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5-FU is one of the key drugs in the treatment of gastric cancer (GC). Much evidence has shown that cancer stem cells (CSCs) play a key role in the acquisition of drug resistance. The organoid is a novel 3D cell culture system technology that sustains stem-cell-driven formation of near-physiological, self-renewing tissues using specific niche factors in a dish. In this study, we established GC organoids (GCOs) and gradually treated them with higher concentrations of 5-FU. We successfully harvested four 5-FU-resistant GCOs, which were supported by significant changes in the expression of molecules related to 5-FU metabolism. We then performed microarray analysis using three normal gastric organoids and three pairs of 5-FU-resistant and parental GCOs. Through the comparison of expression profiles and further validation, we chose KHDRBS3 as a target gene. We found KHDRBS3 to be an independent prognostic factor in GC patients, especially in GC patients treated with 5-FU chemotherapy. We also determined that KHDRBS3 might play an important role in the acquisition of stem cell-like features, such as multi-drug resistance and organoid formation, by regulating CD44 variant expression. We found KHDRBS3, which is thought to play an important role in the acquisition of characteristics of CSCs in GC, to be a promising candidate marker for predicting therapeutic effect and prognosis in GC patients.

Purpose The high prevalence of chronic pain and difficulties in pain management in older people are challenging for healthcare providers globally. Patient satisfaction regarding pain management is one of the measures to assess efficacy of pain control as well as healthcare services. Thus, our study aimed to evaluate the older patients' satisfaction with pain management and its associated factors in Vietnam. Patients and methods A cross-sectional study was conducted at National Geriatric Hospital, Hanoi, Vietnam from May to October 2018. Face-to-face interviews were conducted on 495 older patients with chronic pain by using a structured questionnaire. The Pain Treatment Satisfaction Scale (PTSS) was used to assess the level of satisfaction with pain management. A Tobit regression model was used to estimate factors associated with satisfaction toward pain management. Results The mean total satisfaction score was 1.77 (SD= 0.22). Older patients were most satisfied with the aspect of side effects of pain relief medication (mean=0.66, SD=0.56). On the contrary, they were most dissatisfied with information provided about pain and its treatment and efficacy of pain relief medication. Outpatients were less satisfied with information provided, the impact of current medication and pain management in general compared to inpatients. The regression model showed that patients with severe pain tended to be more dissatisfied with pain management than those with no pain. Conclusion This study indicated that the general satisfaction with chronic pain management in older patients was quite good especially in the aspect of pain medication's side effects. However, dissatisfactory factors remained, including information provided about pain and efficacy of current pain medication. Intensive training regarding pain in geriatric care, health education communication for older people, and improved quality of medical services should be performed to ensure the quality of pain management, especially in the older population.

Anh Trung Nguyen,1,2 Hai Quang Pham,3,4 Thanh Xuan Nguyen,1,2,5 Thu Thi Hoai Nguyen,1,2 Huong Thi Thu Nguyen,1,2 Tam Ngoc Nguyen,1,2 Dung Thi Kim Dinh,1 Hai Thanh Phan,3,4 Son Hoang Nguyen,6 Bach Xuan Tran,7,8 Carl A Latkin,8 Roger CM Ho,9,10 Cyrus SH Ho,9 Thang Pham,1,2 Huyen Thi Thanh Vu1,2 1Hanoi Medical University, Hanoi, Vietnam; 2National Geriatric Hospital, Hanoi, Vietnam; 3Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 4Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam; 5Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam; 6Center of Excellence in Health Services and System Research, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam; 7Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; 8Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 9Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; 10Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, SingaporeCorrespondence: Huyen Thi Thanh VuDepartment of Geriatrics, Hanoi Medical University, 01 Ton That Tung, Hanoi, VietnamTel +84 913531579Email vuthanhhuyen11@hmu.edu.vnBackground: Diabetes-related complications have become increasingly prevalent and complicated to manage, especially among frail older adults with co-morbidities, poor physical function, and impaired cognition. Thus, knowledge, attitude, and practice (KAP) of elderly diabetic patients play an essential role in controlling the disease and its complications.Patients and Methods: A cross-sectional study was conducted on 176 diabetic patients at the outpatient clinics, National Geriatric Hospital, Hanoi, Vietnam from August to November 2015. Patients’ knowledge, attitude, and practice regarding diabetes mellitus were assessed using a structured questionnaire. Exploratory factor analysis and multivariate Tobit regression model were used to identify factors associated with knowledge, attitude, practice about diabetes mellitus.Results: Of 176 diabetic patients, patients’ knowledge was divided into two main groups: “Diabetes definition and management” (mean score = 57.7 ± 25.6) and “Targets for diabetic control” (mean score = 66.1 ± 30.4). Patients scored high points of attitudes toward diabetes severity and its complications (mean score = 95.8 ± 13.0); however, knowledge and practice scores were only moderate (mean score = 68.1 ± 16.8). There were only 8.5% of people having daily self-blood glucose monitoring. Advanced age, low educational level, rural area, and duration of diabetes less than 5 years were negative associated with knowledge, attitude, and practice regarding diabetes mellitus. This study also shows that frailty and co-morbidities/diabetic complications could impair patients’ knowledge.Conclusion: Older patients with diabetes had high levels of perceived severity attitudes on diabetes mellitus. However, the knowledge and practice levels were still inadequate. Pragmatic diabetic health literacy, counseling and education programs, as well as home-based treatments are viable options to improve health outcomes.Keywords: attitude, diabetes, elderly, knowledge, practice

Professor Jonathan Wu’s career was devoted to rigorous development of internal stability in reinforced soil as a new and evolving technology. This paper presents two of Professor Wu’s students’ work on the search for internal stability by tracing his work. Engineering design of reinforced soil originated in France with Schlosser and Vidal in the late 1960s. The first designs were based on a simple limit state method. Analyzing test data, Schlosser later found that the limit method was insufficient and that internal stability involves stiffness. Wu found that stiffness was affected by reinforcement spacing. Settlement or collapse is shown in examples that violate this spacing criterion. Initial analysis and validation involved geosynthetic sheets, but these were extended to other materials and to strip reinforcement. The analysis has been validated both by laboratory data and by field observations. These findings corroborate those of international companies in the reinforced soil community, but they are often incompatible with code in North America. The studies and discussions presented in this paper are further enhanced with the most current testing and work to confirm Professor’s Wu insights and visions.

Background The SARC-F questionnaire has been developed as a rapid diagnostic test that can be used to screen for sarcopenia. Aim To investigate the reliability and validity of the Vietnamese version of SARC-F as a screening tool for sarcopenia in older patients in Vietnam. Methods A cross-sectional study was conducted in older people attending the outpatient clinics of the National Geriatric Hospital in Vietnam. Muscle mass (using dual-energy X-ray absorptiometry), handgrip strength and gait speed were assessed. SARC-F was validated against the three standard criteria for sarcopenia: the Foundation for the National Institutes of Health (FNIH), Asia Working Group for Sarcopenia (AWGS 2019) and European Working Group on Sarcopenia in Older People (EWGSOP2). Results There were 764 participants (mean age 71.5 ± 8.9 years). The Vietnamese SARC-F questionnaire had a good internal consistency (Cronbach's alpha 0.85). The prevalence of sarcopenia was 49.2% according to SARC-F and 48.3%, 61.1% and 52.6% according to FNIH, AWGS 2019 and EWGSOP2, respectively. The sensitivity and specificity of SARC-F in identifying sarcopenia were 67.1% and 66.7% (for FINH), 66.7% and 67.1% (for AWGS 2019), and 64.9% and 68.2% (for EWGSOP2). The AUCs of SARC-F were 0.71-0.72 against the three sarcopenia criteria. Conclusion The Vietnamese version of SARC-F questionnaire has acceptable diagnostic value for sarcopenia. SARC-F could be used as an initial screening for sarcopenia in hospital clinics.

The transcribed ultraconserved regions (T-UCRs) are a novel class of long non-coding RNAs and are involved in the development of several types of cancer. Although several different papers have described the oncogenic role of Uc.63+, there are no reports mentioning its importance in gastric cancer (GC) biology. In this study, we evaluated Uc.63+ expression using clinical samples of GC by qRT-PCR, and also assessed the correlation between Uc.63+ expression and clinico-pathological factors. The upregulation of Uc.63+ was significantly correlated with advanced clinico-pathological features. Knockdown of Uc.63+ significantly repressed GC cell growth and migration, whereas overexpression of Uc.63+ conversely promoted those of GC cells. In situ hybridization of Uc.63+ revealed its preferential expression in poorly differentiated adenocarcinoma. We further conducted a microarray analysis using MKN-1 cells overexpressing Uc.63- and found that NF-κB signaling was significantly upregulated in accordance with Uc.63+ expression. Our results suggest that Uc.63+ could be involved in GC progression by regulating GC cell growth and migration via NF-κB signaling

Background Bladder cancer (BC) is the 10th most common cancer in the world. BC with muscle invasion results in a poor prognosis and is usually fatal. Cancer cell metabolism has an essential role in the development and progression of tumors. Expression of tryptophan 2,3‐dioxygenase (TDO2) is associated with tumor progression and worse survival in some other cancers. However, no studies have been performed to uncover the biofunctional roles of TDO2 in BC. Aim This study aim to investigate the clinicopathologic significance of TDO2 in BC. Methods and results TDO2 expression was evaluated by qRT‐PCR and immunohistochemistry in an integrated analysis with the Cancer Genome Atlas (TCGA) and other published datasets. TDO2 overexpression was significantly associated with T classification, N classification, and M classification, tumor stage, recurrence, and basal type, and with the expression of CD44 and aldehyde dehydrogenase 1 (ALDH1) in BC. High TDO2 expression correlated with poor outcome of BC patients. Using BC cell lines with knockdown and forced expression of TDO2, we found that TDO2 was involved in the growth, migration, and invasiveness of BC cells. Moreover, TDO2 was found to be crucial for spheroid formation in BC cells. Importantly, TDO2 promoted BC cells resistance to cetuximab through integration of the EGFR pathway. Conclusion Our results indicate that TDO2 might take an essential part in BC progression and could be a potential marker for targeted therapy in BC.

The utility of Schlafen 11 (SLFN11) expression as a predictive biomarker for platinum-based chemotherapy has been established for cancers from different histologies. However, the therapeutic relevance of SLFN11 in bladder cancer (BC) is unknown. Here, we examined the clinicopathologic significance of SLFN11 expression across 120 BC cases by immunohistochemistry. We divided the cases into two cohorts, one including 50 patients who received adjuvant or neoadjuvant platinum-based chemotherapy, and the other including 70 BC patients treated by surgical resection without chemotherapy. In the cohort of 50 BC cases treated with platinum-based chemotherapy, the SLFN11-positive group (n = 25) showed significantly better overall survival than the SLFN11-negative group (n = 25, P = .012). Schlafen 11 expression correlated significantly with the expression of luminal subtype marker GATA3. Multivariate analyses identified SLFN11 expression as an independent prognostic predictor (odds ratio, 0.32; 95% confidence interval, 0.11-0.91; P = .033). Conversely, in the cohort of 70 BC cases not receiving platinum-based chemotherapy, the SLFN11-positive group (n = 29) showed significantly worse overall survival than the SLFN11-negative group (n = 41, P = .034). In vitro analyses using multiple BC cell lines confirmed that SLFN11 KO rendered cells resistant to cisplatin. The epigenetic modifying drugs 5-azacytidine and entinostat restored SLFN11 expression and resensitized cells to cisplatin and carboplatin in SLFN11-negative BC cell lines. We conclude that SLFN11 is a predictive biomarker for BC patients who undergo platinum-based chemotherapy and that the combination of epigenetic modifiers could rescue refractory BC patients to platinum derivatives by reactivating SLFN11 expression.

Kinesin family member C1 (KIFC1), a minus end-directed motor protein, is reported to play an essential role in cancer. This study aimed to analyze KIFC1 expression and examine KIFC1 involvement in cisplatin resistance in bladder cancer (BC). Immunohistochemistry showed that 37 of 78 (47.4%) BC cases were positive for KIFC1. KIFC1-positive cases were associated with high T stage and lymph node metastasis. Kaplan-Meier analysis showed that KIFC1-positive cases were associated with poor prognosis, consistent with the results from public databases. Molecular classification in several public databases indicated that KIFC1 expression was increased in basal type BC. Immunohistochemistry showed that KIFC1-positive cases were associated with basal markers 34βE12, CK5 and CD44. KIFC1 expression was increased in altered TP53 compared to that in wild-type TP53. Immunohistochemistry showed that KIFC1-positive cases were associated with p53-positive cases. P53 knockout by CRISPR-Cas9 induced KIFC1 expression in BC cell lines. Knockdown of KIFC1 by siRNA increased the sensitivity to cisplatin in BC cells. Kaplan-Meier analysis indicated that prognosis was poor among KIFC1-positive BC patients treated with cisplatin-based chemotherapy. Immunohistochemistry showed that KIFC1-positive cases were associated with PD-L1-positive cases. High KIFC1 expression was associated with a favorable prognosis in patients treated with atezolizumab from the IMvigor 210 study. These results suggest that KIFC1 might be a promising biomarker and therapeutic target in BC.

The interaction of chronic pain and depression among older people has been studied for many years. This study aimed to investigate the frequency of chronic pain and depression among older patients and correlated factors. A cross-sectional study was conducted in 921 older patients at the National Geriatric Hospital from November 2019 to March 2020. We used the Charlson Comorbidity Index (CCI) to assess the comorbid condition, a numerical rating scale (NRS) to examine pain severity, and Geriatric Depression Scale—15 items (GDS-15) to measure depression among participants. A chi-square test and Tobit regression were used to analyze the relationships. A total of 921 older patients participated in the study. The proportion of depression accounted for 55.8%. The mean Charlson score and number of diseases were 1.2 and 4.7, respectively. A positive correlation was found between comorbidity and chronic pain and depression. Moreover, socio-demographic variables such as occupation, education, and income were associated with pain and depressive symptoms. This study highlights the issue of mental health in older people with chronic pain. The results indicate the necessity of frequent depression screening, pain management, and social activity programs for older people to enhance their health.

Background Tryptophan 2,3-dioxygenase (TDO2) is the primary enzyme catabolizing tryptophan. Several lines of evidence revealed that overexpression of TDO2 is involved in anoikis resistance, spheroid formation, proliferation, and invasion and correlates with poor prognosis in some cancers. The aim of this research was to uncover the expression and biofunction of TDO2 in renal cell carcinoma (RCC). Methods To show the expression of TDO2 in RCC, we performed qRT-PCR and immunohistochemistry in integration with TCGA data analysis. The interaction of TDO2 with PD-L1, CD44, PTEN, and TDO2 expression was evaluated. We explored proliferation, colony formation, and invasion in RCC cells line affected by knockdown of TDO2. Results RNA-Seq and immunohistochemical analysis showed that TDO2 expression was upregulated in RCC tissues and was associated with advanced disease and poor survival of RCC patients. Furthermore, TDO2 was co-expressed with PD-L1 and CD44. In silico analysis and in vitro knockout of PTEN in RCC cell lines revealed the ability of PTEN to regulate the expression of TDO2. Knockdown of TDO2 suppressed the proliferation and invasion of RCC cells. Conclusion Our results suggest that TDO2 might have an important role in disease progression and could be a promising marker for targeted therapy in RCC. (199 words)

Although docetaxel (DTX) confers significant survival benefits in patients with castration‐resistant prostate cancer (CRPC), resistance to DTX inevitably occurs. Therefore, clarifying the mechanisms of DTX resistance may improve survival in patients with CRPC. Claspin plays a pivotal role in DNA replication stress and damage responses and is an essential regulator for the S‐phase checkpoint. CLSPN is an oncogenic gene that contributes to tumor proliferation in several human solid tumors. However, the clinical significance of claspin in prostate cancer (PCa) has not been examined. The present study aimed to elucidate the role of claspin and its relationship with DTX resistance in PCa. We immunohistochemically analyzed the expression of claspin in 89 PCa cases, of which 31 (35%) were positive for claspin. Claspin‐positive cases were associated with higher Gleason score, venous invasion, and perineural invasion. Kaplan–Meier analysis showed that high claspin expression was related to poor prostate‐specific antigen (PSA) relapse‐free prognosis. In a public database, high CLSPN expression was associated with poor PSA relapse‐free prognosis, Gleason score, T stage, lymph node metastasis, CRPC, and metastatic PCa. Claspin knockdown by siRNA decreased cell proliferation, upregulated DTX sensitivity, and suppressed the expression of Akt, Erk1/2, and CHK1 phosphorylation in DU145 and PC3 cell lines. Furthermore, claspin expression was much more upregulated in DTX‐resistant DU145 (DU145‐DR) than in parental DU145 cells. Claspin knockdown significantly upregulated the sensitivity to DTX in DU145‐DR cells. These results suggest that claspin plays an important role in PCa tumor progression and DTX resistance., Claspin overexpression was related to poor PSA relapse‐free prognosis. Claspin knockdown significantly upregulated the sensitivity to docetaxel in DU145 docetaxel‐resistant cells.

Background Gastrointestinal stromal tumors (GISTs) are the most frequent mesenchymal neoplasms of the gastrointestinal tract. Management of GIST patients is currently based on clinicopathological features and associated genetic changes. However, the detailed characteristics and molecular genetic features of GISTs have not yet been described in the Vietnamese population. Methods We first identified 155 patients with primary GIST who underwent surgery with primary curative intent between 2011 and 2014 at University Medical Center at Ho Chi Minh City, Vietnam. We evaluated the clinicopathological features and immunohistochemical reactivity to p53 and Ki-67 in these patients. Additionally, KIT genotyping was performed in 100 cases. Results The largest proportion of GISTs was classified as high-risk (43.2%). Of the 155 GISTs, 52 (33.5%) were positive for Ki-67, and 58 (37.4%) were positive for p53. The expression of Ki-67 and p53 were correlated with mitotic rate, tumor size, risk assessment, and tumor stage. Out of 100 GIST cases, KIT mutation was found in 68%, of which 62 (91.2%) were found in exon 11, two (2.9%) in exon 9, and four (5.8%) in exon 17. No mutation in exon 13 was identified. Additionally, KIT mutations did not correlate with any clinicopathological features. Conclusions The expression of Ki-67 and p53 were associated with high-risk tumors. Mutations in exon 11 were the most commonly found, followed by exon 17 and exon 9. Additionally, KIT mutation status was not correlated with any recognized clinicopathological features.

Background and Objectives: Exam anxiety is a commonly seen problem among medical students. Auricular acupuncture has been shown to have an anxiety-reducing effect, however, data on exam anxiety is limited. Research in dental and preoperative anxiety has indicated that anxiety level could be reduced by using ear acupoints on the non-dominant side. Therefore, this study aims to determine whether needling at acupoints on the non-dominant side can reduce exam anxiety in medical students. Method: This is a prospective observational study on 32 students at The Faculty of Traditional Medicine, Ho Chi Minh City University of Medicine and Pharmacy. Eligible students received auricular acupuncture on the non-dominant side at the Master cerebral, Tranquilizer and Relaxation points. Levels of anxiety were measured using a visual analogue scale before and after the intervention as well as before the exam. The State-Trait Anxiety Inventory, heart rate, exam performance and adverse events occurring during the study were also collected. Results: Exam anxiety level and heart rate decreased 30 minutes after auricular acupuncture (p0.05). No adverse events from auricular acupuncture were observed. Conclusion: Auricular acupuncture at the Master cerebral, Tranquillizer and Relaxation points on the non-dominant side is effective in reducing exam anxiety in medical students.

Purpose: Nutritional status is an important element for the wellness among older diabetic outpatients. This study aimed to assess the nutritional status of the older diabetic outpatient by using the Mini-Nutrition Assessment Short Form (MNA-SF) tool, and describe the relationship among related factors in older diabetic outpatients in the National Geriatric Hospital, Hanoi, Vietnam. Patients and methods: A cross-sectional study was conducted from June to September 2015 in the National Geriatric Hospital. A total of 158 diabetic patients aged ≥60 years at the Outpatient Department were included in this study. Patients were interviewed face-to-face to evaluate their nutritional status by using the MNA-SF. Socio-demographic, diabetic treatment information, frailty, exhaustion, cognitive function, hand grip strength and 4 m walk test were collected. Multivariate regression was used to determine factors associated with nutritional status. Results: The mean age was 69.52 (SD=6.758) with 31% patients malnourished and at risk of malnutrition. A significant association was found between the nutritional status and exhaustion, cognitive impairment, and frailty. In multiple logistic regression, the study found that risk of malnutrition was associated with frailty (OR=8.45; 95%CI=1.91-37.39) and cognitive impairment (OR=2.21; 95%CI=1.01-4.84). Conclusion: The results suggest that frailty was significantly associated with risk of malnutrition in older diabetic outpatients. Thus, early screening by nutritional assessment, and other interventions might improve the nutritional status of older outpatients with diabetes to prevent this complication and its effects.

Background There is still limited data on severe recurrent pneumonia in children, especially in developing countries as Vietnam. This study was conducted to identify the underlying causes and clinical profile of children with severe recurrent pneumonia admitted to the Pediatric Intensive Care Unit (PICU), National Children's Hospital. Methods This was a prospective and descriptive study on 110 children with severe pneumonia admitted to the PICU from November 2019 to August 2020. Data were collected to investigate the clinical profile and underlying diseases. Results Severe recurrent pneumonia accounted for 29.4%. Underlying causes were diagnosed in 91.8% of sRP children, in which the most common causes were abnormalities in respiratory, cardiovascular system and immune disorders. 74.5% of sRP children admitted to ICU had been previously intubated or ventilated, 34.5% had shock, 7.3% had multiple organ failure. Recurrent lesions on chest x-ray in the same lobe accounted for 18.2%. Conclusions The majority of patients with severe recurrent pneumonia had an underlying disease. Comprehensive management is necessary for severe recurrent pneumonia., Highlights • Highlight: • Severe recurrent pneumonia accounted for 29.4% of pneumonia cases and 14.4% of all cases admitted to PICU. • Underlying causes were diagnosed in 91.8% of severe recurrent pneumonia children. • In Vietnam, most common causes of sRP were abnormalities in respiratory, cardiovascular system and immune disorders.

Anh Trung Nguyen,1,2 Anh Kim Dang,3 Huong Thi Thu Nguyen,1,2,4 Thanh Xuan Nguyen,1,2 Tam Ngoc Nguyen,1,2 Thu Thi Hoai Nguyen,1,2 Thang Pham,1,2 Anh Lan Nguyen,1,2 Thuy Thi Ngoc Nguyen,1 Hien Nguyen Thi,5,6 Trang Ha Nguyen,5,6 Son Hoang Nguyen,7 Bach Xuan Tran,3,8 Carl Latkin,8 Roger CM Ho,9,10 Cyrus SH Ho,11 Huyen Thi Thanh Vu1,2 1Department of Geriatrics, Hanoi Medical University, Hanoi, 100000, Vietnam; 2Scientific Research Department, National Geriatric Hospital, Hanoi, 100000, Vietnam; 3Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam; 4Dinh Tien Hoang Institute of Medicine, Hanoi, 100000, Vietnam; 5Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam; 6Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam; 7Center of Excellence in Health Services and System Research, Nguyen Tat Thanh University, Ho Chi Minh, 700000, Vietnam; 8Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA; 9Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore; 10Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119228, Singapore; 11Department of Psychological Medicine, National University Hospital, Singapore, 119228, SingaporeCorrespondence: Anh Trung NguyenGeriatrics Department, Hanoi Medical University, No 1 Ton That Tung, Dong Da, Hanoi, 100000, VietnamTel +84 903480774Email trunganhvlk@gmail.comBackground: Nurses play a pivotal role in pain management. Knowing more about nurses’ knowledge and attitudes regarding pain is important as we develop multidisciplinary pain services. Therefore, this study aimed to assess knowledge and attitudes regarding pain management among nurses in a geriatric hospital and its associated factors.Subjects and Methods: A survey was conducted of nurses worked at the National Geriatric Hospital over a 3-month period. The Knowledge and Attitudes Survey Regarding Pain (KASRP) was utilized to assess nurses’ knowledge and attitudes toward pain management. Four domains were defined based on KASRP, included cancer-related pain, pain assessment, pharmacology and substance abuse and physical dependence. Knowledge and attitudes regarding pain were classified as poor, fair, or good (≤ 50%, 50% - 75%, or ≥ 75% of the KASRP score). Multivariate Tobit regression models were applied to identify factors associated with the knowledge and attitudes regarding pain management.Results: Of 154 participants completed the survey, 72.2% (111 participants) had poor knowledge and attitudes regarding pain management. The participants had a correct mean score of 45.2% (SD = 2.2). Nurses’ knowledge of pain assessment was poor, with the proportion of correct answers to nine questions ranging from 2.6% to 50%. 44.8% of nurses reported never or rarely using pain assessment tools. Nurses who had previous training regarding pain at medical universities had significantly higher scores of knowledge and attitudes compared to those without training. Nurses who often use pain assessment tools had a significantly higher level of knowledge and attitudes than those who never or rarely use them.Conclusion: This study highlights significant deficits of knowledge and negative attitudes regarding pain management among nurses. The subject of pain management should be applied and enhanced in the nursing undergraduate curriculum. Nurses’ active participation in pain management should be encouraged by healthcare providers for older patients.Keywords: knowledge, attitude, nurse, pain management, older people

Falls in older people are a major public health issue, as they are associated with increased risks of morbidity and mortality. This study aims to investigate the prevalence and factors associated with falls among older outpatients. A cross-sectional study was conducted in 539 outpatients aged 60 and over at the National Geriatric Hospital, Hanoi, Vietnam. Falls and their associated factors were analyzed by multivariable logistic regression. The prevalence of falls was 23.7% (single fall 17.9%, recurrent falls 5.8%). The majority of falls occurred at home (69.6%) and were caused by a slippery floor (51.6%). After falling, most patients sustained physical injuries (65.6%), notably, women suffered more severe injuries than men. Alcohol consumption, using psychotropic medications, having three or more comorbidities, hypertension, COPD, urinary incontinence, frailty, fear of falling, ADL/IADL limitation, slow walking speed and mobility impairment were significantly associated with falls. Overall, the data indicated that falls were prevalent among older outpatients. Behavior factors, comorbidities, geriatric syndromes and physical function were substantially associated with falls, suggesting that most falls are preventable. Further longitudinal studies of longer periods are needed to comprehensively investigate the risk factors for falls.

Objective. To describe handgrip strength (HGS) and identify associated factors in community-dwelling older adults in rural Vietnam. Methods. A cross-sectional study was conducted in community-dwelling older adults 80 years and over in five rural communities in Hanoi, Vietnam. Age-gender-BMI stratified HGS values were reported as means and standard deviations. Demographic characteristics, malnutrition, risk of fall, basic activities of daily living (ADL), and instrumental activities of daily living (IADL) were investigated. Multivariate linear regression explored the association between HGS and these factors. Results. In 308 participants, mean age was 85.4 ± 4.2 years. Mean HGS was 21.6 ± 6.1 kg for males and 15.3 ± 4.3 kg for females. HGS in our sample was generally lower than that in other European countries and Asian threshold. Low HGS was correlated with older age ( β = − 0.196 , p < 0.001 ), female ( β = − 0.443 , p < 0.001 ), low education ( β = − 0.130 , p < 0.05 ), risk of falls ( β = − 0.114 , p < 0.05 ), and lower IADL ( β = 0.153 , p = 0.001 ). Conclusions. The age-gender-BMI stratified HGS values of 80 years and over community-dwellers in rural Vietnam were described. HGS decreased with advanced age, female, low education, high risk of falls, and impaired IADLs. The results could provide useful reference data for further investigations and measures in clinical practice.

Objectives. This study investigated associations between frailty and functional disability in elder suburban Vietnamese. Method. Cross-sectional analysis was carried out on 251 participants aged 80 and over in Soc Son district. We used the Instrumental Activities of Daily Living (IADL) scale including 8 items, and functional disability was defined as ≥3 IADL impairment. We defined frail as ≥3 out of 5 frailty components including weight loss > 5 % , weak grip, exhaustion, low walking speed, and low physical activity. Results. Of 251 participants with a mean age of 84.6, 11.2% was classified as frail and 64.5% had ≥3 IADLs. Among the frailty components, low walking speed and low physical activity were significantly associated with increased odds of having ≥3 IADLs: ORs (95% CI) were 4.2 (2.3-7.9) and 3.7 (1.7-8.2). Conclusion. Frailty is associated with the higher likelihood of having functional disability. Further longitudinal studies are needed to examine the causal this relationship.

Fill compaction in the construction of Geosynthetic Reinforced Soil (GRS) mass is typically performed by operating a vibratory or roller compactor, which in turns imposed a compaction load in direction perpendicular to the wall face. The compaction process resulted in the development of the so-called compaction-induced stress (CIS), which may subsequently increase the stiffness and strength of the fill material. Compaction process is normally simulated using one of the following compaction procedures&mdash, (i) a uniformly distributed load acting on the top surface of each soil lift, (ii) a uniformly distributed load acting on the top and bottom surface of each soil lift, and (iii) a moving strip load with different width. Uncertainties such as compaction procedures, compaction and surcharge loads led to the disparity in studying the mechanism of GRS mass. This paper aimed to study the impact of compaction load, compaction procedure, surcharge load and CIS on the stress-deformation behavior of GRS mass via the simulation of a 2 m high Soil Geosynthetic Composite (SGC) mass and a 6 m high GRS mass. The results were examined in terms of reinforcement strains, wall lateral displacements, and net CIS. Results from the analysis show the important impacts of compaction conditions on the stress-deformation behavior of SGC mass and the CIS.

ObjectivesThis study aims to investigate the prevalence of sarcopenia and its associated factors in patients attending geriatric clinics in Vietnam.Design and settingA cross-sectional study was conducted in consecutive patients aged ≥60 visiting outpatient clinics of the National Geriatric Hospital in Hanoi, Vietnam, from January 2018 to October 2018. Handgrip strength was measured with a hand dynamometer. Whole-body dual-energy X-ray absorptiometry was applied to measure the appendicular skeletal muscle mass. Sarcopenia was defined by the criteria proposed by the Asian Working Group for Sarcopenia (AWGS 2019) and by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project.ResultsThere were 600 participants, mean age 70.0±8.0, 60.8% female. The prevalence of sarcopenia was 54.7% according to AWGS 2019 criteria and 40.5% according to FNIH. In multivariate logistic regression, age (adjusted OR 1.08, 95% CI 1.05 to 1.11), male (adjusted OR 2.03, 95% CI 1.29 to 3.21), underweight (adjusted OR 2.32, 95% CI 1.22 to 4.41), being malnourished (adjusted OR 3.77, 95% CI 1.19 to 11.91), chronic lung diseases (adjusted OR 3.48, 95% CI 2.10 to 5.77) and lower physical activity were significantly associated with sarcopenia defined by AWGS 2019 criteria. With FNIH definition, the significantly associated factors were age (adjusted OR 1.07, 95% CI 1.04 to 1.11), male (adjusted OR 6.78, 95% CI 4.12 to 11.17), low education (adjusted OR 2.15, 95% CI 1.27 to 3.63), being malnourished (adjusted OR 3.35, 95% CI 1.28 to 8.76), chronic lung diseases (adjusted OR 2.58, 95% CI 1.56 to 4.28) and lower physical activity level.ConclusionThe prevalence of sarcopenia in patients attending geriatric clinics was high. Further studies are needed to examine the impact of sarcopenia on adverse outcomes in this population.

Cancer is the second leading cause of death globally, and despite the advances in drug development, it is still necessary to develop new plant-derived medicines. Compared with using conventional chemical drugs to decrease the side effects induced by chemotherapy, natural herbal medicines have many advantages. The present study aimed to discover the potential cytotoxicity of ethanol extract and its derived fractions (chloroform, ethyl acetate, butanol, and aqueous) of Adenosma bracteosum Bonati. (A. bracteosum) on human large cell lung carcinoma (NCI-H460) and hepatocellular carcinoma (HepG2). Among these fractions, the chloroform showed significant activity in the inhibition of proliferation of both cancerous cells because of the presence of bioactive compounds including xanthomicrol, 5,4&rsquo, dihydroxy-6,7,8,3&rsquo, tetramethoxyflavone, and ursolic acid which were clearly revealed by nuclear magnetic resonance spectroscopy (1H-NMR, 13C-NMR, Heteronuclear Multiple Bond Coherence, and Heteronuclear Single Quantum Coherence Spectroscopy) analyses. According to the radical scavenging capacity, the 5,4&rsquo, tetramethoxyflavone compound (AB2) exhibited the highest anticancer activity on both NCI-H460 and HepG2 with IC50 values of 4.57 &plusmn, 0.32 and 5.67 &plusmn, 0.09 &micro, g/mL respectively, followed by the ursolic acid with the lower percent inhibition at 13.05 &plusmn, 0.55 and 10.00 &plusmn, 0.16 &micro, g/mL, respectively (p &lt, 0.05). Remarkably, the AB2 compound induced to significant increase in the production of reactive oxygen species accompanied by attenuation of mitochondrial membrane potential, thus inducing the activation of caspase-3 activity in both human lung and liver cancer cells. These results suggest that A. bracteosum is a promising source of useful natural products and AB2 offers opportunities to develop the novel anticancer drugs.

IntroductionLow- and middle-income countries have rapidly increasing numbers of people with dementia, yet little evidence on family caregiving interventions. We tested the preliminary efficacy and feasibility of a family caregiving intervention in northern Vietnam.MethodsNine clusters comprising 60 family caregivers were randomized to a culturally adapted version of a four- to six-session, multicomponent intervention delivered in-home over 2 to 3 months, or enhanced control. Eligible caregivers were ≥18 years of age and scored ≥6 on the Zarit Burden Inventory (ZBI).ResultsFifty-one caregivers (85%) completed the study. Using analysis of covariance with 3-month assessment as the outcome and baseline assessment as a covariate, intervention group caregivers had an average ZBI (primary outcome) score 1.2 standard deviation (SD) lower (P=.02) and Patient Health Questionnaire-4 (psychological distress) score 0.7 SD lower (P=.03) than controls.DiscussionIn the first study of its kind in Vietnam, a culturally adapted, manualized, family caregiver intervention was both efficacious and feasible.

Objective: To foster a national dialogue on addressing dementia as an emerging public health problem and formulating a strategy for developing Vietnam's national dementia plan. Methods: In September 2018, the Vietnamese National Geriatric Hospital supported by University staff in Australia and the United States organised the first Vietnam National Dementia Conference in Hanoi. Results: Over 270 Vietnamese dementia stakeholders and international dementia experts participated in the conference. The participants agreed dementia was a public health priority in Vietnam and identified the need for the development of Vietnam's national dementia plan. Policymakers supported positioning dementia as a priority in the national health agenda. Research institutions created collaboration to generate scientific information for policymaking process. Funding and international supports were obtained to develop Vietnam's national dementia plan. Conclusion: Strong leadership, stakeholder engagement and international support are critical in raising awareness and advocating for the development of Vietnam's national dementia plan usc Refereed/Peer-reviewed

Adenosma bracteosum Bonati. (A. bracteosum) has been used in traditional and modern medicine in Vietnam for curing hepatitis. In this study, ethanol and aqueous extracts of A. bracteosum were evaluated for their &alpha, glucosidase inhibitory activities and anti-hyperglycemic effects on glucose loaded hyperglycemic and streptozotocin (STZ) induced diabetic mice. The &alpha, glucosidase inhibition of the extracts was evaluated by colorimetric assays, and the anti-diabetic activity was tested on a STZ-induced diabetic mice model. The ethanol and aqueous extracts showed a significant &alpha, glucosidase inhibitory activity, which was more effective than acarbose at the same concentration. In the STZ-induced diabetic mice, both extracts showed a strong anti-hyperglycemic activity, with the group receiving 50 mg/kg of ethanol extract and the group receiving 50 mg/kg of aqueous extract presenting 64.42% and 57.69% reductions, respectively, in the blood glucose levels when compared with the diabetic control group, on day 21 (p &gt, 0.05). Isoscutellarein-8-O-&beta, D-glucopyranoside (IG) was identified from the ethanol extract, which showed a strong inhibitory activity against &alpha, glucosidase, with a ten times higher potency compared with the positive control acarbose. The anti-hyperglycemic effect of IG was effectively similar to the standard drug, glibenclamide, at the same dose of 10 mg/kg (p &gt, 0.05). These results indicated that A. bracteosum has a great antidiabetic potential.

Objective: Esophageal cancer is one of the deadliest cancers in the world, and the main subtype is esophageal squamous cell carcinoma (ESCC), which comprises 90% of cases. Expression of tryptophan 2,3-dioxygenase (TDO2), an enzyme involved in tryptophan catabolism, has been linked with tumor survival and poor prognosis of brain and breast cancer. However, no studies have investigated the potential role of TDO2 in esophageal cancer. Here we explored the expression and biological significance of TDO2 in ESCC. Methods: TDO2 protein expression was evaluated in 90 ESCC tissue samples by immunohistochemistry. TDO2 function in ESCC cell lines and spheroid colony formation were evaluated by RNA interference (RNAi). Results: TDO2 overexpression was associated with tumor stage, recurrence status, and the CD44 cancer stem cell marker in ESCC. TDO2 overexpression was correlated with poor outcome of ESCC patients. Inhibition of TDO2 expression by RNAi in TE-10 and TE-11 cell lines reduced both the number and the size of spheroid colonies as well as cell proliferation. Knockdown of TDO2 expression also induced inactivation of the epidermal growth factor receptor signaling pathway. Conclusion: Our results imply that TDO2 could play an important role in the progression of ESCC. Furthermore, TDO2 may be a potential therapeutic target in ESCC.

Homeobox genes function as master regulatory transcription factors during embryogenesis. HOXB5 is known to play an important role in several cancers. However, the biological role of HOXB5 in prostate cancer (PCa) is not fully elucidated. This study aimed to analyze the expression and function of HOXB5 and involvement of HOXB5 in neuroendocrine differentiation in PCa. Immunohistochemistry showed that 56 (43.8%) of 128 cases of localized PCa were positive for HOXB5. HOXB5-positive cases were associated with poor prostate-specific antigen recurrence-free survival after prostatectomy. Among 74 cases of metastatic PCa, 43 (58.1%) were positive for HOXB5. HOXB5 expression was higher in metastatic PCa than that in localized PCa. HOXB5 knockdown suppressed cell growth and invasion, but HOXB5 overexpression increased cell growth and invasion in PCa cell lines. Furthermore, HOXB5 regulated RET expression. Gene set enrichment analysis revealed that Nelson androgen response gene set was enriched in low HOXB5 expression group. RB1 knockout increased HOXB5 expression. Of note, additional p53 knockdown further increased HOXB5 expression in RB1 knockout cells. In silico analysis showed that HOXB5 expression was increased in neuroendocrine PCa (NEPC). These results suggest that HOXB5 may be a promising prognostic marker after prostatectomy and is involved in progression to NEPC.

This study assessed the knowledge and attitude toward palliative care for the elderly among health professionals in a tertiary geriatric hospital in Vietnam and explored their determinants. Cross-sectional data were obtained on 161 geriatric health professionals at the National Geriatric Hospital. Modified-Palliative Care Knowledge Test and Frommelt Attitudes Toward Care of the Dying instruments were used to measure knowledge and attitude toward geriatric palliative care. As a result, 40.5% physicians and 74.2% nurses showed insufficient knowledge about geriatric palliative care (p &lt, 0.05). The lowest score was for dyspnea, following by gastrointestinal and pain problems. No significant difference was found regarding the attitude between physicians and nurses (p &gt, 0.05). Health professional category, age, and years of experience were found to be associated with knowledge about palliative care. Meanwhile, only knowledge score had correlations with total attitude score (Coef. = 0.2, 95%CI = 0.1&ndash, 0.3), attitude toward patients (Coef. = 0.1, 95%CI = 0.0&ndash, 0.1) and toward patients&rsquo, family (Coef. = 0.1, 0.1). This study highlights a significant knowledge gap and preferable attitude toward palliative care for the elderly among physicians and nurses in the geriatric hospital. Intensive training about geriatric palliative care, focusing on pain, dyspnea and gastrointestinal issue management, should be performed to ensure the quality of palliative care services, especially in nurses.

Objectives To investigate the prevalence of polypharmacy and the common drugs prescribed at discharge in frail and non-frail older inpatients, and to examine whether frailty is significantly associated with polypharmacy. Methods Cross-sectional analysis from data of a study about the prevalence of frailty in older inpatients in Vietnam in 2015. Polypharmacy was defined as using ≥5 medications. Frailty was defined by Fried's frailty criteria. Results There were 382 participants, mean age 76.4, 56.5% female and 35.9% frail. At discharge, 59.2% had polypharmacy (62.8% in the frail and 57.1% in the non-frail). Vitamin/supplements were the most common drugs prescribed, followed by antiplatelets. Frailty was not significantly associated with polypharmacy (adjusted OR 1.45, 95% CI 0.89-2.34). Conclusions The prevalence of polypharmacy at discharge was high in both frail and non-frail participants. The association between frailty and polypharmacy needs to be investigated further in multicentre studies with larger sample sizes in Vietnam.

Anh Trung Nguyen,1,2 Thanh Xuan Nguyen,1,2 Tu N Nguyen,1,3 Thu Hoai Thi Nguyen,1,2,4 Thang Pham,1,2 Robert Cumming,5 Sarah N Hilmer,6 Huyen Thi Thanh Vu1,2 1The National Geriatric Hospital, Hanoi, Vietnam; 2Department of Geriatrics and Gerontology, Hanoi Medical University, Hanoi, Vietnam; 3Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada; 4Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam; 5Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia; 6Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital and Kolling Institute of Medical Research, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia Aims: To investigate the impact of frailty on outcomes in older hospitalized patients, including prolonged length of stay and all-cause mortality 6 months after admission, using both the frailty phenotype and the Reported Edmonton Frail Scale (REFS).Patients and methods: This study is the follow-up phase of a study designed to investigate the prevalence of frailty and its impact on adverse outcomes in older hospitalized patients at the National Geriatric Hospital in Hanoi, Vietnam.Results: A total of 461 participants were included, with a mean age 76.2±8.9 years, and 56.8% were female. The prevalence of frailty was 31.9% according to the REFS and 35.4% according to Fried’s criteria. The kappa coefficient was 0.57 (95% CI =0.49–0.66) between the two frailty criteria in identifying frail and non-frail participants. There was a trend toward increasing the likelihood of prolonged hospitalization in participants with frailty defined by Fried’s criteria (adjusted OR =1.49, 95%CI =0.94–2.35) or by REFS (adjusted OR =1.43, 95% CI =0.89–2.29). During 6 months of follow-up, 210 were lost and 18/251 (7.2%) participants died. Mortality was higher in those with frailty defined by either Fried’s criteria or REFS. On multivariable survival analysis, adjusted HRs for mortality were 2.65 (95% CI =1.02–6.89) for Fried’s criteria and 4.19 (95% CI =1.59–10.99) for REFS.Conclusion: Fried’s frailty phenotype or REFS can be used as a screening tool to detect frailty in older inpatients in Vietnam and predict mortality. Frailty screening can help prioritize targeted frailty-tailored treatments, such as nutrition, early mobility and medication review, for these vulnerable patients to improve clinical outcomes. Keywords: frailty, elderly, inpatients, Vietnam

Huyen Thi Thanh Vu,1,2 Thanh Xuan Nguyen,2,3 Huong Thi Thu Nguyen,1,2 Tu Anh Le,4 Tam Ngoc Nguyen,1,2 Anh Trung Nguyen,2 Thu Thi Hoai Nguyen,1,2 Hoang Long Nguyen,5 Cuong Tat Nguyen,6 Bach Xuan Tran,7,8 Carl A Latkin,8 Thang Pham,2 Melvyn WB Zhang,9 Roger CM Ho10 1Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam; 2National Geriatric Hospital, Hanoi, Vietnam; 3Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam; 4Department of Endocrinology, Nghe An Endocrinology Hospital, Nghe An, Vietnam; 5Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam; 6Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 7Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 8Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 9Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore; 10Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Background and aims: Depression and diabetes are becoming increasingly prevalent within the Vietnamese elderly population. However, the linkage between these health conditions in the Vietnamese elderly has not yet been fully investigated. This study aimed to assess the level of depressive symptoms and associated factors among elderly diabetic patients.Methods: A cross-sectional study was conducted at National Geriatric Hospital in the elder patients aged ≥60 years with type 2 diabetes mellitus (T2DM). Depressive symptoms were assessed using the Geriatric Depression Scale, with three categories: normal (0–4 points), mild (5–9 points), and moderate/severe depressive symptoms (≥10 points). We obtained information on the patient’s sociodemographic, medical history, glycemic control (fasting plasma glucose and HbA1c), daily activities (activities of daily living [ADLs] and instruments activities of daily living [IADLs] scale), and fall risks (Time Up and Go test). Logistic regression was used to analyze the factors associated with the presence of depressive symptoms.Results: Among 412 patients, 236 (57.3%) had HbA1c level at 7.0% or higher. There were 327 (79.4%) patients having depressive symptoms. The level of HbA1c was significantly different between the depressive symptom group and the non-depressive symptom group (7.74% and 6.61%, P

Background The transcribed ultraconserved regions (T-UCRs) are a novel class of non-coding RNAs that are absolutely conserved across species and are involved in carcinogenesis in some cancers. However, the expression and biological role of T-UCRs in renal cell carcinoma (RCC) remain poorly understood. This study aimed to examine the expression and functional role of Uc.416 + A and analyze the association between Uc.416 + A and epithelial-to-mesenchymal transition in RCC. Methods Expression of Uc.416 + A in 35 RCC tissues, corresponding normal kidney tissues and 13 types of normal tissue samples was determined by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). We performed a cell growth and migration assay in RCC cell line 786-O transfected with negative control and siRNA for Uc.416 + A. We evaluated the relation between Uc.416 + A and miR-153, which has a complimentary site of Uc.416 + A. Results qRT-PCR analysis revealed that the expression of Uc.416 + A was higher in RCC tissues than that in corresponding normal kidney tissues. Inhibition of Uc.416 + A reduced cell growth and cell migration activity. There was an inverse correlation between Uc.416 + A and miR-153. Western blot analysis showed Uc.416 + A modulated E-cadherin, vimentin and snail. The expression of Uc.416 + A was positively associated with the expression of SNAI1, VIM and inversely associated with the expression of CDH1. Conclusions The expression of Uc.416 + A was upregulated in RCC and especially in RCC tissues with sarcomatoid change. Uc.416 + A promoted epithelial-to-mesenchymal transition through miR-153. These results suggest that Uc.416 + A may be a promising therapeutic target. Electronic supplementary material The online version of this article (10.1186/s12885-018-4863-y) contains supplementary material, which is available to authorized users.

The reuse of whey waste, a by-product of the dairy industry, is an emerging issue due to the environmental impacts. Some previous experimental studies have indicated that whey waste can be used as an admixture for cement-based materials, including mortar and concrete, to reduce the setting time and increase the workability, thus reduce the amount of required cement. However, influence of whey waste on cemented soil has not received sufficient attention. This study investigates variations of unconfined compressive strength (UCS) and Young’s modulus (E) of cemented Kaolin clay when water in cement slurry was replaced by different whey waste proportions. Unconfined compression tests were conducted on treated specimens after two different curing times, namely 14 days and 56 days. Stress-strain relationship in each test was used to compute UCS and E at different dosages of cement and whey waste. Results of the experiments show improvements of UCS and E only for specimens when less than 10% water in cement slurry was replaced by liquid whey waste at 56 day-curing age, regardless of cement dosage. For the other cases, the presence of whey waste resulted in reductions of both UCS and E, indicating that although whey waste can be used to improve mechanical properties of cement treated clay, the optimum dosage should be selected very carefully to minimize the adverse effects. Different responses of UCS and E with curing age, dosages of cement and liquid whey waste are explained while discussing about the effects of lactose (milk sugar) available in whey waste acting as a retarding agent.

This study examined the use of potentially inappropriate medicines that may affect cognition (PIMcog) in people with dementia and its associated factors. Medical records of all outpatients with dementia attending a tertiary hospital in Vietnam between January 1, 2015, and December 31, 2016, were examined. Medicine use was assessed against a list of PIMcog. Variables associated with having a PIMcog were assessed using a multiple logistic regression. Of the 128 patients, 41% used a PIMcog, 39.1% used cholinesterase inhibitors (CEIs) concomitantly with anticholinergics, and 18% used antipsychotics. The number of hospital visits (adjusted odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.02-1.16) and number of treating specialists (adjusted OR: 0.61; 95% CI: 0.45-0.83) were associated with PIMcog use. This study highlights a high-level use of medicines that can further impair cognition or reduce the effectiveness of CEIs in people with dementia. Efforts to improve quality use of medicines for this population are warranted. Refereed/Peer-reviewed

Introduction : In Vietnam, HIV testing services had been available only at provincial and district health facilities, but not at the primary health facilities. Consequently, access to HIV testing services had been limited especially in rural areas. In 2012, Vietnam piloted decentralization and integration of HIV services at commune health stations (CHSs). As a part of this pilot, a three-rapid test algorithm was introduced at CHSs. The objective of this study was to assess the performance of a three-rapid test algorithm and the implementation of quality assurance measures to prevent misdiagnosis, at primary health facilities. Methods : The three-rapid test algorithm (Determine HIV-1/2, followed by ACON HIV 1/2 and DoubleCheckGold HIV 1&2 in parallel) was piloted at CHSs from August 2012 to December 2013. Commune health staff were trained to perform HIV testing. Specimens from CHSs were sent to the provincial confirmatory laboratory (PCL) for confirmatory and validation testing. Quality assurance measures were undertaken including training, competency assessment, field technical assistance, supervision and monitoring and external quality assessment (EQA). Data on HIV testing were collected from the testing logbooks at commune and provincial facilities. Descriptive analysis was conducted. Sensitivity and specificity of the rapid testing algorithm were calculated. Results : A total of 1,373 people received HIV testing and counselling (HTC) at CHSs. Eighty people were diagnosed with HIV infection (5.8%). The 755/1244 specimens reported as HIV negative at the CHS were sent to PCL and confirmed as negative, and all 80 specimens reported as HIV positive at CHS were confirmed as positive at the PCL. Forty-nine specimens that were reactive with Determine but negative with ACON and DoubleCheckGold at the CHSs were confirmed negative at the PCL. The results show this rapid test algorithm to be 100% sensitive and 100% specific. Of 21 CHSs that received two rounds of EQA panels, 20 CHSs submitted accurate results. Conclusions : Decentralization of HIV confirmatory testing to CHS is feasible in Vietnam. The results obtained from this pilot provided strong evidence of the feasibility of HIV testing at primary health facilities. Quality assurance measures including training, competency assessment, regular monitoring and supervision and an EQA scheme are essential for prevention of misdiagnosis. Keywords HIV testing; rapid test; algorithm; decentralization; misdiagnosis; quality assurance; Vietnam (Published: 29 August 2017) Nguyen VTT et al. Journal of the International AIDS Society 2017, 20 :21752 http://www.jiasociety.org/index.php/jias/article/view/21752 | http://dx.doi.org/10.7448/IAS.20.7.21752

Background Renal cell carcinoma (RCC) is one of the most common types of cancer in developed countries. Bone marrow stromal cell antigen 2 (BST2) gene, which encodes BST2 transmembrane glycoprotein, is overexpressed in several cancer types. In the present study, we analyzed the expression and function of BST2 in RCC. Materials and methods BST2 expression was analyzed by immunohistochemistry in 123 RCC cases. RNA interference was used to inhibit BST2 expression in a RCC cell line. Results Immunohistochemical analysis showed that 32% of the 123 RCC cases were positive for BST2. BST2 expression was positively associated with tumour stage. Furthermore, BST2 expression was an independent predictor of survival in patients with RCC. BST2 siRNA-transfected Caki-1 cells displayed significantly reduced cell growth and invasive activity relative to negative control siRNA-transfected cells. Conclusion These results suggest that BST2 plays an important role in the progression of RCC. Because BST2 is expressed on the cell membrane, BST2 is a good therapeutic target for RCC.

The presence of geosynthetic reinforcement in soil mass has been shown to reduce the tendency of dilation of the soil when subject to shear stress, especially when the reinforcement is closely spaced. As tensile loads are induced in geosynthetic reinforcement, adjacent reinforcement layers tend to act as tensioned membranes that inhibit dilation of the soil enclosed between the reinforcement layers. The suppression of soil dilation leads to stronger soil and is regarded as a reinforcing mechanism. This paper presents for the first time measured volume change behavior of field-scale experiments on reinforced and unreinforced soils. The volume change behavior, as characterized quantitatively by the angle of dilation, is presented and discussed. This paper also describes finite element analysis for the stress–strain and volume change behavior of field-scale soil-geosynthetic composites. Using the calibrated finite element model, a parametric study was conducted to examine the effects of reinforcement spacing, reinforcement stiffness, and soil stiffness on volume change behavior of soil-geosynthetic composites. The measured data and finite element analysis results suggest that the mechanism of suppression of soil dilation (addresses volume change behavior), and the mechanisms of apparent confining pressure and apparent cohesion (two popular mechanisms that address strength behavior) are likely independent.

Measuring health-related quality of life (HRQOL) is critical to evaluate the burden of frailty in the older population.This study explored the prevalence of frailty among Vietnamese older people in rural communities, determined the factors associated with frailty, and examined the differences in HRQOL between non-frail, pre-frail, and frail people. A cross-sectional study was conducted on older adults (&ge, 60 years old) residing in Soc Son district, northern Vietnam. Non-frailty, pre-frailty, and frailty conditions were evaluated using Fried&rsquo, s frailty criteria. The EuroQol-5 Dimensions-5 Levels(EQ-5D-5L) instrument was employed to measure HRQOL. Socioeconomic, behavioral, health status, and healthcare utilization characteristics were collected as covariates. Among 523 older adults, 65.6% were pre-frail, and 21.7% were frail. The mean EQ-5D-5L indexes of the non-frailty, pre-frailty, and frailty groups were 0.70 (SD = 0.18), 0.70 (SD = 0.19), and 0.58 (SD = 0.20), respectively. The differences were found between non-frailty and frailty groups (p &lt, 0.01), as well as the pre-frailty and frailty groups (p&lt, 0.01). After adjusting for covariates, the estimated mean difference in the HRQOL between the non-frailty and frailty groups was &minus, 0.10 (95%CI= &minus, 0.17, &minus, 0.02) (R2 = 45.2%), showing a 10% reduction of the maximum EQ-5D-5L index.This study emphasized the high prevalence of frailty among older adults in the rural communities of Vietnam. Frailty was found to be associated with a small reduction of HRQOL in this population.

(1) Background: Major causes of the burden of disease in older persons include mental disorders and neurological diseases, such as depression. This study aims to explore the prevalence of older people at risk for depression and identify the factors associated with this risk in rural Vietnam. (2) Methods: A cross-sectional study was conducted in Soc Son, Hanoi with 523 community dwelling elders aged 60 and over. Face-to-face interviews were performed to collect data about socioeconomic status, risk for depression, health status, and health utilization. The Geriatric Depression Scale-4 items (GDS-4) was used to assess the risk for depression occurrence. Multivariable logistic regression was employed for determining the factors associated with the risk for depression. (3) Results: Among 523 participants, there were 26.4% of participants at risk for depression. The proportion of females at risk for depression (29.0%) was significantly higher than males (20.4%). Differences were found in economic status (near poor group had higher risk for depression compared to the poor group) (p &lt, 0.01). Older adults living with spouse/partner, living in near-poor household, and suffering pain/discomfort were all more likely to be at risk for depression. (4) Conclusions: Being female, living in a near poor household, being in pain or experiencing discomfort are all factors strongly correlated to high risk for depression. These findings highlight the urgent need for additional research among Vietnamese community-dwelling older people.

Background: The evidence about prevalence of atrial fibrillation (AF) in Vietnam is very limited and there have been no published studies about the pharmacological treatment of AF in older Vietnamese patients. This study aims to investigate the prevalence of AF, its associated factors and pharmacological treatment in older hospitalized patients in Vietnam.The secondary aim is to investigate the impact of frailty, an emerging geriatric syndrome which is still a new concept in Vietnam, on the pharmacological treatment of AF. Methods: We used data from a study of the prevalence of frailty in older hospitalized patients at the National Geriatric Hospital in Hanoi, Vietnam. Consecutive patients aged ≥60 years were recruited from 4/2015 to 10/2015. Results: A total of 461 patients was recruited, 56.8% were female, and mean age was 76.2±8.9. The prevalence of AF was 3.9% (18 patients). Amongst patients with AF, the most common medical conditions were hypertension (72.2%), followed by stroke (55.6%), heart failure (50.0%), type2 diabetes (44.4%). Living alone (OR=10.2, 95%CI 1.5–70.1), having a habit of using vitamins at home (OR=3.8, 95%CI 1.1–13.4), having heart failure (OR=31.3, 95%CI 9.6–101.8), and having type 2 diabetes (OR=3.5, 95%CI 1.2–10.7) were associated with the presence of AF on admission. All patients with AF had a high risk of stroke (CHA2DS2-VASc score≥2) and 72.2% of them had a high risk of bleeding with anticoagulant medications (HAS-BLED score≥3). Only 22.2% were anticoagulated on admission and 22.2% upon discharge, with no difference between frail and non-frail patients. Conclusions: The prevalence of AF among older hospitalized patients in Vietnam is similar to that reported in other countries. Anticoagulation for stroke prevention was underused, without any significant difference between frail and non-frail patients.

In current design methods for geosynthetic-reinforced soil (GRS) walls and abutments, there is a fundamental design assumption that the reinforcement strength and spacing play an equal role in the performance of a GRS wall/abutment, i.e., larger reinforcement spacing can be fully compensated by using proportionally stronger reinforcement and lead to the same performance. This has encouraged designers to use larger reinforcement spacing in conjunction with stronger reinforcement for reduction in construction time. Recent studies, however, has indicated that reinforcement spacing plays a much more significant role in the performance of a GRS wall/abutment than reinforcement strength. In this paper, an analytical model that is capable of reflecting more accurately the roles of reinforcement spacing and reinforcement strength is presented. Using available data from large-scale experiments, it is shown that the analytical model provides a much improved tool for predicting reinforcement forces at failur...

Background: Resources for Enhancing All Caregivers Health in the Department of Veterans Affairs (REACH VA) is an evidence-based intervention supporting family dementia caregivers that has been shown to improve caregiver outcomes for culturally diverse populations in the United States. However, this model has not been tested in low- and middle-income countries (LMICs) including Vietnam, where community-based psychosocial interventions are urgently needed. The objectives of this study are to assess the feasibility and preliminary effectiveness of a culturally adapted version of the Resources for Enhancing All Caregivers Health in Vietnam (REACH VN).Methods: A cluster randomized controlled trial (RCT) will be conducted over a 6-month period in Soc Son district located in Hanoi. An expected sample of 10 to 12 communes, representing approximately 50 dementia primary caregivers, will be randomized to either the REACH VN intervention or an enhanced control condition. Inclusion criteria for the caregiver include age ≥18, family member who provides the most day-to-day care for person with dementia, and a total score for the brief (4 item) Zarit Burden Scale of ≥6. Over the course of 2 to 3 months, each participant in the intervention group will receive the REACH VN intervention comprised of 4 core sessions on problem solving, mood management/cognitive restructuring, stress management, and communication, and up to 2 additional sessions based on caregiver's needs. The enhanced control group will receive a single session that provides verbal and written information on dementia. Caregiver outcomes will be assessed at baseline (i.e., time of enrolment) and 3 months. The feasibility will be assessed with regard to recruitment, retention, treatment adherence, treatment fidelity, and assessment processes. For preliminary effectiveness, we will examine caregiver burden as the primary outcome and changes in caregiver depressive symptoms and in Alzheimer disease knowledge as secondary outcomes.Discussion: This is the first study to test community-based family dementia caregiver intervention in Vietnam. Results from this study will provide the foundation for a larger effectiveness trial and broader dissemination in Vietnam and may help inform efforts to develop similar community-based family dementia caregiver support programs in other LMICs. Refereed/Peer-reviewed

When an earth fill is subject to loading and subsequent unloading, it will bring about an increase in the lateral stress, provided that there is sufficient constraint to lateral deformation of the soil mass. The increase in lateral stress is commonly known as the "residual" or "lock-in" lateral stress. The residual stress resulted from compaction operation, which involves a series of loading and unloading onto a soil mass, is referred to as "compaction-induced stress" (CIS). The CIS will increase the stiffness and strength of the soil mass, and is an important factor to be considered in the behavior of compacted soil. A number of studies have been conducted on the CIS in an unreinforced soil mass. With a reinforced soil, the CIS is likely to be much more pronounced because there is a higher degree of constraint to lateral deformation in a reinforced soil mass due to soil-reinforcement friction. An analytical model, referred to as the CIS model, is developed for evaluation of compaction-induced str...

Compared to geosynthetic-reinforced soil (GRS) retaining walls, GRS abutment walls are generally subjected to much greater intensity surface loads that are fairly close to the wall face. A major issue with the design of GRS abutments is the allowable bearing pressure of the bridge sill on the abutments. The allowable bearing pressure of a bridge sill over reinforced soil retaining walls has been limited to 200 kPa in the current NHI and Demo 82 design guidelines. A study was undertaken to investigate the allowable bearing pressures of bridge sills over GRS abutments with flexible facing. The study was conducted by the finite element method of analysis. The capability of the finite element computer code for analyzing the performance of GRS bridge abutments with modular block facing has been evaluated extensively prior to this study. A series of finite element analyses were carried out to examine the effect of sill type, sill width, soil stiffness/strength, reinforcement spacing, and foundation stiffness on the load-carrying capacity of GRS abutment sills. Based on the results of the analytical study, allowable bearing pressures of GRS abutments were determined based on two performance criteria: A limiting displacement criterion and a limiting shear strain criterion, as well as the writers' experiences with GRS walls and abutments. In addition, a recommended design procedure for determining the allowable bearing pressure is provided.

Surveying 60 Vietnamese patients with either current or past post-traumatic stress disorder, this article aims to phenomenologically characterize the syndrome of `hit by the wind' in a multidimensional manner. This includes determining the patient conceptualization of the disorder, profiling `hit by the wind' episodes suffered by patients in the previous month, and presenting case vignettes. Eighteen of the 60 patients (30%) suffered at least one episode of `hit by the wind' in the last month; all 18 patients had at least one episode of `hit by the wind' in the last month that met panic attack criteria. For the 18 patients, 33 episodes of `hit by the wind' that met panic attack criteria were experienced in the previous month. For these 33 episodes, the most frequently reported DSM-IV panic attack symptoms were chills (100%; 33/33) and dizziness (88%; 29/33). Flashbacks played a role in the `hit by the wind' episodes for 5 of the 18 patients (28%). In the discussion, a model of how the syndrome of `hit by the wind' generates panic is adduced; also, possible Chinese origins of the disorder are discussed.