Concomitant tricuspid valve regurgitation repair in patients with minimally invasive mitral valve surgery: a single-centre experience in Vietnam.

Background: This study aims to present the early and mid-term outcomes of combining minimally invasive mitral valve surgery (MIMVS) with tricuspid valve repair (TVR) at the authors' centre. Methods: From January 2017 to March 2022, our centre treated a total of 67 patients with both MIMVS and TVR. Among these patients, 41 were women (61.2%), and 26 were men (38.8%). The average Euro SCORE II was 2.67±1.54%, and the patients had an average follow-up period of 25.45±16.2 months. Results: Pre-discharge echocardiography revealed no or mild TR in 82.8% of cases. The overall 30-day mortality rate was 4.5%, with 3 deaths. Five-year survival was 94.5%±3.2%. In patients with mild or moderate preoperative tricuspid regurgitation (TR), the 5-year survival rate was 95.7%±4.3%, while for those with severe TR, it was 93.7%±4.5% (P=0.947). Conclusions: The authors' 5-year experience demonstrates that the combination of MIMVS and TVR can be routinely performed with favourable perioperative and postoperative outcomes in patients undergoing non-high-risk surgery. Additionally, there is no significant difference in five-year survival between the severe TR and mild to moderate TR groups preoperatively.

Joint genotypic and phenotypic outcome modeling improves base editing variant effect quantification.

CRISPR base editing screens enable analysis of disease-associated variants at scale; however, variable efficiency and precision confounds the assessment of variant-induced phenotypes. Here, we provide an integrated experimental and computational pipeline that improves estimation of variant effects in base editing screens. We use a reporter construct to measure guide RNA (gRNA) editing outcomes alongside their phenotypic consequences and introduce base editor screen analysis with activity normalization (BEAN), a Bayesian network that uses per-guide editing outcomes provided by the reporter and target site chromatin accessibility to estimate variant impacts. BEAN outperforms existing tools in variant effect quantification. We use BEAN to pinpoint common regulatory variants that alter low-density lipoprotein (LDL) uptake, implicating previously unreported genes. Additionally, through saturation base editing of LDLR, we accurately quantify missense variant pathogenicity that is consistent with measurements in UK Biobank patients and identify underlying structural mechanisms. This work provides a widely applicable approach to improve the power of base editing screens for disease-associated variant characterization.

Synthesis, crystal structure and Hirshfeld surface analysis of 2-({5-[(naphthalen-1-yl)meth-yl]-4-phenyl-4H-1,2,4-triazol-3-yl}sulfan-yl)-1-(4-nitro-phen-yl)ethanone.

The title compound, C27H20N4O3S, crystallizes in the monoclinic system, space group P21/n, with Z = 4. The global shape of the mol-ecule is determined by the orientation of the substituents on the central 4H-1,2,4-triazole ring. The nitro-phenyl ring, phenyl ring, and naphthalene ring system are oriented at dihedral angles of 82.95 (17), 77.14 (18) and 89.46 (15)°, respectively, with respect to the triazole ring. The crystal packing features chain formation in the b-axis direction by S⋯O inter-actions. A Hirshfeld surface analysis indicates that the highest contributions to surface contacts arise from contacts in which H atoms are involved.

Concomitant Surgical Ablation for Treatment of Atrial Fibrillation in Patients Undergoing Minimally Invasive Mitral Valve Surgery: A Single-Center Experience in Vietnam.

BACKGROUND: This study presents the early and midterm outcomes of combining atrial fibrillation (AF) treatment with minimally invasive mitral valve surgery (MIMVS) at our center. METHODS: From January 2017 to June 2022, our center treated a total of 86 patients with both MIMVS and surgical AF ablation. The patient cohort included 62 women (72.1%) and 24 men (27.9%). The average EuroScore II was 2.64 ± 1.49%, and the patients were followed up for an average period of 46.31 ± 9.84 months. RESULTS: Postoperatively, 95.3% of patients experienced a change in sinus rhythm, and 86.2% were discharged in sinus rhythm. The hospital's mortality rate was 2.3%, with a late mortality rate of 3.5%. Survival analysis revealed an atrial fibrillation-free 5-year follow-up rate of 59.1 ± 9.1%. The 5-year survival rate was 92.7 ± 3.3%. CONCLUSION: Our 5-year experience demonstrates that the combination of MIMVS and surgical AF ablation can be routinely performed with favorable peri- and postoperative outcomes. This reflects our hospital's culture and guidance on patient selection, particularly when adopting minimally invasive approaches for multiple procedures.

Coffee Husk By-Product as Novel Ingredients for Cascara Kombucha Production.

Kombucha, a fermented beverage, is gaining popularity due to its numerous beneficial health effects. Various substrates such as herbs, fruits, flowers, and vegetables, have been used for kombucha fermentation in order to enhance the flavor, aroma, and nutritional composition. This study aims to investigate the potential suitability of cascara as a novel ingredient for kombucha production. Our findings suggested that cascara is a suitable substrate for kombucha production. Fermentation elevated the total phenolic and flavonoid content in cascara, which enhanced the antioxidant, antibacterial, and prebiotic characteristics of the product. Furthermore, the accumulation of acetic acid-induced the pH lowering reached 2.7 after 14 days of fermentation, which achieved the microbiological safety of the product. Moreover, 14 days of fermentation resulted in a balanced amalgamation of acidity, sweetness, and fragrance according to sensory evaluation. Our findings not only highlight the potential of cascara kombucha as a novel substrate for kombucha production but also contribute to repurposing coffee by-products, promoting environmentally friendly and sustainable agricultural development.

Sustainability, performance, and production perspectives of waste-derived functional carbon nanomaterials towards a sustainable environment: A review.

The survival of humanity is severely threatened by the massive accumulation of waste in the ecosystem. One plausible solution for the management and upcycling of waste is conversing waste at the molecular level and deriving carbon-based nanomaterial. The field of carbon nanomaterials with distinctive properties, such as exceptionally large surface areas, good thermal and chemical stability, and improved propagation of charge carriers, remains a significant area of research. The study demonstrates recent developments in high-value carbon-based photocatalysts synthesis from various waste precursors, including zoonotic, phytogenic, polyolefinic, electronic, and biomedical, highlighting the progression as photocatalysts and adsorbents for wastewater treatment and water splitting applications. This review highpoints the benefits of using waste as a precursor to support sustainability and circular economy and the risks associated with their use. Finally, we support that a sustainable society will eventually be realized by exploring present obstacles and potential steps for creating superior carbon-based nanomaterials in the future.

Successful surgical management of large pulmonary artery thrombosis in a patient with primary severe mitral regurgitation and complex congenital heart disease: A case report.

INTRODUCTION: Pulmonary artery thrombosis presents a rare and formidable challenge, especially in individuals with untreated complex congenital heart diseases and concurrent valvular abnormalities. PRESENTATION OF CASE: This case details a distinctive instance of pulmonary artery thrombosis in a patient with untreated congenital atrial septal defect, severe pulmonary hypertension, pulmonary aneurysm, valvular heart disease, and triple-positive antiphospholipid antibodies. Collaborative decision-making by a heart team guided the diagnostic and therapeutic processes, resulting in surgical interventions encompassing pulmonary thrombectomy, mitral and tricuspid regurgitation repair, and atrial septal defect closure. DISCUSSION: The case underscores the nuanced management of pulmonary artery thrombosis within the realm of congenital heart disease, highlighting the imperative role of a multidisciplinary approach in achieving accurate diagnoses and timely interventions. The multifaceted treatment strategy implemented further accentuates the need for continual monitoring and personalized interventions in intricate clinical scenarios. CONCLUSION: In conclusion, this case emphasizes the complexity of addressing pulmonary artery thrombosis in the context of congenital heart disease. The collaborative efforts of a multidisciplinary team proved pivotal in navigating diagnostic uncertainties and formulating a tailored treatment plan. Ongoing monitoring and personalized strategies remain crucial for optimizing outcomes in such intricate cases.

Coronary Artery Bypass Surgery: Evidence-Based Practice.

Coronary artery bypass graft (CABG) surgery remains a pivotal cornerstone, offering established symptomatic alleviation and prognostic advantages for patients grappling with complex multivessel and left main coronary artery diseases. Despite the lucid guidance laid out by contemporary guidelines regarding the choice between CABG and percutaneous coronary intervention (PCI), a notable hesitation persists among certain patients, characterized by psychological reservations, knowledge gaps, or individual beliefs that sway their inclination toward surgical intervention. This comprehensive review critically synthesizes the prevailing guidelines, modern practices, and outcomes pertaining to CABG surgery, delving into an array of techniques and advancements poised to enhance both short-term and enduring surgical outcomes. The exploration encompasses advances in on-pump and off-pump procedures, conduit selection strategies encompassing the bilateral utilization of internal mammary artery and radial artery conduits, meticulous graft evaluation methodologies, and the panorama of minimally invasive approaches, including those assisted by robotic technology. Furthermore, the review navigates the terrain of hybrid coronary revascularization, shedding light on the pivotal roles of shared decision-making and the heart team in shaping treatment pathways. As a comprehensive compendium, this review not only navigates the intricate landscape of CABG surgery but also aligns it with contemporary practices, envisioning its trajectory within the evolving currents of healthcare dynamics.

Adoption of minimally invasive mitral valve surgery: single-centre implementation experience in Vietnam.

The adoption of minimally invasive mitral valve surgery (MIMVS) has become a prominent trend in mitral valve procedures. This article emphasizes that the success of the MIMVS program relies not only on effective teamwork but also on comprehensive hospital support and a clearly defined training strategy. Additionally, targeted marketing initiatives that highlight the value of the heart valve centre are crucial for sustaining the program's success and attracting a consistent patient flow. The implementation of these strategies requires diligent execution, consistent maintenance, and continuous improvement to ensure the triumph of the MIMVS program. This article aims to share our experience in implementing MIMVS at our centre, providing valuable insights for centres that have yet to adopt this approach or have low adoption rates. While acknowledging that sharing our centre's experience cannot guarantee success in all centres, customizing the implementation by selecting appropriate features and access points is vital. Each centre may encounter unique challenges, and tailoring the strategy to address specific needs will enhance the effectiveness of the MIMVS program.

Joint genotypic and phenotypic outcome modeling improves base editing variant effect quantification.

CRISPR base editing screens are powerful tools for studying disease-associated variants at scale. However, the efficiency and precision of base editing perturbations vary, confounding the assessment of variant-induced phenotypic effects. Here, we provide an integrated pipeline that improves the estimation of variant impact in base editing screens. We perform high-throughput ABE8e-SpRY base editing screens with an integrated reporter construct to measure the editing efficiency and outcomes of each gRNA alongside their phenotypic consequences. We introduce BEAN, a Bayesian network that accounts for per-guide editing outcomes and target site chromatin accessibility to estimate variant impacts. We show this pipeline attains superior performance compared to existing tools in variant classification and effect size quantification. We use BEAN to pinpoint common variants that alter LDL uptake, implicating novel genes. Additionally, through saturation base editing of LDLR, we enable accurate quantitative prediction of the effects of missense variants on LDL-C levels, which aligns with measurements in UK Biobank individuals, and identify structural mechanisms underlying variant pathogenicity. This work provides a widely applicable approach to improve the power of base editor screens for disease-associated variant characterization.

Synthesis of Inexpensive Ternary Metal Oxides by a Co-Precipitation Method for Catalytic Oxidation of Carbon Monoxide.

By using a simple co-precipitation method, new Fe2 O3 -based nanocatalysts (samples) were synthesized. The samples were composites of two or three transition metal oxides, MOx (M=Fe, Mn, Co, Ni, and Cu). The average size of CuO crystallites in the composites composed of two oxide components (CuO-Fe2 O3 ) was about 14.3 nm, while in those composed of three (CuO-MnOx -Fe2 O3 ), the composite's phase compositions were almost in the amorphous form when annealing the sample at 300 °C. The latter sample had a specific surface area higher than that of the former, 207.9 and 142.1 g/m2 , respectively, explaining its higher catalytic CO oxidation. The CO conversion over the CuO-MnOx -Fe2 O3 -300 catalyst (1 g of catalyst, 2600 ppm of CO concentration in air, and 1.0 L/min of gas flow rate) begins at about 40 °C; the temperature for 50 % CO conversion (t50 ) is near 82 °C; and CO removal is almost complete at t99 ≈110 °C. The activity of the optimal sample was tested in different catalytic conditions, thereby observing a high durability of 99-100 % CO conversion at 130 °C. The obtained results were derived from XRD, FTIR, BET, SEM, elemental analysis and mapping, as well as catalytic experiments.

Mathematical modeling of dark fermentative hydrogen and soluble by-products generations from water hyacinth.

The production of hydrogen and soluble metabolite products from water hyacinth via dark fermentation was modeled. The model was built on the assumption that the substrate exists in two forms (i.e., soluble and particulate) and undergoes two stages (i.e., hydrolysis and acidogenesis) in the dark fermentation process. The modified Michaelis-Menten and surface-limiting models were applied to describe the hydrolysis of soluble and particulate forms, respectively. Meanwhile, the acidogenesis stage was modeled based on the multi-substrate-single-biomass model. The effects of temperature, pH, and substrate concentration were integrated into the model to increase flexibility. As a result, the model prediction agreed with the experimental and literature data of water hyacinth-fed dark fermentation, with high coefficient of determination values of 0.92 - 0.97 for hydrogen and total soluble metabolite products. These results indicate that the proposed model could be further applied to dark fermentation's downstream and hybrid processes using water hyacinth and other substrates.

High-Performance Uncooled Mid-Infrared Detector Based on a Polycrystalline PbSe/CdSe Heterojunction.

Developing high-performance, uncooled mid-wavelength infrared (MWIR) detectors is a challenging task due to the inherent physical properties of materials and manufacturing technologies. In this study, we designed and manufactured an uncooled polycrystalline PbSe/CdSe heterojunction photovoltaic (PV) detector through vapor physical deposition. The resulting 10 µm × 10 µm device exhibited a peak detectivity of 7.5 × 109 and 3 × 1010 cm·Hz1/2·W-1 at 298 and 220 K, respectively, under blackbody radiation. These values are comparable to those of typical PbSe photoconductive detectors fabricated through standard chemical bath deposition. Additionally, the sensitization-free process used to create these PbSe/CdSe PV detectors allows for high replicability and yield, making them promising candidates for low-cost, high-performance, uncooled MWIR focal plane array imaging in commercial applications.

Prevalence of periodontal disease among Vietnamese adults: A systematic review and meta-analysis.

To synthesize previous findings on the prevalence of periodontal disease (PD) in the adult Vietnamese population, a search for peer-reviewed literature was conducted using the MEDLINE, PubMed and Scopus databases through January 10, 2022. Two reviewers individually assessed abstracts and full-text articles to determine their suitability for inclusion. Only English articles were included if their results described the prevalence of PD among the Vietnamese. Among 900 potential studies, 8 cross-sectional studies with 7,262 adult participants qualified to be included. We found that overall the prevalence of PD was 64.9% (95% confidence interval (CI): 45-81%), with very high heterogeneity across the observed prevalence estimates (Q = 1,204.8776; df = 7; p < 0.001; I2 = 99.42%). Further subgroup analyses stratified by age, location, sampling, study design, and region also revealed significant differences, with a higher prevalence of PD among (1) population-based studies, (2) participants aged ≥65 years, (3) participants with non-chronic diseases, (4) studies using the WHO, community periodontal index (CPI) and standard oral examinations, (5) studies conducted in Central Vietnam, and (6) studies using randomization sampling (p < 0.01) than in other populations. Sensitivity analyses validated the stability of the current findings. Within the limits of the available evidence, this meta-analysis showed a high percentage of Vietnamese adults suffer from PD. Nonetheless, the findings should be taken cautiously due to the limited number of published articles and the possibility of bias in the included research. More well-designed studies with larger sample sizes are thus required for further verification.

Phylogeography as a Proxy for Population Connectivity for Spatial Modeling of Foot-and-Mouth Disease Outbreaks in Vietnam.

Bayesian space-time regression models are helpful tools to describe and predict the distribution of infectious disease outbreaks and to delineate high-risk areas for disease control. In these models, structured and unstructured spatial and temporal effects account for various forms of non-independence amongst case counts across spatial units. Structured spatial effects capture correlations in case counts amongst neighboring provinces arising from shared risk factors or population connectivity. For highly mobile populations, spatial adjacency is an imperfect measure of connectivity due to long-distance movement, but we often lack data on host movements. Phylogeographic models inferring routes of viral dissemination across a region could serve as a proxy for patterns of population connectivity. The objective of this study was to investigate whether the effects of population connectivity in space-time regressions of case counts were better captured by spatial adjacency or by inferences from phylogeographic analyses. To compare these two approaches, we used foot-and-mouth disease virus (FMDV) outbreak data from across Vietnam as an example. We identified that accounting for virus movement through phylogeographic analysis serves as a better proxy for population connectivity than spatial adjacency in spatial-temporal risk models. This approach may contribute to design surveillance activities in countries lacking movement data.

Mercury waste from artisanal and small-scale gold mining facilities: a risk to farm ecosystems-a case study of Obuasi, Ghana.

Frequent discharge of mercury waste from artisanal and small-scale gold mining (ASGM) facilities into nearby farms may contaminate foodstuffs and the entire farms. High contamination levels may result in ecological risks to the soil, plants, animals, humans, and the entire farm ecosystem. This original research is the first study within the catchment areas that describes the effects of mercury waste on the entire farm ecosystem. In this study, the contamination levels and the associated ecological risks of farmland soils, plantains, and cassavas from farms sited near ASGM facilities in four communities around Obuasi, Ghana, were evaluated using the Hakanson (1980) model. Results showed that all samples except for the edible parts of plantains from Tweapease, Nyamebekyere, and Ahansonyewodea and plantain peels from Nyamebekyere and Ahansonyewodea were contaminated and may pose moderate to very high ecological risks. All farms were also contaminated and may pose considerable to very high ecological risks. The farms at Odumase were the highest contaminated with degree of contamination (Cdeg) above 20, while those at Ahansonyewodea were the least contaminated with Cdeg = 8.1. This meant that farms at Odumase may pose the highest potential ecological risk (Per) to plants, animals, humans, and the entire farm ecosystem since Per > 600, while the farms at Ahansonyewodea may pose the least ecological risks with Per = 324. There is, therefore, the need for strict control of ASGM activities in these study areas to preserve the integrity of the ecosystem.

Impact of Reference Mismatch on Procedure Outcomes of Percutaneous Coronary Intervention.

A significant mismatch between proximal and distal reference lumen diameters of the target lesion may pose challenges during percutaneous coronary intervention (PCI) and therefore influence the outcomes. We investigated total 1706 lesions underwent IVUS guided percutaneous coronary intervention, that were divided into 2 groups, including 411 lesions in Mismatch group and 1295 lesions in Non-Mismatch group. After propensity score matching, 397 lesions in each group were selected for final data set. The analysis showed that Mismatch group PCI required more frequently use of post-stenting optimization (79.6% vs 53.9%, P < .001) using higher max pressure (19.5 ± 3.9 vs 16.7 ± 3.7 atm, P < .001). Besides, Mismatch group also encountered more PCI major complications (7.8% vs 4.0%, P = .024) and lower procedure success rate (91.4% vs 95.5%, P = .022). On final angiogram, Mismatch group had smaller minimum lumen diameter (2.62 ± .45 vs 2.90 ± .57 mm, P < .001) and lower angiographic success rate (93.2% vs 96.7%, P = .023). On final IVUS, Mismatch group had higher rate of incomplete stent apposition and stent edge dissection (6.3% vs 3.0%, P = .029 and 2.5% vs .5%, P = .021, respectively). In conclusion, reference mismatch posed significant challenging during PCI that led to unfavorable procedural outcomes. These impacts may translate into long-term clinical implications that need to be addressed in future studies.

Multi-Strain Probiotics Enhance the Bioactivity of Cascara Kombucha during Microbial Composition-Controlled Fermentation.

Kombucha is a widely consumed fermented tea beverage with diverse health benefits. In a previous study, we demonstrated that the use of cascara as a substrate results in a special kombucha beverage with high bioactivity. Traditional kombucha fermentation using a symbiotic culture of bacteria and yeast (SCOBY) can lead to inconsistent product quality because of the lack of control over microbial composition. We successfully isolated and identified yeast and bacteria, including Saccharomyces cerevisiae, Komagataeibacter rhaeticus, and Lactobacillus brevis that are appropriate starter cultures for cascara kombucha fermentation. We also demonstrated that a supplementation with lactic acid bacteria (LAB) and a mixture of S. cerevisiae and K. rhaeticus resulted in higher total polyphenol and flavonoid content of cascara kombucha compared with the traditionally fermented product using SCOBY as the inoculum. The free radical scavenging activity, inhibitory effects on α-amylase, tyrosinase activity, and antibacterial properties of cascara kombucha were also enhanced as a result of LAB supplement. These findings provide valuable insights into the controlled microbiological composition required for the fermentation of cascara kombucha, thereby ensuring consistent quality and enhanced bioactivity of the product. Further, the use of cascara as a substrate for kombucha production not only offers various health benefits and biological effects, but also repurposes by-products from the coffee industry, which contributes to sustainable development and is eco-friendly.

Students' Perceived Well-Being and Online Preference: Evidence from Two Universities in Vietnam during COVID-19.

University education is still being impacted two years after the COVID-19 outbreak. We performed a rapid survey in February 2022 at two public universities in Vietnam to examine the effects of the pandemic on well-being and the factors that may associate with online class preference among university students as well as to investigate the need for support to improve resilience. A web-based survey included 1589 undergraduate students in total. Both quantitative and qualitative data analysis was carried out. Overall, approximately a quarter of respondents said that they perceived an influence on their health, 42.9% expressed stress, and more than 70% reported worrying about the future. In total, 61.9% of the respondents reported having satisfaction with online classes, while over half of them preferred a program of 50% online classes. Students who live in an urban area, are female, have had pre-COVID-19 campus life experience, have decreased income, and/or experience low online satisfaction and over-information may be in need of more support. The results show implications for universities to consider policies addressing well-being and post-pandemic online education. Providing support to university students to improve their resilience against the impact on their studying, campus life, health, and well-being should be prioritized during and post-pandemic.

Surgical treatment of tension pneumomediastinum in patients with covid-19 at the field hospital: a case series.

BACKGROUND: Tension pneumomediastinum is one of the most serious complications in COVID-19 patients with respiratory distress requiring invasive mechanical ventilation. This complication can lead to rapid hemodynamic instability and death if it is not recognized in a timely manner and intervenes promptly. CASE PRESENTATION: We reported 7 COVID-19 patients with tension pneumomediastinum at a field hospital. All patients were critically ill with ARDS. These 7 patients, including 3 females and 4 males in this series, were aged between 39 and 70 years. Tension pneumomediastinum occurred on the first day of mechanical ventilation in 3 patients and later in the course of hospital stay, even 10 days after being intubated and ventilated. The tension pneumomediastinum caused hemodynamic instability and worsened respiratory mechanics with imminent cardiopulmonary collapse. In this series, we used two surgical techniques: (i) mediastinal decompression by suprasternal drainage with or without simultaneous pleural drainage in the first two cases and (ii) mediastinal drainage via suprasternal and subxiphoid incisions in 5 patients. The surgical procedures were feasible and reversed the pending cardiopulmonary collapse. Four patients had a favorable postprocedural period and were discharged from the intensive care center. Both patients undergoing suprasternal drainage died of failed/recurrent tension pneumomediastinum and nosocomial infection. Only one in five patients who underwent mediastinal drainage via suprasternal and subxiphoid incisions died of septic shock secondary to ventilator-associated pneumonia. CONCLUSION: Tension pneumomediastinum was a life-threatening complication in critically ill COVID-19 patients requiring mechanical ventilation. Surgical mediastinal decompression was the salvage procedure. The surgical technique of mediastinal drainage via suprasternal and subxiphoid incisions proved an advantage in tension relief, hemodynamic improvement and mortality reduction.