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The SPOT-MAS assay "Screening for the Presence Of Tumor by Methylation And Size" detects the five most common cancers in Vietnam by evaluating circulating tumor DNA in the blood. Here, we validated its performance in a prospective multi-center clinical trial, K-DETEK. Our analysis of 2795 participants from 14 sites across Vietnam demonstrates its ability to detect cancers in asymptomatic individuals with a positive predictive value of 60%, with 83.3% accuracy in detecting tumor location. We present a case report to support further using SPOT-MAS as a complementary method to achieve early cancer detection and provide the opportunity for early treatment.
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Mixed matrix materials (MMMs) hold great potential for membrane gas separations by merging nanofillers with unique nanostructures and polymers with excellent processability. In situ growth of the nanofillers is adapted to mitigate interfacial incompatibility to avoid the selectivity loss. Surprisingly, functional polymers have not been exploited to co-grow the nanofillers for membrane applications. Herein, in situ synergistic growth of crystalline zeolite imidazole framework-8 (ZIF-8) in polybenzimidazole (PBI), creating highly porous structures with high gas permeability, is demonstrated. More importantly, PBI contains benzimidazole groups (similar to the precursor for ZIF-8, i.e., 2-methylimidazole) and induces the formation of amorphous ZIFs, enhancing interfacial compatibility and creating highly size-discriminating bottlenecks. For instance, the formation of 15 mass% ZIF-8 in PBI improves H2 permeability and H2 /CO2 selectivity by ≈100% at 35 °C, breaking the permeability/selectivity tradeoff. This work unveils a new platform of MMMs comprising functional polymer-incorporated amorphous ZIFs with hierarchical nanostructures for various applications.
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BACKGROUND: [68Ga]Ga-FAPI-46 is a novel positron emission tomography (PET) ligand that targets fibroblast activation protein (FAP) expression as FAP inhibitor (FAPI) and could already show promising results in several tumor entities. It could be demonstrated that an increased FAP expression correlates with tumor aggressivity in urothelial carcinoma (UC). Given the limited value of [18F]FDG in UC, [68Ga]Ga-FAPI-46 could add diagnostic information in staging and response assessment in UC. We present the first data of [68Ga]Ga-FAPI-46 PET imaging in a pilot cohort of UC patients evaluating uptake characteristics in metastases and primary tumors. METHODS: Fifteen patients with UC prior to or after local treatment underwent [68Ga]Ga-FAPI-46 PET/CT imaging for detection of metastatic spread. We compared the biodistribution in non-affected organs and tumor uptake of UC lesions by standard uptake value measurements (SUVmean and SUVmax). Additionally, metastatic sites on PET were compared to its morphological correlate on contrast-enhanced computed tomography (CT). RESULTS: Overall, 64 tumor sites were detected on PET and/or CT. The highest uptake intensity was noted at the primary site (SUVmax 20.8 (range, 8.1-27.8)) followed by lymph node metastases (SUVmax 10.6 (range, 4.7-29.1)). In 4/15 (26.7%) patients there were [68Ga]Ga-FAPI-46-positive lesions that were missed on standard routine CT imaging. On the other hand, 2/15 patients had suspicious prominent bipulmonary nodules as well as pelvic lymph nodes previously rated as suspicious for metastatic spread on CT, but without increased FAPI expression; here histopathology excluded malignancy. CONCLUSION: [68Ga]Ga-FAPI-46 PET shows distinctly elevated uptake in UC lesions. Therefore, the tracer has potential as a promising new biomarker in metastatic UC patients, as [68Ga]Ga-FAPI-46 PET might improve detection of metastatic sites compared to CT alone. These findings highly emphasize larger studies investigating FAPI imaging in UC patients.
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Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Estudos de Viabilidade , Fluordesoxiglucose F18 , Radioisótopos de Gálio , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Quinolinas , Distribuição TecidualRESUMO
BACKGROUND: Heart failure (HF) is becoming a growing public health concern. Diagnostic tests for determining the severity of HF often come with high costs and require specialized expertise, which makes it difficult to assess HF severity, especially in low-income countries or at primary healthcare facilities. Recently, red blood cell distribution width (RDW) has emerged as a promising, easily accessible marker associated with HF severity. The study aimed to assess changes in RDW levels in HF patients and the diagnostic value of RDW in detecting acute heart failure (AHF) among HF patients. METHODS: We conducted a cross-sectional examination involving 351 participants divided into HF and non-HF cohorts. HF was defined and categorized according to the diagnostic and treatment guidelines for AHF and chronic heart failure (CHF) set forth by the European Society of Cardiology (2021). Univariate and multivariate analysis of factors associated with AHF was performed. RESULTS: The study revealed that HF patients displayed higher median RDW levels (14.90% [13.70-17.00]) compared to non-HF individuals (13.00% [12.23-13.78]). RDW was notably elevated in HF patients with left ventricular ejection fraction < 50% compared to those with left ventricular ejection fraction ≥ 50%. ROC curve analysis of RDW for AHF detection identified a cutoff value of 13.85%, with a sensitivity of 86.05% and specificity of 47.18%, statistically significant at p < 0.001. RDW > 13.85% was identified as an independent risk factor for AHF in patients with HF, with odds ratios of 2.644 (95% CI, 1.190-5.875; p = 0.017). CONCLUSION: The study revealed significant RDW variations in patients with CHF and AHF compared to the control group. These findings suggest that RDW could be a biomarker for detecting HF severity.
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Índices de Eritrócitos , Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/diagnóstico , Feminino , Estudos Transversais , Masculino , Pessoa de Meia-Idade , Idoso , Vietnã/epidemiologia , Eritrócitos/patologia , Curva ROC , Biomarcadores/sangue , Volume Sistólico , População do Sudeste AsiáticoRESUMO
Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare cause of acute abdominal pain, but could potentially be fatal to patients, and should be recognized soon in the emergency department after excluding other common causes. Computed tomography (CT) is the modality of choice for initial diagnosis and follow-up. Currently there is no evidence-based guidelines for managing SISMAD. A 58-year-old man being suspected of a mesenteric artery dissection was referred to our emergergy department. The patient was monitored, treated conservatively with anticoagulant and discharged after 3 days. Follow-up CT scans at 6 month, 1 year and 1 year and a half post discharge showed a partially occluded false lumen, the diameter of true lumen had increased in size and no signs of bowel ischemia. SISMAD should be considered as part of differential diagnoses when patients in their fifth to seventh decades of life present with acute abdominal pain. Treatment includes conservative management, percutaneous endovascular interventions, or surgery, but most patients can be managed conservatively.
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Hierarchically porous materials containing sub-nm ultramicropores with molecular sieving abilities and microcavities with high gas diffusivity may realize energy-efficient membranes for gas separations. However, rationally designing and constructing such pores into large-area membranes enabling efficient H2 separations remains challenging. Here, we report the synthesis and utilization of hybrid carbon molecular sieve membranes with well-controlled nano- and micro-pores and single zinc atoms and clusters well-dispersed inside the nanopores via the carbonization of supramolecular mixed matrix materials containing amorphous and crystalline zeolitic imidazolate frameworks. Carbonization temperature is used to fine-tune pore sizes, achieving ultrahigh selectivity for H2/CO2 (130), H2/CH4 (2900), H2/N2 (880), and H2/C2H6 (7900) with stability against water vapor and physical aging during a continuous 120-h test.
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The complex iron oxide copper and gold (IOCG) Sin Quyen deposit in northern Vietnam is known as hydrothermal veins and multi-stages of mineralization. Thus, it is complicated to make a probabilistic 3D geometric model using traditional methods and to predict the hidden mineral potential. In this study, computer modeling with nearly 8000 archival data was recorded from 146 boreholes within the study area, and the chemical analysis was done on 40 samples. The 3D block model was constructed using geological structure, optimal parameters, and computational tools approach to the 3D geometric models of surface and ore bodies distribution. The Cu and Ag reserves were estimated based on the 3D geometric models. The total reserve of all ore bodies at the current depth was recorded at 540000 and 25 tons for Cu and Ag, respectively. In the study area, almost all ore bodies were observed as hydrothermal vein types, extending in Northwest-Southeast strikes and dipping around 750 m, closest to the geological observation. The mineralization characteristics of the study area are controlled by left-lateral zipper tectonic activity and faults. Based on tectonic and the 3D geometric model characteristics, the Cu ore bodies are trending continuously to more than 300 m depth at the Southeast of Ngoi Phat stream, while the Northwest shows no signs.
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Water evaporation-driven energy harvesting is an emerging mechanism for contributing to green energy production with low cost. Herein, we developed polyacrylonitrile (PAN) nanofiber-based evaporation-driven electricity generators (PEEGs) to confirm the feasibility of utilizing electrospun PAN nanofiber mats in an evaporation-driven energy harvesting system. However, PAN nanofiber mats require a support substrate to enhance its durability and stability when it is applied to an evaporation-driven energy generator, which could have additional effects on generation performance. Accordingly, various support substrates, including fiberglass, copper, stainless mesh, and fabric screen, were applied to PEEGs and examined to understand their potential impacts on electrical generation outputs. As a result, the PAN nanofiber mats were successfully converted to a hydrophilic material for an evaporation-driven generator by dip-coating them in nanocarbon black (NCB) solution. Furthermore, specific electrokinetic performance trends were investigated and the peak electricity outputs of Voc were recorded to be 150.8, 6.5, 2.4, and 215.9 mV, and Isc outputs were recorded to be 143.8, 60.5, 103.8, and 121.4 µA, from PEEGs with fiberglass, copper, stainless mesh, and fabric screen substrates, respectively. Therefore, the implications of this study would provide further perspectives on the developing evaporation-induced electricity devices based on nanofiber materials.
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BACKGROUND: The associations among dietary zinc intakes and biomarkers of zinc status are unknown in apparently healthy children at high risk for zinc deficiency. OBJECTIVE: To assess associations among zinc-related parameters in a sample of Guatemalan school-aged children. METHODS: We assessed total dietary intakes and biomarkers of zinc status before and after receiving 6 months of zinc supplementation or placebo in 691 Guatemalan schoolchildren aged 6 to 11 years. Most of the children also received zinc-fortified milk from a government program that started shortly after the trial began. We assessed associations between zinc intakes and serum zinc, alkaline phosphatase (ALP), and albumin. RESULTS: At baseline, the prevalence of serum zinc < 65 microg/dL and dietary zinc intake below Estimated Average Requirements (EAR) (< 4 and < 7 mg/day for children < 9 and > or = 9 years, respectively) were 21.6% and 39.4%, respectively. Pearson correlations between serum zinc concentration and dietary zinc intake, serum ALP, and serum albumin were r = 0.07, 0.15, and 0.07, respectively. At the 6-month follow-up, low serum zinc and low total (diet plus fortified milk) zinc intakes were observed in 1.2% and 0.0% of children in the zinc-supplemented group and 4.0% and 34.1% in the placebo group, respectively. Pearson correlations between serum zinc concentration and total zinc intake, serum ALP, and serum albumin were 0.10, 0.06, and -0.11 in the zinc-supplemented group and -0.04, 0.05, and 0.01 in the placebo group, respectively. CONCLUSIONS: Zinc intake was inconsistently associated with markers of serum zinc concentration. Zinc fortification or supplementation attenuated the associations.
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Biomarcadores/sangue , Dieta , Zinco/administração & dosagem , Fosfatase Alcalina/sangue , Animais , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Alimentos Fortificados , Guatemala , Humanos , Masculino , Leite , Necessidades Nutricionais , Placebos , Albumina Sérica/análise , Zinco/sangue , Zinco/deficiênciaRESUMO
Purpose: To compare the risk of transient vision loss (TVL) probably attributable to a severe intraocular pressure spike after intravitreal aflibercept application using the novel prefilled syringe (PFS) vs. the established vial system (VS). Methods: Datasets of the intravitreal injection service of the Ludwig Maximilians-University Munich and the Technical University Munich, Germany, were screened for documentation of TVL after intravitreal injection of aflibercept. The observation period included two full months prior to the introduction of the novel PFS and two months afterwards. TVL was defined as loss of perception of hand motion for a duration of >30 s. Results: Over a period of four months, 1720 intravitreal injections of aflibercept were administered in 672 patients. There were 842 injections with the old VS, and 878 injections using the novel PFS. Using the VS, TVL was noted during two injections (0.24%) in two patients, as compared to 11 cases of TVL (1.25%) in 10 patients with the PFS (p = 0.015). Using the PFS, patients had a 5.3-fold risk of TVL as compared to the VS (OR: 5.33; 95% CI: 1.2-24.1; p = 0.0298). Conclusion: There was a more than five-fold risk of TVL using the novel pre-filled aflibercept syringe as compared to the established vial system. During informed consent, this risk should be discussed.
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Thin-film composite membranes are a leading technology for post-combustion carbon capture, and the key challenge is to fabricate defect-free selective nanofilms as thin as possible (100 nm or below) with superior CO2/N2 separation performance. Herein, we developed high-performance membranes based on an unusual choice of semi-crystalline blends of amorphous poly(ethylene oxide) (aPEO) and 18-crown-6 (C6) using two nanoengineering strategies. First, the crystallinity of the nanofilms decreases with decreasing thickness and completely disappears at 500 nm or below because of the thickness confinement. Second, polydimethylsiloxane is chosen as the gutter layer between the porous support and selective layer, and its surface is modified with bio-adhesive polydopamine (<10 nm) with an affinity toward aPEO, enabling the formation of the thin, defect-free, amorphous aPEO/C6 layer. For example, a 110 nm film containing 40 mass % C6 in aPEO exhibits CO2 permeability of 900 Barrer (much higher than a thick film with 420 Barrer), rendering a membrane with a CO2 permeance of 2200 GPU and CO2/N2 selectivity of 27 at 35 °C, surpassing Robeson's upper bound. This work shows that engineering at the nanoscale plays an important role in designing high-performance membranes for practical separations.
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Computational fluid dynamics simulations of fibrous filters with 56 combinations of different fiber sizes, packing densities, face velocities, and thicknesses were conducted for developing models that predict pressure drops across nanofiber filters. The accuracy of the simulation method was confirmed by comparing the numerical pressure drops to the experimental data obtained for polyacrylonitrile electrospun nanofiber filters. In the simulations, an aerodynamic slip effect around the surface of the small nanofibers was considered. The results showed that, unlike in the case of conventional filtration theory, pressure drops across the thin layers of electrospun nanofiber filters are not proportional to the thickness. This might be a critical factor for obtaining precise pressure drops across the electrospun nanofiber filters with extremely thin layers. Finally, we derived the product of drag coefficient and Reynolds number as a function of packing density, Knudsen number, and ratio of thickness to fiber diameter to get the correlation equation for pressure drop prediction. The obtained equation predicted the pressure drops across the nanofiber filters with the maximum relative difference of less than 15%.
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In renal cell carcinoma (RCC), accurate imaging methods are required for treatment planning and response assessment to therapy. In addition, there is an urgent need for new therapeutic options, especially in metastatic RCC. One way to combine diagnostics and therapy in a so-called theranostic approach is the use of radioligands directed against surface antigens. For instance, radioligands against prostate-specific membrane antigen (PSMA) have already been successfully used for diagnosis and radionuclide therapy of metastatic prostate cancer. Recent studies have demonstrated that PSMA is expressed not only in prostate cancer but also in the neovasculature of several solid tumors, which has raised hopes to use PSMA-guided theranostic approaches in other tumor entities, too. However, data on PSMA expression in different histopathological subtypes of RCC are sparse. Because a better understanding of PSMA expression in RCC is critical to assess which patients would benefit most from theranostic approaches using PSMA-targeted ligands, we investigated the expression pattern of PSMA in different subtypes of RCC on protein level. Immunohistochemical staining for PSMA was performed on formalin-fixed, paraffin-embedded archival material of major different histological subtypes of RCC (clear cell RCC (ccRCC)), papillary RCC (pRCC) and chromophobe RCC (cpRCC). The extent and intensity of PSMA staining were scored semi-quantitatively and correlated with the histological RCC subtypes. Group comparisons were calculated with the Kruskal-Wallis test. In all cases, immunoreactivity was detected only in the tumor-associated vessels and not in tumor cells. Staining intensity was the strongest in ccRCC, followed by cpRCC and pRCC. ccRCC showed the most diffuse staining pattern, followed by cpRCC and pRCC. Our results provide a rationale for PSMA-targeted theranostic approaches in ccRCC and cpRCC.
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BACKGROUND: Cardiac papillary fibroelastomas are rare, accounting for approximately 10% of all cardiac tumors, with 44% of cases located on the aortic valve and only 15% of cases located on the tricuspid valve. However, the optimal management of papillary fibroelastomas remains varied. CASE PRESENTATION: We present two successful instances of treating heart valve papillary fibroelastomas through minimally invasive surgery. These cases involved heart valve papillary fibroelastomas located in two common sites: the aortic valve on the left heart, which was accessed via an upper hemi-sternotomy, and the tricuspid valve on the right heart, which was accessed via beating heart total thoracoscopy. CONCLUSION: The article consistently demonstrates the effectiveness of a minimally invasive surgical approach in managing heart valve papillary fibroelastomas. This study provides further evidence by presenting two cases of heart valve papillary fibroelastomas - one on the aortic valve and the other on the tricuspid valve - that were successfully treated using this approach, resulting in favorable outcomes.
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Fibroelastoma Papilar Cardíaco , Fibroma , Neoplasias Cardíacas , Humanos , Fibroelastoma Papilar Cardíaco/patologia , Valva Aórtica/cirurgia , Valva Aórtica/patologia , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Fibroma/diagnóstico por imagem , Fibroma/cirurgiaRESUMO
Nanoparticles (NPs) at high loadings are often used in mixed matrix membranes (MMMs) to improve gas separation properties, but they can lead to defects and poor processability that impede membrane fabrication. Herein, it is demonstrated that branched nanorods (NRs) with controlled aspect ratios can significantly reduce the required loading to achieve superior gas separation properties while maintaining excellent processability, as demonstrated by the dispersion of palladium (Pd) NRs in polybenzimidazole for H2 /CO2 separation. Increasing the aspect ratio from 1 for NPs to 40 for NRs decreases the percolation threshold volume fraction by a factor of 30, from 0.35 to 0.011. An MMM with percolated networks formed by Pd NRs at a volume fraction of 0.039 exhibits H2 permeability of 110 Barrer and H2 /CO2 selectivity of 31 when challenged with simulated syngas at 200 °C, surpassing Robeson's upper bound. This work highlights the advantage of NRs over NPs and nanowires and shows that right-sizing nanofillers in MMMs is critical to construct highly sieving pathways at minimal loadings. This work paves the way for this general feature to be applied across materials systems for a variety of chemical separations.
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This study aims to investigate climate change's impact on health and adaptation in Vietnam through a systematic review and additional analyses of heat exposure, heat vulnerability, awareness and engagement, and projected health costs. Out of 127 reviewed studies, findings indicated the wider spread of infectious diseases, and increased mortality and hospitalisation risks associated with extreme heat, droughts, and floods. However, there are few studies addressing health cost, awareness, engagement, adaptation, and policy. Additional analyses showed rising heatwave exposure across Vietnam and global above-average vulnerability to heat. By 2050, climate change is projected to cost up to USD1-3B in healthcare costs, USD3-20B in premature deaths, and USD6-23B in work loss. Despite increased media focus on climate and health, a gap between public and government publications highlighted the need for more governmental engagement. Vietnam's climate policies have faced implementation challenges, including top-down approaches, lack of cooperation, low adaptive capacity, and limited resources.
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Supplementation with multiple micronutrients (MM) during pregnancy may result in improved pregnancy and infant outcomes. We conducted meta-analyses of randomised controlled trials that evaluated the effects of prenatal supplementation with MM (defined as containing at least five micronutrients and typically included iron or iron and folic acid). The outcomes of interest were low birthweight (<2500 g), birthweight, small-for-gestational age (SGA), gestational age, preterm birth (<37 weeks' gestation), stillbirth and neonatal death, maternal morbidity and mortality. We identified eligible studies through PubMed and EMBASE database searches. Meta-analyses were performed by pooling results for outcomes that were reported from more than one trial and sub-analyses were conducted to evaluate the effect of timing of intervention and amount of iron. We included published results from 16 trials in this review. Compared with control supplementation that was usually iron plus folic acid in most studies, MM supplementation resulted in a significant reduction in the incidence of low birthweight [pooled risk ratio (RR) 0.86; 95% confidence interval (CI) 0.81, 0.91] and SGA (pooled RR 0.83 [95% CI 0.73, 0.95]) and an increase in mean birthweight (weighted mean difference (WMD) 52.6 g [95% CI 43.2 g, 62.0 g]). There was no significant difference in the overall risk of preterm birth, stillbirth, and maternal or neonatal mortality, but we found an increased risk of neonatal death for the MM group compared with iron-folate in the subgroup of five trials that began the intervention after the first trimester (RR 1.38 [95% CI 1.05, 1.81]). None of the studies evaluated maternal morbidity. Compared with iron plus folic acid supplementation alone, prenatal maternal supplementation with MM resulted in a reduction in the incidence of low birthweight and SGA but increased risk of neonatal death in the subgroup of studies that began the intervention after the first trimester.
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Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Micronutrientes/administração & dosagem , Peso ao Nascer , Feminino , Humanos , Recém-Nascido , Serviços de Saúde Materna/métodos , Serviços de Saúde Materna/normas , Micronutrientes/deficiência , Gravidez , Complicações na Gravidez/prevenção & controle , Resultado da Gravidez , Fatores de RiscoRESUMO
A 38-year-old Asian male with severe mitral valve regurgitation underwent elective minimally invasive mitral valve repair with artificial chordae and concomitant Cox-Maze procedure. Cardiopulmonary bypass required large peripheral cannulas due to the patient's increased body surface area with a total bypass time of 216 min. At 10 h, the patient reported progressive right lower extremity pain with evidence of swelling, diffuse paresthesias, and weak peripheral pulses. The patient underwent double-incision lower leg fasciotomies, revealing significant interstitial fluid and bulging muscle chambers. Compartment syndrome demonstrates non-traumatic etiologies. Elevated body mass index, Kawashima Type D femoral artery classification, prolonged bypass times, driven partially due to concomitant Cox-Maze, and larger cannula sizes should increase the index of suspicion.
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Background: Cold plasma has many characteristics that allow for effective wound healing. Due to its efficacy, we have applied it in treating patients with severe Covid-19 who have soft tissue skin lesions and diseases including burns, pressure ulcers, shingles, and contact or atopic dermatitis. This study aims to assess the general characteristics of Covid-19 patients with soft tissue lesions and to conduct a fundamental evaluation of the efficacy of cold plasmamed beams in treating soft tissue wounds in patients with severe Covid-19. Methods: This prospective study was conducted on 20 severe Covid-19 patients with soft tissue lesions at the Intensive Care Center for Covid-19 of Hue Central Hospital in Ho Chi Minh City from September 25 to November 11, 2021. These patients was performed cold plasma irradiation at any stage of wound progression, including new injuries and chronic wounds. Results: Among 915 severe Covid-19 patients treated at our center, 20 patients had soft tissue lesions. Grade I, II, and III pressure ulcers accounted for 70% of the 20 cases of soft tissue lesions and 1.53% of the total patients at the time of the survey. Pressure ulcers were present in only 0.55% of patients (5/915 patients). Eleven out of 20 patients (55.0%) had lesions before admission, and 9 (45.0%) had lesions that appeared after admission. After 14 days of treatment, 14/20 patients had complete epithelialization (70%), and in 18/20 patients, wound exudation had ceased. The wounds became painless; after 3 weeks, the rashes had completely disappeared. Conclusion: The study emphasizes that irradiation with cold plasma contributes to the wound healing process.