Determinants of antibiotic prescribing in primary care in Vietnam: a qualitative study using the Theoretical Domains Framework.

BACKGROUND: To formulate effective strategies for antimicrobial stewardship (AMS) in primary care, it is crucial to gain a thorough understanding of factors influencing prescribers' behavior within the context. This qualitative study utilizes the Theoretical Domains Framework (TDF) to uncover these influential factors. METHODS: We conducted a qualitative study using in-depth interviews and focus group discussions with primary care workers in two provinces in rural Vietnam. Data analysis employed a combined inductive and deductive approach, with the deductive aspect grounded in the TDF. RESULTS: Thirty-eight doctors, doctor associates, and pharmacists participated in twenty-two interviews and two focus group discussions. We identified sixteen themes, directly mapping onto seven TDF domains: knowledge, skills, behavioral regulation, environmental context and resources, social influences, social/professional role and identity, and optimism. Factors driving unnecessary prescription of antibiotics include low awareness of antimicrobial resistance (AMR), diagnostic uncertainty, prescription-based reimbursement policy, inadequate medication supplies, insufficient financing, patients' perception of health insurance medication as an entitlement, and maintaining doctor-patient relationships. Potential factors facilitating AMS activities include time availability for in-person patient consultation, experience in health communication, and willingness to take action against AMR. CONCLUSION: Utilizing the TDF to systematically analyze and present behavioral determinants offers a structured foundation for designing impactful AMS interventions in primary care. The findings underscore the importance of not only enhancing knowledge and skills but also implementing environmental restructuring, regulation, and enablement measures to effectively tackle unnecessary antibiotic prescribing in this context.

Cloning, characterization of ß-glucosidase from Furfurilactobacillus rossiae in bioconversion and its efficacy.

Minor ginsenosides produced by ß-glucosidase are interesting biologically and pharmacologically. In this study, new ginsenoside-hydrolyzing glycosidase from Furfurilactobacillus rossiae DCYL3 was cloned and expressed in Escherichia coli strain BL21. The enzyme converted Rb1 and Gyp XVII into Rd and compound K following the pathways: Rb1→Rd and Gyp XVII→F2→CK, respectively at optimal condition: 40 °C, 15 min, and pH 6.0. Furthermore, we examined the cytotoxicity, NO production, ROS generation, and gene expression of Gynostemma extract (GE) and bioconverted Gynostemma extract (BGE) in vitro against A549 cell lines for human lung cancer and macrophage RAW 264.7 cells for antiinflammation, respectively. As a result, BGE demonstrated significantly greater toxicity than GE against lung cancer at a dose of 500 µg/mL but in normal cells showed lower toxicity. Then, we indicated an enhanced generation of ROS, which may be boosting cancer cell toxicity. By blocking the intrinsic way, BGE increased p53, Bax, Caspase 3, 9, and while Bcl2 is decreased. At 500 µg/mL, the BGE sample was less toxic in normal cells and decreased the LPS-treated NO and ROS level to reduce inflammation. In addition, BGE inhibited the expression of pro-inflammatory genes COX-2, iNOS, IL-6, and IL-8 in RAW 264.7 cells than the sample of GE. In conclusion, FrBGL3 has considerable downstream applications for high-yield, low-cost, effective manufacture of minor ginsenosides. Moreover, the study's findings imply that BGE would be potential materials for anti-cancer and anti-inflammatory agent after consideration of future studies.

•The first time ß-glucosidase (FrBGL3) from Furfurilactobacillus rossiae was identified and characterized.•FrBGL3 activity in ginsenoside and gypenoside bioconversion were found and confirmed.•Application in Gynostemma extract bioconversion by FrBGL3 boosts anti-inflammatory and anti-cancer activities.

Improving organic and nutrient removal efficiencies in seafood processing wastewater using anaerobic membrane bioreactor (AnMBR) integrates with anoxic/oxic (AO) processes.

Wastewater from seafood processing is a significant source of pollution, containing many harmful organic and inorganic compounds such as proteins, lipids, carbohydrates, nitrogen and phosphorus. This study investigated the enhancement of organic and nutrient removal efficiencies in seafood processing wastewater by integrating an Anaerobic Membrane Bioreactor (AnMBR) with an anoxic/oxic (AO) processes. A pilot-scale system was constructed with a capacity of 0.5 m3/day directly at the factory operated continuously, featuring an AnMBR process with a 24-hour hydraulic retention time (HRT) and an AO process with HRT values and internal recycle changes. The AnMBR system exhibited consistent and high-performance biochemical oxygen demand (COD) elimination, approximately 80 ± 5 %. However, this system demonstrated low-efficiency removal of total nitrogen (TN) at about 20 ± 5 %, and total phosphorus (TP) 15 ± 5 %, under organic loading rates (OLR) of 0.6 to 1.3 kg-COD/(L·d). The AO process was then continually employed to improve the treatment efficacy (at HRT, 5 h in the anoxic phase, and 8.3 h in the oxic phase, at a recycling rate of 300 %) resulting in the final post-treatment concentrations of COD 27-41 mg/L (removal 98.3 ± 0.3 %), TN 12-25 mg/L (90 ± 2 %), and TP 18 ± 2 mg/L (35 ± 5 %). The performance of the integrated AnMBR-AO system met the established Vietnamese discharge standards for seafood processing wastewater, as outlined in QCVN 11-MT: 2015/BTNMT.

Tube-like Gold Clusters M2@Au17 q (M = W, Mo; q = 0, ±1): Structure, Electronic Property, and Optical Nonlinearity.

Density functional theory (DFT) calculations are carried out to determine the geometries and electronic and nonlinear optical (NLO) properties of the doubly doped gold clusters in three charge states M2 @ Au17 q with M = W, Mo and q = 0, ±1. At their lowest-lying equilibrium structures, the impurities that are vertically encapsulated inside a cylindrical gold framework, significantly enhance the stability and modify properties of the host. The presence of M2 units results in the formation of a tube-like ground state, which is identified for the first time for gold clusters. Having 30 itinerant electrons, the electron shell of M2@Au17 - can be described as 1S21P61D102S2{1F xz 2 21F yz 2 2}1F z 3 2{1F xyz 21F z(x 2-y 2) 2}{1F y(3x 2 -y 2),1F x(x 2 -3y 2)}. The species is thus stabilized upon doping, but it is not a magic cluster. The optical transitions are shifted to the lower-energy region upon doping Mo and W atoms into Au17 q . The static and dynamic NLO properties of M2@Au17 q are also computed and compared to those of the pure Au19 q (having the same number of atoms) and an external reference molecule, i.e., para-nitroaniline (p-NA). For hyperpolarizabilities, the doped clusters possess smaller values than those of their pure counterparts but much larger values than the p-NA. Of the doubly doped systems, the neutral M2@Au17 exhibits particularly high first and second hyperpolarizability tensors. The doped cluster units can also be used as building blocks for the design of gold-based nanowires with outstanding electronic and optical characteristics.

Specific cultural traits of the precarity of older Latinos living alone with cognitive impairment in the San Francisco Bay Area.

OBJECTIVES: Latinos are about twice as likely to develop cognitive impairment. Culturally, filial support and familismo are expected within Latino families. Yet approximately twenty percent of Latinos live alone in the United States. The purpose of this study is to explore the concerns and priorities of older Latinos living alone with cognitive impairment, using a precarity framework. METHOD: We conducted 22 in-home interviews with older Latinos living alone with cognitive impairment, and we supplemented the interviews with interviews with members of the older adults' social circle and providers. Themes influencing the precarity of Latino older adults living alone were organized through the major areas of the precarity lens; 1) Limited awareness of cognitive impairment; 2) Self-management of cognitive impairment; and 3) Lacking tailored services for cognitive impairment. RESULTS: Latino culture permeated and intersected across the lived experiences of participants living alone with cognitive impairment. Precarity was prevalent in all participants' lives and was exacerbated by familismo combined with cognitive impairment. CONCLUSION: Findings showed precarity in the experiences the participants shared. Participant narratives reveal how the Latino culture intersects with the experience of precarity while living alone with cognitive impairment, especially in reference to the role that family plays through the expectation of familismo. However, given the difficult demands of employment and raising their own families, familismo can become more like a goal than a practice. Further research is needed to better understand how to bridge the gap between the needs of these older Latino adults living alone with cognitive impairment, their families, and formal services.

Optimization of the Diagnosis of Central Nervous System Infections in Vietnamese Hospitals: Results From a Retrospective Multicenter Study.

Introduction: Central nervous system infections pose significant health challenges, particularly in low- and middle-income countries, because of high morbidity and mortality rates. Rapid and accurate diagnosis is essential for effective treatment to prevent adverse outcomes. Traditional culture-based diagnostics are often slow and lack specificity. This study evaluates the BioFire FilmArray Meningitis/Encephalitis (FAME) Panel against standard diagnostics in Vietnam to assess its clinical impact and suitability for local epidemiology. Methods: We conducted a prospective study involving 330 patients with suspected central nervous system infections at 4 hospitals in northern Vietnam from July 2022 to April 2023. Cerebrospinal fluid samples were analyzed using routine culture methods and FAME. We compared pathogen detection rates and assessed the potential clinical impact of FAME results on patient management. Results: Of the 330 cerebrospinal fluid specimens, 64 (19%) were positive by either conventional diagnostics (n = 48) and/or FAME (n = 33). The agreement between FAME and conventional diagnostics was 87%. Key pathogens Mycobacterium tuberculosis (n = 7), Klebsiella pneumoniae (n = 5), Streptococcus suis (n = 5), Epstein-Barr virus (n = 3), Acinetobacter baumannii (n = 1), and Trichosporon asahii (n = 1) were not detected by FAME. Classical meningitis parameter clinical symptoms, altered glucose, protein, and pleocytosis were good predictors of FAME positivity, indicating their utility in optimizing local diagnostic algorithms. Conclusions: FAME complements traditional diagnostics by offering rapid and broad pathogen detection, crucial for timely and appropriate therapy. However, its effectiveness varies with local epidemiology, and it should not replace conventional methods entirely. Tailoring diagnostic panels to regional pathogen prevalence is recommended to enhance diagnostic accuracy and clinical outcomes in low- and middle-income countries.

Enhancing cell death in B-cell malignancies through targeted inhibition of Bcl-3.

The t(14;19)(q32;q13) is a rare recurring translocation found in B-cell lymphoproliferative malignancies, involving the Bcl-3 gene. This chromosomal translocation is often found in patients under the age of 50 and causes a more progressive disease. The Bcl-3 gene encodes a protein belonging to the IκB family of proteins, which tightly regulates NFκB signaling by acting as an activator or repressor of transcription. Previously, we developed a second-generation Bcl-3 inhibitor that could directly interfere with Bcl-3 signaling pathway, resulting in reduced melanoma cell proliferation, invasion, and migration. The present study aimed to investigate the effect of a Bcl-3 inhibitor on B-cell lymphoma and leukemia cells. It was found that treatment of cells with this inhibitor caused a decrease in cell proliferation and cell survival. Furthermore, Bcl-3 inhibition in B-cell malignant cells resulted in the loss of mitochondrial membrane potential and functionality, as well as the increased expression of cleaved caspase 3, indicating that cell death occurs through the intrinsic apoptotic pathway. This observation is further supported by reduced expression of cIAP1 protein 1 (cIAP1) upon treatment of cancer cells. Given the current lack of clinical advancements targeting Bcl-3 in oncology, this opens a novel avenue for the development and investigation of highly specific therapeutic interventions against B-cell malignancies.

Efficacy of Jasminum subtriplinerve Extract against 7,12-Dimethylbenz[a]anthracene-Induced Cancer in Mice.

Jasminum subtriplinerve Blume tea is a traditional Vietnamese medicine used to treat impetigo, menstruation issues, and painful menstrual hematometra. Previous studies have shown that extracts and isolated compounds from J. subtriplinerve possess diverse pharmacological properties, such as antioxidant, antibacterial, and antidiabetic effects. However, their potential anticancer effects and underlying mechanisms of action have not been clear. Here, we examined the effects of J. subtriplinerve extracts against three human cancer cell lines. We also conducted in vivo analyses using a mouse model of 7,12-dimethylbenz[a]anthracene-induced breast cancer, including an investigation of changes in histological sections. The effect of the J. subtriplinerve ethyl acetate fraction on cytokine levels (IL-2, PGE2, TNF-α) in serum was determined using ELISA kits. Results showed that the EtOAc fraction had the highest anti-proliferative activity (IC50 = 13.7 mg/ml) against the breast cancer (MCF-7) cell line, while the BuOH and water fractions did not show any anticancer effects. Additionally, the EtOAc fraction at a dose of 14.4 mg/kg was able to elevate IL-2 levels and suppress the expression of PGE2 in the serum of mice. A remarkable decrease in the percentage of death and tumor incidence in mice was achieved following treatment with the EtOAc fraction at a dose of 14.4 mg/kg. No abnormal parameters in blood were observed in the J. subtriplinerve treatment groups. These results suggest that J. subtriplinerve, when used as tea or a functional food, is nontoxic and has clear chemopreventive effects against breast cancer.

Structural identification and immunostimulatory effect of Bacillus velezensis GV1 polysaccharides via TLR4/NF-κB signaling pathway in RAW264.7 macrophages.

Microbial polysaccharides derived from bacterial sources possess unique properties because of their structural complexity contributing to exceptional characteristics, including potent immunostimulatory effects. In this study, we extracted crude polysaccharide from Bacillus velezensis GV1 (BPS) which was isolated from Korean ginseng vinegar, and subsequently characterized for sugar composition and functional groups using FT-IR and methylation method. Structural analysis indicated that BPS was composed of mannan and glucan in a ratio of 7.5:2.5. The immunostimulatory effect of BPS was investigated in RAW264.7 macrophages. The results revealed that BPS significantly increased NO production, as well as the secretion and expression of key cytokines, such as IL-6, TNF-α, and IL-1ß. These effects were confirmed using a TLR4 antagonist (TAK-242). Moreover, BPS exhibited immunostimulatory potential by promoting the NF-κB signaling pathway. In conclusion, this study establishes a foundation for the potential application of BPS as an immunostimulatory adjuvant or alternative component in functional foods, particularly for enhancing innate immune responses.

Lipid Composition, Cytotoxic and Acetylcholinesterase Inhibition Effects of Two Brown Algae Species Lobophora tsengii and Lobophora australis.

In this paper, the lipid classes, compositions of the neutral lipids, phospholipids and fatty acids, acetylcholinesterase inhibition and cytotoxic activity of two brown algae Lobophora tsengii D. Tien & Z. Sun and Lobophora australis Z. Sun, F. C. Gurgel & H. Kawai have been investigated. The polar lipid class had the highest content in total lipid (TL) (43.47% in L. tsengii and 48.95% in L. australis). Phosphatidylcholine (PC) and phosphatidylethanolamine (PE) were the main components in the phospholipids of two studied brown algae with contents varied from 32.27% to 52.33%. Total lipids were rich in PUFA (42.54% of total fatty acids for L. australis and 32.98% for L. tsengii), with EPA (11.46%, 14.30%) and AA (8.0%, 11.96%). L. tsengii methanol extract inhibited acetylcholinesterase (AChE) in in vitro assay with an IC50 value of 25.45 µg/mL. Both Lobophora methanol extracts display cytotoxic effects against four human cancer cell lines (KB, MCF7, HepG2 and A549) with IC50 in the range of 21.11-83.61 µg/mL. Especially, L. australis extract showed a strong cytotoxicity against KB cell lines with IC50 value of 21.11±0.39 µg/mL.

Musa paradisiaca L. peel extract-bioinspired anisotropic nano-silver with the multipurpose of hydrogenation eco-catalyst and antimicrobial resistance.

In an effort to pursue a green synthesis approach, the biosynthesis of nano-silver (nAg) using plant extracts has garnered significant attention, particularly for its antimicrobial resistance and medical applications, which have been the focus of numerous studies. However, there remains a gap in surface catalytic studies, especially regarding the hydrogenation of 4-nitrophenol. While some studies have addressed catalytic kinetics, thermodynamic aspects have been largely overlooked, leaving the catalytic mechanisms of biosynthesized nAg unclear. In this context, the present work offers a straightforward, eco-friendly, and efficient protocol to obtain nano-silver inspired by Musa paradisiaca L. peel extract. This nAg serves multiple purposes, including antimicrobial resistance and as an eco-catalyst for hydrogenation. Predominantly consisting of zero-valent silver with anisotropic polyhedral shapes, mainly decahedra with an edge length of 50 nm, this nAg demonstrated effective antimicrobial action against both S. aureus and E. coli bacteria. More importantly, both kinetic and thermodynamic studies on the hydrogenation of 4-nitrophenol to 4-aminophenol catalyzed by this bio-inspired nAg revealed that the rate-limiting step is not diffusion-limited. Instead, the adsorbed hydrogen and 4-nitrophenolate react together via electron transfer on the surface of the nAg. The activation energy of 26.24 kJ mol-1 indicates a highly efficient eco-catalyst for such hydrogenation processes.

High photocatalytic efficiency of a ZnO nanoplate/Fe2O3 nanospindle hybrid using visible light for methylene blue degradation.

In this work, ZnO nanoplates and Fe2O3 nanospindles were successfully fabricated via a simple hydrothermal method using inorganic salts as precursors. The ZnO/Fe2O3 hybrid was fabricated using a mechanical mixture of two different ZnO : Fe2O3 weight ratios to investigate the effect of weight ratio on catalytic properties. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) images showed that ZnO nanoplates (NPls) are about 20 nm thick with lateral dimensions of 100 × 200 nm, and Fe2O3 nanospindles (NSs) are about 500 nm long and 50 nm wide. X-ray diffraction (XRD) patterns revealed the successful formation of the ZnO, Fe2O3, and ZnO/Fe2O3 samples and indicated that their crystallite sizes varied from 20 to 29 nm depending on the ZnO : Fe2O3 weight ratio. Ultraviolet-visible (UV-vis) spectra showed that the bandgap energies of ZnO and Fe2O3 were 3.15 eV and 2.1 eV, respectively. Energy dispersive X-ray spectroscopy (EDS) results revealed the successful combination of ZnO and Fe2O3. Photocatalytic activity of the materials was evaluated through the degradation of methylene blue (MB) in aqueous solution under green light-emitting diode (GLED) irradiation. The results indicated that the ZnO/Fe2O3 composite showed a remarkable enhanced degradation capacity compared to bare ZnO NPls and Fe2O3 NSs. The ZnO : Fe2O3 = 3 : 2 sample demonstrated the best performance among all samples under identical conditions with a degradation efficiency of 99.3% for MB after 85 min. The optimum photocatalytic activity of the sample with ZnO : Fe2O3 = 3 : 2 was nearly 3.6% higher than that of the pure ZnO sample and 1.12 times more than that of the pristine Fe2O3 sample. Moreover, the highest photo-degradation was obtained at a photocatalyst dosage of 0.25 g l-1 in dye solution.

A new diphenyl ether from the cultured lichen mycobiont of Graphis cf. handelii.

Lichen is well-known for its various purposes. However, understanding the chemical composition and antimicrobial characteristics of Graphis cf. handelii remains insufficient. In this study, a new compound, graphinone A (1), together with three known compounds, handelone (2), 4-O-methylhiascic acid (3), and ethyl orsellinate (4) were isolated and structurally elucidated. Their chemical structures were established using comprehensive spectroscopic data (1D- and 2D-NMR and HRESIMS). Compounds 1-4 were tested for antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA) and evaluated for the alpha-glucosidase inhibition.

Current status of nanoparticle-mediated immunogenic cell death in cancer immunotherapy.

Immunogenic cell death (ICD) encompasses various forms of cell death modalities, including apoptosis, necroptosis, ferroptosis, and pyroptosis. It arises from a harmonious interplay of adjuvant (damage-associated molecular patterns-DAMPs and chemokines/cytokines) and antigenicity (tumor-associated antigens-TAA) to induce immune-reaction toward cancer cells. Inducing ICD stands out as a promising approach in cancer immunotherapy, capable of directly eliminating cancer cells and of eliciting enduring antitumor immune responses. Conventional tumor therapies like radiation therapy, photodynamic therapy, and chemotherapy can also induce ICD which could amplify their activities. The development of effective ICD inducers like nano-systems is crucial for ensuring safe and efficacious immunotherapy. Nanoparticles hold considerable promise in cancer therapy, offering enhanced therapeutic outcomes and mitigated side effects. They could be the capacity to adjust systemic biodistribution, augment the accumulation of therapeutic agents at the intended site and protect active agents from the complexity of human biofluid. This review aims to outline the role of nanoparticles in triggering ICD for cancer immunotherapy that potentially pave the way for cancer treatment.

Evaluating potential of H'mong chicken bone marrow-derived mesenchymal stem cells at different ages for primordial germ cells' feeder layer.

Primordial germ cells (PGCs) have potential applications in genetic conservation, vaccination, tissue repair therapies, and genetic research. Chicken bone marrow-derived mesenchymal stem cells (cbMSCs) is a good candidate for co-culture with PGCs. However, there is no consensus on the optimal age of donors. In this study, we aimed to compare specific parameters of H'Mong cbMSCs obtained from day 14th and 19th embryos, and day 3rd newborns. Isolated cbMSCs showed characteristics of MSCs. Cells had fibroblast-like morphology, plastic-adherent, expressed specific markers of MSCs and multilineage differentiation potential. The growth rate of cells from day 19th embryos was higher than from other ages. Moreover, cells expressed markers of pluripotency such as Nanog, PouV, Sox2, CVH, DAZL, and KIT, known for their role in maintaining stem cell self-renewal and pluripotency. As feeder cells, cbMSCs from three different ages promoted proliferation of H'Mong PGCs during co-culture. These results suggested that cbMSCs from different ages can be used for co-culture H'Mong PGCs which were further used for genetic preservation of H'Mong chicken or gene editing research.

Promoting patient-centred care in the management of allergic rhinitis in Asia-Pacific countries.

Background: Allergic rhinitis (AR) has a high burden of disease in the Asia-Pacific region (APAC). Although guidelines provide recommendations regarding the diagnosis and treatment of AR, it is increasingly being recognised that there are gaps in their implementation. Patient-centred care involves accounting for the specific needs and desires of patients as well as including the patient in the decision-making process, and this may provide a means to reduce these gaps and consequently the burden of AR. Methods: A group of 11 experts in immunology and otorhinolaryngology from APAC provided information regarding their practices and experiences in the management of AR through an online survey. The group then discussed the barriers and solutions for the implementation of patient-centred care across the patient journey in a face-to-face meeting. Results: Key barriers to the implementation of patient-centred care for AR in APAC included a lack of patient awareness of the condition and treatment options, low adherence to treatments, financial constraints for patients, and time constraints for physicians. The solutions proposed include improving the knowledge of the patients about their conditions, the use of shared decision-making, the consideration of patient characteristics when choosing treatments, and the use of outcome measures to aid the optimisation of patient care. We provide specific recommendations for clinical practice. Conclusion: A greater focus on patient-centred approaches has the potential to improve the management of AR in APAC. More emphasis should be placed on each patient's specific health needs and desired outcomes.

The impact of green finance on green growth: The role of green energy and green production.

This study examines the linkage of green finance and green growth under the regulatory role of green energy and green production in 52 countries worldwide from 2005 to 2019. Applying the Bayesian regression and GMM regression, the results of these two methods are similar. When ignoring the regulatory role of green energy and green production, green finance negatively impacts green growth. This result is entirely opposite when considering the regulatory role of green energy and green production, green finance impacts green growth positively. However, Bayesian regression is more effective when providing different posterior probability intervals and probability ranges for independent variables to affect the dependent variable. Specifically, the probability that green financial growth has a negative impact on green growth is above 75.86 %. Similarly, under the role of green energy, the probability that green finance growth has a positive impact on green growth is 80.45 % and under the role of green production, this probability is 76.64 %. These findings imply that countries should build a financial system associated with the goal of green energy and green production, thereby helping the economy become greener.

Growth of Single Crystals of (K1-xNax)NbO3 by the Self-Flux Method and Characterization of Their Phase Transitions.

In this study, single crystals of (K1-xNax)NbO3 are grown by the self-flux crystal growth method and their phase transitions are studied using a combination of Raman scattering and impedance spectroscopy. X-ray diffraction shows that single crystals have a perovskite structure with monoclinic symmetry. Single crystal X-ray diffraction shows that single crystals have monoclinic symmetry at room temperature with space group P1211. Electron probe microanalysis shows that single crystals are Na-rich and A-site deficient. Temperature-controlled Raman scattering shows that low temperature monoclinic-monoclinic, monoclinic-tetragonal and tetragonal-cubic phase transitions take place at -20 °C, 220 °C and 440 °C. Dielectric property measurements show that single crystals behave as a normal ferroelectric material. Relative or inverse relative permittivity peaks at ~-10 °C, ~230 °C and ~450 °C with hysteresis correspond to the low temperature monoclinic-monoclinic, monoclinic-tetragonal and tetragonal-cubic phase transitions, respectively, consistent with the Raman scattering results. A conduction mechanism with activation energies of about 0.5-0.7 eV was found in the paraelectric phase. Single crystals show polarization-electric field hysteresis loops of a lossy normal ferroelectric. The combination of Raman scattering and impedance spectroscopy is effective in determining the phase transition temperatures of (K1-xNax)NbO3.

A consultation and work-up diagnosis protocol for a multicancer early detection test: a case series study.

The emergence of multicancer early detection (MCED) tests holds promise for improving early cancer detection and public health outcomes. However, positive MCED test results require confirmation through recommended cancer diagnostic imaging modalities. To address these challenges, we have developed a consultation and work-up protocol for definitive diagnostic results post MCED testing, named SPOT-MAS. Developed through circulating tumor DNA (ctDNA) analysis and in line with professional guidelines and advisory board consensus, this protocol standardizes information to aid general practitioners in accessing, interpreting and managing SPOT-MAS results. Clinical effectiveness is demonstrated through a series of identified cancer cases. Our research indicates that the protocol could empower healthcare professionals to confidently interpret circulating tumor DNA test results for 5 common types of cancer, thereby facilitating the clinical integration of MCED tests.

New tests can now screen for multiple types of cancer early, offering hope for better health outcomes. If one of these tests shows a positive result, doctors need to confirm it with imaging tests. We have developed a guide to help doctors understand and confirm these results. This guide could help healthcare professionals interpret results for five common types of cancer, making it easier to use these tests in regular medical practice.

Identification of a novel BAAT frameshift mutation in a female child diagnosed with skeletal dysplasia: A case report.

RATIONALE: Skeletal dysplasias are a complex series of rare genetic disorders that cause irregular development of bones, joints, and cartilages in children. A total of 770 disorders associated with 41 groups of skeletal dysplasia have been documented, demonstrating a wide range of clinical manifestations and varying levels of severity. In addition to conventional methods, whole genome sequencing has emerged as a useful approach to pinpointing the underlying etiology of skeletal dysplasias. PATIENT CONCERNS: A 13-month-old female was admitted to the hospital due to the symptoms of jaundice and failure to thrive. DIAGNOSES: The child was subjected to blood tests and a radiographic assessment. The blood chemistries revealed elevated levels of total bilirubin (178 µmol/L), bile acids (198 µmol/L), and low levels of serum calcium (1.69 mmol/L) and phosphate (0.8 mmol/L), along with irregular skeletal development in the forearms and legs, considering rickets and cholestasis. INTERVENTIONS: Whole exome sequencing data of the proband revealed a homozygous mutation of c.388dupA in the BAAT (bile acid-CoA: amino acid N-acyltransferase) gene sequence. This mutation caused a frameshift in the amino acid of the BAAT protein, resulting in the pR130Kfs*12 variant. This mutation has been identified as the underlying cause of skeletal dysplasia in the proband. OUTCOMES: A novel frameshift mutation in the BAAT gene of a Vietnamese female child diagnosed with skeletal dysplasia has been studied by whole exome sequencing analysis. LESSONS: This research reported a case of skeletal dysplasia caused by a frameshift mutation in the BAAT gene. The results of this study contribute to our understanding of the diverse factors that influence irregular skeletal development in children and provide genetic data to support clinical practice.