Assessment of Health-Related Quality of Life in Patients with Chronic Heart Failure: A Cross-Sectional Study in Vietnam.

Introduction Heart failure is currently a global health issue, imposing a burden on disease prevalence and mortality rates for patients, while simultaneously impacting the quality of life for affected individuals. Data on assessing the health-related quality of life (HRQoL) of patients with chronic heart failure in developing countries, including Vietnam, is still limited. This study was conducted with the aim of describing the quality of life of patients with chronic heart failure in Vietnam. Methods This cross-sectional investigation enrolled 140 chronic heart failure outpatients, utilizing a convenience sample at Hai Duong Province Hospital, Vietnam, spanning from December 2021 to April 2022. Essential patient variables encompassing age, gender, and heart failure duration were gathered. Surveying of patients took place at the outpatient clinic during chronic heart failure follow-up visits using the 36-Item Short Form Health Survey (SF-36) questionnaire. The SF-36 comprises eight dimensions: (1) Physical functioning, (2) Role limitations due to physical health, (3) Bodily pain, (4) General health perceptions, (5) Vitality, (6) Social role functioning, (7) Role limitations due to emotional health, and (8) Mental health. Component analysis of the SF-36 revealed two distinct concepts: a physical component summary (PCS) reflecting the physical aspect and a mental component summary (MCS) reflecting the mental aspect. Results The research involved 140 participants diagnosed with chronic heart failure, having a median age of 59 years (interquartile range (IQR): 52-63). Among them, 61.4% were male, and 50% exhibited reduced left ventricular ejection fraction (LVEF) (≤ 40%). The role limitations due to the physical health domain indicated the lowest score, registering a median value of 0 (IQR 0-25). Domains with median scores below the 25-point threshold encompassed role limitations due to physical health (0 points). Those with scores ranging from 25 to 49 points constituted general health perceptions (25 points), role limitations due to emotional health (33.3 points), vitality (45 points), and mental health (48 points). Bodily pain and social role functioning achieved median scores at a moderate level (50-74 points), scoring 62 and 62.5 points, respectively. The overall HRQoL score on the SF-36 scale was 45.2 (IQR: 32.1-58.7) points. Median scores for the PCS and MCS were 44.3 (IQR: 30.5-52) and 47.0 (IQR: 32.6-65.4), respectively. No statistically significant differences in PCS and MCS scores were observed when subgroup analysis was performed based on variables like age, gender, or LVEF. However, in the vitality domain, female patients exhibited a significantly lower median score than male patients (p-value = 0.046). In the physical functioning domain, individuals aged ≥ 60 had lower median scores than those aged < 60 years (p = 0.022). Additionally, the group with LVEF ≤ 40% had lower median scores compared to the group with LVEF > 40% (p = 0.038) in role limitations due to emotional health domain. Conclusion In Vietnam, the HRQoL in the outpatient population with chronic heart failure was notably low when assessed using the SF-36 questionnaire. Large-scale, multicenter studies are needed to provide stronger, more conclusive evidence.

Mitral prosthetic size predictor in minimally invasive mitral valve replacement.

BACKGROUND: Minimally invasive mitral valve replacement has become popular across the world. However, annular rupture and patient - prosthetic mismatch (PPM) are still problematic, particularly in the Asian population. To avoid this, a predictor model could be beneficial. Our study aimed to assess the value of mitral valve diameters measured on TTE and CT scan on predicting the actual mitral prostheses. METHODS: From January 2018 to December 2019, a total number of 96 patients underwent minimally invasive mitral valve replacement. The association between imaging measurements and the outcome was checked by scatter plot and Pearson's correlation coefficient. Univariable linear regression was used to build the prediction model. RESULTS: The three strongest correlations for the whole population are the following features: Mean TTE diameter (0.702), mean diameter on CT lowest plane through the mitral annulus (0.679), and area-derived diameter on CT highest plane through the mitral annulus (0.665). The prosthetic size of the tissue valve group was more correlated to the calculated annulus diameters than that of the mechanical valve group. Tissue valve size predictor models based on these calculated diameters were 16.19 + 0.27 × d (r = 0.744), 12.74 + 0.44 × d (r = 0.756) and 12.79 + 0.38 × d (r = 0.730), respectively. CONCLUSION: Mitral prosthetic size could be predicted based on the mitral diameters measured on TTE and CT scan. The overall correlation coefficient varied from 0.665 (CT Scan) to 0.702 (TTE). These models performed better when applied to bioprosthesis.

Siamese KG-LSTM: A deep learning model for enriching UMLS Metathesaurus synonymy.

The Unified Medical Language System, or UMLS, is a repository of medical terminology developed by the U.S. National Library of Medicine for improving the computer system's ability of understanding the biomedical and health languages. The UMLS Metathesaurus is one of the three UMLS knowledge sources, containing medical terms and their relationships. Due to the rapid increase in the number of medical terms recently, the current construction of UMLS Metathesaurus, which heavily depends on lexical tools and human editors, is error-prone and time-consuming. This paper takes advantages of the emerging deep learning models for learning to predict the synonyms and non-synonyms between the pairs of biomedical terms in the Metathesaurus. Our learning approach focuses a subset of specific terms instead of the whole Metathesaurus corpus. Particularly, we train the models with biomedical terms from the Disorders semantic group. To strengthen the models, we enrich the inputs with different strategies, including synonyms and hierarchical relationships from source vocabularies. Our deep learning model adopts the Siamese KG-LSTM (Siamese Knowledge Graph - Long Short-Term Memory) in the architecture. The experimental results show that this approach yields excellent performance when handling the task of synonym detection for Disorders semantic group in the Metathesaurus. This shows the potential of applying machine learning techniques in the UMLS Metathesaurus construction process. Although the work in this paper focuses only on specific semantic group of Disorders, we believe that the proposed method can be applied to other semantic groups in the UMLS Metathesaurus.

In Vitro Effects of Pioglitazone on the Expression of Components of Wnt Signaling Pathway and Markers of Bone Mineralization.

Pioglitazone is an insulin-sensitizing thiazolidinedione (TZD) whose use is associated with bone loss. We examined the effects of pioglitazone on components of the Wnt signaling pathway (Wnt1, ß-catenin) and markers of bone mineralization [osteoprotegerin (OPG), bone sialoprotein (BSP), fibroblast growth factor (FGF)23] as well as mineral content in human osteoblast hFOB 1.19 cells. hFOB 1.19 cells were cultured in K12/DMD medium with or without pioglitazone. PPARγ Wnt1, OPG, BSP, or FGF23 mRNA expression was measured using qRT-PCR; ß-catenin, OPG, BSP, or FGF23 using ELISA; and calcium or phosphate content using colorimetry. Treatment with pioglitazone resulted in increased expression of PPARγ mRNA in hFOB 1.19 osteoblasts. Pioglitazone decreased Wnt1 mRNA levels and suppressed components of Wnt signaling pathway as evidenced by a decrease in ß-catenin gene expression and secretion as well as ß-catenin specific activity. The expression and the activity of OPG, BSP, and FGF23 were also reduced by pioglitazone together with total (but not specific) calcium and phosphate content. Pioglitazone affects Wnt1 signaling pathway and mineral matrix regulation components in human osteoblasts.

Effects of Larval Density and Habitat Drying on Developmental Success of Ochlerotatus albifasciatus (Diptera: Culicidae) in Urban Rain Pools: Evidence From Field and Experimental Studies.

Ochlerotatus albifasciatus (Macquart) (Diptera: Culicidae) larvae develop synchronously after rainfall events in ephemeral or temporary pools, where they occasionally attain very high abundance. The aims of the current study were to analyze the response of life history parameters such as daily larval mortality, time to pupation, and adult size of Oc. albifasciatus to increasing larval density under controlled conditions, and to analyze the relationships of daily larval mortality with density and environmental variables (drying rate, temperature, and season) in urban rain pools in Buenos Aires, Argentina. An exponential increase in mortality was observed at high larval densities under controlled conditions. Development times and adult size (wing length) differed between males and females, and were also affected by density. Development times extended for 0.36 d for each order of magnitude of increase in larval density, and wing length decreased 0.0021 mm per additional larva in 600 cm(2). Larval density in the field varied from <1 larva per square meter to nearly 1100 larvae per square meter. Daily larval mortality values in the field were variable (0.02-0.91), positively related to the drying rate, and exhibited seasonal differences. No significant relation with larval density or temperature was found in the field. It remains to be established whether the density-independent mortality observed in this study is a generalized pattern of Oc. albifasciatus populations in Buenos Aires Province or a pattern restricted only to urban habitats.

Thiazolidinediones (TZDs) affect osteoblast viability and biomarkers independently of the TZD effects on aromatase.

Thiazolidinediones (TZDs) are insulin sensitizers used for treatment of diabetes. We have previously reported that TZDs reduce estrogen synthesis by inhibiting aromatase activity in human granulosa cells (HGC). Multiple clinical trials demonstrated that TZDs increase the risk of fractures in postmenopausal women with type 2 diabetes. We studied mouse osteoblasts alone or in a co-culture with HGC to determine whether TZD inhibition of aromatase plays a role in their effects on bone metabolism. Mouse osteoblasts were cultured with and without HGC, and incubated in a medium with or without testosterone, pioglitazone or rosiglitazone. Cell growth, oleic acid uptake, alkaline phosphatase activity, and osteocalcin production were measured. TZDs inhibited estradiol production by up to 84% in HGC/mouse osteoblast co-cultures. TZDs induced mouse osteoblast death and increased oleic acid uptake. TZDs also inhibited alkaline phosphatase activity (58-75%, p<0.046) and osteocalcin production (52-75%, p<0.031). For all the parameters, there were no significant differences between the osteoblast cultures alone and the HCG/osteoblast co-cultures. TZD effects on osteoblast viability, oleic acid uptake, alkaline phosphatase and osteocalcin production are independent of their effects on aromatase.