), and discharge disposition. Methods A retrospective case-matched study was conducted with two adult cohorts treated for cerebrovascular accidents: those who use MADs and those who do not use MADs prior to their stroke. Subjects identified for the users of MADs cohort were matched at a 1:1 ratio to those who do not use MADs (control cohort) by age, sex, and stroke type (e.g., hemorrhagic or ischemic). Logistic regression was used to calculate odds ratios for functional outcomes for stroke patients with and without prior MAD use. Results Active users of MADs had an increased overall risk of poor stroke outcome, i.e., increased length of stay, discharge disposition other than to home or to rehabilitation, discharge modified Rankin scale (mRS) 3-6 after controlling for stroke severity from initial National Institutes of Health Stroke Scale (NIHSS) (X2{9}=21.68, p<0.01, Cox adjusted R2=0.31). This finding was driven predominately by increased hospital LOS (p=0.006) among the MAD cohort, whereas discharge mRS 3-6 (p=0.24) and discharge disposition to care facility (p=0.27) and expired (p=0.26) did not vary significantly between groups. Conclusion Our study suggests that patients who had actively used MADs prior to their stroke may be at risk of poorer stroke outcomes, namely an increased LOS. Future research should be conducted to further elucidate which factors, such as individual drugs, amount of drug, acute or recreational use versus chronic or long-term use, and route of administration, for instance, specifically contribute to a longer LOS so that they may be targeted for mitigation.
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Affiliation(s)
- Richard T Rogers
- Neurology, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Ha Tran
- Pediatrics, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
- Pediatrics, Children's National Hospital, Washington, D.C., USA
| | - Starlie C Belnap
- Miami Neuroscience Institute, Baptist Health South Florida, Miami, USA
| | - Amy K Starosciak
- Translational Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
- Center for Research, Baptist Health South Florida, Coral Gables, USA
- Miami Neuroscience Institute, Baptist Health South Florida, Miami, USA
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Bui TD, Tran DK, Vu VH, Tran H, Le MK, Truong QB, Thanh Hiep N, Minh Duc N. Beneficial effects of pulmonary embolism response team establishment in patients with pulmonary embolism in a developing country: a single-center experience. Clin Ter 2023; 174:518-524. [PMID: 38048115 DOI: 10.7417/ct.2023.5019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Objective The impact of establishing a pulmonary embolism response team (PERT) in patients with pulmonary embolism (PE) has been proven in many developed countries. However, the efficacy of a PERT largely depends on expertise and infrastructure. This study explored the benefit of establishing a PERT in developing countries with limited healthcare resources by comparing the outcomes of patients with acute PE before and after PERT establishment at University Medical Center Ho Chi Minh City in Vietnam. Methods We conducted a single-center observational study from January 1, 2019, to August 1, 2021. All patients with PE confirmed on computed tomography were included. Patients admitted before PERT establishment were treated by cardiologists alone, while those hospitalized after PERT establishment were managed by the PERT. Results A total of 130 patients were included (pre-PERT estab-lishment: 51 patients; post-PERT establishment: 79 patients). The demographic characteristics, severity of PE, and clinical and laboratory findings were similar between the two groups. The post-PERT establishment group had a lower incidence rate of major and clinically relevant nonmajor bleeding (11.3% vs. 31.4%, p = 0.005) and required more interventional therapies (16.5% vs. 3.9%, p = 0.046) than did the pre-PERT establishment group. The in-hospital mortality rate decreased in the post-PERT establishment group compared with that in the pre-PERT establishment group (8.9% vs. 21.6%, p = 0.041). Conclusions Involvement of the PERT in PE management was associated with improved outcomes of patients with PE, including reduced bleeding and mortality rates in a resource-constrained hospital.
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Affiliation(s)
- T D Bui
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - D K Tran
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - V H Vu
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - H Tran
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - M K Le
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Critical Care Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Q B Truong
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - N Thanh Hiep
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - N Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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Wischnewski M, Tran H, Zhao Z, Shirinpour S, Haigh Z, Rotteveel J, Perera N, Alekseichuk I, Zimmermann J, Opitz A. Induced neural phase precession through exogeneous electric fields. bioRxiv 2023:2023.03.31.535073. [PMID: 37034780 PMCID: PMC10081336 DOI: 10.1101/2023.03.31.535073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
The gradual shifting of preferred neural spiking relative to local field potentials (LFPs), known as phase precession, plays a prominent role in neural coding. Correlations between the phase precession and behavior have been observed throughout various brain regions. As such, phase precession is suggested to be a global neural mechanism that promotes local neuroplasticity. However, causal evidence and neuroplastic mechanisms of phase precession are lacking so far. Here we show a causal link between LFP dynamics and phase precession. In three experiments, we modulated LFPs in humans, a non-human primate, and computational models using alternating current stimulation. We show that continuous stimulation of motor cortex oscillations in humans lead to a gradual phase shift of maximal corticospinal excitability by ~90°. Further, exogenous alternating current stimulation induced phase precession in a subset of entrained neurons (~30%) in the non-human primate. Multiscale modeling of realistic neural circuits suggests that alternating current stimulation-induced phase precession is driven by NMDA-mediated synaptic plasticity. Altogether, the three experiments provide mechanistic and causal evidence for phase precession as a global neocortical process. Alternating current-induced phase precession and consequently synaptic plasticity is crucial for the development of novel therapeutic neuromodulation methods.
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Affiliation(s)
- M. Wischnewski
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - H. Tran
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Z. Zhao
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - S. Shirinpour
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Z.J. Haigh
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - J. Rotteveel
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - N.D. Perera
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - I. Alekseichuk
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - J. Zimmermann
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - A. Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
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Baek Y, Ademi Z, Tran T, Owen A, Nguyen T, Luchters S, Hipgrave DB, Hanieh S, Tran T, Tran H, Biggs BA, Fisher J. Considering equity and cost-effectiveness in assessing a parenting intervention to promote early childhood development in rural Vietnam. Health Policy Plan 2023; 38:916-925. [PMID: 37552643 PMCID: PMC10506530 DOI: 10.1093/heapol/czad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/17/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023] Open
Abstract
Considering equity in early childhood development (ECD) is important to ensure healthy development for every child. Equity-informative cost-effectiveness analysis can further guide decision makers to maximize outcomes with limited resources while promoting equity. This cost-effectiveness study aimed to examine the equity impacts of a multicomponent ECD intervention in rural Vietnam. We estimated the cost-effectiveness of the intervention with a 30-month time horizon from the service provider and household perspectives with equity considerations. Data were from a cluster-randomized controlled trial comparing the intervention with the local standard of care. The incremental cost-effectiveness ratios (ICERs) per child cognitive development score gained were estimated by household wealth quintile and maternal education level, adjusted for cluster effects and baseline characteristics such as maternal parity and age. A 3% discount rate was applied to costs, and non-parametric cluster bootstrapping was used to examine uncertainty around ICERs. Children in the intervention had higher cognitive development scores than those in the control arm across all subgroups. Based on intervention recurrent cost, the ICER per cognitive development score gained was lower in children from the poorest quintile (-US$6) compared to those from the richest quintile (US$16). Similarly, the ICER per cognitive development score gained was lower in children whose mothers had the lowest education level (-US$0.02) than those with mothers who had the highest education level (US$7). Even though our findings should be interpreted with caution due to the insufficient study power, the findings suggest that the intervention could promote equity while improving child cognitive development with greater cost-effectiveness in disadvantaged groups.
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Affiliation(s)
- Yeji Baek
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Trang Nguyen
- Research and Training Centre for Community Development (RTCCD), No. 6, Alley 46, Tran Kim Xuyen Street, Trung Hoa, Cau Giay District, Hanoi 10000, Vietnam
| | - Stanley Luchters
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), 4 Bath Road, Harare, Zimbabwe
- Liverpool School of Tropical Medicine (LSTM), Pembroke Place, Liverpool L3 5QA, UK
| | - David B Hipgrave
- UNICEF Iraq, Karadat Maryam District, Haifa Street, Baghdad 10011, Iraq
| | - Sarah Hanieh
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, 792 Elizabeth Street, Melbourne 3000, Australia
| | - Tuan Tran
- Research and Training Centre for Community Development (RTCCD), No. 6, Alley 46, Tran Kim Xuyen Street, Trung Hoa, Cau Giay District, Hanoi 10000, Vietnam
| | - Ha Tran
- Research and Training Centre for Community Development (RTCCD), No. 6, Alley 46, Tran Kim Xuyen Street, Trung Hoa, Cau Giay District, Hanoi 10000, Vietnam
| | - Beverley-Ann Biggs
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, 792 Elizabeth Street, Melbourne 3000, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
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Baek Y, Ademi Z, Tran T, Owen A, Nguyen T, Luchters S, Hipgrave DB, Hanieh S, Tran T, Tran H, Biggs BA, Fisher J. Promoting early childhood development in Viet Nam: cost-effectiveness analysis alongside a cluster-randomised trial. Lancet Glob Health 2023; 11:e1269-e1276. [PMID: 37474233 DOI: 10.1016/s2214-109x(23)00271-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 04/03/2023] [Accepted: 06/02/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Economic evaluations are critical to ensure effective resource use to implement and scale up child development interventions. This study aimed to estimate the cost-effectiveness of a multicomponent early childhood development intervention in rural Viet Nam. METHODS We did a cost-effectiveness study alongside a cluster-randomised trial with a 30-month time horizon. The study included 669 mothers from 42 communes in the intervention group, and 576 mothers from 42 communes in the control group. Mothers in the intervention group attended Learning Clubs sessions from mid-pregnancy to 12 months after delivery. The primary outcomes were child cognitive, language, motor, and social-emotional development at age 2 years. In this analysis, we estimated the incremental cost-effectiveness ratios (ICERs) of the intervention compared with the usual standard of care from the service provider and household perspectives. We used non-parametric bootstrapping to examine uncertainty, and applied a 3% discount rate. FINDINGS The total intervention cost was US$169 898 (start-up cost $133 692 and recurrent cost $36 206). The recurrent cost per child was $58 (1 341 741 Vietnamese dong). Considering the recurrent cost alone, the base-case ICER was $14 and mean ICER of 1000 bootstrap samples was $14 (95% CI -0·48 to 30) per cognitive development score gained with a 3% discount rate to costs. The ICER per language and motor development score gained was $22 and $20, respectively, with a 3% discount rate to costs. INTERPRETATION The intervention was cost-effective: the ICER per child cognitive development score gained was 0·5% of Viet Nam's gross domestic product per capita, alongside other benefits in language and motor development. This finding supports the scaling up of this intervention in similar socioeconomic settings. FUNDING Australian National Health and Medical Research Council and Grand Challenges Canada. TRANSLATION For the Vietnamese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Yeji Baek
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Trang Nguyen
- Research and Training Centre for Community Development, Hanoi, Viet Nam
| | - Stanley Luchters
- Centre for Sexual Health and HIV AIDS Research, Harare, Zimbabwe; Liverpool School of Tropical Medicine, Liverpool, UK; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - David B Hipgrave
- UNICEF, Baghdad, Iraq; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sarah Hanieh
- Department of Medicine and Victorian Infectious Diseases Service at the Doherty Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Tuan Tran
- Research and Training Centre for Community Development, Hanoi, Viet Nam
| | - Ha Tran
- Research and Training Centre for Community Development, Hanoi, Viet Nam
| | - Beverley-Ann Biggs
- Department of Medicine and Victorian Infectious Diseases Service at the Doherty Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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Vo T, Tran T, Ho T, Le C, Pham H, Tran H, Ho N, Cao T, Vo B. Clinical evaluation of hysterectomy for the treatment of invasive mole in Southern Vietnam. Eur Rev Med Pharmacol Sci 2023; 27:7720-7727. [PMID: 37667950 DOI: 10.26355/eurrev_202308_33426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
OBJECTIVE This study aimed to determine the rate of salvage chemotherapy and review associated factors in invasive mole patients treated by primary or delayed hysterectomy. PATIENTS AND METHODS This study was carried out at the Tu Du Hospital, where a total of 189 patients were diagnosed with invasive mole based on histologic examination by hysterectomy between 01/2016 to 12/2020. We used the life table method to estimate the cumulative rate. We applied the Cox proportional hazard model to determine the factors associated with the need for salvage chemotherapy. RESULTS At 12-month follow-up, 47 patients had required salvage chemotherapy. The incidence was 24.87% (95% CI: 18.88-31.66). Applying the multivariate model, prophylactic chemotherapy (HR = 2.75, 95% Cl: 1.20-6.30) and two weeks postoperative hCG value greater than 1,900 mIU/mL (HR = 4.30, 95% Cl: 2.08-8.87) increased the risk of requiring salvage chemotherapy. Postoperative chemotherapy decreased the risk of requiring salvage chemotherapy (HR = 0.43, 95% Cl: 0.22-0.83). CONCLUSIONS Hysterectomy can be considered safe and effective in treating invasive mole patients. Although patients were treated by hysterectomy, 24.87% of patients needed salvage chemotherapy to achieve remission. This study affirms the malignant nature of invasive mole, a subtype of gestational trophoblastic neoplasia (GTN). It is not purely a local invasion of molar villi. Postoperative chemotherapy plays an essential role in reducing the risk of requiring salvage chemotherapy.
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Affiliation(s)
- T Vo
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Hills R, Mossman JA, Bratt-Leal AM, Tran H, Williams RM, Stouffer DG, Sokolova IV, Sanna PP, Loring JF, Lelos MJ. Neurite Outgrowth and Gene Expression Profile Correlate with Efficacy of Human Induced Pluripotent Stem Cell-Derived Dopamine Neuron Grafts. Stem Cells Dev 2023; 32:387-397. [PMID: 37166357 PMCID: PMC10398740 DOI: 10.1089/scd.2023.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/08/2023] [Indexed: 05/12/2023] Open
Abstract
Transplantation of human induced pluripotent stem cell-derived dopaminergic (iPSC-DA) neurons is a promising therapeutic strategy for Parkinson's disease (PD). To assess optimal cell characteristics and reproducibility, we evaluated the efficacy of iPSC-DA neuron precursors from two individuals with sporadic PD by transplantation into a hemiparkinsonian rat model after differentiation for either 18 (d18) or 25 days (d25). We found similar graft size and dopamine (DA) neuron content in both groups, but only the d18 cells resulted in recovery of motor impairments. In contrast, we report that d25 grafts survived equally as well and produced grafts rich in tyrosine hydroxylase-positive neurons, but were incapable of alleviating any motor deficits. We identified the mechanism of action as the extent of neurite outgrowth into the host brain, with d18 grafts supporting significantly more neurite outgrowth than nonfunctional d25 grafts. RNAseq analysis of the cell preparation suggests that graft efficacy may be enhanced by repression of differentiation-associated genes by REST, defining the optimal predifferentiation state for transplantation. This study demonstrates for the first time that DA neuron grafts can survive well in vivo while completely lacking the capacity to induce recovery from motor dysfunction. In contrast to other recent studies, we demonstrate that neurite outgrowth is the key factor determining graft efficacy and our gene expression profiling revealed characteristics of the cells that may predict their efficacy. These data have implication for the generation of DA neuron grafts for clinical application.
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Affiliation(s)
- Rachel Hills
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Jim A. Mossman
- Independent Bioinformatics Consultant, Del Mar, California, USA
| | - Andres M. Bratt-Leal
- Department of Molecular Medicine, Center for Regenerative Medicine, Scripps Research, La Jolla, California, USA
- Summit for Stem Cell Foundation, San Diego, California, USA
| | - Ha Tran
- Department of Molecular Medicine, Center for Regenerative Medicine, Scripps Research, La Jolla, California, USA
- Summit for Stem Cell Foundation, San Diego, California, USA
| | - Roy M. Williams
- Department of Molecular Medicine, Center for Regenerative Medicine, Scripps Research, La Jolla, California, USA
| | - David G. Stouffer
- Department of Molecular Medicine, Center for Regenerative Medicine, Scripps Research, La Jolla, California, USA
| | - Irina V. Sokolova
- Department of Immunology and Microbiology, Scripps Research, La Jolla, California, USA
| | - Pietro P. Sanna
- Department of Immunology and Microbiology, Scripps Research, La Jolla, California, USA
| | - Jeanne F. Loring
- Department of Molecular Medicine, Center for Regenerative Medicine, Scripps Research, La Jolla, California, USA
| | - Mariah J. Lelos
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, United Kingdom
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10
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Zhao Z, Shirinpour S, Tran H, Wischnewski M, Opitz A. Intensity- and frequency-specific effects of transcranial alternating current stimulation are explained by network dynamics. bioRxiv 2023:2023.05.19.541493. [PMID: 37293105 PMCID: PMC10245793 DOI: 10.1101/2023.05.19.541493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Transcranial alternating current stimulation (tACS) can be used to non-invasively entrain neural activity, and thereby cause changes in local neural oscillatory power. Despite an increased use in cognitive and clinical neuroscience, the fundamental mechanisms of tACS are still not fully understood. Here, we develop a computational neuronal network model of two-compartment pyramidal neurons and inhibitory interneurons which mimic the local cortical circuits. We model tACS with electric field strengths that are achievable in human applications. We then simulate intrinsic network activity and measure neural entrainment to investigate how tACS modulates ongoing endogenous oscillations. First, we show that intensity-specific effects of tACS are non-linear. At low intensities (<0.3 mV/mm), tACS desynchronizes neural firing relative to the endogenous oscillations. At higher intensities (>0.3 mV/mm), neurons are entrained to the exogenous electric field. We then further explore the stimulation parameter space and find that entrainment of ongoing cortical oscillations also depends on frequency by following an Arnold tongue. Moreover, neuronal networks can amplify the tACS induced entrainment via excitation-inhibition balance. Our model shows that pyramidal neurons are directly entrained by the exogenous electric field and drive the inhibitory neurons. Our findings can thus provide a mechanistic framework for understanding the intensity- and frequency- specific effects of oscillating electric fields on neuronal networks. This is crucial for rational parameters selection for tACS in cognitive studies and clinical applications.
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Affiliation(s)
- Z. Zhao
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - S. Shirinpour
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - H. Tran
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - M. Wischnewski
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - A. Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
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Tran H, Li G, Ngo NH, Ebert V. Non-impact effects in the absorption spectra of HCl diluted in CO2, air, and He: Measurements and predictions. J Chem Phys 2023; 158:2889000. [PMID: 37154274 DOI: 10.1063/5.0147916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023] Open
Abstract
Non-impact effects in the absorption spectra of HCl in various collision-partners are investigated both experimentally and theoretically. Fourier transform spectra of HCl broadened by CO2, air, and He have been recorded in the 2-0 band region at room temperature and for a wide pressure range, from 1 to up to 11.5 bars. Comparisons between measurements and calculations using Voigt profiles show strong super-Lorentzian absorptions in the troughs between successive lines in the P and R branches for HCl in CO2. A weaker effect is observed for HCl in air, while for HCl in He, Lorentzian wings are in very good agreement with measurements. In addition, the line intensities retrieved by fitting the Voigt profile on the measured spectra decrease with the density of the perturber. This perturber-density dependence decreases with the rotational quantum number. For HCl in CO2, the decrease in the retrieved line intensity can reach 2.5% per amagat for the first rotational quantum numbers. This number is about 0.8% per amagat for HCl in air, while for HCl in He, no density dependence of the retrieved line intensity is observed. Requantized classical molecular dynamics simulations have been performed for HCl-CO2 and HCl-He in order to simulate the absorption spectra for various perturber-density conditions. The density dependence of the intensities retrieved from the simulated spectra and the predicted super-Lorentzian behavior in the troughs between lines are in good agreement with experimental determinations for both HCl-CO2 and HCl-He. Our analysis shows that these effects are due to incomplete or ongoing collisions, which govern the dipole auto-correlation function at very short times. The effects of these ongoing collisions strongly depend on the details of the intermolecular potential: they are negligible for HCl-He but significant for HCl-CO2 for which a line-shape model beyond the impact approximation will be needed to correctly model the absorption spectra from the center to the far wings.
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Affiliation(s)
- Ha Tran
- Laboratoire de Météorologie Dynamique, IPSL, Sorbonne Université, ENS, Université PSL, École Polytechnique, Institut Polytechnique de Paris, CNRS, Paris, France
| | - Gang Li
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
| | - Ngoc Hoa Ngo
- Faculty of Physics, Hanoi National University of Education, 136 Xuan Thuy, Cau Giay, Hanoi, Vietnam
| | - Volker Ebert
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
- Physikalisch Chemisches Institut, Heidelberg University, INF 253, 69116 Heidelberg, Germany
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Fisher J, Tran T, Tran H, Luchters S, Hipgrave DB, Nguyen H, Tran T, Hanieh S, Simpson JA, Biggs BA, Tran T. Structured, multicomponent, community-based programme for women's health and infant health and development in rural Vietnam: a parallel-group cluster randomised controlled trial. Lancet Child Adolesc Health 2023; 7:311-325. [PMID: 37011652 DOI: 10.1016/s2352-4642(23)00032-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Interventions to improve early childhood development have previously addressed only one or a few risk factors. Learning Clubs is a structured, facilitated, multicomponent programme designed to address eight potentially modifiable risk factors, and offered from mid-pregnancy to 12 months post partum; we aimed to establish whether this programme could improve the cognitive development of children at 2 years of age. METHODS For this parallel-group cluster-randomised controlled trial, 84 of 116 communes (the clustering unit) in HaNam Province in rural Vietnam were randomly selected and randomly assigned to receive the Learning Clubs intervention (n=42) or usual care (n=42). Women aged at least 18 years who were pregnant (gestational age <20 weeks) were eligible for inclusion. Data sources were standardised, and study-specific questionnaires assessing risks and outcomes were completed in interviews in mid-pregnancy (baseline), late pregnancy (after 32 weeks of gestation), at 6-12 months post partum, and at the end of the study period when children were 2 years of age. Mixed-effects models were used to estimate trial effects, adjusting for clustering. The primary outcome was the cognitive development of children at 2 years of age, assessed by the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III) cognitive score. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000442303). FINDINGS Between April 28, 2018, and May 30, 2018, 1380 women were screened and 1245 were randomly assigned (669 to the intervention group and 576 to the control group). Data collection was completed on Jan 17, 2021. Data at the end of the study period were contributed by 616 (92%) of 669 women and their children in the intervention group, and by 544 (94%) of 576 women and their children in the control group. Children aged 2 years in the intervention group had significantly higher mean Bayley-III cognitive scores than those in the control group (99·6 [SD 9·7] vs 95·6 [9·4]; mean difference 4·00 [95% CI 2·56-5·43]; p<0·0001). At 2 years of age, 19 (3%) children in the intervention group had Bayley-III scores less than 1 SD, compared with 32 (6%) children in the control group, but this difference was not significant (odds ratio 0·55 [95% CI 0·26-1·17]; p=0·12). There were no significant differences between groups in maternal, fetal, newborn, or child deaths. INTERPRETATION A facilitated, structured, community-based, multicomponent group programme improved early childhood development to the standardised mean in rural Vietnam and could be implemented in other similarly resource-constrained settings. FUNDING Australian National Health and Medical Research Council and Grand Challenges Canada Saving Brains Initiative. TRANSLATION For the Vietnamese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jane Fisher
- Women and Global Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Thach Tran
- Women and Global Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ha Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
| | - Stanley Luchters
- Centre for Sexual Health and HIV AIDS Research (CeSHHAR), Harare, Zimbabwe; Liverpool School of Tropical Medicine, Liverpool, UK; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - David B Hipgrave
- UNICEF, New York, NY, USA; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Hau Nguyen
- Women and Global Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Thuy Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
| | - Sarah Hanieh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Julie Anne Simpson
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Beverley-Ann Biggs
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Department of Medicine and Victorian Infectious Diseases Service at the Doherty Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Tuan Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
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13
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Bui-Thi HD, Nguyen DK, To GK, Bui TD, Tran H, Nguyen MD, Le MK. Uncovering hypercoagulation status using rotational thromboelastometry in patients with sepsis presented with hypocoagulation based on conventional coagulation tests: an observational study. Eur Rev Med Pharmacol Sci 2023; 27:4492-4503. [PMID: 37259730 DOI: 10.26355/eurrev_202305_32455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Conventional coagulation tests (CCTs) cannot identify hypercoagulation, despite being common in patients with sepsis. Moreover, CCTs overdiagnose hypocoagulation, which increases unnecessary blood transfusion. Therefore, we aimed to use rotational thromboelastometry (ROTEM) to classify the coagulation status of patients with sepsis with abnormal CCTs and to identify the main coagulation components that affect coagulation status. PATIENTS AND METHODS This study was part of an observational study to investigate ROTEM use in 161 patients with sepsis with the Sepsis-3 criteria. They underwent concurrent CCTs and ROTEM assessments within 24 hours of Intensive Care Unit admission at the University Medical Center, Ho Chi Minh City, from June 2020 to December 2021. This study only extracted data from patients with sepsis with abnormal CCTs, including activated partial thromboplastin time ratio, international normalized ratio (INR), platelet count, and fibrinogen concentration. RESULTS A total of 158 patients with sepsis with abnormal CCTs had a median age of 69, and 48.7% were women. Of 34 patients with INR ≥1.6, ROTEM identified 11.8% with hypercoagulation and 20.6% with normal coagulation. Of 29 patients with platelet counts <100 (103/mm3), ROTEM identified 3.5% with hypercoagulation and 24.1% with normal coagulation. In the ROTEM-based hypercoagulability group, an increase in maximum clot firmness was observed in 95.1% of cases; also, this group had significantly higher plasma fibrinogen concentrations than other groups (p<0.005). CONCLUSIONS ROTEM can reveal hypercoagulability in patients with sepsis with hypocoagulation based on CCTs. Hyperfibrinogenemia causes hypercoagulation in patients with sepsis.
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Affiliation(s)
- H-D Bui-Thi
- Department of Intensive Care, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Reed ZD, Tran H, Ngo HN, Hartmann JM, Hodges JT. Effect of Non-Markovian Collisions on Measured Integrated Line Shapes of CO. Phys Rev Lett 2023; 130:143001. [PMID: 37084433 DOI: 10.1103/physrevlett.130.143001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/25/2023] [Accepted: 03/10/2023] [Indexed: 05/03/2023]
Abstract
Using cavity ring-down spectroscopy to probe R-branch transitions of CO in N_{2}, we show that the spectral core of the line shapes associated with the first few rotational quantum numbers, J, can be accurately modeled using a sophisticated line profile, provided that a pressure-dependent line area is introduced. This correction vanishes as J increases and is always negligible in CO-He mixtures. The results are supported by molecular dynamics simulations attributing the effect to non-Markovian behavior of collisions at short times. This work has large implications because corrections must be considered for accurate determinations of integrated line intensities, and for spectroscopic databases and radiative transfer codes used for climate predictions and remote sensing.
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Affiliation(s)
- Zachary D Reed
- Chemical Sciences Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, USA
| | - Ha Tran
- Laboratoire de Météorologie Dynamique/IPSL, CNRS, Sorbonne Université, Ecole Polytechnique, Institut polytechnique de Paris, Ecole Normale Supérieure, PSL Research University, 4 place Jussieu, 75252, Paris, France
| | - Hoa N Ngo
- Faculty of Physics, Hanoi National University of Education, 136 Xuan Thuy, Cau Giay, Hanoi, Vietnam
| | - Jean-Michel Hartmann
- Laboratoire de Météorologie Dynamique/IPSL, CNRS, Sorbonne Université, Ecole Polytechnique, Institut polytechnique de Paris, Ecole Normale Supérieure, PSL Research University, 4 place Jussieu, 75252, Paris, France
| | - Joseph T Hodges
- Chemical Sciences Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, USA
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15
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Enciso JS, Duran A, Tran H, Urey M, Adler E, White R, Kearns M, Pretorius V. Donor Characteristic Between Donor Circulatory Death and Donor Brain Death. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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16
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Barriola Rubarth R, Duran A, Sung K, Bui Q, McLenon M, Cruz Rodriguez J, Urey M, Adler E, Wettersten N, Kearns M, Pretorius V, Silva Enciso J, Tran H. Low Pulmonary Artery Pulsatility Index (PAPi) Early Post Heart Transplant is Associated with Short Term Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Duran A, Rubarth R, Agdashian D, Kumar A, Bui Q, McLenon M, Rodriguez JC, Urey M, Adler E, Wettersten N, Tran H, Kearns M, Pretorius V, Enciso JS. Early Graft Function by Hemodynamics is Similar Between Brain Death (DBD) and Circulatory Death Donors (DCD). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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18
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Lin A, Bui Q, Duran A, Gernhofer Y, White R, Sharaf K, Cookish D, Tran H, Hong K, Adler E, Wettersten N, Enciso JS, Urey M, Kearns M, Pretorius V. Impact of Dcd Donor Hearts on Transplant Outcomes: A Propensity-Matched Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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19
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Kearns M, Brann A, White R, Jackson B, Cookish D, Sharaf K, Huynh D, Gernhofer Y, Tran H, Urey M, Adler E, Pretorius V. A Single Center Comparison of DCD Heart Transplantation Using Two Procurement Strategies: Direct Procurement and Perfusion versus Normothermic Regional Perfusion. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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20
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Bui Q, Gernhofer Y, Duran A, Lin A, Ding J, Birs A, Ma G, White R, Sharaf K, Cookish D, Wettersten N, Rodriguez JC, Tran H, Hong K, Adler E, Enciso JS, Urey M, Kearns M, Pretorius V. One Year Cardiac Allograft Vasculopathy (cav) Outcomes in Donor after Circulatory Death (dcd) Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Bui TD, Pham ND, Phan-Nguyen TV, Vu-Thi LN, Tran VT, Nguyen VH, Nguyen MD, Tran H. Sinus arrest in familial hypokalemic periodic paralysis caused by SCN4A mutation: a case report. Eur Rev Med Pharmacol Sci 2023; 27:1767-1773. [PMID: 36930492 DOI: 10.26355/eurrev_202303_31538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Primary hypokalemic periodic paralysis (HypoPP), a rare skeletal muscle channelopathy resulting in episodic muscle weakness or paralysis under hypokalemic conditions, is caused by autosomal-dominant genetic mutations. HypoPP limits physical activity, and cardiac arrhythmias during paralytic attacks have been reported. We describe a rare familial HypoPP case complicated by sinus arrest and syncope requiring urgent temporary pacemaker implantation. CASE REPORT A 27-year-old Vietnamese man with a family history of periodic paralysis presented with his third attack of muscle weakness triggered by intense football training the previous day. Clinical and laboratory features justified a HypoPP diagnosis. During intravenous potassium replacement, the patient experienced syncopal sinus arrest requiring urgent temporary pacemaker implantation. The patient gradually improved, responding favorably to oral potassium supplements. Genetic testing revealed an Arg1132Gln mutation in the sodium ion channel (SCN4A, chromosome 17: 63947091). At discharge, the patient received expert consultation regarding nonpharmacological preventive strategies, including avoidance of vigorous exercise and carbohydrate-rich diet. CONCLUSIONS No evidence has established a relationship between hypokalemia and sinus arrest, and no specific treatment exists for familial HypoPP due to SCN4A mutation. Clinician awareness of this rare condition will promote appropriate diagnostic approaches and management strategies for acute paralytic attacks. Treatment should be tailored according to HypoPP phenotypes and genotypes.
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Affiliation(s)
- T-D Bui
- Department of Cardiology, University Medical Center HCMC, Ho Chi Minh City, Vietnam.
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22
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Tran H, Li G, Ngo NH, Ebert V. Pressure dependence of the measured line intensity and super-Lorentzian effects in the absorption spectra of pure HCl. Phys Chem Chem Phys 2023; 25:10343-10352. [PMID: 36988150 DOI: 10.1039/d2cp04892b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Super-Lorentzian effects in the troughs between lines and the pressure dependence of the line intensities retrieved from fits of absorption spectra of pure HCl have been investigated both experimentally and...
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Affiliation(s)
- Ha Tran
- Laboratoire de Météorologie Dynamique, IPSL, CNRS, Sorbonne Université, Ecole polytechnique, Institut polytechnique de Paris, École normale supérieure, PSL Research University, F-75005 Paris, France.
| | - Gang Li
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
| | - Ngoc Hoa Ngo
- Faculty of Physics, Hanoi National University of Education, 136 Xuan Thuy, Cau Giay, Hanoi, Vietnam
| | - Volker Ebert
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
- Physikalisch-Chemisches Institut, Heidelberg University, INF 253, 69116 Heidelberg, Germany
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Al-Falahi Z, Tran H, Middleton P, Basilakis J, Lo S, Dang V, Joseph V, Femia G, Nia A, Moore N, Houltham J, Silva R. Corrigendum to ‘Automation of Optical Coherence Tomography (OCT) Tissued Morphology and Vessel Sizing With Artificial Intelligence’ [Heart, Lung and Circulation volume 31 (2022) S321-S322]. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Chao D, Tran H, Hogan QH, Pan B. Analgesic dorsal root ganglion field stimulation blocks both afferent and efferent spontaneous activity in sensory neurons of rats with monosodium iodoacetate-induced osteoarthritis. Osteoarthritis Cartilage 2022; 30:1468-1481. [PMID: 36030058 PMCID: PMC9588581 DOI: 10.1016/j.joca.2022.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/03/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Chronic joint pain is common in patients with osteoarthritis (OA). Non-steroidal anti-inflammatory drugs and opioids are used to relieve OA pain, but they are often inadequately effective. Dorsal root ganglion field stimulation (GFS) is a clinically used neuromodulation approach, although it is not commonly employed for patients with OA pain. GFS showed analgesic effectiveness in our previous study using the monosodium iodoacetate (MIA) - induced OA rat pain model. This study was to evaluate the mechanism of GFS analgesia in this model. METHODS After osteoarthritis was induced by intra-articular injection of MIA, pain behavioral tests were performed. Effects of GFS on the spontaneous activity (SA) were tested with in vivo single-unit recordings from teased fiber saphenous nerve, sural nerve, and dorsal root. RESULTS Two weeks after intra-articular MIA injection, rats developed pain-like behaviors. In vivo single unit recordings from bundles teased from the saphenous nerve and third lumbar (L3) dorsal root of MIA-OA rats showed a higher incidence of SA than those from saline-injected control rats. GFS at the L3 level blocked L3 dorsal root SA. MIA-OA reduced the punctate mechanical force threshold for inducing AP firing in bundles teased from the L4 dorsal root, which reversed to normal with GFS. After MIA-OA, there was increased retrograde SA (dorsal root reflex), which can be blocked by GFS. CONCLUSIONS These results indicate that GFS produces analgesia in MIA-OA rats at least in part by producing blockade of afferent inputs, possibly also by blocking efferent activity from the dorsal horn.
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Affiliation(s)
- D Chao
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - H Tran
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Q H Hogan
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - B Pan
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA.
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Cannatà M, Russo R, Beghella Bartoli F, Palumbo I, Tran H, Votta C, Lupattelli M, Boldrini L, Dinapoli N, Camilli F, Balducci M, Gambacorta M, Valentini V, Aristei C, Sabatino G, Pignotti F, Gaudino S, Chiesa S. P02.11.B An hypothesis generating study of MRI-Derived Radiomics on tumor and microenvironment tissue heterogeneity to guide post-operative management of glioblastoma: toward personalized radiation treatment volume delineation. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The glioblastoma’s bad prognosis is primarily due to intra-tumor heterogeneity, demonstrated from several studies that collected molecular biology, cytogenetic data and more recently radiomic features for a better prognostic stratification.The GLIFA project (GLIoblastoma Feature Analysis) is a multicentric project planned to investigated the role of radiomic analysis in GBM management, to verify if radiomic features in the tissue around the resection cavity which may guide the radiation target volume delineation.
Material and Methods
We retrospectively analyze from three centers radiomic features extracted from 90 patients with total or near total resection, who completed the standard adjuvant treatment and for whom we had post-operative images available for features extraction.The Manual segmentation was performed on post gadolinium T1w MRI sequence by 2 radiation oncologist reviewed by a neuroradiologist, both with at least 10 years of experience. The Region of interest (ROI) considered for the analysis were: the surgical cavity +/- post-surgical residual mass (CTV_cavity); the CTV a margin of 1.5 cm added to CTV_cavity and the volume resulting from subtracting the CTV_cavity from the CTV was defined as CTV_Ring. Radiomic analysis and modelling were conducted in RStudio. Z-score normalization was applied to each radiomic feature. A radiomic model was generated using the 226 features extracted from the Ring to perform a binary classification and predict the PFS at 6 months (statistical, morphological and textural features). A 3-fold cross-validation repeated five times was implemented for internal validation of the model.
Results
Two-hundred and seventy ROIs were contoured. The proposed radiomic model was given by the best fitting logistic regression model, and included the following 3 features: F_cm_merged.contrast, F_cm_merged.info.corr.2, F_rlm_merged.rlnu. A good agreement between model predicted probabilities and observed outcome probabilities was obtained (p-value of 0.49 by Hosmer and Lemeshow statistical test). The ROC curve of the model reported an AUC of 0.78 (95% CI: 0.68 - 0.88).
Conclusion
This is the first hypothesis-generating study who applies a radiomic analysis focusing on healthy tissue ring around the surgical cavity on post-operative MRI. This study provides a preliminary model for a decision support tool for a customization of the radiation target volume in GBM patients in order to achieve a margin reduction strategy.
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Affiliation(s)
- M Cannatà
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - R Russo
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - F Beghella Bartoli
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - I Palumbo
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - H Tran
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - C Votta
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - M Lupattelli
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - L Boldrini
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - N Dinapoli
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - F Camilli
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - M Balducci
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - M Gambacorta
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - V Valentini
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - C Aristei
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - G Sabatino
- Radiation Oncology, Mater Olbia Hospital , 07026, Olbia , Italy
| | - F Pignotti
- Department of Neurosurgery, Mater Olbia Hospital , Olbia , Italy
| | - S Gaudino
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - S Chiesa
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
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Heeke S, Gay C, Estecio M, Stewart A, Tran H, Zhang B, Tang X, Raso M, Concannon K, De Sousa LG, Lewis W, Kondo K, Nilsson M, Xi Y, Diao L, Wang Q, Zhang J, Wang J, Wistuba I, Byers L, Heymach J. MA01.03 Exploiting DNA Methylation for Classification of SCLC Subtypes from Liquid Biopsies Using a Robust Machine Learning Approach. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kim S, Rebmann P, Tran H, Kellner E, Reisert M, Bamberg F, Kotter E, Russe M. Deep Learning zur Erkennung von Osteosynthesematerial, Hartverbänden und postoperativen Veränderungen am Beispiel des Sprunggelenks. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - P Rebmann
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg i. Br
| | - H Tran
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - E Kellner
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - M Reisert
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - F Bamberg
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - E Kotter
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - M Russe
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
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Hanel W, Lata P, Youssef Y, Tran H, Tsyba L, Sehgal L, Blaser BW, Huszar D, Helmig-Mason J, Zhang L, Schrock MS, Summers MK, Chan WK, Prouty A, Mundy-Bosse BL, Chen-Kiang S, Danilov AV, Maddocks K, Baiocchi RA, Alinari L. A sumoylation program is essential for maintaining the mitotic fidelity in proliferating mantle cell lymphoma cells. Exp Hematol Oncol 2022; 11:40. [PMID: 35831896 PMCID: PMC9277803 DOI: 10.1186/s40164-022-00293-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mantle cell lymphoma (MCL) is a rare, highly heterogeneous type of B-cell non-Hodgkin's lymphoma. The sumoylation pathway is known to be upregulated in many cancers including lymphoid malignancies. However, little is known about its oncogenic role in MCL. METHODS Levels of sumoylation enzymes and sumoylated proteins were quantified in MCL cell lines and primary MCL patient samples by scRNA sequencing and immunoblotting. The sumoylation enzyme SAE2 was genetically and pharmacologically targeted with shRNA and TAK-981 (subasumstat). The effects of SAE2 inhibition on MCL proliferation and cell cycle were evaluated using confocal microscopy, live-cell microscopy, and flow cytometry. Immunoprecipitation and orbitrap mass spectrometry were used to identify proteins targeted by sumoylation in MCL cells. RESULTS MCL cells have significant upregulation of the sumoylation pathway at the level of the enzymes SAE1 and SAE2 which correlated with poor prognosis and induction of mitosis associated genes. Selective inhibition of SAE2 with TAK-981 results in significant MCL cell death in vitro and in vivo with mitotic dysregulation being an important mechanism of action. We uncovered a sumoylation program in mitotic MCL cells comprised of multiple pathways which could be directly targeted with TAK-981. Centromeric localization of topoisomerase 2A, a gene highly upregulated in SAE1 and SAE2 overexpressing MCL cells, was lost with TAK-981 treatment likely contributing to the mitotic dysregulation seen in MCL cells. CONCLUSIONS This study not only validates SAE2 as a therapeutic target in MCL but also opens the door to further mechanistic work to uncover how to best use desumoylation therapy to treat MCL and other lymphoid malignancies.
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Affiliation(s)
- Walter Hanel
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Pushpa Lata
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Youssef Youssef
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Ha Tran
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Liudmyla Tsyba
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Lalit Sehgal
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Bradley W Blaser
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | | | - JoBeth Helmig-Mason
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Liwen Zhang
- Proteomics and Mass Spectrometry Facility, The Ohio State University, 460 W. 12th Avenue, Columbus, OH, 43210, USA
| | - Morgan S Schrock
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Matthew K Summers
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Wing Keung Chan
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Alexander Prouty
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Bethany L Mundy-Bosse
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Selina Chen-Kiang
- Weil Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
| | - Alexey V Danilov
- City of Hope National Medical Center, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | - Kami Maddocks
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Robert A Baiocchi
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA
| | - Lapo Alinari
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W 10th Ave, Columbus, OH, 43210, USA.
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Scott A, Kim P, Tran H, Kligerman S, Adler E, Contijoch F. 465 Free Wall And Septal Wall Right Ventricular Strain With Ct For Postoperative Right Ventricular Failure Risk. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Nguyen T, Cashin J, Tran H, Vu D, Nandi A, Pham M, Nguyen V, Weissman A, Nguyen B, Pham T, Mathisen R. Paid Maternity Leave in Vietnam: Awareness, Perceptions, Gaps, and Uptake Among Formally Employed Pregnant Women and Mothers of Infants. Curr Dev Nutr 2022. [PMCID: PMC9194070 DOI: 10.1093/cdn/nzac071.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
To examine the uptake of Vietnam's paid maternity leave policy in terms of entitlements and awareness, perceptions, and gaps in implementation through the lens of formally employed female workers.
Methods
In this mixed methods study, we interviewed 494 formally employed female workers, among whom 107 were pregnant and 387 were mothers of infants and conducted in-depth interviews with a subset of these women (n = 39).
Results
Of the 494 women interviewed, 268 (54.3%) were working in blue-collar jobs and more than 90% were contributing to the public social insurance fund. Among the 387 mothers on paid maternity leave, 51 (13.2%) did not receive cash entitlements during their leave. Among the 182 mothers with infants aged 6–11 months, 30 (16.5%) returned to work before accruing 180 days of maternity leave. Of 121 women who had returned to work, 26 (21.5%) did not receive a one-hour paid break every day to express breastmilk, relax or breastfeed, and 46 (38.0%) worked the same or more hours per day than before maternity leave. Although most women perceived maternity leave as beneficial for the child's health (92.5%), mother's health (91.5%), family (86.2%), and society (90.7%), fewer women perceived it as beneficial for their income (59.5%), career (46.4%), and employers (30.4%). Not all formally employed women were aware of their maternity protection rights: women were more likely to mention the six-month paid maternity leave (78.7%) and one-hour nursing break (62.3%) than the other nine entitlements (2.0–35.0%). In-depth interviews with pregnant women and mothers of infants supported findings from the quantitative survey.
Conclusions
Although Vietnam's maternity protection policy helps protect the rights of women and children, our study identified implementation gaps that limit its effectiveness. In order to ensure that all women and their families can fully benefit from maternity protection, there is a need to increase awareness of the full set of maternity entitlements, strengthen enforcement of existing policies, and expand entitlements to the informal sector.
Funding Sources
Bill & Melinda Gates Foundation (Grant Number OPP50838) and Irish Aid.
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Affiliation(s)
| | | | | | | | - Arijit Nandi
- Research and Training Center for Community Development
| | | | | | - Amy Weissman
- Vietnam Ministry of Labor, Invalids and Social Affairs
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Brichko L, Van Breugel L, Underhill A, Tran H, Mitra B, Cameron P, Smit D, Giles ML, McCreary D, Paton A, O'Reilly G. The Impact of COVID-19 Vaccinations on Emergency Department Presentations. Emerg Med Australas 2022; 34:913-919. [PMID: 35475322 PMCID: PMC9111314 DOI: 10.1111/1742-6723.14012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/07/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022]
Abstract
Objective The aim of the present study was to describe the burden of patients presenting to the ED with symptoms occurring after receiving a COVID‐19 vaccination. Methods This was a retrospective cohort study performed over a 4‐month period across two EDs. Participants were eligible for inclusion if it was documented in the ED triage record that their ED attendance was associated with the receipt of a COVID‐19 vaccination. Data regarding the type of vaccine (Comirnaty or ChAdOx1) were subsequently extracted from their electronic medical record. Primary outcome was ED length of stay (LOS) and secondary outcomes included requests for imaging and ED disposition destination. Results During the study period of 22 February 2021 to 21 June 2021, 632 patients were identified for inclusion in the present study, of which 543 (85.9%) had received the ChAdOx1 vaccination. The highest proportion of COVID‐19 vaccine‐related attendances occurred in June 2021 and accounted for 21 (8%) of 262 total daily ED attendances. Patients who had an ED presentation related to ChAdOx1 had a longer median ED LOS (253 vs 180 min, P < 0.001) compared to Comirnaty and a higher proportion had haematology tests and imaging requested in the ED. Most patients (n = 588, 88.8%) were discharged home from the ED. Conclusion There was a notable proportion of ED attendances related to recent COVID‐19 vaccination administration, many of which were associated with lengthy ED stays and had multiple investigations. In the majority of cases, the patients were able to be discharged home from the ED.
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Affiliation(s)
- L Brichko
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,Emergency Department, Cabrini Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - L Van Breugel
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia
| | - A Underhill
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia
| | - H Tran
- Haematology Department, Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - B Mitra
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,National Trauma Research Institute, Melbourne, Australia
| | - P Cameron
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - D Smit
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,National Trauma Research Institute, Melbourne, Australia
| | - M L Giles
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.,Department of Infectious Diseases, Alfred Hospital, Melbourne, Australia
| | - D McCreary
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - A Paton
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,Adult Retrieval Victoria, Melbourne, Australia
| | - G O'Reilly
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,National Trauma Research Institute, Melbourne, Australia
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Blackowicz MJ, Falzon L, Beck W, Tran H, Weiner DE. Economic evaluation of expanded hemodialysis with the Theranova 400 dialyzer: A post hoc evaluation of a randomized clinical trial in the United States. Hemodial Int 2022; 26:449-455. [PMID: 35441486 PMCID: PMC9544662 DOI: 10.1111/hdi.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 01/21/2022] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
Abstract
Introduction The Theranova 400 is a medium cut‐off dialyzer that allows for superior clearance of larger middle molecules than traditional high‐flux dialyzers. This study evaluates the association of expanded hemodialysis (HDx) using the Theranova dialyzer versus conventional hemodialysis (HD) with a high‐flux dialyzer on hospitalization rates and healthcare costs as compared to conventional HD in a post hoc analysis of a randomized controlled trial. Methods In a non‐concealed, 24‐week clinical trial, maintenance HD patients were randomized to receive treatment with either Theranova 400 or a similar size high‐flux dialyzer. Hospitalization rate and average length of stay were calculated from trial data. Use of erythropoiesis‐stimulating agents and iron were assumed to be equal and therefore excluded from the model. Average cost per inpatient day was obtained from a publicly available published source. Probabilistic sensitivity analyses were conducted to account for variability in model inputs. Findings There were 86 patients (389 patient‐months) in the Theranova group and 85 patients (366 patient‐months) in the high‐flux HD group. All‐cause hospitalization rate was 45% lower with Theranova compared to high‐flux HD (IRR = 0.55; p = 0.05). Average annual estimated cost of hospitalization was $6098 lower with Theranova compared to high‐flux HD. Compared to high‐flux HD, average annual estimated cost associated with Theranova use was $4772 lower per patient. Hospitalization rate and hospital length of stay were the main drivers of cost. Conclusions Use of the Theranova dialyzer is associated with lower estimated costs of care among maintenance HD patients, driven by fewer hospitalization events.
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Affiliation(s)
| | - Luke Falzon
- Baxter Healthcare Corporation, San Gwann, Malta
| | - Werner Beck
- Baxter Healthcare Corporation, Hechingen, Germany
| | - Ha Tran
- Baxter Healthcare Corporation, Deerfield, Illinois, USA
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Lipinski J, Dharmavaram G, Cruz Rodriguez J, Urey M, Pretorius V, Adler E, Tran H. Normal Geriatric Nutritional Risk Index is Associated with Rehospitalization After Orthotopic Heart Transplant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Brown M, Cruz Rodgriguez J, Duran J, Tran H, Urey M, Silva J, Winnike K, Topik A, Anguiano H, Kearns M, Pretorius V, Adler E. Outcomes in Cardiac Transplantation in Patients with a History of Methamphetamine Use: A Single Center Experience. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Frankul L, Ramirez-Sanchez C, Sigler R, Kozuch J, Law N, Tran H, Aslam S. Risk Factors for Invasive Fungal Infections in Heart Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Dharmavaram G, Lin A, Hannsun G, Nguyen V, Mendenhall M, Sirignano M, Adler E, Pretorius V, Tran H. Association of Fried's Frailty Score and Sarcopenia with Outcomes After Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Al-Falahi Z, Tran H, Middleton P, Basilakis J, Lo S, Dang V, Joseph V, Fema G, Nia A, Moore N, Houltham J, Silva R. Automation of Optical Coherence Tomography (OCT) Tissued Morphology and Vessel Sizing With Artificial Intelligence. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Doma H, Tran TD, Tran T, Hanieh S, Tran H, Nguyen T, Biggs BA, Fisher J. Continuing breastfeeding for at least two years after birth in rural Vietnam: prevalence and psychosocial characteristics. Int Breastfeed J 2021; 16:78. [PMID: 34641917 PMCID: PMC8507108 DOI: 10.1186/s13006-021-00427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background The World Health Organization recommends breastfeeding for at least two years (24 months or more) after birth. In Vietnam, 22% of women continue breastfeeding for at least two years. The aim of this study was to determine the sociodemographic and psychosocial characteristics of mother-baby dyads associated with breastfeeding for 24 months or more in a rural setting in Vietnam. Methods A secondary analysis was conducted on existing data obtained from a prospective study in Ha Nam, Vietnam. Women were recruited when they were pregnant and were followed up until 36 months after giving birth. The data were collected between 2009 and 2011. The associations between sociodemographic and psychosocial characteristics and continued breastfeeding for 24 months or more were examined using a multivariable logistic regression model. Results Overall, 363 women provided complete data which were included in the analyses. Among those, 20.9% breastfed for 24 months or more. Women who were 31 years old or older were more likely to breastfeed for 24 months or more than women who were 20 years old or younger (adjusted odds ratio, AOR, 9.54 [95% CI 2.25, 40.47]). Women who gave birth to girls were less likely to breastfeed for 24 or more months than women who had boys (AOR 0.44; 95% CI 0.25, 0.80). Conclusions This study provides evidence that may be useful for policy-makers to help improve breastfeeding practices for all children in Vietnam by targeting policy towards younger women and women with girls to promote continued breastfeeding for at least 24 months. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00427-8.
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Affiliation(s)
- Hemavarni Doma
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Thach Duc Tran
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Research and Training Centre for Community Development, Hanoi, Vietnam
| | - Tuan Tran
- Research and Training Centre for Community Development, Hanoi, Vietnam
| | - Sarah Hanieh
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Ha Tran
- Research and Training Centre for Community Development, Hanoi, Vietnam
| | - Trang Nguyen
- Research and Training Centre for Community Development, Hanoi, Vietnam
| | - Beverley-Ann Biggs
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.,The Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jane Fisher
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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John S, Ignatyeva Y, Greenberg B, Lin A, Wettersten N, Urey M, Kim P, Hong K, Tran H, Encisco JS, Pretorius V, Yagil A, Adler E. Machine Learning for Prognostication in Patients Undergoing LVAD Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Kabra N, McLenon M, Gernhofer Y, Mariski M, Pretorius V, Tran H, Cronin B. The Perfect Match: A Combination of Cangrelor and Heparin for Heparin-Induced Thrombocytopenia during Cardiopulmonary Bypass in Heart and Kidney Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Patel S, Herynk M, Cascone T, Saigal B, Nilsson M, Tran H, Ramachandran S, Minna J, Wistuba I, Heymach J. P71.02 Estrogen Promotes Resistance to Bevacizumab Treatment in Non-Small Cell Lung Cancer (NSCLC) Xenograft Models. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wallace M, James AE, Silver R, Koh M, Tobolowsky FA, Simonson S, Gold JAW, Fukunaga R, Njuguna H, Bordelon K, Wortham J, Coughlin M, Harcourt JL, Tamin A, Whitaker B, Thornburg NJ, Tao Y, Queen K, Uehara A, Paden CR, Zhang J, Tong S, Haydel D, Tran H, Kim K, Fisher KA, Marlow M, Tate JE, Doshi RH, Sokol T, Curran KG. Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May-June, 2020. Emerg Infect Dis 2021; 27:421-429. [PMID: 33395380 PMCID: PMC7853536 DOI: 10.3201/eid2702.204158] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
To assess transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a detention facility experiencing a coronavirus disease outbreak and evaluate testing strategies, we conducted a prospective cohort investigation in a facility in Louisiana, USA. We conducted SARS-CoV-2 testing for detained persons in 6 quarantined dormitories at various time points. Of 143 persons, 53 were positive at the initial test, and an additional 58 persons were positive at later time points (cumulative incidence 78%). In 1 dormitory, all 45 detained persons initially were negative; 18 days later, 40 (89%) were positive. Among persons who were SARS-CoV-2 positive, 47% (52/111) were asymptomatic at the time of specimen collection; 14 had replication-competent virus isolated. Serial SARS-CoV-2 testing might help interrupt transmission through medical isolation and quarantine. Testing in correctional and detention facilities will be most effective when initiated early in an outbreak, inclusive of all exposed persons, and paired with infection prevention and control.
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Tran H, Nguyen KD, Pathirana PN, Horne MK, Power L, Szmulewicz DJ. A comprehensive scheme for the objective upper body assessments of subjects with cerebellar ataxia. J Neuroeng Rehabil 2020; 17:162. [PMID: 33276783 PMCID: PMC7718681 DOI: 10.1186/s12984-020-00790-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/17/2020] [Indexed: 01/28/2023] Open
Abstract
Background Cerebellar ataxia refers to the disturbance in movement resulting from cerebellar dysfunction. It manifests as inaccurate movements with delayed onset and overshoot, especially when movements are repetitive or rhythmic. Identification of ataxia is integral to the diagnosis and assessment of severity, and is important in monitoring progression and improvement. Ataxia is identified and assessed by clinicians observing subjects perform standardised movement tasks that emphasise ataxic movements. Our aim in this paper was to use data recorded from motion sensors worn while subjects performed these tasks, in order to make an objective assessment of ataxia that accurately modelled the clinical assessment. Methods Inertial measurement units and a Kinect© system were used to record motion data while control and ataxic subjects performed four instrumented version of upper extremities tests, i.e. finger chase test (FCT), finger tapping test (FTT), finger to nose test (FNT) and dysdiadochokinesia test (DDKT). Kinematic features were extracted from this data and correlated with clinical ratings of severity of ataxia using the Scale for the Assessment and Rating of Ataxia (SARA). These features were refined using Feed Backward feature Elimination (the best performing method of four). Using several different learning models, including Linear Discrimination, Quadratic Discrimination Analysis, Support Vector Machine and K-Nearest Neighbour these extracted features were used to accurately discriminate between ataxics and control subjects. Leave-One-Out cross validation estimated the generalised performance of the diagnostic model as well as the severity predicting regression model. Results The selected model accurately (\documentclass[12pt]{minimal}
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\begin{document}$$96.4\%$$\end{document}96.4%) predicted the clinical scores for ataxia and correlated well with clinical scores of the severity of ataxia (\documentclass[12pt]{minimal}
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\begin{document}$$p < 0.001$$\end{document}p<0.001). The severity estimation was also considered in a 4-level scale to provide a rating that is familiar to the current clinically-used rating of upper limb impairments. The combination of FCT and FTT performed as well as all four test combined in predicting the presence and severity of ataxia. Conclusion Individual bedside tests can be emulated using features derived from sensors worn while bedside tests of cerebellar ataxia were being performed. Each test emphasises different aspects of stability, timing, accuracy and rhythmicity of movements. Using the current models it is possible to model the clinician in identifying ataxia and assessing severity but also to identify those test which provide the optimum set of data. Trial registration Human Research and Ethics Committee, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia (HREC Reference Number: 11/994H/16).
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Affiliation(s)
- Ha Tran
- School of Engineering, Deakin University, Pigdons Road, Waurn Ponds, VIC, 3220, Australia.
| | - Khoa D Nguyen
- School of Engineering, Deakin University, Pigdons Road, Waurn Ponds, VIC, 3220, Australia
| | - Pubudu N Pathirana
- School of Engineering, Deakin University, Pigdons Road, Waurn Ponds, VIC, 3220, Australia
| | - Malcolm K Horne
- Florey Institute of Neuroscience and Mental Health, Royal Parade, Parkville, VIC, 3052, Australia
| | - Laura Power
- Balance Disorders & Ataxia Service, Royal Victorian Eye and Ear Hospital (RVEEH), Gisborne St, East Melbourne, VIC, 3002, Australia
| | - David J Szmulewicz
- Florey Institute of Neuroscience and Mental Health, Royal Parade, Parkville, VIC, 3052, Australia.,Balance Disorders & Ataxia Service, Royal Victorian Eye and Ear Hospital (RVEEH), Gisborne St, East Melbourne, VIC, 3002, Australia.,Cerebellar Ataxia Clinic, Alfred Hospital, Commercial Road, Prahran, VIC, 3004, Australia
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Ngo MD, Ngo VQB, Nguyen KA, Le DH, Tran H. A powerful model predictive control via stability condition for direct matrix converter. SN Appl Sci 2020. [DOI: 10.1007/s42452-020-03857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abeysekara LL, Tran H, Pathirana PN, Horne M, Power L, Szmulewicz D. Multi-domain Data Capture and Cloud Buffered Multimodal Evaluation Platform for Clinical Assessment of Cerebellar Ataxia. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:5640-5643. [PMID: 33019256 DOI: 10.1109/embc44109.2020.9176341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cerebellar Ataxia is a neurological disorder without an approved treatment. Patients will have impaired and uncoordinated motor functionality making them unable to complete their day-to-day activities. Ataxia clinics are established around the world to facilitate research and rehabilitate patients. However, the patients are generally evaluated by human - observation. Therefore, machine learning based data analysis is popular on motion captured via sensors. There are many neurological tests designed to analyse the motor impairments in different domains (such as upper limb, lower limb, gait, balance and speech). Clinicians follow scoring protocols to record the severity of patients for each domain test. This paper delivers a clinical assessment platform combining 12 neurological tests in 5 domains. It captures motion (from BioKin sensors), haptic and audio data (from the tablet or laptop screen). A data analysis system is hosted in a remote server which evaluates data to produce a severity score via different models built for each neurological test. The assessment platform clients and server communicate via a cloud buffer system. The scores input by the clinicians and predicted by the machine learning models are logged in the cloud database. This enables clinicians and doctors to view and compare the history of patient diagnosis. The server system is structured for automated score model upgrades via prompted approval. Thus, the most viable scoring model could be accommodated for each test based on longitudinal studies.
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Weiner DE, Falzon L, Skoufos L, Bernardo A, Beck W, Xiao M, Tran H. Efficacy and Safety of Expanded Hemodialysis with the Theranova 400 Dialyzer: A Randomized Controlled Trial. Clin J Am Soc Nephrol 2020; 15:1310-1319. [PMID: 32843372 PMCID: PMC7480550 DOI: 10.2215/cjn.01210120] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Expanded hemodialysis therapy enabled by medium cut-off membranes may promote greater clearance of larger middle molecules that comprise putative uremic solutes than conventional high-flux dialysis. This randomized trial evaluated the efficacy and safety of hemodialysis treatment with a medium cut-off dialyzer. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Clinically stable patients on maintenance hemodialysis were randomized to receive dialysis with either a medium cut-off dialyzer (Theranova 400) or a high-flux dialyzer (Elisio-17H) over 24 weeks of treatment. The primary safety end point was the predialysis serum albumin level after 24 weeks of treatment. The primary efficacy end point was the reduction ratio of free λ light chains at 24 weeks of treatment. RESULTS Among 172 patients on maintenance hemodialysis, mean age was 59±13 years, 61% were men, 40% were Black, and mean dialysis vintage was 5±4 years. Of the 86 patients randomized to each dialyzer, 65 completed the trial in each group. The reduction ratio for the removal of free λ light chains was significantly higher in the Theranova 400 group compared with the Elisio-17H group after 4 weeks (39% versus 20%) and 24 weeks (33% versus 17%; both P<0.001). Among secondary end points, the Theranova 400 group demonstrated significantly larger reduction ratios at 4 and 24 weeks for complement factor D, free κ light chains, TNFα, and β2-microglobulin (P<0.001 for all), but not for IL-6. Predialysis serum albumin levels were similar between groups after 24 weeks (4 g/dl with the Theranova 400 and 4.1 g/dl with the Elisio-17H), consistent with noninferiority of the Theranova 400 dialyzer in maintaining predialysis serum albumin levels after 24 weeks of treatment. CONCLUSIONS Hemodialysis therapy with the Theranova 400 dialyzer provides superior removal of larger middle molecules, as exemplified by free λ light chains, compared with a similar size high-flux dialyzer, while maintaining serum albumin level. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER A Multi-Center, Prospective, Randomized, Controlled, Open-Label, Parallel Study to Evaluate the Safety and Efficacy of the Theranova 400 Dialyzer in End Stage Renal Disease (ESRD) Patients, NCT03257410.
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Affiliation(s)
- Daniel E. Weiner
- Tufts Medical Center, Medicine, Nephrology, Boston, Massachusetts
| | - Luke Falzon
- Baxter Healthcare Corporation, Worldwide Medical, San Gwann, Malta
| | - Line Skoufos
- Baxter Healthcare Corporation, Worldwide Medical, Deerfield, Illinois
| | - Angelito Bernardo
- Baxter Healthcare Corporation, Worldwide Medical, Deerfield, Illinois
| | - Werner Beck
- Baxter International Inc., Worldwide Medical, Hechingen, Germany
| | - Mengqi Xiao
- Baxter Healthcare Corporation, Worldwide Medical, Deerfield, Illinois
| | - Ha Tran
- Baxter Healthcare Corporation, Worldwide Medical, Deerfield, Illinois
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Njuguna H, Wallace M, Simonson S, Tobolowsky FA, James AE, Bordelon K, Fukunaga R, Gold JAW, Wortham J, Sokol T, Haydel D, Tran H, Kim K, Fisher KA, Marlow M, Tate JE, Doshi RH, Curran KG. Serial Laboratory Testing for SARS-CoV-2 Infection Among Incarcerated and Detained Persons in a Correctional and Detention Facility - Louisiana, April-May 2020. MMWR Morb Mortal Wkly Rep 2020; 69:836-840. [PMID: 32614816 PMCID: PMC7332096 DOI: 10.15585/mmwr.mm6926e2] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tran H, Nguyen KD, Pathirana PN, Horne M, Power L, Szmulewicz DJ. Multimodal Data Acquisition for the Assessment of Cerebellar Ataxia via Ballistic Tracking. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:859-862. [PMID: 33018120 DOI: 10.1109/embc44109.2020.9176379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cerebellar ataxia (CA) results from injury to or disease of the cerebellum. It describes the resulting motor dysfunction, characterised by inaccuracy, incoordination and delay in initiation of movement, tremor, and imbalance. Assessment of ataxia to diagnose and monitor progress is by clinical observance of the performance of standard motor tasks. An accurate instrumented measurement of CA would therefore be of great interest. This study was aimed at assessing upper-limb ataxia during ballistic tracking of a computer-generated target in individuals with CA and controls using motion measures obtained from a Kinect camera and a wearable motioncaptured device. A set of features derived from these motion measurements were used to develop a method for objective quantification of CA. Difference between ataxic and non-ataxic movements can be readily be observed in features from both devices (p= 0.008) and their values associated with a standard clinical scale (rho = 0.80, p < 0.001). The combination of multimodal features improved the ability to distinguish between CA subjects and controls and to measure the severity of upper limb ataxia.
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Stocker R, Nguyen T, Tran T, Tran H, Tran T, Hanieh S, Biggs BA, Fisher J. Social and economic development and pregnancy mental health: secondary analyses of data from rural Vietnam. BMC Public Health 2020; 20:1001. [PMID: 32586374 PMCID: PMC7318479 DOI: 10.1186/s12889-020-09067-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/05/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study aimed to establish whether changes in the socioeconomic context were associated with changes in population-level antenatal mental health indicators in Vietnam. METHODS Social, economic and public policies introduced in Vietnam (1986-2010) were mapped. Secondary analyses of data from two cross-sectional community-based studies conducted in 2006 (n = 134) and 2010 (n = 419), involving women who were ≥ 28 weeks pregnant were completed. Data for these two studies had been collected in structured individual face-to-face interviews, and included indicators of antenatal mental health (mean Edinburgh Postnatal Depression Scale Vietnam-validation (EPDS-V) score), intimate partner relationships (Intimate Bonds Measure Vietnam-validation) and sociodemographic characteristics. Socioeconomic characteristics and mean EPDS-V scores in the two study years were compared and mediation analyses were used to establish whether indicators of social and economic development mediated differences in EPDS-V scores. RESULTS Major policy initiatives for poverty reduction, hunger eradication and making domestic violence a crime were implemented between 2006 and 2010. Characteristics and circumstances of pregnant women in Ha Nam improved significantly. Mean EPDS-V score was lower in 2010, indicating better population-level antenatal mental health. Household wealth and intimate partner controlling behaviours mediated the difference in EPDS-V scores between 2006 and 2010. CONCLUSIONS Changes in the socioeconomic and political context, particularly through policies to improve household wealth and reduce domestic violence, appear to influence women's lives and population-level antenatal mental health. Cross-sectoral policies that reduce social risk factors may be a powerful mechanism to improve antenatal mental health at a population level.
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Affiliation(s)
- Ruby Stocker
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Trang Nguyen
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
- Research and Training Centre for Community Development, No 39 Lane 255, Vong Street, Hai Ba Trung District, Hanoi, Vietnam
| | - Thach Tran
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Ha Tran
- Research and Training Centre for Community Development, No 39 Lane 255, Vong Street, Hai Ba Trung District, Hanoi, Vietnam
| | - Tuan Tran
- Research and Training Centre for Community Development, No 39 Lane 255, Vong Street, Hai Ba Trung District, Hanoi, Vietnam
| | - Sarah Hanieh
- Department of Medicine and Victorian Infectious Diseases Services at the Doherty Institute, University of Melbourne, 792 Elizabeth Street, Melbourne, 3000, Australia
| | - Beverley-Ann Biggs
- Department of Medicine and Victorian Infectious Diseases Services at the Doherty Institute, University of Melbourne, 792 Elizabeth Street, Melbourne, 3000, Australia
| | - Jane Fisher
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia.
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Molano Trivino A, Zúñiga E, Sanabria M, Vesga J, Ramos C, Gutiérrez JF, Tran H, Ronco C, Rivera A. P1117EXPLORATORY COMPARISON OF DIALYSIS EFFICIENCY AT DIFFERENT DIALYSATE FLOW (QD) IN EXPANDED HEMODIALYSIS IN TWO CENTERS IN COLOMBIA. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and Aims
Dialysate flow rate (Qd) has minimal effect in removal of molecules in hemodialysis, allowing to use lower amounts of dialysate with no effect in clearance of molecules. According to recent literature, Expanded hemodialysis (HDx) improves the clearance of middle size molecules, diminishing the effect of Qd in adequacy. We found no data about clearance at different dialysate flow rates in HDx.
Our aim is to evaluate the clearance of middle molecules (beta 2 microglobuline [Mβ2], interleukin-6 [IL-6], interleukin-10 [IL-10 light chains (CLL-κ -λ) with HDx at different Qd using membranes TheranovaMR in patients with body weight less than 70 Kg.
Method
We performed an observational retrospective analysis of clearance of Mβ2, IL-6, IL-10, CLL-κ; CLL-λ in HDx using TheranovaMR filters with Qd 400 mL/min and 500 mL/min. We performed variance analysis, T student test and Wilcoxon test. Data were extracted from an HDx multicentric trial performed in Bogotá, Colombia in 2018.
Results
11 (47%) patients received Qd 400 mL/min and 12 (52.1%) patients with Qd 500ml/min. Demographic data are included in table 1. We found no differences in reduction rate of mid-molecules. (Table 2) We found that lower water consume in the Qd 400 mL/min group, with water savings of 24 Liters/patient (13824 L in 12 weeks of follow up). (Table 3)
Conclusion
Expanded hemodialysis seems to allow diminishing Qd rate without changes in mid-size molecules clearance.
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Affiliation(s)
- Alejandra Molano Trivino
- Fundacion Cardio Infantil Instituto De Cardiologia, Nephrology, Bogotá, Colombia
- RTS Cardioinfantil, Nephrology, Bogotá, Colombia
- International Renal Research Institute of Vicenza IRRIV, Dialysis and Transplantation, Vicenza, Italy
| | - Eduardo Zúñiga
- Fundacion Cardio Infantil Instituto De Cardiologia, Nephrology, Bogotá, Colombia
- RTS Cardioinfantil, Nephrology, Bogotá, Colombia
| | - Mauricio Sanabria
- Baxter Health Services Latin America, Clinical research, Bogotá, Colombia
| | - Jasmin Vesga
- Baxter Health Services Latin America, Clinical research, Bogotá, Colombia
| | | | | | - Ha Tran
- Baxter Healthcare, Miami, United States of America
| | - Claudio Ronco
- International Renal Research Institute of Vicenza IRRIV, Dialysis and Transplantation, Vicenza, Italy
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