A study survey on molnupiravir treatment in COVID-19 patients at home in Ninh Thuan province, Vietnam.

OBJECTIVE: Molnupiravir (MOV) is an oral antiviral drug that received use authorization in Vietnam for the treatment of mild COVID-19 (F0). There was a need to develop alternative approaches that allowed patients to access medication, decongest hospitals, clinics, and facilities, and protect people from infection. During the COVID-19 crisis, the Ninh Thuan Health Authorities implemented the home delivery of medication by community health workers. This study conducted in collaboration with two important Italian entities [the Aldo Moro University of Bari City and the 118 Department of Territorial Emergency System (118 SET) of Taranto City] aimed to evaluate the implementation of home delivery F0 treatment package assessing the rate of infection recovering during the coronavirus pandemic in Ninh Thuan province, Vietnam. PATIENTS AND METHODS: A convergent mixed methods research, based on a longitudinal study with quantitative research and qualitative assessments, evaluated four implementation outcomes: the feasibility, fidelity, coverage, sustainability, and effectiveness of the initiative. Data sources included routinely collected data, a telephonic survey of patients, an analysis of set-up and recurrent costs, as well as descriptive exploratory qualitative and quantitative analysis. RESULTS: After taking the MOV for 5 days, only 35 out of the initial 400 F0 patients remained positive, while 365 patients (91.2%) were negative (CT≥30). Whilst, the successful rate after using the drug during the course accounted for 99.85% and 100% after the entire treatment course, without any death. After 5 days of taking the drug, a positive test result (CT<30) was associated with age group ≥60 (OR=2.7) and comorbidities (OR=3.0) (p<0.05) compared to negative and positive results (CT≥30). Negative factors impacting F0 at home include a shortage of healthcare workers, inadequate supply of thermometers and SpO2 meters, and insufficient financial support for healthcare workers. CONCLUSIONS: MOV caused a reduction in the risk of hospitalization or death in mild COVID-19 patients, and molnupiravir was also found to be well tolerated and safe without any major adverse events during the administration period.

Thermodynamic insights into selenium oxyanion removal from synthetic flue gas desulfurization wastewater with temperature-swing solvent extraction.

Temperature-swing solvent extraction (TSSE) is a cost-effective, simple, versatile, and industry-ready technology platform capable of desalinating hypersaline brines toward zero liquid discharge. In this work, we demonstrate the potential of TSSE in the effective removal of selenium oxyanions and traces of mercury with the coexistence of high contents of chloride and sulfate often encountered in flue gas desulfurization wastewater streams. We compare the rejection performance of the two common solvents broadly used for TSSE, decanoic acid (DA) and diisopropylamine (DPA), and correlate those with the solvent physicochemical properties (e.g., dielectric constant, polarity, molecular bulkiness, and hydrophobicity) and ionic properties (e.g., hydrated radii and H-bonding). The results show that TSSE can remove >99.5% of selenium oxyanions and 96%-99.6% of mercury traces coexisting with sulfate (at a sixfold Se concentration) and chloride (at a 400-fold Se concentration) in a synthetic wastewater stream. Compared to diisopropylamine, decanoic acid is more effective in rejecting ions for all cases, ranging from a simple binary system to more complex multicomponent systems with highly varied ionic concentrations. Furthermore, the H-bonding interaction with water and the hydrated radii of the oxyanions (i.e., selenate vs. selenite) along with the hindrance effects caused by the molecular bulkiness and hydrophobicity (or lipophilicity) of the solvents play important roles in the favorable rejection of TSSE. This study shows that TSSE might provide a technological solution with a high deionization potential for the industry in complying with the Environmental Protection Agency regulations for discharge streams from coal-fired power facilities.

Effectiveness of erectogenic condom against semen exposure among women in Vietnam: Randomized controlled trial.

A key barrier to the consistent use of condoms is their negative effect on sexual pleasure. Although sexual pleasure is a primary motivation for engaging in sex and is an integral part of overall sexual health, most programs to improve sexual health operate within a pregnancy and disease-prevention paradigm. A new condom, CSD500 (Futura Medical Developments; Surrey, UK), containing an erectogenic drug was developed for use among healthy couples to improve sexual pleasure by increasing penile firmness, size and erection duration. We conducted a randomized controlled trial to test whether promoting the novel condom CSD500 for improved sexual pleasure is effective in reducing condomless sex compared to the provision of standard condoms with counseling for pregnancy and disease prevention. We randomized 500 adult, heterosexual, monogamous couples in Thanh Hoa province, Vietnam to receive either CSD500 (n = 248) or standard condoms (n = 252). At enrollment and after 2, 4, and 6 months, we interviewed women and sampled vaginal fluid to test for the presence of prostate-specific antigen (PSA), an objective, biological marker of recent semen exposure. We registered the protocol before trial initiation at ClinicalTrials.gov (identifier: NCT02934620). Overall, 11.0% of women were PSA positive at enrollment. The proportion of follow-up visits with PSA-positivity did not differ between the intervention (6.8%) and control arms (6.7%; relative risk, 1.01; 95% confidence interval, 0.66-1.54). Thus, we found no evidence that promoting an erectogenic condom to women in a monogamous, heterosexual relationship in Vietnam reduced their exposure to their partner's semen. These findings might not hold for other populations, especially those with a higher frequency of condomless sex.

Siamese KG-LSTM: A deep learning model for enriching UMLS Metathesaurus synonymy.

The Unified Medical Language System, or UMLS, is a repository of medical terminology developed by the U.S. National Library of Medicine for improving the computer system's ability of understanding the biomedical and health languages. The UMLS Metathesaurus is one of the three UMLS knowledge sources, containing medical terms and their relationships. Due to the rapid increase in the number of medical terms recently, the current construction of UMLS Metathesaurus, which heavily depends on lexical tools and human editors, is error-prone and time-consuming. This paper takes advantages of the emerging deep learning models for learning to predict the synonyms and non-synonyms between the pairs of biomedical terms in the Metathesaurus. Our learning approach focuses a subset of specific terms instead of the whole Metathesaurus corpus. Particularly, we train the models with biomedical terms from the Disorders semantic group. To strengthen the models, we enrich the inputs with different strategies, including synonyms and hierarchical relationships from source vocabularies. Our deep learning model adopts the Siamese KG-LSTM (Siamese Knowledge Graph - Long Short-Term Memory) in the architecture. The experimental results show that this approach yields excellent performance when handling the task of synonym detection for Disorders semantic group in the Metathesaurus. This shows the potential of applying machine learning techniques in the UMLS Metathesaurus construction process. Although the work in this paper focuses only on specific semantic group of Disorders, we believe that the proposed method can be applied to other semantic groups in the UMLS Metathesaurus.

IL-13-regulated Macrophage Polarization during Granuloma Formation in an In Vitro Human Sarcoidosis Model.

The mechanisms underlying abnormal granuloma formation in patients with sarcoidosis are complex and remain poorly understood. A novel in vitro human granuloma model was used to determine the molecular mechanisms of granuloma genesis in patients with sarcoidosis in response to putative disease-causing mycobacterial antigens. Peripheral blood mononuclear cells (PBMCs) from patients with active sarcoidosis and from normal, disease-free control subjects were incubated for 7 days with purified protein derivative-coated polystyrene beads. Molecular responses, as reflected by differential expression of genes, extracellular cytokine patterns, and cell surface receptor expression, were analyzed. Unbiased systems biology approaches were used to identify signaling pathways engaged during granuloma formation. Model findings were compared with human lung and mediastinal lymph node gene expression profiles. Compared with identically treated PBMCs of control subjects (n = 5), purified protein derivative-treated sarcoidosis PBMCs (n = 6) were distinguished by the formation of cellular aggregates resembling granulomas. Ingenuity Pathway Analysis of differential expression gene patterns identified molecular pathways that are primarily regulated by IL-13, which promotes alternatively activated (M2) macrophage polarization. M2 polarization was further demonstrated by immunohistochemistry performed on the in vitro sarcoidosis granuloma-like structures. IL-13-regulated gene pathways were confirmed in human sarcoidosis lung and mediastinal lymph node tissues. The in vitro human sarcoidosis granuloma model provides novel insights into early granuloma formation, particularly IL-13 regulation of molecular networks that regulate M2 macrophage polarization. M2 macrophages are predisposed to aggregation and multinucleated giant cell formation, which are characteristic features of sarcoidosis granulomas. Clinical trial registered with www.clinicaltrials.gov (NCT01857401).

Assessment of reductive acetogenesis with indigenous ruminal bacterium populations and Acetitomaculum ruminis.

The objective of this study was to evaluate the role of reductive acetogenesis as an alternative H2 disposal mechanism in the rumen. H2/CO2-supported acetogenic ruminal bacteria were enumerated by using a selective inhibitor of methanogenesis, 2-bromoethanesulfonic acid (BES). Acetogenic bacteria ranged in density from 2.5 x 10(5) cells/ml in beef cows fed a high-forage diet to 75 cells/ml in finishing steers fed a high-grain diet. Negligible endogenous acetogenic activity was demonstrated in incubations containing ruminal contents, NaH13CO3, and 100% H2 gas phase since [U-13C]acetate, as measured by mass spectroscopy, did not accumulate. Enhancement of acetogenesis was observed in these incubations when methanogenesis was inhibited by BES and/or by the addition of an axenic culture of the rumen acetogen Acetitomaculum ruminis 190A4 (10(7) CFU/ml). To assess the relative importance of population density and/or H2 concentration for reductive acetogenesis in ruminal contents, incubations as described above were performed under a 100% N2 gas phase. Both selective inhibition of methanogenesis and A. ruminis 190A4 fortification (>10(5) CFU/ml) were necessary for the detection of reductive acetogenesis under H2-limiting conditions. Under these conditions, H2 accumulated to 4, 800 ppm. In contrast, H2 accumulated to 400 ppm in incubations with active methanogenesis (without BES). These H2 concentrations correlated well with the pure culture H2 threshold concentrations determined for A. ruminis 190A4 (3,830 ppm) and the ruminal methanogen 10-16B (126 ppm). The data demonstrate that ruminal methanogenic bacteria limited reductive acetogenesis by lowering the H2 partial pressure below the level necessary for H2 utilization by A. ruminis 190A4.