Abstract
Background
An endotracheal tube cuff pressure between 20 and 30 cmH2O is recommended to prevent ventilator-associated respiratory infection (VARI). We aimed to evaluate whether continuous ...cuff pressure control (CPC) was associated with reduced VARI incidence compared with intermittent CPC.
Methods
We conducted a multicenter open-label randomized controlled trial in intensive care unit (ICU) patients within 24 hours of intubation in Vietnam. Patients were randomly assigned 1:1 to receive either continuous CPC using an automated electronic device or intermittent CPC using a manually hand-held manometer. The primary endpoint was the occurrence of VARI, evaluated by an independent reviewer blinded to the CPC allocation.
Results
We randomized 600 patients; 597 received the intervention or control and were included in the intention to treat analysis. Compared with intermittent CPC, continuous CPC did not reduce the proportion of patients with at least one episode of VARI (74/296 25% vs 69/301 23%; odds ratio OR 1.13; 95% confidence interval CI .77–1.67. There were no significant differences between continuous and intermittent CPC concerning the proportion of microbiologically confirmed VARI (OR 1.40; 95% CI .94–2.10), the proportion of intubated days without antimicrobials (relative proportion RP 0.99; 95% CI .87–1.12), rate of ICU discharge (cause-specific hazard ratio HR 0.95; 95% CI .78–1.16), cost of ICU stay (difference in transformed mean DTM 0.02; 95% CI −.05 to .08, cost of ICU antimicrobials (DTM 0.02; 95% CI −.25 to .28), cost of hospital stay (DTM 0.02; 95% CI −.04 to .08), and ICU mortality risk (OR 0.96; 95% CI .67–1.38).
Conclusions
Maintaining CPC through an automated electronic device did not reduce VARI incidence.
Clinical Trial Registration
NCT02966392.
The results of this randomised controlled trial demonstrate that continuous endotracheal cuff pressure control using an electronic automated device does not reduce the occurrence of ventilator-associated respiratory infection (VARI) in intubated patients compared with intermittent control.
Water pollution within and nearby different livestock farm types was assessed comprehensively for the first time in Vietnam. The samples of wastewater, ground water, and surface water were collected ...from 130 pig farms, 80 poultry farms, and 40 cow farms. Water quality was first assessed by individual parameter evaluation method in which measured values of water quality parameters were compared with the permissible limits in the national technical regulations on livestock’s effluent (QCVN 62), surface water quality, and ground water quality. Subsequently, the overall quality of surface and ground water samples was evaluated by mean of water quality index (WQI). The results showed the large variations in effluent’s quality, implying the considerable differences in wastewater treatment efficiency within and among farm types. Effluent from livestock farms was highly polluted by organic matters (expressed as BOD
5
and COD) and especially by microorganisms (expressed as total coliform—CF). Almost all wastewater samples contained higher number of CF than QCVN 62 (3900 MPN/100ml), with mean concentration of CF in effluent from cow farms, pig farms, and poultry farms were 1.2e+07 ± 5.0e+07 MPN/100ml, 8.8e+04 ± 7.1e+04 MPN/100ml, 1.5e+06 ± 4.2e+06 MPN/100ml, respectively. Improperly treated livestock’s waste was likely to have impacts on quality of ground water and receiving surface water bodies. High CF contamination in effluent leads to 70% of the ground water samples in cow farms and poultry farms classified as unsuitable for drinking water supply by WQI values. Although effluent from poultry farms had smaller quantity and better quality, their receiving surface water bodies exhibited the worst quality, with average WQI of 37.5 ± 16.2 compared to 49.9 ± 12 of pig farms and 50.3 ± 20.8 of cow farms. This result suggests that livestock’s effluent was not only pollution source of surface water bodies nearby livestock farms.
Parkinson’s disease (PD) is characterized by progressive locomotive defects and loss of dopaminergic neurons. Polyscias fruticosa leaves are used by Vietnamese as herbal medicines to support the ...treatment of some diseases related to neurodegeneration such as Parkinson’s and Alzheimer’s diseases. However, recent scientific data have not provided sufficient evidence for the use of P. fruticosa leaves to treat PD or decelerate PD progression. In the present study, the capacity of P. fruticosa leaf extract for PD treatment on the dietary supplementation was investigated using dUCH-knockdown Drosophila model. The results indicated that P. fruticosa leaf extract decelerated dopaminergic neuron degeneration induced by dUCH knockdown in not only the larval stage but also the adult stage, which might result in the amelioration in locomotor ability of dUCH-knockdown larvae and flies. Furthermore, antioxidant activities and some key phytochemicals such as saponins, polyphenols, and flavonoids that might contribute to the effects of the P. fruticosa leaf extract were identified.
Abstract
Adrinandra megaphylla
Hu is a medicinal plant belonging to the
Adrinandra
genus, which is well-known for its potential health benefits due to its bioactive compounds. This study aimed to ...assemble and annotate the chloroplast genome of
A. megaphylla
as well as compare it with previously published cp genomes within the
Adrinandra
genus. The chloroplast genome was reconstructed using de novo and reference-based assembly of paired-end reads generated by long-read sequencing of total genomic DNA. The size of the chloroplast genome was 156,298 bp, comprised a large single-copy (LSC) region of 85,688 bp, a small single-copy (SSC) region of 18,424 bp, and a pair of inverted repeats (IRa and IRb) of 26,093 bp each; and a total of 51 SSRs and 48 repeat structures were detected. The chloroplast genome includes a total of 131 functional genes, containing 86 protein-coding genes, 37 transfer RNA genes, and 8 ribosomal RNA genes. The
A. megaphylla
chloroplast genome indicated that gene content and structure are highly conserved. The phylogenetic reconstruction using complete cp sequences,
matK
and
trnL
genes from Pentaphylacaceae species exhibited a genetic relationship. Among them,
matK
sequence is a better candidate for phylogenetic resolution. This study is the first report for the chloroplast genome of the
A. megaphylla
.
Due to the potential impact of the (currency) exchange rate risk in the financial market, forecasting exchange rate (FET) has become a hot topic in both academic and practical worlds. For many years, ...the various methods have been proposed and used for FET problems including the method of the artificial neural network (ANN). However, in many cases of FET, there is the limitation of using separate methods since they are not able to fully capture financial characteristics. Recently, more researchers have been beginning to pay attention to FET based on an ensemble of forecasting models (in other words, the combination of individual methods). Previous studies of ensemble methods have shown that the performance of an ensemble depends on two key elements (1) The individual performance and (2) diversity degree of base learners. The main idea behind this paper comes from these key elements, the authors use ANNs as the base method (or weak learners), and weights of these ANNs will be optimized by using multi-objective evolutionary algorithms (MOEAs) including the Non-Dominated Sorting Genetic Algorithm II (NSGA-II) and the Non-Dominated Sorting Differential Evolution (NSDE) using directional information. To assist MOEAs, a number of diversity-preservation mechanisms are used to generate diverse sets of base classifiers and finally we propose to use modified Adaboost algorithms to combine the results of weak learners for overall forecasts. The results show that the proposed novel ensemble learning approach can achieve higher forecasting performance than those of individual ones.
The deposition of TiN on stainless steel substrates may improve the stability and compatibility of this material with bone, which may be advantageously exploited for the elaboration of advanced pros- ...thetic devices. In this work, TiN-coated 316LSS (by way of DC magnetron sputtering) was used as a starting material for investigating the electrochemical post-deposition of hydroxyapatite (HAp) which has a composition close to that of bone. Electrodeposition was carried out starting from an aqueous medium containing solubilized Ca(NO3)2 and NH4H2PO4 in the presence of H2O2. We report the influence of experimental conditions on the morphology of the obtained HAp coating on TiN/316LSS. The effect of applied potential, temperature, H2O2 concentration, pH and duration of reaction were thoroughly discussed on the basis of X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier Transform Infrared (FTIR) spectroscopy and Energy Dispersive X-ray Spectroscopy (EDX) results. This method appears advantageous for producing HAp-coated implant materials.
Callicarpa candicans (Burm. f.) Hochr. (Callicarpa cana L.) is a medicinal plant that is distributed mainly in the tropics and subtropics of Asia and finds a wide range of uses in traditional ...medicine. In this study, we attempted and optimized the microwave-assisted hydro-distillation (MAHD) process to obtain essential oil from the leaves of C. candicans. In addition, the obtained oil was analyzed for volatile composition by gas chromatography–mass spectrometry (GC-MS) and assayed for bioactivity against several bacteria and cancer cell lines. To optimize the extraction process, response surface methodology (RSM) in combination with central composite design (CCD) was adopted. Experimental design and optimization were carried out with respect to three experimental factors including the ratio of water to raw material, extraction time, and microwave power. The optimal extraction conditions were obtained as follows: water to raw material ratio of 6/1 (v/w), extraction time 42 min, and microwave power 440 W. Composition determination of the obtained C. candicans essential oil indicated the presence of predominant components including caryophyllene (10.45%), cadinene (10.28%), gurjunene (8.95%), muurolene (8.92%), selinene (7.06%), selinene (5.59%), and copaene (5.40%). In comparison with the essential oils obtained via traditional hydro-distillation method, the essential oil extracted by MAHD exhibited superior anti-proliferative activity on all tested cancer cell lines. Current results imply that the MAHD is capable of recovering biologically-active natural products of greater quantity than that recovered by the conventional distillation.
Background The etiology of ischemic stroke is multifactorial. Several gene mutations have been identified as leading causes of cerebral autosomal dominant arteriopathy with subcortical infarcts and ...leukoencephalopathy (CADASIL), a hereditary disease that causes stroke and other neurological symptoms. Objective We aimed to identify the variants of NOTCH3 and thrombophilia genes, and their complex interactions with other factors. Methods We conducted a hierarchical cluster analysis (HCA) on the data of 100 patients diagnosed with ischemic stroke. The variants of NOTCH3 and thrombophilia genes were identified by polymerase chain reaction with confronting 2-pair primers and real-time polymerase chain reaction. The overall preclinical characteristics, cumulative cutpoint values, and factors associated with these somatic mutations were analyzed in unidimensional and multidimensional scaling models. Results We identified the following optimal cutpoints: creatinine, 83.67 (SD 9.19) µmol/L; age, 54 (SD 5) years; prothrombin (PT) time, 13.25 (SD 0.17) seconds; and international normalized ratio (INR), 1.02 (SD 0.03). Using the Nagelkerke method, cutpoint 50% values of the Glasgow Coma Scale score; modified Rankin scale score; and National Institutes of Health Stroke Scale scores at admission, after 24 hours, and at discharge were 12.77, 2.86 (SD 1.21), 9.83 (SD 2.85), 7.29 (SD 2.04), and 6.85 (SD 2.90), respectively. Conclusions The variants of MTHFR (C677T and A1298C) and NOTCH3 p.R544C may influence the stroke severity under specific conditions of PT, creatinine, INR, and BMI, with risk ratios of 4.8 (95% CI 1.53-15.04) and 3.13 (95% CI 1.60-6.11), respectively (Pfisher<.05). It is interesting that although there are many genes linked to increased atrial fibrillation risk, not all of them are associated with ischemic stroke risk. With the detection of stroke risk loci, more information can be gained on their impacts and interconnections, especially in young patients.
Ventilator-associated pneumonia (VAP) is a serious healthcare-associated infection that affects up to 30 % of intubated and mechanically ventilated patients in intensive care units (ICUs) worldwide. ...The bacterial aetiology and corresponding antimicrobial susceptibility of VAP is highly variable, and can differ between countries, national provinces and even between different wards in the same hospital. We aimed to understand and document changes in the causative agents of VAP and their antimicrobial susceptibility profiles retrospectively over an 11 year period in a major infectious disease hospital in southern Vietnam. Our analysis outlined a significant shift from Pseudomonas aeruginosa to Acinetobacter spp. as the most prevalent bacteria isolated from quantitative tracheal aspirates in patients with VAP in this setting. Antimicrobial resistance was common across all bacterial species and we found a marked proportional annual increase in carbapenem-resistant Acinetobacter spp. over a 3 year period from 2008 (annual trend; odds ratio 1.656, P = 0.010). We further investigated the possible emergence of a carbapenem-resistant Acinetobacter baumannii clone by multiple-locus variable number tandem repeat analysis, finding a blaOXA-23-positive strain that was associated with an upsurge in the isolation of this pathogen. We additionally identified a single blaNDM-1-positive A. baumannii isolate. This work highlights the emergence of a carbapenem-resistant clone of A. baumannii and a worrying trend of antimicrobial resistance in the ICU of the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.
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