Guillain-Barré Syndrome due to COVID-19 Vero Cell Vaccination Associated with Concomitant COVID-19 Infection-induced ARDS and Treated Successfully by Therapeutic Plasma Exchange: A First Case Report from Vietnam.

Post-vaccination adverse reactions have been reported with varying symptoms and severity owing to research and production time pressures during the coronavirus disease 2019 (COVID-19) pandemic. In this article, we report a rare case of Guillain-Barré syndrome (GBS) in a patient with COVID-19 with acute respiratory distress syndrome (ARDS) after receiving Sinopharm's Vero Cell vaccine (China). The patient who was initially negative for COVID-19 was diagnosed with GBS based on paralysis that developed from the lower extremities to the upper extremities, as confirmed by cytoalbuminologic dissociation in the cerebrospinal fluid. The patient's condition worsened with ARDS caused by COVID-19 infection during the hospital stay, and SpO2 decreased to 83% while receiving oxygen through a non-rebreather mask (15 l/min) on day 6. The patient was treated with standard therapy for severe COVID-19, invasive mechanical ventilation, and five cycles of therapeutic plasma exchange (TPE) with 5% albumin replacement on day 11 due to severe progression. The patient was weaned off the ventilator on day 28, discharged on day 42, and was completely healthy after 6 months without any neurological sequelae until now. Our report showed the potential of TPE for GBS treatment in critically ill patients with COVID-19 after COVID-19 vaccination.

A Study on the Fabrication of an Effective Natural Substance Based on Schisandra chinensis Extracted Fermentation.

PURPOSE: In this study, a high-efficiency Schisandra chinensis extract (SCE) produced by the fermentation of effective microorganisms (EM) was used as an antioxidant material in preparing cosmetic products. SUBJECTS AND METHODS: We conducted the study by extracting S. chinensis via EM fermentation to increase the efficiency. Tyrosinase inhibitory factor analysis, pH, and thermal stability were measured to verify the properties of the prepared products. RESULTS: The efficacy and whitening effects of the prepared substances were verified using tyrosinase inhibitory factor analysis. As a result, it was found that both the SCE and SCE fermentation (SCEF) exhibited high, naturally originating, antioxidation ability. In addition, the pH and thermal stability of the substances were evaluated to optimize the cosmetic fabrication conditions. In this context, as the concentration of the added extract increased, the pH value decreased. The evaluation of safety and stability indicated that the substances contained effective chemical components having antioxidant activity, suppressing skin aging, and whitening effects in a weak acid range consistent with a pH of 6.25-2.98. Furthermore, there were no safety problems with the use of the obtained products even after they had been stored for 60 days. CONCLUSION: The SCE substance is demonstrated as a possible material for cosmetic application.

Efficacy and adherence of auto-CPAP therapy in patients with obstructive sleep apnea: a prospective study.

INTRODUCTION: The use of auto-continuous positive airway pressure (auto-CPAP) therapy has been recommended for subjects with moderate-to-severe obstructive sleep apnea (OSA) without significant comorbidities. This study is aimed at evaluating the efficacy and adherence of auto-CPAP therapy in subjects with OSA. METHODS: It was a perspective and descriptive study. All study subjects who had apnea-hypopnea index (AHI) > 30/h, measured by polysomnography, were included. They were treated with auto-CPAP and followed-up for 6 months for evaluating the effect of CPAP-therapy on clinical and biological features and treatment adherence. RESULTS: One hundred and thirty-nine subjects with severe OSA were accepted for auto-CPAP therapy at inclusion. BMI was 28.4±3.8 kg/m2; neck and abdomen circumferences were 38.2±6.4 and 85.7±11.6. Epworth and Pichot scores were 18.4±6.3 and 28.3±4.5, respectively; AHI was 39±7/h and arousal index was 39±13/h. At 6th month, 96.4% of study subjects continued to use auto-CPAP-therapy within 6.5±2.4 h/night. There was a significant correlation between the modification (Δ) of Epworth scores and (Δ) AHI after 3 and 6 months of auto-CPAP-therapy (R=0.568 and p=0.003; R=0.745 and p=0.002; respectively). At 6th month follow up, the main side effects of auto-CPAP were difficult sleeping, dry mouth or nose, skin marks or rashes, discomfort when breathing, and nasal congestion (36.1%, 32.0%, 20.8%, 16.0%, and 11.9%, respectively). CONCLUSION: Auto-CPAP is effective in treatment of Vietnamese patients with severe OSA in short term follow up.

The beneficial role of FeNO in association with GINA guidelines for titration of inhaled corticosteroids in adult asthma: A randomized study.

PURPOSE: This study aimed to demonstrate the role of fractional concentration of exhaled nitric oxide (FeNO) in association with Global Initiative for Asthma (GINA) guidelines for treatment of adult patients with asthma. METHODS: It was a prospective and randomized study. The symptomatic asthmatic patients were randomly divided into two groups: GINA group (followed GINA guidelines; N = 86) or GINA + FeNO group (followed GINA guidelines + FeNO for titration of inhaled corticosteroids - ICS; N = 90). They were followed-up for 9 months. RESULTS: In GINA group, 37.2% patients had no treatment and 62.8% patients discontinued treatment vs. 40.0% and 60.0% in GINA + FeNO, respectively. After 3, 6 and 9 months of treatment, the percentage of mild, moderate and severe asthma showed no significant difference between the two groups. At 9th month, Δ moderate asthma (reduction) in GINA + FeNO group was significantly higher than in the GINA group (-22.0% vs. -11.6%; P = 0.018). The improvement of asthma control test (ACT) score was not different between the groups at 9th month (12 ± 6 vs. 10 ± 5; P > 0.05); the level of FeNO reduction in GINA + FeNO group was significantly higher than that in GINA group (-42 ± 11 vs. -35 ± 9; P = 0.022). The daily dose of ICS in GINA + FeNO group was significantly lower than that in GINA group (397 ± 171 vs. 482 ± 240 mcg and 375 ± 203 vs. 424 ± 221 mcg; respectively) at the end of 6 and 9 months. CONCLUSION: The use of FeNO in association with GINA guidelines has a beneficial role for accurate daily dose of ICS in adult patients with asthma.

Zwitterion Nondetergent Sulfobetaine-Modified SnO2 as an Efficient Electron Transport Layer for Inverted Organic Solar Cells.

Tin oxide (SnO2) has been widely accepted as an effective electron transport layer (ETL) for optoelectronic devices because of its outstanding electro-optical properties such as its suitable band energy levels, high electron mobility, and high transparency. Here, we report a simple but effective interfacial engineering strategy to achieve highly efficient and stable inverted organic solar cells (iOSCs) via a low-temperature solution process and an SnO2 ETL modified by zwitterion nondetergent sulfobetaine 3-(4-tert-butyl-1-pyridinio)-1-propanesulfonate (NDSB-256-4T). We found that NDSB-256-4T helps reduce the work function of SnO2, resulting in more efficient electron extraction and transport to the cathode of iOSCs. NDSB-256-4T also passivates the defects in SnO2, which serves as recombination centers that greatly reduce the device performance of iOSCs. In addition, NDSB-256-4T provides the better interfacial contact between SnO2 and the active layer. Thus, a higher power conversion efficiency (PCE) and longer device stability of iOSCs are expected for a combination of SnO2 and NDSB-256-4T than for devices based on SnO2 only. With these enhanced interfacial properties, P3HT:PC60BM-based iOSCs using SnO2/NDSB-256-4T (0.2 mg/mL) as an ETL showed both a higher average PCE of 3.72%, which is 33% higher than devices using SnO2 only (2.79%) and excellent device stability (over 90% of the initial PCE remained after storing 5 weeks in ambient air without encapsulation). In an extended application of the PTB7-Th:PC70BM systems, we achieved an impressive average PCE of 8.22% with SnO2/NDSB-256-4T (0.2 mg/mL) as the ETL, while devices based on SnO2 exhibited an average PCE of only 4.45%. Thus, the use of zwitterion to modify SnO2 ETL is a promising way to obtain both highly efficient and stable iOSCs.

Modified SnO2 with Alkali Carbonates as Robust Electron-Transport Layers for Inverted Organic Solar Cells.

We report for the first time that alkali carbonates (Li2CO3, K2CO3, and Rb2CO3) based on a low-temperature solution process can be used as interfacial modifiers for SnO2 as robust electron-transport layers (ETL) for inverted organic solar cells (iOSCs). The room-temperature photoluminescence, the electron-only devices, and the impedance studies altogether suggested the interfacial properties of the alkali carbonates-modified SnO2 ETLs, which were much better than those based on the SnO2 only, provided efficient charge transport, and reduced the charge recombination rates for iOSCs. The iOSCs using the polymer donor poly[4,8-bis(5-(2-ethylhexyl)thiophen-2-yl)benzo[1,2-b;4,5-b']dithiophene-2,6-diyl-alt-(4-(2-ethylhexyl)-3-fluorothieno[3,4-b]thiophene-)-2-carboxylate-2-6-diyl] and the fullerene acceptor phenyl-C70-butyric acid methyl ester as the active layer showed the average power-conversion efficiencies (PCEs) based on ten devices of 6.70, 6.85, and 7.35% with Li2CO3-, K2CO3-, and Rb2CO3-modified SnO2 as ETLs, respectively; these are more than 22, 24, and 33% higher than those based on the SnO2 only (5.49%). Moreover, these iOSC devices exhibited long-term stabilities, with over 90% PCEs remaining after the devices were stored in ambient air for 6 weeks without encapsulations. We believe that alkali carbonates-modified SnO2 approaches are an effective way to achieve stable and highly efficient iOSCs and might also be suitable for other optoelectronic devices where an ETL is needed, such as perovskite solar cells or organic light-emitting diodes.

Clinical and Functional Characteristics of Subjects with Asthma, COPD, and Asthma-COPD Overlap: A Multicentre Study in Vietnam.

Introduction: Subjects with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) share common features of patients with asthma and COPD. Our study was planned to describe the clinical and functional features of subjects with ACO compared to asthma and COPD patients. Subjects and Methods: Study subjects who met the inclusion criteria were classified into three different groups: asthma, COPD, and ACO groups. All study subjects underwent clinical examination and biological and functional testing. They were then followed for 6 months to evaluate the response to conventional treatment. Results: From March 2015 to March 2017, 76 asthmatic (mean age: 41 ± 22 years), 74 COPD (59 ± 13 years), and 59 ACO (52 ± 14 years) subjects were included. The percentage of subjects with dyspnea on excretion in the ACO group was higher than that in asthma and COPD groups (P < 0.001 and P < 0.05, resp.). Subjects with COPD and ACO had significant airflow limitation (FEV1) compared to asthma (64 ± 17% and 54 ± 14% versus 80 ± 22%; P < 0.01 and P < 0.01, resp.). The levels of FENO in subjects with asthma and ACO were significantly higher than those in subjects with COPD (46 ± 28 ppb and 34 ± 12 ppb versus 15 ± 8 ppb; P < 0.001 and P < 0.001, resp.). VO2 max and 6MWD were improved in study subjects after 6 months of treatment. Increased CANO and AHI > 15/hour had a significant probability of risk for ACO (OR = 33.2, P < 0.001, and OR = 3.4, P < 0.05, resp.). Conclusion: Subjects with ACO share the common clinical and functional characteristics of asthma and COPD but are more likely to have sleep apnea. The majority of patients with ACO have a favourable response to combined treatment.

Low-Temperature Solution-Processed SnO2 Nanoparticles as a Cathode Buffer Layer for Inverted Organic Solar Cells.

SnO2 recently has attracted particular attention as a powerful buffer layer for organic optoelectronic devices due to its outstanding properties such as high electron mobility, suitable band alignment, and high optical transparency. Here, we report on facile low-temperature solution-processed SnO2 nanoparticles (NPs) in applications for a cathode buffer layer (CBL) of inverted organic solar cells (iOSCs). The conduction band energy of SnO2 NPs estimated by ultraviolet photoelectron spectroscopy was 4.01 eV, a salient feature that is necessary for an appropriate CBL. Using SnO2 NPs as CBL derived from a 0.1 M precursor concentration, P3HT:PC60BM-based iOSCs showed the best power conversion efficiency (PCE) of 2.9%. The iOSC devices using SnO2 NPs as CBL revealed excellent long-term device stabilities, and the PCE was retained at ∼95% of its initial value after 10 weeks in ambient air. These solution-processed SnO2 NPs are considered to be suitable for the low-cost, high throughput roll-to-roll process on a flexible substrate for optoelectronic devices.