Predictive value of neutrophil-to-lymphocyte ratio for adverse outcomes in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease: A retrospective study.

Chronic obstructive pulmonary disease (COPD) stands as one of the leading causes of mortality worldwide. Acute exacerbations of COPD (AECOPD) lead to rapid respiratory function decline and worsened disease status. Despite recent studies, the ability of the neutrophil-to-lymphocyte ratio (NLR) to predict outcomes in patients with COPD remains controversial. We investigated the predictive value of NLR for adverse outcomes in hospitalized patients with AECOPD. A retrospective study was conducted at the Department of Pulmonary Medicine, Cho Ray Hospital (Vietnam) from November 2019 to November 2021. The study extracted data from patients diagnosed with AECOPD at discharge and met the inclusion criteria. NLR is calculated by dividing the number of neutrophils by the number of lymphocytes in the peripheral blood test. Adverse outcomes are defined as invasive mechanical ventilation, admission to intensive care unit, or in-hospital mortality. Multivariable regression analysis was conducted to identify variables predicting adverse outcomes. The cutoff, sensitivity, specificity, area under the curve, and receiver operating characteristic of NLR were determined for predicting adverse outcomes. Two hundred eighty-seven patients with AECOPD were included in the final analysis, with a mean age of 70.9, and males comprising 92.7%. The rate of adverse outcomes was 15.7%. Multivariable logistic regression identified reduced consciousness at admission (adjusted odds ratio = 0.08, 95% confidence interval [CI]: 0.02-0.38, P = .001) and high NLR (adjusted odds ratio = 1.17, 95% CI: 1.10-1.24, P < .001) as predictors of adverse outcomes. The receiver operating characteristic of NLR's predictive value yielded an area under the curve of 0.877 (95% CI: 0.83-0.93). An NLR cutoff of 11.0 predicted adverse outcomes with a sensitivity of 80.0%, specificity of 77.7%, and an odds ratio of 13.9 (95% CI: 6.3-30.7), P < .001. NLR is a simple, routine, and cost-effective tool for predicting adverse outcomes in hospitalized patients with AECOPD. Future studies should evaluate the kinetics of NLR in predicting treatment response in patients with AECOPD.

Triple burden of malnutrition among Vietnamese 0·5-11-year-old children in 2020-2021: results of SEANUTS II Vietnam.

OBJECTIVE: SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old. DESIGN: Cross-sectional survey. SETTING: A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. PARTICIPANTS: 4001 children between 6 months and 11.9 years of age. RESULTS: Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI. CONCLUSIONS: SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.

The Role and Associated Factors of Liquid-Based Cytology of Bronchoalveolar Lavage Fluid in Lung Cancer Diagnosis: A Prospective Study.

Background Liquid-based cytology (LBC) has shown advantages over conventional smears (CS), but previous applications in bronchoalveolar lavage (BAL) fluid have produced inconsistent results. This study compared LBC and CS for diagnosing lung cancer using BAL fluid. Methodology A prospective study was conducted on 92 patients suspected of having lung cancer. All patients underwent bronchoscopy and had a final diagnosis confirmed by histopathology of lesions tissue through biopsy. The study aimed to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the two cytological methods, in a pair-wise fashion. In addition, the study evaluated the correlation of factors, such as the volume of fluid used in LBC and bronchoscopy lesion morphology, with the sensitivity of LBC. Results The study involved 78 participants who were diagnosed with lung cancer. The sensitivity, specificity, PPV, and NPV of LBC were 25.7%, 100%, 100%, and 19.4%, respectively, whereas those of CS were 15.4%, 85.7%, 85.7%, and 15.4%, respectively. Although the sensitivity of LBC was higher than that of CS, the difference was not statistically significant (p=0.096, McNemar test). Furthermore, the median fluid volume performed during LBC in patients with positive results was significantly higher than in those with negative results (p=0.001, Mann-Whitney U test). Conclusions The application of LBC to BAL fluid has demonstrated similar and potentially superior diagnostic accuracy compared to CS in detecting lung cancer. It is recommended that further investigation be undertaken to examine the relationship between the volume of fluid utilized during the LBC process and its diagnostic accuracy to enhance its sensitivity.

Primary Pulmonary T-Cell Lymphoma Mimicking Asthma and Community-Acquired Pneumonia: A Rare Case Report.

Primary pulmonary T-cell lymphoma (PPTL) is a rare disease. Diagnosing PPTL is challenging due to non-specific clinical symptoms and imaging. A 32-year-old female presented with persistent fever, cough, and dyspnoea. The symptoms were initially treated as asthma and community-acquired pneumonia without improvement. Chest computed tomography (CT) revealed bilateral consolidations with a CT angiogram sign, and flexible bronchoscopy showed infiltrative lesions causing bronchial stenosis. Histopathological examination of the tissue biopsy identified T-cell lymphoma through immunohistochemical staining positive for CD3. This case highlights the importance of considering differential diagnoses such as PPTL in patients with atypical presentations of asthma or non-resolving pneumonia. This case also demonstrates the diagnostic utility of flexible bronchoscopy in identifying airway obstruction due to malignant cells, which can mimic asthma. LEARNING POINTS: Primary pulmonary T-cell lymphoma can manifest as atypical asthma and non-resolving pneumonia, making early diagnosis challenging.Malignant aetiologies, including primary pulmonary T-cell lymphoma, should be considered in cases of bilateral consolidations that do not respond to antibiotics and present CT angiogram signs.Histopathology remains the gold standard in primary pulmonary T-cell lymphoma diagnosis, wherein flexible bronchoscopy should be employed as a minimally invasive first-line approach for tissue biopsy.

Cloning and characterization of the LvCTL genes encoding C-type lectin from white-leg shrimp ( Litopenaeus vannamei).

Background: Lectins are carbohydrate-binding protein domains. The C-type lectin designates a requirement for calcium for binding. Proteins contain C-type lectin domains that have a diverse range of functions, including cell-cell adhesion, immune response to pathogens, and apoptosis. This study aimed to investigate the characters of LvCTL-encoding genes from white-leg shrimp ( Litopenaeus vannamei) in Central Vietnam. Methods: Two PCR products (LvCTL3 and LvCTL4) were cloned and sequenced. The structure and characterization of LvCTL proteins were predicted using bioinformatics tools. Results: The results showed that the LvCTL3 gene was 444 nucleotides in length and 98.87% similar to the published LvCTL3 gene (accession number: KF156943). The polypeptide sequence had 147 amino acids, which were 97.28% identical to the reference sequence (AGV68681) and the LvCTL4 gene had a length of 417 nucleotides and homology of 99.52% compared to the published gene (KM387560). The deduced polypeptide sequence had 138 amino acids, and was 100% similar to the reference sequence (AKA64754). The LvCTL3 had a molecular weight of 16.91 kDa and an isoelectric point (pI) of 4.66, while LvCTL4 had 15.75 and 4.58 kDa, respectively. The structure prediction results showed that LvCTL3 and LvCTL4 had one domain (CTLD), LvCTL3 had two α helices and nine ß sheets, and LvCTL4 had two α helices and eight ß sheets. Conclusions: Our results provide essential information for the heterologous expression and biosynthesis production of C-type lectins.

The protective effect of green space on heat-related respiratory hospitalization among children under 5 years of age in Hanoi, Vietnam.

Combined effects of global warming and rapid urbanization replace green spaces with urban facilities. Children in urban areas are at a higher risk of heat-related adverse health effects. Our study aimed to examine the protective effect of urban green space on heat-related respiratory hospitalization among children under 5 years of age in Hanoi, the capital city of Vietnam. We estimated district-specific meteorological conditions from 2010 to 2014 by using a dynamic downscaling approach with a fine-resolution numerical climate model. The green space in each district was calculated using satellite data. The attributable fraction of heat-related respiratory hospitalization was estimated using a two-stage model, including a distributed lag non-linear model (DLNM) coupled with multivariate meta-analysis. The association between heat-related respiratory hospitalization and green spaces at the district level was explored using a linear regression model. The central districts were more crowded and hotter, with less green spaces than the outer districts. At temperatures > 34 °C (extreme heat threshold), the hospitalizations in the central districts increased significantly; however, in the outer districts, the hospitalization rate was insignificant. On average, extreme heat attributed 0.33% to citywide hospitalization, 0.35% in the center, and 0.32% in the outer region. Every 1% increase in the green space fraction will reduce heat-related respiratory hospitalization risk by 3.8%. Heat significantly increased the risk of respiratory hospitalization among children under 5 years in Hanoi, Vietnam. These findings are valuable for authorities to consider strategies to protect children's health against the effects of heat, including increasing green space.

Biological processes dominate seasonality of remotely sensed canopy greenness in an Amazon evergreen forest.

Satellite observations of Amazon forests show seasonal and interannual variations, but the underlying biological processes remain debated. Here we combined radiative transfer models (RTMs) with field observations of Amazon forest leaf and canopy characteristics to test three hypotheses for satellite-observed canopy reflectance seasonality: seasonal changes in leaf area index, in canopy-surface leafless crown fraction and/or in leaf demography. Canopy RTMs (PROSAIL and FLiES), driven by these three factors combined, simulated satellite-observed seasonal patterns well, explaining c. 70% of the variability in a key reflectance-based vegetation index (MAIAC EVI, which removes artifacts that would otherwise arise from clouds/aerosols and sun-sensor geometry). Leaf area index, leafless crown fraction and leaf demography independently accounted for 1, 33 and 66% of FLiES-simulated EVI seasonality, respectively. These factors also strongly influenced modeled near-infrared (NIR) reflectance, explaining why both modeled and observed EVI, which is especially sensitive to NIR, captures canopy seasonal dynamics well. Our improved analysis of canopy-scale biophysics rules out satellite artifacts as significant causes of satellite-observed seasonal patterns at this site, implying that aggregated phenology explains the larger scale remotely observed patterns. This work significantly reconciles current controversies about satellite-detected Amazon phenology, and improves our use of satellite observations to study climate-phenology relationships in the tropics.