Deep learning for prediction of post-thrombectomy outcomes based on admission CT angiography in large vessel occlusion stroke.

Purpose: Computed Tomography Angiography (CTA) is the first line of imaging in the diagnosis of Large Vessel Occlusion (LVO) strokes. We trained and independently validated end-to-end automated deep learning pipelines to predict 3-month outcomes after anterior circulation LVO thrombectomy based on admission CTAs. Methods: We split a dataset of 591 patients into training/cross-validation (n = 496) and independent test set (n = 95). We trained separate models for outcome prediction based on admission "CTA" images alone, "CTA + Treatment" (including time to thrombectomy and reperfusion success information), and "CTA + Treatment + Clinical" (including admission age, sex, and NIH stroke scale). A binary (favorable) outcome was defined based on a 3-month modified Rankin Scale ≤ 2. The model was trained on our dataset based on the pre-trained ResNet-50 3D Convolutional Neural Network ("MedicalNet") and included CTA preprocessing steps. Results: We generated an ensemble model from the 5-fold cross-validation, and tested it in the independent test cohort, with receiver operating characteristic area under the curve (AUC, 95% confidence interval) of 70 (0.59-0.81) for "CTA," 0.79 (0.70-0.89) for "CTA + Treatment," and 0.86 (0.79-0.94) for "CTA + Treatment + Clinical" input models. A "Treatment + Clinical" logistic regression model achieved an AUC of 0.86 (0.79-0.93). Conclusion: Our results show the feasibility of an end-to-end automated model to predict outcomes from admission and post-thrombectomy reperfusion success. Such a model can facilitate prognostication in telehealth transfer and when a thorough neurological exam is not feasible due to language barrier or pre-existing morbidities.

Hemodynamic characteristics in ruptured and unruptured intracranial aneurysms: a prospective cohort study utilizing the AneurysmFlow™ tool.

BACKGROUND AND PURPOSE: Hemodynamic factors significantly influence the onset, progression, and rupture of intracranial aneurysms (IAs). Current rupture risk prediction scores focus primarily on the clinical, anatomical and morphological aspects. This study aimed to investigate the hemodynamic characteristics differences between ruptured and unruptured IAs. MATERIALS AND METHODS: Conducted from July 2021 to July 2022, this prospective cohort study involved patients with ruptured and unruptured IAs undergoing digital subtraction angiography (DSA). Hemodynamic characteristics were assessed using the AneurysmFlow™ tool. Hemodynamic, clinical, anatomical and morphological parameters were compared between ruptured and unruptured IA groups. RESULTS: The study included 127 patients with 135 aneurysms (67 ruptured, 68 unruptured). Complex flow patterns (type 3 and 4) were observed more frequently in ruptured aneurysms compared to unruptured aneurysms (odds ratio [OR], 5.57; 95% confidence interval [CI], 2.49-12.45; P < 0.001) in univariate analysis, and were also more common in unruptured aneurysms associated with daughter sacs features (P = 0.015). The mean aneurysm flow amplitude (MAFA) was lower in ruptured aneurysms, and associated with lower flow velocity in the parent artery related to vasospasm. MAFA in the aneurysmal dome or any additional daughter sacs was lowest compared to other regions inside the aneurysms. The technical failure rate of AneurysmFlow™ measurements was 8.5% (12 out of 139 patients). Additionally, hypertension (OR, 0.42; 95% CI, 0.30-0.54; P < 0.001), bifurcation location (AcomA/ACA/MCA/PcomA/posterior circulation) (OR, 0.17; 95% CI, 0.05-0.29; P = 0.005), and irregular shape (OR, 0.19; 95% CI, 0.05-0.35; P = 0.012) were identified as independently associated with rupture. CONCLUSIONS: Complex flow patterns identified on the AneurysmFlow™ tool are significantly more common in ruptured and unruptured aneurysms associated with daughter sac features. The lowest MAFA in the aneurysmal dome and daughter sacs likely indicates specific pathophysiological changes within the aneurysm wall associated with rupture incidence. Hypertension, bifurcation location, and an irregular shape are independently associated with the risk of rupture. Further multicenter studies with larger sample sizes are needed to validate these findings. ABBREVIATIONS: ACA = anterior cerebral artery; AcomA = anterior communicating artery; IAs = intracranial aneurysms; ICA = internal carotid artery; MAFA = mean aneurysm flow amplitude; MCA = middle cerebral artery; PcomA = posterior communicating artery; RIAs = ruptured intracranial aneurysms; SAH = subarachnoid hemorrhage; UIAs = unruptured intracranial aneurysms.

A Hyper-Transformer model for Controllable Pareto Front Learning with Split Feasibility Constraints.

Controllable Pareto front learning (CPFL) approximates the Pareto optimal solution set and then locates a non-dominated point with respect to a given reference vector. However, decision-maker objectives were limited to a constraint region in practice, so instead of training on the entire decision space, we only trained on the constraint region. Controllable Pareto front learning with Split Feasibility Constraints (SFC) is a way to find the best Pareto solutions to a split multi-objective optimization problem that meets certain constraints. In the previous study, CPFL used a Hypernetwork model comprising multi-layer perceptron (Hyper-MLP) blocks. Transformer can be more effective than previous architectures on numerous modern deep learning tasks in certain situations due to their distinctive advantages. Therefore, we have developed a hyper-transformer (Hyper-Trans) model for CPFL with SFC. We use the theory of universal approximation for the sequence-to-sequence function to show that the Hyper-Trans model makes MED errors smaller in computational experiments than the Hyper-MLP model.

Phylogeography of horseshoe bat sarbecoviruses in Vietnam and neighbouring countries. Implications for the origins of SARS-CoV and SARS-CoV-2.

Previous studies on horseshoe bats (Rhinolophus spp.) have described many coronaviruses related to SARS-CoV (SARSCoVr) in China and only a few coronaviruses related to SARS-CoV-2 (SARSCoV2r) in Yunnan (southern China), Cambodia, Laos and Thailand. Here, we report the results of several field missions carried out in 2017, 2021 and 2022 across Vietnam during which 1218 horseshoe bats were sampled from 19 locations. Sarbecoviruses were detected in 11% of faecal RNA extracts, with much more positives among Rhinolophus thomasi (46%). We assembled 38 Sarbecovirus genomes, including 32 SARSCoVr, four SARSCoV2r, and two recombinants of SARSCoVr and SARSCoV2r (RecSar), one showing a Spike protein very similar to SARS-CoV-2. We detected a bat co-infected with four coronaviruses, including two sarbecoviruses. Our analyses revealed that Sarbecovirus genomes evolve in Vietnam under strong geographical and host constraints. First, we found evidence for a deep separation between viruses from northern Vietnam and those from central and southern Vietnam. Second, we detected only SARSCoVr in Rhinolophus thomasi, both SARSCoVr and SARSCoV2r in Rhinolophus affinis, and only RecSar in Rhinolophus pusillus captured close to the border with China. Third, the bias in favour of Uracil in synonymous third codon positions of SARSCoVr extracted from R. thomasi showed a negative correlation with latitudes. Our results also provided support for an emergence of SARS-CoV in horseshoe bats from northern Yunnan and emergence of SARS-CoV-2 in horseshoe bats from northern Indochina subtropical forests (southern Yunnan, northern Laos and north-western Vietnam).

A new variant of lumpy skin disease virus circulating in Vietnam based on sequencing analysis of GPCR gene.

Background: In 2021, Vietnam experienced an outbreak of Lumpy skin disease (LSD), which infected 207,687 cattle and buffaloes, as officially reported, and resulted in the culling of 29,182 animals. Aim: In this study, samples from cattle that died and showed typical signs of LSD in the Ha Tinh province of Vietnam were confirmed by three World Organization for Animal Health (WOAH)-recommended methods and further studied to compare the Vietnam and China reference strains to the new clinical cases. Methods: Three methods recommended by WOAH for agent detection (PCR, virus isolation, and transmission electron microscopy) were used to confirm this clinical LSD case. The sequence analysis of three well-known markers (P32, RPO30, and GPCR genes) has been utilized in Vietnam to understand this circulating pathogen better. Results: Our findings showed that the CX01 LSDV strain is 100% identical to the Vietnam reference strain HL01 and China reference strains based on P32 and RPO30 genes. Interestingly, analysis of the nucleotide sequence of the GPCR gene showed that the CX01 strain belongs to the same cluster as the reference strains, but it has branches different from those of both the HL01 and China LSDV strains. The nucleotide identification between the CX01 strain and these reference virus strains ranked 99.65%-99.91%, suggesting that it is a new variant of LSDV. Conclusion: This finding is new and indicates that at least two variants of the LSD virus were circulating in Vietnam based on analysis of the GPCR gene. Additionally, these results suggest that the sequence analysis of the GPCR gene is a great tool for subgrouping LSDV circulating in Vietnam.

Correlation of resin composite translucency and IOS accuracy: An in-vitro study.

Background: Different restoration materials have different optical characteristics that influence the intraoral scanner's (IOS) image accuracy. The purpose of this in-vitro investigation was to investigate how composite translucency affected the accuracy of IOS. Material and Methods: GC G-aenial Universal Injectable JE composite plates were used for the study at 3 thicknesses (1-2-3mm). A lab scanner (3Shape E1) obtained 1 reference scan, whereas IOS (Trios3) was used to conduct 10 experimental scans per group. After 3D superimposition, deviation values were used to assess the accuracy (trueness and precision) outcomes for the corresponding groups. Using an LS170 V2.0 colorimeter, the translucency parameter (TP) of the plates was determined from L*a*b* values of CIELAB color space. Results: The composite translucency resulted in a decrease in the scale of digital impressions. The 1mm group had the largest scale reduction (0.02mm) significantly, followed by the 2mm and 3mm groups (0.01mm). No difference was found in mean precision. The colorimeter detects the L*a*b* values and showed that 1mm composite plate expressed the highest TP value, then 2mm and 3mm groups (28.90, 14.26 and 6.49 respectively). The thinner composite, the higher translucency and TP were highly positively correlated to IOS trueness of composite plates. Conclusions: Composite translucency has an impact on optical impression accuracy. In correlation, the optical impression becomes less accurate the more translucent the composite is. This implies that in the digital process, the dentist should specify the appropriate optical properties of composite materials concerning both their mechanical and aesthetic qualities. Key words:Accuracy, translucency, resin composite, digital dentistry, intraoral-scanner.

Cost analysis of establishing and operating the first human milk bank at Da Nang Hospital for Women and Children in Vietnam: an activity-based costing ingredients study.

BACKGROUND: Breastfeeding is the biological norm for feeding infants and young children. When mothers' breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This study aims to estimate and analyze such costs at the first facility established in Vietnam. METHODS: An activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation. RESULTS: The total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB's 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021. CONCLUSION: Although the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs.

Why do we engage in everyday interpersonal emotion regulation?

Interpersonal emotion regulation occurs when people influence others' emotions (extrinsic regulation) or turn to others to influence their own emotions (intrinsic regulation). Research on interpersonal regulation has tended to focus on how people regulate emotions, with little interrogation of why people do it, despite the importance of motives in driving emotion regulation goals and strategy selection. To fill this gap, we conducted a systematic exploration of interpersonal emotion regulation motives, employing a participant-driven approach to document the breadth of motives that people hold across different social contexts. Study 1a (N = 100) provided an initial qualitative examination of motives for both intrinsic and extrinsic interpersonal emotion regulation. Study 1b (N = 399) quantitatively catalogued these motives in recalled social interactions. Study 2 (N = 200), a daily diary study, used the motive taxonomy generated in Studies 1a and 1b to understand why people regulated their own and others' emotions in everyday social interactions over the course of 14 days. Together, our findings reveal the diversity of intrinsic and extrinsic interpersonal emotion regulation motives and open avenues to further explore motives both as a precursor to and an outcome of regulatory processes in daily life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Work loss among privately insured employees with overweight and obesity in the United States.

Background: Rising obesity rates in the workforce are accompanied by a hidden cost burden to employers due to work productivity loss. Understanding the impact of obesity on work productivity is essential for employers to provide tailored weight loss interventions in the workplace. Objectives: To measure work loss and associated productivity costs among employees with overweight/obesity compared with employees with normal weight. Methods: This retrospective cohort study used the MerativeTM MarketScan® Health and Productivity Management Database to identify adult employees with ≥1 diagnosis code reporting a body mass index (BMI) between 1/1/2015-12/31/2019. Based on the earliest BMI, employees were assigned to normal weight (BMI 19-24.9), overweight (BMI 25-29.9), obesity class 1 (BMI 30-34.9), obesity class 2 (BMI 35-39.9), and obesity class 3 (BMI ≥40) cohorts. Among employees with data for each work loss category (absenteeism, short-term disability [STD], long-term disability [LTD], worker's compensation [WC]) during the 12-month follow-up, the percentage of employees with work loss, number of hours/days lost, and associated productivity costs were reported. Results: 719,482 employees (normal weight: 106,631, overweight: 230,637, obesity class 1: 185,850, obesity class 2: 101,909, obesity class 3: 94,455) were included. Outcomes increased with each higher BMI category for the mean number of absence hours ([in order of BMI category]: 262, 273, 285, 290, 304) and percentage of employees with a claim (STD: 6.8%, 7.6%, 9.7%, 11.7%, 17.0%; LTD: 0.4%, 0.4%, 0.5%, 0.6%, 0.8%; WC: 2.7%, 2.8%, 3.4%, 3.6%, 3.5%). Estimated costs to the employer associated with absenteeism, STD, LTD, and WC were $1,036, $611, $38, and $95 higher per year (respectively) in the obesity class 3 cohort relative to the normal weight cohort. Conclusions: This real-world analysis demonstrated that employees with overweight/obesity had higher loss of work productivity compared with employees with normal weight. Further studies are warranted to determine the long-term impacts on work productivity loss if overweight and obesity are left untreated.

Machine learning-enhanced gesture recognition through impedance signal analysis.

Gesture recognition is a crucial aspect in the advancement of virtual reality, healthcare, and human-computer interaction, and requires innovative methodologies to meet the increasing demands for precision. This paper presents a novel approach that combines Impedance Signal Spectrum Analysis (ISSA) with machine learning to improve gesture recognition precision. A diverse dataset that included participants from various demographic backgrounds (five individuals) who were each executing a range of predefined gestures. The predefined gestures were designed to encompass a broad spectrum of hand movements, including intricate and subtle variations, to challenge the robustness of the proposed methodology. The machine learning model using the K-Nearest Neighbors (KNN), Gradient Boosting Machine (GBM), Naive Bayes (NB), Logistic Regression (LR), Random Forest (RF), and Support Vector Machine (SVM) algorithms demonstrated notable precision in performance evaluations. The individual accuracy values for each algorithm are as follows: KNN, 86%; GBM, 86%; NB, 84%; LR, 89%; RF, 87%; and SVM, 87%. These results emphasize the importance of impedance features in the refinement of gesture recognition. The adaptability of the model was confirmed under different conditions, highlighting its broad applicability.

Demand for mental health support services among health professionals in Vietnam: Lesson from COVID-19 Pandemic.

BACKGROUND: This study aimed to measure the preferences for mental health support among health professionals, their willingness to support the mental health of colleagues and associated factors. METHOD: A descriptive cross-sectional study was performed from August to October 2022 within five hospitals located in Hanoi, Vietnam. A total of 244 health professionals participated in the study. Data on socio-economic status, health and COVID-19-related characteristics, Depression Anxiety Stress Scale (DASS-21); and preferences for mental health support services were collected by using a structured self-reported questionnaire. Multivariate logistic regression models were utilized to identify associated factors with the demand for mental support services. RESULTS: 13.9%, 17.1% and 8.6% reported having at least mild depression, anxiety and stress, respectively. There 13.9% did not seek any mental health support during the COVID-19 pandemic. The most common support included talking with friends (52.9%), family (50.8%), colleagues (47.6%) and using social networks/Internet (43.5%). There 31.1% had been aware of mental health services, but only 18.0% used this service at least once. Regarding preferences, 47.3% had a demand for mental support services, and the most preferred service was providing coping skills (25.9%), followed by skills to support others against mental problems (22.2%). Major sources of support included psychiatrists (34.4%), colleagues (29.1%) and family (27.9%). The main preferred channels for support included telephone/mobile phone (35.7%) and Internet (20.9%). Only 12.3% were willing to provide mental support for colleagues during the pandemic. Age, education, perceived mental health status, ever seeking any mental service, and DASS-21 depression score were associated with demand for mental support services. CONCLUSION: This study found a lack of awareness of mental health services for health professionals, as well as moderate levels of demand for this service in this population. Raising awareness and developing tailored mental health support services are important to enhancing the mental well-being of health professionals in Vietnam to prepare for the next pandemic.

Compensatory Modulation of Seed Storage Protein Synthesis and Alteration of Starch Accumulation by Selective Editing of 13 kDa Prolamin Genes by CRISPR-Cas9 in Rice.

Rice prolamins are categorized into three groups by molecular size (10, 13, or 16 kDa), while the 13 kDa prolamins are assigned to four subgroups (Pro13a-I, Pro13a-II, Pro13b-I, and Pro13b-II) based on cysteine residue content. Since lowering prolamin content in rice is essential to minimize indigestion and allergy risks, we generated four knockout lines using CRISPR-Cas9, which selectively reduced the expression of a specific subgroup of the 13 kDa prolamins. These four mutant rice lines also showed the compensatory expression of glutelins and non-targeted prolamins and were accompanied by low grain weight, altered starch content, and atypically-shaped starch granules and protein bodies. Transcriptome analysis identified 746 differentially expressed genes associated with 13 kDa prolamins during development. Correlation analysis revealed negative associations between genes in Pro13a-I and those in Pro13a-II and Pro13b-I/II subgroups. Furthermore, alterations in the transcription levels of 9 ER stress and 17 transcription factor genes were also observed in mutant rice lines with suppressed expression of 13 kDa prolamin. Our results provide profound insight into the functional role of 13 kDa rice prolamins in the regulatory mechanisms underlying rice seed development, suggesting their promising potential application to improve nutritional and immunological value.

Progerin forms an abnormal meshwork and has a dominant-negative effect on the nuclear lamina.

Progerin, the protein that causes Hutchinson-Gilford progeria syndrome, triggers nuclear membrane (NM) ruptures and blebs, but the mechanisms are unclear. We suspected that the expression of progerin changes the overall structure of the nuclear lamina. High-resolution microscopy of smooth muscle cells (SMCs) revealed that lamin A and lamin B1 form independent meshworks with uniformly spaced openings (~0.085 µm2). The expression of progerin in SMCs resulted in the formation of an irregular meshwork with clusters of large openings (up to 1.4 µm2). The expression of progerin acted in a dominant-negative fashion to disrupt the morphology of the endogenous lamin B1 meshwork, triggering irregularities and large openings that closely resembled the irregularities and openings in the progerin meshwork. These abnormal meshworks were strongly associated with NM ruptures and blebs. Of note, the progerin meshwork was markedly abnormal in nuclear blebs that were deficient in lamin B1 (~50% of all blebs). That observation suggested that higher levels of lamin B1 expression might normalize the progerin meshwork and prevent NM ruptures and blebs. Indeed, increased lamin B1 expression reversed the morphological abnormalities in the progerin meshwork and markedly reduced the frequency of NM ruptures and blebs. Thus, progerin expression disrupts the overall structure of the nuclear lamina, but that effect-along with NM ruptures and blebs-can be abrogated by increased lamin B1 expression.

Development and evaluation of a liquid chromatography-tandem mass spectrometry method for simultaneous measurement of toxic aldehydes from brain tissue.

Reactive aldehydes are a class of electrophilic low molecular weight compounds that play an essential role in physiological function and lipid peroxidation. These molecules are implicated in many diseases, especially cardiovascular and neurodegenerative diseases, and are potential endogenous markers of lipid peroxidation. However, there are limited options to accurately quantify multiple reactive aldehydes in brain tissue. This study developed and validated a 3-nitrophenylhydrazine derivatization-based LC-MS/MS method to quantify four reactive aldehydes: malondialdehyde, acrolein, 4-hydroxy-2-hexenal and 4-hydroxy-2-nonenal. Method development involved comparing the sensitivity of detection between widely used derivatization reagents: 2,4-dinitrophenylhydrazine and 3-nitrophenylhydrazine. Our data showed that 3-nitrophenylhydrazine resulted in greater sensitivity. Additional method development included evaluation of hydrolysis sample pretreatment, selection of protein precipitation reagent, and optimization of derivatization conditions. The optimized conditions included no hydrolysis and use of 20 % trichloroacetic acid as the protein precipitation reagent. The optimized derivatization condition was 25 mM 3-nitrophenylhydrazine reacted at 20 °C for 30 min. The chromatographic conditions were optimized to reduce matrix effects, ion suppression, and efficient analysis time (<7-minute analytical run). The four aldehyde species were accurately quantified in brain tissue using stable-labeled internal standards. Application of this assay to a traumatic brain injury mouse model revealed significant accumulation of acrolein, 4-hydroxy-2-hexenal, and 4-hydroxy-2-nonenal at 28 days post injury. Overall, a validated method was developed to rapidly quantify the most prominent reactive aldehydes associated with lipid peroxidation during injury progression following acute brain trauma.

Effects of Bacillus subtilis supplementation on reproductive parameters during late gestation in multiparous sows.

Background and Aim: Probiotics are used at different stages of gestation to promote reproductive performance in sows. This study investigated the effect of Bacillus subtilis QST 713 supplementation during late gestation in multiparous sows on different reproductive parameters. Materials and Methods: On day 85 of gestation, 115 multiparous healthy Landrace Yorkshire sows were randomly assigned to two groups with equal parity numbers. The control group (58 sows) was fed with basal diets, and the probiotic group (57 sows) was fed with basal diets +1010 colony-forming unit (CFU) B. subtilis QST 713 from day 85 to parturition. Back fat thickness on days 85 and 110, number of total born, number of born alive, stillbirth and mummy rates, individual birth weight, litter birth weight, within-litter variation of piglet birth weight, and postpartum vaginal discharge duration were recorded and compared between the two groups. Results: The number of total born, number born alive, back fat thickness of sows before farrowing, litter weight, within-litter variation of piglet birth weight, and postpartum vaginal discharge duration were similar in both groups (p > 0.05). Dietary supplementation with B. subtilis QST 713 decreased the stillbirth rate (3.96 vs. 6.39%, p = 0.046) and born dead rate (5.12 vs. 8.57%, p = 0.035) and increased the birth weight of piglets (1552.78 vs. 1506.15 g, p = 0.049). Conclusion: Daily supplementation with 1010 CFU of B. subtilis QST 713 during late gestation in multiparous sows could increase reproductive performance by increasing birth weight and decreasing stillbirth rate.

The 2023 Annual Report of DataDerm: The database of the American Academy of Dermatology.

The American Academy of Dermatology launched DataDerm in 2016 as the clinical data registry platform of American Academy of Dermatology. DataDerm has evolved to be the largest database in the world containing information about dermatology patients, capturing information about their course of disease, associated therapeutic interventions, and health outcomes. As of December 31, 2022, DataDerm contained data from 14.2 million unique patients and 53.5 million unique patient visits, with 415 practices representing 1663 clinicians actively participating in DataDerm in 2022. This article is the fourth in a series of Annual Reports about the status of DataDerm. This year's 2023 Annual Report presents the progress DataDerm has made in conjunction with OM1, the data analytics partner of DataDerm, with a special highlight on the longitudinal care of common dermatologic conditions in the registry and a detailed focus on skin cancer. Furthermore, we review the current status of DataDerm as a robust representation of real world specialty data, reflecting the day-to-day dermatologic care of patients over time.

A practical approach to nutritional intervention for people with chronic kidney disease in Vietnam.

BACKGROUND AND OBJECTIVES: A comprehensive nutritional management is necessary for favourable outcomes in patients with chronic kidney disease (CKD). We aimed to assess the changes in nutritional status and disease progression with nutritional management where renal replacement therapy (RRT) was not in place. METHODS AND STUDY DESIGN: A quasi-experiment intervention was conducted on 70 CKD patients at stages 3-5 from July to December 2022. Participants were excluded if they underwent RRT, including dialy-sis (hemodialysis or peritoneal dialysis), or kidney transplantation. The nutritional regimen covered nutrition-al counseling, samples of the dietary menu, and supplement products. We evaluated nutritional status using Subjective Global Assessment (SGA) scale and sub-clinical blood test at T0 (hospital admission) and T1 (two weeks after the admission or 24 hours before the discharge). RESULTS: After the intervention, the number of patients classified as malnutrition or at risk of malnourished reduced significantly (65.7% to 54.3% and 25.7% and 5.7%, respectively). The serum concentration of urea, creatinine and parathyroid hormone decreased remarkably, especially in patients receiving nutritional management. In the intervention group, the dietary pattern provided increased intakes of calcium and iron at T1, while phosphorus, sodium and potassium decreased after follow-up. Nausea/vomiting, loss of appetite, tiredness and sleep disorders were improved in the intervention compared to the control group. CONCLUSIONS: Nutritional therapy enhanced the nutritional sta-tus, and quality of dietary and renal function in CKD patients without RRT. Applying nutrition education and treatment at an early stage can slow CKD progression, which should be applicable elsewhere in Vietnam.

Spatio-temporal characterization of drought variability in data-scarce regions using global precipitation data: a case study in Cauto river basin, Cuba.

Drought is considered the most severe water-related disaster in the Cauto river basin, which is the longest river and the main agricultural producer in Cuba. Better understanding of drought characteristics is crucial to drought management. Given the sparsity of ground-based precipitation observations in the Cauto, this study aims at using gridded global precipitation to analyze the spatio-temporal variations of drought in this river basin. Firstly, the monthly Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS) was calibrated with the gauged precipitation using the Thiessen polygon-based method and linear least squares regression equations. Then, the gridded standardized precipitation index (SPI) with time scales of 3, 6, 9 months and drought characteristics, namely, drought frequency, duration and intensity were calculated using the calibrated CHIRPS. Finally, the spatio-temporal analysis was performed to investigate the variations of drought in the Cauto river basin in time and space. The obtained results show that the calibrated CHIRPS is highly consistent with the gauged observations and is capable of determining the magnitude, time, and spatial extent of drought events in the Cauto river basin. The trend analysis by the Mann-Kendall test reveals that although the trend is not statistically significant, the SPI tends to decrease with time in the dry season, which indicates the more severe drought. The spatial analysis indicates that the lower altitude area of the Cauto river basin is suffered from longer drought duration and higher drought intensity than the upper one. This study expresses the importance of open global precipitation data sources in monitoring and quantifying drought characteristics in data-scarce regions.

Bracketed Stability Evaluation of Methimazole USP in PLO Gel Mediflo™30 Pre-Mixed.

Extemporaneously compounded Methimazole 1% and 10% in PLO Gel Mediflo™30 Pre-Mixed were studied to assess physical, chemical and microbial stability over time. The formulations were stored at room temperature in tightly closed, light resistant plastic containers. Chemical stability was evaluated using a validated, stability indicating HPLC analysis and physical stability was evaluated through observation of organoleptic appearance and pH measurement at predetermined time points. Lastly, antimicrobial effectiveness testing was conducted per USP <51> guidelines. The results indicate that compounded Methimazole remained within the stability criteria for the duration of the study and can be assigned an extended beyond-use-date of 120 days under the studied conditions.