A novel method in COPD diagnosing using respiratory signal generation based on CycleGAN and machine learning.

OBJECTIVE: The main goal of this research is to use distinctive features in respiratory sounds for diagnosing Chronic Obstructive Pulmonary Disease (COPD). This study develops a classification method by utilizing inverse transforms to effectively identify COPD based on unique respiratory features while comparing the classification performance of various optimal algorithms. METHOD: Respiratory sounds are divided into individual breathing cycles. In the data standardization and augmentation phase, the CycleGAN model enhances data diversity. Comprehensive analyses for these segments are then implemented using various Wavelet families and different spectral transformations representing characteristic signals. Advanced convolutional neural networks, including VGG16, ResNet50, and InceptionV3, are used for the classification task. RESULTS: The results of this study demonstrate the effectiveness of the mentioned method. Notably, the best-performing method utilizes Wavelet Bior1.3 after standardization in combination with InceptionV3, achieving a remarkable 99.75% F1-score, the gold standard for classification accuracy. CONCLUSION: Inverse transformation techniques combined with deep learning models show significant accuracy in detecting COPD disease. These findings suggest the feasibility of early COPD diagnosis through AI-powered characterization of acoustic features. MOTIVATION AND SIGNIFICANCE: The motivation behind this research stems from the urgent need for early and accurate diagnosis of Chronic Obstructive Pulmonary Disease (COPD). COPD is a respiratory disease that poses many difficulties when detected late, potentially causing severe harm to the patient's quality of life and increasing the healthcare burden. Timely identification and intervention are crucial to reduce the progression of the disease and improve patient outcomes.

Role of noninvasive ocular imaging as a biomarker in peripheral artery disease (PAD): A systematic review.

This study aimed to review the current literature exploring the utility of noninvasive ocular imaging for the diagnosis of peripheral artery disease (PAD). Our search was conducted in early April 2022 and included the databases Medline, Scopus, Embase, Cochrane, and others. Five articles were included in the final review. Of the five studies that used ocular imaging in PAD, two studies used retinal color fundus photography, one used optical coherence tomography (OCT), and two used optical coherence tomography angiography (OCTA) to assess the ocular changes in PAD. PAD was associated with both structural and functional changes in the retina. Structural alterations around the optic disc and temporal retinal vascular arcades were seen in color fundus photography of patients with PAD compared to healthy individuals. The presence of retinal hemorrhages, exudates, and microaneurysms in color fundus photography was associated with an increased future risk of PAD, especially the severe form of the disease. The retinal nerve fiber layer (RNFL) was significantly thinner in the nasal quadrant in patients with PAD compared to age-matched healthy individuals in OCT. Similarly, the choroidal thickness in the subfoveal region was significantly thinner in patients with PAD compared to controls. Patients with PAD also had a significant reduction in the retinal and choroidal circulation in OCTA compared to healthy controls. As PAD causes thinning and ischemic changes in retinal vessels, examination of the retinal vessels using retinal imaging techniques can provide useful information about early microvascular damage in PAD. Ocular imaging could potentially serve as a biomarker for PAD. PROSPERO ID: CRD42022310637.

The Frail Scale - A Risk Stratification in Older Patients with Acute Coronary Syndrome.

Purpose: The aim of this study was to explore the impact of frailty on in-hospital adverse outcomes and net adverse clinical events (NACE) in older patients with acute coronary syndrome. Patients and Methods: This observational study included elderly patients (≥60 years old), diagnosed with acute coronary syndrome (ACS) at admission from February 2021 to August 2021. The primary outcome was net adverse clinical events (NACE) defined as a composite of all-cause mortality, stroke, and major bleeding. Secondary outcome was in-hospital adverse outcomes including arrhythmia, acquired pneumonia, stroke, major bleeding, and all-cause mortality. Frailty was assessed using the Frail scale (FS). Data about socio-demographics, comorbidities, body mass index, ACS type, coronary angiography, left ventricular ejection fraction, and length of hospital stay were also collected. Univariate and multivariate logistic regressions were employed to identify the potential association between frailty and outcomes. Results: Of the 116 ACS patients, 38 patients were frail (32.76%). Frail subjects were more often female (50%) and older (p < 0.01) and had higher rates of in-hospital adverse outcomes (OR = 2.37, p = 0.05) and NACE (OR = 7.12; p < 0.01). In univariate analysis, the increased frail score was significantly associated with increased odds of NACE (unadjusted OR = 1.98, 95% CI 1.17-3.35 for each score increase in Frail Score). In multivariable logistic regression, models controlling for age, gender, PCI, LVEF, and coronary angiography (adjusted OR 2.19, 95% CI 1.12-4.29 for each score increase in Frail Score). Conclusion: This study revealed the reference data of frailty assessment in older patients with ACS in Vietnam. Our result indicated that over 30% of ACS older patients presented with frailty which was associated with an increased risk of in-hospital adverse outcomes and NACE. This study also provided promising information about the simple FRAIL scale's potential role in the risk stratification of older patients with ACS.

Outcomes of autologous bone marrow mononuclear cell administration in the treatment of neurologic sequelae in children with spina bifida.

BACKGROUND: To evaluate the safety and efficacy of autologous bone marrow mononuclear cell (BMMNC) infusion in the management of neurological sequelae in children with spina bifida (SB). METHODS: BMMNCs were harvested from bilateral anterior iliac crests. Two intrathecal BMMNC administrations were performed with an interval of 6 months. The measurements of outcomes included clinical assessments, cystomanometry and rectomanometry. RESULTS: Eleven children with SB underwent autologous BMMNC infusions from 2016 to 2020. There were no severe adverse events during the study period. The number of patients requiring assistance to expel stools decreased from 11 before cell infusion to 3 after the second cell infusion. The number of patients who had urine leakage decreased from 9 patients at baseline to 3 patients after the second BMMNC infusion. The mean bladder capacity increased from 127.7 ± 59.2 ml at baseline to 136.3 ± 54.8 ml at six months and to 158.3 ± 56.2 ml at 12 months after BMMNC infusions. Detrusor pressure (pdet) decreased from 32.4 ± 22.0 cm H2O at baseline to 21.9 ± 11.8 cm H2O after 12 months of follow-up. At baseline, six patients could walk independently. After the 2nd infusion, eight patients could walk independently. CONCLUSION: Intrathecal infusions of autologous bone marrow mononuclear cells are safe and may improve bowel, bladder, and motor function in children with SB. TRIAL REGISTRATION: NCT, NCT05472428. Registered July 25, 2022- Retrospectively registered, https://www. CLINICALTRIALS: gov/ct2/show/NCT05472428 .

TGF-ß3 in differentiation and function of Tph-like cells and its relevance to disease activity in patients with systemic lupus erythematosus.

OBJECTIVES: T peripheral helper (Tph) cells have major roles in pathological processes in SLE. We sought to clarify the mechanisms of Tph cell differentiation and their relevance to clinical features in patients with SLE. METHOD: Phenotypes and functions of Tph cell-related markers in human CD4+ T cells purified from volunteers or patients were analysed using flow cytometry and quantitative PCR. Renal biopsy specimens from patients with LN were probed by multicolour immunofluorescence staining. RESULTS: Among multiple cytokines, transforming growth factor (TGF)-ß3 characteristically induced programmed cell death protein 1 (PD-1)hi musculoaponeurotic fibrosarcoma (MAF)+, IL-21+IL-10+ Tph-like cells with a marked upregulation of related genes including PDCD-1, MAF, SOX4 and CXCL13. The induction of Tph-like cells by TGF-ß3 was suppressed by the neutralization of TGF-ß type II receptor (TGF-ßR2). TGF-ß3-induced Tph-like cells efficiently promoted the differentiation of class-switch memory B cells into plasmocytes, resulting in enhanced antibody production. The proportion of Tph cells in the peripheral blood was significantly increased in patients with SLE than in healthy volunteers in concordance with disease activity and severity of organ manifestations such as LN. TGF-ß3 was strongly expressed on macrophages, which was associated with the accumulation of CD4+ C-X-C chemokine receptor (CXCR5)-PD-1+ Tph cells, in the renal tissue of patients with active LN. CONCLUSION: The induction of Tph-like cells by TGF-ß3 mainly produced from tissue macrophages plays a pivotal role in the pathological processes of active LN by enhancing B-cell differentiation in patients with SLE.

Epstein-Barr virus-induced gene 3 commits human mesenchymal stem cells to differentiate into chondrocytes via endoplasmic reticulum stress sensor.

Mesenchymal stem cells (MSC) can differentiate into chondrocytes. Epstein-Barr virus-induced gene 3 (EBI3) is differentially expressed during chondrogenic differentiation and can be produced by MSC. EBI3 is also a subunit of interleukin (IL)-27 and IL-35, and it accumulates in the endoplasmic reticulum (ER) when its partners, such as IL-27 p28 and IL-35 p35, are insufficient. ER stress induced by protein accumulation is responsible for chondrogenic differentiation. However, the role of EBI3 and its relevance to the ER stress in chondrogenic differentiation of MSC have never been addressed. Here, we demonstrate that EBI3 protein is expressed in the early stage of chondrogenic differentiation of MSC. Additionally, knockdown, overexpression, or induction of EBI3 through IL-1ß inhibits chondrogenesis. We show that EBI3 localizes and accumulates in the ER of MSC after overexpression or induction by IL-1ß and TNF-α, whereas ER stress inhibitor 4-phenylbutyric acid decreases its accumulation in MSC. Moreover, EBI3 modulates ER stress sensor inositol-requiring enzyme 1 α (IRE1α) after induced by IL-1ß, and MSC-like cells coexpress EBI3 and IRE1α in rheumatoid arthritis (RA) synovial tissue. Altogether, these data demonstrate that intracellular EBI3 commits to chondrogenic differentiation by regulating ER stress sensor IRE1α.

IL-6 production through repression of UBASH3A gene via epigenetic dysregulation of super-enhancer in CD4+ T cells in rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is associated with immune dysfunction. UBASH3A as a negative regulator of T cell receptors (TCRs) signaling is a susceptible factor in RA. The aim of this study was to determine the role of UBASH3A in RA pathogenesis, by assessing the role of super-enhancer (SE) in the control of UBASH3A expression in CD4+ T cells and the contribution of the latter in proinflammatory cytokine production in patients with RA. METHODS: UBASH3A mRNA and protein levels were quantified by PCR and western blotting, respectively. The cells were treated with a locked nucleic acid to inhibit enhancer RNA (eRNA) expression. Chromatin immunoprecipitation was used to identify the factors recruited to UBASH3A loci displaying SE architecture. CD4+ T cells were transfected with UBASH3A plasmids, and cytokine levels were measured by a cytometric bead array. RESULTS: UBASH3A was extracted as a RA susceptibility gene associated with SNPs in the SEs that are highly expressed in CD4+ T cells by in silico screening. UBASH3A mRNA and protein expression levels were lower in CD4+ T cells of RA patients than in the control. eRNA_1 and eRNA_3 knockdown reduced UBASH3A mRNA levels. RA patients exhibited accumulation of BTB and CNC homology 2 (BACH2), the silencing transcription factor, at the UBASH3A loci in CD4+ T cells, but not the SE-defining factor, mediator complex subunit 1 (MED1)/bromodomain 4 (BRD4). However, opposite changes were observed in the control. Stimulation of TCRs expressed on CD4+ T cells of RA patients resulted in interleukin (IL)-6 production, while UBASH3A over-expression significantly inhibited the production. CONCLUSIONS: In RA, transcription of UBASH3A is suppressed via epigenetic regulation of SE in CD4+ T cells. Low UBASH3A levels result in excessive TCR signal activation with subsequent enhancement of IL-6 production.

Enhancer RNA commits osteogenesis via microRNA-3129 expression in human bone marrow-derived mesenchymal stem cells.

BACKGROUND: Highly regulated gene expression program underlies osteogenesis of mesenchymal stem cells (MSCs), but the regulators in the program are not entirely identified. As enhancer RNAs (eRNAs) have recently emerged as a key regulator in gene expression, we assume a commitment of an eRNA in osteogenesis. METHODS: We performed in silico analysis to identify potential osteogenic microRNA (miRNA) gene predicted to be regulated by super-enhancers (SEs). SE inhibitor treatment and eRNA knocking-down were used to confirm the regulational mechanism of eRNA. miRNA function in osteogenesis was elucidated by miR mimic and inhibitor transfection experiments. RESULTS: miR-3129 was found to be located adjacent in a SE (osteoblast-specific SE_46171) specifically activated in osteoblasts by in silico analysis. A RT-quantitative PCR analysis of human bone marrow-derived MSC (hBMSC) cells showed that eRNA_2S was transcribed from the SE with the expression of miR-3129. Knockdown of eRNA_2S by locked nucleic acid as well as treatment of SE inhibitors JQ1 or THZ1 resulted in low miR-3129 levels. Overexpression of miR-3129 promoted hBMSC osteogenesis, while knockdown of miR-3129 inhibited hBMSC osteogenesis. Solute carrier family 7 member 11 (SLC7A11), encoding a bone formation suppressor, was upregulated following miR-3129-5p inhibition and identified as a target gene for miR-3129 during differentiation of hBMSCs into osteoblasts. CONCLUSIONS: miR-3129 expression is regulated by SEs via eRNA_2S and this miRNA promotes hBMSC differentiation into osteoblasts through downregulating the target gene SLC7A11. Thus, the present study uncovers a commitment of an eRNA via a miR-3129/SLC7A11 regulatory pathway during osteogenesis of hBMSCs.

Occurrence of the Omicron variant of SARS-CoV-2 in northern Viet Nam in early 2022.

The Omicron variant caused a surge of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Viet Nam in early 2022, signalling community transmission. We report on active whole-genome sequencing surveillance of positive SARS-CoV-2 samples collected at that time in northern Viet Nam from international arrivals and community clusters. We used an amplicon protocol developed with 14 polymerase chain reaction products and the Illumina iSeq 100 platform. Overall, 213 nasopharyngeal or throat swabs were analysed, of which 172 samples were identified with the Omicron variant. Of these, 80 samples were collected from community cases in February 2022, among which 59 samples were sublineage BA.2 and one sample was the recombinant XE variant. Our results indicated that Omicron had replaced Delta as the dominant variant in a very short period of time and that continuously conducting active whole-genome sequencing surveillance is necessary in monitoring the evolution and genomic diversity of SARS-CoV-2 in Viet Nam.

Virological characteristics of cases of COVID-19 in northern Viet Nam, January-May 2020.

Background: Viet Nam confirmed its first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on 23 January 2020 among travellers from Wuhan, China, and experienced several clusters of community transmission until September. Viet Nam implemented an aggressive testing, isolation, contact tracing and quarantine strategy in response to all laboratory-confirmed cases. We report the results of SARS-CoV-2 testing during the first half of 2020 in northern Viet Nam. Methods: Between January and May 2020, 15 650 upper respiratory tract specimens were collected from 14 470 suspected cases and contacts in northern Viet Nam. All were tested for SARS-CoV-2 by real-time RT-PCR. Individuals with positive specimens were tested every three days until two tests were negative. Positive specimens from 81 individuals were cultured. Results: Among 14 470 tested individuals, 158 (1.1%) cases of SARS-CoV-2 infection were confirmed; 89 were imported and 69 were associated with community transmission. Most patients (122, 77%) had negative results after two tests, while 11 and 4 still tested positive when sampled a third and fourth time, respectively. SARS-CoV-2 was isolated from 29 of 81 specimens (36%) with a cycle threshold (Ct) value < 30. Seven patients who tested positive again after testing negative had Ct values > 30 and negative cultures. Conclusion: Early, widespread testing for SARS-CoV-2 in northern Viet Nam identified very few cases, which, when combined with other aggressive strategies, may have dramatically contained the epidemic. We observed rapid viral clearance and very few positive results after clearance. Large-scale molecular diagnostic testing is a critical part of early detection and containment of COVID-19 in Viet Nam and will remain necessary until vaccination is widely implemented.

Intimate Partner Violence Myths in Police Reports: A Directed Content Analysis.

Although much has changed in social and criminal justice system responses to intimate partner violence (IPV) since public awareness campaigns began in the 1970s, stigmatization around IPV offense and victimization remains a barrier to victims obtaining available assistance, including those offered by police forces. Unfortunately, stigma is often perpetuated by mythology about the crime, its offenders, its victims, and overarching gender norms. Since IPV cases are managed under the auspices of the criminal justice system, the manner in which the system itself perpetuates IPV myths is worthy of attention. Prior literature suggests that police officers may be vulnerable to this mythology in their decision-making and reporting of IPV calls. This is troubling for IPV victims and offenders alike, since police reports follow them through the criminal justice system and associated IPV intervention programs. A report heavily influenced by IPV mythology is unlikely to serve IPV offenders or victims particularly well. Guided by four popular IPV myths identified in Eigenberg et al.'s (2012) study, the purpose of the present qualitative study of IPV in police reports (N = 58) is to explore the influence of IPV mythology on police officers' decision-making and intervention. One overarching theme emerged after the analysis: undetected coercive control evident in the cases. Implications on improvement in police training are suggested.

Surveillance of Severe Acute Respiratory Infection (SARI) for Hospitalized Patients in Northern Vietnam, 2011-2014.

Severe acute respiratory infections (SARI) are leading causes of hospitalization, morbidity, and mortality in children worldwide. The aim of this study was to identify viral pathogens responsible for SARI in northern Vietnam in the period from 2011 to 2014. Throat swabs and tracheal aspirates were collected from SARI patients according to WHO guidelines. The presence of 13 different viral pathogens (influenza A[H1N1]pdm09; A/H3N2; A/H5; A/H7 and B; para influenza 1,2,3; RSV; HMPV; adeno; severe acute respiratory syndrome-CoV and rhino) was tested by conventional/real-time reverse transcription-polymerase chain reaction. During the study period, 975 samples were collected and tested. More than 30% (32.1%, 313 samples) of the samples showed evidence of infection with influenza viruses, including A/H3N2 (48 samples), A (H1N1) pdm09 (221 samples), influenza B (42 samples), and co-infection of A (H1N1) pdm09 or A/H3N2 and influenza B (2 samples). Other respiratory pathogens were detected in 101 samples, including rhinovirus (73 samples), adenovirus (10 samples), hMPV (9 samples), parainfluenza 3 (5 samples), parainfluenza 2 (3 samples), and RSV (1 sample). Influenza A/H5, A/H7, or SARS-CoV were not detected. Respiratory viral infection, particularly infection of influenza and rhinoviruses, were associated with high rates of SARI hospitalization, and future studies correlating the clinical aspects are needed to design interventions, including targeted vaccination.

Isosorbide as the structural component of bio-based unsaturated polyesters for use as thermosetting resins.

In recent years, the development of renewable bio-based resins has gained interest as potential replacements for petroleum based resins. Modified carbohydrate-based derivatives have favorable structural features such as fused bicyclic rings that offer promising candidates for the development of novel renewable polymers with improved thermomechanical properties when compared to early bio-based resins. Isosorbide is one such compound and has been utilized as the stiffness component for the synthesis of novel unsaturated polyesters (UPE) resins. Resin blends of BioUPE systems with styrene were shown to possess viscosities (120-2200 cP) amenable to a variety of liquid molding techniques, and after cure had Tgs (53-107 °C) and storage moduli (430-1650 MPa) that are in the desired range for composite materials. These investigations show that BioUPEs containing isosorbide can be tailored during synthesis of the prepolymer to meet the needs of different property profiles.

Correlation between HIV and sexual behavior, drug use, trichomoniasis and candidiasis among female sex workers in a Mekong Delta province of Vietnam.

To determine the prevalence of HIV and correlates of HIV infection among female sex workers (FSWs) in Soc Trang province, Vietnam, a survey of 406 FSWs in Soc Trang province was conducted between May and August, 2003. The participants were interviewed, using a standardized interview, to obtain information about socio-demographic and behavioral characteristics, and gynecologic and sexually transmitted infection (STI) history. The prevalence of HIV was 3.3%. An increased risk for HIV was associated with ever using illicit drugs, direct sex work, early sexual debut, age of FSWs, and infection with candidiasis and trichomoniasis. Reduced likelihood of HIV was only associated with withdrawal as a contraceptive method. A strong association of HIV with drug use and candidiasis and trichomoniasis infection among FSWs was found. Needle/syringe exchange, STI treatment, and methadone programs targeting FSWs should be implemented, and should include 100% condom use promotion.

Sexually transmitted infections and risk factors for gonorrhea and chlamydia in female sex workers in Soc Trang, Vietnam.

GOAL: To determine the prevalence of selected STIs and correlates of chlamydia (CT) and gonorrhea (GC) infection among (FSWs) in Soc Trang province, Vietnam. STUDY DESIGN: Four hundred and six FSWs in Soc Trang province participated in a cross-sectional study between May and August, 2003. The study subjects were interviewed to obtain information about socio-demographic and behavioral characteristics and gynecologic and STI history, using a standardized interview. They underwent a physical examination during which cervical swabs were collected for GC and CT testing by polymerase chain reaction (PCR). Vaginal wet mount microscopy was performed to detect candidiasis and trichomoniasis (TV), and blood was drawn for testing for syphilis using rapid plasma reagin (RPR)+ Treponema pallidum hemagglutination assay (TPHA). Univariate and multivariate analyses were used to assess the associations of GC, CT, and GC/CT with selected variables. RESULTS: Prevalences were 14.9% for GC, 48.4% for CT, 54.9% for GC/CT, 3.8% for syphilis, 8.9% for trichomoniasis, and 12.2% for candidiasis. Increased risk for CT was associated with sex work for more than 6 months (aOR = 2.40, 95% CI: 0.99-5.82), receiving $4 US or less per sexual transaction (aOR = 1.91, 95% CI 1.13-3.23), and ever having terminated a pregnancy (aOR = 1.68, 95% CI 1.00-2.82). Reduced likelihood of CT was associated with older age (aOR = 0.96, 95% CI: 0.93-1.00) and ever having douched in the past month (aOR = 0.60, 95% CI 0.36-1.00). Only ever douching in the past month was associated with decreased risk for GC (aOR = 0.47, 95% CI 0.25-0.87). Higher likelihood of GC/CT was associated with having more than 4 clients per month (OR = 2.35, 95% CI 1.02-5.41) and receiving $4 US or less per sexual transaction (aOR = 1.74, 95% CI 1.04-2.93). CONCLUSIONS: The prevalence of GC/CT is high amongst FSWs in Soc Trang. Therefore, periodic presumptive treatment (PPT) for cervicitis, together with World Health Organization-recommended periodic syndromic sexually transmitted disease management, for FSWs and further interventions should be considered, and a 100% condom use program should be promptly implemented. The existing STI health education program for FSWs should be strengthened, with special consideration of the correlates observed in this study.