Epidural injection-related pneumorrhachis: A case report with cauda equina syndrome.

Pneumorrhachis (PR) is an uncommon condition characterized by the accumulation of air within the spinal canal. This finding may occur due to various causes, mostly after trauma and medical procedures. It can manifest with various features depending on the underlying cause, the location, and the extent of the air trapped. Clinically, the symptoms in affected patients can span a spectrum, ranging from being asymptomatic to manifesting as radiculopathies resulting from compression. The pneumorrhachis-related cauda equina syndrome is incredibly rare and typically appears as a large volume of air causing compression or irritation of the nerve roots in the lower spinal cord. In this report, we present a female patient whose cauda equina syndrome developed as a result of accidental extradural pneumorrhachis after epidural injection in the lumbar spine.

Enhanced photocatalytic efficiency of porous ZnO coral-like nanoplates for organic dye degradation.

ZnO nanomaterials have been extensively used as photocatalysts for the removal of pollutants in aqueous environments. This study explores the enhanced photocatalytic performance of porous ZnO coral-like nanoplates synthesized via a one-pot wet-chemical method and subsequent annealing treatment. Characterization through scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HRTEM), powder X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), Raman spectroscopy, photoluminescence (PL) spectroscopy, and Brunauer-Emmett-Teller (BET) measurements confirmed the nanoplates' porous structure, single-crystal structure, 100 nm thickness, and 80 nm pore size. These unique structural characteristics of the ZnO coral-like nanoplates enabled effective photodegradation of the organic dye rhodamine B (RhB) under visible light irradiation. Under simulated sunlight, the ZnO photocatalyst exhibited exceptional performance, achieving a 97.3% removal rate of RhB after 210 minutes of irradiation. The prepared ZnO photocatalyst also showed remarkable photostability and regeneration capability for RhB photodegradation with a decreased efficiency of less than 15% after eight testing cycles. The potential mechanism of the ZnO photocatalyst toward RhB degradation was also studied and is discussed in detail.

Life table parameters of Amblyseius largoensis, Amblyseius swirskii and Proprioseiopsis lenis (Acari: Phytoseiidae) fed on eggs and larvae of Frankliniella occidentalis.

The immature development and reproduction of the predatory mites Amblyseius largoensis (Muma), Proprioseiopsis lenis (Corpuz and Rimando), and Amblyseius swirskii Athias-Henriot (Acari: Phytoseiidae) were investigated using both thrips eggs and first instars of the western flower thrips, Frankliniella occidentalis Pergande, as prey in a controlled laboratory environment at 25 °C and 60% relative humidity. When provided with thrips eggs as food, A. largoensis exhibited a notably shorter immature development period for both males (7.05 days) and females (6.51 days) as compared with A. swirskii (8.05 and 7.19 days, respectively) and P. lenis (8.10 days and 7.05 days, respectively). Amblyseius largoensis also displayed a higher oviposition rate (2.19 eggs/female/day) than A. swirskii and P. lenis (1.79 and 1.78 eggs/female/day, respectively). Moreover, it exhibited the highest fecundity (25.34 eggs/female), followed by P. lenis (24.23 eggs/female) and A. swirskii (22.86 eggs/female). These variations led to A. largoensis having the highest intrinsic rate of increase (rm) at 0.209, followed by A. swirskii at 0.188, and P. lenis at 0.165. However, when the predatory mites were provided with first instars of F. occidentalis, A. swirskii demonstrated a faster immature development period for both males (7.67 days) and females (7.59 days) as compared with P. lenis (9.00 days and 7.86 days, respectively) and A. largoensis (8.47 days and 8.61 days, respectively). While the oviposition rates of P. lenis (1.92 eggs/female/day) and A. swirskii (1.90 eggs/female/day) were similar when feeding on this prey, A. largoensis produced fewer eggs (1.83 eggs/female/day). Further, A. swirskii exhibited the highest fecundity (31.93 eggs/female), followed by A. largoensis (25.71 eggs/female) and P. lenis (23 eggs/female). Consequently, the intrinsic rate of increase (rm) on thrips first instars was highest in A. swirskii (0.190), followed by A. largoensis (0.186), and P. lenis (0.176). In summary, our findings indicate that in terms of life history parameters A. largoensis performs optimally when feeding on thrips eggs, whereas A. swirskii performs best when preying on the mobile first instars of the thrips. These insights into the dietary preferences and reproductive capabilities of the studied predatory mite species have important implications for their potential use as biological control agents against F. occidentalis in agricultural settings.

Retroperitoneal laparoscopic partial nephrectomy with selective renal artery clamping for renal cell carcinoma: initial outcomes.

Introduction: To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy (RLPN) with selective artery clamp (SAC) in patients with renal cell carcinoma (RCC). Methods: The authors recruited three men and two women who underwent RLPN for T1 RCC between December 2022 and May 2023 at a tertiary hospital. The median age of the patients was 32 years (range, 25-70 years). The tumour size ranged from 3 to 4.5 cm. The R.E.N.A.L scores were 4x, 5p, 8a, 5a, and 8ah. The median preoperative eGFR was 96.9 (74.3-105.2). Renal computed tomography angiography was performed before the surgery to evaluate the artery branches. The operation time, number of clamped arteries, warm ischaemic time (WIT), intraoperative blood loss, RCC type, postoperative hospital stay, changes in renal function, and complications were evaluated. The follow-up duration was 6 months. Results: The median operation time was 120 (75-150) minutes. One artery was clamped in four patients, while three were clamped in one patient. The median WIT was 22 (15-30) min, and the median blood loss was 150 (100-300) ml. No complications were recorded, and the resection margin was negative in all patients. The median decrease in eGFR was 6 (4-30%). Conclusions: RLPN with SAC for T1 RCC is safe and feasible in clinical practice.

Recent advances in innovative osmotic membranes for resource enrichment and energy production in wastewater treatment.

Wastewater is a valuable resource that we can no longer afford to overlook. By recovering the nutrients and metals it contains and generating renewable energy, we can not only meet the rising demands for natural resources but also create a more sustainable and resilient future. Forward osmosis (FO) membranes are one of the most intriguing resource recovery process technologies because of their high organic retention, economical energy usage, and straightforward operation. However, the widespread adoption of FO membranes on a full-scale basis is hindered by several issues with previous membrane products. These include limited selectivity to different types of ions, insufficient water flux, and high susceptibility to membrane fouling during extended periods of operation. Hence, it is essential to either invent new FO membranes or modify the existing ones. The objective of this work is to provide a comprehensive and organized review of up-to-date advancements in the development of innovative osmotic membrane (IOM) materials for resource recovery (RR) and energy production (EP). The paper covers several aspects, including the limitations of current osmotic membrane technologies, a review of new membranes specifically designed for effective RR/EP, their applications in various industrial fields, integrated IOM systems, recent improvements in IOM fabrication processes using artificial intelligence, and a discussion of the challenges and prospects of the potential research. In general, recently developed IOMs have proven to be highly efficient in recovering organics (>99 %), nutrients (>86 %), and precious metals (>90 %). These new membranes have also demonstrated an ability to effectively harvest osmotic energy (with power output ranging from 6 to 38 W/m2) by applied pressure in the range of 8 to 30 bar. These findings suggest that IOMs is promised for efficient resource recovery and renewable energy production.

Base- and sulfur-promoted oxidative lactonization of chalcone-acetate Michael adducts: access to pyran-2-ones.

A cost-effective, practical, straightforward and scalable synthesis of α-pyrones via base- and sulfur-promoted annulation of phenylacetates and chalcones is reported. Generated in situ from the starting components by using dbu as a base catalyst, the Michael adducts underwent a smooth oxidative cyclization into 3,4,6-triaryl-2-pyranones upon heating with DABCO and sulfur in DMSO. Extension to malonate in place of phenylacetates led to 4,6-diaryl-2-pyranone-2-carboxylates.

Biphasic water-oil systems for functional augmentation of probiotic Lactobacillus acidophilus nanoencapsulated in luteolin-Fe3+ shells.

Single-cell nanoencapsulation (SCNE) has great potential in the enhancement of therapeutic effects of probiotic microbes. However, the material scope has been limited to water-soluble compounds to avoid non-biocompatible organic solvents that are harmful to living cells. In this work, the SCNE of probiotic Lactobacillus acidophilus with water-insoluble luteolin and Fe3+ ions is achieved by the vortex-assisted, biphasic water-oil system. The process creates L. acidophilus nanoencapsulated in the luteolin-Fe3+ shells that empower the cells with extrinsic properties, such as resistance to lysozyme attack, anti-ROS ability, and α-amylase-inhibition activity, as well as sustaining viability under acidic conditions. The proposed protocol, embracing water-insoluble flavonoids as shell components in SCNE, will be an advanced add-on to the chemical toolbox for the manipulation of living cells at the single-cell level.

Cu2MoS4 Nanocatalyst-based Electrochemical Sensor for Ofloxacin Electro-Oxidation: Delineating the Combined Roles of Crystallinity and Morphology on the Analytical Performance.

In this study, we demonstrate the influence of crystallinity and morphology on the analytical performance of various Cu2MoS4 (CMS) nanocatalysts-based electrochemical sensors for the high-efficiency detection of Ofloxacin (OFX) antibiotic. The electrochemical kinetics parameters including peak current response (ΔIp), peak-to-peak separation (ΔEp), electrochemically active surface area (ECSA), electron-transfer resistance (Rct), were obtained through the electrochemical analyses, which indicate the single-crystalline nature of CMS nanomaterials (NMs) is beneficial for enhanced electron-transfer kinetics. The morphological features and the electrochemical results for OFX detection substantiate that by tuning the tube-like to plate-like structures of the CMS NMs, it might noticeably enhance multiple adsorption sites and more intrinsic active catalytic sites due to the diffusion of analytes into the interstitial spaces between CMS nanoplates. As results, highly single-crystalline and plate-shaped morphology structures of CMS NMs would significantly enhance the electrocatalytic OFX oxidation in terms of onset potential (Eonset), Tafel slope, catalytic rate constant (kcat), and adsorption capacity (Γ). The CMS NMs-based electrochemical sensing platform showed excellent analytical performance toward the OFX detection with two ultra-wide linear detection concentration ranges from 0.25 - 100 and 100 - 1000 µM, a low detection limit of 0.058 µM, and an excellent electrochemical sensitivity (0.743 µA µM-1 cm-2).

Enhanced acetone gas-sensing characteristics of Pd-NiO nanorods/SnO2 nanowires sensors.

Acetone is a well-known volatile organic compound that is widely used in different industrial and domestic areas, but it can cause dangerous effects on human health. Thus, the fabrication of highly sensitive and selective sensors for recognition of acetone is incredibly important. Here, we prepared the SnO2/Pd-NiO (SPN) nanowires-based gas sensor for the detection of acetone, in which, the amount of Pd nanoparticles were varied to enhance the performance of the devices. We demonstrated that the acetone gas sensing performance of the SPN device was significantly enhanced, showing increases of 3.72 and 6.53 folds compared to pristine SnO2 and NiO sensors, respectively. The Pd-NiO 0.01% wt Pd SPN sensor (SPN-1) exhibited an excellent response (Ra/Rg = 14.88) toward 500 ppm acetone gas. The SPN-1 sensor also showed a fast gas response time of 11/150 seconds with 500 ppm Acetone at 450 °C, while the recovery time was 468/526 seconds. Additionally, the sensor showed good selectivity toward acetone over other reducing gases, such as NH3, CH4, and VOCs. With those results, the SPN-1 sensor shows superiority compared to sensors based on pure materials.

Appendiceal Diverticulitis Mimics Cecal Diverticulitis Diagnosed Preoperatively.

Appendiceal diverticulitis is an uncommon condition that clinically resembles acute appendicitis. However, it is an incidental finding in histopathological studies and is rarely diagnosed preoperatively by imaging studies. In this article, we present the clinical and imaging findings of a male patient presenting with right upper quadrant pain with a preoperative imaging diagnosis of appendiceal diverticulitis. He underwent laparoscopic appendectomy and confirmed the diagnosis of appendiceal diverticulitis. This is a rare preoperative diagnosis. The management is often like typical appendicitis which is appendectomy. It is important to differentiate it from diverticulitis of the small intestine or colon because these diseases usually require only conservative treatment.

Prevalence of adolescent mental disorders in Kenya, Indonesia, and Viet Nam measured by the National Adolescent Mental Health Surveys (NAMHS): a multi-national cross-sectional study.

BACKGROUND: Mental disorders are the leading global cause of health burden among adolescents. However, prevalence data for mental disorders among adolescents in low-income and middle-income countries are scarce with often limited generalisability. This study aimed to generate nationally representative prevalence estimates for mental disorders in adolescents in Kenya, Indonesia, and Viet Nam. METHODS: As part of the National Adolescent Mental Health Surveys (NAMHS), a multinational cross-sectional study, nationally representative household surveys were conducted in Kenya, Indonesia, and Viet Nam between March and December, 2021. Adolescents aged 10-17 years and their primary caregiver were interviewed from households selected randomly according to sampling frames specifically designed to elicit nationally representative results. Six mental disorders (social phobia, generalised anxiety disorder, major depressive disorder, post-traumatic stress disorder, conduct disorder, and attention-deficit hyperactivity disorder) were assessed with the Diagnostic Interview Schedule for Children, Version 5. Suicidal behaviours and self-harm in the past 12 months were also assessed. Prevalence in the past 12 months and past 4 weeks was calculated for each mental disorder and collectively for any mental disorder (ie, of the six mental disorders assessed). Prevalence of suicidal behaviours (ie, ideation, planning, and attempt) and self-harm in the past 12 months was calculated, along with adjusted odds ratios (aORs) to show the association with prevalence of any mental disorder in the past 12 months. Inverse probability weighting was applied to generate national estimates with corresponding 95% CIs. FINDINGS: Final samples consisted of 5155 households (ie, adolescent and primary caregiver pairs) from Kenya, 5664 households from Indonesia, and 5996 households from Viet Nam. In Kenya, 2416 (46·9%) adolescents were male and 2739 (53·1%) were female; in Indonesia, 2803 (49·5%) adolescents were male and 2861 (50·5%) were female; and in Viet Nam, 3151 (52·5%) were male and 2845 (47·4%) were female. Prevalence of any mental disorder in the past 12 months was 12·1% (95% CI 10·9-13·5) in Kenya, 5·5% (4·3-6·9) in Indonesia, and 3·3% (2·7-4·1) in Viet Nam. Prevalence in the past 4 weeks was 9·4% (8·3-10·6) in Kenya, 4·4% (3·4-5·6) in Indonesia, and 2·7% (2·2-3·3) in Viet Nam. The prevalence of suicidal behaviours in the past 12 months was low in all three countries, with suicide ideation ranging from 1·4% in Indonesia (1·0-2·0) and Viet Nam (1·0-1·9) to 4·6% (3·9-5·3) in Kenya, suicide planning ranging from 0·4% in Indonesia (0·3-0·8) and Viet Nam (0·2-0·6) to 2·4% (1·9-2·9) in Kenya, and suicide attempts ranging from 0·2% in Indonesia (0·1-0·4) and Viet Nam (0·1-0·3) to 1·0% (0·7-1·4) in Kenya. The prevalence of self-harm in the past 12 months was also low in all three countries, ranging from 0·9% (0·6-1·3) in Indonesia to 1·2% (0·9-1·7) in Kenya. However, the prevalence of suicidal behaviours and self-harm in the past 12 months was significantly higher among those with any mental disorder in the past 12 months than those without (eg, aORs for suicidal ideation ranged from 7·1 [3·1-15·9] in Indonesia to 14·7 [7·5-28·6] in Viet Nam). INTERPRETATION: NAMHS provides the first national adolescent mental disorders prevalence estimates for Kenya, Indonesia, and Viet Nam. These data can inform mental health and broader health policies in low-income and middle-income countries. FUNDING: The University of Queensland in America (TUQIA) through support from Pivotal Ventures, a Melinda French Gates company.

Structure and dynamics of a pentameric KCTD5/CUL3/Gßγ E3 ubiquitin ligase complex.

Heterotrimeric G proteins can be regulated by posttranslational modifications, including ubiquitylation. KCTD5, a pentameric substrate receptor protein consisting of an N-terminal BTB domain and a C-terminal domain, engages CUL3 to form the central scaffold of a cullin-RING E3 ligase complex (CRL3KCTD5) that ubiquitylates Gßγ and reduces Gßγ protein levels in cells. The cryo-EM structure of a 5:5:5 KCTD5/CUL3NTD/Gß1γ2 assembly reveals a highly dynamic complex with rotations of over 60° between the KCTD5BTB/CUL3NTD and KCTD5CTD/Gßγ moieties of the structure. CRL3KCTD5 engages the E3 ligase ARIH1 to ubiquitylate Gßγ in an E3-E3 superassembly, and extension of the structure to include full-length CUL3 with RBX1 and an ARIH1~ubiquitin conjugate reveals that some conformational states position the ARIH1~ubiquitin thioester bond to within 10 Å of lysine-23 of Gß and likely represent priming complexes. Most previously described CRL/substrate structures have consisted of monovalent complexes and have involved flexible peptide substrates. The structure of the KCTD5/CUL3NTD/Gßγ complex shows that the oligomerization of a substrate receptor can generate a polyvalent E3 ligase complex and that the internal dynamics of the substrate receptor can position a structured target for ubiquitylation in a CRL3 complex.

Discovery of new triterpene glycosides from Dendrobium officinale with their α-glucosidase and α-amylase inhibitory activity.

In this study, seven new pentacyclic triterpene glycosides, named dendrocinaosides A-G (1-7), and six known ones (8-13) were isolated from the whole plants of Dendrobium officinale. Their structures were determined by analyses of HR-ESI-MS, 1D and 2D NMR spectra. Compounds 1-4, 8, and 9 potentially inhibited α-glucosidase and α-amylase activities with the IC50 values ranging from 31.3 ± 2.2 to 42.4 ± 2.5 µM for anti α-glucosidase and from 36.5 ± 1.8 to 56.4 ± 2.0 µM for anti α-amylase activities, respectively, which were lower than that of the positive control, acarbose, showing IC50 values of 47.1 ± 1.4 µM for anti α-glucosidase and 145.7 ± 2.2 µM for anti α-amylase.

Enhanced photoreduction efficiency of Cr(VI) driven by visible light in a new Zr-based metal-organic framework modified by hydroxyl groups.

While metal-organic framework (MOF) photocatalysts have demonstrated a unique Cr(VI) photoreduction capability in recent decades, their performance is still insufficient for practical applications because of their low Cr(VI) uptake and poor visible light response. To cope with these drawbacks, a new OH-modified Zr-based MOF, termed HCMUE-1, was successfully prepared via a solvothermal method in this work. The complete characterization of HCMUE-1 was performed through various techniques, including powder X-ray diffraction (PXRD), Raman spectroscopy, Fourier transform infrared (FT-IR), thermogravimetric analysis and differential scanning calorimetry (TGA-DSC), scanning electron microscopy combined with energy-dispersive X-ray (SEM-EDX), and X-ray photoelectron spectroscopy (XPS). The obtained data exhibited the excellent Cr(VI) photoreduction efficiency of HCMUE-1, reaching up to 98% after 90 min and almost 100% after 120 min under visible light illumination in a low acidic medium. Noteworthily, HCMUE-1 retained the same Cr(VI) removal rate for at least seven cycles without considerable loss. Further experimental investigations demonstrated that the structural stability and surface morphology of HCMUE-1 were retained after photoreduction. Moreover, the photocatalytic reduction mechanism of Cr(VI) to Cr(III) was interpreted through a series of systematic experimental measurements. These results indicate that HCMUE-1 possesses potential as an efficient photocatalyst for reducing toxic Cr(VI) species from wastewater in real-life conditions.

Inter-subject correlation of electroencephalographic and behavioural responses reflects time-varying engagement with natural music.

Musical engagement can be conceptualized through various activities, modes of listening and listener states. Recent research has reported that a state of focused engagement can be indexed by the inter-subject correlation (ISC) of audience responses to a shared naturalistic stimulus. While statistically significant ISC has been reported during music listening, we lack insight into the temporal dynamics of engagement over the course of musical works-such as those composed in the Western classical style-which involve the formulation of expectations that are realized or derailed at subsequent points of arrival. Here, we use the ISC of electroencephalographic (EEG) and continuous behavioural (CB) responses to investigate the time-varying dynamics of engagement with functional tonal music. From a sample of adult musicians who listened to a complete cello concerto movement, we found that ISC varied throughout the excerpt for both measures. In particular, significant EEG ISC was observed during periods of musical tension that built to climactic highpoints, while significant CB ISC corresponded more to declarative entrances and points of arrival. Moreover, we found that a control stimulus retaining envelope characteristics of the intact music, but little other temporal structure, also elicited significantly correlated EEG and CB responses, though to lesser extents than the original version. In sum, these findings shed light on the temporal dynamics of engagement during music listening and clarify specific aspects of musical engagement that may be indexed by each measure.

Neonatal intestinal mucus barrier changes in response to maturity, inflammation, and sodium decanoate supplementation.

The integrity of the intestinal mucus barrier is crucial for human health, as it serves as the body's first line of defense against pathogens. However, postnatal development of the mucus barrier and interactions between maturity and its ability to adapt to external challenges in neonatal infants remain unclear. In this study, we unveil a distinct developmental trajectory of the mucus barrier in preterm piglets, leading to enhanced mucus microstructure and reduced mucus diffusivity compared to term piglets. Notably, we found that necrotizing enterocolitis (NEC) is associated with increased mucus diffusivity of our large pathogen model compound, establishing a direct link between the NEC condition and the mucus barrier. Furthermore, we observed that addition of sodium decanoate had varying effects on mucus diffusivity depending on maturity and health state of the piglets. These findings demonstrate that regulatory mechanisms governing the neonatal mucosal barrier are highly complex and are influenced by age, maturity, and health conditions. Therefore, our results highlight the need for specific therapeutic strategies tailored to each neonatal period to ensure optimal gut health.

Cryptobuchanosides A-G: seven previously undescribed triterpene glycosides from Cryptolepis buchananii R.Br. ex Roem. and Schult. with nitric oxide production inhibition activity.

In this study, nine triterpene glycosides including seven previously undescribed compounds (1-7), were isolated from leaves of Cryptolepis buchananii R.Br. ex Roem. and Schult. using various chromatographic methods. The chemical structures of the compounds were elucidated to be 3-O-ß-D-glucopyranosyl-(1 → 6)-ß-D-glucopyranosyluncargenin C 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (1), 3-O-ß-D-glucopyranosyl-(1 → 2)-ß-D-glucopyranosyluncargenin C 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (2), 3-O-ß-D-glucopyranosyl-(1 → 2)-ß-D-glucopyranosyluncargenin C 28-O-ß-D-glucopyranosyl-(1 → 4)-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (3), 3-O-ß-D-glucopyranosyl-(1 → 2)-ß-D-glucopyranosylhederagenin 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (4), 3-O-ß-D-glucopyranosylarjunolic acid 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (5), 3-O-ß-D-glucopyranosyl-(1 → 2)-ß- D-glucopyranosyl-6ß,23-dihydroxyursolic acid 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (6), 3-O-ß-D-glucopyranosyl-6ß,23-dihydroxyursolic acid 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (7), asiatic acid 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (8), and 3-O-ß-D-glucopyranosylasiatic acid 28-O-α-L-rhamnopyranosyl-(1 → 2)-ß-D-glucopyranosyl ester (9), through infrared, high-resolution electrospray ionization mass spectrometry, one- and two-dimensional nuclear magnetic resonance spectral analyses. The isolates inhibited nitric oxide production in lipopolysaccharide-activated RAW 264.7 cells, with half-maximal inhibitory concentration (IC50) values of 18.8-58.5 µM, compared to the positive control compound, dexamethasone, which exhibited an IC50 of 14.1 µM.

Acute Kidney Injury After Percutaneous Coronary Intervention Guided by Intravascular Ultrasound.

Purpose We investigated the impact of intravascular ultrasound guidance on reducing the incidence of contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention (PCI). Methods Ninety-nine patients were enrolled in this prospective cohort who were not randomly assigned to angiography-guided percutaneous coronary intervention or intravascular ultrasound-guided percutaneous coronary intervention. The patients were hospitalized at the Vietnam National Heart Institute - Bach Mai Hospital between 2019 and 2020. Acute kidney injury incidence during hospitalization was the primary endpoint. Results A total of 99 patients were divided into two groups: the intravascular ultrasound-guided group (33 participants) and the angiography-guided group (66 participants). The mean ± SD contrast volume of each group was 95.2 ± 37.1 mL and 133.0 ± 36.0 mL for the ultrasound-guided and angiography-guided groups, with P < 0.0001. Intravascular imaging-guided percutaneous coronary intervention (IVUS-guided PCI) was associated with reduced acute kidney injury incidence during hospitalization: 0.0% vs. 12.12% and P = 0.049. Conclusions Intravascular ultrasound is a safe imaging tool that guides percutaneous coronary intervention and significantly reduces the rate of acute kidney injury compared to angiography alone. Patients who have a high chance of experiencing acute kidney injury benefit from using intravascular ultrasound.

Predicting Blood Pressures for Pregnant Women by PPG and Personalized Deep Learning.

Blood pressure (BP) is predicted by this effort based on photoplethysmography (PPG) data to provide effective pre-warning of possible preeclampsia of pregnant women. Towards frequent BP measurement, a PPG sensor device is utilized in this study as a solution to offer continuous, cuffless blood pressure monitoring frequently for pregnant women. PPG data were collected using a flexible sensor patch from the wrist arteries of 194 subjects, which included 154 normal individuals and 40 pregnant women. Deep-learning models in 3 stages were built and trained to predict BP. The first stage involves developing a baseline deep-learning BP model using a dataset from common subjects. In the 2nd stage, this model was fine-tuned with data from pregnant women, using a 1-Dimensional Convolutional Neural Network (1D-CNN) with Convolutional Block Attention Module (CBAMs), followed by bi-directional Gated Recurrent Units (GRUs) layers and attention layers. The fine-tuned model results in a mean error (ME) of -1.40 ± 7.15 (standard deviation, SD) for systolic blood pressure (SBP) and -0.44 (ME) ± 5.06 (SD) for diastolic blood pressure (DBP). At the final stage is the personalization for individual pregnant women using transfer learning again, enhancing further the model accuracy to -0.17 (ME) ± 1.45 (SD) for SBP and 0.27 (ME) ± 0.64 (SD) for DBP showing a promising solution for continuous, non-invasive BP monitoring in precision by the proposed 3-stage of modeling, fine-tuning and personalization.

Job satisfaction of health workers at a Vietnamese University Hospital and its predicted factors: A cross-sectional study.

Background and Aims: Job satisfaction of healthcare workers from conventional and university hospitals (or teaching hospitals) might be different due to several factors, for example medical staff required to carry out multiple clinical and teaching tasks simultaneously. Our study aimed to determine how the job satisfaction among healthcare workers in university hospitals is different from those in conventional hospitals. Methods: A cross-sectional study was conducted by using the validated and contextualized job satisfaction tool for the Vietnamese context to survey 216 healthcare workers at a university hospital in Vietnam from January to March 2020 with online Google forms. Results: The results indicated low overall job satisfaction (43.1%) in our study university hospital with the score cutoff of 80%. However, healthcare workers still reported high job satisfaction rates in certain aspects, such as personal empathy (70.8%), discipline, and reward (67.6%), co-worker collaboration (65.3%), training and promotion (63%), workplace environment (57.4%), and salary and allowance (44.9%). Subgroup analysis revealed statistically significant differences in job satisfaction (p < 0.01) related to age (31 to 40-year-old), and job position with ORs 3.9, and 8.6 respectively. Conclusion: University hospitals need to improve the healthcare workers' job satisfaction. It is recommended that special human resource strategies should be developed focusing on keeping satisfying older healthcare staff by recognizing their contributions and providing appropriate benefits based on their positions in the hospital.