Patient outcomes in public sector hepatitis C treatment programmes: a retrospective cohort analysis across five low- and middle-income countries.

OBJECTIVES: Given limited data on factors associated with hepatitis C virus (HCV) treatment discontinuation and failure in low- and middle-income countries, we aimed to describe patient populations treated for HCV in five countries and identify patient groups that may need additional support. DESIGN: Retrospective cohort analysis using routinely collected data. SETTING: Public sector HCV treatment programmes in India (Punjab), Indonesia, Myanmar, Nigeria (Nasarawa) and Vietnam. PARTICIPANTS: 104 957 patients who initiated treatment in 2016-2022 (89% from Punjab). PRIMARY OUTCOMES: Treatment completion and cure. RESULTS: Patient characteristics and factors associated with outcomes varied across countries and facilities. Across all patients, median age was 40 years (IQR: 29-52), 30.6% were female, 7.0% reported a history of injecting drugs, 18.2% were cirrhotic and 4.9% were coinfected with HIV. 79.8% were prescribed sofosbuvir+daclastasvir. Of patients with adequate follow-up, 90.6% (89,551) completed treatment. 77.5% (69,426) of those who completed treatment also completed sustained virological testing at 12 weeks (SVR12), and of those, 92.6% (64 305) were cured. In multivariable-adjusted models, in most countries, significantly lower treatment completion was observed among patients on 24-week regimens (vs 12-week regimens) and those initiated in later years of the programme. In several countries, males, younger patients <20 years and certain groups of cirrhotic patients were less likely to complete treatment or be cured. In Punjab, treatment completion was also lower in those with a family history of HCV and people who inject drugs (PWID); in other countries, outcomes were comparable for PWID. CONCLUSION: High proportions of patients completed treatment and were cured across patient groups and countries. SVR12 follow-up could be strengthened. Males, younger people and those with decompensated cirrhosis on longer regimens may require additional support to complete treatment and achieve cure. Adequate programme financing, minimal user fees and implementation of evidence-based policies will be critical to close gaps.

Moisturizing effectiveness of immediate compared with delayed moisturization.

INTRODUCTION: Moisturizers play an essential role in maintaining the integrity of the skin barrier by increasing stratum corneum hydration (SCH) and reducing transepidermal water loss (TEWL). According to dermatology and allergy guidelines, moisturizers should be applied on the skin within 3 min after bathing or showering. However, there is very little evidence supporting this recommendation. This study aimed to investigate the effectiveness of immediate and delayed moisturizing after bathing/washing on the improvement of SCH and TEWL. METHODS: This was a crossover study of 60 healthy Vietnamese volunteers aged 18-25 years. In each subject, SCH and TEWL levels were measured at three areas: non-moisturized, immediate moisturizing after washing, and delayed moisturizing at 30 min after washing. RESULTS: In non-moisturized skin, SCH and TEWL levels were significantly different from the baseline at 60 min after washing, while significantly decreased TEWL levels were observed immediately after moisturizing. In addition, moisturized skin had significantly higher SCH and lower TEWL levels compared with non-moisturized areas at every time point (p < 0.05). Interestingly, the percentage changes of SCH and TEWL levels from baseline did not differ between immediately and delayed moisturized areas. CONCLUSIONS: Tested moisturizer helped increase SCH and decrease TEWL; however, there was no difference in moisturizing effectiveness between immediate and delayed moisturizing in healthy skin. The recommendation of immediate application of moisturizers after bathing/washing should be reconsidered, and more studies are needed to establish a stronger recommendation.

Renewable energy from biomass surplus resource: potential of power generation from rice straw in Vietnam.

Biomass, one of the renewable resources, is expected to play an important role in the world's energy future. In Asia, rice straw is an abundant agricultural surplus because rice is one of the leading staple food crops in the region. Often, rice straw is burned directly in the field via uncontrolled combustion methods that emit large amounts of short-lived air pollutants, greenhouse gases, and other pollutants. In Vietnam, the energy and environment protection sectors are facing great challenges because of rapid urbanisation and industrialisation. A national strategic choice is to exploit renewable energy, including biomass-derived energy, to achieve energy security and CO2 emission reduction. This study investigates the potential of rice straw as an energy source for power plants at a local scale in Vietnam using data derived from satellite Sentinel-1 images. The results show that Vietnam can produce 2,565 MW from rice straw, for which 24 out of 63 provinces have a potential capacity higher than 30 MW, and the Kien Giang province has the highest capacity (245 MW). The study also analyses limitations and obstacles overcoming which can promote the biomass energy sector in the country.

Initial success from a public health approach to hepatitis C testing, treatment and cure in seven countries: the road to elimination.

With political will, modest financial investment and effective technical assistance, public sector hepatitis C virus (HCV) programmes can be established in low- and middle-income countries as a first step towards elimination. Seven countries, with support from the Clinton Health Access Initiative (CHAI) and partners, have expanded access to HCV treatment by combining programme simplification with market shaping to reduce commodity prices. CHAI has supported a multipronged approach to HCV programme launch in Cambodia, India, Indonesia, Myanmar, Nigeria, Rwanda and Vietnam including pricing negotiations with suppliers, policy development, fast-track registrations of quality-assured generics, financing advocacy and strengthened service delivery. Governments are leading programme implementation, leveraging HIV programme infrastructure/financing and focusing on higher-HCV prevalence populations like people living with HIV, people who inject drugs and prisoners. This manuscript aims to describe programme structure and strategies, highlight current commodity costs and outline testing and treatment volumes across these countries. Across countries, commodity costs have fallen from >US$100 per diagnostic test and US$750-US$900 per 12-week pan-genotypic direct-acting antiviral regimen to as low as US$80 per-cure commodity package, including WHO-prequalified generic drugs (sofosbuvir + daclatasvir). As of December 2019, 5900+ healthcare workers were trained, 2 209 209 patients were screened, and 120 522 patients initiated treatment. The cure (SVR12) rate was >90%, including at lower-tier facilities. Programmes are successfully implementing simplified, decentralised public health approaches. Combined with political will and affordable pricing, these efforts can translate into commitments to achieve global targets. However, to achieve elimination, additional investment in scale-up is required.

Isolation and structural identification of a new T1-conotoxin with unique disulfide connectivities derived from Conus bandanus.

BACKGROUND: Conopeptides are neuropharmacological peptides derived from the venomous salivary glands of cone snails. Among 29 superfamilies based on conserved signal sequences, T-superfamily conotoxins, which belong to the smallest group, include four different frameworks that contain four cysteines denominated I, V, X and XVI. In this work, the primary structure and the cysteine connectivity of novel conotoxin of Conus bandanus were determined by tandem mass spectrometry using collision-induced dissociation. METHODS: The venom glands of C. bandanus snails were dissected, pooled, and extracted with 0.1% trifluoroacetic acid in three steps and lyophilized. The venom was fractionated and purified in an HPLC system with an analytical reversed-phase C18 column. The primary peptide structure was analyzed by MALDI TOF MS/MS using collision-induced dissociation and confirmed by Edman's degradation. The peptide's cysteine connectivity was determined by rapid partial reduction-alkylation technique. RESULTS: The novel conotoxin, NGC1C2(I/L)VREC3C4, was firstly derived from de novo sequencing by MS/MS. The presence of isoleucine residues in this conotoxin was confirmed by the Edman degradation method. The conotoxin, denominated Bn5a, belongs to the T1-subfamily of conotoxins. However, the disulfide bonds (C1-C4/C2-C3) of Bn5a were not the same as found in other T1-subfamily conopeptides but shared common connectivities with T2-subfamily conotoxins. The T1-conotoxin of C. bandanus proved the complexity of the disulfide bond pattern of conopeptides. The homological analysis revealed that the novel conotoxin could serve as a valuable probe compound for the human-nervous-system norepinephrine transporter. CONCLUSION: We identified the first T1-conotoxin, denominated Bn5a, isolated from C. bandanus venom. However, Bn5a conotoxin exhibited unique C1-C4/C2-C3 disulfide connectivity, unlike other T1-conotoxins (C1-C3/C2-C4). The structural and homological analyses herein have evidenced novel conotoxin Bn5a that may require further investigation.

Isolation and structural identification of a new T1-conotoxin with unique disulfide connectivities derived from Conus bandanus

Conopeptides are neuropharmacological peptides derived from the venomous salivary glands of cone snails. Among 29 superfamilies based on conserved signal sequences, T-superfamily conotoxins, which belong to the smallest group, include four different frameworks that contain four cysteines denominated I, V, X and XVI. In this work, the primary structure and the cysteine connectivity of novel conotoxin of Conus bandanus were determined by tandem mass spectrometry using collision-induced dissociation. Methods: The venom glands of C. bandanus snails were dissected, pooled, and extracted with 0.1% trifluoroacetic acid in three steps and lyophilized. The venom was fractionated and purified in an HPLC system with an analytical reversed-phase C18 column. The primary peptide structure was analyzed by MALDI TOF MS/MS using collision-induced dissociation and confirmed by Edman's degradation. The peptide's cysteine connectivity was determined by rapid partial reduction-alkylation technique. Results: The novel conotoxin, NGC1C2(I/L)VREC3C4, was firstly derived from de novo sequencing by MS/MS. The presence of isoleucine residues in this conotoxin was confirmed by the Edman degradation method. The conotoxin, denominated Bn5a, belongs to the T1-subfamily of conotoxins. However, the disulfide bonds (C1-C4/C2-C3) of Bn5a were not the same as found in other T1-subfamily conopeptides but shared common connectivities with T2-subfamily conotoxins. The T1-conotoxin of C. bandanus proved the complexity of the disulfide bond pattern of conopeptides. The homological analysis revealed that the novel conotoxin could serve as a valuable probe compound for the human-nervous-system norepinephrine transporter. Conclusion: We identified the first T1-conotoxin, denominated Bn5a, isolated from C. bandanus venom. However, Bn5a conotoxin exhibited unique C1-C4/C2-C3 disulfide connectivity, unlike other T1-conotoxins (C1-C3/C2-C4). The structural and homological analyses herein have evidenced novel conotoxin Bn5a that may require further investigation.(AU)

MEMS-Based Wavelength-Selective Bolometers.

We propose and experimentally demonstrate a compact design for membrane-supported wavelength-selective infrared (IR) bolometers. The proposed bolometer device is composed of wavelength-selective absorbers functioning as the efficient spectroscopic IR light-to-heat transducers that make the amorphous silicon (a-Si) bolometers respond at the desired resonance wavelengths. The proposed devices with specific resonances are first numerically simulated to obtain the optimal geometrical parameters and then experimentally realized. The fabricated devices exhibit a wide resonance tunability in the mid-wavelength IR atmospheric window by changing the size of the resonator of the devices. The measured spectral response of the fabricated device wholly follows the pre-designed resonance, which obviously evidences that the concept of the proposed wavelength-selective IR bolometers is realizable. The results obtained in this work provide a new solution for on-chip MEMS-based wavelength-selective a-Si bolometers for practical applications in IR spectroscopic devices.

Host choice and fitness of anemonefish Amphiprion ocellaris (Perciformes: Pomacentridae) living with host anemones (Anthozoa: Actiniaria) in captive conditions.

In this study, we investigated the host choice of naïve Amphiprion ocellaris, a specialist, at two different stages of development (newly settling juveniles and post-settlement juveniles). The fish were exposed to their natural and unnatural host species in the laboratory and their fitness was assessed in terms of activity and growth rate. Newly settling juveniles exhibited little host preference, while post-settlement juveniles immediately associated with their most common host in the wild. The analysis of fish activity confirmed that A. ocellaris is diurnal; they are most active in the morning, less at midday and barely move at night. The average travelling distance of juveniles was shorter in the groups living with their natural host, increasing in the groups living with an unnatural host and was highest in groups that did not become associated with any other unnatural host species. Post-settlement juveniles living with the natural host species grew better than those living with unnatural hosts or without anemone contact. These results suggest that the welfare of A. ocellaris in captivity will be optimized by keeping them with their natural anemone host species, although more generalist Amphiprion species may survive in association with other hosts.

Effects of low-frequency ultrasound on heterogenous deacetylation of chitin.

The effects of low frequency ultrasound to the heterogeneous deacetylation of chitin from the shell of white shrimp (Penaeus vannamei) were examined. The deacetylation process was carried out in the range of NaOH concentrations from 35% to 65% (w/w) with and without the ultrasound in the frequency of 37kHz, RMS=300W. The chitosan obtained was characterized in the degree of deacetylation, solubility, FT-IR and X-ray diffraction. The results showed that the behaviors of the deacetylation in two cases, with and without ultrasound, were similar but the ultrasound enhanced the deacetylation rate and therefore reduced the time of the reaction to get the same degree of deacetylation. The role of ultrasound in the process showed more clearly in the low concentration of sodium hydroxide, below 45% (w/w). At the higher concentration of sodium hydroxide, the influence of ultrasound on facilitating deacetylation decreased significantly, however, ultrasound was still keeping on its improving effect on the solubility of the chitosan obtained. The data from FT-IR and X-ray diffraction did not show any considerable change in structure of both kinds of chitosan. This study showed the potential of using low frequency ultrasound in enhancing the deacetylation of chitin for reducing the chemical consumption.

Effective management for acidic pollution in the canal network of the Mekong Delta of Vietnam: a modeling approach.

Acidic pollution can cause severe environmental consequences annually in coastal areas overlain with acid sulfate soils (ASS). A water quality model was used as an analytical tool for exploring the effects of water management options and other interventions on acidic pollution and salinity in Bac Lieu, a coastal province of the Mekong Delta. Fifty eight percent of the provincial area is covered by ASS, and more than three-fourths (approximately 175,000 ha) are used for brackish-water shrimp culture. Simulations of acid water propagation in the canal network indicate that the combination of opening the two main sluices along the East Sea of the study area at high tide for one day every week in May and June and widening the canals that connect these sluices to the West Sea allows for adequate saline water intake and minimizes the acidic pollution in the study area. On the other hand, canal dredging in the freshwater ASS area should be done properly as it can create severe acidic pollution.

High accuracy mass spectrometry comparison of Conus bandanus and Conus marmoreus venoms from the South Central Coast of Vietnam.

Cone snail (genus Conus) venoms provide a rich source of small bioactive peptides known as conopeptides or conotoxins, which are highly interesting in pharmacological studies for new drug discovery. Conus species have evolved expressing a variety of conopeptides, adapted to the biological targets of their own specific preys at their living environments. Therefore, the potential proteomic evaluation of Conus venom components, poorly studied, is of great interest. Early studies supposed about 5% overlap in venom peptides from different Conus species. In this study, we compare using nano-liquid chromatography coupled with electrospray ionisation-mass spectrometry and bioinformatics, the molluscivorous Conus bandanus venom to that of its close-relative Conus marmoreus of the South Central Coast of Vietnam. With this approach, we demonstrate with high precision that 92 common conopeptides are present in the venom of the two mollusc-hunting cone snails, representing 24.4% (out of 376 peptides) and 18.4% (out of 499 peptides) of C. bandanus and C. marmoreus components, respectively. The proteomic comparison of the two close-relative interspecies suggests both common and different strategies for mature conopeptide production in the two species. The overall estimation of putative conopeptide disulphide bridges reveals 75% and 61% of "disulphide-rich" peptides in C. bandanus and C. marmoreus venom components, respectively. The same amino acid sequence for Bn1.1 and Mr1.1, determined at the genomic level, was also found in the two venoms, besides other common conopeptides. Confidently, the broader distribution of C. bandanus compared to C. marmoreus guarantee new opportunities for discovering conopeptides with original pharmacological properties.

Heavy metals in the farming environment and in some selected aquaculture species in the Van Phong Bay and Nha Trang Bay of the Khanh Hoa Province in Vietnam.

Aquaculture is currently one of the most rapidly growing production sectors in Vietnam. This publication describes the concentrations of heavy metals in the farming environment and some aquaculture species in the Khanh Hoa Province in Vietnam. The concentration of total As in the sediments ranged from 0.07 to 0.64 mg/kg, whereas the concentration of Hg varied from <0.0005 to 0.56 mg/kg. The corresponding concentration span for Cd and Pb, were 0.001-0.069 and 0.016-0.078 mg/kg, respectively. The concentrations of As in the aquaculture organisms spanned from 0.14 to 1.03 mg/kg. For Hg the concentrations varied from 0.1 to 0.45 mg/kg, for Cd from 0.02 to 0.10 mg/kg and for Pb from 0.07 to 0.37 mg/kg.