Development of RP HPLC-PDA method for simultaneous quantitative analysis of Inoscavin A and Meshimakobnol A and application on some Phellinus mushroom species.

Phellinus igniarius, a medicinal mushroom containing many active ingredients with health benefits, can be applied in functional food. At present, the quantification of the main active ingredients from higher fungi (Ganoderma, Phellinus…) materials from different growing sources is a mandatory requirement to standardize the input resources of pharmaceutical and food production. Our study's aims are to perfect the RP HPLC-PDA method for quantitative analysis of Inoscavin A and Meshimakobnol A which are two main active ingredients present in Phellinus mushroom. In this analytical method, a C18-HPLC column and the mixture of methanol and formic acid solutions (pH = 2.2) are used to analyze and elute the active substances with the column activity parameters being the concentration gradient. This perfect method was tested for system suitability, repeatability, intermediate precision, recovery, and linear curve calibration to validate the method. After validation, the perfected RP HPLC-PDA method was applied to analyze eight samples of Phellinus and three samples of Ganoderma mushroom category. This method can be the basis for classifying between Phellinus and some other medicinal mushrooms.

The Impact of Chemotherapy on Cardiovascular Mortality across Breast Cancer Subtypes.

Breast cancer is associated with cardiovascular mortality as an adverse effect of chemotherapy. Considering the variances across breast cancer subtypes, this study aims to investigate the cardiovascular mortality patterns in each subtype. METHODS: This retrospective study used the SEER database of chemotherapy-receiving breast cancer patients (diagnosed in 2013-2020). The study population was categorized by cancer subtype, stage, patient age, and cause of death (COD). The percentage of cardiovascular CODs, odds ratio (ORs), 5-year cumulative crude probability of death, and standardized mortality ratios (SMRs) of each group were analyzed. RESULTS: Among 23,263 nonsurviving breast cancer patients, 5.8% died from cardiovascular disease, whereas the HER2+/HR+ and HER2+/HR- subtypes exhibited the highest ORs of cardiovascular death and percentages of cardiovascular CODs, at 8.21% and 6.55%, respectively. The cardiovascular SMR increased with advancing stages and decreasing patient age. The HER2+/HR- subtype had the highest cardiovascular SMR, at 0.83 (p < 0.05), followed by TNBC, at 0.78 (p < 0.05). The 5-year cumulative probability of cardiovascular CODs also showed the highest risk in the HER2+/HR- subtype (1.02 ± 0.11%) and the TNBC subtype (0.95 ± 0.07%). CONCLUSION: Breast cancer patients on chemotherapy face an elevated cardiovascular mortality risk, especially with aggressive subtypes (HER2-enriched, TNBC), advanced age, or HER2+/HR+ cancer receiving long-term treatment.

Cardiac metastasis mimicking STEMI-impact of point-of-care ultrasound on clinical decision-making: A case report.

Introduction: The manifestations of cardiac metastases are extremely variable depending on their location and extension. Case presentation: A 62-year-old man was admitted to the cardiac emergency department presenting with chest pain, worsening shortness of breath and palpitations. He had a history of esophageal squamous cell carcinoma treated with chemoradiotherapy, and he was not diagnosed with cardiovascular disease before. The electrocardiogram showed significant ST-segment elevations in leads II, III, and aVF. Initially, the patient was diagnosed with ST-segment elevation myocardial infarction. A cardiac point-of-care ultrasound was performed immediately revealing two large heterogeneous masses in the left ventricular wall and the apex, which changed the diagnosis and the management strategy. There was no significant change in serial cardiac biomarkers in the setting of persistent STE. Thoracic computed tomography and cardiac magnetic resonance confirmed that the patient was suffering from cardiac and lung metastases. Conclusion: ECG findings of localized and prolonged STE without Q waves or changes in biomarkers may suggest myocardial tumor invasion, especially in the cancer setting. Cardiac point-of-care ultrasound is an effective, convenient, noninvasive imaging modality to guide real-time clinical decision-making.

Anomaly Detection in Automatic Meter Intelligence System Using Positive Unlabeled Learning and Multiple Symbolic Aggregate Approximation.

With the development of automatic electrical devices in smart grids, the data generated by time and transmitted are vast and thus impossible to control consumption by humans. The problem of abnormal detection in power consumption is crucial in monitoring and controlling smart grids. This article proposes the detection of electrical meter anomalies by detecting abnormal patterns and learning unlabeled data. Furthermore, a framework for big data and machine learning-based anomaly detection framework are introduced. The experimental results show that the time series anomaly detection for electric meters has better results in accuracy and time than the expert alternatives.

Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam.

BACKGROUND: The Mobile Continuing Medical Education (mCME) 2.0 project was a randomized controlled trial that found that a 6-month text message-based CME intervention improved both the use of online medical training resources and medical knowledge among a cadre of HIV clinicians in Vietnam. This companion study analyzed intervention costs and cost-effectiveness. METHODS: We conducted (1) a financial analysis based on costs incurred during the trial's planning and implementation; (2) an economic analysis to consider resource utilization; and (3) cost-effectiveness analyses to estimate cost inputs relative to impact: increase in self-study (measured by visits to online courses) and increase in knowledge (measured by exam score improvement) (in 2016 US$). Finally, we estimated the economic cost of a 9-month national program and a 10-year scaled-up model (in 2021 US$). RESULTS: The total financial cost of the intervention was US$49,552; the main cost drivers were personnel time (71.4%) and technology inputs (14.9%). The total economic cost was estimated at US$92,212, with the same key cost inputs (representing 77.7% and 8.0%, respectively, of total costs). The financial cost per 10% increase in accessing online courses was US$923, while the cost of improving knowledge, measured by a 10% improvement in mean exam score across the study population, was US$32,057 (US$605 per intervention clinician). The comparable total economic cost of each improvement, respectively, was US$1,770 and US$61,452 (US$1,159 per intervention clinician). A future 9-month national program was estimated to cost US$37,403, while the full 10-year scaled-up program was estimated at US$196,446. CONCLUSIONS: This analysis indicates that leveraging mobile technology could be a feasible way to provide distance learning to health professions across Vietnam at a relatively low cost. Given the need for practical ways to expand CME in resource-constrained regions of the world, this approach warrants further study and possible adoption.

Risk factors for cutaneous reactions to allopurinol in Kinh Vietnamese: results from a case-control study.

OBJECTIVE: The aim of this study was to investigate risk factors for cutaneous adverse reactions (CARs) in Kinh Vietnamese. METHODS: All patients were prospectively recruited in Ho Chi Minh City. Presence of the HLA-B*58:01 allele was determined by real-time PCR-sequence-specific amplification by using the PG5801 Detection Kit (Pharmigene, Taipei). Patients with severe (SCARs) and mild (MCARs) CARs and controls were compared for differences in features prospectively collected, and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. RESULTS: On comparing 32 patients with SCARs and 395 tolerant controls, we identified eight strong risk factors: increased age (OR 15.1 [95% CI 5.8-40.1], P < 0.0001), female sex (OR 333 [40-43,453], P < 0.0001), allopurinol for asymptomatic hyperuricemia (OR 955 [120-125,847], P < 0.0001), allopurinol starting dose > 150 mg (OR 316 [101-122], P < 0.0001), diuretics intake (OR 304 [35-40,018], P < 0.0001), eGFR < 60 ml/min/1.73 m2 (OR 100 [32-353], P < 0.0001), history of allopurinol-induced skin reaction (OR 78 [6-10,808], P = 0.004), and HLA-B*58:01 carriage (OR 147 [45-746], P < 0.0001). HLA-B*58:01 allele frequency in controls was 7.3%. For MCARs (n = 74), risk factors were eGFR < 60 ml/min/1.73 m2 (OR 4.9 [1.61-14.6], P = 0.006), history of allopurinol-induced skin reaction (OR 27 [2-3777], P = 0.01), and asymptomatic hyperuricemia (OR 27 [2-3777], P = 0.01). CONCLUSION: This study confirmed 8 risk factors, including HLA-B*58:01, for SCARs and identified 3 risk factors for MCARs in Kinh Vietnamese. HLA-B*58:01 genotyping could guide the indication for allopurinol in Kinh Vietnamese patients with gout.

The cost-effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of brain metastasis in Vietnam from the perspective of patients and families.

BACKGROUND: This study aims to evaluate the cost-effectiveness of the treatment of brain metastasis with surgical resection (SR) and stereotactic radiosurgery (SRS) in the lower-middle-income country of Vietnam from the perspective of patients and families. METHODS: The treatment of 111 patients with brain metastases who underwent SR (n = 64) and SRS (n = 47) was retrospectively reviewed. Propensity score matching was used to adjust for selection bias (n = 30 each); mean and curves of survival time were defined by the Kaplan-Meier estimator; the cost analysis focused on the time period of relevant treatment. RESULTS: The mean survival times of SRS and SR were 11.9 and 10.5 months, and the 18-month survival rates were 32% and 14%, respectively (P = 0.346). The mean number of hospital bed days was significantly higher for SR than SRS (16.5 versus 7.6 days, P < 0.05), but direct costs of SR were significantly lower (14.5 as opposed to 35.3 million Vietnamese dong [VND] per patient, P < 0.001). However, indirect costs of SR were 10 times higher (26.0 versus 2.5 million VND per patient, P < 0.001). The cost per life year gained was higher for SR than SRS (46.4 and 38.1 million VND, respectively). CONCLUSIONS: SRS is similarly effective as SR. However, in the broader context of the cost-effectiveness from the perspective of patients and their families, SRS is more cost-effective. The lower costs directly charged by the hospital for SR may prevent poorer and older patients from choosing SRS. Thus, the overall cost-effectiveness of each treatment option should be taken into consideration in deciding on the treatment.