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The impact of HIV antiretroviral therapy (ART) on immune dysregulation associated with hepatitis C virus (HCV)/HIV coinfection is incompletely understood. We serially assessed monocyte activation (neopterin, sCD14, and sCD163) and T cell activation (HLA-DR, CD38) and immune exhaustion [program cell death protein 1 (PD1), TIGIT] in HIV/HCV-coinfected individuals who participated in a randomized trial performed in Vietnam designed to assess the hepatotoxicity of raltegravir (RAL)- versus efavirenz (EFV)-based therapy when used as first-time ART in combination with tenofovir disoproxil fumarate and emtricitabine. Baseline pre-ART values were compared with those from ART-naive HIV-monoinfected and HIV-seronegative individuals. Before ART, HIV/HCV-coinfected individuals had higher levels of neopterin, sCD14, and sCD163, and increased frequencies of CD38(+)HLA-DR(+), PD1(+), and TIGIT(+) CD4 and CD8 T cells compared with ART-naive HIV-monoinfected or HIV-seronegative individuals (all p

In this letter, we propose a solution to improve efficiency and selectivity of triplexers, which operate as filters (or matching circuits) for triple-band energy harvesting. The triplexer consists of multiple higher-order open stubs of $(2n+1)\lambda /4$ length ( $n$ is an integer, $n \geq 1$ ), which is proven to yield high selectivity. With the high selectivity of the filters, the proposed triplexer achieves the efficiencies of 92%, 86%, and 83% at 1.85, 2.1, and 2.45 GHz, respectively. The triplexer is incorporated in a rectenna, yielding a final efficiency of 60% at 5 dBm input power.

Background and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. Registration: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921.

High operational costs of modern medical devices and the required specialized, skilled personnel with certifications to operate most medical instrumentation remains a challenge and an impediment to...

Viewpoint is a key structural matter. The author can not describe and narrate any events about life without selecting a viewpoint for things and phenomena. The artistic point of view is just a means that helps the readers and listeners have a deeper look at the artistic structure of the work to better understand the ideological content and values as well as artistic values of the work. When studying the narrative viewpoint in the Indian Ramayana epic, we want to consider the technique of choosing the author’s position in the spatial and temporal coordinates to observe and tell to the listeners and readers. We have found that the narrative viewpoint is structured very flexibly in the creation of the epic writer, and narrator in the Ramayana epic. That is the narrator’s omniscient viewpoint with the shift of point of view in space and time, showing the attitude and feelings of descendants with the “absolute past” at the unchanging viewpoint.

Talaromycosis is a leading cause of AIDS-associated opportunistic infections and death in Southeast Asia. We have recently shown in the Itraconazole versus Amphotericin for Talaromycosis (IVAP) trial that induction therapy with amphotericin B reduced mortality over 24 weeks, but not during the first 2 weeks. Antifungal treatment effects in real-world settings have not been rigorously evaluated. Using data obtained from patient records at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam from 2004 to 2009, we first developed a prognostic model using Bayesian logistic regression to identify predictors of death. Second, we developed a causal model using propensity score matching to assess the treatment effects of amphotericin B and itraconazole. Our prognostic model identified intravenous drug use (odds ratio [OR] = 2.01), higher respiratory rate (OR = 1.12), higher absolute lymphocyte count (OR = 1.62), a concurrent respiratory infection (OR = 1.67) or central nervous system infection (OR = 2.66) as independent predictors of death. Fever (OR = 0.56) was a protective factor. Our prognostic model exhibits good in-sample performance and out-of-sample validation, with a discrimination power of 0.85 and 0.91, respectively. Our causal model showed no significant difference in treatment outcomes between amphotericin B and itraconazole over the first 2 weeks (95% credible interval: 0.62, 2.50). Our prognostic model provides a simple tool based on routinely collected clinical data to predict individual patient outcome. Our causal model shows similar results to the IVAP trial at 2 weeks, demonstrating an agreement between real-world data and clinical trial data.

Object coreference resolution is used in sentiment analysis to identify sentiment words referring to an aspect of an object in a document. However, this poses a challenge in natural language processing and is consequently an area of ongoing research. Further, to the best of our knowledge, object coreference resolution with more than one object has not been given much attention. To effectively address object coreference resolution, this paper proposes a method in which machine learning is applied to a large volume of textual data represented by context vectors, constituting a new form of language representation. The proposed machine learning model uses these vectors to achieve state-of-the-art performance in object coreference resolution. In addition, a combination of dependency grammar, sentiment ontology, and coreference graphs is used to obtain triplets of object, aspect, and sentiment. In experiments conducted on sentiment textual data obtained from Amazon.com, the proposed method achieved an average coreference resolution of object, aspect, and sentiment precision value of approximately 90%. This result suggests that the proposed method can contribute considerably to the field of object coreference resolution, and further research is therefore warranted.

One of the widely used prominent biometric techniques for identity authentication is Face Recognition. It plays an essential role in many areas, such as daily life, public security, finance, the military, and the smart school. The facial recognition task is identifying or verifying the identity of a person base on their face. The first step is face detection, which detects and locates human faces in images and videos. The face match process then finds an identity of the detected face. In recent years there have been many face recognition systems improving the performance based on deep learning models. Deep learning learns representations of the face based on multiple processing layers with multiple levels of feature extraction. This approach has made sufficient improvement in face recognition since 2014, launched by the breakthroughs of Deep Face and Deep ID. However, finding a way to choose the best hyperparameters remains an open question. In this paper, we introduce a method for adaptive hyperparameters selection to improve recognition accuracy. The proposed method achieves improvements on three datasets.

Indoor positioning has attracted commercial developers and researchers in the last few decades. Global positioning system (GPS) cannot well localize in indoor environment. For clinical applications such as workflow analysis, Bluetooth Low Energy (BLE) beacons have been employed to map the positions of individuals in indoor environments. The received signal strength indicator (RSSI) fingerprinting plays a key role in the access point performance services. This paper deals with the issue of indoor localization based RSSI fingerprint using only RSSI vectors without any prior knowledge of the pose. We proposed to use machine learning (ML) combined with modified kNN algorithm to enhance the real-time performance and propose method to detect uncertainty of estimated pose. The mentioned ML algorithm is Gaussian Process Regression (GPR). In the online phase of our system, GPR gives a prediction for the location of the pose using RSSI vector. This prediction helps kNN algorithm therefore limits the searching region leading to reduce the computational cost. An analysis on the distribution of k nearest points is also presented which aims to evaluate the confidence of the estimated pose for extracting a list of trustable points. Furthermore, we also present an extrapolation process using this trust-list to have an optimized trajectory. The accuracy and timing analysis of our proposal was realized on a challenging BBIL dataset which contains very noisy RSSI signals due to a fast moving of the object. The experimental results show that our system exhibits a much better performance than traditional kNN or WkNN algorithms. The RMSE of our optimal trajectory is 1.78 m in the room with a dimension of 10 m $\times$ 25 m, which is competitive in comparison to other methods where initial pose is known.

In this work, a dual-polarized wide-angle energy harvester operating at 3.75 GHz is proposed for ambient RF energy harvesting applications. A $4\times 4$ array harvester can efficiently harvest incident RF waves from all polarizations, resulting in high RF-AC efficiency of 94% and final RF-DC efficiency of 34% at 0.02 W/m2 input power density, or −15 dBm input power. This performance is preserved under a wide incident angle up to 65 degrees in TE mode and 75 degrees in TM mode. Owing to its simple power combining configuration, the array can be easily expanded to incorporate more unit cells, increasing the amount of collected power. Not only having the RF-DC conversion function, it is also equipped with a power management circuit to create a usable output voltage level. With this advantage, the harvester is suitable to be employed in real-life applications in which the polarization and angle of incidence are unknown and the incident power is very low.

This letter presents a novel multiband rectenna for the ambient wireless energy harvesting of an autonomous internet of thing (IoT) sensor. A bow-tie antenna with slits is proposed to obtain four frequency bands at 840 MHz, 1.86, 2.1, and 2.45 GHz, respectively. Furthermore, a multiband rectifying circuit combined of four single ring-loop rectifiers is designed with high conversion efficiency. Finally, a power management circuit with storing and converting the harvested voltage is proposed for smoothing dc output voltage. The energy harvester can be used in practical wireless sensor applications.

The free-positioning wireless power transfer (WPT) system has drawn attention in recent years. Traditionally, a WPT system can transfer energy in one or two directions on the same plane, but it leads the restrictions of angle and axis misalignment between a transmitter and a receiver coil. In this paper, we propose a free-positioning WPT system using a three-dimensional cubic-shaped transmitting coil for portable device charging. A small receiving coil is placed inside the transmitter to achieve the transferred energy through the magnetic resonant coupling. In addition, the equivalent circuit and the mutual inductance between the Tx and Rx coils are analyzed. Finally, a practical experiment is implemented to verify the transfer performance, which can reach up to about 50% power transfer efficiency. The proposed system can charge in spatial freedom.

In 2012, Centers for Medicare and Medicaid Services (CMS) announced it would penalize any hospitals that had 30-day readmission rates for heart failure (HF) patients above 20%. Mather Hospital Northwell Health, a community teaching hospital, organized a proactive task force to meet these goals. We describe our hospital-wide Readmission Prevention in Heart Failure (RAP-HF) project. We focused on the following interventions: early identification of patients at risk for readmission, discipline-specific mitigation planning by the interdisciplinary rounding team, enhanced medication education for heart failure patients, education of family/caregivers on medication and heart failure symptoms, facilitation in scheduling of post-discharge follow up visits and hard-wired communication between hospital and post-discharge care providers. We saw a 25.53% decrease in 30-day readmission rates.

In Indian literature, Kalidasa always occupies the "monopoly position of the Lord of poetry" and the Sakuntala dramatic poem is an exemplary work of the court stage norm. In Sakuntala, poet Kalidasa focuses on praising pure and faithful love. He praises the pure soul and the aspirations of love, happiness of people in life and uses love to criticize the rigid and paranoid teachings of religion, as well as the strict laws of the caste system that stifle people's hearts. Kalidasa pushes the issue of caste down to secondary position, lets love become the main theme and makes the characters act and show their personality in relationships and highlight the victory of love.

Background: Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population.Methods: AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921.Findings: Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [Interpretation: Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke.Funding: National Health and Medical Research Council of Australia.

Breast cancer is the most common cause of cancer-related deaths among women worldwide. Thus, the development of new and effective low-toxicity drugs is vital. The specific characteristics of breast cancer have allowed for the development of targeted therapy towards each breast cancer subtype. Nevertheless, increasing drug resistance is displayed by the changing phenotype and microenvironments of the tumor through mutation or dysregulation of various mechanisms. Recently, emerging data on the therapeutic potential of biocompounds isolated from ginseng have been reported. Therefore, in this review, various roles of ginsenosides in the treatment of breast cancer, including apoptosis, autophagy, metastasis, epithelial-mesenchymal transition, epigenetic changes, combination therapy, and drug delivery system, have been discussed.

In this work toward a sustainable operation of a self-powered wireless sensor, we investigated a multiband Wi-Fi/3G/4G/5G energy harvester based on a novel wideband circularly polarized antenna, a quadplexer, and rectifiers at four corresponding bands. This proposed antenna consisted of four sequentially rotated dual-dipoles, fed by a hybrid feeding network with equal amplitude and an incremental 90° phase delay. The feeding network was composed of three Wilkinson power dividers and Schiffman phase shifters. Based on the sequential rotation method, the antenna obtained a −10 dB reflection coefficient bandwidth of 71.2% from 1.4 GHz to 2.95 GHz and a 3 dB axial ratio (AR) bandwidth of 63.6%, from 1.5 GHz to 2.9 GHz. In addition, this antenna gain was higher than 6 dBi in a wide bandwidth from 1.65 GHz to 2.8 GHz, whereas the peak gain was 9.9 dBi. The quad-band rectifier yielded the maximum AC–DC conversion efficiency of 1.8 GHz and was 60% at −1 dBm input power, 2.1 GHz was 55% at 0 dBm, 2.45 GHz was 55% at −1 dBm, and 2.6 GHz was 54% at 0.5 dBm, respectively. The maximum RF–DC conversion efficiency using the wideband circularly polarized antenna was 27%, 26%, 25.5%, and 27.5% at −6 dBm of input power, respectively.

Chemotherapeutic agents and radiation therapy are associated with numerous potential adverse events (AEs). Many of these common AEs, namely chemotherapy- or radiation-induced nausea and vomiting, hypersensitivity reactions, and edema, can lead to deleterious outcomes (such as treatment nonadherence or cessation, or poor clinical outcomes) if not prevented appropriately. The occurrence and severity of these AEs can be prevented with the correct prescribing of prophylactic medications, often called “premedications.” The advanced practitioner in hematology/oncology should have a good understanding of which chemotherapeutic agents are known to place patients at risk for these adverse events as well as be able to determine appropriate prophylactic medications to employ in the prevention of these adverse events. While several guidelines and literature exist regarding best practices for prophylaxis strategies, differences among guidelines and quality of data should be explored in order to accurately implement patient-specific recommendations. Herein, we review the existing literature for prophylaxis and summarize best practices.

We report the first case of Curvularia alcornii aortic pseudoaneurysm following bioprosthetic aortic valve replacement in an immunocompetent host. Infection was complicated by septic emboli to multiple organs. Despite aggressive surgical intervention and antifungal therapy, infection progressed. We review the literature on invasive Curvularia infection to inform diagnosis and management.

In this paper, we present a novel millimeter-wave antenna using the Grounded coplanar waveguide (GCPW)-to- Substrate Integrated Waveguide (SIW) transition. This high-gain and wideband antenna consists of four patches and each patch is fed by the SIW and a cross-shaped aperture. The antenna operates from 27.1 GHz to 31.9 GHz (S11 ≤ -10dB) with a peak gain of 10 dBi, and an efficiency of 89%.

Air pollution is a critical issue in cities in developing countries like Hanoi, Vietnam. An efficient and comprehensive air quality monitoring system may reduce the harmfulness and improve the cities' sustainability. This paper presents a novel approach to realize such a system in which the air monitoring sensors are mobile. More specifically, we introduce a three-tier architecture for the air quality system, including sensing, communication, and application layers. Initially, we discuss each layer concept to bypass the limitation of the traditional stationary monitoring system. We then describe our design and implementation of air quality monitoring devices installed on vehicles, such as buses. The device is carefully designed to satisfy the conditions of impedance matching and power integrity. Besides, it fully functions in measuring parameters from the ambient environment. The device is aware of its location (using GPS) and uses Wi-Fi and 4G (LTE) to transmit sensing data on the Internet. We have conducted various experiments, including a trial deployment of the devices on a vehicle running in Hanoi. The results show our device achieves sensing data transmission with high-reliability levels (i.e., 97%, 100% on Wi-Fi, 4G (LTE), respectively). Moreover, the trial deployment confirms the feasible operation of our device in actual condition.

Vietnam’s Payment for Forest Ecosystem Services (PFES) scheme has the goal of protecting remaining natural forests by providing financial support to people involved in forest protection. However, studying the case of Dak Lak province in the Central Highlands region of Vietnam shows that even after eight years of PFES implementation, achieving this goal remains a challenge. Although PFES does provide a stable income source and higher payments than state forest protection programs, enables the mobilization of more personnel resources for patrolling forest and relieves a great burden on the state budget in terms of investment in forest protection and development, forest cover in Dak Lak province is still decreasing, mainly due to conversion for other land uses, especially commercial agricultural and industrial crops. These drivers are rooted in national socio-economic planning aimed at boosting economic growth and in local people’s need to sustain their livelihoods. In addition, our paper shows that illegal logging is still widespread in Dak Lak. Weak law enforcement in areas of forest managed by state forest authorities and state companies also contributes to deforestation. However, these drivers are neither fully recognized nor addressed, and instead, the blame for deforestation is laid on local communities. PFES alone cannot protect forests in Dak Lak province. It needs to be backed up by political commitment to address underlying drivers of deforestation, improved social programs to help local people diversify their income sources and clarity over land use.

Purpose of Review The spread of the novel coronavirus SARS-CoV-2 and its associated disease, coronavirus disease of 2019 (COVID-19), has significantly derailed cancer care. Patients with leukemia are more likely to have severe infection and increased rates of mortality. There is paucity of information on how to modify care of leukemia patients in view of the COVID-19 risks and imposed restrictions. We review the available literature on the impact of COVID-19 on different types of leukemia patients and suggest general as well as disease-specific recommendations on care based on available evidence. Recent Findings The COVID-19 infection impacts leukemia subtypes in variable ways and the standard treatments for leukemia have similarly, varying effects on the course of COVID-19 infection. Useful treatment strategies include deferring treatment when possible, use of less intensive regimens, outpatient targeted oral agents requiring minimal monitoring, and prioritization of curative or life-prolonging strategies. Reducing health care encounters, rational transfusion standards, just resource allocation, and pre-emptive advance care planning will serve the interests of leukemia patients. Summary Ad hoc modifications based on expert opinions and extrapolations of previous well-designed studies are the way forward to navigate the crisis. This should be supplanted with more rigorous prospective evidence.

This paper presents a wideband (1.575 GHz-2.875GHz) printed dipole antenna design with an integrated balun. The peak antenna gain is 7.5 dBi at 2.45 GHz using a director that is placed in parallel with the dipole arms. The compact size and high efficiency are the advantages of this antenna which makes it useable for RF energy harvesters from the GSM 1800, UMTS 2100, the WLAN 2450 based IEEE 802.11b/g and LTE 2600 sources to power a wireless sensor.

The European Space Agency's 7th Earth Explorer mission, BIOMASS, was proposed in 2005 and since then there have been major changes in the scientific and political conditions within which it was conceived, and also within the technology and methodology both of the mission itself and of the complementary systems that BIOMASS will work with. This paper describes some of the most important recent developments in this overall environment of the mission, and how they affect the likely use of data from BIOMASS mission after its launch in 2023 and over its nominal five-year lifetime.

BackgroundInfants are at highest risk of pneumococcal disease. Their added protection through herd effects is a key part in the considerations on optimal pneumococcal vaccination strategies. Yet, little is currently known about the main transmission pathways to this vulnerable age group.Methods and findingsWe conducted a nested cross-sectional contact and nasopharyngeal swabbing survey in randomly selected infants across all 27 communes of Nha Trang, Vietnam. Bayesian logistic regression models were used to estimate age specific carriage prevalence in the population, a proxy for the probability that a contact of a given age could lead to pneumococcal exposure for the infant. We used another Bayesian logistic regression model to estimate the correlation between infant carriage and the probability that at least one of their reported contacts carried pneumococci, controlling for age and locality. In total 1583 infants between 4 and 13 months old participated, with 7428 contacts reported. Few infants (5%) attended day care and carriage prevalence was 22%. Most infants (61%) had less than a 25% probability to have had close contact with a pneumococcal carrier on the surveyed day. Pneumococcal infection risk and contact behavior were highly correlated: if adjusted for age and locality the odds of an infant’s carriage increased by 22% (95%CI:15-29) per 10 percentage points increase in the probability to have had close contact with at least one pneumococcal carrier. Two to six year old children contributed 51% (95%CI: 39-63) to the total pneumococcal exposure risks to infants in this setting.ConclusionsCross-sectional contact and infection studies can help identify pneumococcal transmission routes. In Nha Trang, preschool age children are the largest reservoir for pneumococcal transmission to infants.

Background Talaromycosis (penicilliosis) is an invasive fungal infection and a major cause of human immunodeficiency virus (HIV)–related deaths in Southeast Asia. Guidelines recommend induction therapy with amphotericin B deoxycholate; however, treatment with itraconazole has fewer toxic effects, is easier to administer, and is less expensive. Our recent randomized controlled trial in Vietnam found that amphotericin B was superior to itraconazole with respect to 6-month mortality. We undertook an economic evaluation alongside this trial to determine whether the more effective treatment is cost-effective. Methods Resource use, direct and indirect costs, and health and quality-of-life outcomes (measured using quality-adjusted life-years [QALYs]) were evaluated for 405 trial participants from 2012 to 2016. Both a Vietnamese health service and a broader societal costing perspective were considered. Mean costs and QALYs were combined to calculate the within-trial cost-effectiveness of amphotericin vs itraconazole from both perspectives. Results From a Vietnamese health service perspective, amphotericin increases costs but improves health outcomes compared to itraconazole, at a cost of $3013/QALY gained. The probability that amphotericin is cost-effective at a conventional (World Health Organization CHOICE) threshold of value for money is 46%. From a societal perspective, amphotericin is cost-reducing and improves outcomes compared to itraconazole, and is likely to be a cost-effective strategy at any value for money threshold greater than $0. Conclusions Our analysis indicates that induction therapy with amphotericin is a cost-effective treatment strategy for HIV-infected adults diagnosed with talaromycosis in Vietnam. These results provide the evidence base for health care providers and policy makers to improve access to and use of amphotericin., Compared to itraconazole as induction therapy for talaromycosis, amphotericin leads to more adverse events and is more expensive, but reduces mortality. Here, we show that, from a societal perspective, amphotericin is likely to be cost-effective in HIV-infected adults in Asia.

Purpose The purpose of this paper is to explore the role of external audit quality in reducing firm misreporting practices. Design/methodology/approach Data are gathered from a number of sources including the Osiris database and firms’ annual reports to construct a comprehensive data set containing financial and non-financial information of over 3,100 publicly listed firms in China during the period 2009–2017. A number of rigorous empirical specifications are utilized with the use of probit, logit and conditional logit regressions, as well as panel pooled OLS and fixed-effect estimators. The IV-2SLS, 2-step system GMM and difference-in-differences techniques are also employed to deal with the potential endogeneity bias to ensure the robustness of the empirical results. Findings The empirical results reveal that larger firms and firms having more tangible assets and greater retained earnings are more likely to employ a better-quality external auditor. Subsequently, higher audit quality leads to a deterioration in corporate misreporting. However, these results are not homogenous across firms. While we document similar findings in the case of non-state-owned firms, state-owned enterprises (SOEs) appear to have less tendency to hire a higher-quality auditor, and higher-quality auditors in turn do not play a significant role in reducing misreporting practices in SOEs. Originality/value This paper contributes to a better understanding of the mechanism to mitigate corporate misreporting practices. It is one of the few to empirically investigate auditor selections and the association between external audit quality and corporate misreporting practices in China.

What is known and objective Under-reporting is a major drawback of a voluntary adverse drug reaction reporting system in pharmacovigilance. However, little is known about facilitators and barriers to ADR reporting by healthcare professionals (HCPs) in developing countries. To investigate factors associated with adverse drug reaction (ADR) reporting among HCPs in Vietnam. Methods A cross-sectional survey of 2091 HCPs was conducted in 2015 at 10 hospitals throughout Vietnam. The binary outcome was ever reporting ADRs. Healthcare professionals knowledge, attitude and practice about ADR reporting were measured. Multiple logistic regression analyses examined factors significantly associated with ever ADR reporting. Results Overall, 29.3%, 2.2% and 68.4% of the sample were doctors, pharmacists and nurses, respectively. More than half (59.3%) had ever reported any ADR. Facilitators for ADR reporting were educational training (OR = 1.77, 95%CI = 1.42-2.22) and having better knowledge, such as awareness of ADR reporting regulation (OR = 1.63, 95%CI = 1.19-2.21), of reporting time (OR = 1.76, 95%CI = 1.35-2.29) and of necessary information in reporting form (OR = 1.94, 95%CI = 1.53-2.45).Conversely, barriers to non-reporting were unknown of reporting procedure (OR = 0.27, 95%CI = 0.22-0.35), unavailability of reporting form (OR = 0.54, 95%CI = 0.42-0.68) and lack of time (OR = 0.59, 95%CI = 0.46-0.74). What is new and conclusion Given the low ADR reporting rate among HCPs, educational interventions to improve their knowledge and attitude should be prioritized in Vietnam. Additional interventions addressing obstacles (i.e. availability and complexity of reporting form, lack of time) should be considered to improve both the quantity and quality of ADR reporting.

The dimorphic fungus Talaromyces marneffei (TM) is a common cause of HIV-associated opportunistic infections in Southeast Asia. Cotrimoxazole (CTX) inhibits folic acid synthesis which is important for the survival of many bacteria, protozoa, and fungi and has been used to prevent several opportunistic infections among HIV/AIDS patients. We question whether CTX is effective in preventing TM infection. To investigate this question, we conducted an 11-year (2005–2016) retrospective observational cohort study of all patients on the Chinese national antiretroviral therapy (ART) programme in Guangxi, a province with high HIV and TM burden in China. Survival analysis was conducted to investigate TM cumulative incidence, and Cox regression and propensity score matching (PSM) were used to evaluate the effect of CTX on TM incidence. Of the 3359 eligible individuals contributing 10,504.66 person-years of follow-up, 81.81% received CTX within 6 months after ART initiation, and 4.73% developed TM infection, contributing 15.14/1,000 person-year TM incidence rate. CTX patients had a significantly lower incidence of TM infection than non-CTX patients (4.11% vs. 7.53%; adjusted hazard ratio (aHR) = 0.50, 95% CI 0.35–0.73). CTX reduced TM incidence in all CD4+ cell subgroups (

International audience; Biallelic variants in PLEKHG5 have been reported so far associated with different clinical phenotypes including Lower motor neuron disease (LMND) [also known as distal hereditary motor neuropathies (dHMN or HMN) or distal spinal muscular atrophy (DSMA4)] and intermediate Charcot-Marie-Tooth disease (CMT). We report four patients from two families presenting with intermediate CMT and atypical clinical and para-clinical findings. Patients presented with predominant distal weakness with none or mild sensory involvement and remain ambulant at last examination (22–36 years). Nerve conduction studies revealed, in all patients, intermediate motor nerve conduction velocities, reduced sensory amplitudes and multiple conduction blocks in upper limbs, outside of typical nerve compression sites. CK levels were strikingly elevated (1611–3867 U/L). CSF protein content was mildly elevated in two patients. Diffuse bilateral white matter lesions were detected in one patient. Genetic analysis revealed three novel frameshift variants c.1835_1860del and c.2308del (family 1) and c.104del (family 2). PLEKHG5-associated disease ranges from pure motor phenotypes with predominantly proximal involvement to intermediate CMT with predominant distal motor involvement and mild sensory symptoms. Leukoencephalopathy, elevated CK levels and the presence of conduction blocks associated with intermediate velocities in NCS are part of the phenotype and may arise suspicion of the disease, thus avoiding misdiagnosis and unnecessary therapeutics in these patients.

Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate the effects of hydroxychloroquine and chloroquine on survival in COVID-19 from all currently available RCT evidence, published and unpublished. We present a rapid meta-analysis of ongoing, completed, or discontinued RCTs on hydroxychloroquine or chloroquine treatment for any COVID-19 patients (protocol: https://osf.io/QESV4/ ). We systematically identified unpublished RCTs (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Cochrane COVID-registry up to June 11, 2020), and published RCTs (PubMed, medRxiv and bioRxiv up to October 16, 2020). All-cause mortality has been extracted (publications/preprints) or requested from investigators and combined in random-effects meta-analyses, calculating odds ratios (ORs) with 95% confidence intervals (CIs), separately for hydroxychloroquine and chloroquine. Prespecified subgroup analyses include patient setting, diagnostic confirmation, control type, and publication status. Sixty-three trials were potentially eligible. We included 14 unpublished trials (1308 patients) and 14 publications/preprints (9011 patients). Results for hydroxychloroquine are dominated by RECOVERY and WHO SOLIDARITY, two highly pragmatic trials, which employed relatively high doses and included 4716 and 1853 patients, respectively (67% of the total sample size). The combined OR on all-cause mortality for hydroxychloroquine is 1.11 (95% CI: 1.02, 1.20; I² = 0%; 26 trials; 10,012 patients) and for chloroquine 1.77 (95%CI: 0.15, 21.13, I² = 0%; 4 trials; 307 patients). We identified no subgroup effects. We found that treatment with hydroxychloroquine is associated with increased mortality in COVID-19 patients, and there is no benefit of chloroquine. Findings have unclear generalizability to outpatients, children, pregnant women, and people with comorbidities.

Clinical research in hematologic malignancies is continually advancing with emerging concepts in therapy and evolving results from clinical protocols. Targeting of the PI3K pathway remains a valuable treatment across both hematologic and solid malignancies. There are currently four United States Food and Drug Administration (FDA)-approved PI3K inhibitors, with several others in development. Copanlisib is a pan-PI3K inhibitor currently FDA-approved for the treatment of relapsed/refractory follicular lymphoma (FL) following two lines of therapy. Since FDA approval, there have been further investigations into the long-term safety profile of copanlisib, as well as treatment of FL and other lymphoma subtypes, both indolent and aggressive. Here, we review the most recent available data from clinical trials, describe the management of the most common side effects, and explore future concepts. The use of copanlisib as part of a combination therapy for various hematologic malignancies will also be discussed. Copanlisib is a unique drug compared with other PI3K inhibitors, with remarkable potential to improve our armamentarium in cancer treatment.

There is a growing interest in the potentially deleterious impact of antibiotics on gut microbiota. Patients with bone and joint infection (BJI) require prolonged treatment that may impact significantly the gut microbiota. We collected samples from patients with BJI at baseline, end of antibiotics (EOT), and 2 weeks after antibiotic withdrawal (follow-up, FU) in a multicenter prospective cohort in France. Microbiota composition was determined by shotgun metagenomic sequencing. Fecal markers of gut permeability and inflammation as well as multi-drug-resistant bacteria (MDRB) and Clostridioides difficile carriage were assessed at each time point. Sixty-two patients were enrolled: 27 native BJI, 14 osteosynthesis-related BJI, and 21 prosthetic joint infections (PJI). At EOT, there was a significant loss of alpha-diversity that recovered at FU in patients with native BJI and PJI, but not in patients with osteosynthesis-related BJI. At EOT, we observed an increase of Proteobacteria and Bacteroidetes that partially recovered at FU. The principal component analysis (PCoA) of the Bray–Curtis distance showed a significant change of the gut microbiota at the end of treatment compared to baseline that only partially recover at FU. Microbiota composition at FU does not differ significantly at the genus level when comparing patients treated for 6 weeks vs. those treated for 12 weeks. The use of fluoroquinolones was not associated with a lower Shannon index at the end of treatment; however, the PCoA of the Bray–Curtis distance showed a significant change at EOT, compared to baseline, that fully recovered at FU. Levels of fecal neopterin were negatively correlated with the Shannon index along with the follow-up (r2 = 0.17; p < 0.0001). The PCoA analysis of the Bray–Curtis distance shows that patients with an elevated plasma level of C-reactive protein (≥5 mg/L) at EOT had a distinct gut microbial composition compared to others. MDRB and C. difficile acquisition at EOT and FU represented 20% (7/35) and 37.1% (13/35) of all MDRB/C. difficile-free patients at the beginning of the study, respectively. In patients with BJI, antibiotics altered the gut microbiota diversity and composition with only partial recovery, mucosal inflammation, and permeability and acquisition of MDRB carriage. Microbiome interventions should be explored in patients with BJI to address these issues.

Tropical forests account more than 50% of recorded terrestrial biodiversity and play an important role in carbon storage and the water cycle. The degradation of tropical forests presents an immediate danger for the global environment and biodiversity. Monitoring of deforestation and understanding its drivers are challenging tasks that are essential to measures of reduction of deforestation.Many researches have been carried out on the detection of deforestation using remote sensing data, and there are several operational systems that work. Those systems are mostly based on optical data, but they show big delays in detections due to the persistent cloud cover in the tropics. Since 2014, Sentinel-1 provides SAR images every 6 to 12 days, insensitive to cloud cover. Deforestation detection methods based on SAR images have increased and start to be operational (Bouvet et al. 2018, Reiche et al. 2021). They allow for faster and more accurate mapping. For example, Ballere et al. 2021 shows that 80% of gold-mining-related deforestation in French Guiana is first detected by a SAR-based method, before the optical method, most often offset by several months.However, the detection of disturbances in itself is not sufficient for measures to halt deforestation. Finer et al. 2017 defined a 5 steps protocol in order to help the near-real-time monitoring to be effective, the first step being the detection. Then comes the prioritization of data: this can be done by integrating spatial data such as protected areas or specific areas of interest. The third step is the identification of the drivers. This usually involves human-work.We present here an automatic method for the identification of the drivers of deforestation in French Guiana (gold mining, urbanization, small-scale agriculture and forest exploitation), and show its results. It is based on geographical and morphological indicators, and makes it possible not to wait for another image after the detection step. The method has the potential to be integrated into an operational system for French Guiana.

Background: Long-term neurocognitive outcomes following first-line suppressive anti-retroviral therapy (ART) remain uncertain for individuals with HIV and hepatitis C (HCV) co-infection. The study examined neurocognitive performance before and after 72 weeks of ART using repeated multivariate analyses and latent trajectory models.Methods: One hundred and sixty adults with chronic, untreated HIV infection (n = 80 with HCV co-infection and n = 80 HIV mono-infected) and 80 demographically similar healthy controls were recruited from the Hospital for Tropical Diseases in Ho Chi Minh City and the surrounding community, respectively. Neurocognitive measures (adapted for use in Vietnam) and liver enzyme tests were compared across groups at baseline. Repeated multivariate and group-based trajectory analyses (GBTA) examined neurocognitive subgroup profiles of the co-infected individuals after 72 weeks of de novo efavirenz- (n = 41) or raltegravir-based (n = 39) ART.Results: Baseline analyses revealed worse motor function in HIV-HCV co-infected individuals compared to both comparison groups. Longitudinal analyses revealed improved neurocognitive performance by week 48 for most participants regardless of treatment arm. GBTA identified a subgroup (35% of HIV-HCV sample) with persistent motor impairment despite otherwise successful ART. Higher HIV viral load and lower CD4+ T cell count at baseline predicted persistent motor dysfunction. Liver indices and ART regimen did not predict neurocognitive outcomes in HIV-HCV co-infected individuals.Conclusions: Most HIV-HCV co-infected individuals achieve normative neurocognitive performance after 48 weeks of de novo suppressive ART. However, individuals with more severe HIV disease prior to ART exhibited motor impairment at baseline and 72 weeks after otherwise successful treatment. Interventions aimed at improving motor symptoms at the time of HIV treatment onset may improve long-term clinical outcomes in HIV-HCV co-infected adults.

Many methods for Alzheimer's disease detection in brain magnetic resonance imaging (MRI) is related to white matter (WM), grey matter (GM), and cerebrospinal fluid (CSF) regions. Therefore, in many neurological applications, the segmentation of these tissues in magnetic resonance imaging (MRI) plays an important role in the analysis. In the trend of deep learning, an application using 3 dimensional (3D) Convolution Neural Network will help doctors get the best result segmentation. In this research, we proposed an effective approach to segment automatically these tissues in Brain MRI 3D by using an adaptive 3D U-Net. In the experiments, a real MRI database, The Internet Brain Segmentation Repository (IBSR) 18, is evaluated with the proposed method and gives the promising Dice with 0.92, 0.87, 0.81 for WM, GM, and CSF segmentation.

In this work, we propose a novel Wi – Fi blocking window based on metamaterial microwave band – stop filter. Made of glass and fluorine – doped tin oxide (FTO), the proposed window is transparent for visible light, allows other RF waves to go though significantly while completely blocks the Wi – Fi signal. With such property, this window can be used for confidential purpose.

In this paper, the circularly polarized (CP) antenna is proposed based on the loop antenna for ambient RF energy harvesting (RFEH) applications. This loop antenna is meandered to achieve a compact size of 30 mm × 50 mm. The proposed CP meandered-loop antenna has a measured bandwidth of 150 MHz at – 10 dB with a center frequency of 2.14 GHz for 3G and 4G technologies. A maximum of 62 % RF-DC conversion efficiency is obtained using the proposed CP antenna and a load of 1.2 KΩ when the power of the incident wave is 0 dBm.

Wireless power transfer presents a robust method to provide a safe and convenient solution for powering biomedical implants. The implanted device is necessarily minimized conducive to the transfer efficiency degradation. This paper presents a wireless power transfer for retinal prosthesis using an artificial intelligent algorithm to optimize the power transfer efficiency with the minimizing implanted device dimension. A novel transmitter is designed based on the conformal strongly coupled magnetic resonator, which is proposed to attach to the glasses lens. An implanted receiver is optimized to obtain the highest efficiency with the minimal dimension of 9.7 x 9.7 x 1.9 mm3. The WPT system achieves approximately 17.5 % at the operating ISM frequency band of 433 MHz and a distance between transmitter and receiver of 20 mm.

Conjunctival pneumococcal serotypes among members of a community have not been investigated well. We determined the prevalence and association of Streptococcus pneumoniae in the nasopharynx and conjunctiva among children in a community before pneumococcal conjugate vaccine introduction. In October 2016, conjunctival and nasopharyngeal swabs were collected from children (< 24 months old) and nasopharyngeal swabs from mothers in Nha Trang, Vietnam. Quantitative lytA PCR and DNA microarray were performed to detect and serotype S. pneumoniae. The association between S.pneumoniae in the nasopharynx and conjunctiva was evaluated using multivariable logistic regression model. Among 698 children,62 (8.9%, 95% CI 6.9–11.2%) were positive for S. pneumoniae in the conjunctiva. Non-encapsulated S. pneumoniae were most commonly identified,followed by serotypes 6A, 6B, and 14. Nasopharyngeal and conjunctival detection were positively associated (aOR 47.30, 95% CI 24.07–92.97). Low birth-weight, day-care attendance, and recent eye symptoms were independently associated with S. pneumoniae detection in the conjunctiva (aOR 11.14, 95% CI 3.76–32.98, aOR 2.19, 95% CI 1.45–3.31, and aOR 3.59, 95% CI 2.21–5.84, respectively). Serotypes and genotypes in the conjunctiva and nasopharynx matched in 87% of the children. Three mothers’ nasopharyngeal pneumococcal samples had matched serotype and genotype with their child’s in the conjunctiva and nasopharynx. S. pneumoniae presence in nasopharynx and conjunctiva were strongly associated. The high concordance of serotypes suggests nasopharyngeal carriage may be a source of transmission to the conjunctiva., Scientific Reports, 11(1), art.no.337; 2021

A novel wideband circularly polarized reconfigurable antenna for 5G devices is presented in this paper. Left hand and right-hand circular polarizations were achieved using the sequential phase rotation feeding network based on 90° hybrid coupler. The proposed antenna has a bandwidth (with AR ≤ 3 dB) of 24.8% and 4% for right hand circular polarization (RHCP) and left-hand circular polarization (LHCP) mode, respectively. At 3.75 GHz, the degree of circular polarization is 42° in LHCP mode and 51° in RHCP mode showing the potential of this proposed antenna for modern 5G terminal devices.

International audience; The global burden of the endemic mycoses (blastomycosis, coccidioidomycosis, emergomycosis, histoplasmosis, paracoccidioidomycosis, sporotrichosis, and talaromycosis) continues to rise yearly and these infectious diseases remain a leading cause of patient morbidity and mortality worldwide. Management of the associated pathogens requires a thorough understanding of the epidemiology, risk factors, diagnostic methods and performance characteristics in different patient populations, and treatment options unique to each infection. Guidance on the management of these infections has the potential to improve prognosis. The recommendations outlined in this Review are part of the "One World, One Guideline" initiative of the European Confederation of Medical Mycology. Experts from 23 countries contributed to the development of these guidelines. The aim of this Review is to provide an up-to-date consensus and practical guidance in clinical decision making, by engaging physicians and scientists involved in various aspects of clinical management.