Choline in pregnant women: a systematic review and meta-analysis.

CONTEXT: Choline is a critical nutrient. Inadequate choline intake during pregnancy increases the risk of adverse maternal and offspring health. OBJECTIVE: A systematic review and meta-analysis were conducted to examine the current recommendations for choline intake by pregnant women, estimate the overall prevalence of pregnant women with adequate choline intake, and explore associations between maternal choline level and adverse pregnancy outcomes (APOs). METHODS: Choline recommendations for pregnant women were assessed from eight nutrient guidelines of the United States, United Kingdom, Canada, Australia, Asia, International Federation of Gynecology and Obstetrics, and World Health Organization. Data on the prevalence of pregnant women with adequate choline intake and the association between maternal choline level and APOs were collected from 5 databases up to May 2023. Meta-analyses with random effects and subgroup analyses were performed for the pooled estimate of prevalence and association. RESULTS: Five recent nutrition guidelines from the United States (United States Department of Agriculture), United States (Food and Drug Administration), Canada, Australia, and the International Federation of Gynecology and Obstetrics have emphasized the importance of adequate choline intake for pregnant women. Of 27 publications, 19 articles explored the prevalence and 8 articles explored the association. Meta-analysis of 12 prevalence studies revealed a concerning 11.24% (95% confidence interval, 6.34-17.26) prevalence of pregnant women with adequate choline intake recommendations. A meta-analysis of 6 studies indicated a significant association between high maternal choline levels and a reduced risk of developing APOs, with an odds ratio of 0.51 (95% confidence interval, 0.40-0.65). CONCLUSION: The existing guidelines highlight the importance of choline in supporting maternal health and fetal development during pregnancy. Furthermore, a high maternal choline level was likely to be associated with a lower risk of APOs. However, 88.76% of pregnant women do not achieve the optimal choline intake. Therefore, specific policies and actions may be necessary to improve choline intake in pregnant women's care and support the well-being of pregnant women. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CDR42023410561.

Analysis of factors affecting the adoption of IFRS in an emerging economy.

This study examines the factors that facilitate or impede the voluntary adoption of International Financial Reporting Standards (IFRS) in an emerging market. We propose practical solutions that are necessary for successful IFRS implementation in enterprises. To collect research data, we surveyed 350 enterprises in Vietnam using a non-probability convenience sampling method. Using qualitative research methods (through case studies and expert surveys) combined with quantitative and structural equation modelling (SEM), this study analyses the causal relationship between the influencing factors and enterprises' willingness to apply IFRS voluntarily. Evidence indicates that compliance with accounting regulations and principles, qualifications and experience of accountants, accounting regimes and government circulars, capabilities and perceptions of managers, and the benefits of IFRS adoption positively impact the application of IFRS. In addition, the factors of firm size and audit activities have a positive effect on promoting the willingness of enterprises to apply IFRS, while tax pressure and accounting psychology negatively affect the application of IFRS. By contrast, tax pressure and accounting psychology harm the application of IFRS. The study has limitations regarding the sample size, geographical scope, and sampling method. Even so, together with other studies drawn in alternative contexts, our findings are helpful to account for policymakers, regulators and businesses in different emerging countries to adopt IFRS in their countries successfully. The new insights gained in this study can help overcome the limitations of the conventional IFRS approach and design appropriate policies and roadmaps to improve the applicability of IFRS. The present study contributes significantly to the theory and practice at the end of the preparatory phase and the beginning of the voluntary phase of IFRS adoption in Vietnam. This is also the period where Vietnamese policymakers have announced their strategic plan for full IFRS adoption by 2025.

Improvement of Hydrophilicity for Polyamide Composite Membrane by Incorporation of Graphene Oxide-Titanium Dioxide Nanoparticles.

In this work, the polyamide (PA) membrane surface has been modified by coating of nanomaterials including graphene oxide (GO) and titanium dioxide (TiO2) to enhance membrane separation and antifouling properties. The influence of surface modification conditions on membrane characteristics has been investigated and compared with a base membrane. Membrane surface properties were determined through scanning electron microscope (SEM) images and Fourier transform infrared-attenuated total reflectance (FTIR-ATR) spectroscopy. Membrane separation performance was determined through the possibility for the removal of methylene blue (MB) in water. Membrane antifouling property was evaluated by the maintained flux ratios (%) after 120 minutes of filtration. The experimental results showed that the appearance of hydrophilic groups after coating of GO and TiO2 nanocomposite materials with or without UV irradiation onto membrane surface made an improvement in the separation property of the coated membranes. The membrane flux increased from 28% to 61%; meanwhile, the antifouling property of the coated membranes was improved clearly, especially for UV-irradiated PA/GO-TiO2 membrane.

Characterization and outcome of 41 patients with beta-ketothiolase deficiency: 10 years' experience of a medical center in northern Vietnam.

Beta-ketothiolase (T2) deficiency is an inherited disease of isoleucine and ketone body metabolism caused by mutations in the ACAT1 gene. Between 2005 and 2016, a total of 41 patients with T2 deficiency were identified at a medical center in northern Vietnam, with an estimated incidence of one in 190,000 newborns. Most patients manifested ketoacidotic episodes of varying severity between 6 and 18 months of age. Remarkably, 28% of patients showed high blood glucose levels (up to 23.3 mmol/L). Ketoacidotic episodes recurred in 43% of patients. The age of onset, frequency of episodes, and identified genotype did not affect patient outcomes that were generally favorable, with the exception of seven cases (five died and two had neurological sequelae). Custom-tailored acute and follow-up management was critical for a positive clinical outcome. Two null mutations, c.622C>T (p.Arg208*) and c.1006-1G>C (p.Val336fs), accounted for 66% and 19% of all identified ACAT1 mutant alleles, respectively. Most patients showed characteristic biochemical abnormalities. A newborn screening program could be expected to have a high yield in Vietnam. Investigation findings of haplotypes linked to the most common ACAT1 mutation (c.622C>T) are consistent with an ancient common founder of mutation-bearing chromosomes belonging to the Kinh ethnic population. The direct management and long-term follow-up of a large number of T2-deficient patients enabled us to study the natural history of this rare disease.

A common mutation, R208X, identified in Vietnamese patients with mitochondrial acetoacetyl-CoA thiolase (T2) deficiency.

Mitochondrial acetoacetyl-CoA thiolase (T2) deficiency is an inborn error of metabolism affecting isoleucine catabolism and ketone body utilization. This disorder is clinically characterized by intermittent ketoacidotic episodes with no clinical symptoms between episodes. In general, T2 gene mutations are heterogeneous. No common mutations have been identified and more than 70 mutations have been identified in 70 patients with T2 deficiency (including unpublished data). We herein identified a common mutation, R208X, in Vietnamese patients. We identified R208X homozygously in six patients and heterozygously in two patients among eight Vietnamese patients. This R208X mutation was also identified heterozygously in two Dutch patients, however, R208X mutant alleles in the Vietnamese have a different haplotype from that in the Dutch, when analyzed using Msp I and Taq I polymorphisms in the T2 gene. The R208X mutant allele was not so frequent in the Vietnamese since we could not find that mutant allele in 400 healthy Vietnamese controls using the Nla III restriction enzyme assay. DNA diagnosis of T2 deficiency may be applicable to the Vietnamese population.

Comparative study on deletions of the dystrophin gene in three Asian populations.

The frequency and distribution of deletions of 19 deletion-prone exons clustered in two hot spots in the proximal and central regions of the dystrophin gene were compared in three populations from Singaporean, Japan, and Vietnam. DNA samples obtained from 105 Singaporean, 86 Japanese, and 34 Vietnamese Duchenne muscular dystrophy patients were examined by polymerase chain reaction amplification. Deletions of the examined exons were found in 51.2% of Japanese patients but in 40.0% or less of the Singaporeans and Vietnamese. About two thirds of the deletions were localized in the central region and the remaining deletions were clustered at the proximal region. The most commonly deleted exons at the central deletion hot spot were exon 50 in the Singaporean, exons 49 and 50 in the Japanese, and exon 51 in the Vietnamese population. At the proximal deletion hot spot, the most commonly deleted exons were exons 6 and 8 in the Singaporeans, exons 12 and 17 in the Japanese, and exons 8 and 12 in the Vietnamese. Two cases each from Singapore and Japan had large-scale gross mutations spanning both deletion hot spots. Our results suggest that, although the presence and frequency of the two deletion hot spots may be similar in the three Asian populations analyzed, the distribution and frequency of deletions among the different exons can vary as a result of population-specific intronic sequences that predispose individuals to preferential deletion breakpoints.