Intron-mediated enhancement of DIACYLGLYCEROL ACYLTRANSFERASE1 expression in energycane promotes a step change for lipid accumulation in vegetative tissues.

BACKGROUND: Metabolic engineering for hyperaccumulation of lipids in vegetative tissues is a novel strategy for enhancing energy density and biofuel production from biomass crops. Energycane is a prime feedstock for this approach due to its high biomass production and resilience under marginal conditions. DIACYLGLYCEROL ACYLTRANSFERASE (DGAT) catalyzes the last and only committed step in the biosynthesis of triacylglycerol (TAG) and can be a rate-limiting enzyme for the production of TAG. RESULTS: In this study, we explored the effect of intron-mediated enhancement (IME) on the expression of DGAT1 and resulting accumulation of TAG and total fatty acid (TFA) in leaf and stem tissues of energycane. To maximize lipid accumulation these evaluations were carried out by co-expressing the lipogenic transcription factor WRINKLED1 (WRI1) and the TAG protect factor oleosin (OLE1). Including an intron in the codon-optimized TmDGAT1 elevated the accumulation of its transcript in leaves by seven times on average based on 5 transgenic lines for each construct. Plants with WRI1 (W), DGAT1 with intron (Di), and OLE1 (O) expression (WDiO) accumulated TAG up to a 3.85% of leaf dry weight (DW), a 192-fold increase compared to non-modified energycane (WT) and a 3.8-fold increase compared to the highest accumulation under the intron-less gene combination (WDO). This corresponded to TFA accumulation of up to 8.4% of leaf dry weight, a 2.8-fold or 6.1-fold increase compared to WDO or WT, respectively. Co-expression of WDiO resulted in stem accumulations of TAG up to 1.14% of DW or TFA up to 2.08% of DW that exceeded WT by 57-fold or 12-fold and WDO more than twofold, respectively. Constitutive expression of these lipogenic "push pull and protect" factors correlated with biomass reduction. CONCLUSIONS: Intron-mediated enhancement (IME) of the expression of DGAT resulted in a step change in lipid accumulation of energycane and confirmed that under our experimental conditions it is rate limiting for lipid accumulation. IME should be applied to other lipogenic factors and metabolic engineering strategies. The findings from this study may be valuable in developing a high biomass feedstock for commercial production of lipids and advanced biofuels.

The first successful bone marrow transplantation in Vietnam for a young Vietnamese boy with chronic granulomatous disease: a case report.

Background: Chronic granulomatous disease (CGD) is an inborn error of immunity (IEI) disorder that results from defects in the respiratory burst activity in phagocytes, leading to the inability to kill bacterial and fungal microorganisms. CGD patients usually have a high incidence of morbidity such as infections and autoinflammatory diseases and a high mortality rate. Allogeneic bone marrow transplantation (BMT) is the only definitive cure for patients who suffer from CGD. Case presentation: We report the first transplant case of chronic granulomatous disease in Vietnam. A 25-month-old boy with X-linked CGD underwent bone marrow transplantation from his 5-year-old, full-matched human leukocyte antigen (HLA)-carrier sibling after myeloablative conditioning regimen with busulfan 5.1 mg/kg/day for 4 days, fludarabine 30 mg/m2/day for 5 days, and rATG (Grafalon-Fresenius) 10 mg/kg/day for 4 days. Neutrophil was engrafted on day 13 posttransplant, donor chimerism was 100% on day 30 with the dihydrorhodamine-1,2,3 (DHR 123) flow cytometric assay test that reached 38% of the normal 45 days posttransplant. Five months after transplant, the patient was free of infection with stable DHR 123 assay at 37%, and donor chimerism remained 100%. No sign of a graft-versus-host disease had been observed posttransplant. Conclusion: We suggest that bone marrow transplantation is a safe and effectual cure for CGD patients, especially for patients with HLA-identical siblings.

Synergistic Enhancement of Filtering Efficiency and Antibacterial Performance of a Nanofiber Air Filter Decorated with Electropolarized Lithium-Doped ZnO Nanorods.

According to clinical case reports, bacterial co-infection with COVID-19 can significantly increase mortality, with Staphylococcus aureus (S. aureus) being one of the most common pathogens causing complications such as pneumonia. Thus, during the pandemic, research on imparting air filters with antibacterial properties was actively initiated, and several antibacterial agents were investigated. However, air filters with inorganic nanostructures on organic nanofibers (NFs) have not been investigated extensively. This study aimed to demonstrate the efficiency of electropolarized poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE) NFs decorated with Li-doped ZnO nanorods (NRs) to improve the filtering ability and antibacterial activity of the ultrathin air filter. The surfactant was loaded onto the ZnO─known for its biocompatibility and low toxicity─nanoparticles (NPs) and transferred to the outer surface of the NFs, where Li-doped ZnO NRs were grown. The Li-doped ZnO NR-decorated NF effectively enhanced the physical filtration efficiency and antibacterial properties. Additionally, by exploiting the ferroelectric properties of Li-doped ZnO NRs and PVDF-TrFE NFs, the filter was electropolarized to increase its Coulombic interaction with PMs and S. aureus. As a result, the filter exhibited a 90% PM1.0 removal efficiency and a 99.5% sterilization rate against S. aureus. The method proposed in this study provides an effective route for simultaneously improving the air filter performance and antibacterial activity.

Insight into the Speciation of Heavy Metals in the Contaminated Soil Incubated with Corn Cob-Derived Biochar and Apatite.

Soil heavy metal contamination is a severe issue. The detrimental impact of contaminated heavy metals on the ecosystem depends on the chemical form of heavy metals. Biochar produced at 400 °C (CB400) and 600 °C (CB600) from corn cob was applied to remediate Pb and Zn in contaminated soil. After a one month amendment with biochar (CB400 and CB600) and apatite (AP) with the ratio of 3%, 5%, 10%, and 3:3% and 5:5% of the weight of biochar and apatite, the untreated and treated soil were extracted using Tessier's sequence extraction procedure. The five chemical fractions of the Tessier procedure were the exchangeable fraction (F1), carbonate fraction (F2), Fe/Mn oxide fraction (F3), organic matter (F4), and residual fraction (F5). The concentration of heavy metals in the five chemical fractions was analyzed using inductively coupled plasma mass spectroscopy (ICP-MS). The results showed that the total concentration of Pb and Zn in the soil was 3023.70 ± 98.60 mg kg-1 and 2034.33 ± 35.41 mg kg-1, respectively. These figures were 15.12 and 6.78 times higher than the limit standard set by the United States Environmental Protection Agency (U.S. EPA 2010), indicating the high level of contamination of Pb and Zn in the studied soil. The treated soil's pH, OC, and EC increased significantly compared to the untreated soil (p > 0.05). The chemical fraction of Pb and Zn was in the descending sequence of F2 (67%) > F5 (13%) > F1 (10%) > F3 (9%) > F4 (1%) and F2~F3 (28%) > F5 (27%) > F1 (16%) > F4 (0.4%), respectively. The amendment of BC400, BC600, and apatite significantly reduced the exchangeable fraction of Pb and Zn and increased the other stable fractions including F3, F4, and F5, especially at the rate of 10% of biochar and a combination of 5:5% of biochar and apatite. The effects of CB400 and CB600 on the reduction in the exchangeable fraction of Pb and Zn were almost the same (p > 0.05). The results showed that CB400, CB600, and the mixture of these biochars with apatite applied at 5% or 10% (w/w) could immobilize lead and zinc in soil and reduce the threat to the surrounding environment. Therefore, biochar derived from corn cob and apatite could be promising materials for immobilizing heavy metals in multiple-contaminated soil.

Metabolic engineering of energycane to hyperaccumulate lipids in vegetative biomass.

BACKGROUND: The metabolic engineering of high-biomass crops for lipid production in their vegetative biomass has recently been proposed as a strategy to elevate energy density and lipid yields for biodiesel production. Energycane and sugarcane are highly polyploid, interspecific hybrids between Saccharum officinarum and Saccharum spontaneum that differ in the amount of ancestral contribution to their genomes. This results in greater biomass yield and persistence in energycane, which makes it the preferred target crop for biofuel production. RESULTS: Here, we report on the hyperaccumulation of triacylglycerol (TAG) in energycane following the overexpression of the lipogenic factors Diacylglycerol acyltransferase1-2 (DGAT1-2) and Oleosin1 (OLE1) in combination with RNAi suppression of SUGAR-DEPENDENT1 (SDP1) and Trigalactosyl diacylglycerol1 (TGD1). TAG accumulated up to 1.52% of leaf dry weight (DW,) a rate that was 30-fold that of non-modified energycane, in addition to almost doubling the total fatty acid content in leaves to 4.42% of its DW. Pearson's correlation analysis showed that the accumulation of TAG had the highest correlation with the expression level of ZmDGAT1-2, followed by the level of RNAi suppression for SDP1. CONCLUSIONS: This is the first report on the metabolic engineering of energycane and demonstrates that this resilient, high-biomass crop is an excellent target for the further optimization of the production of lipids from vegetative tissues.

Enhanced Output Performance of a Flexible Piezoelectric Nanogenerator Realized by Lithium-Doped Zinc Oxide Nanowires Decorated on MXene.

A flexible piezoelectric composite is composed of a polymer matrix and piezoelectric ceramic fillers to achieve good mechanical flexibility and processability. The overall piezoelectric performance of a composite is largely determined by the piezoelectric filler inside. Thus, different dispersion methods and additives that can promote the dispersion of piezoelectric ceramics and optimal composite structures have been actively investigated. However, relatively few attempts have been made to develop a filler that can effectively contribute to the performance enhancement of piezoelectric devices. In the present work, we introduce the fabrication and performance of the composite piezoelectric devices composed of Li-doped ZnO nanowires (Li: ZnO NWs) grown on the surface of MXene (Ti3C2) via the hydrothermal process. Through this approach, a semiconductor-metal hybrid structure is formed, increasing the overall permittivity. Moreover, the Ti3C2 layer can serve as a local ground in the composite so that the ferroelectric phase-transformed Li: ZnO NWs grown on its surface can be more effectively polarized during the poling process. In addition, the NW-covered surface of Ti3C2 prevents the aggregation of metallic Ti3C2 particles, promoting a more uniform electric field distribution during the poling process. As a result, the output performance of the piezoelectric nanogenerator (PENG) fabricated with a Li: ZnO NW/Ti3C2 composite was greatly improved compared to that of the devices fabricated with Li: ZnO NWs without the Ti3C2 platform. Specifically, the Li: ZnO NW/Ti3C2 composite piezoelectric nanogenerator (PENG) demonstrated a twofold higher output power density (∼9 µW/cm2) compared with the values obtained from the PENG devices based on Li: ZnO NWs. The approach introduced in this work can be easily adopted for an effective ferroelectric filler design to improve the output performance of the piezoelectric composite.

The key role of contact time in elucidating the mechanisms of enhanced decontamination by Fe0/MnO2/sand systems.

Metallic iron (Fe0) has shown outstanding performances for water decontamination and its efficiency has been improved by the presence of sand (Fe0/sand) and manganese oxide (Fe0/MnOx). In this study, a ternary Fe0/MnOx/sand system is characterized for its discoloration efficiency of methylene blue (MB) in quiescent batch studies for 7, 18, 25 and 47 days. The objective was to understand the fundamental mechanisms of water treatment in Fe0/H2O systems using MB as an operational tracer of reactivity. The premise was that, in the short term, both MnO2 and sand delay MB discoloration by avoiding the availability of free iron corrosion products (FeCPs). Results clearly demonstrate no monotonous increase in MB discoloration with increasing contact time. As a rule, the extent of MB discoloration is influenced by the diffusive transport of MB from the solution to the aggregates at the bottom of the vessels (test-tubes). The presence of MnOx and sand enabled the long-term generation of iron hydroxides for MB discoloration by adsorption and co-precipitation. Results clearly reveal the complexity of the Fe0/MnOx/sand system, while establishing that both MnOx and sand improve the efficiency of Fe0/H2O systems in the long-term. This study establishes the mechanisms of the promotion of water decontamination by amending Fe0-based systems with reactive MnOx.

Predicting methane solubility in water and seawater by machine learning algorithms: Application to methane transport modeling.

The upward migration of methane from natural gas wells associated with fracking operations may lead to contamination of groundwater resources and surface leakage. Numerical simulations of methane transport in the subsurface environment require knowledge of methane solubility in the aqueous phase. This study employs machine learning (ML) algorithms to predict methane solubility in aquatic systems for temperatures ranging from 273.15 to 518.3 K and pressures ranging from 1 to 1570 bar. Four regression algorithms including regression tree (RT), boosted regression tree (BRT), least square support vector machine (LSSVM) and Gaussian process regression (GPR) were utilized for predicting methane solubility in pure water and mixed aquatic systems containing Na+, K+, Ca2+, Mg2+, Cl- and SO4-2. The experimental data collected from the literature were used to implement the models. We used Grid search (GS), Random search (RS) and Bayesian optimization (BO) for tuning hyper-parameters of the ML models. Moreover, the predicted values of methane solubility were compared against Spivey et al. (2004) and Duan and Mao (2006) equations of state. The results show that the BRT-BO model is the most rigorous model for the prediction task. The coefficient of determination (R2) between experimental and predicted values is 0.99 and the mean squared error (MSE) is 1.19 × 10-7. The performance of the BRT-BO model is satisfactory, showing an acceptable agreement with experimental data. The comparison results demonstrated the superior performance of the BRT-BO model for predicting methane solubility in aquatic systems over a span of temperature, pressure and ionic strength that occurs in deep marine environments.

Enhanced Piezoelectric Output Performance of the SnS2/SnS Heterostructure Thin-Film Piezoelectric Nanogenerator Realized by Atomic Layer Deposition.

Recently, the inherent piezoelectric properties of the 2D transition-metal dichalcogenides (TMDs) tin monosulfide (SnS) and tin disulfide (SnS2) have attracted much attention. Thus the piezoelectricity of these materials has been theoretically and experimentally investigated for energy-harvesting devices. However, the piezoelectric output performance of the SnS2- or SnS-based 2D thin film piezoelectric nanogenerator (PENG) is still relatively low, and the fabrication process is not suitable for practical applications. Here we report the formation of the SnS2/SnS heterostructure thin film for the enhanced output performance of a PENG using atomic layer deposition (ALD). The piezoelectric response of the heterostructure thin film was increased by ∼40% compared with that of the SnS2 thin film, attributed to large band offset induced by the heterojunction formation. Consequently, the output voltage and current density of the heterostructure PENG were 60 mV and 11.4 nA/cm2 at 0.6% tensile strain, respectively. In addition, thickness-controllable large-area uniform thin-film deposition via ALD ensures that the reproducible output performance is achieved and that the output density can be lithographically adjusted depending on the applications. Therefore, the SnS2/SnS heterostructure PENG fabricated in this work can be employed to develop a flexible energy-harvesting device or an attachable self-powered sensor for monitoring pulse and human body movement.

The mechanism of contaminant removal in Fe(0)/H2O systems: The burden of a poor literature review.

The global effort to mitigate the impact of environmental pollution has led to the use of various types of metallic iron (Fe(0)) in the remediation of soil and groundwater as well as in the treatment of industrial and municipal effluents. During the past three decades, hundreds of scientific publications have controversially discussed the mechanism of contaminant removal in Fe(0)/H2O systems, with the large majority considering Fe(0) to be oxidized by contaminants of concern. This view assumes that contaminant reduction is the cathodic reaction occurring simultaneously with Fe0 oxidative dissolution (anodic reaction). This view contradicts the century-old theory of the electrochemical nature of aqueous iron corrosion and hinders progress in designing efficient and sustainable remediation Fe(0)/H2O systems. The aim of the present communication is to demonstrate the fallacy of the current prevailing view based on articles published before 1910. It is shown that properly reviewing the literature would have avoided the mistake. Going back to the roots is recommended as the way forward and should be considered first while designing laboratory experiments.

Characterizing the impact of MnO2 addition on the efficiency of Fe0/H2O systems.

The role of manganese dioxide (MnO2) in the process of water treatment using metallic iron (Fe0/H2O) was investigated in quiescent batch experiments for t ≤ 60 d. MnO2 was used as an agent to control the availability of solid iron corrosion products (FeCPs) while methylene blue (MB) was an indicator of reactivity. The investigated systems were: (1) Fe0, (2) MnO2, (3) sand, (4) Fe0/sand, (5) Fe0/MnO2, and (6) Fe0/sand/MnO2. The experiments were performed in test tubes each containing 22.0 mL of MB (10 mg L-1) and the solid aggregates. The initial pH value was 8.2. Each system was characterized for the final concentration of H+, Fe, and MB. Results show no detectable level of dissolved iron after 47 days. Final pH values varied from 7.4 to 9.8. The MB discoloration efficiency varies from 40 to 80% as the MnO2 loading increases from 2.3 to 45 g L-1. MB discoloration is only quantitative when the operational fixation capacity of MnO2 for Fe2+ was exhausted. This corresponds to the event where adsorption and co-precipitation with FeCPs is intensive. Adsorption and co-precipitation are thus the fundamental mechanisms of decontamination in Fe0/H2O systems. Hybrid Fe0/MnO2 systems are potential candidates for the design of more sustainable Fe0 filters.

Polybenzimidazole-Benzophenone Composite Nanofiber Window Air Filter with Superb UV Resistance and High Chemical and Thermal Durability.

There is a growing interest in window air filters to protect indoor air quality from ultrafine particulate matter (PM) in outdoor air. The filters for this purpose must achieve high filtering efficiency without compromising the original functions of the window, such as high air permeability and visibility. Several filters meeting these requirements have been developed and demonstrate a high PM2.5 filtering efficiency. However, these filters are installed outside the window or on the window screen guard, thereby requiring high levels of ultraviolet (UV), chemical, and thermal resistance. These requirements have been overlooked so far. In this study, we examine the fabrication and performance of a polybenzimidazole-benzophenone (PBI-BP) composite nanofiber air filter that demonstrates superb UV resistance and chemical and thermal durability. Because of the UV absorbance of the BP in the nanofibers, the filter membrane is robust even under prolonged UV exposure, which is essential for filters for this purpose. The filter membrane is not damaged even after treatment in strong acids or annealing at high temperature up to 400 °C. Thus, the PBI-BP composite filter is suitable for practical application in window air filters and can be adapted to develop filters used under other harsh environments.

Novel 3,4-dihydro-4-oxoquinazoline-based acetohydrazides: Design, synthesis and evaluation of antitumor cytotoxicity and caspase activation activity.

In search for novel small molecules with antitumor cytotoxicity via activating procaspase-3, we have designed and synthesized three series of novel (E)-N'-benzylidene-4-oxoquinazolin-3(4H)-yl)acetohydrazides (5a-j, 6a-h, and 7a-h). On the phenyl ring ò the benzylidene part, three different substituents, including 2-OH-4-OCH3, 4-OCH3, and 4-N(CH3)2, were introduced, respectively. Biological evaluation showed that the acetohydrazides in series 5a-j, in which the phenyl ring of the benzylidene part was substituted by 2-OH-4-OCH3 substituent, exhibited potent cytotoxicity against three human cancer cell lines (SW620, colon; PC-3, prostate; NCI-H23, lung). Most of the compounds, in this series, especially compounds 5c, 5b and 5h, also significantly activated caspase-3 activity. Among these, compound 5c displayed 1.61-fold more potent than PAC-1 as caspase-3 activator. Cell cycle analysis showed that compounds 5b, 5c, and 5h significantly arrested the cell cycle in G1 phase. Further apoptotic studies also demonstrated compounds 5b, 5c, and 5h as strong apoptotic cell death inducers. The docking simulation studies showed that these compounds could activate procaspase via chelating Zn2+ ion bound to the allosteric site of the zymogen.

(E)-N'-Arylidene-2-(4-oxoquinazolin-4(3H)-yl) acetohydrazides: Synthesis and evaluation of antitumor cytotoxicity and caspase activation activity.

In our search for novel small molecules activating procaspase-3, we have designed and synthesised a series of novel acetohydrazides incorporating quinazolin-4(3H)-ones (5, 6, 7). Biological evaluation revealed eight compounds with significant cytotoxicity against three human cancer cell lines (SW620, colon cancer; PC-3, prostate cancer; NCI-H23, lung cancer). The most potent compound 5t displayed cytotoxicity up to 5-fold more potent than 5-FU. Analysis of structure-activity relationships showed that the introduction of different substituents at C-6 position on the quinazolin-4(3H)-4-one moiety, such as 6-chloro or 6-methoxy potentially increased the cytotoxicity of the compounds. In term of caspase activation activity, several compounds were found to exhibit potent effects, (e.g. compounds 7 b, 5n, and 5l). Especially, compound 7 b activated caspases activity by almost 200% in comparison to that of PAC-1. Further docking simulation also revealed that this compound potentially is a potent allosteric inhibitor of procaspase-3.

N'-[(E)-Arylidene]-2-(2,3-dihydro-3-oxo-4H-1,4-benzoxazin-4-yl)-acetohydrazides: Synthesis and Evaluation of Caspase Activation Activity and Cytotoxicity.

In our search for novel small cytotoxic molecules potentially activating procaspase-3, we have designed and synthesized a series of novel N'-[(E)-arylidene]-2-(2,3-dihydro-3-oxo-4H-1,4-benzoxazin-4-yl)acetohydrazides (5, 6). Biological evaluation revealed that seven compounds, including 5h, 5j, 5k, 5l, 5n, 6a, and 6b, exhibited moderate to strong cytotoxicity against three human cancer cell lines (SW620, colon cancer; PC-3, prostate cancer; NCI-H23, lung cancer). Among these compounds, two most cytotoxic compounds (5h and 5j) displayed from 3- up to 10-fold higher potency than PAC-1 and 5-FU in three cancer cell lines tested. Three compounds 5j, 5k, and 5n were also found to display better caspases activation activity in comparison to PAC-1. Especially, compound 5k activated the level of caspases activity by 200% higher than that of PAC-1. From this study, three compounds 5j, 5k, and 5n could be considered as potential leads for further design and development of caspase activators and anticancer agents.

Biosynthesis and accumulation of 20-hydroxyecdysone in individual male and female spinach plants during the reproductive stage.

The steroid 20-hydroxyecdysone (20E) is a major component of phytoecdysteroid in plants and may play a defensive role against insect pests in higher plants. In spinach, the biosynthesis and accumulation of 20E have been investigated during the vegetative stage; however, these processes have not been clearly studied during the reproductive stage, particularly in male and female individuals. In this study, we analyzed the level and distribution of 20E in individual male and female spinach plants during the reproductive stage via high performance liquid chromatography (HPLC). We found that 20E biosynthesis and accumulation were markedly different between male and female spinach during the late flowering stage. Compared with the male plant, biosynthesis of 20E in the leaves was more active and its accumulation in the floral parts was higher in female plants during the late flowering stage. These results indicate that the female reproductive organs at least in PE-positive plants could be effectively protected against harmful insects via active biosynthesis and accumulation of PE during the late flowering stage to protect floral parts from harmful insects for seed formation and store the available 20E in seeds for the next generation.

Outcomes of thoracoscopic clipping versus transcatheter occlusion of patent ductus arteriosus: randomized clinical trial.

AIM: To compare outcomes of thoracoscopic clipping (TC) versus transcatheter occlusion (TO) for patent ductus arteriosus (PDA). PATIENTS AND METHODS: One hundred patients were enrolled in the study from May 2010 to December 2011. Those patients were randomized into 2 groups: group one received TC, group two received TO. RESULT: There were no significant differences concerning width or length of the ductus (P>0.05). However the median age and median weight of patients in the TO group were greater than in the TC group (P<0.05). Mean operative time was 32 ± 12 min in the TC group versus 20 ± 3 min in the TO group (P<0.05). There were no deaths in either group. There were no complications in the TC group whereas three patients in the TO group had complications and required subsequent operation. Median postoperative stay was 3.5 days (IQR: 3.0-4.3) in the TC group versus 3 days (IQR: 2.0-4.0) in the TO group (P<0.05). There was no residual shunting in either group. Average cost for one patient was $645 ± 232 in the TC group versus $1,260 ± 204 in the TO group (P<0.001). CONCLUSION: Thoracoscopic clipping is safer than transcatheter occlusion for PDA repair, with the same effectiveness and lower cost.

Clinical features of human influenza A (H5N1) infection in Vietnam: 2004-2006.

BACKGROUND: The first cases of avian influenza A (H5N1) in humans in Vietnam were detected in early 2004, and Vietnam has reported the second highest number of cases globally. METHODS: We obtained retrospective clinical data through review of medical records for laboratory confirmed cases of influenza A (H5N1) infection diagnosed in Vietnam from January 2004 through December 2006. Standard data was abstracted regarding clinical and laboratory features, treatment, and outcome. RESULTS: Data were obtained for 67 (72%) of 93 cases diagnosed in Vietnam over the study period. Patients presented to the hospital after a median duration of illness of 6 days with fever (75%), cough (89%), and dyspnea (81%). Diarrhea and mucosal bleeding at presentation were more common in fatal than in nonfatal cases. Common findings were bilateral pulmonary infiltrates on chest radiograph (72%), lymphopenia (73%), and increased serum transaminase levels (aspartate aminotransferase, 69%; alanine aminotransferase, 61%). Twenty-six patients died (case fatality rate, 39%; 95% confidence interval, 27%-51%) and the most reliable predictor of a fatal outcome was the presence of both neutropenia and raised alanine aminotransferase level at admission, which correctly predicted 91% of deaths and 82% of survivals. The risk of death was higher among persons aged < or =16 years, compared with older persons (P < .001), and the risk of death was higher among patients who did not receive oseltamivir treatment (P = .048). The benefit of oseltamivir treatment remained after controlling for potential confounding by 1 measure of severity (odds ratio, 0.15; 95% confidence interval, 0.026-0.893; P = .034). CONCLUSION: In cases of infection with Influenza A (H5N1), the presence of both neutropenia and raised serum transaminase levels predicts a poor outcome. Oseltamivir treatment shows benefit, but treatment with corticosteroids is associated with an increased risk of death.

An effectiveness trial of multiple micronutrient supplementation during pregnancy in Vietnam: impact on birthweight and on stunting in children at around 2 years of age.

BACKGROUND: Multiple micronutrient deficiencies during pregnancy in Vietnam may contribute to poor fetal growth and stunting, which are major determinants of the health and development offuture generations. OBJECTIVE: We assessed the effects of prenatal multiple micronutrient supplementation on maternal weight gain during pregnancy, infant birthweight, and height of the child at around 2 years of age. METHODS: We conducted a nonrandomized, non-blinded, side-by-side effectiveness trial in a normal program setting in three districts in the Red River Delta in the north of Vietnam. Women in one district received the standard iron-folic acid supplement during prenatal care; women in the second district received the multiple micronutrient supplement; in the third district, gender training was provided in addition to the multiple micronutrient supplement. Cluster surveys were carried out in the three districts at the end of the trial to verify low birthweight (LBW) and at around 2 years after the trial to measure children's height and weight, as well as to collect demographic data on the mothers. RESULTS: Mean birthweight was higher in the districts receiving multiple micronutrient supplements than in the district receiving iron-folic acid tablets. The mean birthweight was 166 g higher in the district receiving multiple micronutrients and 105 g higher in the district receiving multiple micronutrients with gender training than in the district receiving iron-folic acid (p < .05). The prevalence of LBW children (< 2500 g) was lower in the district receiving multiple micronutrients (4.0%) and the district receiving multiple micronutrients plus gender training (5.8%) than in the district receiving iron-folic acid (10.6%) (p < .05). Children at around 2 years of age were taller in the district receiving multiple micronutrients (82.66 cm) and the district receiving multiple micronutrients plus gender training (83.61 cm) than in the district receiving iron-folic acid (81.64 cm), and the stunting rates were about 10% lower than in the district receiving iron-folic acid. CONCLUSIONS: Multiple micronutrient supplementation during pregnancy could be an important intervention to help reduce stunting rates in Vietnam.

Research on clinical features and laboratory findings of septic shock in children at intensive care unit of National Hospital of Pediatrics

The study included 49 patients from 1 month to 15 years old who had diagnosis of septic shock and treated at ICU of the National Hospital of Paediatrics. The result showed that: group of age3 seconds (100%); drop blood pressure (69.4%); weak pulse (71.4%), oliguria and anuresis (100%) and CVP<5 cmH2O (51.2%)