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Recent studies have developed varied delivery systems incorporating natural compounds to improve the limitations of plant extracts for clinical use while enabling their controlled release at treatment sites. For the first time, ethanolic limeberry extract (Triphasia trifolia) has been successfully encapsulated in thermo-sensitive chitosan hydrogels by a facile in situ loading. The extract-incorporated chitosan hydrogels have a pH value of nearly 7.00, gelation temperatures in the range of 37-38 °C, and exhibit an open-cell porous structure, thus allowing them to absorb and retain 756 % of their mass in water. The in vitro extract release from the hydrogels is driven by both temperature and pH, resulting in more than 70 % of the initial extract being released within the first 24 h. Although the release half-life of hydrogels at pH 7.4 is longer, their release capacity is higher than that at pH 6.5. Upon a 2 °C increase in temperature, the time to release 50 % initial extract is sharply reduced by 20-40 %. The release kinetics from the hydrogels mathematically demonstrated that diffusion is a prominent driving force over chitosan relaxation. Consequently, the developed hydrogels encapsulating the limeberry extract show their heat and pH sensitivity in controlled release for treating chronic wounds., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The aim of this study was to compare the efficacy and safety of transradial approach (TRA) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) with the efficacy and safety of transfemoral approach (TFA). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies (OS) reporting the outcomes of TRA versus TFA in CTO PCI. The primary end point was procedural success. Secondary end points included access-site complications, in-hospital adverse events, procedural efficacy outcomes, and 30-day all-cause mortality. A total of 28,754 CTO PCI cases from 19 studies were included (2 RCTs and 17 OS). The pooled mean J-CTO score is 2.3. The main analysis showed a trend toward a higher success rate for TRA (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.00 to 1.38), but this was not the case in the secondary analysis, which included only RCTs and OS with moderate risk of bias (OR 0.99, 95% CI 0.81 to 1.22). TRA was associated with significant reductions in access-site complications (OR 0.33, 95% CI 0.24 to 0.45) and major bleeding (OR 0.34, 95% CI 0.20 to 0.59), and a similar risk of other in-hospital adverse events and 30-day mortality (p >0.05) to that of TFA. Moreover, there was less fluoroscopy time (minutes) and contrast volume use (ml) in the transradial CTO PCI (mean difference: -6.19 [-10.98 to -1.40] and -22.14[-34.56 to -9.72], respectively). In conclusion, the transradial PCI in appropriate CTO lesions was associated with a lower incidence of access-site complications/major bleeding than was TFA and a similar other periprocedural complications rate, without compromising procedural success., Competing Interests: Declaration of Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (Copyright © 2023 Elsevier Inc. All rights reserved.)

A coal-fired power plant's operation can release radioactive nuclides and radon gas into the environment, affecting the surrounding ecosystem. In this work, the collective effective dose due to the inhalation and the consumption of food containing the deposited radionuclides from the atmospheric release of the plants were evaluated. The results show that the radioactivity concentration in coal and fly ash samples depends on the origin of feed coal. The distribution of Th and U radionuclides in the 6a1 dust coal and bituminous coal is different. In general, the collective effective dose for different organs due to radiation exposure from the atmospheric release of two surveyed CFPP complexes are lower than the corresponding value published by UNSCEAR., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Comprehensive profiling of actionable mutations in non-small cell lung cancer (NSCLC) is vital to guide targeted therapy, thereby improving the survival rate of patients. Despite the high incidence and mortality rate of NSCLC in Vietnam, the actionable mutation profiles of Vietnamese patients have not been thoroughly examined. Here, we employed massively parallel sequencing to identify alterations in major driver genes (EGFR, KRAS, NRAS, BRAF, ALK and ROS1) in 350 Vietnamese NSCLC patients. We showed that the Vietnamese NSCLC patients exhibited mutations most frequently in EGFR (35.4%) and KRAS (22.6%), followed by ALK (6.6%), ROS1 (3.1%), BRAF (2.3%) and NRAS (0.6%). Interestingly, the cohort of Vietnamese patients with advanced adenocarcinoma had higher prevalence of EGFR mutations than the Caucasian MSK-IMPACT cohort. Compared to the East Asian cohort, it had lower EGFR but higher KRAS mutation prevalence. We found that KRAS mutations were more commonly detected in male patients while EGFR mutations was more frequently found in female. Moreover, younger patients (<61 years) had higher genetic rearrangements in ALK or ROS1. In conclusions, our study revealed mutation profiles of 6 driver genes in the largest cohort of NSCLC patients in Vietnam to date, highlighting significant differences in mutation prevalence to other cohorts.

Background and Aim: Vietnam's burden of liver cancer is largely due to its high prevalence of chronic hepatitis B virus (HBV) infection. This study aimed to examine healthcare workers' (HCWs) knowledge, attitude and practices regarding HBV prevention and management., Methods: A cross-sectional survey among health care workers working at primary and tertiary facilities in two Northern provinces in Vietnam in 2017. A standardized questionnaire was administered to randomly selected HCWs. Multivariate regression was used to identify predictors of the HBV knowledge score., Results: Among the 314 participants, 75.5% did not know HBV infection at birth carries the highest risk of developing chronic infection. The median knowledge score was 25 out of 42 (59.5%). About one third (30.2%) wrongly believed that HBV can be transmitted through eating or sharing food with chronic hepatitis B patients. About 38.8% did not feel confident that the hepatitis B vaccine is safe. Only 30.1% provided correct answers to all the questions on injection safety. Up to 48.2% reported they consistently recap needles with two hands after injection, a practice that would put them at greater risk of needle stick injury. About 24.2% reported having been pricked by a needle at work within the past 12 months. More than 40% were concerned about having casual contact or sharing food with a person with chronic hepatitis B infection (CHB). In multivariate analysis, physicians scored significantly higher compared to other healthcare professionals. Having received training regarding hepatitis B within the last two years was also significantly associated with a better HBV knowledge score., Conclusions: Findings from the survey indicated an immediate need to implement an effective hepatitis B education and training program to build capacity among Vietnam's healthcare workers in hepatitis B prevention and control and to dispel hepatitis B stigma., Competing Interests: The authors have declared that no competing interests exist.

Background and Aim: Infection at birth due to mother-to-child (MTC) transmission is the most common cause of chronic hepatitis B virus (HBV) infection in Vietnam. This study was undertaken to examine the knowledge, attitudes, and practices of pregnant women and mothers in Vietnam concerning HBV prevention and immunization., Methods: A cross-sectional survey was conducted in Quang Ninh and Hoa Binh provinces in 2017. A standardized questionnaire was administered to women when they received care at primary and tertiary maternal health clinics. Multivariate regression was used to identify predictors of HBV knowledge and practices., Results: Among the 380 women surveyed, 50.3% were pregnant and 49.7% were postpartum. Despite 70.3% of participants reported having received information about HBV during their pregnancy, only 10.8% provided correct answers to all questions regarding HBV transmission routes and preventive measures. Around half of the participants incorrectly believed that HBV is transmitted through sneezing, contaminated water or sharing foods with chronic HBV patients. Although 86.1% of participants believed that HBV vaccination is necessary for infants, only 66.1% responded they were definitely willing to have their own child vaccinated within 24 hours. More than a third of participants expressed concern about having casual contacts or sharing foods with chronic HBV patients. In multivariate analysis, having received information about HBV during their pregnancy was significantly associated with better HBV knowledge score. Delivery at provincial level clinics was a strong predictor for perinatal HBV screening and hepatitis B birth dose administration., Conclusions: The results highlight the need to prioritize educating pregnant women and mothers in future public health campaigns in order to increase knowledge, reduce misperception, and improve hepatitis B vaccine birth dose coverage in Vietnam., Competing Interests: The authors have declared that no competing interests exist.

Transplantation centers have historically considered a history of multiple myeloma as a contraindication to kidney transplantation due to high recurrence rates and poor transplant survival. However, there have been significant advances in the treatment of multiple myeloma, with improved patient survival, which may allow for successful kidney transplantation in these patients. We report on 4 patients who underwent kidney transplantation at our institution between 2009 and 2015 after having achieved a very good partial response or better with chemotherapy and autologous stem cell transplantation. All 4 patients received kidneys from living donors; 2 underwent induction therapy with basiliximab, and 2, with thymoglobulin. One patient had progression of myeloma, which responded well to therapy. All had functioning transplants at 1 year after kidney transplantation. No patients experienced a rejection episode or infections with BK polyomavirus or cytomegalovirus, with follow-up ranging from 16 to 58 months after kidney transplantation. Our experience suggests that kidney transplantation is feasible in a subset of patients with multiple myeloma. Future studies are necessary to compare outcomes in these patients with other high-risk patients undergoing kidney transplantation., (Copyright © 2017 National Kidney Foundation, Inc. All rights reserved.)

Objectives: This study evaluates the sensitivity and specificity of stenosis index (SI), which accounts for the entire spectral Doppler waveform, to detect significant transplant hepatic arterial stenosis., Materials and Methods: In this institutional review board-approved, HIPAA compliant study, we retrospectively analyzed 69 patients who had catheter angiography for suspected transplant hepatic arterial stenosis (THAS) between January 2006 and December 2010; all patients had Doppler ultrasound within 30 days before angiography. Patients with angiographic stenosis requiring intervention were considered positive for THAS. Stenosis index was calculated from each patient's spectral Doppler ultrasound images by obtaining the ratio of the area under the high-frequency signal to low-frequency signal in the spectral Doppler. Resistive index (RI) and pulsatility index (PI) were also calculated. Receiver operator curve analysis was performed and the area under the curve (AUC) was compared among the three metrics., Results: Forty-eight of 69 patients had THAS by angiography requiring intervention; 21patients had no angiographic evidence of THAS. SI was significantly different (P < .001) between patients with THAS (SI = 1.04 ± 0.20) and those without THAS (SI = 1.39 ± 0.30). Stenosis index had an AUC of 0.86 for detecting THAS, which was significantly higher than that from RI (AUC = 0.68, P = .038 for the comparison) and PI (AUC = 0.70, P = .029). For SI < 1.35, the sensitivity for THAS was 94% and specificity was 52%. For RI < 0.5, the sensitivity was 96% and the specificity was 29%., Conclusions: Stenosis index is more accurate than the resistive index and the pulsatility index for detecting transplant hepatic artery stenosis., (© 2016 by the American Institute of Ultrasound in Medicine.)

Improving long-term transplant and patient survival is still an ongoing challenge in kidney transplant medicine. Our objective was to identify the subsequent risks of new-onset diabetes after transplant (NODAT) and acute rejection (AR) in the first year post-transplant in predicting mortality and transplant failure. A total of 4687 patients without preexisting diabetes (age 2-20 years, 2004-2010) surviving with a functioning transplant for longer than 1 year with at least one follow-up report were identified from the OPTN/UNOS database as of September 2014. Study population was stratified into four mutually exclusive groups: Group 1, patients with a history of AR; Group 2, NODAT+; Group 3, NODAT+ AR+; and Group 4, the reference group (neither). Multivariate regression was used to analyze the relative risks for the outcomes of transplant failure and mortality. The median follow-up time was 1827 days after 1 year post-transplant. AR was associated with an increased risk of adjusted graft and death-censored graft failure (HR 2.87, CI 2.48-3.33, P < .001 and HR 2.11, CI 1.81-2.47, P < .001), respectively. NODAT and AR were identified in 3.5% and 14.5% of all study patients, respectively. AR in the first year post-transplant was a major risk factor for overall and death-censored graft failure, but not mortality. However, NODAT was not a risk factor on graft survival or mortality., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)