Continental Scale Hydrostratigraphy: Comparing Geologically Informed Data Products to Analytical Solutions

This study synthesizes two different methods for estimating hydraulic conductivity (K) at large scales. We derive analytical approaches that estimate K and apply them to the contiguous United States. We then compare these analytical approaches to three-dimensional, national gridded K data products and three transmissivity (T) data products developed from publicly available sources. We evaluate these data products using multiple approaches: comparing their statistics qualitatively and quantitatively and with hydrologic model simulations. Some of these datasets were used as inputs for an integrated hydrologic model of the Upper Colorado River Basin and the comparison of the results with observations was used to further evaluate the K data products. Simulated average daily streamflow was compared to daily flow data from 10 USGS stream gages in the domain, and annually averaged simulated groundwater depths are compared to observations from nearly 2000 monitoring wells. We find streamflow predictions from analytically informed simulations to be similar in relative bias and Spearman's rho to the geologically informed simulations. R-squared values for groundwater depth predictions are close between the best performing analytically and geologically informed simulations at 0.68 and 0.70 respectively, with RMSE values under 10 m. We also show that the analytical approach derived by this study produces estimates of K that are similar in spatial distribution, standard deviation, mean value, and modeling performance to geologically-informed estimates. The results of this work are used to inform a follow-on study that tests additional data-driven approaches in multiple basins within the contiguous United States.

Continental Scale Hydrostratigraphy: Basin-Scale Testing of Alternative Data-Driven Approaches

Integrated hydrological modeling is an effective method for understanding interactions between parts of the hydrologic cycle, quantifying water resources, and furthering knowledge of hydrologic processes. However, these models are dependent on robust and accurate datasets that physically represent spatial characteristics as model inputs. This study evaluates multiple data-driven approaches for estimating hydraulic conductivity and subsurface properties at the continental-scale, constructed from existing subsurface dataset components. Each subsurface configuration represents upper (unconfined) hydrogeology, lower (confined) hydrogeology, and the presence of a vertical flow barrier. Configurations are tested in two large-scale U.S. watersheds using an integrated model. Model results are compared to observed streamflow and steady state water table depth (WTD). We provide model results for a range of configurations and show that both WTD and surface water partitioning are important indicators of performance. We also show that geology data source, total subsurface depth, anisotropy, and inclusion of a vertical flow barrier are the most important considerations for subsurface configurations. While a range of configurations proved viable, we provide a recommended Selected National Configuration 1 km resolution subsurface dataset for use in distributed large-and continental-scale hydrologic modeling.

Alcohol use as a mediator of the effect of two alcohol reduction interventions on mental health symptoms of ART clients in Vietnam

We aimed to examine the mediating role of alcohol use in the pathway from the interventions to depression and anxiety symptoms using data from a randomized controlled trial among people living with HIV (PWH) with hazardous alcohol use (n = 440) in Thai Nguyen, Vietnam. Participants were randomized into either a combined intervention (CoI), a brief intervention (BI) and a standard of care arm. Both interventions were based on cognitive behavioral therapy and motivational enhancement therapy. Alcohol use was measured as the percentage of days abstinent from alcohol in the last 30 days. Symptoms of depression and anxiety were measured with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales. Alcohol use was a significant mediator of the effects of two alcohol interventions on depression symptoms, but not anxiety symptoms. There were significant indirect effects via alcohol use of both interventions on depression symptoms at 12 months (CoI: mean difference (MD) = -0.134; 95%CI: -0.251, -0.035); (BI: MD = -0.141; 95%CI: -0.261, -0.038). There were no significant direct or total effects of the interventions on either symptoms at 12 months. Interventions with a dual focus on mental health and alcohol disorders are needed to determine optimal ways to tackle these common comorbidities among PWH.

MIL-88B(Fe)-NH2: an amine-functionalized metal-organic framework for application in a sensitive electrochemical sensor for Cd2+, Pb2+, and Cu2+ ion detection

We propose here an electrochemical platform for multi-heavy metal ion detection in water based on MIL-88B(Fe)-NH₂, an amine-functioned metal-organic framework (MOF) for modifying the surface of a glassy carbon electrode (GCE). Herein, MIL-88B(Fe)-NH₂ with abundant functionalized amine groups can play the role of capture sites for the enrichment of metal ions before electrochemical oxidation sensing. MIL-88B(Fe)-NH₂ was synthesized under optimized conditions through a solvothermal method and characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), transition electron microscopy (TEM), Fourier-transform infrared spectroscopy (FT-IR), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) techniques. MIL-88B(Fe)-NH₂ was then drop-casted on GCE to electrochemically determine the Cd²⁺, Pb²⁺ and Cu²⁺ ion concentrations by differential pulse voltammetry (DPV). The electrochemical sensor exhibits excellent electrochemical performance toward Cd²⁺, Pb²⁺ and Cu²⁺ ions in the large linear ranges of 0.025-1.000 μM, 0.3-10.0 μM and 0.6-10.0 μM with limits of detection that are 2.0 × 10^-10 M, 1.92 × 10^-7 M and 3.81 × 10^-7 M, respectively. The fabricated sensor also shows high reliability and good selectivity. This MIL-88B(Fe)-NH₂ application strategy is promising for the evaluation of various heavy metal ions in water.

Synthesis and photocatalytic activity of a lanthanum doped CoFe2O4/TiO2 nanocomposite for photodegradation of methylene blue organic dye

In this study, a 0.2CoFe2O4/0.8TiO2-5%La nanocomposite was synthesized by a co-precipitation and a hydrothermal method and then was applied as a high activity photocatalyst for degradation of methylene blue under visible light irradiation. The 0.2CoFe2O4/0.8TiO2-5%La material was characterized by X-ray diffraction, Raman spectra, scanning electron microscope/transmission electron microscope and UV-Vis techniques. The photocatalytic activity of the material was initially investigated through the decomposition of methylene blue. The synthetic 0.2 CoFe2O4/0.8 TiO2-5% La showed excellent photocatalytic activity for degradation of methylene blue under visible light irradiation. Methylene blue could be degraded by more than 99.14% after only 50 min.

Identifying Transcription Factors That Prefer Binding to Methylated DNA Using Reduced G-Gap Dipeptide Composition

Transcription factors (TFs) play an important role in gene expression and regulation of 3D genome conformation. TFs have ability to bind to specific DNA fragments called enhancers and promoters. Some TFs bind to promoter DNA fragments which are near the transcription initiation site and form complexes that allow polymerase enzymes to bind to initiate transcription. Previous studies showed that methylated DNAs had ability to inhibit and prevent TFs from binding to DNA fragments. However, recent studies have found that there were TFs that could bind to methylated DNA fragments. The identification of these TFs is an important steppingstone to a better understanding of cellular gene expression mechanisms. However, as experimental methods are often time-consuming and labor-intensive, developing computational methods is essential. In this study, we propose two machine learning methods for two problems: (1) identifying TFs and (2) identifying TFs that prefer binding to methylated DNA targets (TFPMs). For the TF identification problem, the proposed method uses the position-specific scoring matrix for data representation and a deep convolutional neural network for modeling. This method achieved 90.56% sensitivity, 83.96% specificity, and an area under the receiver operating characteristic curve (AUC) of 0.9596 on an independent test set. For the TFPM identification problem, we propose to use the reduced g-gap dipeptide composition for data representation and the support vector machine algorithm for modeling. This method achieved 82.61% sensitivity, 64.86% specificity, and an AUC of 0.8486 on another independent test set. These results are higher than those of other studies on the same problems.

Characteristics, in-hospital management, and complications of acute myocardial infarction in northern and Central Vietnam

INTRODUCTION

Contemporary data on the epidemiology of acute myocardial infarction (AMI) in Vietnam are extremely limited.

METHODS

We established population-based registries of residents from 2 provinces in a northern urban (Hai Phong), and a central rural (Thanh Hoa), province of Vietnam hospitalized with a validated first AMI in 2018. We described patient characteristics, in-hospital management and clinical complications, and estimated incidence rates of AMI in these two registries.

RESULTS

A total of 785 patients (mean age = 71.2 years, 64.7% men) were admitted to the two hospitals with a validated first AMI. Approximately 64% of the AMI cases were ST-segment-elevation AMI. Patients from Thanh Hoa compared with Hai Phong were more likely to delay seeking acute hospital care. The incidence rates (per 100,000 population) of initial AMI in Thanh Hoa and Hai Phong were 16 and 30, respectively. Most patients were treated with aspirin (Thanh Hoa: 96%; Hai Phong: 90%) and statins (both provinces: 91%) during their hospitalization. A greater proportion of patients in Hai Phong (69%) underwent percutaneous revascularization than those in Thanh Hoa (58%). The most common in-hospital complications were heart failure (both provinces:12%), cardiogenic shock (Thanh Hoa: 10%; Hai phong: 7%); and cardiac arrest (both provinces: 9%). The in-hospital case-fatality rates for patients from Thanh Hoa and Hai Phong were 6.8% and 3.8%, respectively.

CONCLUSIONS

The incidence and hospital case-fatality rates of AMI were low in two Vietnamese provinces. Extent of pre-hospital delay and in-hospital use of evidence-based therapies were suboptimal, being more prominent in the rural province.

Effects of Two Alcohol Reduction Interventions on Depression and Anxiety Symptoms of ART Clients in Vietnam

Little is known about the potential mental health impacts of cognitive behavioral therapy and motivational interviewing interventions that focus on alcohol reduction among people with HIV (PWH). Our study aimed to assess the impact of two evidence-based alcohol reduction interventions on depression and anxiety symptoms of antiretroviral therapy (ART) clients with hazardous alcohol use. We conducted a secondary data analysis of data from a three-arm randomized controlled trial among ART clients in Thai Nguyen, Vietnam that evaluated the impacts of two alcohol reduction interventions in Vietnam. ART clients 18 years old or more with hazardous alcohol use (based on the Alcohol Use Disorders Identification Test-Consumption) were enrolled and randomized into one of three arms: Combined intervention, Brief intervention, and Standard of care (SOC). Symptoms of depression, measured with the Patient Health Questionnaire-9, and anxiety, measured with the Generalized Anxiety Disorder-7 scale, were assessed at baseline and 3, 6, and 12 months post-intervention. Generalized estimating equations were used to evaluate the effects of the interventions on depression and anxiety symptoms. The prevalence of depression and anxiety symptoms at baseline was 25.1% and 16.1%, respectively. Decreases in depression and anxiety symptoms were observed in all three arms from baseline to 12-month follow-up. There were no significant differences in depression and anxiety symptoms among participants receiving either intervention, relative to the SOC. Interventions with a dual focus on alcohol and mental health are needed to achieve more pronounced and sustainable improvements in depression and anxiety symptoms for PWH with hazardous alcohol use.

Verbascoside extracted from Clerodendrum inerme: A natural monomer for the fabrication of a sensitive electrochemical Cu(II) sensor

Verbascoside is isolated from the whole plants of the Verbenaceae family and demonstrates significant levels of bioactivity. In this work, we report on the isolation of verbascoside, a phenolic glycoside, from the stems of Clerodendrum inerme collected in Vietnam and verify its structure by comparing its spectroscopic data with those reported in the literature. Verbascoside is then applied as a monomer for the electrochemical deposition of a layer of polyverbascoside onto glassy carbon electrodes toward Cu2+ sensing. Electrochemical results demonstrate that the polyverbascoside-modified glassy carbon electrode is highly selective for Cu2+ ions compared to other evaluated ions including Ni2+ and Co2+. The developed sensor can detect Cu2+ in a concentration range from 0 to 175 μM with a sensitivity of 0.372 µA µM−1 and a limit of detection of 50 nM Cu2+ ions.

"I refused to drink but they still forced me": A mixed-methods approach to understanding the pathways to reduce alcohol use among Vietnamese people with HIV

AIMS

This study explores the effects of two evidence-based alcohol reduction counseling interventions on readiness to change, alcohol abstinence self-efficacy, social support, and alcohol abstinence stigma among people with HIV (PWH) who have hazardous alcohol use in Vietnam.

METHODS

PWH receiving antiretroviral therapy (ART) were screened for hazardous drinking and randomized to one of three study arms: combined intervention (CoI), brief intervention (BI), and standard of care (SOC). A quantitative survey was conducted at baseline (N = 440) and 3-month post-intervention (N = 405), while in-depth interviews were conducted with a subset of BI and CoI participants at baseline (N = 14) and 3 months (N = 14). Data was collected from March 2016 to August 2017. A concurrent mixed-methods model was used to triangulate quantitative and qualitative data to cross-validate findings.

RESULTS

At 3 months, receiving the BI and CoI arms was associated with 2.64 and 3.50 points higher in mean readiness to change scores, respectively, compared to the SOC group (BI: β = 2.64, 95% CI: 1.17-4.12; CoI: β = 3.50, 95% CI 2.02-4.98). Mean alcohol abstinence self-efficacy scores were 4.03 and 3.93 points higher among the BI and CoI arm at 3 months, compared to SOC (BI: β = 4.03, 95% CI: 0.17-7.89; CoI: β = 3.93, 95% CI: 0.05-7.81). The impacts of the interventions on social support and alcohol abstinence stigma were not significant. Perceived challenges to refusing drinks at social events remained due to strong alcohol abstinence stigma and perceived negative support from family and friends who encouraged participants to drink posed additional barriers to reducing alcohol use.

CONCLUSIONS

Both the CoI and BI were effective in improving readiness to change and alcohol abstinence self-efficacy among PWH. Yet, participants still faced significant barriers to reducing their drinking due to social influences and pressure to drink. Interventions at different levels addressing social support and alcohol abstinence stigma are warranted.

Thermal Exfoliated Graphite/Chitosan Modified Glassy Carbon Electrode for Cu(II) Ion Sensing

Aim:

Here, we report a simple strategy for the preparation of thermally exfoliated graphite (EG) and its application to modify glassy carbon electrode (GCE) surfaces for electrochemical Cu2+ ion sensing.

Method:

The electrochemical Cu2+ sensor was constructed by a layer modification of a glassy carbon electrode (GCE) with exfoliated graphite (EG) and chitosan (CS) as a binder, and CS also supports a large number of -NH2 functional groups for Cu2+ capture.

Result:

Due to the creation of a three-dimensional (3D) structure, the EG/CS-coated GCE (EG/CS/GCE) electrode exhibited a higher sensitivity towards Cu2+ detection than that of modification by graphite/chitosan (GP/CS), chitosan (CS) or graphite intercalated compounds (GIC)/chitosan.

Conclusion:

The proposed method could detect Cu2+ in the range of 10 µM to 3 mM with a detection limit of 0.5 µM and sensitivity of 43.62 μA mM-1.

iAnt: Combination of Convolutional Neural Network and Random Forest Models Using PSSM and BERT Features to Identify Antioxidant Proteins

Background:

Reactive Oxygen Species (ROS) play many roles in the body, such as cell signaling, homeostasis, or protection from harmful bacteria. However, an excess of ROS in the body will damage lipids, proteins, and DNA. Many studies have shown that various environmental factors increase the amount of ROS produced in the body. Antioxidant proteins are responsible for neutralizing these ROS or free radicals. Although the amount of data on protein sequences has increased over the last two decades, we still lack bioinformatics tools to be able to accurately identify antioxidant protein sequences. Furthermore, biochemical methods to determine antioxidant proteins are very expensive and time-consuming. Therefore, a machine learning approach must be used to speed up the computation.

Methods:

In this study, we propose a new method that combines a convolutional neural network and Random Forest using two features, the normalized PSSM and the best-selected feature of the ProtBert output.

Results:

Our model gave very good results on the independent test dataset with 97.3% sensitivity and 95.9% specificity. Comparison with current state-of-the-art models shows that our model is superior. We have also installed iAnt as an online website with a friendly interface available at a website: http: //antixiodant.nguyenhongquang.edu.vn.

Conclusion:

iAnt has been developed to accurately identify the antioxidant protein. It shows results outperforming the existing state-of-the-art methods; it is also available online.

Social support modifies the association between hazardous drinking and depression symptoms among ART clients in Vietnam

INTRODUCTION

Hazardous drinking is widespread among people with HIV (PWH). PWH are also vulnerable to depression due to HIV-related social stigma, and social support can play an important role in improving mental health for this population. No studies have explored whether social support modifies the association of hazardous drinking and depressive symptoms among PWH.

METHODS

We used baseline data from a randomized controlled trial of two evidence-based alcohol reduction interventions among antiretroviral therapy clients in Vietnam. Hazardous alcohol use was defined as having a score ≥8 for men and ≥ 7 for women on the Alcohol Use Disorders Identification Test. The presence of depression symptoms was defined as a score ≥ 5 on the Patient Health Questionnaire-9. Social support was measured with a 5-question modified version of the Medical Outcomes Study Social Support Instrument. Crude (CPRs) and adjusted prevalence ratios (aPRs) of the association were presented.

RESULTS

Hazardous drinking was significantly associated with increased likelihood of having depressive symptoms (aPR = 1.26;95%CI 1.04-1.52). Hazardous drinking and depression symptoms were not associated among those with high social support (aPR = 1.01;95%CI 0.76-1.35), but were associated among those with medium (aPR = 1.24;95%CI 0.92-1.69) and low social support (aPR = 1.71;95%CI 1.25-2.34).

CONCLUSIONS

Social support significantly modified the association between hazardous drinking and depression symptoms among ART clients in Vietnam. Interventions to decrease hazardous alcohol use are broadly indicated for PWH in Vietnam and other low-resource settings, but special attention or modifications may be needed to support mental health among those with lower levels of social support.

Clinically significant ventricular arrhythmias and progression of depression and anxiety following an acute coronary syndrome

BACKGROUND

Depression and anxiety are common and associated with worse clinical outcomes in patients who experience an acute coronary syndrome (ACS). We investigated the association between major ventricular arrhythmias (VAs) with the progression of depression and anxiety among hospital survivors of an ACS.

METHODS

Patients were interviewed in hospital and by telephone up to 12 months after hospital discharge. The primary outcome was the presence of moderate/severe symptoms of depression and anxiety defined as a Patient Health Questionnaire (PHQ)-9 score ≥ 10 and a Generalized Anxiety Disorder (GAD)-7 score ≥ 10 at baseline and 1 month and PHQ-2 ≥ 3 and GAD-2 ≥ 3 at 3, 6, and 12 months. We used marginal models to examine the association between major VAs and the symptoms of depression or anxiety over time.

RESULTS

The average age of the study population (n = 2074) was 61.1 years, 33.5% were women, and 78.3% were white. VAs developed in 105 patients (5.1%). Symptoms of depression and anxiety were present in 22.2% and 23.5% of patients at baseline, respectively, and declined to 14.1% and 12.6%, respectively, at 1-month post-discharge. VAs were not significantly associated with the progression of symptoms of depression (adjusted relative risk [aRR] = 1.29, 95% confidence interval [CI] = 0.94-1.77) and anxiety (aRR = 1.22, 95% CI = 0.86-1.72), or with change in average scores of PHQ-2 and GAD-2 over time, both before and after risk adjustment.

CONCLUSION

The prevalence of symptoms of depression and anxiety was high after an ACS but declined thereafter and may not be associated with the occurrence of major in-hospital VAs.

Decade Long Trends (2001-2011) in the Incidence Rates of Initial Acute Myocardial Infarction

Despite the magnitude and impact of acute coronary disease, there are limited population-based data in the United States describing relatively recent trends in the incidence rates of acute myocardial infarction (AMI). The objectives of this study were to describe decade long (2001-2011) trends in the incidence rates of initial hospitalized episodes of AMI, with further stratification of these rates by age, sex, and type of AMI, in residents of central Massachusetts hospitalized at 11 area medical centers. The study population consisted of 3,737 adults hospitalized with a first AMI at 11 medical centers in central Massachusetts on a biennial basis between 2001 and 2011. The median age of this study population was 70 years, 57% were men, and 90% were white. Patients hospitalized during the most recent study years (2009/11) were younger, more likely to be men, have more co-morbidities, and less in-hospital complications as compared with those in the earliest study years (2001/03). The overall age-adjusted hospital incidence rates (per 100,000 persons) of initial AMI declined (from 319 to 163), for men (from 422 to 219), women (from 232 to 120), for patients with a ST segment elevation (129 to 56), and for those with an non-ST segment elevation (190 to 107) between 2001 and 2011, respectively. In conclusion, the incidence rates of initial AMI declined appreciably in residents of central Massachusetts who were hospitalized with AMI during the years under study.

Hyperglycemia and risk of ventricular tachycardia among patients hospitalized with acute myocardial infarction

Background

Little is known about the association of hyperglycemia with the development of ventricular tachycardia (VT) in patients hospitalized with acute myocardial infarction (AMI) which we examined in the present study. The objectives of this community-wide observational study were to examine the relation between elevated serum glucose levels at the time of hospital admission for AMI and occurrence of VT, and time of occurrence of VT, during the patient’s acute hospitalization.

Methods

We used data from a population-based study of patients hospitalized with AMI at all central Massachusetts medical centers between 2001 and 2011. Hyperglycemia was defined as a serum glucose level ≥ 140 mg/dl at the time of hospital admission. The development of VT was identified from physicians notes and electrocardiographic findings by our trained team of data abstractors.

Results

The average age of the study population was 70 years, 58.0% were men, and 92.7% were non-Hispanic whites. The mean and median serum glucose levels at the time of hospital admission were 171.4 mg/dl and 143.0, respectively. Hyperglycemia was present in 51.9% of patients at the time of hospital admission; VT occurred in 652 patients (15.8%), and two-thirds of these episodes occurred during the first 48 h after hospital admission (early VT). After multivariable adjustment, patients with hyperglycemia were at increased risk for developing VT (adjusted OR = 1.48, 95% CI = 1.23–1.78). The presence of hyperglycemia was significantly associated with early (multivariable adjusted OR = 1.39, 95% CI = 1.11–1.73) but not with late VT. Similar associations were observed in patients with and without diabetes and in patients with and without ST-segment elevation AMI.

Conclusions

Efforts should be made to closely monitor and treat patients who develop hyperglycemia, especially early after hospital admission, to reduce their risk of VT.

Trends in Length of Hospital Stay and the Impact on Prognosis of Early Discharge After a First Uncomplicated Acute Myocardial Infarction

Few studies have examined recent trends in the length of stay (LOS) among patients hospitalized with a first uncomplicated acute myocardial infarction (AMI) and the impact of early hospital discharge on various short-term outcomes in these low-risk patients. We used data from 1,501 residents hospitalized with a first uncomplicated AMI from all central Massachusetts medical centers on a biennial basis between 2001 and 2011. The association between hospital LOS and subsequent hospital readmission or death was examined using logistic regression modeling. The average age of the study population was 63.7 years, 63.0% were men, and 91.4% were non-Hispanic whites. The average hospital LOS declined from 4.1 days in 2001 to 2.9 days in 2011. During the years under study, the average 30-day hospital readmission rate was 11.9%, whereas the 30- and 90-day death rates were 1.5% and 2.9%, respectively. The multivariable adjusted odds ratio of a 30-day hospital readmission (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.52 to 1.41), or 30-day (OR = 0.93, 95% CI = 0.29 to 2.98) and 90-day (OR = 0.89, 95% CI = 0.36 to 2.20) death rates were not significantly different between patients who were discharged from central Massachusetts medical centers during the first 2 days as compared with those discharged thereafter. In conclusion, the average LOS in patients with a first uncomplicated AMI declined during the years under study, and early discharge from the hospital at day 2 or sooner of these low-risk patients does not appear to be associated with an increased risk of adverse events post discharge compared with those discharged at a later time.

Underuse of Effective Cardiac Medications Among Women, Middle-Aged Adults, and Racial/Ethnic Minorities With Coronary Artery Disease (from the National Health and Nutrition Examination Survey 2005 to 2014)

Given the proven effectiveness of several cardiac medications for patients with coronary artery disease (CAD), we examined the national use of 4 classes of effective medications, overall and by age, sex, and race/ethnicity in 2005 to 2014. We used data from the National Health and Nutrition Examination Survey, including a self-reported diagnosis of CAD and independently verified medication use. Weighting procedures extrapolated our data to the adult US population with CAD. Analyses included 1,789 US adults aged ≥45 years with a history of CAD. The average age of this population was 68 years; 40% were women and 79% were non-Hispanic whites. In 2005 to 2014, 53.2% (standard error [SE] = 1.5) reported use of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers, 58.5% (SE = 1.5) β blockers, and 67.2% (SE = 1.4) statins. Two of these medications were used by 64.1% (SE = 1.5) of the study population and all 3 by 29.1% (SE = 1.3). In 2011 to 2014, 68.5% (SE = 2.4) of American adults with a history of CAD reported use of aspirin. The use of statins increased from 63.1% in 2005/2006 to 76.8% in 2013/2014. Adults aged 45 to 64 years old, women, and racial/ethnic minorities had lower use of effective cardiac medications compared with older adults, men, and non-Hispanic whites. In conclusion, the use of statins, but not other medications, has increased over the past 10 years among American adults with previously diagnosed CAD. Continued targeted efforts are needed to increase the receipt of effective cardiac medications among all US adults with CAD, especially those aged 45 to 64 years, women, and racial/ethnic minorities.

Is low iodine a risk factor for cardiovascular disease in Americans without thyroid dysfunction? Findings from NHANES

BACKGROUND AND AIMS

Low body iodine levels are associated with cardiovascular disease, in part through alterations in thyroid function. While this association suggested from animal studies, it lacks supportive evidence in humans. This study examined the association between urine iodine levels and presence of coronary artery disease (CAD) and stroke in adults without thyroid dysfunction.

METHODS AND RESULTS

This cross-sectional study included 2440 adults (representing a weighted n = 91,713,183) aged ≥40 years without thyroid dysfunction in the nationally-representative 2007-2012 National Health and Nutrition Examination Survey. The age and sex-adjusted urine iodine/creatinine ratio (aICR) was categorized into low (aICR<116 μg/day), medium (116 μg/day ≤ aICR < 370μg/day), and high (aICR ≥ 370μg/day) based on lowest/highest quintiles. Stroke and CAD were from self-reported physician diagnoses. We examined the association between low urine aICR and CAD or stroke using multivariable logistic regression modeling. The mean age of this population was 56.0 years, 47% were women, and three quarters were non-Hispanic whites. Compared with high urine iodine levels, multivariable adjusted odds ratios aOR (95% confidence intervals) for CAD were statistically significant for low, aOR = 1.97 (1.08-3.59), but not medium, aOR = 1.26 (0.75-2.13) urine iodine levels. There was no association between stroke and low, aOR = 1.12 (0.52-2.44) or medium, aOR = 1.48 (0.88-2.48) urine iodine levels.

CONCLUSION

The association between low urine iodine levels and CAD should be confirmed in a prospective study with serial measures of urine iodine. If low iodine levels precede CAD, then this potential and modifiable new CAD risk factor might have therapeutic implications.

Correlates of HIV infection among female sex workers in Vietnam: injection drug use remains a key risk factor

OBJECTIVE

Women who sell sex and use drugs have dual risks for HIV infection. Despite increasing reports of drug use among female sex workers (FSW) in Vietnam, FSW HIV interventions remain focused mainly on sexual risk reduction. We assessed the impact of drug use and inconsistent condom use on HIV infection among FSW in Vietnam, which few studies have quantified.

METHODS

We surveyed 5298 women aged ≥18 years who had sold sex in the past month from ten geographically dispersed provinces. We performed multivariate logistic regression on data from provinces with high (≥10%) or low (<10%) HIV prevalence among FSW.

RESULTS

Compared to FSW who never used illicit drugs, the odds of HIV infection among FSW who had ever injected drugs and those who reported non-injection drug use were 3.44 (CI 2.32-5.09) and 1.76 (CI 1.14-2.71), respectively, in high-prevalence provinces. FSW who always used condoms with clients had lower odds of HIV infection than those who did not (AOR=0.71; CI 0.52-0.98). In low-prevalence provinces lifetime injection drug use (AOR 22.05, CI 12.00-40.49), but not non-injecting drug use or inconsistent condom use, was significantly associated with HIV infection.

CONCLUSIONS

Because injection drug use and inconsistent condom use were key risk factors for HIV infection in high-prevalence provinces, drug injection risk reduction should be as much a focus of HIV prevention as sexual risk reduction. Where HIV prevalence remains low in FSW, a more general emphasis on harm reduction for all drug users will benefit FSW.

An electrochemical ELISA-like immunosensor for miRNAs detection based on screen-printed gold electrodes modified with reduced graphene oxide and carbon nanotubes

We design an electrochemical immunosensor for miRNA detection, based on screen-printed gold electrodes modified with reduced graphene oxide and carbon nanotubes. An original immunological approach is followed, using antibodies directed to DNA.RNA hybrids. An electrochemical ELISA-like amplification strategy was set up using a secondary antibody conjugated to horseradish peroxidase (HRP). Hydroquinone is oxidized into benzoquinone by the HRP/H2O2 catalytic system. In turn, benzoquinone is electroreduced into hydroquinone at the electrode. The catalytic reduction current is related to HRP amount immobilized on the surface, which itself is related to miRNA.DNA surface density on the electrode. This architecture, compared to classical optical detection, lowers the detection limit down to 10 fM. Two miRNAs were studied: miR-141 (a prostate biomarker) and miR-29b-1 (a lung cancer biomarker).

An innovative strategy for direct electrochemical detection of microRNA biomarkers

We report an electrochemical method for direct, reagentless, and label-free detection of microRNA, based on a conjugated copolymer, poly(5-hydroxy-1,4-naphthoquinone-co-5-hydroxy-2-carboxyethyl-1,4-naphthoquinone), acting as hybridization transducer. Hybridization between the oligonucleotide capture probe and a microRNA target of 22 base pairs generates an increase in the redox current ("signal-on"), which is evidenced by square wave voltammetry. Selectivity is good, with little hybridization for non-complementary targets, and the limit of detection reaches 650 fM. It is also evidenced that this sensitivity benefits from the high affinity of DNA for RNA.

The potential impact of expanding antiretroviral therapy and combination prevention in Vietnam: towards elimination of HIV transmission

BACKGROUND

Few studies have assessed the effects of antiretroviral therapy (ART) to prevent HIV transmission in Asian HIV epidemics. Vietnam has a concentrated HIV epidemic with the highest prevalence among people who inject drugs. We investigated the impact of expanded HIV testing and counseling (HTC) and early ART, combined with other prevention interventions on HIV transmission.

METHODS

A deterministic mathematical model was developed using HIV prevalence trends in Can Tho province, Vietnam. Scenarios included offering periodic HTC and immediate ART with and without targeting subpopulations and examining combined strategies with methadone maintenance therapy and condom use.

RESULTS

From 2011 to 2050, maintaining current interventions will incur an estimated 18,115 new HIV infections and will cost US $22.1 million (reference scenario). Annual HTC and immediate treatment, if offered to all adults, will reduce new HIV infections by 14,513 (80%) and will cost US $76.9 million. Annual HTC and immediate treatment offered only to people who inject drugs will reduce new infections by 13,578 (75%) and will cost only US $23.6 million. Annual HTC and immediate treatment for key populations, combined with scale-up of methadone maintenance therapy and condom use, will reduce new infections by 14,723 (81%) with similar costs (US $22.7 million). This combination prevention scenario will reduce the incidence to less than 1 per 100,000 in 14 years and will result in a relative cost saving after 19 years.

CONCLUSIONS

Targeted periodic HTC and immediate ART combined with other interventions is cost-effective and could lead to potential elimination of HIV in Can Tho.

In vivocharacterization of the mechanical properties of human skin derived from MRI and indentation techniques

The human skin is an exceedingly complex and multi-layered material. This paper aims to introduce the application of the finite element analysis (FEA) to the in vivo characterization of the non-linear mechanical behaviour of three human skin layers. Indentation tests combined with magnetic resonance imaging (MRI) technique have been performed on the left dorsal forearm of a young man in order to reveal the mechanical behaviour of all skin layers. Using MRI images processing and a pre and post processor allows to make numerically individualized 2D model which consists of three skin layers and the muscles. FEA has been applied to simulate indentation tests. Neo-Hookean slightly compressible material model of two material constants (C(10), K) has been used to model the mechanical behaviour of the three skin layers and the muscles. The identification of material model parameters was done by applying Levenberg-Marquardt algorithm (LMA). Our methodology of identification provides a range of values for each constant. Range of values of different material properties of epidermis, dermis, hypodermis are respectively, C10(E)=0.12+/-0.06 MPa, C10(D)=1.11+/-0.09 MPa, C10(H)=0.42+/-0.05 KPa, K(E)=5.45+/-1.7 MPa, K(D)=29.6+/-1,28 MPa, K(H)=36.0+/-0.9 KPa.

[Surgical correction of subjective excyclotorsion by tucking the anterior part of the superior oblique muscle tendon]

BACKGROUND

Asymmetrical folding of the anterior portion of the superior oblique muscle is a simplified variant of the Harada-Ito procedure that is supposed to selectively correct ocular torsion.

PATIENTS AND METHODS

This surgical technique was applied to 22 patients suffering from bilateral acquired IV nerve palsy. Ocular torsion was evaluated with the Harms tangent screen. Pre- and post-operative torsional values were compared. Post-operative follow-up was 12 months.

RESULTS

Pre-operatively, mean excyclotropia was 8.8 degrees in primary position and 15.9 degrees in downgaze. Post-operatively, these values decreased to 1.5 degrees and 4.1 degrees, respectively. An enlarged field of binocular single vision, extending beyond 10 degrees inferiorly, was obtained in 17/22 patients.

CONCLUSIONS

The selective technique of superior oblique muscle anterior tendon tucking allows one to efficiently correct the ocular torsion induced by acquired bilateral IV nerve palsy.

Evanescent White Linear Flecks and Posterior Microphthalmos: New Features of a Recently Established Disease

BACKGROUND

Posterior microphthalmos is a rare autosomal recessive condition with normal anterior segment and small posterior segment resulting in axial hyperopia and retinal folding.

HISTORY AND SIGNS

The proband from a consanguineous Turkish family was clinically investigated at 5 months of age and followed for the next 8 years. At five months of age, refraction revealed a severe hyperopia of + 10 diopters in both eyes (OU) with a mean axial length of 16.5 mm. Fundus examination showed a dystrophic maculo-papillar bundle. Multiple whitish deep intraretinal linear lesions sparing the macula were present in the mid-periphery with no preferential orientation.

THERAPY AND OUTCOME

By 8 years of age, visual acuity was 20/25 in the right eye (OD) and 20/30 in the left eye (OS) with S + 14 OU. The whitish linear lesions had disappeared and were replaced by retinal pigment epithelium alterations. Optical coherence tomography (OCT) revealed a thickened retina with normal appearance at the site of the linear lesions.

CONCLUSIONS

This is the first report of long-term follow-up and OCT findings in this rare ocular developmental abnormality.

Enantioselective synthesis of the [6,6] spiroketal core of reveromycin A

[structure: see text] Reveromycin A (1) belongs to a family of microbial polyketides with unusual structural features and biological activities. The structure of 1 is composed of a [6,6] spiroketal core decorated with highly unsaturated side chains. As a prelude to the synthesis of 1, we present herein a short, efficient, and enantioselective synthesis of the C9-C21 fragment 5 (spiroketal core) of reveromycin A.