Adult-to-adult right lobe graft living donor liver transplantation for acute-on-chronic liver failure: a single-centre retrospective study in Vietnam.

Introduction: Acute-on-chronic liver failure (ACLF) has a high mortality rate, and liver transplantation is considered a definite treatment for patients with this condition. This study aims to evaluate the outcomes of living donor liver transplantation (LDLT) in ACLF patients in a single centre in a lower middle-income country, Vietnam. Materials and methods: This was a retrospective study at the 108 Military Central Hospital (Hanoi, Vietnam), enroling 51 patients diagnosed with ACLF based on Asian Pacific Association for the Study of the Liver (APASL) criteria who underwent LDLT with a right lobe graft from December 2019 to December 2022. The authors utilize the model for end-stage liver disease (MELD) and APASL ACLF Research Consortium (AARC) scores to evaluate and stratify the severity of ACLF. Results: The average age of all patients was 47.27±13.61, with 88.24% being male. The average BMI was 22.78±2.61. The most common underlying liver disease was chronic viral hepatitis B (88.2%). The average MELD score of the patients was 34.90±5.61, with 33.3% having MELD score greater than or equal to 40. In terms of ACLF severity, five patients (9.8%) had grade I ACLF, 35 patients (68.6%) had grade II ACLF, and 11 patients (21.6%) had grade III ACLF. The average AARC score was 9.43±1.68. The duration of treatment in the ICU was 8.59±7.27 days, and the length of hospital stay was 28.02±13.45 days. The most common post-transplant complication was biliary complication (19.61%). Death occurred in 7 patients (13.7%). The survival rates at 6 months, 1 year, and 3 years were 84%, 81.7%, and 81.7%, respectively. Conclusion: Living donor liver transplantation for ACLF patients is safe and has a high post-transplant survival rate. Multidisciplinary care before, during, and after surgery, and the decision to do a liver transplant early, is essential in saving the lives of ACLF patients.

Trifluoroethylation and Pentafluoropropylation of C(sp3)-H Bonds.

Polyfluorinated substituents often enhance effectiveness, improve the stability within metabolic processes, and boost the lipophilicity of biologically active compounds. However, methods for their introduction into aliphatic carbon chains remain very limited. A potentially general route to integrate the fluorinated scaffolds into organic molecules involves insertion of fluorine-containing carbenes into C(sp3)-H bonds. The electron-withdrawing characteristics of perfluoroalkyl groups enhances the reactivity of these carbenes which should enable the functionalization of unactivated C(sp3)-H bonds. Curiously, it appears that use of perfluoroalkyl-containing carbenes in alkane C-H functionalization is exceedingly rare. This concept describes photolysis, enzymatic catalysis, and transition metal catalysis as three primary approaches to C(sp3)-H functionalization by trifluoromethylcarbene and its homologues.

"Sandwich" Diimine-Copper Catalyzed Trifluoroethylation and Pentafluoropropylation of Unactivated C(sp3 )-H Bonds by Carbene Insertion.

We report here "sandwich"-diimine copper complex-catalyzed trifluoroethylation and pentafluoropropylation of unactivated C(sp3 )-H bonds in alkyl esters, halides, and protected amines by employing CF3 CHN2 and CF3 CF2 CHN2 reagents. Reactions proceed in dichloromethane solvent at room temperature. Identical C-H functionalization conditions and stoichiometries are employed for generality and convenience. Selectivities for C-H insertions are higher for compounds possessing stronger electron-withdrawing substituents. Preliminary mechanistic studies point to a mechanism involving a pre-equilibrium forming a "sandwich"-diimine copper-CF3 CHN2 complex followed by rate-determining loss of nitrogen affording the reactive copper carbene. It reacts with trifluoromethyldiazomethane about 6.5 times faster than with 1-fluoroadamantane explaining the need for slow addition of the diazo compound.

"Sandwich" Diimine-Copper Catalysts for C-H Functionalization by Carbene Insertion.

We report here "sandwich" diimine-copper(I) catalysts for C(sp3 )-H bond functionalization. Reactions of alkanes and ethers with trimethylsilyldiazomethane, ethyl diazoacetate, and trifluoromethyl-diazomethane have been demonstrated. We also report C(sp3 )-H bond methylation, benzylation, and diphenylmethylation by diazomethane, aryldiazomethanes, and diphenyldiazomethane. These reactions are rare examples of base-metal catalyzed, intermolecular C(sp3 )-H functionalizations by employing unactivated diazo compounds. Electrophilicity and unique steric environment of "sandwich"-copper catalysts are likely reasons for their catalytic efficiency.

In situ ortho-lithiation/functionalization of pentafluorosulfanyl arenes.

A general method for ortho-functionalization of pentafluorosulfanyl arenes has been developed. ortho-Lithiation with lithium tetramethylpiperidide at -60 °C in the presence of silicon, germanium, and tin electrophiles affords trapped products in moderate to high yields. Precise temperature regimes and the presence of electrophiles during lithiation are important for successful reactions, since the pentafluorosulfanyl group acts as a competent leaving group at temperatures above -40 °C. Fluoro, bromo, iodo, enolizable keto, cyano, ester, amide, and unsubstituted amino functionalities are compatible with the reaction conditions. Conversion of 2-dimethylsilylpentafluorosulfanyl benzene to 2-halosubstituted derivatives, useful as starting materials in cross-coupling chemistry, was also demonstrated.

High mobility group A protein-2 as a tumor cancer diagnostic and prognostic marker: a systematic review and meta-analysis.

High mobility group A protein-2 (HMGA2) is an architectural transcription factor that binds to the A/T-rich DNA minor groove and is responsible for regulating transcriptional activity of multiple genes indirectly through chromatin change and assembling enhanceosome. HMGA2 is overexpressed in multiple tumor types, suggesting its involvement in cancer initiation and progression, thus, making it an ideal candidate for cancer diagnostic and prognostic. We performed a systematic review to examine the role of HMGA2 as a universal tumor cancer diagnostic and prognostic marker. We used Reporting Recommendations for Tumor Marker Prognostic Studies to systematically search OvidMedline, PubMed, and the Cochrane Library for English language studies, published between 1995 and June 2019. Meta-analysis provided pooled risk estimates and their 95% confidence intervals (CIs) for an association between overall survival and recurrence of cancers for studies with available estimates. We identified 42 eligible studies with a total of 5123 tumor samples in 15 types of cancer. The pooled percentage of HMGA2 gene expression in tumor samples was 65.14%. Meta-analysis showed that cancer patients with HMGA2 positive have significantly reduced survival, compared to patients without HMGA2 gene [pooled-hazard ratio (HR) = 1.85, 95% CI 1.48-2.22]. There was a positive association between cancer patients with HMGA2 overexpression and cancer recurrence though this association did not reach significance (pooled-HR = 1.44, 95% CI 0.80-2.07). Overexpression of HMGA2 was found in 15 types of cancer. There was an association between HMGA2 overexpression with reduced survival of cancer patients. HMGA2 is thus considered a promising universal tumor marker for prognostics.

Effectiveness of cervical pessary compared to cervical cerclage with or without vaginal progesterone for the prevention of preterm birth in women with twin pregnancies and a short cervix: study protocol for a two-by-two factorial randomised clinical trial.

INTRODUCTION: Women with twin pregnancies and a short cervix are at increased risk for preterm birth (PTB). Given the burden of prematurity and its attendant risks, the quest for effective interventions in twins has been an area of considerable research. Studies investigating the effectiveness of cervical cerclage, cervical pessary and vaginal progesterone in preventing PTB have yielded conflicting results. The aim of this study is to compare the effectiveness of cervical pessary and cervical cerclage with or without vaginal progesterone to prevent PTB in women with twin pregnancies and a cervical length (CL) ≤ 28 mm. METHODS AND ANALYSIS: This multicentre, randomised clinical trial will be conducted at My Duc Hospital and My Duc Phu Nhuan Hospital, Vietnam. Asymptomatic women with twin pregnancies and a CL ≤28 mm, measured at 16-22 weeks' gestation, will be randomised in a 1:1:1:1 ratio to receive a cerclage, pessary, cerclage plus progesterone or pessary plus progesterone. Primary outcome will be PTB <34 weeks. Secondary outcomes will be maternal and neonatal complications. We preplanned a subgroup analysis according to CL from all women after randomisation and divided into four quartiles. Analysis will be conducted on an intention-to-treat basis. The rate of PTB <34 weeks' gestation in women with twin pregnancies and a cervix ≤28 mm and treated with pessary in our previous study at My Duc Hospital was 24.2%. A sample size of 340 women will be required to show or refute that cervical cerclage decreases the rate of PTB <34 weeks by 50% compared with pessary (from 24.2% to 12.1%, α level 0.05, power 80%, 5% lost to follow-up and protocol deviation). This study is not to be powered to assess interactions between interventions. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Institutional Ethics Committee of My Duc Hospital and informed patient consent was obtained before study enrolment. Results of the study will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03863613 (date of registration: 4 March 2019).

Drug-related problems in prescribing for coronary artery diseases in Vietnam: cross-sectional study.

OBJECTIVES: To determine the prevalence, patterns and determinants of drug-related problems (DRPs) in prescribing for coronary artery diseases (CADs) in Vietnam. METHODS: Retrospective cross-sectional study on outpatients with CADs at a general hospital in Can Tho, Vietnam. DRPs were classified according to Pharmaceutical Care Network Europe definitions. We determined the prevalence and patterns of DRPs. Logistic regression was used to identify the determinants of DRPs. RESULTS: Among 683 patients (mean age 63.4; 64.3% female), the prevalence of DRPs was 61.1%. DRPs comprised inappropriate indication (3.5%), inappropriate dosage (22.2%), wrong frequency of use (24.2%), wrong time of taking medications (4.1%), taking medications at the wrong time around meals (19.2%) and drug interactions (19.3%). Patients who took ≥ 5 drugs were more likely to have DRPs (adjusted odds ratio = 1.96; 95% confidence interval = 1.31-2.93). Patients without health insurance were more likely to have inappropriate indication (ORa = 2.93; 95%CI = 1.28-6.70). Taking medications at inappropriate times around meals was common among men (ORa = 1.82; 95%CI = 1.23-2.69) and among those with health insurance (ORa = 1.66; 95%CI = 1.05-2.63). Patients < 65 years old were more likely to be prescribed inappropriate doses (ORa = 1.67; 95%CI = 1.15-2.45). Prescriptions with ≥ 5 drugs were more likely to be taken at inappropriate frequency (ORa = 1.87; 95%CI = 1.09-3.21) and to cause drug interactions (ORa = 6.48; 95%CI = 2.59-16.24). CONCLUSIONS: DRPs are common among patients with CADs in Vietnam. The number of DRPs increases with the number of drugs in prescriptions. Further studies should identify other potential determinants of DRPs and effective interventions to improve prescribing practice in Vietnam.

PROBLÈMES LIÉS AUX MÉDICAMENTS DANS LES PRESCRIPTIONS POUR LES MALADIES CORONARIENNES AU VIETNAM: ÉTUDE TRANSVERSALE: OBJECTIFS: Déterminer la prévalence, les caractéristiques et les déterminants des problèmes liés aux médicaments (PLM) lors des prescriptions pour des maladies coronariennes au Vietnam. MÉTHODES: Etude transversale rétrospective sur les patients ambulatoires atteints de coronaropathies dans un hôpital général à Can Tho, au Vietnam. Les PLM ont été classés selon les définitions du Pharmaceutical Care Network Europe. Nous avons déterminé la prévalence et les modèles de PLM. La régression logistique a été utilisée pour identifier les déterminants des PLM. RÉSULTATS: Parmi 683 patients (âge moyen 63,4 ans; femme 64,3%), la prévalence de PLM était de 61,1%. Les PLM comprenaient une indication inappropriée (3,5%), une posologie inappropriée (22,2%), une fréquence d'utilisation inappropriée (24,2%), prendre les médicaments à des mauvais moments (4,1%), prendre les médicaments au mauvais moment autour des repas (19,2%) et les interactions médicamenteuses (19,3%). Les patients ayant pris 5 médicaments ou plus étaient plus susceptibles d'avoir un PLM (odds ratio ajusté = 1,96; intervalle de confiance à 95%: 1,31-2,93). Les patients sans assurance santé étaient plus susceptibles d'avoir une indication inappropriée (ORa = 2,93; IC95%: 1,28-6,70). La prise de médicaments à des moments inappropriés autour des repas était courante chez les hommes (ORa = 1,82; IC 95% = 1,23-2,69) et chez ceux ayant une assurance santé (ORa = 1,66; IC95%: 1,05-2,63). Les patients de moins de 65 ans étaient plus susceptibles de prendre des doses inappropriées (ORa = 1,67; IC95% = 1,15-2,45). Les prescriptions de 5 médicaments ou plus étaient plus susceptibles d'être prises à une fréquence inappropriée (ORa = 1,87; IC95%: 1,09-3,21) et à provoquer des interactions médicamenteuses (ORa = 6,48; IC95%: 2,59-16,24). CONCLUSIONS: Les PLM sont fréquents chez les patients atteints de coronaropathies au Vietnam. Le nombre de PLM augmente avec le nombre de médicaments dans les prescriptions. Des études supplémentaires devraient identifier d'autres déterminants potentiels des PLM et des interventions efficaces pour améliorer les pratiques des prescriptions au Vietnam.

Racial/ethnic, age and sex disparities in leukemia survival among adults in the United States during 1973-2014 period.

There has been marked improvement in leukemia survival, particularly among children in recent time. However, the long-term trends in survival among adult leukemia patients and the associated sex and racial survival disparities are not well understood. We, therefore, evaluated the secular trends in survival improvement of leukemia patients from 1973 through 2014, using Surveillance Epidemiology and End-Result Survey Program (SEER) data. ICD-O-3 morphology codes were used to group leukemia into four types: acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML). Survival analysis for each leukemia type stratified by race/ethnicity, age, sex was performed to generate relative survival probability estimates for the baseline time period of 1973 through 1979. Hazard ratios (HR) and respective 95% confidence intervals (CIs) for survival within subsequent 10-year time periods by race, age and sex were calculated using Cox proportional hazard models. Of the 83,255 leukemia patients for the current analysis, the 5-year survival of patients with ALL, AML, CLL, and CML during 1973-1979 were 42.0%, 6.5%, 66.5%, and 20.9%, respectively. Compared to the baseline, there were substantial improvements of leukemia-specific survival in 2010-2014 among African-American (81.0%) and Asian (80.0%) patients with CML and among 20-49 year of age with CLL (96.0%). African-American patients, those with AML and those older than 75 years of age had the lowest survival improvements. Asians experienced some of the largest survival improvements during the study period. Others, including African-American and the elderly, have not benefited as much from advances in leukemia treatment.

Magnetic reversal in Mn5Ge3 thin films: an extensive study.

We present a comprehensive study of magnetization reversal process in thin films of Mn5Ge3. For this investigation, we have studied the magnetic anisotropy of Mn5Ge3 layers as a function of the film thickness using VSM and SQUID magnetometers. The samples grown by molecular beam epitaxy exhibit a reorientational transition of the easy axis of magnetization from in-plane to out-of-plane as the film thickness increases. We provide evidence that above a critical thickness estimated as 20 nm, the magnetic structure is most probably constituted of stripes with out-of-plane magnetization pointing alternately up and down. We have analyzed our results using different phenomenological models and all the calculations converge towards values for magnetocrystalline anisotropy constant and saturation magnetization that are in excellent agreement with the reported values for bulk Mn5Ge3. This study has also led to the first estimation in Mn5Ge3 of the exchange constant, the surface energy of domain walls as well as their width. These parameters are essential for determining whether this material can be used in the next generation of spintronic devices.