Emerging Enterovirus A71 Subgenogroup B5 Causing Severe Hand, Foot, and Mouth Disease, Vietnam, 2023.

We report on a 2023 outbreak of severe hand, foot, and mouth disease in southern Vietnam caused by an emerging lineage of enterovirus A71 subgenogroup B5. Affected children were significantly older than those reported during previous outbreaks. The virus should be closely monitored to assess its potential for global dispersal.

Uterine cancer among Asian Americans - Disparities & clinical characteristics.

OBJECTIVE: To evaluate the patterns and trends of uterine cancer among Asian subgroups living in the U.S. METHODS: Data were obtained from United States Cancer Statistics (2001-2017), National Cancer Database (2004-2015), and World Population Review (2023). SEER*Stat version 8.3.9.2, Joinpoint regression program 4.9.0.0, and SAS v 9.4 were employed for statistical analysis. RESULTS: Based on data from 778,891 women in the United States Cancer Statistics database, Asians had a 3.4-fold higher rate of incident uterine cancer compared to White populations (2.14% vs. 0.63%; p < 0.001). Using the National Cancer Database, 7,641 Asian women from six subgroups were analyzed: Filipino, Korean, Indian/Pakistani, Vietnamese, Chinese, and Japanese. Indian and Pakistani women had the greatest increase in the proportion of cancer diagnoses (5.0% to 14.4%; p = 0.0003). Additionally, Indian and Pakistani patients had higher comorbidity scores while Koreans had the lowest (22.7% vs. 10.7%, p < 0.0001). Regarding stage of disease, 25.3% of Filipinos presented with advanced stage disease compared to 19.2% of Indians and Pakistanis (p = 0.0001). Furthermore, Filipinos had the highest proportion of non-endometrioid cancers at 18.4% compared to other subgroups (p = 0.0003). Using the World Population Review, female obesity was highest in Pakistan (8.6%) and the Philippines (7.5%) and lowest in Vietnam (2.6%). CONCLUSION: Uterine cancer incidence increased at higher rates among Asians compared to White populations. Specifically, Indian and Pakistani uterine cancer patients were more likely to have higher comorbidity rates and Filipino patients had more advanced stage cancer with non-endometrioid histologies than other Asian subgroups. Further research is warranted to better understand these trends.

Feasibility of wearable monitors to detect heart rate variability in children with hand, foot and mouth disease.

Hand foot and mouth disease (HFMD) is caused by a variety of enteroviruses, and occurs in large outbreaks in which a small proportion of children deteriorate rapidly with cardiopulmonary failure. Determining which children are likely to deteriorate is difficult and health systems may become overloaded during outbreaks as many children require hospitalization for monitoring. Heart rate variability (HRV) may help distinguish those with more severe diseases but requires simple scalable methods to collect ECG data.We carried out a prospective observational study to examine the feasibility of using wearable devices to measure HRV in 142 children admitted with HFMD at a children's hospital in Vietnam. ECG data were collected in all children. HRV indices calculated were lower in those with enterovirus A71 associated HFMD compared to those with other viral pathogens.HRV analysis collected from wearable devices is feasible in a low and middle income country (LMIC) and may help classify disease severity in HFMD.

Synthesis of chimera oligopeptide including furanoid ß-sugar amino acid derivatives with free OHs: mild but successful removal of the 1,2-O-isopropylidene from the building block.

Complementary to hydrophobic five membered ring ß-amino acids (e.g. ACPC), ß-sugar amino acids (ß-SAAs) have found increasing application as hydrophilic building blocks of foldamers and α/ß chimeric peptides. Fmoc-protected ß-SAAs [e.g. Fmoc-RibAFU(ip)-OH] are indeed useful Lego elements, ready to use for SPPS. The removal of 1,2-OH isopropylidene protecting group increasing the hydrophilicity of such SAA is presented here. We first used N3-RibAFU(ip)-OH model compound to optimize mild deprotection conditions. The formation of the 1,2-OH free product N3-RibAFU-OH and its methyl glycoside methyl ester, N3-RibAFU(Me)-OMe were monitored by RP-HPLC and found that either 50% TFA or 8 eqv. Amberlite IR-120 H+ resin in MeOH are optimal reagents for the effective deprotection. These conditions were then successfully applied for the synthesis of chimeric oligopeptide: -GG-X-GG- [X=RibAFU(ip)]. We found the established conditions to be effective and-at the same time-sufficiently mild to remove 1,2-O-isopropylidene protection and thus, it is proposed to be used in the synthesis of oligo- and polypeptides of complex sequence combination.

Established soft contact lens wearers' awareness of and initial experiences with orthokeratology.

OBJECTIVES: To understand the initial awareness of and experience with orthokeratology in a group of adult, symptomatic, soft contact lens (CL) wearers. METHODS: This was a prospective, 3-month, open-label study of symptomatic soft CL wearers who were between the ages of 18 and 45 years. Baseline measurements were taken and then all subjects were treated with orthokeratology. A dry eye evaluation was completed at baseline prior to orthokeratology treatment. This same dry eye evaluation was completed 1 week and 1 month after orthokeratology treatment. An investigator-designed questionnaire that aimed to understand the subject's initial awareness of and experience with orthokeratology was also administered at the baseline, 1-week, 1-month and 3-month visits (perceptions, knowledge, tolerance and ability to apply and remove orthokeratology lenses). RESULTS: Twenty-nine out of 40 subjects completed this study. Completed subjects (age = 24.28 ± 3.75 years) had significant improvements in ocular comfort over the course of the study compared to their soft CLs. Most subjects were unfamiliar with orthokeratology before the study, were able to quickly adapt to the treatment and were likely to recommend orthokeratology to friends or children for myopia management. CONCLUSIONS: This study found that few subjects knew about orthokeratology before learning about it through this investigation, suggesting that patients should be offered this treatment more regularly. This conclusion is supported by the ability of the subjects to learn and adapt to orthokeratology with ease, and their likelihood to recommend it to a friend or child.

Treating Uncomfortable Contact Lens Wear With Orthokeratology.

OBJECTIVES: Many contact lens (CL) users permanently discontinue wear because of ocular dryness and discomfort. This study aimed to determine whether refitting symptomatic soft CL wearers in to orthokeratology could improve ocular symptoms and signs. METHODS: This was a prospective, 3-month, open-label study of symptomatic (Contact Lens Dry Eye Questionnaire [CLDEQ-8] ≥12) soft CL wearers who were between the ages of 18 and 45 years. All subjects were refit into orthokeratology CLs (Emerald, Euclid Systems). The following tests were completed: CL history, Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire, CLDEQ-8, CLDEQ-4, logarithm of the minimum angle of resolution visual acuity, pupil size, refractive error, slit-lamp biomicroscopy, noninvasive tear break-up time, tear meniscus height, phenol red thread, conjunctival staining, corneal aesthesiometry, and corneal topography. RESULTS: Twenty-nine of 40 qualifying subjects (age=24.43±4.62 years) completed the study. No significant differences were detected between completed and noncomplete subjects. Completed subjects had significantly better CLDEQ-8, CLDEQ-4, and SPEED scores at 3 months compared with baseline. Completed subjects had significantly better conjunctival staining scores and flatter keratometry values at 1 month compared with baseline. CONCLUSIONS: Although not all symptomatic soft CL wearers were able to be refit into orthokeratology, subjects who were wearing orthokeratology at 3 months had a significant and clinically meaningful improvement in ocular symptoms. Additional work is needed to determine the mechanism leading to improved comfort because few clinical signs were changed after switching to orthokeratology.

Neutralizing Antibodies against Enteroviruses in Patients with Hand, Foot and Mouth Disease.

Hand, foot and mouth disease (HFMD) is an emerging infection with pandemic potential. Knowledge of neutralizing antibody responses among its pathogens is essential to inform vaccine development and epidemiologic research. We used 120 paired-plasma samples collected at enrollment and >7 days after the onset of illness from HFMD patients infected with enterovirus A71 (EV-A71), coxsackievirus A (CVA) 6, CVA10, and CVA16 to study cross neutralization. For homotypic viruses, seropositivity increased from <60% at enrollment to 97%-100% at follow-up, corresponding to seroconversion rates of 57%-93%. Seroconversion for heterotypic viruses was recorded in only 3%-23% of patients. All plasma samples from patients infected with EV-A71 subgenogroup B5 could neutralize the emerging EV-A71 subgenogroup C4. Collectively, our results support previous reports about the potential benefit of EV-A71 vaccine but highlight the necessity of multivalent vaccines to control HFMD.

Recurrence rate and associated factors of borderline ovarian tumors in the south of Vietnam.

AIM: This study aimed to determine the recurrence rate and related risk factors of borderline ovarian tumors (BOT). METHODS: We conducted a retrospective cohort study with 433 patients who were surgically treated for primary BOT at Tu Du Hospital from 11/2008 to 09/2015. We used the life table method to estimate the cumulative recurrence rate. We used the log-rank test and Cox proportional hazard model to determine recurrence-associated factors. RESULTS: Median follow-up time was 43 months (range: 3-105 months). Eighteen patients developed recurrence. The cumulative BOT recurrence rates at year 1, 2, 3 and 4 were 1.2% (95% confidence interval [CI] = 0.5-2.8), 3.0% (95% CI = 1.7-5.2), 4.6% (95% CI = 2.9-7.4), and 5.1% (95% CI = 3.2-8.0), respectively. In the final multivariate model, a higher recurrence rate was significantly associated with primary tumor stages (stage I vs stages II and III, hazards ratio [HR] = 4.44, 95% CI = 1.60-12.38), pre-operative tumor's capsule rupture (HR = 4.14, 95% CI = 1.78-9.64), and cystectomy (HR = 5.33, 95% CI = 1.43-19.91). CONCLUSION: The overall BOT recurrence rate in women in southern Vietnam was moderate. Primary tumor stage, capsule rupture, and cystectomy were main factors associated with BOT recurrence. Appropriate follow-up strategies for patients with high-risk factors are needed for early detection and management of recurrence.

Severe enterovirus A71 associated hand, foot and mouth disease, Vietnam, 2018: preliminary report of an impending outbreak.

Since January 2018, over 53,000 hospitalisations and six deaths due to hand, foot and mouth disease (HFMD) have occurred across Vietnam with most cases from September onward. In a large tertiary referral hospital, Ho Chi Minh City, enterovirus A71 subgenogroup C4 was predominant, while B5 was only sporadically detected. The re-emergence of C4 after causing a severe HFMD outbreak with > 200 deaths in 2011-12 among susceptible young children raises concern of another impending severe outbreak.

Premarital sex, contraceptive use among unmarried women migrant workers in industrial parks in Vietnam, 2015.

Most of internal female migrants are young, at risk of unintended pregnancy, unsafe abortion. This paper aims to describe premarital sexual behaviors and contraceptive use among unmarried female migrant workers in industrial parks, Vietnam. A cross-sectional survey was completed with a sample of 2,996 workers aged 18-49 years. We found that premarital sex rate was 12.6%. Most of them were inconsistent contraceptive users. About 27.8% did not use any contraception in the last 6/months. Condom was the most popular contraceptive used (61.3%) and obtained through pharmacies, kiosk systems. Contraceptive use was significantly associated with age, education, private companies, and income.

Glia Open Access Database (GOAD): A comprehensive gene expression encyclopedia of glia cells in health and disease.

Recently, the number of genome-wide transcriptome profiles of pure populations of glia cells has drastically increased, resulting in an unprecedented amount of data that offer opportunities to study glia phenotypes and functions in health and disease. To make genome-wide transcriptome data easily accessible, we developed the Glia Open Access Database (GOAD), available via www.goad.education. GOAD contains a collection of previously published and unpublished transcriptome data, including datasets from isolated microglia, astrocytes and oligodendrocytes both at homeostatic and pathological conditions. It contains an intuitive web-based interface that consists of three features that enable searching, browsing, analyzing, and downloading of the data. The first feature is differential gene expression (DE) analysis that provides genes that are significantly up and down-regulated with the associated fold changes and p-values between two conditions of interest. In addition, an interactive Venn diagram is generated to illustrate the overlap and differences between several DE gene lists. The second feature is quantitative gene expression (QE) analysis, to investigate which genes are expressed in a particular glial cell type and to what degree. The third feature is a search utility, which can be used to find a gene of interest and depict its expression in all available expression data sets by generating a gene card. In addition, quality guidelines and relevant concepts for transcriptome analysis are discussed. Finally, GOAD is discussed in relation to several online transcriptome tools developed in neuroscience and immunology. In conclusion, GOAD is a unique platform to facilitate integration of bioinformatics in glia biology.

Ante-, Peri-, and Neonatal Factors Associated with Autism Spectrum Disorders in Vietnam: A Population-Based Cross-Sectional Survey.

Background: Autism Spectrum Disorders (ASDs) are common behavioral syndromes but limited critical evidence in Vietnam. This study aimed to identify ante-, peri- and neonatal factors for ASDs amongst children in Vietnam. Methods: This population-based study applied the cross-sectional design with a multistage sampling in 21 urban and rural districts in seven cities/provinces in Vietnam during 2017-2018. Overall, 42,551 children age 18 to 30 months were enrolled in the study. Two phases of assessment using Modified Checklist for Autism in Toddlers (M-CHAT) for screening and diagnostic assessment using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for confirmation. We employed univariate and binary logistic regression to identify. Results: Our study showed a fast-growing trend of ASDs amongst children age 18 and 30 months (75.8 per 10,000 individuals). Nine ante-, peri-, and neonatal factors were associated with ASDs: five factors of antenatal period (history of miscarriage/abortion or stillbirth, children conceived by assisted reproduction technologies, having cold, flu or acquiring virus during pregnancy, having gestational diabetes, toxemia, high blood pressure or pre-eclampsia during pregnancy, and having stress or mental disorders during pregnancy); one factors of perinatal period (mode of delivery); and three factors of neonatal period (jaundice, respiratory distress, and newborn seizures). Conclusion: This first large-scale survey in Vietnam confirms some prenatal, perinatal, and postnatal factors with ASDs amongst children age 18 and 30 months. Future interventions should focus on these factors to early diagnosis and intervention to improve functional outcomes for risky children.

Coxsackievirus A16 in Southern Vietnam.

Background: Hand, Foot and Mouth Disease (HFMD) is a major public health concern in the Asia-Pacific region. Most recent HFMD outbreaks have been caused by enterovirus A71 (EV-A71), coxsackievirus A16 (CVA16), CVA10, and CVA6. There has been no report regarding the epidemiology and genetic diversity of CVA16 in Vietnam. Such knowledge is critical to inform the development of intervention strategies. Materials and Methods: From 2011 to 2017, clinical samples were collected from in- and outpatients enrolled in a HFMD research program conducted at three referral hospitals in Ho Chi Minh City (HCMC), Vietnam. Throat or rectal swabs positive for CVA16 with sufficient viral load were selected for whole genome sequencing and evolutionary analysis. Results: Throughout the study period, 320 CVA16 positive samples were collected from 2808 HFMD patients (11.4%). 59.4% of patients were male. The median age was 20.8 months (IQR, 14.96-31.41). Patients resided in HCMC (55.3%), Mekong Delta (22.2%), and South East Vietnam (22.5%). 10% of CVA16 infected patients had moderately severe or severe HFMD. CVA16 positive samples from 153 patients were selected for whole genome sequencing, and 66 complete genomes were obtained. Phylogenetic analysis demonstrated that Vietnamese CVA16 strains belong to a single genogroup B1a that clusters together with isolates from China, Japan, Thailand, Malaysia, France and Australia. The CVA16 strains of the present study were circulating in Vietnam some 4 years prior to its detection in HFMD cases. Conclusion: We report for the first time on the molecular epidemiology of CVA16 in Vietnam. Unlike EV-A71, which showed frequent replacement between subgenogroups B5 and C4 every 2-3 years in Vietnam, CVA16 displays a less pronounced genetic alternation with only subgenogroup B1a circulating in Vietnam since 2011. Our collective findings emphasize the importance of active surveillance for viral circulation in HFMD endemic countries, critical to informing outbreak response and vaccine development.

Magnetic luminescent porous silicon microparticles for localized delivery of molecular drug payloads.

Magnetic manipulation, fluorescent tracking, and localized delivery of a drug payload to cancer cells in vitro is demonstrated, using nanostructured porous silicon microparticles as a carrier. The multifunctional microparticles are prepared by electrochemical porosification of a silicon wafer in a hydrofluoric acid-containing electrolyte, followed by removal and fracture of the porous layer into particles using ultrasound. The intrinsically luminescent particles are loaded with superparamagnetic iron oxide nanoparticles and the anti-cancer drug doxorubicin. The drug-containing particles are delivered to human cervical cancer (HeLa) cells in vitro, under the guidance of a magnetic field. The high concentration of particles in the proximity of the magnetic field results in a high concentration of drug being released in that region of the Petri dish, and localized cell death is confirmed by cellular viability assay (Calcein AM).

Ganglion cell complex loss in patients with type 1 diabetes: A 36-month retrospective study.

BACKGROUND: To analyze changes over a 3-year period in ganglion cell complex (GCC) thickness in individuals with type 1 diabetes mellitus (T1DM) using spectral-domain optical coherence tomography (Optovue, Fremont, CA, USA). METHODS: Thirty-seven individuals from "Friends for Life Conference" with T1DM and a 3-year history of GCC thickness measurements were included in the study. Data analysis using SPSS 22 and Excel StatPlus was completed to note the subgroups that had a significant change. RESULTS: Significant decreases were noted in the following subgroups with slope in parenthesis. Overall: GCC superior thickness OD (-0.48)Male: GCC thickness OD (-0.86), GCC superior thickness OD (-0.735)Body mass index (BMI) 25.0-29.9: GCC thickness OD (-0.48), GCC superior thickness OS (-0.915), GCC inferior thickness OD (-0.43)Ages 10-20 years: GCC superior thickness OD (-0.635)Duration of diabetes 10-20 years: GCC thickness OD (-1.055), GCC superior thickness OD (-0.99). CONCLUSION: GCC loss was noted in individuals who were males, those with BMIs of 25.0-29.9, and those who had diabetes for 10-20 years. Ganglion cell loss was also noted before the presence of any diabetic retinopathy, suggesting onset of neuronal loss before any vasculature changes.

A Computational Workflow Translates a 58-Gene Signature to a Formalin-Fixed, Paraffin-Embedded Sample-Based Companion Diagnostic for Personalized Treatment of the BRAF-Mutation-Like Subtype of Colorectal Cancers.

Colorectal cancer patients with the BRAF(p.V600E) mutation have poor prognosis in metastatic setting. Personalized treatment options and companion diagnostics are needed to better treat these patients. Previously, we developed a 58-gene signature to characterize the distinct gene expression pattern of BRAF-mutation-like subtype (accuracy 91.1%). Further experiments repurposed drug Vinorelbine as specifically lethal to this BRAF-mutation-like subtype. The aim of this study is to translate this 58-gene signature from a research setting to a robust companion diagnostic that can use formalin-fixed, paraffin-embedded (FFPE) samples to select patients with the BRAF-mutation-like subtype. BRAF mutation and gene expression data of 302 FFPE samples were measured (mutants = 57, wild-type = 245). The performance of the 58-gene signature in FFPE samples showed a high sensitivity of 89.5%. In the identified BRAF-mutation-like subtype group, 50% of tumours were known BRAF mutants, and 50% were BRAF wild-type. The stability of the 58-gene signature in FFPE samples was evaluated by two control samples over 40 independent experiments. The standard deviations (SD) were within the predefined criteria (control 1: SD = 0.091, SD/Range = 3.0%; control 2: SD = 0.169, SD/Range = 5.5%). The fresh frozen version and translated FFPE version of this 58-gene signature were compared using 170 paired fresh frozen and FFPE samples and the result showed high consistency (agreement = 99.3%). In conclusion, we translated this 58-gene signature to a robust companion diagnostic that can use FFPE samples.