Allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: Signal detection and preventability from Vietnam National pharmacovigilance database.

WHAT IS KNOWN AND OBJECTIVE: Allopurinol, the first-line medication for hyperuricemia is well-known for its association with severe cutaneous adverse reactions, especially Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). In the current study, we analysed the Vietnamese spontaneous reporting database to identify signals and preventability of allopurinol-induced SJS/TEN in Vietnam from 2010 to 2019. METHODS: Signal generation was assessed using the case/non-case method. Reporting odds ratios (RORs) and 95% confidence intervals (95% CI) were calculated. RESULTS: Among 72,822 spontaneous ADR reports submitted to the Vietnam National Drug Information and Adverse Drug Reaction Monitoring Centre, 392 reports were on SJS/TEN, of which, 65 cases (16.6%) were related to allopurinol. The signals of allopurinol-induced SJS/TEN in Vietnam started in 2014 (ROR of 3.531, 95% CI: 1.830-6.810) and annually increased until 2019 (ROR of 11.923, 95% CI: 8.508-16.710). The preventability assessment showed that no allopurinol-induced SJS/TEN case was definitely unpreventable. 61.6% of the SJS/TEN cases were avoidable because they were associated with inappropriate prescribing such as unapproved indications, too high initial dose and even rechallenging in patients with a history of allopurinol allergy. WHAT IS NEW AND CONCLUSION: The signals of allopurinol-induced SJS/TEN in Vietnam started in 2014 and annually increased until 2019. Our first report specifically focusing on the ADR preventability of allopurinol showed that correction of medical errors relating to prescription could prevent more than 60% of SJS/TEN cases in Vietnamese allopurinol users. This is a feasible and practical solution, provided that there would be a systematic change in both healthcare systems and public awareness.

Arabidopsis MAPKKK δ-1 is required for full immunity against bacterial and fungal infection.

The genome of Arabidopsis encodes more than 60 mitogen-activated protein kinase kinase (MAPKK) kinases (MAPKKKs); however, the functions of most MAPKKKs and their downstream MAPKKs are largely unknown. Here, MAPKKK δ-1 (MKD1), a novel Raf-like MAPKKK, was isolated from Arabidopsis as a subunit of a complex including the transcription factor AtNFXL1, which is involved in the trichothecene phytotoxin response and in disease resistance against the bacterial pathogen Pseudomonas syringae pv. tomato DC3000 (PstDC3000). A MKD1-dependent cascade positively regulates disease resistance against PstDC3000 and the trichothecene mycotoxin-producing fungal pathogen Fusarium sporotrichioides. MKD1 expression was induced by trichothecenes derived from Fusarium species. MKD1 directly interacted with MKK1 and MKK5 in vivo, and phosphorylated MKK1 and MKK5 in vitro. Correspondingly, mkk1 mutants and MKK5RNAi transgenic plants showed enhanced susceptibility to F. sporotrichioides. MKD1 was required for full activation of two MAPKs (MPK3 and MPK6) by the T-2 toxin and flg22. Finally, quantitative phosphoproteomics suggested that an MKD1-dependent cascade controlled phosphorylation of a disease resistance protein, SUMO, and a mycotoxin-detoxifying enzyme. Our findings suggest that the MKD1-MKK1/MKK5-MPK3/MPK6-dependent signaling cascade is involved in the full immune responses against both bacterial and fungal infection.

Effect of coatings containing 1-methylcyclopropane or mandarin peel extract on the freshness and metabolic profiles of cold stored strawberry.

The application of coatings is a strategy for maintaining the freshness of highly perishable fruits. This research aimed to evaluate the quality indices of strawberries (Amaou) coated with new coatings based on the sodium carboxymethyl cellulose (CMC) and cellulose nanofibres (CNF) with incorporated mandarin peel extract (ME) or 1-methylcyclopropene (1-MCP) during storage at 20days at 5 °C and 85% relative humidity (RH). Dissolving the coating solution containing ME in 1-MCP maintained its colour for up to 50 days. Coatings enhanced with ME and/or 1-MCP maintained fresh strawberries more effectively than the control, reducing weight loss and maintaining firmness, total soluble solids (TSS), citric acid, colour, and total phenolic content. The CCM2-2 coating solution showed superior effects on the weight loss and relative percentages of strawberry metabolites compared to the other coatings, as confirmed by the different components.

Persimmon preservation using edible coating of chitosan enriched with ginger oil and visualization of internal structure changes using X-ray computed tomography.

The incorporation of ginger oil (GO) influenced the physical, optical, and structural properties of the chitosan (CH) film including the decreases of moisture content (60.15 %), water solubility (35.37 %) and water vapor permeability (WVP) (32.79 %) and the increases of tensile strength (TS) (125 %), elongation at break (EAB) (2.74 %) and opacity (131.08 %). Antifungal capacity of the CH film was enhanced when GO was added to the film. The CH + GO film showed a less homogeneous surface that the presence of the oil droplets on the film surface. Moreover, the CH and CH + GO coatings reduced weight loss of persimmon by 14.87 %, and 21.13 %, respectively, compared to the control. Moisture content loss of the coated CH- and the coated CH + GO- persimmons was decreased by 1.94 % and 4.92 %, respectively, compared to that of the control persimmon. Furthermore, the CH and CH + GO coatings decreased in color changes, respiration rate, ethylene production, changes in pH and TSS, and remained firmness of persimmon during storage at 25 °C. In addition, X-ray CT images can be used to monitor internal changes and observe the tissue breakdown during storage period. The ΔGS value can be used as a predictor of persimmon internal qualities. Thus, the CH film containing GO can be applied as an active packaging material.

Improvement of cross-linked films based on chitosan/diepoxy-poly (ethylene glycol) incorporating trans-cinnamaldehyde essential oil: Preparation, properties, and application in banana storage.

In this study, development of bioactive coatings containing 1 % (w/v) chitosan (CS), 0.6 % (w/v) diepoxy-polyethylene glycol (PEG), and trans-cinnamaldehyde (CIN) was achieved. The physicochemical and biological properties of the coatings were investigated. The tensile strength, light transmission, water vapor permeability (WVP), and antibacterial properties were enhanced by the incorporation of CIN. The CIN-containing films appeared compact and rough, as observed using scanning electron microscopy (SEM) and atomic force microscopy (AFM). In addition, the quality attributes of the bananas were evaluated at room temperature for 24 days, and the results showed that the CS/PEG/CIN coating delayed the respiration peak, weight loss, sugar content loss, and maintained firmness, color, total soluble solids (TSS), titratable acid (TA), and the appearance of the bananas. Principal component analysis (PCA) revealed that the bioactive coating significantly affected the respiration rate and weight loss of bananas.

Nutritional status and dietary intake before hospital admission of pulmonary tuberculosis patients.

Conducting research on nutritional status and dietary intake of pulmonary tuberculosis patients is essential for developing interventions in clinical nutrition practice and treatment during hospitalization, which can improve the quality of patients life. This cross-sectional descriptive study aimed to determine nutritional status and some related factors (such as geography, occupation, educational level, economic classification, etc.) of 221 patients with pulmonary tuberculosis who were examined and treated at the Respiratory Tuberculosis Department, National Lung Hospital in July 2019-May 2020. The results showed that the risk of undernutrition: According to BMI (Body Mass Index): 45.8% of patients were malnourished, 44.2% normal and 10.0% overweight/obese. According to MUAC (Mid-Upper Arm Circumference): 60.2% of patients were malnourished, 39.8% of patients were normal. According to SGA (Subjective Global Assessment): 57.9% of patients were at risk of undernutrition, of which 40.7% were at moderate risk of undernutrition and 17.2% risk of severe undernutrition. Classification of nutritional status according to serum albumin index: 50% of patients were malnourished, the rate of undernutrition of mild, moderate and severe levels was 28.9%, 17.9% and 3.2%, respectively. Most patients eat with others and eat less than four meals a day. The average dietary energy of patients with pulmonary tuberculosis in was 1242.6 ± 46.5 Kcal and 1084 ± 57.9 Kcal, respectively. 85.52% of patients did not eat enough food, 4.07% had enough, 10.41% consumed excess energy. The ratio of energy-generating substances in the diet (Carbohydrate:Protein:Lipid) was on average 54:18:28 for males and 55:16:32 for females. Most of the study population had diets that did not meet the experimental study in terms of micronutrient content. Specifically, more than 90% do not meet the requirements for magnesium, calcium, zinc, and vitamin D. The water-soluble and fat-soluble vitamins respond poorly, only about 30-40%. Selenium is the mineral with the best response rate, above 70%. Our findings revealed that the majority of the study subjects had poor nutritional status, as evidenced by diets lacking in essential micronutrients.

Genomic characterization of endemic diarrheagenic Escherichia coli and Escherichia albertii from infants with diarrhea in Vietnam.

BACKGROUND: Diarrheagenic Escherichia coli (DEC) is a group of bacterial pathogens that causes life-threatening diarrhea in children in developing countries. However, there is limited information on the characteristics of DEC isolated from patients in these countries. A detailed genomic analysis of 61 DEC-like isolates from infants with diarrhea was performed to clarify and share the characteristics of DEC prevalent in Vietnam. PRINCIPAL FINDINGS: DEC was classified into 57 strains, including 33 enteroaggregative E. coli (EAEC) (54.1%), 20 enteropathogenic E. coli (EPEC) (32.8%), two enteroinvasive E. coli (EIEC) (3.3%), one enterotoxigenic E. coli (ETEC), and one ETEC/EIEC hybrid (1.6% each), and surprisingly into four Escherichia albertii strains (6.6%). Furthermore, several epidemic DEC clones showed an uncommon combination of pathotypes and serotypes, such as EAEC Og130:Hg27, EAEC OgGp9:Hg18, EAEC OgX13:H27, EPEC OgGp7:Hg16, and E. albertii EAOg1:HgUT. Genomic analysis also revealed the presence of various genes and mutations associated with antibiotic resistance in many isolates. Strains that demonstrate potential resistance to ciprofloxacin and ceftriaxone, drugs recommended for treating childhood diarrhea, accounted for 65.6% and 41%, respectively. SIGNIFICANCE: Our finding indicate that the routine use of these antibiotics has selected resistant DECs, resulting in a situation where these drugs do not provide in therapeutic effects for some patients. Bridging this gap requires continuous investigations and information sharing regarding the type and distribution of endemic DEC and E. albertii and their antibiotic resistance in different countries.

Reassessing the most popularly suggested measurement models and measurement invariance of the Maslach Burnout Inventory - human service survey among Vietnamese healthcare professionals.

BACKGROUND: Despite its popularity, Maslach Burnout Inventory-Human Service Survey (MBI-HSS)'s factorial structure has been subject to considerable debate, and its measurement invariance (MI) is seldomly examined. This cross-sectional study aims at reassessing the most popularly suggested structures of this instrument, namely the 20- and 22-item three-factor model on Vietnamese healthcare professionals. It also examines the MI of MBI-HSS across genders, occupations, and mental health conditions. METHOD: Self-administered questionnaires were sent out to 1500 doctors and nurses working at 15 hospitals in big cities in Vietnam in September and October 2020, and 1162 valid questionnaires were collected. The questionnaire consists of three sets of questions covering (1) demographic information of participants; (2) MBI-HSS questionnaire; and (3) The 21-item version of the Depression-Anxiety-Stress Scale. MBI-HSS scale was validated on Vietnamese sample for the first time; therefore, we used the repeated forward-backward procedure to translate this scale into Vietnamese. To examine which model best fits the data, a series of Confirmatory Factor Analysis (CFA) was used to test the model fit of correlated three-factor model, second-order hierarchical model, and bi-factor model. The reliability of the MBI-HSS was assessed using Cronbach's α coefficients. Then, multiple-group CFA (MGCFA) was applied to determine whether the MBI-HSS has a similar structure between groups different in gender, occupation, and mental health condition. RESULTS: Our findings confirmed that the 22-item MBI-HSS best fit the data, and this scale measures three distinct but related aspects of burnout, including Emotional Exhaustion, Depersonalization, and Personal Accomplishment. The MI of MBI-HSS across genders and occupations was also confirmed. However, data did not fit well with group at risk for common mental health disorders. It can be concluded that the Vietnamese version of MBI-HSS is a valid measure to assess burnout level of healthcare professionals in Vietnam who are not at risk for mental health disorders.

On-chip silicon photonic controllable 2 × 2 four-mode waveguide switch.

Multimode optical switch is a key component of mode division multiplexing in modern high-speed optical signal processing. In this paper, we introduce for the first time a novel 2 × 2 multimode switch design and demonstrate in the proof-of-concept. The device composes of four Y-multijunctions and 2 × 2 multimode interference coupler using silicon-on-insulator material with four controllable phase shifters. The shifters operate using thermo-optic effects utilizing Ti heaters enabling simultaneous switching of the optical signal between the output ports on four quasi-transverse electric modes with the electric power consumption is in order of 22.5 mW and the switching time is 5.4 µs. The multimode switch exhibits a low insertion loss and a low crosstalk below - 3 dB and - 19 dB, respectively, in 50 nm bandwidth in the third telecom window from 1525 to 1575 nm. With a compact footprint of 10 µm × 960 µm, this device exhibits a relatively large width tolerance of ± 20 nm and a height tolerance of ± 10 nm. Furthermore, the conceptual principle of the proposed multimode switch can be reconfigurable and scalable in multifunctional on-chip mode-division multiplexing optical interconnects.

Removal of Lindane from Aqueous Solution Using Aluminum Hydroxide Nanoparticles with Surface Modification by Anionic Surfactant.

In the present study, we investigated the removal of an emerging pesticide lindane from aqueous solution using synthesized aluminum hydroxide Al(OH)3 (bayerite) nanomaterials with surface modification by an anionic surfactant sodium dodecyl sulfate (SDS). The Al(OH)3 nanoparticles were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), Brunauer-Emmett-Teller (BET) and zeta potential. The lindane removal using SDS-modified nano-aluminum hydroxide nanoparticles (SMNAH) achieved removal of up to 93.68%, which was 3.3 times higher than that of nano-aluminum hydroxide nanoparticles. The adsorptive removal conditions were studied and found to have an adsorption time of 60 min, a pH of 6, an adsorbent dosage of 25 mg/mL and an ionic strength of 10 mM NaCl. After reusing four times, the removal efficiency of lindane using SMNAH still reached 75%. Two-step adsorption can fit adsorption isotherms of lindane onto SMNAH at two salt concentrations. On the basis of the change in zeta potential, surface functional groups and adsorption isotherms, we suggest that the formation of a bilayer micelle induced the removal of lindane.

Adsorptive Removal of Rhodamine B Using Novel Adsorbent-Based Surfactant-Modified Alpha Alumina Nanoparticles.

The objective of the present study is to investigate removal of cationic dye, rhodamine B (RhB), in water environment using a high-performance absorbent based on metal oxide nanomaterials toward green chemistry. The adsorption of sodium dodecyl sulfate (SDS) onto synthesized alpha alumina (α-Al2O3) material (M0) at different ionic strengths under low pH was studied to fabricate a new adsorbent as SDS-modified α-Al2O3 material (M1). The RhB removal using M1 was much higher than M0 under the same experimental conditions. The optimal conditions for RhB removal using M1 were found to be contact time 30 min, pH 4, and adsorbent dosage 5 mg/mL. The maximum RhB removal using M1 achieved 100%, and adsorption amount reached 52.0 mg/g. Adsorption isotherms of RhB onto M1 were well fitted by the two-step adsorption model. The electrostatic attraction between positive RhB molecules and negatively charged M1 surface controlled the adsorption that was evaluated by the surface charge change with zeta potential and adsorption isotherms. Very high RhB removal of greater than 98% after four regenerations of M1 and the maximum removal for all actual textile wastewater samples demonstrate that SDS-modified nano α-Al2O3 is a high-performance and reusable material for RhB removal from wastewater.

Genetic diversity of environmental Vibrio cholerae O1 strains isolated in Northern Vietnam.

Cholera epidemics have been recorded periodically in Vietnam during the seventh cholera pandemic. Since cholera is a water-borne disease, systematic monitoring of environmental waters for Vibrio cholerae presence is important for predicting and preventing cholera epidemics. We conducted monitoring, isolation, and genetic characterization of V. cholerae strains in Nam Dinh province of Northern Vietnam from Jul 2013 to Feb 2015. In this study, four V. cholerae O1 strains were detected and isolated from 110 analyzed water samples (3.6%); however, none of them carried the cholera toxin gene, ctxA, in their genomes. Whole genome sequencing and phylogenetic analysis revealed that the four O1 isolates were separated into two independent clusters, and one of them diverged from a common ancestor with pandemic strains. The analysis of pathogenicity islands (CTX prophage, VPI-I, VPI-II, VSP-I, and VSP-II) indicated that one strain (VNND_2014Jun_6SS) harbored an unknown prophage-like sequence with high homology to vibriophage KSF-1 phi and VCY phi, identified from Bangladesh and the USA, respectively, while the other three strains carried tcpA gene with a distinct sequence demonstrating a separate clonal lineage. These results suggest that the aquatic environment can harbor highly divergent V. cholera strains and serve as a reservoir for multiple V. cholerae virulence-associated genes which may be exchanged via mobile genetic elements. Therefore, continuous monitoring and genetic characterization of V. cholerae strains in the environment should contribute to the early detection of the sources of infection and prevention of cholera outbreaks as well as to understanding the natural ecology and evolution of V. cholerae.