Recurrent splanchnic and extrasplanchnic thrombotic events in patients with non-cirrhotic portal vein thrombosis associated with local factors.

BACKGROUND & AIMS: One-third of non-cirrhotic portal vein thrombosis (NCPVT) cases are associated with local factors. The risk of rethrombosis after anticoagulation withdrawal is unknown. We aimed to determine factors associated with new splanchnic or extrasplanchnic thrombotic events in this setting. METHODS: We performed a retrospective study including cases of recent NCPVT associated with local factors. High- and low-risk prothrombotic factors, prespecified according to RIPORT study criteria, were assessed. Univariate and multivariate Cox models assessed the influence of different variables on the occurrence of new thrombotic events. RESULTS: At baseline, 83/154 (53.9%) patients had at least one prothrombotic factor including 50 (32.5%) with a high-risk and 33 (21.4%) with a low-risk prothrombotic factor. Oestrogen-containing contraception was discontinued in all patients. During follow-up, 63/140 (45%) patients had at least one prothrombotic factor, including 47 (33.6%) with a high-risk and 16 (11.4%) with a low-risk prothrombotic factor. Seventeen new thrombotic events occurred after a median follow-up of 52 (IQR 14-62) (min-max 3.0-69.0) months. New thromboses were associated with high-risk factors (hazard ratio [HR] 3.817, 95% CI 1.303-11.180, p = 0.015), but were inversely related to recanalization (HR 0.222, 95% CI 0.078-0.635, p = 0.005) and anticoagulation (HR 0.976, 95% CI 0.956-0.995, p = 0.016). When a high-risk factor was present a new thrombotic event occurred in 7.4%, 14.6%, 14.6% and 28.8% of patients at 1, 3, 5 and 7 years under anticoagulants, respectively, compared to 21.2%, 21.2%, 58% and 58% without anticoagulants, respectively. CONCLUSIONS: In cases of recent NCPVT associated with local factors, high-risk factors for thrombosis are associated with new thrombotic events. Permanent anticoagulation appears beneficial in this high-risk situation. IMPACT AND IMPLICATIONS: In non-cirrhotic portal vein thrombosis (NCPVT) associated with local factors, systematic screening for prothrombotic factors is recommended, but the prevalence of the latter is not clearly established, and the risk of recurrent intra or extrasplanchnic thromboembolism is poorly described. Thus, interest in permanent anticoagulation remains. NCPVT associated with local factors is a matter of concern for hepatologists, gastroenterologists and digestive surgeons. Due to a lack of knowledge, practices are heterogeneous. Our findings highlight that systematic screening for prothrombotic factors in NCPVT is needed even when associated with local factors, as it may justify long-term anticoagulation for the prevention of new intra or extrasplanchnic thrombotic events in at least one-third of cases. The interest in long-term anticoagulation should be investigated prospectively in the absence of high-risk prothrombotic factors. CLINICAL TRIAL NUMBER: NCT0536064.

Assessment of possible biomedical applications of green synthesized TiO2NPs-an in-vitro approach.

Biomedical applications for various types of nanoparticles are emerging on a daily basis. Hence this research was performed to evaluate the antifungal (Aspergillus sp., Alternaria sp., Trichophyton sp., Candida sp., and Penicillium sp.), cytotoxicity (MCF10A cell lines), and antioxidant (DPPH) potential of Coleus aromaticus mediated and pre-characterized TiO2NPs were studied with respective standard methodology. Interestingly, the TiO2NPs exhibited significant antifungal activity on pathogenic fungal strains like Alternaria sp., Aspergillus sp. (31 ± 1.4), Penicillium sp. (31 ± 1.9) Trichophyton sp. (27 ± 2.1), and Candida sp. (26 ± 2.3) at high concentration (250 µg mL-1). However, the considerable levels of zone of inhibitions on fungal pathogens were recorded at 100 µg mL-1 of TiO2NPs as well as it was considerably greater than positive control. It also demonstrated dose based anti-inflammatory and antidiabetic activities. The plant-mediated TiO2NPs demonstrated a maximum DPPH scavenging efficiency of 91% at a dosage of 250 µg mL-1, comparable to the positive control's 94%. Furthermore, TiO2NPs at 100 µg mL-1 concentration did not cause cytotoxicity in MCF10A cell lines. At higher concentrations (250 µg mL-1), the nanoparticles showed the lowest cytotoxicity (17%). These findings suggest that C. aromaticus-mediated TiO2NPs have significant biomedical applications. However, in-vivo studies are needed to learn more about their (C. aromaticus-mediated TiO2NPs) potential biomedical applications.

Performance and neural modeling of a compost-based biofilter treating a gas-phase mixture of benzene and xylene.

Biofilter (BF) has been regarded as a versatile gas treatment technology for removing volatile organic compounds (VOCs) from contaminated gas streams. In order for BF to be utilized in the industrial setting, it is essential to conduct research aimed at removing VOC mixtures under different inlet loading conditions, i.e. as a function of the gas flow rate and inlet VOC concentrations. The main aim of this study was to apply artificial neural networks (ANN) and determine the relationship between flow rate (FR), pressure drop (PD), inlet concentration (C), and removal efficiency (RE) in the BF treating gas-phase benzene and xylene mixtures. The ANN model was trained and tested to assess the removal efficiency of benzene (REB) and xylene (REX) under the influence of different FR, PD and C. The model's performance was assessed using a cross-validation method. The REb varied from 20% to >60%, while the REx varied from 10% to 70% during the different experimental phases of BF operation. The causal index (CI) technique was used to determine the sensitivity of the input parameters on the output variables. The ANN model with a topology of 4-4-2 performed the best in terms of predicting the RE profiles of both the pollutants. Furthermore, the effect was more pronounced for xylene because an increase in the benzene concentration reduced xylene removal (CI = -25.7170) more severely than benzene removal. An increase in the xylene concentration had a marginally positive effect on the benzene removal (CI = +0.1178).

Deciphering the anticancer, anti-inflammatory and antioxidant potential of Ti nanoparticles fabricated using Zingiber officinale.

Rapid and sustainable green technology was implemented in the current study to fabricated Ti nanoparticles. The vegetable ginger with the scientific name Zingiber officinale was employed as a biological source in the fabrication process of nanoparticles. The optical, structural, morphological, and particle size of the fabricated Ti nanoparticles were characterized with the help of UV-visible absorption spectrum, FTIR (Fourier Transform Infrared) spectrum, SEM (Scanning Electron Microscope) analysis, DLS (Dynamic Light Scattering) technique and XRD (X-ray powder diffraction) crystallography technique. The presence of spherical-shaped Ti nanoparticles with an average particle size of 93 nm was confirmed based on these characterization techniques. The anti-cancer properties of the Z. officinale mediated Ti nanoparticles were analyzed through MTT assay against cell lines MCF-7 (Human breast adenocarcinoma cell line) and concentration-dependent anti-cancer properties were observed. The anti-inflammatory capacity of the Z. officinale mediated Ti nanoparticles were examined through protein denaturation and nitric oxide scavenging assay. The antioxidant capacity of the Z. officinale mediated Ti nanoparticles were examined through DPPH assay, hydrogen peroxide radical scavenging assay, hydroxyl radical scavenging assay, and FRAP (Ferric Reducing Antioxidant Power) analysis. The fabricated Ti nanoparticles exhibited anti-inflammatory and antioxidant capacity in a concentration-dependent pattern.

Comprehensive design method of a soft multifocal contact lens with NURBS.

This study presents a comprehensive method for designing a multifocal contact lens (MCL) with Snell's law and non-uniform rational B-spline (NURBS) curves. Instead of using thin lens approximation, general mathematical formulas have been developed to achieve the accurate coordinates of points on the anterior lens surface profile of the MCL to meet various given optical power distributions. Then the NURBS curve is adjusted to fit these data points to obtain the smooth front lens surface profile. This method not only improves the accuracy of the optical power profiles of MCLs but also reduces the spherical aberration in near/distance optical zones. The experimental results show that the power profiles of soft MCLs agree with those of the simulation results and original design requirements. The proposed method has been proven for the MCL design, and it can be feasibly applied in complex optical lens designs.

Allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: Signal detection and preventability from Vietnam National pharmacovigilance database.

WHAT IS KNOWN AND OBJECTIVE: Allopurinol, the first-line medication for hyperuricemia is well-known for its association with severe cutaneous adverse reactions, especially Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). In the current study, we analysed the Vietnamese spontaneous reporting database to identify signals and preventability of allopurinol-induced SJS/TEN in Vietnam from 2010 to 2019. METHODS: Signal generation was assessed using the case/non-case method. Reporting odds ratios (RORs) and 95% confidence intervals (95% CI) were calculated. RESULTS: Among 72,822 spontaneous ADR reports submitted to the Vietnam National Drug Information and Adverse Drug Reaction Monitoring Centre, 392 reports were on SJS/TEN, of which, 65 cases (16.6%) were related to allopurinol. The signals of allopurinol-induced SJS/TEN in Vietnam started in 2014 (ROR of 3.531, 95% CI: 1.830-6.810) and annually increased until 2019 (ROR of 11.923, 95% CI: 8.508-16.710). The preventability assessment showed that no allopurinol-induced SJS/TEN case was definitely unpreventable. 61.6% of the SJS/TEN cases were avoidable because they were associated with inappropriate prescribing such as unapproved indications, too high initial dose and even rechallenging in patients with a history of allopurinol allergy. WHAT IS NEW AND CONCLUSION: The signals of allopurinol-induced SJS/TEN in Vietnam started in 2014 and annually increased until 2019. Our first report specifically focusing on the ADR preventability of allopurinol showed that correction of medical errors relating to prescription could prevent more than 60% of SJS/TEN cases in Vietnamese allopurinol users. This is a feasible and practical solution, provided that there would be a systematic change in both healthcare systems and public awareness.

Cataract Surgery Destabilises Temporary the Tear Film of the Ocular Surface. / Kataraktchirurgie destabilisiert vorübergehend die Benetzung der Augenoberfläche.

BACKGROUND: Symptoms due to dry eye in the form of keratoconjunctivitis sicca (KCS) are often seen after cataract surgery. We investigated the influence of cataract surgery on tear film stability on the ocular surface. MATERIAL AND METHODS: 60 eyes of 60 patients who underwent cataract surgery were included in a prospective study in 2017 at the Eye Hospital in Hanoi (Vietnam National Institute of Ophthalmology). The mean age of the patients was 65 ± 10 years. The phacoemulsification was performed under topical anaesthesia by a clear corneal incision and implantation of a foldable IOL. The parameters for the evaluation of the change of the tear film included subjective patient data using the Ocular Surface Disease Index questionnaire (OSDI), findings of the Schirmer I test, the tear break-up time (TBUT) as well as the tear meniscus height (TMH) measured noninvasively with the Keratograph 5M (Oculus). In addition, conjunctival and corneal changes were examined after vital staining with fluorescein for the cornea and rose bengal for the conjunctiva. Data were collected preoperatively, at 1 week, 1 month and 3 months postoperatively. According to DEWS, the disease is classified into 4 groups: mild, moderate, severe and very severe. RESULTS: One week after surgery, the total score according to OSDI was significantly increased with a total value of 14.4 ± 4.2 (p = 0.001). Schirmer I was 15.8 ± 4.3 mm preoperatively and decreased significantly in the first postoperative week (p = 0.001), before reaching the preoperative level again after three months. TBUT was 12.6 ± 1.5 s preoperatively, decreased significantly to 9.7 ± 1.5 s during the first postoperative week, and normalized to 12.4 ± 1.3 s by the end of the third month. The meniscus height was 0.245 ± 0.055 mm preoperatively, significantly lowered to 0.229 ± 0.057 mm in the first postoperative period and nearly normalised by the third postoperative month to 0.241 ± 0.051 mm. In the first postoperative week, the rate of mild KCS was observed in 30% of patients. At one month, this decreased to 10% and at three months was no longer demonstrable in any patient. CONCLUSION: One of three patients experienced mild KCS after cataract surgery. The symptoms lasted up to three months. This should be taken into account preoperatively and appropriate therapy should be planned.

Entropy Correlation and Its Impacts on Data Aggregation in a Wireless Sensor Network.

A correlation characteristic has significant potential advantages for the development of efficient communication protocols in wireless sensor networks (WSNs). To exploit the correlation in WSNs, the correlation model is required. However, most of the present correlation models are linear and distance-dependent. This paper proposes a general distance-independent entropy correlation model based on the relation between joint entropy and the number of members in a group. This relation is estimated using entropy of individual members and entropy correlation coefficients of member pairs. The proposed model is then applied to evaluate two data aggregation schemes in WSNs including data compression and representative schemes. In the data compression scheme, some main routing strategies are compared and evaluated to find the most appropriate strategy. In the representative scheme, with the desired distortion requirement, a method to calculate the number of representative nodes and the selection of these nodes are proposed. The practical validations showed the effectiveness of the proposed correlation model and data reduction schemes.

Synthesis and anti-proliferative activity of novel azazerumbone conjugates with chalcones.

The conjugation of azazerumbone ((3E,7E,11E)-5,5,8,12-tetramethylazacyclododeca-3,7,11-trien-2-one (7)) and 2,4-dihydroxychalcones was carried out for the preparation of novel target compounds 9a-g with 1-ethylene-4-methylene-1,2,3-triazole linker and 10a-f with propylene linker between amide nitrogen of azazerumbone and 4-hydroxy group of chalcone. The anti-proliferative activity of these compounds against the LU-1, Hep-G2, MCF-7 and SW480 human cancer cell lines were significantly improved compared to those of azazerumbone or zerumbone. The anti-proliferative activities of (3E,7E,11E)-1-((1-(2-(3-hydroxy-4-((E)-3-(3-methoxyphenyl)acryloyl)phenoxy)ethyl)-1H-1,2,3-triazol-4-yl)methyl)-5,5,8,12-tetramethyl azacyclododeca-3,7,11-trien-2-one (9b) and (3E,7E,11E)-1-(3-(4-((E)-3-(3,4,5-trimethoxyphenyl)acryloyl)phenoxy)propyl)-5,5,8,12-tetramethylazacyclododeca-3,7,11-trien-2-one (10d) are nearly comparable to those of ellipticine.

Gallbladder volvulus in a 5-years old Vietnamese female: A case report.

Gallbladder volvulus (GV) is a medical emergency and a rare cause of acute abdominal pain among the pediatric population. GV is more prominent usually in boys in pediatric patients. If it is not diagnosed and surgically intervened promptly, GV will become a life-threating condition. Fortunately, a safe and effective laparoscopic cholecystectomy is now widely indicated. A 5 years old female patient with abdominal pain and heavy much vomiting was referred to the emergency room in our hospital. She was suspiciously diagnosed with acute inflammation of the gallbladder according to the results of abdominal ultrasound and computerized tomography (CT) scan already performed on admission. One day after the hospitalization, abdominal ultrasound, and CT scan were performed again because of intensification of her abdominal pain and revealed the clinical portrait of GV such as a "floating gallbladder" sign, an echogenic cone structure, an elongated axis displaced horizontally instead of vertically and a lack of intramural blood flow. The acute GV diagnosis was made and the patient was operated, using the laparoscopic cholecystectomy on time, the gallbladder was tightly twisted clockwise at approximately 720°. The operation and postoperative treatment went quite well and the patient was discharged from the hospital on postoperative Day 7. GV is very rare in children, easily omitted or misdiagnosed with cholecystitis. Imaging diagnosis such as ultrasound, CT with contrast helps make diagnosis promptly that avoids severe complications such as gallbladder perforation, necrosis, and biliary peritonitis.

Draft genomes announcement of Vietnamese Xanthomonas euvesicatoria strains causing bacterial spot on pepper.

Xanthomonas euvesicatoria the primary causal agent of bacterial spot of pepper (BSP), poses a significant global challenge, resulting in severe defoliation and yield losses for pepper growers. We present the whole genome sequences of eight X. euvesicatoria strains associated with BSP in Vietnam. These genomes contribute to representation of pepper production regions in the global sample of X. euvesicatoria genomes, enabling the development of precise global disease management strategies.

Genomic adaptation to small population size and saltwater consumption in the critically endangered Cat Ba langur.

Many mammal species have declining populations, but the consequences of small population size on the genomic makeup of species remain largely unknown. We investigated the evolutionary history, genetic load and adaptive potential of the Cat Ba langur (Trachypithecus poliocephalus), a primate species endemic to Vietnam's famous Ha Long Bay and with less than 100 living individuals one of the most threatened primates in the world. Using high-coverage whole genome data of four wild individuals, we revealed the Cat Ba langur as sister species to its conspecifics of the northern limestone langur clade and found no evidence for extensive secondary gene flow after their initial separation. Compared to other primates and mammals, the Cat Ba langur showed low levels of genetic diversity, long runs of homozygosity, high levels of inbreeding and an excess of deleterious mutations in homozygous state. On the other hand, genetic diversity has been maintained in protein-coding genes and on the gene-rich human chromosome 19 ortholog, suggesting that the Cat Ba langur retained most of its adaptive potential. The Cat Ba langur also exhibits several unique non-synonymous variants that are related to calcium and sodium metabolism, which may have improved adaptation to high calcium intake and saltwater consumption.

Corrigendum: Effectiveness of perindopril/amlodipine fixed-dose combination in the treatment of hypertension: a systematic review.

[This corrects the article DOI: 10.3389/fphar.2023.1156655.].

Clinical characteristics of Dengue shock syndrome in Vietnamese children: a 10-year prospective study in a single hospital.

BACKGROUND: Dengue shock syndrome (DSS) is a severe manifestation of dengue virus infection that particularly affects children and young adults. Despite its increasing global importance, there are no prospective studies describing the clinical characteristics, management, or outcomes of DSS. METHODS: We describe the findings at onset of shock and the clinical evolution until discharge or death, from a comprehensive prospective dataset of 1719 Vietnamese children with laboratory-confirmed DSS managed on a single intensive care unit between 1999 and 2009. RESULTS: The median age of patients was 10 years. Most cases had secondary immune responses, with only 6 clear primary infections, and all 4 dengue virus serotypes were represented during the 10-year study. Shock occurred commonly between days 4 and 6 of illness. Clinical signs and symptoms were generally consistent with empirical descriptions of DSS, although at presentation 153 (9%) were still febrile and almost one-third had no bleeding. Overall, 31 (2%) patients developed severe bleeding, primarily from the gastrointestinal tract, 26 of whom required blood transfusion. Only 8 patients died, although 123 of 1719 (7%) patients had unrecordable blood pressure at presentation and 417 of the remaining 1596 (26%) were hypotensive for age. The majority recovered well with standard crystalloid resuscitation or following a single colloid infusion. All cases were classified as severe dengue, while only 70% eventually fulfilled all 4 criteria for the 1997 World Health Organization classification of dengue hemorrhagic fever. CONCLUSIONS: With prompt intervention and assiduous clinical care by experienced staff, the outcome of this potentially fatal condition can be excellent.

Application of Essential Oils Extracted from Peel Wastes of Four Orange Varieties to Control Anthracnose Caused by Colletotrichum scovillei and Colletotrichum gloeosporioides on Mangoes.

A huge amount of orange peel waste is annually discharged into the environment. Processing of this waste for the control of post-harvest fruit diseases can reduce environmental pollution. Essential oils (EOs) from fruit peels of Citrus reticulata × sinensis (Sanh cultivar) and Citrus sinensis (Xoan, Mat and Navel cultivar) were investigated for their ability to control anthracnose caused by Colletotrichum gloeosporioides and Colletotrichum scovillei on mangoes. EOs were extracted by hydro-distillation and analyzed by GC-MS and GC-FID. The antifungal activity of the EOs was determined by in vitro and in vivo assays. The Mat cultivar had the highest extraction yield of 3% FW, followed by Xoan (2.9%), Sanh (2.2%), and Navel (1%). The chemical composition of the EOs was similar, with limonene as the main compound (around 96%). The antifungal activity of EOs was not different, with a minimum fungicidal concentration of 16% for both fungi. The disease inhibition of EOs increased with their concentration. The highest inhibition of anthracnose caused by both fungi on mangoes was achieved at 16% EO. EOs had no adverse effect on mango quality (pH, total soluble solids, total acidity, color and brightness of mangoes), except firmness and weight loss at high concentrations (16%). Orange EOs can be used as bio-fungicides to control mango anthracnose at high concentrations.

A Two-Flap Combination for Auricular Elevation in Microtia Reconstruction.

BACKGROUND: The aims of this study were to describe and evaluate the effectiveness of combined flaps, a modification of the Nagata technique, for providing a reasonable projection for reconstructed auricles. METHODS: The authors modified the Nagata method for covering the cartilage block by introducing a new combined flap technique, including the temporoparietal skin flap and retroauricular flap. The authors compared the shape, size, and position of the reconstructed ear to the opposite ear, and we evaluated postoperative complications and patient satisfaction levels. They verified the effectiveness of the combined flap by assessing flap necrosis, skin color, thickness, hair in the auricular area, and scars. RESULTS: A total of 38 consecutive patients (39 ears) with microtia, aged 6 to 34 years, underwent reconstruction using the modified method and were followed up for 33.6 months on average. The reconstructed auricle's shape was well defined, with 41.0% having good and 15.4% having excellent results. Most cases achieved good and acceptable levels in size, position, medial longitudinal axis angle, and auriculocephalic angles, and 79.9% of patients/their families were satisfied. The authors observed no cases of flap necrosis or hypertrophic scarring, and there were low rates of flap complications, such as unmatched skin color (7.7%), unacceptable thickness (5.1%), or hair and stretch marks (10.3%). CONCLUSIONS: The modified method's reconstructed ear achieved stable projection, symmetric appearance, and obvious anatomical landmarks with high patient satisfaction. The combined flap method showed certain advantages: high survival rate, less skin contrast, no hypertrophic scars, and fewer complications. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Changes in the Correlates for Intimate Partner Violence Against Women in Vietnam: Evidence From the 2010 and 2019 National Prevalence Surveys.

This study sought to understand whether the risk and protective factors associated with current partner violence changed in Vietnam using findings from two comparable surveys conducted in 2010 and 2019. Fifteen (2010) and 17 (2019) factors were significantly associated with violence, and the level of consistency was high-nonpartner sexual violence, respondent and partner prior abuse, men's expressions of masculinity, and indicators of low economic status continue to put women at risk. Gender-transformative approaches that address power inequalities, foster positive parenting, and promote the political and social influence of women are required and should be adapted to the Vietnam context.

One Health Surveillance Highlights Circulation of Viruses with Zoonotic Potential in Bats, Pigs, and Humans in Viet Nam.

A One Health cross-sectoral surveillance approach was implemented to screen biological samples from bats, pigs, and humans at high-risk interfaces for zoonotic viral spillover for five viral families with zoonotic potential in Viet Nam. Over 1600 animal and human samples from bat guano harvesting sites, natural bat roosts, and pig farming operations were tested for coronaviruses (CoVs), paramyxoviruses, influenza viruses, filoviruses and flaviviruses using consensus PCR assays. Human samples were also tested using immunoassays to detect antibodies against eight virus groups. Significant viral diversity, including CoVs closely related to ancestors of pig pathogens, was detected in bats roosting at the human-animal interfaces, illustrating the high risk for CoV spillover from bats to pigs in Viet Nam, where pig density is very high. Season and reproductive period were significantly associated with the detection of bat CoVs, with site-specific effects. Phylogeographic analysis indicated localized viral transmission among pig farms. Our limited human sampling did not detect any known zoonotic bat viruses in human communities living close to the bat cave and harvesting bat guano, but our serological assays showed possible previous exposure to Marburg virus-like (Filoviridae), Crimean-Congo hemorrhagic fever virus-like (Bunyaviridae) viruses and flaviviruses. Targeted and coordinated One Health surveillance helped uncover this viral pathogen emergence hotspot.

Effectiveness of perindopril/amlodipine fixed-dose combination in the treatment of hypertension: a systematic review.

Background: Uncontrolled blood pressure is a major risk factor for cardiovascular diseases. Fixed-dose combination (FDC) therapy offers a promising approach to addressing this challenge by providing a convenient single-tablet solution that enhances the effectiveness of blood pressure control. In our systematic review, we assess the effectiveness of perindopril/amlodipine FDC in managing blood pressure. Methods: We conducted a comprehensive search across four primary electronic databases, namely, PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of 8 February 2022. Additionally, we performed a manual search to find relevant articles. The quality of the selected articles was evaluated using the Study Quality Assessment Tools (SQAT) checklist from the National Institute of Health and the ROB2 tool from Cochrane. Results: Our systematic review included 17 eligible articles. The findings show that the use of perindopril/amlodipine FDC significantly lowers blood pressure and enhances the quality of blood pressure control. Compared to the comparison group, the perindopril/amlodipine combination tablet resulted in a higher rate of blood pressure response and normalization. Importantly, perindopril/amlodipine FDC contributes to improved patient adherence with minimal side effects. However, studies conducted to date have not provided assessments of the cost-effectiveness of perindopril/amlodipine FDC. Conclusion: In summary, our analysis confirms the effectiveness of perindopril/amlodipine FDC in lowering blood pressure, with combination therapy outperforming monotherapy and placebo. Although mild adverse reactions were observed in a small subset of participants, cost-effectiveness assessments for this treatment remain lacking in the literature.

WildHealthNet: Supporting the development of sustainable wildlife health surveillance networks in Southeast Asia.

Wildlife and wildlife interfaces with people and livestock are essential surveillance targets to monitor emergent or endemic pathogens or new threats affecting wildlife, livestock, and human health. However, limitations of previous investments in scope and duration have resulted in a neglect of wildlife health surveillance (WHS) systems at national and global scales, particularly in lower and middle income countries (LMICs). Building on decades of wildlife health activities in LMICs, we demonstrate the implementation of a locally-driven multi-pronged One Health approach to establishing WHS in Cambodia, Lao PDR and Viet Nam under the WildHealthNet initiative. WildHealthNet utilizes existing local capacity in the animal, public health, and environmental sectors for event based or targeted surveillance and disease detection. To scale up surveillance systems to the national level, WildHealthNet relies on iterative field implementation and policy development, capacity bridging, improving data collection and management systems, and implementing context specific responses to wildlife health intelligence. National WHS systems piloted in Cambodia, Lao PDR, and Viet Nam engaged protected area rangers, wildlife rescue centers, community members, and livestock and human health sector staff and laboratories. Surveillance activities detected outbreaks of H5N1 highly pathogenic avian influenza in wild birds, African swine fever in wild boar (Sus scrofa), Lumpy skin disease in banteng (Bos javanicus), and other endemic zoonotic pathogens identified as surveillance priorities by local stakeholders. In Cambodia and Lao PDR, national plans for wildlife disease surveillance are being signed into legislation. Cross-sectoral and trans-disciplinary approaches are needed to implement effective WHS systems. Long-term commitment, and paralleled implementation and policy development are key to sustainable WHS networks. WildHealthNet offers a roadmap to aid in the development of locally-relevant and locally-led WHS systems that support the global objectives of the World Organization for Animal Health's Wildlife Health Framework and other international agendas.