Improving the prediction of wildfire susceptibility on Hawai'i Island, Hawai'i, using explainable hybrid machine learning models.

This study presents a comparative analysis of four Machine Learning (ML) models used to map wildfire susceptibility on Hawai'i Island, Hawai'i. Extreme Gradient Boosting (XGBoost) combined with three meta-heuristic algorithms - Whale Optimization (WOA), Black Widow Optimization (BWO), and Butterfly Optimization (BOA) - were employed to map areas susceptible to wildfire. To generate a wildfire inventory, 1408 wildfire points were identified within the study area from 2004 to 2022. The four ML models (XGBoost, WOA-XGBoost, BWO-XGBoost, and BOA-XGBoost) were run using 14 wildfire-conditioning factors categorized into four main groups: topographical, meteorological, vegetation, and anthropogenic. Six performance metrics - sensitivity, specificity, positive predictive values, negative predictive values, the Area Under the receiver operating characteristic Curve (AUC), and the average precision (AP) of Precision-Recall Curves (PRCs) - were used to compare the predictive performance of the ML models. The SHapley Additive exPlanations (SHAP) framework was also used to interpret the importance values of the 14 influential variables for the modeling of wildfire on Hawai'i Island using the four models. The results of the wildfire modeling indicated that all four models performed well, with the BWO-XGBoost model exhibiting a slightly higher prediction performance (AUC = 0.9269), followed by WOA-XGBoost (AUC = 0.9253), BOA-XGBoost (AUC = 0.9232), and XGBoost (AUC = 0.9164). SHAP analysis revealed that the distance from a road, annual temperature, and elevation were the most influential factors. The wildfire susceptibility maps generated in this study can be used by local authorities for wildfire management and fire suppression activity.

Novel single nucleotide polymorphisms of insulin-like growth factor-binding protein 7 (IGFBP7) gene significantly associated with growth traits in striped catfish (Pangasianodon hypophthalmus Sauvage, 1878).

Breeding program to improve economically important growth traits in striped catfish (Pangasianodon hypophthalmus) requires effective molecular markers. This study was conducted to identify single nucleotide polymorphisms (SNPs) of Insulin-like Growth Factor-Binding Protein 7 (IGFBP7) gene which plays multiple roles in regulating growth, energy metabolism and development. The association between SNPs in IGFBP7 gene and growth traits in striped catfish was analyzed in order to uncover the SNPs that have potential to be valuable markers for improving growth traits. Firstly, fragments of IGFBP7 gene from ten fast-growing fish and ten slow-growing fish were sequenced in order to discover SNPs. After filtering the detected SNPs, an intronic SNP (2060A > G) and two non-synonymous SNPs (344 T > C and 4559C > A) causing Leu78Pro and Leu189Met in protein, respectively, were subjected to further validated by individual genotyping in 70 fast-growing fish and 70 slow-growing fish using single base extension method. Our results showed that two SNPs (2060A > G and 4559 C > A (p. Leu189Met)) were significantly associated with the growth in P. hypophthalmus (p < 0.001), thus being candidate SNP markers for the growth traits of this fish. Moreover, linkage disequilibrium and association analysis with growth traits of haplotypes generated from the 3 filtered SNPs (344 T > C, 2060 A > G and 4559 C > A) were examined. These revealed that the non-coding SNP locus (2060A > G) had higher genetic diversity at which the G allele was predominant over the A allele in the fast-growing fish. Furthermore, the results of qPCR showed that expression of IGFBP7 gene with genotype GG (at locus 2060) in fast-growing group was significantly higher than that with genotype AA in slow-growing group (p < 0.05). Our study provides insights into the genetic variants of IGFBP7 gene and useful data source for development molecular marker for growth traits in breeding of the striped catfish.

Effects of core buildup composite resin translucency on intraoral scanner accuracy: an in vitro study.

AIM: The accuracy of 3D images produced by an intraoral scanner (IOS) is affected by the optical characteristics of restorative materials such as metal, ceramic, and composite resin. The present in vitro study aimed to investigate the impact of core buildup composite resin translucency on IOS accuracy. MATERIALS AND METHODS: A core buildup procedure was performed on a proprietary 3D-printed model using injectable composite resins in four groups with different levels of translucency (highest to lowest: AE, A3, AO3, and EX). Ten experimental scans per group were performed using a Medit i700 IOS on a phantom head-mounted model. Reference scans were obtained using an industrial scanner (Solutionix C500). Values of accuracy (trueness and precision) for the respective groups were evaluated using mean deviation values following 3D superimposition. RESULTS: Composite resin translucency caused the scale reduction of the optical impressions. Values of trueness showed the highest scale reduction in AE, significantly, followed by A3, AO3, and EX. Considering 50 µm as the cut-off value of deviations for clinical acceptability, the analysis showed most deviations in AE and A3. Similar results were found with precision, where AE showed the highest deviation value statistically, followed by A3, AO3, and EX. CONCLUSIONS: Composite resin translucency affects the accuracy of optical impressions, causing a fitting error of CAD/CAM prostheses. The more translucent the composite resin, the less accurate the optical impression. This suggests the need for proper compensation during prosthesis designing for an optimal clinical result. In addition, practitioners should indicate in the digital workflow the proper restorative materials regarding not only the mechanical properties and esthetics, but also the optical characteristics.

Aerobic vaginitis in the third trimester and its impact on pregnancy outcomes.

BACKGROUND: Aerobic vaginitis (AV) is a vaginal inflammation characterized by disruption of the lactobacillus microbiota and increased counts of different aerobic bacteria. AV may result in severe complications, especially during pregnancy, including preterm delivery, neonatal and maternal infections. This study aimed to determine the prevalence of AV in the third trimester of pregnancy, and the relationship between AV and pregnancy outcomes.  METHODS: A cross-sectional descriptive study included 323 pregnant women attending for routine antenatal care in the Hue University Hospital. Vaginal samples collected at the third trimester of pregnancy were evaluated for AV according to the scoring system of Donders and cultured for identification of predominant bacteria. Pregnancy was followed to its end, and pregnancy outcomes were recorded for both mothers and infants. RESULTS: The proportion of pregnant women diagnosed with AV in the third trimester was found to be 15.5%, with the vast majority of the cases (84%) displaying the light AV and 16% the moderate AV. The vaginal cultures in the women with AV revealed most frequently Streptococcus agalactiae (6%), followed by Enterococcus spp (4%), Staphylococcus aureus (4%), and Acinetobacter baumannii (2%). In addition, AV during the last trimester of pregnancy was associated with an increased risk of puerperal sepsis (OR 8.65, 95% CI: 1.41-53.16, p = 0.020) and there was a slightly increased risk for neonatal infections, which was statistically insignificant. CONCLUSIONS: The proportion of AV is relatively high in Vietnamese pregnant women. Since it is associated with an increased risk of puerperal sepsis, it needs to be diagnosed and treated before delivery.

Relationship between autoantibodies to erythropoietin receptor and renal outcome in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis.

Purpose: We examined the relationship between autoantibodies to erythropoietin receptor (EPOR) and renal outcome in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).Materials and methods: Sixty-three Japanese patients with AAV were enrolled and followed for a median of 31.4 months. Patients were screened for serum anti-EPOR antibodies using an enzyme-linked immunosorbent assay. Associations of anti-EPOR antibodies with clinical parameters were analyzed using logistic-regression models.Results: Anti-EPOR antibodies were detected in 7 (11%) of the 63 patients, and levels of the antibodies decreased with immunosuppressive therapy. The presence of anti-EPOR antibodies was associated with a higher Birmingham vasculitis activity score. In addition, anti-EPOR antibodies were more frequently observed in patients with renal outcomes, which was defined as a sustained 50% reduction in the estimated glomerular filtration rate from baseline, than in those without. Multiple logistic regression analysis revealed that presence of anti-EPOR antibodies, as well as age at disease onset, were as risk factors for the renal outcome.Conclusion: Anti-EPOR antibodies were associated with the progression of renal dysfunction in patients with AAV.

Characterisation of 12 microsatellite loci in the Vietnamese commercial clam Lutraria rhynchaena Jonas 1844 (Heterodonta: Bivalvia: Mactridae) through next-generation sequencing.

The marine clam Lutraria rhynchaena is gaining popularity as an aquaculture species in Asia. Lutraria populations are present in the wild throughout Vietnam and several stocks have been established and translocated for breeding and aquaculture grow-out purposes. In this study, we demonstrate the feasibility of utilising Illumina next-generation sequencing technology to streamline the identification and genotyping of microsatellite loci from this clam species. Based on an initial partial genome scan, 48 microsatellite markers with similar melting temperatures were identified and characterised. The 12 most suitable polymorphic loci were then genotyped using 51 individuals from a population in Quang Ninh Province, North Vietnam. Genetic variation was low (mean number of alleles per locus = 2.6; mean expected heterozygosity = 0.41). Two loci showed significant deviation from Hardy-Weinberg equilibrium (HWE) and the presence of null alleles, but there was no evidence of linkage disequilibrium among loci. Three additional populations were screened (n = 7-36) to test the geographic utility of the 12 loci, which revealed 100 % successful genotyping in two populations from central Vietnam (Nha Trang). However, a second population from north Vietnam (Co To) could not be successfully genotyped and morphological evidence and mitochondrial variation suggests that this population represents a cryptic species of Lutraria. Comparisons of the Qang Ninh and Nha Trang populations, excluding the 2 loci out of HWE, revealed statistically significant allelic variation at 4 loci. We reported the first microsatellite loci set for the marine clam Lutraria rhynchaena and demonstrated its potential in differentiating clam populations. Additionally, a cryptic species population of Lutraria rhynchaena was identified during initial loci development, underscoring the overlooked diversity of marine clam species in Vietnam and the need to genetically characterise population representatives prior to microsatellite development. The rapid identification and validation of microsatellite loci using next-generation sequencing technology warrant its integration into future microsatellite loci development for key aquaculture species in Vietnam and more generally, aquaculture countries in the South East Asia region.

A simple and precise alignment calibration method for cone-beam computed tomography with the verifications.

Cone-beam Computed Tomography (CBCT) is widely used in dental imaging, small animal imaging, radiotherapy, and non-destructive industrial inspection. The quality of CBCT images depends on the precise knowledge of the CBCT system's alignment. We introduce a distinct procedure, "precision alignment loop (PAL)", to calibrate any CBCT system with a circular trajectory. We describe the calibration procedure by using a line-beads phantom, and how PAL determines the misalignments from a CBCT system. PAL also yields the uncertainties in the simulated calibration to give an estimate of the errors in the misalignments. From the analytical simulations, PAL can precisely obtain the source-to-rotation axis distance (SRD), and the geometric center G, "the point in z-axis meets the detector", where the z-axis is coincident with the line from the X-ray source that intersects the axis of the rotation (AOR) orthogonally. The uncertainties of three misalignment angles of the detector are within ±0.05°, which is close to ±0.04° for the results of Yang et al. [18], but our method is easy and simple to implement. Our distinct procedure, on the other hand, yields the calibration of a micro-CT system and an example of reconstructed images, showing our calibration method for the CBCT system to be simple, precise, and accurate.

A preliminary retrospective evaluation of screening and diagnosis of ornithine transcarbamylase deficiency in high-risk patients at a referral center in Vietnam.

Introduction: To date, newborn screening (NBS) for proximal urea cycle disorders, including Ornithine transcarbamylase deficiency (OTCD), was not recommended due to the lack of appropriate tests and insufficient evidence of the benefits. This study aimed to investigate the potential of tandem mass spectrometry (MS/MS) for OTCD screening and its value in guiding further investigation to obtain a final diagnosis in high-risk patients. Methods: The study included patients with OTCD referred to the National Children's Hospital between April 2020 and November 2023. A retrospective evaluation of amino acid concentrations measured by MS/MS and their ratios in patients with early-onset and late-onset OTCD was conducted. Results: While all ten early-onset cases had glutamine concentrations above the upper limit, only five of them had citrulline concentrations below the lower limit of the reference interval. Only two late-onset cases had elevated glutamine levels, while all had citrulline within reference intervals. The Cit/Phe ratio was decreased, and the Gln/Cit and Met/Cit ratios were increased in all early-onset OTCD cases, while they were abnormal in only one late-onset case. Conclusions: The preliminary results suggest that hyperglutaminemia, in combination with low or normal citrulline concentrations and specific ratios (Gln/Cit, Met/Cit, and Cit/Phe), can serve as reliable markers for screening early-onset OTCD in high-risk patients. However, these markers proved less sensitive for detecting the late-onset form, even in symptomatic patients.

Sociodemographic, biological, and timing characteristics of dental caries and fluorosis using mixed-type cluster analysis on 12-year-olds in Ho Chi Minh city, 1989-2019.

Objectives: In 1990, Ho Chi Minh City started Community water fluoridation (CWF) at 0.7 ppm F, and in 2000, it was adjusted to 0.5 ppm F. Here, we analyzed dental caries and fluorosis data in Ho Chi Minh City to explore commonalities associated with CWF among 12-year-old children. Methods: Dental caries and fluorosis data were collected in 1989, 2003, 2012, and 2019 (N = 4773). Trained dentists scored dental caries using the WHO detection criteria and fluorosis using Dean's Fluorosis Index. We used these data and the k-prototypes method by the R package to identify clusters of participants with shared clinical and water fluoride levels. Results: We used datasets 1 (4773 participants) and 2 (4194 participants, missing fluorosis data in 1989). K-prototypes analysis identified three clusters in each dataset. Cluster 1, with 80 % of the sample at 0.5 ppm F area characterized by low caries and fluorosis scores. Cluster 2 with 60 % of the sample non-fluoridated area had high caries and low fluorosis scores. Cluster 3, with 75 % of the sample in 0.7 ppm area, had low caries but borderline high fluorosis scores. Conclusion: Identifying three clusters based on clinical and environmental scores supports the decision to fluoridate the water to prevent caries (0-0.7 ppm) and the shift from 0.7 to 0.5 ppm to keep the caries preventive effect while reducing the risk of fluorosis. Clinical significance: Our results support the effectiveness of CWF in preventing dental caries and the appropriateness of changing the F concentration to reduce the risk of fluorosis while maintaining its effectiveness.

The therapeutic landscape for COVID-19 and post-COVID-19 medications from genetic profiling of the Vietnamese population and a predictive model of drug-drug interaction for comorbid COVID-19 patients.

Despite the raised awareness of the role of pharmacogenomic (PGx) in personalized medicines for COVID-19, data for COVID-19 drugs is extremely scarce and not even a publication on this topic for post-COVID-19 medications to date. In the current study, we investigated the genetic variations associated with COVID-19 and post-COVID-19 therapies by using whole genome sequencing data of the 1000 Vietnamese Genomes Project (1KVG) in comparison with other populations retrieved from the 1000 Genomes Project Phase 3 (1KGP3) and the Genome Aggregation Database (gnomAD). Moreover, we also evaluated the risk of drug interactions in comorbid COVID-19 and post-COVID-19 patients based on pharmacogenomic profiles of drugs using a computational approach. For COVID-19 therapies, variants related to the response of two causal treatment agents (tolicizumab and ritonavir) and antithrombotic drugs are common in the Vietnamese cohort. Regarding post-COVID-19, drugs for mental manipulations possess the highest number of clinical annotated variants carried by Vietnamese individuals. Among the superpopulations, East Asian populations shared the most similar genetic structure with the Vietnamese population, whereas the African population showed the most difference. Comorbid patients are at an increased drug-drug interaction (DDI) risk when suffering from COVID-19 and after recovering as well due to a large number of potential DDIs which have been identified. Our results presented the population-specific understanding of the pharmacogenomic aspect of COVID-19 and post-COVID-19 therapy to optimize therapeutic outcomes and promote personalized medicine strategy. We also partly clarified the higher risk in COVID-19 patients with underlying conditions by assessing the potential drug interactions.

Correlation of resin composite translucency and IOS accuracy: An in-vitro study.

Background: Different restoration materials have different optical characteristics that influence the intraoral scanner's (IOS) image accuracy. The purpose of this in-vitro investigation was to investigate how composite translucency affected the accuracy of IOS. Material and Methods: GC G-aenial Universal Injectable JE composite plates were used for the study at 3 thicknesses (1-2-3mm). A lab scanner (3Shape E1) obtained 1 reference scan, whereas IOS (Trios3) was used to conduct 10 experimental scans per group. After 3D superimposition, deviation values were used to assess the accuracy (trueness and precision) outcomes for the corresponding groups. Using an LS170 V2.0 colorimeter, the translucency parameter (TP) of the plates was determined from L*a*b* values of CIELAB color space. Results: The composite translucency resulted in a decrease in the scale of digital impressions. The 1mm group had the largest scale reduction (0.02mm) significantly, followed by the 2mm and 3mm groups (0.01mm). No difference was found in mean precision. The colorimeter detects the L*a*b* values and showed that 1mm composite plate expressed the highest TP value, then 2mm and 3mm groups (28.90, 14.26 and 6.49 respectively). The thinner composite, the higher translucency and TP were highly positively correlated to IOS trueness of composite plates. Conclusions: Composite translucency has an impact on optical impression accuracy. In correlation, the optical impression becomes less accurate the more translucent the composite is. This implies that in the digital process, the dentist should specify the appropriate optical properties of composite materials concerning both their mechanical and aesthetic qualities. Key words:Accuracy, translucency, resin composite, digital dentistry, intraoral-scanner.

Influence of titanium dioxide and composite on the accuracy of an intraoral scanner for bilateral upper posterior edentulous jaw (Kennedy class I) scanning: An in vitro study.

OBJECTIVES: The accuracy of 3-dimensional images produced by the intraoral scanner (IOS) is affected by scanning-aid materials. This in vitro study aimed to elucidate the influence of scanning-aid materials on the accuracy (trueness and precision) of digital scanning on the bilateral upper posterior edentulous jaw (Kennedy class I). METHODS: The asymmetrical bilateral upper posterior edentulous model (reference model) was generated using a 3D printer with three groups (application of TiO2 powder - composite and no-treatment control). The experimental scans were executed (n = 10 per group) using TRIOS3 (3shape), while one reference scan was obtained by an industrial scanner (Solutionix - C500). Values of trueness and precision were evaluated using the 3D superimposition method on mean deviation values. The accuracy was assessed using mean deviation values following the 3D superimposition method. RESULTS: IOS had high trueness (20.6 µm), and significant differences were found between the no-treatment and TiO2 groups. Considering the cut-off value of deviations as 300 µm for clinical acceptability, the analysis clarified the most variations in the control group. There was a significant difference between the no-treatment group and others in the maxillary tuberosity area relating to long-span edentulous. The composite group had the best precision values (1.1 µm). Significant differences were found between composite and TiO2 groups (2.7 µm). CONCLUSIONS: The bilateral upper posterior edentulous jaw digital impressions obtained using IOS were accurate. However, the digital images in the palate and maxillary tuberosity area related to long-span edentulous differed significantly. TiO2-containing powder and composite landmarks affected the accuracy and stability of the IOS. CLINICAL SIGNIFICANCE: Scanning aid materials can increase the accuracy of the bilateral upper posterior edentulous jaw scanning with IOS.

Effects of food hardness on temporomandibular joint osteoarthritis: Qualitative and quantitative micro-CT analysis of rats in vivo.

BACKGROUND: Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative joint disease in which quantitative analysis based on magnetic resonance image (MRI) or cone-beam computed tomography (CBCT) remains limited. Moreover, the long-term effects of soft food on the adaptive condylar remodeling process in TMJ-OA remain unclear. This study aimed to assess the effects of food hardness on adaptive condylar remodeling in a healthy TMJ, TMJ-OA, and controlled TMJ-OA. METHODS: Complete Freund's adjuvant (CFA) was used for TMJ-OA induction and Link-N (LN) for TMJ repair. Eighteen mature rats were randomly divided into six groups: (1) control/normal diet (Ctrl-N); (2) control/soft diet (Ctrl-S); (3) TMJ-OA/normal diet (CFA-N); (4) TMJ-OA/soft diet (CFA-S); (5) Link-N-controlled TMJ-OA/normal diet (LN-N); and (6) Link-N-controlled TMJ-OA/soft diet (LN-S). Micro-CT was performed 14, 21, and 28 days after CFA injection to analyze the bone volume, bone volume fraction (BVF), bone mineral density (BMD), and trabecular bone number and thickness (Tb.N, Tb.Th). MRI and histological imaging were performed to support the analysis. RESULTS: Under CFA treatment, the BVF and BMD decreased significantly (p < 0.01) and later recovered to normal. However, more significant improvements occurred in normal-diet groups than soft-diet groups. Additionally, bone volume changes were more predictable in the normal-diet groups than in the soft-diet groups. The normal-diet groups presented a significant decrease and increase in the Tb.N and Tb.Th, respectively (p < 0.05), while the Tb.N and Tb.Th in the soft-diet groups remained largely unchanged. Furthermore, a significantly higher frequency of irregularities on the condylar articular surface was found in the soft-diet groups. CONCLUSIONS: Compared with a soft diet, a normal diet may be beneficial for preserving condyle articular surface and directing bone remodeling in TMJ-OA rats.

Molecular subtypes of Adenovirus-associated acute respiratory infection outbreak in children in Northern Vietnam and risk factors of more severe cases.

BACKGROUND: Under the pressure of Human Adenovirus (HAdV)-associated acute respiratory infection (ARI) outbreak in children in Northern Vietnam in the end of 2022, this study was initiated to identify the HAdV subtype(s) and examine the associated clinical features and risk factors of more severe cases. METHODS: This study evaluated pediatric patients with ARI which had tested positive for HAdV between October and November 2022 using a multiplex real-time PCR panel. Nasopharyngeal aspirates or nasal swab samples were used for sequencing to identify HAdV subtypes. Clinical data were collected retrospectively. RESULTS: Among 97 successfully sequenced samples, the predominant subtypes were HAdV-B3 (83%), HAdV-B7 (16%) and HAdV-C2 (1%). Lower respiratory manifestations were found in 25% of the patients of which 5% were diagnosed with severe pneumonia. There was no significant association between HAdV subtype and clinical features except higher white blood cell and neutrophil counts in those detected with HAdV-B3 (p<0.001). Co-detection of HAdV with ≥1 other respiratory viruses was found in 13/24(54%) of those with lower respiratory manifestations and 4/5(80%) of those with severe pneumonia (odds ratio (95% confidence interval) vs. those without = 10.74 (2.83, 48.17) and 19.44 (2.12, 492.73) respectively after adjusting for age, sex, birth delivery method, day of disease). CONCLUSION: HAdV-B3 and HAdV-B7 were predominant in the outbreak. Co-detection of HAdV together with other respiratory viruses was a strong risk factor for lower respiratory tract illnesses and severe pneumonia. The findings advocate the advantages of multi-factor microbial panels for the diagnosis and prognosis of ARI in children.

Therapeutic Effect and Optimal Electrode Placement of Transcutaneous Neuromuscular Electrical Stimulation in Patients with Post-Stroke Dysphagia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: To date, there is no conclusive evidence that transcutaneous neuromuscular electrical stimulation (TNMES) benefits patients with post-stroke dysphagia (PSD). In addition, the optimal TNMES electrode placement has not been well-established. This systematic review and meta-analysis were conducted to investigate these two research gaps. Methods: Five major databases were systematically searched for randomized controlled trials (RCTs) through January 2022. Effect sizes were computed using Hedges' g statistic, which were then entered into the random-effects model to obtain pooled effect estimates. Results: Twenty-four RCTs met the eligibility criteria. On the improvement of swallowing function, TNMES alone was not superior to conventional swallowing therapies (CSTs); combined therapy of TNMES and CSTs significantly surpassed CSTs alone (standardized mean difference (SMD) = 0.91, 95% confidence interval (95% CI): 0.68 to 1.14, p < 0.0001; I2 = 63%). Moreover, significant pooled effect sizes were observed in subgroups with horizontal electrode placement above the hyoid bone (SMD = 0.94, 95% CI: 0.72 to 1.16; I2 = 0%) and horizontal electrode placement just above and below the hyoid bone (SMD = 0.87, 95% CI: 0.59 to 1.14; I2 = 0%). The largest pooled effect size was observed in the subgroup that individualized electrode placement according to dysphagia evaluation (SMD = 1.65, 95% CI: 0.38 to 2.91; I2 = 90%). Conclusion: TNMES should be used in combination with CSTs for PSD. Horizontal electrode placement should target suprahyoid muscles or both suprahyoid and thyrohyoid muscles.

Changes in the Proportion of Gastrointestinal Emergency Endoscopy and Peptic Ulcer Disease During the COVID-19 Pandemic: A Local Retrospective Observational Study From Vietnam.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has disrupted the practice of gastrointestinal (GI) endoscopy units and may increase the risk of digestive disorders. We described the situational changes in GI endoscopy and peptic ulcer disease (PUD) proportion during COVID-19 in Vietnam and examined the associated factors. METHODS: A retrospective ecological study was conducted on data of Hanoi Medical University Hospital, Vietnam. The number of upper GI endoscopy and the proportion of GI emergency endoscopy and PUD were compared between 2019 and 2020 by month (January to June). Log-binomial regression was used to explore associated factors of GI emergency endoscopy and PUD. RESULTS: The number of endoscopies decreased remarkably during the nationwide social distancing in April 2020. Compared to April 2019, the proportion in April 2020 of both GI emergency endoscopy [4.1 vs. 9.8%, proportion ratio (PR) 2.39, 95% CI 2, 2.87], and PUD [13.9 vs. 15.8%; PR, 1.14; 95% CI, 1.01, 1.29] was significantly higher. In log-binomial models, the proportion of GI emergency endoscopy was higher in April 2020 compared to April 2019 (adjusted PR, 2.41; 95% CI, 2.01, 2.88). Male sex and age of ≥50 years were associated with an increased PUD and GI emergency conditions. CONCLUSION: The proportion of both GI emergency endoscopy and PUD was significantly higher during the time of the state of emergency due to the ongoing COVID-19 pandemic in 2020 when compared to 2019 at the same health facility in Vietnam. The findings suggest that healthcare delivery reforms during the era of an emerging pandemic are required to reduce digestive disorders, in particular, and chronic diseases in general.

Clinical and Pathological Significance of Autoantibodies to Erythropoietin Receptor in Type 2 Diabetic Patients With CKD.

INTRODUCTION: We examined the impact of autoantibodies on the erythropoietin receptor (EPOR) in type 2 diabetic patients with chronic kidney disease (CKD). METHODS: A total of 112 Japanese patients with type 2 diabetes who had CKD were enrolled in this study and followed for a mean of 45 months. Sera from these patients were screened for anti-EPOR antibodies using enzyme-linked immunosorbent assays. RESULTS: Anti-EPOR antibodies were detected in 26 patients (23%). Anti-EPOR antibodies were associated with low hemoglobin concentrations and decreased renal function. In patients with biopsy-proven diabetic nephropathy, anti-EPOR antibodies were associated with increased levels of interstitial inflammation. A decrease in renal function was observed more frequently in patients with antibodies than in those without antibodies, and the presence of the antibodies together with well-known clinical parameters, including proteinuria and low glomerular filtration rate, was a significant risk factor for end-stage renal disease. In human tubular epithelial HK-2 cells, IgG fractions containing anti-EPOR antibodies upregulated the expression of monocyte chemoattractant protein-1 mRNA under a high concentration of glucose. CONCLUSION: Anti-EPOR antibodies might be involved in the progression of renal lesions and in the impaired erythropoiesis in type 2 diabetic patients with CKD. Furthermore, the presence of anti-EPOR antibodies may be an additional predictor for end-stage renal disease in type 2 diabetes.

Prevalence of Helicobacter pylori infection and atrophic gastritis in patients with dyspeptic symptoms in Myanmar.

AIM: To survey the detailed analyses for Helicobacter pylori (H. pylori) infection and gastric mucosal status in Myanmar. METHODS: A total of 252 volunteers with dyspeptic symptoms (155 female and 97 male; mean age of 43.6 ± 14.2 years) was participated in Yangon and Mandalay. The status of H. pylori infection was determined based on 5 different tests including rapid urease test, culture, histology, immunohistochemistry and serology. Histological scores were evaluated according to the update Sydney system and the Operative Link for Gastritis Assessment system. Pepsinogen (PG) I and PG II were measured using enzyme-linked immunosorbent assays. RESULTS: The overall prevalence of H. pylori infection was 48.0%. There was no relationship between age and infection rate. Even in young group (less than 29 years old), the H. pylori infection rate was relatively high (41.9%). The prevalence of H. pylori infection was significantly higher in Yangon than that of Mandalay. H. pylori infection was significantly associated with the presence of gastric mucosal atrophy. All 7 subjects with peptic ulcer were infected with H. pylori. Although H. pylori-positive subjects showed stronger gastritis than H. pylori-negative subjects, most cases had mild gastritis. CONCLUSION: We revealed the prevalence of H. pylori infection in patients with dyspeptic symptoms in Myanmar. The H. pylori infection was a risk factor for peptic ulcer and stronger gastritis.

Development of a new biochemical test to diagnose and monitor neuroblastoma in Vietnam: homovanillic and vanillylmandelic acid by gas chromatography-mass spectrometry.

OBJECTIVES: The aim of this study was to develop an accurate robust testing method to simultaneously measure urine levels of HVA and VMA using gas chromatography mass spectrometry (GCMS) and to establish age-specific reference intervals of HVA and VMA in random urines for Vietnamese children. DESIGN AND METHODS: The assay for urinary HVA and VMA was developed based on a classical urinary organic acid profiling method. Briefly, this incorporated 3-phenyl butyric acid as the internal standard and liquid-liquid extraction with ethyl acetate followed by derivatization with BSTFA. The Agilent 7890A GC and 5975C Mass Selective Detector in single ion monitoring mode was used for analysis. Reference intervals were developed from random urine samples collected from 634 disease free Vietnamese children and compared to 50 known neuroblastoma patient samples. Results were reported relative to creatinine concentration. Age related 95% reference intervals for urinary HVA and VMA were estimated from sample quantiles. The analytes (expressed as analyte/creatinine ratios) diagnostic values were determined by calculating the related sensitivity, specificity and likelihood ratios. RESULTS: HVA and VMA were linear to at least 193 and 221µmol/L, respectively. The limit of quantitation for both analytes was 0.9µmol/L. Using the bi-level control (n=15), the within-batch coefficients of variations (CVs) were less than 3% for both analytes across the assay range. The between-batch CVs (n=20 over three months), were 3.6% at 11µmol/L and 2.1% at 88µmol/L for HVA, 6.6% at 18.2µmol/L and 2.6% at 90.6µmol/L for VMA. Vietnamese age related reference intervals were established for urinary HVA and VMA per creatinine. HVA for children <6months (n=91) was 5.3-37.0µmol/mmol; 6months to <1year (n=141) was 2.7-27.7µmol/mmol; 1 to 5years (n=139) was 3.4-17.9µmol/mmol; 6 to 10years (n=136) was 2.7-8.8µmol/mmol; and 11 to 15years (n=127) was 1.1-9.4µmol/mmol. VMA for children <6months was 1.8-12.2µmol/mmol; 6months to <1year was 1.5-9.3µmol/mmol; 1 to 5years was 1.9-7.8µmol/mmol; 6 to 10years was 1.6-5.1µmol/mmol; and 11 to 15years was <0.9-6.3µmol/mmol. CONCLUSIONS: A robust testing method for simultaneous quantitation of urinary HVA and VMA by GCMS was developed. This method is accurate, precise and fit for its clinical purpose and suitable for developing countries. Age-related reference intervals of urinary HVA and VMA were established for Vietnamese children and the intervals declined progressively with increasing age for each analyte.