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Quang Tuan Pham,1 Thua Nguyen Tran,2 Thanh Thuy Le-Thi,1 Anh Khoa Phan,3 Anh Vu Nguyen4 1Cardiology Department, Hue Central Hospital, Hue City, Vietnam; 2Department of General Internal Medicine and Geriatrics, Hue Central Hospital, Hue City, Vietnam; 3Emergency Department of Cardiovascular Intervention, Hue Central Hospital, Hue City, Vietnam; 4Cardiovascular Center, Hospital of University of Medicine and Pharmacy, Hue City, VietnamCorrespondence: Thua Nguyen Tran, Department of General Internal Medicine and Geriatrics, Hue Central Hospital, Hue City, Vietnam, Tel +84 903597695, Email tranthuanguyen23@gmail.comObjectives: To assess left ventricular diastolic function by using echocardiography in patients with dilated cardiomyopathy, and the relationship between left ventricular diastolic function and left ventricular dilatation, New York Heart Association (NYHA) heart failure index, left ventricular ejection fraction, and left ventricular fractional shortening.Methods: A descriptive cross-sectional study was conducted on patients with primary dilated cardiomyopathy hospitalized in Hue Central Hospital from April 2018 to August 2020.Results: The mean end-diastolic left ventricular volume was 133.57± 31.58 mL and the mean end-systolic left ventricular volume was 99.9± 26.03 mL. The mean left atrial volume was 61.63± 27.13 mL. The mean end-diastolic and end-systolic left ventricular diameters were 66.11± 7.3 mm and 57.7± 8.02 mm, respectively. The mean left ventricular ejection fraction was 24.68± 5.97%. The mean left ventricular fractional shortening was 12.91± 4.55%. The highest rate was grade II diastolic dysfunction (44.6%), followed by grade III diastolic dysfunction (35.8%) and grade I diastolic dysfunction at 19.6%. There was a moderate positive correlation between the left ventricular diastolic dysfunction and the NYHA class of heart failure with r=0.445, p< 0.001. All dilated cardiomyopathy patients in the study group had mainly grade II–III severe diastolic dysfunction.Conclusions: Routine evaluation of diastolic function in patients with heart failure can help in elucidation of pathogenesis and management of patients. This dysfunction was clearly demonstrated by the change in the parameters of the evaluation of left ventricular diastolic function on echocardiography according to the 2016 ASE/EACVI recommendations, a new recommendation introduced to approach the assessment of diastolic function in a more convenient and easier way.Keywords: dilated cardiomyopathy, left ventricular diastolic dysfunction

We have previously reported the draft genome sequences of 59 endospore-forming Gram-positive bacterial strains isolated from Vietnamese crop plants due to their ability to suppress plant pathogens. Based on their draft genome sequence, eleven of them were assigned to the Brevibacillus and one to the Lysinibacillus genus. Further analysis including full genome sequencing revealed that several of these strains represent novel genomospecies. In vitro and in vivo assays demonstrated their ability to promote plant growth, as well as the strong biocontrol potential of Brevibacilli directed against phytopathogenic bacteria, fungi, and nematodes. Genome mining identified 157 natural product biosynthesis gene clusters (BGCs), including 36 novel BGCs not present in the MIBiG data bank. Our findings indicate that plant-associated Brevibacilli are a rich source of putative antimicrobial compounds and might serve as a valuable starting point for the development of novel biocontrol agents.

Background: Men who have sex with men are increasingly diagnosed with sexually transmitted infections (STI) in France. To address this situation, quarterly screening for HIV combined with hepatitis B (HBV) and hepatitis C (HCV), as well as annual screening for C.trachomatis (CT) and N.gonorrhoeae (NG) are recommended. The MemoDepistages program offered an at-home screening solution for these infections. This study describes the feasibility of this screening process, the rate of positive test results, and the factors associated with positivity., Methods: Participants were recruited online. Laboratories verified the quantity and quality of the samples. Logistic regression was used to determine the associated factors for infection., Results: Overall, 1556 out of 1908 (81.6%) blood samples were tested for at least HIV. A total of eight participants (0.5%) were newly diagnosed with HIV and four with HCV (0.3%). No new infection was confirmed for HBV. Overall positivity was 9.3% for CT and 9.6% for NG. The highest positivity was reported in rectal swabs for CT (7.3%) and in pharyngeal swabs for NG (7.2%). Factors associated with extragenital CT/NG were age under 30 years (for pharyngeal and rectal infections) and having at least 10 partners in the past 6 months ( p <0.001) (for pharyngeal infections only)., Conclusions: The self-sampling kit for multiple STIs can perform comprehensive tests and identify new infections in young people, especially in extragenital sites.

Our objective is to analyze the economic burden of chronic kidney disease (CKD) in Vietnam, particularly in District 2 Hospital at Ho Chi Minh City in 2019. This is a descriptive cross-sectional study. The data source is the medical records of the patients. Encoding the data, analyzing treatment cost, regression modeling, and verification were performed using Stata 15 software. Patients with stage 3 CKD account for the highest proportion of the CKD patient population. CKD comorbidities include hypertension, diabetes, cardiovascular disease, and anemia, which increase the treatment fees of patients. Approximately half of the patients with CKD have diabetes or cardiovascular disease. Treatment costs increase as the condition of the patient worsens (except for stage 1 and 2 CKD). The total expenses of all CKD patients in District 2 Hospital were USD 916 423 988.60. Five main factors that affect the treatment fee of a patient: CKD stage, age, gender, and the presence of diabetes, cardiovascular disease, and anemia. The regression model correctly predicts 96% of cases and can explain 64.15% of the fluctuations in costs. The cost of CKD treatment was higher than Vietnam's per capita GDP in 2019, and the primary factors affecting costs are comorbidities and dialysis., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

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 ( r 2 = 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., Competing Interests: BL and CG are employed by the commercial company MaaT Pharma. LB was employed by the commercial company MaaT Pharma. NB declared a travel grant from Maat. JD is co-founder of MaaT Pharma. TF received advisory honorarium from MaaT Pharma and was the principal investigator of this study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declare that this study received funding from MaaT Pharma. The funder had the following involvement in the study: design, management and analysis., (Copyright © 2021 Levast, Benech, Gasc, Batailler, Senneville, Lustig, Pouderoux, Boutoille, Boucinha, Dauchy, Zeller, Maynard, Cazanave, Le Thi, Josse, Doré, Laurent and Ferry.)

Objectives: In 2017, to reduce the proportion of men who have sex with men (MSM) in the undiagnosed HIV population in France (38%), HIV screening is advised each 3 months and STI screening is advised each year in multipartner MSM. Despite the range of testing solutions, over 40% of MSM were not tested for HIV and over 50% for STIs in the past year. Based on international experiments that offer screening solutions via online advertising, the French National Health Agency launched a programme (MemoDepistages) to provide a free self-sampling kit (SSK) for HIV and STIs. This article analyses the sociodemographic and behavioural characteristics of MSM in terms of kit acceptance and sample return., Methods: Participants were registered for the programme online after ordering an SSK. The study included men aged over 18 years, living in one of the four selected French regions, and willing to disclose their postal and email address; they had health insurance, acknowledged more than one male partner in the past year, indicated a seronegative or unknown HIV status and were not taking medically prescribed pre-exposure prophylaxis drugs. Samples were collected by users and posted directly to the laboratory. Characteristics associated with kit acceptance and sample return were analysed using logistic regression., Results: Overall, 7158 eligible MSM were offered to participate in the programme, with 3428 ordering the kit (47.9%) and 1948 returning their sample, leading to a return rate of 56.8% and an overall participation rate of 27.2%. Acceptance and return rates were strongly associated with sociodemographic characteristics, mainly education level but not with behavioural characteristics. Non-college graduates had lower acceptance (44.2%) and return rates (47.7%)., Conclusion: The programme rapidly recruited a large number of MSM. It removed geographical inequalities related to screening access., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

This work was performed to establish a model describing bacterial surface structures involved in biofilm development, in curli-overproducing Escherichia coli K-12 strains, at 30 degrees C, and in minimal growth medium. Using a genetic approach, in association with observations of sessile communities by light and electron microscopic techniques, the role of protein surface structures, such as flagella and curli, and saccharidic surface components, such as the E. coli exopolysaccharide, colanic acid, was determined. We show that, in the context of adherent ompR234 strains, (i) flagellar motility is not required for initial adhesion and biofilm development; (ii) both primary adhesion to inert surfaces and development of multilayered cell clusters require curli synthesis; (iii) curli display direct interactions with the substratum and form interbacterial bundles, allowing a cohesive and stable association of cells; and (iv) colanic acid does not appear critical for bacterial adhesion and further biofilm development but contributes to the biofilm architecture and allows for the formation of voluminous biofilms.