Establishment of an in-house real-time RT-PCR assay for the detection of severe acute respiratory syndrome coronavirus 2 using the first World Health Organization international standard in a resource-limited country.

BACKGROUND: The COVID-19 pandemic caused by SARS-CoV-2 remains public health burdens and many unresolved issues worldwide. Molecular assays based on real-time RT-PCR are critical for the detection of SARS-CoV-2 in clinical specimens from patients suspected of COVID-19. OBJECTIVE: We aimed to establish and validate an in-house real-time RT-PCR for the detection of SARS-CoV-2. METHODOLOGY: Primers and probes sets in our in-house real-time RT-PCR assay were designed in conserved regions of the N and E target genes. Optimized multiplex real-time RT-PCR assay was validated using the first WHO International Standard (NIBSC code: 20/146) and evaluated clinical performance. RESULTS: The limit of detection validated using the first WHO International Standard was 159 IU/ml for both E and N target genes. The evaluation of clinical performance on 170 clinical samples showed a positive percent agreement of 100% and the negative percent agreement of 99.08% for both target genes. The Kappa value of 0.99 was an excellent agreement, the strong correlation of Ct values observed between two tests with r2  = 0.84 for the E gene and 0.87 for the N gene. Notably, we assessed on 60 paired saliva and nasopharyngeal samples. The overall agreement was 91.66%, and Kappa value of 0.74 showed a high agreement between two types of samples. When using nasopharyngeal swabs as the reference standard, positive percent agreement, and negative percent agreement were 91.83% and 90.90%, respectively. CONCLUSION: In the present study, we established and validated an in-house real-time RT-PCR for molecular detection of SARS-CoV-2 in a resource-limited country.

Quality of life and health status of hospitalized adults with congenital heart disease in Vietnam: a cross-sectional study.

BACKGROUND: Little is known about the quality of life (QOL) and health status of adults with congenital heart disease (CHD) in developing countries. Therefore, this study aimed to describe the QOL and health status of hospitalized adults with CHD in Vietnam and investigate the association between QOL and their biological-social characteristics. METHODS: A cross-sectional study was conducted with 109 adults with CHD, hospitalized in the Vietnam National Heart Institute, between June and December 2019. Validated instruments to assess QOL and health status describing patient-reported outcomes were used, including the EuroQOL-5 Dimensions-5 Level, Satisfaction with Life Scale, and Hospital Anxiety and Depression Scale. RESULTS: The mean scores on the EuroQOL-descriptive system (EQ-DS) and EuroQOL visual analogue scale (EQ-VAS) were 0.792 (SD = 0.122, 95% confidence interval [CI] 0.769-0.815) and 66.3 (SD = 12.5, 95% CI 63.9-68.7), respectively. A total of 9.2% (n = 9) patients experienced life dissatisfaction. The prevalence of anxiety and depression were 18.7% (n = 20) and 11% (n = 12), respectively. Scores of QOL in patients aged > 30 years were lower than in those aged ≤ 30 years. Stratified multivariate logistic regression revealed that poor QOL related to being unemployed/unstable employment (OR 4.43, 95% CI 1.71-11.47, p = 0.002), life dissatisfaction associated with unmarried status (OR 4.63, 95% CI 1.2-17.86, p = 0.026), anxiety regarding unemployment/unstable employment (OR 3.88, 95% CI 1.27-11.84, p = 0.017) and complex CHD/PAH (OR 4.84, 95% CI 1.33-17.54, p = 0.016), and depression regarding unemployment/unstable employment (OR 4.63, 95% CI 1.22-17.59, p = 0.003). CONCLUSIONS: Reduced QOL and elevated psychological problems were common experiences among hospitalized adults with CHD in Vietnam. Biological-social characteristics such as unmarried status, unemployment/unstable employment, and complex CHD/PAH related to poor QOL, life dissatisfaction, anxiety, and depression.

Advanced cellulose-based hydrogel TiO2 catalyst composites for efficient photocatalytic degradation of organic dye methylene blue.

Sustainable cellulose-based hydrogels are used in medicine and environmental science. Hydrogels' porosity makes them excellent adsorbents and stable substrates for immobilizing photocatalysts to remove organic dyes. Despite their potential, the implementation of hydrogels for this purpose is still limited due to their high synthesis temperature and low cellulose content. To overcome these challenges, this study develops cellulose-based hydrogels, which have a high cellulose content and can be easily synthesized under ambient conditions. Containing a higher cellulose concentration than previous hydrogels, the synthesized hydrogels are more stable and can be reused numerous times in treatment operations. The hydrogel properties were investigated using Fourier transform infrared spectroscopy, X-ray diffraction and thermal analysis. Scanning electronic microscopy revealed that TiO2 nanoparticles were homogeneously distributed throughout the hydrogel's matrices. In addition, transparent hydrogels allow light to pass through, making them suitable substrates to remove organic dye. The results showed that the hydrogel with TiO2 was able to degrade nearly 90% of organic dye within 180 min. Furthermore, the hydrogel with the embedded catalyst exhibits the potential for reusability with a regeneration efficiency of 80.01% after five runs. These findings suggest that this novel hydrogel is a promising candidate for water pollution remediation.

Synthesis of heated aluminum oxide particles impregnated with Prussian blue for cesium and natural organic matter adsorption: Experimental and machine learning modeling.

Heated aluminum oxide particles impregnated with Prussian blue (HAOPs-PB) are synthesized for the first time using different molar ratios of aluminum sulfate and PB to improve the adsorption of cesium (133Cs+) and natural organic matter (NOM) from an aqueous solution. The Cs+ adsorption from various aqueous solutions, including surface, tap and deionized water by synthesized HAOPs-PB, is investigated. The influencing factors such as HAOPs-PB mixing ratio, pH and dosage are studied. In addition, pseudo 1st and 2nd order is tested for adsorption kinetics study. A machine learning model is developed using gene expression programming (GEP) to evaluate and optimize the adsorption process for Cs+ and NOM removal. Synthesized adsorbent showed maximum adsorption at a 1:1 M ratio of aluminum sulfate and PB in DI, tap, and surface water. The pseudo 2nd order kinetics model described the Cs + adsorption by HAOPs-PB more accurately that indicating physiochemical adsorption. Adsorption of Cs+ showed an increasing trend with higher HAOPs-PB concentration, while high pH also favored the adsorption. Maximum NOM adsorption is found at a higher HAOPs-PB dosage and a neutral pH value. Furthermore, the proposed GEP model shows outstanding performance for Cs+ adsorption modeling, whereas a modified-GEP model presents promising results for NOM adsorption prediction for testing dataset by learning the relationship between inputs and output with R2 values of 0.9348 and 0.889, respectively.

Outcomes of pregnant women hospitalized with unrepaired congenital heart disease: Insights from a multidisciplinary center in Vietnam.

Background: In developing countries, fewer women have access to multidisciplinary congenital heart disease and reproductive programs staffed by experts. We report pregnancy outcomes of a multidisciplinary healthcare strategy utilizing an in-hospital teamwork approach in Vietnam. Methods: This retrospective cohort study included pregnant women with unrepaired congenital heart disease managed at a referral cardiovascular center. Results: Undiagnosed congenital heart disease before pregnancy, a lack of pre-pregnancy cardiology counseling, and modified World Health Organization class III/IV were common. Under the multispecialty healthcare strategy, although the rate of maternal death was 8.2% in the modified World Health Organization class IV group, no deaths occurred in any other group. Fetal/neonatal complications occurred in 54% of pregnancies, and 49.4% of neonates survived. Poor pregnancy outcomes were associated with admission during the first/seconde trimester for fetus/neonates, third trimester for mother, modified World Health Organization class III/IV, cyanosis, and heart failure. Conclusion: The outcomes of pregnant women with unrepaired congenital heart disease were poor but seemed to improve with a multidisciplinary in-hospital healthcare teamwork strategy.

Treating reverse osmosis concentrate to address scaling and fouling problems in zero-liquid discharge systems: A scientometric review of global trends.

Currently, reverse osmosis concentrate (ROC) treatment is one of the most promising techniques for its disposal because it produces freshwater with high recovery and valuable materials such as salts and reduces waste volume and environmental pollution. Public attention to the severe consequences of water pollution and strict environmental regulations on wastewater discharge has pushed water-polluting industries toward zero-liquid discharge (ZLD). However, scaling and fouling problems increase energy consumption and limit permeate flux at high salt concentrations, mainly due to calcium, magnesium, and silica precipitation, ultimately decreasing ZLD performance. Therefore, this study discusses drivers and ROC pretreatment technologies to improve ZLD efficiency and presents a scientometric review of global trends. The advantages, disadvantages, and economic and environmental aspects of conventional and emerging pre-treatment technologies were studied. Traditional treatment of chemical processes combined with precipitation removes a large amount of scaling ions; however, high operation and maintenance costs and limited full-scale plant experience are the main drawbacks. Softening and coagulation are most commonly applied to treat large volumes at a moderate cost; however, substantial sludge production and increased conductivity are major operational issues. Moreover, emerging technologies efficiently remove scale-forming ions with high capital and operating costs. New variations in standard reverse osmosis technologies have improved ZLD efficiency; nonetheless, scaling and fouling are of concern. Therefore, this review presents the studies on ROC pre-treatment technologies for removing scaling ions to enhance ZLD efficiency, which can help in future research.

Low bone mineral density and its related factors in adults with congenital heart disease in Vietnam: A cross-sectional study.

Background and Aims: Recent studies have highlighted the increased risk of low bone mineral density (BMD) in adults with cardiovascular disease. However, little is known about BMD in adults with congenital heart disease (CHD), particularly in developing countries. We hypothesized that factors related to BMD would lead to a high prevalence of low BMD in adults with CHD. This study aimed to determine the prevalence of low BMD and its related factors in Vietnamese adults with CHD. Methods: We conducted a cross-sectional study of 73 adults diagnosed with CHD in Vietnam. Low BMD was classified based on their site-specific Z-scores and T-scores at the posteroanterior lumbar spine and left proximal femur. Logistic regression analyses were performed to evaluate factors related to low BMD. Results: Low BMD was confirmed in one-third of the adults with CHD. There were trends of more bone loss in certain parts of the body than in others, with the prevalence of low BMD at the sites of the lumbar vertebrae (L1‒L4) and left proximal femur (femoral neck, trochanteric femur, and intertrochanteric area) of 43.9%, 31.8%, 28.8%, 33.3%, 8.8%, 1.5%, and 6.1%, respectively. The prevalence of low BMD in the lumbar spine was significantly higher than that in the left proximal femur (34.3% vs. 2.9%, p < 0.001). Moreover, the prevalence of low BMD was significantly higher in adults with CHD than in those without polycythemia and vitamin D deficiency (55.6% vs. 20.9%, p = 0.001 and 46.2% vs. 19.4%, p = 0.002, respectively). A stratified multivariate logistic regression analysis revealed that low BMD was associated with polycythemia (odds ratio: 4.72; 95% confidence interval: 1.64-13.58, p = 0.004). Conclusions: Low BMD is common among adults with CHD in Vietnam and related to polycythemia.

Genetics, Screening, and Treatment of Familial Hypercholesterolemia: Experience Gained From the Implementation of the Vietnam Familial Hypercholesterolemia Registry.

Familial hypercholesterolemia (FH) is underdiagnosed and undertreated in a majority of the low- and middle-income countries. FH registries could prove useful in bridging the knowledge gaps, supporting genetic and clinical research, and improving health-care planning and patient care. Here, we report the first usage experience of the Vietnam FH (VINAFH) Registry. The VINAFH Registry was established in 2016 as a long-term database for prospective cohorts. FH patients were detected based on the opportunistic and cascade screening. Diagnosis of FH was assessed using the Dutch Lipid Clinic Network criteria, plasma levels of low-density lipoprotein (LDL) cholesterol, and genetic testing. To date, a total of 130 patients with FH have been registered, with 48 index cases and 82 relatives. Of the 130 patients, 8 were homozygous FH patients and 38 were children. Of FH individuals, 46.7% was confirmed by genetic testing: 61 patients (96.8%) carried the LDLR mutation (c.681C > G, c.1427C > G, c.1187-?_2140 ± ?del, c.2529_2530delinsA), and two patients (3.2%) carried the PCSK9 (protein convertase subtilisin/kexin type 9) mutation (c.42_43insTG). The c.2529_2530delinsA mutation detected in this study is novel and reported only in the Vietnamese population. However, only 53.8% of FH patients were followed up post diagnosis, and only 15.3% of these were approved for lipid-lowering therapy and specialized care. Notably, factors such as knowledge about FH in patients and/or guardians of FH children and support of primary care physicians affected patient participation with respect to treatment strategies and follow-up. Genetic identification, screening, and treatment of FH were feasible in Vietnam. The VINAFH Registry significantly contributed to the formation of the government agencies legislative acts that established the importance of FH as a socially and medically important disease requiring appropriate management strategies. Other low- and middle-income countries could, thus, use the VINAFH Registry model as a reference to establish programs for FH management according to the current status.

Homozygous familial hypercholesterolaemia in Vietnam: Case series, genetics and cascade testing of families.

BACKGROUND AND AIMS: Familial hypercholesterolaemia has not been previously described in the Vietnamese population. We aimed to describe the features of patients with homozygous familial hypercholesterolaemia (hoFH) in Vietnam and the outcomes of screening family members using genetic and cholesterol testing. METHODS: Mutation testing by massively parallel sequencing for genes causative of FH was undertaken in five index cases presenting to a single cardiac center with a presumptive diagnosis of hoFH. Cascade testing of all available family members was subsequently undertaken. The number of new cases of FH detected and commenced on lipid-lowering treatment was evaluated. RESULTS: All five index cases had true homozygous mutations in the LDL receptor gene (LDLR). Cascade screening was undertaken in four families. 107 relatives were screened and FH was identified in 56 relatives (52%), including 3 new cases of hoFH. Only 5 FH relatives (9%) were subsequently treated owing to the adverse perceptions and comparative high cost of drug treatment, and lack of awareness of FH among patients and local doctors. CONCLUSIONS: HoFH due to LDLR mutations is a severe disorder in Vietnam that needs early detection and treatment with LDL-cholesterol lowering drugs. Cascade testing of families allows effective detection of new cases of FH that may also benefit from early treatment. However, convincing patients to commence statin treatment is a challenge. Extended education and awareness programs and treatment subsidies are imperative to improve the care of patients and families suffering from FH in Vietnam.