End-to-End Ultrasonic Hand Gesture Recognition.

As the number of electronic gadgets in our daily lives is increasing and most of them require some kind of human interaction, this demands innovative, convenient input methods. There are limitations to state-of-the-art (SotA) ultrasound-based hand gesture recognition (HGR) systems in terms of robustness and accuracy. This research presents a novel machine learning (ML)-based end-to-end solution for hand gesture recognition with low-cost micro-electromechanical (MEMS) system ultrasonic transducers. In contrast to prior methods, our ML model processes the raw echo samples directly instead of using pre-processed data. Consequently, the processing flow presented in this work leaves it to the ML model to extract the important information from the echo data. The success of this approach is demonstrated as follows. Four MEMS ultrasonic transducers are placed in three different geometrical arrangements. For each arrangement, different types of ML models are optimized and benchmarked on datasets acquired with the presented custom hardware (HW): convolutional neural networks (CNNs), gated recurrent units (GRUs), long short-term memory (LSTM), vision transformer (ViT), and cross-attention multi-scale vision transformer (CrossViT). The three last-mentioned ML models reached more than 88% accuracy. The most important innovation described in this research paper is that we were able to demonstrate that little pre-processing is necessary to obtain high accuracy in ultrasonic HGR for several arrangements of cost-effective and low-power MEMS ultrasonic transducer arrays. Even the computationally intensive Fourier transform can be omitted. The presented approach is further compared to HGR systems using other sensor types such as vision, WiFi, radar, and state-of-the-art ultrasound-based HGR systems. Direct processing of the sensor signals by a compact model makes ultrasonic hand gesture recognition a true low-cost and power-efficient input method.

Measuring effects of ivermectin-treated cattle on potential malaria vectors in Vietnam: A cluster-randomized trial.

BACKGROUND: Malaria elimination using current tools has stalled in many areas. Ivermectin (IVM) is a broad-antiparasitic drug and mosquitocide and has been proposed as a tool for accelerating progress towards malaria elimination. Under laboratory conditions, IVM has been shown to reduce the survival of adult Anopheles populations that have fed on IVM-treated mammals. Treating cattle with IVM has been proposed as an important contribution to malaria vector management, however, the impacts of IVM in this One Health use case have been untested in field trials in Southeast Asia. METHODS: Through a randomized village-based trial, this study quantified the effect of IVM-treated cattle on anopheline populations in treated vs. untreated villages in Central Vietnam. Local zebu cattle in six rural villages were included in this study. In three villages, cattle were treated with IVM at established veterinary dosages, and in three additional villages cattle were left as untreated controls. For the main study outcome, the mosquito populations in all villages were sampled using cattle-baited traps for six nights before, and six nights after a 2-day IVM-administration (intervention) period. Anopheline species were characterized using taxonomic keys. The impact of the intervention was analyzed using a difference-in-differences (DID) approach with generalized estimating equations (with negative binomial distribution and robust errors). This intervention was powered to detect a 50% reduction in total nightly Anopheles spp. vector catches from cattle-baited traps. Given the unusual diversity in anopheline populations, exploratory analyses examined taxon-level differences in the ecological population diversity. RESULTS: Across the treated villages, 1,112 of 1,523 censused cows (73% overall; range 67% to 83%) were treated with IVM. In both control and treated villages, there was a 30% to 40% decrease in total anophelines captured in the post-intervention period as compared to the pre-intervention period. In the control villages, there were 1,873 captured pre-intervention and 1,079 captured during the post-intervention period. In the treated villages, there were 1,594 captured pre-intervention, and 1,101 captured during the post-intervention period. The difference in differences model analysis comparing total captures between arms was not statistically significant (p = 0.61). Secondary outcomes of vector population diversity found that in three villages (one control and two treatment) Brillouin's index increased, and in three villages (two control and one treatment) Brillouin's index decreased. When examining biodiversity by trapping-night, there were no clear trends in treated or untreated vector populations. Additionally, there were no clear trends when examining the components of biodiversity: richness and evenness. CONCLUSIONS: The ability of this study to quantify the impacts of IVM treatment was limited due to unexpectedly large spatiotemporal variability in trapping rates; an area-wide decrease in trapping counts across all six villages post-intervention; and potential spillover effects. However, this study provides important data to directly inform future studies in the GMS and beyond for IVM-based vector control.

Interaction between stabilized droplets of different phases in the same continuous phase of an aqueous three-phase system.

Water-in-water (W/W) emulsions, also called aqueous two-phase systems, are formed by mixing two incompatible polymers in water that phase separate into two distinct phases. They can be stabilized by addition of colloidal particles. Droplets of the dispersed phase can be used to compartmentalize ingredients and induce localized reactions. By mixing more types of incompatible polymers, emulsions containing droplets of different phases can be formed that can potentially capture different ingredients. Here the interaction between dispersed droplets of different types was studied by gently mixing a W/W emulsion containing droplets rich in dextran (DEX) dispersed in a continuous phase rich in polyethylene oxide with an emulsion containing droplets rich in fish gelatin (GEL) dispersed in the same continuous medium. Bis-hydrophilic microgels (MG) consisting of DEX grafted with poly(N-isopropylacrylamide) were added and their effect on the stability of each binary emulsion was investigated. Interestingly, when two very stable emulsions were gently mixed, droplets of different types were observed with confocal scanning laser microscopy to coalesce immediately upon contact. In this manner, Janus-type droplets were formed containing a DEX and a GEL compartment with no MG at the GEL/DEX interface that further associated into strings of alternating droplets. Contact angles between the different phases in emulsions with and without MG were compared and used to determine the effect of the microgels on the interfacial tension between the phases.

Supplementary Respiratory Therapy Improves Pulmonary Function in Pediatric Patients with Cerebral Palsy: A Systematic Review and Meta-Analysis.

BACKGROUND: Despite medical advances, individuals with cerebral palsy (CP) face significant respiratory challenges, leading to heightened hospitalization rates and early mortality among this population. We hypothesize that integrating supplementary respiratory therapy into standard rehabilitation will result in significant improvements in pulmonary function, enhanced respiratory muscle strength, and an overall increase in the quality of life among pediatric patients with CP. METHODS: A systematic search of literature across five databases was conducted, and random-effects meta-analyses were performed to assess the impact of supplementary respiratory therapy on (a) pulmonary function: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio, peak expiratory flow (PEF), and (b) respiratory muscle strength: maximal inspiratory and expiratory pressure (MIP, MEP), and (c) quality of life. Certainty of evidence was determined by the GRADE assessment. RESULTS: Analysis of data from 11 eligible randomized controlled trials revealed clinically meaningful changes in pulmonary function. We found a relevant mean difference (MD) in absolute PEF of 0.50 L/s (95% confidence interval (CI): 0.19; 0.82 p = 0.0107). The certainty of the evidence ranged from moderate to high. CONCLUSIONS: This study presents current evidence on the impact of various supplementary respiratory therapies for CP patients classified under gross motor function classification level I-IV, demonstrating clinically meaningful improvements in pulmonary function and respiratory muscle strength. These improvements suggest the potential for an enhanced quality of life. Our findings hold the promise of serving as a foundational reference for potential revisions to conventional rehabilitation care, incorporating supplementary respiratory therapy.

Sorption of four antibiotics onto pristine biochar derived from macadamia nutshell.

In this study, the sorption properties of ciprofloxacin, ofloxacin, sulfamethoxazole, and trimethoprim on biochar derived from macadamia nut shells were investigated. The raw biomass was pyrolyzed at 600 °C to create a highly porous material with a surface area of 392 m2 g-1. The produced biochar was found to be a valuable material for both environmental remediation and carbon sequestration due to its high carbon and oxygen content. The sorption properties of four antibiotics on the produced biochar were compared using Bayesian nonlinear regression based on second-order kinetics and the Langmuir model. The Bayesian estimation successfully compared the adsorption coefficients of the antibiotics, which can be directly visualized through graphical grammar using the probability density distribution. The results demonstrated the ability of macadamia nut shell biochar to remove antibiotics from water at neutral pH, and this material has the potential to be used for treating other emerging contaminants.

Detection of chromosome-mediated blaNDM-1-carrying Aeromonas spp. in the intestinal contents of fresh water river fish in Ho Chi Minh City, Vietnam.

The spread of antibiotic-resistant bacteria is a global problem that should be addressed through the perspective of the "one health" concept. The purpose of this study was to determine the contamination rate of antibiotic-resistant Aeromonas spp. in fresh water river fish purchased from a fish market in Vietnam. We then defined the pattern of antibiotic resistance to assess antibiotic-resistant contamination. Antibiotic-resistant Aeromonas spp. were detected in the intestinal contents of 32 of 80 fish. blaNDM-1 was detected in seven strains. Extended-spectrum ß-lactamase and AmpC ß-lactamase-related genes were detected in 28 strains, including blaCTX-M-55, blaCTX-M-15, blaCTX-M-1, and blaDHA,blaFOX, and blaMOX. The blaNDM-1 detected in the seven Aeromonas spp. strains were found chromosomally. This finding suggests that the blaNDM gene is stable in the natural environment and may spread widely into animals and humans via Aeromonas spp. with a transposon. Our results suggest the importance of continuing to monitor carbapenemase genes in Aeromonas spp. to evaluate the possibility that they may spread in other Enterobacterales, and to elucidate the mechanism of spread.

Effect of charge on the stabilization of water-in-water emulsions by thermosensitive bis-hydrophilic microgels.

HYPOTHESIS: Molecular surfactants are not able to stabilize water-in-water (W/W) emulsions, unlike nano or micro-particles, which can achieve this in some cases. However, the effect of electrostatic interactions between particles on the emulsion stability has rarely been investigated. We hypothesize that introducing charges modifies the stabilization capacity of particles and renders it both pH- and ionic strength-dependent. EXPERIMENTS: Charge was introduced into bis-hydrophilic and thermoresponsive dextran/polyN-isopropylacrylamide microgels by replacing a small fraction of polyN-isopropylacrylamide with acrylic acid groups. The size of the microgels was obtained by dynamic light scattering. The stability and microstructure of dextran/poly(ethyleneoxide)-based W/W emulsions, was studied as a function of pH, NaCl concentration and temperature using confocal microscopy and by analytical centrifugation. FINDINGS: The swelling degree of charged microgels depends on the pH, ionic strength and the temperature. In the absence of salt, charged microgels do not adsorb at the interface and have little stabilizing effect even after neutralization. However, the interfacial coverage and the stability increase with rising concentration of NaCl. Saltinduced stabilization of these emulsions was also observed at 50 °C. Increasing the temperature strongly influences the emulsion stability at low pH.

Current Trends in Clinical Characteristics, Diagnosis, and Treatment of Polypoidal Choroidal Vasculopathy: A Perspective from Vietnam.

Polypoidal choroidal vasculopathy (PCV) is a common choroidal disease in the Asian population including Vietnam and is characterized by subretinal red-orange nodules, pigmented epithelium detachment, and massive subretinal hemorrhage. The recent focus on PCV in Vietnam can be attributed to advancements in PCV diagnosis and treatment. However, there is a scarcity of published literature and clinical data on PCV in the Vietnamese population, highlighting a key knowledge gap in this region. In order to address this gap, we gathered the opinions of experienced clinicians and retinal experts in Vietnam and reviewed available medical literature with the aim of: (i) providing an overview of PCV in the Vietnamese population-in terms of epidemiology, clinical characteristics, and management; (ii) tailoring international/national guidelines for the diagnosis and management of PCV, in line with available resources and medical equipment in Vietnam; and (iii) identifying gaps in clinical data in order to guide future PCV research in Vietnam and other countries with similar clinical conditions. The present review will enable healthcare providers and researchers to gain insight into current clinical practices and the limitations of PCV management in Vietnam and provide optimal and effective solutions.

Differential pulse voltammetry determination of salbutamol using disulfite tungsten/activated carbon modified glassy carbon electrode.

In the present article, the disulfide tungsten/activated carbon derived from Eichhornia crassipes (WS2/AC) was synthesized by the hydrothermal process. The received materials were examined by X-ray diffraction, scanning electron microscopy, energy-dispersive X-ray - mapping, and nitrogen adsorption/desorption isotherms. The morphology of WS2/AC was tailored to have a micro/meso/macro structure that facilized large electric conductivity and quick ion diffusion. The WS2/AC sample was used as an electrode modifier for developing an electrochemical sensor for salbutamol detection. WS2/AC exhibited excellent oxidation toward salbutamol. Through some optimized conditions, the electrochemical signal of the proposed sensor varied linearly to the salbutamol concentration ranging from 1 to 210 µM with a low LOD (detection limit) of 0.52 µM. The developed sensor showed several merits: easy producing, convenient usage, fabulous selectivity, and good repeatability as well as reproducibility. Finally, the suggested technique can be applied to determine salbutamol in people's biological fluid with satisfactory recoveries of 98.5-104.4% and without statistics different from standard HPLC.

A review on the determination of veterinary drug residues in food products.

In this paper, we discuss veterinary medicine and its applications in the food industry as well as the risk to the health of humans and animals caused by these residues. We review how the veterinary residues enter and cause some detrimental effects. We also mention two techniques to determine the residue of veterinary medications that exist in food originating from animals, including classic and advanced techniques. Finally, we discuss the potential of various developed methods and compare them with some traditional techniques.

A state-of-the-art review on the nanomaterial-based sensor for detection of venlafaxine.

Venlafaxine (denoted as VFX), a member of the most extensively prescribed antidepressants, is used to handle major depressive disorder, panic disorder and anxiety. This medication affects brain chemistry, which could cause an imbalance in depressed people. VFX and its metabolites, on the other hand, are pollutants in the water environment. Through movement and transformation in several procedures like adsorption, photolysis, hydrolysis and biodegradation, they have harmed living creatures, resulting in the enhancement of diverse active chemicals found in the environment. As a result, determining VFX at modest concentrations with excellent sensitivity, specificity and repeatability are critical. To quantify VFX, various analytical methodologies have been developed. Electroanalytical processes, on the other hand, have piqued interest because of their superior benefits over traditional techniques such as speed, sensitivity, directness and affordability. Subsequently, the purpose of this article is to show how to determine VFX electrochemically using a wide range of electrodes, including CPE, GCE, MCE, SPE, PGE and ISE.

Deep Learning Model With Convolutional Neural Network for Detecting and Segmenting Hepatocellular Carcinoma in CT: A Preliminary Study.

Introduction Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world. Early detection and accurate diagnosis of HCC play an important role in patient management. This study aimed to develop a convolutional neural network-based model to identify and segment HCC lesions utilizing dynamic contrast agent-enhanced computed tomography (CT). Methods This retrospective study used CT image sets of histopathology-confirmed hepatocellular carcinoma over three phases (arterial, venous, and delayed). The proposed convolutional neural network (CNN) segmentation method was based on the U-Net architecture and trained using the domain adaptation technique. The proposed method was evaluated using 115 liver masses of 110 patients (87 men and 23 women; mean age, 56.9 years ± 11.9 (SD); mean mass size, 6.0 cm ± 3.6). The sensitivity for identifying HCC of the model and Dice score for segmentation of liver masses between radiologists and the CNN model were calculated for the test set. Results The sensitivity for HCC identification of the model was 100%. The median Dice score for HCC segmenting between radiologists and the CNN model was 0.81 for the test set. Conclusion Deep learning with CNN had high performance in the identification and segmentation of HCC on dynamic CT.

Electrochemical sensor to detect terbutaline in biological samples by a green agent.

In this research, reduced graphene oxide (RGO) which is a form of graphene oxide (GO) was formed through a reduction process using a "green agent" called Ascorbic acid (AA). RGO was then modified on the surface of the glassy carbon electrode (GCE) to generate RGO/GCE (an advanced electrode). The RGO/GCE was then used to detect Terbutaline (TB) in urine samples of volunteer athletes (n = 5) using well-known spectrophotometric analyses including X-ray diffraction analysis (XRD), Fourier-transform infrared spectroscopy (FT-IR), ultraviolet-visible Spectroscopy (UV-Vis), and Raman and electrochemical methods using voltammetric analyses such as differential pulse anodic stripping voltammetry (DP-ASV) and cyclic voltammetry (CV). Comparing various analysis methods using RGO/GCE to detect TB in human urine samples, voltammetric analysis specifically DP-ASV demonstrated higher sensitivity and selectivity in detecting TB than spectrophotometric analyses. Thus, in this study, several factors that would affect the voltammetric signals such as pH and interferents were evaluated and the electroactive surface area was also calculated. Our findings indicated that the RGO/GCE showed excellent repeatability, reproducibility, and long-term stability suggesting that TB could be detected more effectively using RGO/GCE than bare GCE. The detection limit of 0.0052 µM achieved in this study indicated that RGO/GCE can effectively detect TB in human urine while demonstrating reasonable selectivity and sensitivity.

Decades of emerging infectious disease, food safety, and antimicrobial resistance response in Vietnam: The role of One Health.

Since facing outbreaks of severe acute respiratory syndrome and avian influenza A in 2003, Vietnam has increasingly applied a One Health approach to address emerging infectious diseases of animal origin. Here, we reflect on the challenges and opportunities of One Health in the context of zoonoses, food safety, and antimicrobial resistance, drawing on a stocktake of One Health training, policy, and research in Vietnam. We also report on the results of a virtual consultation workshop held on July 2021 with representatives from 32 institutions in Vietnam to explore future One Health directions. As Vietnam approaches nearly two decades of disease preparedness and response, we hope our experiences can provide practical insights to support countries in developing coordination mechanisms and moving the One Health agenda forward toward better public health outcomes.

Early centralized isolation strategy for all confirmed cases of COVID-19 remains a core intervention to disrupt the pandemic spreading significantly.

BACKGROUND: In response to the spread of the coronavirus disease 2019 (COVID-19), plenty of control measures were proposed. To assess the impact of current control measures on the number of new case indices 14 countries with the highest confirmed cases, highest mortality rate, and having a close relationship with the outbreak's origin; were selected and analyzed. METHODS: In the study, we analyzed the impact of five control measures, including centralized isolation of all confirmed cases, closure of schools, closure of public areas, closure of cities, and closure of borders of the 14 targeted countries according to their timing; by comparing its absolute effect average, its absolute effect cumulative, and its relative effect average. RESULTS: Our analysis determined that early centralized isolation of all confirmed cases was represented as a core intervention in significantly disrupting the pandemic's spread. This strategy helped in successfully controlling the early stage of the outbreak when the total number of cases were under 100, without the requirement of the closure of cities and public areas, which would impose a negative impact on the society and its economy. However, when the number of cases increased with the apparition of new clusters, coordination between centralized isolation and non-pharmaceutical interventions facilitated control of the crisis efficiently. CONCLUSION: Early centralized isolation of all confirmed cases should be implemented at the time of the first detected infectious case.

Comparing the Safety and Efficacy of Phacogoniosynechialysis With Phacotrabeculectomy in the Management of Refractory Acute Primary Closure Angle Glaucoma With Cataract: A Multicenter Randomized Trial.

PRCIS: Combined phacoemulsification-goniosynechialysis (phaco-GSL) and unaugmented phacotrabeculectomy were both found to be effective in treating eyes with significant cataract and medically unresponsive acute primary angle closure glaucoma (PACG). Phaco-GSL seemed to be safer, with fewer surgical complications, and achieved better visual acuity than phacotrabeculectomy. OBJECTIVES: To compare the results of combined phaco-GSL with unaugmented phacotrabeculectomy in the management of eyes with medically unresponsive acute PACG and cataract. PARTICIPANTS AND RESEARCH METHODS: This was a prospective randomized controlled trial involving patients with significant cataract and acute PACG who were not responsive to maximal medical therapy. Three ophthalmic centers in Hanoi, Vietnam, participated in this trial. Study subjects were randomized into 2 groups: phaco-GSL or phacotrabeculectomy. Of note, mitomycin-C or 5-fluorouracil were not used during trabeculectomy, but postoperative bleb needling with 5-fluorouracil injection(s) was allowed. The primary outcome of the study was the rate of postoperative surgical complications in the first 3 months after surgery. The secondary outcome, determined at 1 year, assessed whether treatment was completely successful [defined as intraocular pressure (IOP)<21 mm Hg without IOP-lowering drops], or partially successful (IOP<21 mm Hg with IOP-lowering drops). Treatment failure was defined as IOP≥21 mm Hg with maximal IOP-lowering drops. RESULTS: In total, 79 eyes from 79 patients (62 females, 17 males) were recruited (42 and 37 eyes in the phaco-GSL and phacotrabeculectomy groups, respectively). There were no statistically significant differences between the 2 groups at baseline in terms of age, visual acuity, IOP, anterior angle width, or preoperative ultrasound biomicroscopy index. Postoperative complications in the first 3 months were seen more frequently in the phacotrabeculectomy group (62.2%) than in the phaco-GSL group (14.3%, P<0.01). At 1 year postsurgery, treatment was 100% successful in both groups, with no difference in the mean IOP (15.38±3.42 vs. 15.72±4.47 mm Hg). The visual field index improved significantly following surgery in both groups, but there was also no significant difference between the 2 groups. However, there was a significant difference in the best corrected visual acuity at 1 year, with patients in the phaco-GSL group achieving better vision (0.45±0.21 logMAR in the phaco-GSL group vs. 0.64±0.27 logMAR in the phacotrabeculectomy group, P=0.04). The mean angle width was also significantly larger in the phaco-GSL group than the phacotrabeculectomy group (2.34±0.33 vs. 1.25±0.41 Shaffer degrees). Similarly, on ultrasound biomicroscopy, the anterior chamber was deeper after 12 months (2.87±0.28 to 2.48±0.33 mm), and the mean trabecular-iris angle area was wider at 12 months (21.88±7.07 vs. 14.95±4.39 degrees) in the phaco-GSL than the phacotrabeculectomy group. CONCLUSIONS: Phaco-GSL and phacotrabeculectomy were both effective in treating medically unresponsive cases of acute PACG with cataracts. However, phaco-GSL showed better visual outcomes, wider drainage angles postsurgery, and fewer complications than phacotrabeculectomy.

Ivermectin Treatment for Cattle Reduced the Survival of Two Malaria Vectors, Anopheles dirus and Anopheles epiroticus, Under Laboratory Conditions in Central Vietnam.

Ivermectin is a low-cost and nontoxic mosquitocide that may have a role in malaria elimination. However, the extent to which this drug impacts the mortality of Anopheles dirus and Anopheles epiroticus, two important malaria vectors in Southeast Asia, is unknown. This study compared and quantified anopheline mortality after feeding on ivermectin-treated cattle and control cattle in Vietnam. Local anopheline colonies fed on cattle 1 to 3, 6 to 8, 13 to 15, 20 to 22, and 28 to 30 days after injection (DAI) with ivermectin (intervention) or saline (control). An. dirus that fed on ivermectin-treated cattle had higher mortality rates than controls for up to 20 DAI (P < 0.05); An. epiroticus that fed on ivermectin-treated cattle had consistently higher mortality rates than controls for up to 8 DAI (P < 0.05). Feeding on ivermectin-treated cattle increased the mortality rate of these vector species for biologically relevant time periods. Therefore, ivermectin has the potential to become an important tool for integrated vector management.

Anxiety Among Inpatients With Cancer: Findings From a Hospital-Based Cross-Sectional Study in Vietnam.

Anxiety, a condition which is commonly found in patients with cancer, has negative impacts on their quality of life and treatment outcome. This study aimed to determine the level of anxiety in patients with cancer and explore sociodemographic, disease-related, and hospital-related factors associated with anxiety in those patients. A cross-sectional study was conducted on 510 inpatients with cancer at Thanh Hoa Oncology Hospital, Vietnam. Data were collected from self-administered questionnaire forms on hospital depression anxiety-A, interviews with patients, and patient medical records. The univariate and multivariate linear regression analyses were performed using STATA ver. 14.0. Our finding that the patients' mean anxiety score (standard deviation) was 7.22 (3.8); 27.6% of the patients had an anxiety score between 8 and 10 points, and 15.5% had an anxiety score of ≥11 points. In the multivariate model, in more advanced stages of cancer, and patients with metastasis were more likely to have higher levels of anxiety than those who presented no sign of metastasis. The longer the patients had cancer, the less anxious they became. Lower levels of anxiety were observed in patients who stated that hospital facilities were adequate or had trust in health workers. Patients with cancer need to be provided with psychological support in the early stage of cancer detection and when metastases form. A strong patient-health-care provider relationship after diagnosis may help reduce distress among patients with cancer with higher levels of medical mistrust.

Stereocontrol in the synthesis of cyclic amino acids: a new ligand for directed hydrogenation through hydrogen bonding.

A system for the directed hydrogenation of nitrogen heterocycles is described in which hydrogen is delivered cis to a hydroxymethyl group by a rhodium catalyst with a simple phosphine ligand. The chemistry is applied to the synthesis of the hygric acid moiety of lincomycin and the pipecolic acid moiety of Argatroban. A series of control experiments indicate that the stereoselectivity is a result of a combination of both coordination and hydrogen bonding.