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Some studies of women’s health show that the risk of overweight, obesity and non-communicable chronic diseases often appear in middle-aged, instead of maintaining the right weight, many women suffer obesity in this age group. Therefore, this study was conducted to determine the prevalence of overweight, obesity and related factors among women aged 40-59 years in Cang Long district, Tra Vinh province. The study uses multivariate analysis and descriptive methods for cross-sectional data of 531 women. The results of overweight and obesity are 26.7% and 4.3% respectively. The study found a statistically significant correlation between overweight and obesity with a number of factors. To be specific, women with higher education levels have the lower rate of overweight and obesity (p

(1) Background: Metal pollution in the Nhue-Day River basin has impacted approximately 12 million people. However, none of the previous studies considered the entire basin’s environmental and health risks. Thus, this research aims to fill knowledge gaps and reduce risks. (2) Methods: Sediment and fish samples from the basin were analyzed to determine the levels of Zn, Cu, Pb, and Cd pollution and their potential ecological (EF, modified Pollution Index—mPI, and expanded, modified potential ecological risk index—emRI) and human health risks (THQ, HI, and TR indices). (3) Results: Metal levels in sediment exceeded Canadian aquatic life protection guidelines, indicating moderate to severe contamination (EFs: 1.3–58.5 and mPIs: 4–39). Compared to the new proposed ecological risk threshold, all river sites and Site 1 for ponds had elevated metal levels; and these posed a very high ecological risk in spring (emRI > 4.5), with Cd being the most hazardous. Lead levels in all fish tissues surpassed Vietnamese and EU food regulations. In agreement with THQ, EWI (Zn, Cu) and EMI (Cd) were both less than 2.5% of the PTWI and PTMI, respectively. However, HI values of 0.67–1.26 suggested a moderate health risk. Carcinogenic risk (TR > 10−6; estimated for Pb) was detected in several localities for Common carp and Tilapia during the warm season. (4) Conclusions: Metals had a negative impact on the basin’s ecosystem, with Cd being the most dangerous. Because of lead, consumption of Common carp and Tilapia from the basin may pose both non-carcinogenic and carcinogenic health concerns.

The I-PASS Handoff Program is linked to reduced medical errors. The enduring handoff practices of residency graduates trained in I-PASS, and attitudes thereof, are unknown. Our objective was to investigate how often residency graduates use I-PASS or other handoff tools, and perspectives regarding standardized handoffs beyond residency. We performed an exploratory electronic survey of residency graduates from programs who participated in the original I-PASS study. Responses were analyzed using descriptive statistics. Of the 106 respondents, 64/106 (60%) identified as “attendings” and the remainder of respondents were subspeciality fellows. The most common practice setting was the inpatient hospital setting, 42/106 (39%). Regarding handoff use, 61/106 (58%) “rarely” or “never” used standardized handoffs. Of those using handoffs, 13/76 (17%) used I-PASS and 59/76 (78%) used a personal system. Most (95/101, 94%) were unaware of any dedicated handoff training or reported it did not exist for attendings, although 77/106 (73%) endorsed their importance for attendings. Despite rigorous residency training and belief in its importance, over one third of graduates did not use standardized handoffs. System-wide requirements for standardized handoffs may improve communication among all providers including physicians, advanced practice providers, and nurses, and enhance patient safety.

A novel bacterial aldehyde dehydrogenase (ALDH) that converts retinal to retinoic acid was first identified in Bacillus cereus . The amino acid sequence of ALDH from B. cereus ( Bc ALDH) was more closely related to mammalian ALDHs than to bacterial ALDHs. This enzyme converted not only small aldehydes to carboxylic acids but also the large aldehyde all- trans -retinal to all- trans -retinoic acid with NAD(P) + . We newly found that Bc ALDH and human ALDH (ALDH1A1) could reduce all- trans -retinal to all- trans -retinol with NADPH. The catalytic residues in Bc ALDH were Glu266 and Cys300, and the cofactor-binding residues were Glu194 and Glu457. The E266A and C300A variants showed no oxidation activity. The E194S and E457V variants showed 15- and 7.5-fold higher catalytic efficiency ( k cat / K m ) for the reduction of all- trans -retinal than the wild-type enzyme, respectively. The wild-type, E194S variant, and E457V variant enzymes with NAD + converted 400 μM all- trans -retinal to 210 μM all- trans -retinoic acid at the same amount for 240 min, while with NADPH, they converted 400 μM all- trans -retinal to 20, 90, and 40 μM all- trans -retinol, respectively. These results indicate that Bc ALDH and its variants are efficient biocatalysts not only in the conversion of retinal to retinoic acid but also in its conversion to retinol with a cofactor switch and that retinol production can be increased by the variant enzymes. Therefore, Bc ALDH is a novel bacterial enzyme for the alternative production of retinoic acid and retinol. IMPORTANCE Although mammalian ALDHs have catalyzed the conversion of retinal to retinoic acid with NAD(P) + as a cofactor, a bacterial ALDH involved in the conversion is first characterized. The biotransformation of all- trans -retinal to all- trans -retinoic acid by Bc ALDH and human ALDH was altered to the biotransformation to all- trans -retinol by a cofactor switch using NADPH. Moreover, the production of all- trans -retinal to all- trans -retinol was changed by mutations at positions 194 and 457 in Bc ALDH. The alternative biotransformation of retinoids was first performed in the present study. These results will contribute to the biotechnological production of retinoids, including retinoic acid and retinol.

Six 5-arylidene-3-methylrhodanine derivatives were synthesized by the crossed aldolization of aromatic aldehydes with 3- methylrhodanine using 1-butyl-3- methylimidazolium chloride ([BMI]Cl) as phase transfer catalyst in water. The reactions, under microwave irradiation (160 watts) during 10 minutes, afforded the yield of 59–83 %. This is the first time [BMI]Cl was used as phase transfer catalyst in the aldol condensation.

Acinetobacter baumanniicauses bacteraemia, pneumonia, other respiratory-tract and urinary-tract infections in humans. OXA-23 carbapenemase-producingA. baumanniiK0420859 (A. baumanniiOXA-23) is resistant to carbapenem, a common antibacterial drug. To develop an efficient and novel antibacterial drug againstA. baumanniiOXA-23, D-alanine-D-alanine ligase, which is essential in bacterial cell-wall synthesis, is of interest. Here, the D-alanine-D-alanine ligase (AbDdl) gene fromA. baumanniiOXA-23 was cloned and expressed, and theAbDdl protein was purified and crystallized; this enzyme can be used as a novel target for an antibacterial drug againstA. baumanniiOXA-23. TheAbDdl crystal diffracted to a resolution of 2.8 Å and belonged to the orthorhombic space groupP212121, with unit-cell parametersa= 113.4,b= 116.7,c= 176.5 Å, a correspondingVMof 2.8 Å3 Da−1and a solvent content of 56.3%, and six protomers in the asymmetric unit.

Xanthomonas oryzae pv. oryzae (Xoo) causes bacterial blight on rice; this species is one of the most destructive pathogenic bacteria in rice cultivation worldwide. Peptide deformylase (PDF) catalyzes the removal of the N-formyl group from the N-terminus of newly synthesized polypeptides in bacterial cells and is an important target to develop antibacterial agents. We determined crystal structures of Xoo PDF (XoPDF) at up to 1.9 A resolution, which include apo, two substrate-bound (methionine-alanine or methionine-alanine-serine), an inhibitor-bound (actinonin), and six fragment chemical-bound structures. Six fragment chemical compounds were bound in the substrate-binding pocket. The fragment chemical-bound structures were compared to the natural PDF inhibitor actinonin-bound structure. The fragment chemical molecules will be useful to design an inhibitor specific to XoPDF and a potential pesticide against Xoo.

Many patients with few cerebral metastases receive radiosurgery alone. The goal of this study was to create a tool to estimate the survival of such patients. To identify characteristics associated with survival, nine variables including radiosurgery dose, age, gender, Eastern cooperative oncology group performance score (ECOG-PS), primary tumor type, number/size of cerebral metastases, location of cerebral metastases, extra-cerebral metastases and time between cancer diagnosis and radiosurgery were analyzed in 214 patients. On multivariate analysis, age (p=0.03), ECOG-PS (p=0.02) and extra-cerebral metastases (p

Cartilage taken from the osteoarthritic bovine patellae was used to investigate the progression of change in the collagenous architecture associated with the development of fibrillated lesions. Differential interference contrast optical microscopy using fully hydrated radial sections revealed a continuity in the alteration of the fibrillar architecture in the general matrix consistent with the progressive destructuring of a native radial arrangement of fibrils repeatedly interconnected in the transverse direction via a non-entwinement-based linking mechanism. This destructuring is shown to occur in the still intact regions adjacent to the disrupted lesion thus rendering them more vulnerable to radial rupture. Two contrasting modes of surface rupture were observed and these are explained in terms of the absence or presence of a skewed structural weakening of the intermediate zone. A mechanism of surface rupture initiation based on simple bi-layer theory is proposed to account for the intensification of surface ruptures observed in the intact regions on advancing towards the fibrillation front. Focusing specifically on the primary collagen architecture in the cartilage matrix, this study proposes a pathway of change from intact to overt disruption within a unified structural framework.

BackgroundMicrobiota of Anopheles midgut can modulate vector immunity and block Plasmodium development. Investigation on the bacterial biodiversity in Anopheles, and specifically on the identification of bacteria that might be used in malaria transmission blocking approaches, has been mainly conducted on malaria vectors of Africa. Vietnam is an endemic country for both malaria and Bancroftian filariasis whose parasitic agents can be transmitted by the same Anopheles species. No information on the microbiota of Anopheles mosquitoes in Vietnam was available previous to this study.MethodThe culture dependent approach, using different mediums, and culture independent (16S rRNA PCR - TTGE) method were used to investigate the bacterial biodiversity in the abdomen of 5 Anopheles species collected from Dak Nong Province, central-south Vietnam. Molecular methods, sequencing and phylogenetic analysis were used to characterize the microbiota.Results and discussionThe microbiota in wild-caught Anopheles was diverse with the presence of 47 bacterial OTUs belonging to 30 genera, including bacterial genera impacting Plasmodium development. The bacteria were affiliated with 4 phyla, Actinobacteria, Bacteroidetes, Firmicutes and Proteobacteria, the latter being the dominant phylum. Four bacterial genera are newly described in Anopheles mosquitoes including Coxiella, Yersinia, Xanthomonas, and Knoellia. The bacterial diversity per specimen was low ranging from 1 to 4. The results show the importance of pairing culture and fingerprint methods to better screen the bacterial community in Anopheles mosquitoes.ConclusionSampled Anopheles species from central-south Vietnam contained a diverse bacterial microbiota that needs to be investigated further in order to develop new malaria control approaches. The combination of both culture and DNA fingerprint methods allowed a thorough and complementary screening of the bacterial community in Anopheles mosquitoes.

This curriculum was developed to provide didactic and simulation-based education for prehospital providers, such as emergency medical technicians and paramedics, caring for critically ill children in the prehospital environment. The course includes a 75-minute didactic lecture focused on pediatric assessment, three pediatric skills stations highlighting differences between adult and pediatric resuscitation skills, and four high-fidelity scenarios focused on neonatal resuscitation, respiratory distress/failure, seizures, and non-accidental trauma. Each scenario is followed by a debriefing session. This curriculum was developed via collaboration between a consensus group of experts in simulation, medical education, pediatric emergency medicine, prehospital pediatrics, and emergency medical services. After initial curriculum development and instructor training, the curriculum was trialed with emergency medical services providers, and then modified based on their feedback and the feedback of the emergency medical services medical directors. This course has been taught to over 550 prehospital providers since February 2012. Posttest results show significant improvement over pretest scores, and course satisfaction surveys demonstrate extremely high learner satisfaction. Future studies are currently evaluating 6-month retention of knowledge with or without interspersed education, and clinical outcomes for patients of providers trained in this course.

Background: Human malaria is still a burden in Dak Nong and Binh Phuoc Provinces in south-central Vietnam that border Cambodia. Several Anopheles species that transmit human malarial Plasmodium may also transmit Wuchereria bancrofti, the nematode that causes Bancroftian lymphatic filariasis. The objective of this study was to investigate the role of Anopheles species in the transmission of these two pathogens in the two highly malaria endemic provinces of Vietnam. Methods: Anopheles mosquitoes were collected in Dak Nong and Binh Phuoc Provinces in November and December of 2010 and 2011. Human landing catches, paired collections on human and buffalo, and resting captures were made with mouth aspirators. Collections were also made with light traps. Morphological and PCR-based methods were used to identify the species. Real-time PCR was used to detect Plasmodium species and W. bancrofti in individual mosquitoes. Results: Twenty-four Anopheles species were identified among 797 captured mosquitoes. Anopheles dirus was found in both provinces and was the predominant species in Binh Phuoc Province; An. maculatus was the most prevalent species in Dak Nong Province. Anopheles minimus was collected only in Binh Phuoc Province. Some specimens of An. minimus and An. pampanai were misidentified based on morphology. Four specimens of An. scanloni were identified, and this is the first report of this species of the Dirus Complex in Vietnam. Two females, one An. dirus and one An. pampanai, collected in Binh Phuoc Province were infected with P. vivax, for an overall infection rate of 0.41% (2/486): 0.28% for An. dirus (1/361) and 20% for An. pampanai (1/5). No mosquitoes were found to be infected with P. falciparum, P. knowlesi or W. bancrofti in either province. Conclusion: A diversity of Anopheles species occurs in Dak Nong and Binh Phuoc Provinces of Vietnam, several of which are considered to be actual and potential vectors of malarial protozoa and microfilariae. It is highly likely that two of the species, An. dirus and An. pampanai, are active in malaria transmission based on the detection of P. vivax in females of these species. This is the first report of An. scanloni in Vietnam.

Acinetobacter baumannii has received much attention owing to its exceptional ability to develop resistance to currently available antibiotics. Alanine racemase (ALR) catalyzes the racemization of L-alanine to D-alanine with pyridoxal 5'-phosphate (PLP) as a cofactor. The D-alanine product is an essential component of the bacterial cell wall and ALR is a potential target for the development of novel antibacterial drugs. The alr gene from A. baumannii was cloned and the protein (AbALR) was expressed, purified and crystallized. The AbALR crystal diffracted to 2.3 Å resolution and belonged to the primitive orthorhombic space group P2(1)2(1)2(1), with unit-cell parameters a = 55.1, b = 85.0, c = 167.7 Å. Two protomers were present in the asymmetric unit, with a corresponding V(M) value of 2.3 Å(3) Da(-1) and a solvent content of 47.5%.

Alcohol dehydrogenases (ADHs) are a group of dehydrogenase enzymes that facilitate the interconversion between alcohols and aldehydes or ketones with the reduction of NAD(+) to NADH. In bacteria, some alcohol dehydrogenases catalyze the opposite reaction as part of fermentation to ensure a constant supply of NAD(+). The adh gene from Kangiella koreensis was cloned and the protein (KkADH) was expressed, purified and crystallized. A KkADH crystal diffracted to 2.5 Å resolution and belonged to the monoclinic space group P2(1), with unit-cell parameters a = 94.1, b = 80.9, c = 115.6 Å, β = 111.9°. Four monomers were present in the asymmetric unit, with a corresponding VM of 2.55 Å(3) Da(-1) and a solvent content of 51.8%.

Factors allowing the development of a pathogen to reach the infecting stage in a mosquito are poorly known. On the 528 species of mosquitoes recorded within the Anopheles genus [1], only 70 to 60 are able to transmit parasites responsible for malaria and filariasis [2, 3]. In vectorparasite interactions, the mosquito gut represents the first point of contact between parasites ingested and the vector epithelial surfaces. In the midgut, the parasites will have the oppor‐ tunity to undergo their life cycle, but of the tens of thousands of Plasmodium gametocytes ingested by mosquitoes, less than five oocysts might be produced [4]. The factors responsible for this drastic reduction are still poorly understood. Recent studies showed that one of these factors concerns the primordial role played by the bacteria naturally present in mosquito midgut. Then, there is a growing interest on bacterial biodiversity in Anopheles mosquitoes and particularly those based on the identification of bacteria to be used for malaria transmission blocking based on bacterial genetic changes to deliver antiparasite molecules or paratransgenic approach [5-13]. Recent studies reported the presence of symbiotic bacteria, such as Pantoea agglomerans or Asaia in midgut lumen with anti-Plasmodium effector proteins that render host mosquitoes refractory to malaria infection [6, 10, 13]. Engineered P. agglomerans strains were able to inhibit Plasmodium falciparum development by 98% [13]. Other studies showed that insects with an important microbiota seem more resistant to infections and certain bacteria, such as Enterobacter sp. (Esp Z) inhibit partially or totally ookinete, oocyst and sporozoite formation [14-16]. In Anopheles albimanus, co-infections with the bacteria, Serratia marcescens

There are two primary geographical divisions within an area collectively called Southeast Asia, Mainland SEA and Maritime SEA. Mainland SEA includes Cambodia, Lao PDR, Myanmar, Thailand, Vietnam and Peninsular Malaysia. The first five countries including Yunnan Province, southern China is referred to as the Greater Mekong Subregion (GMS). Maritime SEA consists of Eastern Malaysia (Sarawak and Sabah States located on Borneo Island), Brunei Darussalam, Indonesia, Philippines, Singapore and East Timor (Timor-Leste). Most of these areas are at risk for a variety of vector-borne diseases, especially malaria, one of the most important diseases transmitted by mosquitoes in the genus Anopheles.

d -Alanine- d -alanine ligase (DDL) catalyzes the biosynthesis of d -alanyl- d -alanine, an essential bacterial peptidoglycan precursor, and is an important drug target for the development of antibacterials. We determined four different crystal structures of DDL from Xanthomonas oryzae pv. oryzae (Xoo) causing Bacteria Blight (BB), which include apo, ADP-bound, ATP-bound, and AMPPNP-bound structures at the resolution between 2.3 and 2.0 A. Similarly with other DDLs, the active site of XoDDL is formed by three loops from three domains at the center of enzyme. Compared with d -alanyl- d -alanine and ATP-bound TtDDL structure, the γ-phosphate of ATP in XoDDL structure was shifted outside toward solution. We swapped the ω-loop (loop3) of XoDDL with those of Escherichia coli and Helicobacter pylori DDLs, and measured the enzymatic kinetics of wild-type XoDDL and two mutant XoDDLs with the swapped ω-loops. Results showed that the direct interactions between ω-loop and other two loops are essential for the active ATP conformation for D-ala-phosphate formation.

Background: The Lectorate Public Sector Innovation (HAN University of Applied Science) is founded to transfer private sector innovation insights to the public sector. For the health care innovation project, it studied several excellent examples of which five cases focused on telehealth and telecare: AED Alert, Digital IVF polyclinic (UMC St Radboud), Caring Home (Proteion Domestic Care), 113 Online and Zorg TV (Proteion Domestic Care). Findings: The cases demonstrate the Herculean efforts needed before innovations come to play. Many anecdotal experiences are described, such as how a medical doctor dealt with the threat of losing his medical practice license because he planned to train volunteers to use automatic external defibrillators. The research yielded facilitators and barriers for health innovation. Examples of facilitators are inspiring visions, using pilot studies and the presence of persons able to bridge technology/health language barriers. Examples of barriers are outdated legislation, underestimating the time needed to attune work with ICT processes and resistance among time-pressured and IT inexperienced staff. Conclusion: In conclusion, innovators seem to be rowing against the current. The absence of innovation management methods common practice in private organizations unnecessarily complicates implementing new ideas in health care settings.

A child with joint or extremity pain is a common presentation to the emergency department. Often, there is some element to the patient's history, whether it is trauma or some other significant history, which leads to a likely diagnosis. When there is a history of fever and progressive arm weakness, an astute emergency physician would have heightened awareness of a possible systemic process. We describe a case of unilateral shoulder pain with associated fever in a 7-year-old boy who presented to the emergency department with progressive arm weakness to the same side.