Transcatheter Edge-to-Edge Mitral Valve Repair in a Patient With Anderson-Fabry Disease.

Severe degenerative mitral regurgitation (DMR) is one cardiac manifestation of the multiorgan metabolic enzyme disorder Anderson-Fabry Disease (AFD). Although DMR is normally managed surgically, many patients with AFD are unsuitable for this. We present the first case of mitral transcatheter edge-to-edge repair in a patient with AFD.

Building a Vietnamese Dataset for Natural Language Inference Models.

Natural language inference models are essential resources for many natural language understanding applications. These models are possibly built by training or fine-tuning using deep neural network architectures for state-of-the-art results. That means high-quality annotated datasets are essential for building state-of-the-art models. Therefore, we propose a method to build a Vietnamese dataset for training Vietnamese inference models which work on native Vietnamese texts. Our approach aims at two issues: removing cue marks and ensuring the writing style of Vietnamese texts. If a dataset contains cue marks, the trained models will identify the relationship between a premise and a hypothesis without semantic computation. For evaluation, we fine-tuned a BERT model, viNLI, on our dataset and compared it to a BERT model, viXNLI, which was fine-tuned on XNLI dataset. The viNLI model has an accuracy of 94.79%, while the viXNLI model has an accuracy of 64.04% when testing on our Vietnamese test set. In addition, we also conducted an answer selection experiment with these two models in which the P@1 of viNLI and of viXNLI are 0.4949 and 0.4044, respectively. That means our method can be used to build a high-quality Vietnamese natural language inference dataset.

Building a Discourse-Argument Hybrid System for Vietnamese Why-Question Answering.

Recently, many deep learning models have archived high results in question answering task with overall F1 scores above 0.88 on SQuAD datasets. However, many of these models have quite low F1 scores on why-questions. These F1 scores range from 0.57 to 0.7 on SQuAD v1.1 development set. This means these models are more appropriate to the extraction of answers for factoid questions than for why-questions. Why-questions are asked when explanations are needed. These explanations are possibly arguments or simply subjective opinions. Therefore, we propose an approach to finding the answer for why-question using discourse analysis and natural language inference. In our approach, natural language inference is applied to identify implicit arguments at sentence level. It is also applied in sentence similarity calculation. Discourse analysis is applied to identify the explicit arguments and the opinions at sentence level in documents. The results from these two methods are the answer candidates to be selected as the final answer for each why-question. We also implement a system with our approach. Our system can provide an answer for a why-question and a document as in reading comprehension test. We test our system with a Vietnamese translated test set which contains all why-questions of SQuAD v1.1 development set. The test results show that our system cannot beat a deep learning model in F1 score; however, our system can answer more questions (answer rate of 77.0%) than the deep learning model (answer rate of 61.0%).

Impact of education and network for avian influenza H5N1 in human: knowledge, clinical practice, and motivation on medical providers in Vietnam.

BACKGROUND: Knowledge, clinical practice, and professional motivation of medical providers relating to H5N1 infection have an important influence on care for H5N1 patients who require early diagnosis and early medical intervention. METHODS/PRINCIPAL FINDINGS: Novel educational programs including training and workshops for medical providers relating to H5N1 infection in Vietnam were originally created and implemented in 18 provincial hospitals in northern Vietnam between 2008 and 2010. A self-administered, structured questionnaire survey was conducted in 8 provincial hospitals where both educational training and workshops were previously provided. A total of 326 medical providers, including physicians, nurses, and laboratory technicians who attended or did not attend original programs were enrolled in the survey. Knowledge, clinical attitudes and practice (KAP), including motivation surrounding caring for H5N1 patients, were evaluated. The study indicated a high level of knowledge and motivation in all professional groups, with especially high levels in laboratory technicians. Conferences and educational programs were evaluated to be the main scientific information resources for physicians, along with information from colleagues. The chest radiographs and the initiation of antiviral treatment in the absence of RT-PCR result were identified as gaps in education. Factors possibly influencing professional motivation for caring for H5N1 patients included healthcare profession, the hospital where the respondents worked, age group, attendance at original educational programs and at educational programs which were conducted by international health-related organizations. CONCLUSIONS: Educational programs provide high knowledge and motivation for medical providers in Vietnam caring for H5N1 patients. Additional educational programs related to chest radiographs and an initiation of treatment in the absence of RT-PCR are needed. Networking is also necessary for sharing updated scientific information and practical experiences. These enhanced KAPs by educational programs and integrated systems among hospitals should result in appropriate care for H5N1 patients and may reduce morbidity and mortality.

Major stent deformation/pseudofracture of 7 Crown Endeavor/Micro Driver stent platform: incidence and causative factors.

AIMS: This is the initial report of stent deformation/pseudofracture of the 7 crown Endeavor/Micro Driver stent platform (2.25-2.75 mm), whereby the post-dilation balloon catches and causes major stent deformation angiographically appearing as a large stent fracture. We sought to determine frequency and cause. METHODS AND RESULTS: Analysis of 1,000 consecutive Endeavor/Micro Driver stents (7 crown) deployed at our institution. Bench testing was also performed by deploying 10 stents in 2.5 mm tubing and then attempting re-crossing with non-compliant balloons. CLINICAL RESULTS: There were 14 cases of major stent deformation/pseudofracture representing an incidence of 1.4% or 1.8% of 775 stents that were post-dilated. Of the 14 deformed stents, re-stenting was required in nine and MACE occurred in five (36%.). Benchtop results: Balloon "catch" was reproducible at an initial frequency of 9% and affected three of the 10 stents. With the use of provocative measures stent deformation occurred in 50% of test stents. CONCLUSIONS: Stent deformation/pseudofracture of the 7 crown Endeavor/Micro Driver platform occurred in 1.8% of cases that were post-dilated. Of these, 36% experience MACE. Deformation can be reproduced on the benchtop. Operators should be aware of the complication, and develop strategies to deal with it.

Skin disease among farmers using wastewater in rice cultivation in Nam Dinh, Vietnam.

OBJECTIVE: To assess the risk of skin disease among farmers occupationally exposed to wastewater. METHODS: One-year follow-up study with monthly assessments of wastewater exposure and skin disease in Nam Dinh, northern Vietnam, in two adjacent communes with contrasting levels of wastewater use. In each commune, 200 households were randomly selected. RESULTS: Of the 1103 individuals aged > or =15 years, 381 reported a skin problem at baseline or at any of the monthly visits, primarily dermatitis (eczema) and superficial fungal infections. Among the 874 subjects who were free from skin disease at baseline and who could be followed up > or =11 months, 183 developed a new skin disease (cumulative incidence 21%). Exposure to wastewater was a major risk factor for skin disease with a relative risk (RR) of 1.89 [95% confidence interval (CI) 1.39-2.57] in multivariable analysis. Other risk factors for skin disease were involvement in agriculture in general (RR = 2.59, 95% CI 1.11-6.02), flower cultivation (RR = 1.36, 95% CI 1.01-1.83), vegetable farming (RR = 1.47, 95% CI 1.04-2.08), and a history of eczema (RR = 1.47, 95% CI 1.05-2.05). CONCLUSION: Exposure to wastewater is a major risk factor for skin disease. In future studies, an attempt should be made to link specific chemical or biological agents in the wastewater to specific skin diseases.

Dermatitis among farmers engaged in peri-urban aquatic food production in Hanoi, Vietnam.

OBJECTIVE: To assess whether exposure to wastewater is a risk factor for dermatitis (eczema) among farmers engaged in peri-urban aquatic food production in Hanoi, Vietnam. METHODS: A cross-sectional study with two follow-ups was conducted from April to December 2005 in two peri-urban communes in Hanoi, one using wastewater and another using river, rain and well water for aquatic food production. In each commune, 100 households were randomly selected and adult household members engaged in farming field work were interviewed in three surveys. Farmers who reported skin problems at the time of interviews were examined and treated by a dermatologist. Data were analysed for one farmer per household. RESULTS: The overall prevalence of dermatitis from 592 interviews was 6.3%. The commune which used wastewater had a much higher overall prevalence of dermatitis (10.4%) than the commune that did not (2.1%; P-value < 0.001). Multivariable logistic regression analyses showed that occupational wastewater contact was an important risk factor for dermatitis (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.1-7.7). Duration of daily wastewater contact was not significantly associated with dermatitis. Aquaculture work in the wet season carried an increased risk of dermatitis in both communes (OR 2.8; 95% CI 1.02-7.6). The use of personal protective measures during field work and washing hands and feet after work did not reduce the risk for dermatitis. However, observations showed that these practices were applied in such a way that they were unlikely to provide effective protection against wastewater contact. CONCLUSION: Contact with wastewater is an important risk factor for dermatitis among farmers engaged in wastewater-fed peri-urban aquatic food production. Additional studies should test preventive and mitigating measures such as improved personal protection and hygiene.