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To identify risk factors associated with in-hospital seizures and new-onset epilepsy in patients with aneurysmal subarachnoid hemorrhage (SAH) who underwent coiling embolization or clipping surgery. This retrospective descriptive study included 195 patients diagnosed with aneurysmal SAH and treated with coiling embolization or clipping surgery between January 2018 and June 2022. Among the 195 patients meeting inclusion criteria, 9 experienced an onset seizure at the time of SAH. In-hospital seizures were observed in 33 patients, of which 24 were electrographic seizures detected in 24 patients with suspected subclinical seizures. After 12 months of follow-up, 11 patients met criteria for diagnosis of epilepsy. The incidence of epilepsy after discharge at 12 months was 2.41% in the coiling group and 8.03% in the clipping group. The risk of in-hospital seizures was significantly higher in the clipping group (P = 0.007), although the difference was not statistically significant after 12 months of follow-up (P = 0.121). Epilepsy following aneurysmal SAH was relatively common. Clipping surgery and brain edema emerged as independent predictive factors for in-hospital seizures, while onset seizures and in-hospital seizures were identified as independent predictors of epilepsy during follow-up. Patients presenting with these risk factors may benefit from long-term electroencephalogram monitoring and should be considered for prophylactic antiepileptic drugs. Additionally, lumbar drainage proved effective in improving both early and late epileptic outcomes in the group with Fisher grades 3 and 4. [ABSTRACT FROM AUTHOR]

• The agricultural transformation timeline of the Mekong delta is developed. • Drivers of transformation are found in groups: Price, Producer, Place and Policy. • A transformation framework using value chain and agribusiness concepts is proposed. Drivers of agricultural transformation vary from place to place. They need to be explored, especially under the new context of changing climate, environment and socio-economic development in coastal regions. This paper aims to discover the drivers of change through an analysis of the agricultural transformation process in the Vietnamese Mekong delta and then develop a framework for the next steps to meet sustainable development objectives. A mixed approach of qualitative and quantitative methods was applied to collect primary and secondary data. Major techniques used in data collection consist of Key Informant Interviews (KII), Focus Group Discussions (FGD) and household surveys with 203 farmers in three coastal provinces, including Ben Tre, Kien Giang and Soc Trang. The results showed that the agricultural sector has been transforming towards the diversification of crops and livelihoods. For example, there has been a shift from rice monoculture to integrated farming systems (i.e. rice-shrimp or grass-cattle) and a move from on-farm to more off-farm or non-farm incomes. This transformation was found to be driven by many factors that can be categorised into the '4Ps of change', consisting of the Price, the Producer, the Place and the Policy. The 4Ps of change are not isolated but interrelated. Then, considering the 4Ps of change, a holistic framework for sustainable agricultural transformation (SAT) has been developed. What distinguishes this SAT framework from others is a combination of value chain theory and agribusiness concepts. Hence, it would create resource use efficiency, add more value to products, deliver healthy food and contribute to successful transformation in the future. Successful implementation would need the government's readiness to provide a practical legal framework and efficient support to motivate all actors involved in the transformation process. [ABSTRACT FROM AUTHOR]

Cross-border e-commerce(CBEC) has created enormous economic benefits for consumers and vendors worldwide. Vietnamese Small and Medium-sized Enterprise (SMEs) can enhance their competitiveness and facilitate their integration into the global market via cross-border e-commerce adoption. This study assesses the critical determinants of cross-border e-commerce adoption intention in Vietnamese SMEs. This study integrates the factors of the technology–organisation–environment (TOE) framework and the theory of planned behaviour (TPB) to construct a holistic framework to assess the critical determinants of cross-border e-commerce adoption intentions among SMEs in Vietnam. The research method utilised Structural Equation Modelling Partial Least Squares (SEM-PLS) with SmartPLS (version 4.0) to evaluate the relationship between variables. The sample size consists of 400 respondents from Vietnamese SMEs. The results indicate that perceived behavioural control, subjective norms, and attitudes toward CBEC adoption are the critical determinants of cross-border e-commerce adoption intention among Vietnamese SMEs. For the technological dimensions of the TOE framework, perceived benefits, perceived compatibility and perceived security positively relate to attitude toward CBEC adoption; perceived complexity and perceived cost negatively relate to attitude toward CBEC adoption and perceived behavioural control. For the organisational dimensions of the TOE framework, government support, customer pressure, and competitive pressure positively relate to subjective norms. For the environmental dimensions of the TOE framework, organisational readiness, organisational innovativeness, and e-commerce knowledge positively relate to perceived behavioural control. By integrating the constructs of TPB and TOE into a single framework, this study adds to current knowledge by addressing the literature gap on the significant role of organisational and environmental factors in the adoption of SMEs' CBEC in developing countries like Vietnam. The managerial implications provided a holistic view of SMEs' perspectives and practices on promoting the CBEC adoption intention. • Cross-border e-commerce (CBEC) has created enormous economic benefits worldwide. • Assessment of the critical determinants of CBEC adoption intention in Vietnamese SMEs. • Partial Least Squares Structural Equation Modeling with a sample size of 400 respondents. • The components of TOE framework and TPB are supported to impact CBEC adoption. • A holistic view of SMEs' perspectives and practices on promoting the CBEC adoption intention. [ABSTRACT FROM AUTHOR]

Deep brain stimulation (DBS) surgery for Parkinson's Disease (PD) has become more and more popular in Vietnam. However, the accuracy of implantation and affecting factors are under investigation. The objective of this study is to evaluate the accuracy of the subthalamic nucleus (STN)-DBS electrode implantation technique for treatment PD at Nguyen Tri Phuong Hospital and University Medical Center. To investigate factors related to accuracy. We carried out a retrospective analysis of 58 patients with advanced PD who underwent STN-DBS surgery at Nguyen Tri Phuong Hospital and University Medical Center in Ho Chi Minh City, Viet Nam between June 2014 and July 2021 (115 leads total). All patients underwent the procedure with standard frame-based techniques under local anesthesia with microelectrode recording and macrostimuation test. Twenty-six female (44.8%) and thirty-two male (55.2%) patients with a mean age of 60.4 ± 8.3 years old (40-76 years) were included. Of total of 115 electrodes implanted, the mean target error (ΔT), radial error (ΔR), angle error (Δθ) were 1.94 ± 0.73 mm; 1.16 ± 0.69 mm; 2.22 ± 4.24 degrees, respectively. Vector error on each coordinate axis ΔX, ΔY, ΔZ were −0.35 ± 1.02 mm, +0.99 ± 0.82 mm, +0.73 ± 0.99 mm, respectively. There was a statistically significant correlation between subdural air volume, cortical shift, intracranial electrode bending, and accuracy. The current STN-DBS electrode implantation technique applied in our centers was quite accurate with acceptable error. More clinical trials are necessary to directly compare affecting factors to the accuracy of electrode implantation. [ABSTRACT FROM AUTHOR]

We sought to evaluate the effectiveness of thermal radiofrequency ablation combined with corticosteroid injection for medial branch block in the management of chronic low back pain, which originates from lumbar facet joint (LFJ) pain. A prospective observational study of 82 patients with chronic LFJ pain undergoing thermal radiofrequency ablation combined with corticosteroid injection was conducted. Primary outcomes included pain relief and functional recovery, measured by the visual analog scale (VAS) and Oswestry Disability Index, respectively. Secondary outcome was the time of recurrent low back pain at the same spinal segment after treatment. Adverse events were also recorded. Mean age is 55.7 ± 15.2 years old, and duration of LFJ pain was 18.2 ± 9.5 months. Median VAS at baseline was 7.0 (7.0−9.0) for all ages. After intervention, VAS and Oswestry Disability Index improved significantly (P < 0.001). Pain relief lasted for 1 month, 3 months, 6 months, 12 months, and 12−24 months' follow-up. During this period, only 5 patients required another radiofrequency neurotomy procedure (6.1%). No complications occurred in the study group. Thermal radiofrequency ablation combined with corticosteroid injection should be a potential method of choice for its effectiveness, long-lasting effect, and safety in the management of LFJ pain. [Display omitted] [ABSTRACT FROM AUTHOR]

The most frequent site of ocular metastasis is the choroid. The occurrence of choroidal metastases has increased steadily due to the longer survival of metastatic patients and the improvement of diagnostic tools. Fundoscopy, ultrasonography, and fluorescein angiography are now complemented by indocyanine green angiography and optical coherence tomography. Choroidal tumor biopsy may also confirm the metastatic nature of the tumor and help to determine the site of the primary malignancy. There is currently no consensus on the treatment strategy. Most patients have a limited life expectancy and for these complex treatments are generally not recommended. However, recent advances in systemic therapy have significantly improved survival of certain patients who may benefit from an aggressive ocular approach that could preserve vision. Although external beam radiation therapy is the most widely used treatment, more advanced forms of radiotherapy that are associated with fewer side effects can be proposed in select cases. In patients with a shorter life expectancy, systemic therapies such as those targeting oncogenic drivers, or immunotherapy can induce a regression of the choroidal metastases, and may be sufficient to temporarily decrease visual symptoms. However, they often acquire resistance to systemic treatment and ocular relapse usually requires radiotherapy for durable control. Less invasive office-based treatments, such as photodynamic therapy and intravitreal injection of anti-VEGF, may also help to preserve vision while reducing time spent in medical settings for patients in palliative care. The aim of this review is to summarize the current knowledge on choroidal metastases, with emphasis on the most recent findings in epidemiology, pathogenesis, diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Purpose: In parapapillary melanoma patients, radiation-induced optic complications are frequent and visual acuity is often compromised. We investigated dose-effect relationships for the optic nerve with respect to visual acuity after proton therapy.Methods and Materials: Of 5205 patients treated between 1991 and 2014, those treated using computed tomography (CT)-based planning to 52 Gy (prescribed dose, not accounting for relative biologic effectiveness correction of 1.1) in 4 fractions, with minimal 6-month follow-up and documented initial and last visual acuity, were included. Deterioration of ≥0.3 logMAR between initial and last visual acuity results was reported.Results: A total of 865 consecutive patients were included. Median follow-up was 69 months, mean age was 61.7 years, tumor abutted the papilla in 35.1% of patients, and tumor-to-fovea distance was ≤3 mm in 74.2% of patients. Five-year relapse-free survival rate was 92.7%. Visual acuity was ≥20/200 in 72.6% of patients initially and 47.2% at last follow-up. A wedge filter was used in 47.8% of the patients, with a positive impact on vision and no impact on relapse. Glaucoma, radiation-induced optic neuropathy, maculopathy were reported in 17.9%, 47.5%, and 33.6% of patients, respectively. On multivariate analysis, age, diabetes, thickness, initial visual acuity and percentage of macula receiving 26 Gy were predictive of visual acuity. Furthermore, patients irradiated to ≥80% of their papilla had better visual acuity when limiting the 50% (30-Gy) and 20% (12-Gy) isodoses to ≤2 mm and 6 mm of optic nerve length, respectively.Conclusions: A personalized proton therapy plan with optic nerve and macular sparing can be used efficiently with good oncological and functional results in parapapillary melanoma patients. [ABSTRACT FROM AUTHOR]

Objective: To examine the population distribution of different types of relationships between people with chronic conditions and their doctors that influence decisions being made from a shared-decision making perspective. Methods: A survey questionnaire based on recurring themes about the doctor/patient relationship identified from qualitative in-depth interviews with people with chronic conditions and doctors was administered to a national population sample (n =999) of people with chronic conditions. Results: Three factors explained the doctor/patient relationship. Factor 1 identified a positive partnership characteristic of involvement and shared decision-making; Factor 2 doctor-controlled relationship; Factor 3 relationship with negative dimensions. Cluster analysis identified four population groups. Cluster 1 doctor is in control (9.7% of the population); Cluster 2 ambivalent (27.6%); Cluster 3 positive long-term relationship (58.6%); Cluster 4 unhappy relationship (4.4%). The proportion of 18–34 year olds is significantly higher than expected in Cluster 4. The proportion of 65+ year olds is significantly higher than expected in Cluster 1, and significantly lower than expected in Cluster 4. Conclusion: This study adds to shared decision-making literature in that it shows in a representative sample of people with chronic illnesses how their perceptions of their experiences of the doctor–patient relationship are distributed across the population. Practice implications: Consideration needs to be given as to whether it is better to help doctors to alter their styles of interactions to suit the preferences of different patients or if it is feasible to match patients with doctors by style of decision-making and patient preference. [Copyright &y& Elsevier]