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Nguyen Van An,1 Hai Thi Nguyen,2 Van Nguyen Le,1 Ha Thi Thu Van,1 Nguyen Minh Hai,1 Vu Huy Luong,3,4 Vinh Thi Ha Nguyen,4,5 Hoa Quynh Pham,6 Hung Van Le,4,6 Dinh Viet Hung,7 Hoang Trung Kien,8 Minh Nhat Le,9,10 Nguyen Hoang Viet,11 Luong Cong Thuc,12 Ta Ba Thang,13 Tran Viet Tien,14 Le Huy Hoang,15 Nguyen Thuy Tram,15 Tuan Dinh Le,16 Nguyen Tien Son,16 Hai Ha Long Le17,18 1Department of Microbiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Central Laboratory, Bac Ninh Provincial General Hospital, Bac Ninh, Vietnam; 3Department of Laser and Skincare, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 4Department of Dermatology and Venereology, Hanoi Medical University, Hanoi, Vietnam; 5Department of General Planning, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 6Department of Microbiology, Mycology and Parasitology, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 7Department of Psychiatry, Military Medical 103, Vietnam Military Medical University, Hanoi, Vietnam; 8Department of Immunology, Vietnam Military Medical University, Hanoi, Vietnam; 9Tay Nguyen Institute of Science Research, Vietnam Academy of Science and Technology, VAST, Hanoi, Vietnam; 10Antimicrobial Resistance Research Center, National Institute of Infectious Disease, Tokyo, Japan; 11Molecular Pathology Department, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 12Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 13Respiratory Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 14Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 15Department of Bacteriology, National of Hygiene and Epidemiology, Hanoi, Vietnam; 16Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 17Department of Clinical Microbiology and Parasitology, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 18Department of Biochemistry, Hematology and Immunology, National Hospital of Dermatology and Venereology, Hanoi, VietnamCorrespondence: Hai Ha Long Le, Department of Clinical Microbiology and Parasitology, Faculty of Medical Technology, Hanoi Medical University, Hanoi, 100000, Vietnam, Tel +84978520055, Email lehalonghai@gmail.comPurpose: Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA) strain, can become resistant to all classes of clinically available antibiotics and causes skin infections and severe infections in the lungs, heart, and bloodstream. The study aimed to evaluate antimicrobial susceptibility patterns and MRSA exhibiting multidrug resistance obtained through a microbiological culture of clinical specimens at Bac Ninh Provincial General Hospital in Bac Ninh Province, Vietnam.Methods: We employed a cross-sectional analysis at Bac Ninh Provincial General Hospital in Vietnam. 15,232 clinical samples from inpatients were examined. S. aureus isolates were identified using established protocols and tested for MRSA and antibiotic susceptibility. Data was analyzed using R software, with statistical calculations to assess associations between variables.Results: Staphylococcus aureus was isolated from 417 samples (2.7%), with 77.2% being MRSA and 22.8% methicillin-susceptible Staphylococcus aureus (MSSA). Significant sources of MRSA were wounds (64.6%) and the surgical unit (50%) according to sample types and hospital wards, respectively. S. aureus showed high resistance rates, the highest being azithromycin (83.2%), and was fully susceptible to vancomycin. Among 294 multidrug-resistant (MDR) strains, the prevalence was 82.0% in MRSA and 18.0% in MSSA.Conclusion: The study highlights widespread antimicrobial resistance among MRSA isolates from a provincial hospital in Vietnam, emphasizing the urgent need for antibiotic surveillance, formulation of antibiotic policies, and preventive measures to tackle the increasing prevalence of multidrug-resistant MRSA.Keywords: Staphylococcus aureus, antibiotic resistance, MRSA, MDR, Vietnam

Nguyen Van An,1,* Hoang Trung Kien,2,* Le Huy Hoang,3 Nguyen Hung Cuong,1 Hoang Xuan Quang,1 Tuan Dinh Le,4 Ta Ba Thang,5 Tien Tran Viet,6 Luong Cong Thuc,7 Dinh Viet Hung,8 Nguyen Hoang Viet,9 Le Nhat Minh,10,11 Vu Huy Luong,12,13 Vinh Thi Ha Nguyen,13,14 Pham Quynh Hoa,15 Hai Ha Long Le16,17 1Department of Microbiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Immunology, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Bacteriology, National of Hygiene and Epidemiology, Hanoi, Vietnam; 4Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 5Respiratory Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 6Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 7Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 8Department of Psychiatry, Military Medical 103, Vietnam Military Medical University, Hanoi, Vietnam; 9Molecular Pathology Department, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 10Antimicrobial Resistance Research Center, National Institute of Infectious Disease, NIID, Tokyo, Japan; 11Tay Nguyen Institute of Science Research, Vietnam Academy of Science and Technology, VAST, Hanoi, Vietnam; 12Department of Laser and Skincare, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 13Department of Dermatology and Venereology, Hanoi Medical University, Hanoi, Vietnam; 14Department of General Planning, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 15Department of Microbiology, Mycology and Parasitology, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 16Department of Clinical Microbiology and Parasitology, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 17Department of Biochemistry, Hematology and Immunology, National Hospital of Dermatology and Venereology, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Hai Ha Long Le, Department of Clinical Microbiology and Parasitology, Faculty of Medical Technology, Hanoi Medical University, Hanoi, 100000, Vietnam, Tel +84 978520055, Email lehalonghai@hmu.edu.vnPurpose: At a teaching Hospital in Vietnam, the persistently high incidence of diagnosed wound infection poses ongoing challenges to treatment. This study seeks to explore the causative agents of wound infection and their antimicrobial and multidrug resistance patterns.Methods: A cross-sectional study was conducted at the Department of Microbiology, Military Hospital 103, Vietnam. Data on microorganisms that caused wound infection and their antimicrobial resistance patterns was recorded from hospitalized patients from 2014 to 2021. Using the chi-square test, we analyzed the initial isolation from wound infection specimens collected from individual patients.Results: Over a third (34.9%) of wound infection samples yielded bacterial cultures. Staphylococcus aureus was the most prevalent bacteria, followed by Pseudomonas aeruginosa. Worryingly high resistance rates were observed for several antibiotics, particularly among Gram-negative bacteria. Ampicillin displayed the highest resistance (91.9%), while colistin and ertapenem remained the most effective. In Gram-positive bacteria, glycopeptides like teicoplanin and vancomycin (0% and 3.3% resistance, respectively) were most effective, but their use was limited. Clindamycin and tetracycline showed decreasing effectiveness. Resistance rates differed between surgical and non-surgical wards, highlighting the complex dynamics of antimicrobial resistance within hospitals. Multidrug resistance (MDR) was substantial, with Gram-negative bacteria exhibiting a 63.6% MDR rate. Acinetobacter baumannii showed the highest MDR rate (88.0%).Conclusion: This study investigated wound infection characteristics, antibiotic resistance patterns of common bacteria, and variations by hospital ward. S. aureus was the most prevalent bacteria, and concerning resistance rates were observed, particularly among Gram-negative bacteria. These findings highlight the prevalence of multidrug resistance in wound infections, emphasizing the importance of infection control measures and judicious antibiotic use.Keywords: wound infection, multidrug resistance, antimicrobial resistance, AMR in Vietnam

Nguyen Van An,1,* Le Ha long Hai,2,3,* Vu Huy Luong,4,5 Nguyen Thi Ha Vinh,5,6 Pham Quynh Hoa,7 Le Van Hung,5,7 Nguyen Thai Son,1 Le Thu Hong,1 Dinh Viet Hung,8 Hoang Trung Kien,9 Minh Nhat Le,10,11 Nguyen Hoang Viet,12 Duc Hoang Nguyen,13 Ngai Van Pham,14 Ta Ba Thang,15 Tran Viet Tien,16 Le Huy Hoang17 1Department of Microbiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Clinical Microbiology and Parasitology, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 3Department of Biochemistry, Hematology and Immunology, National Hospital of Dermatology and Venereology, Hanoi, Vietnam; 4Department of Laser and Skin Care, National hospital of Dermatology and Venereology, Hanoi, Vietnam; 5Department of Dermatology and Venereology, Hanoi Medical University, Hanoi, Vietnam; 6Department of General Planning, National hospital of Dermatology and Venereology, Hanoi, Vietnam; 7Department of Microbiology, Mycology and Parasitology, National hospital of Dermatology and Venereology, Hanoi, Vietnam; 8Department of Psychiatry, Military Medical 103, Vietnam Military Medical University, Hanoi, Vietnam; 9Department of Immunology, Vietnam Military Medical University, Hanoi, Vietnam; 10Tay Nguyen Institute of Science Research, Vietnam Academy of Science and Technology, VAST, Hanoi, Vietnam; 11Antimicrobial Resistance Research Center, National Institute of Infectious Disease, Tokyo, Japan; 12Molecular Pathology Department, Faculty of Medical Technology, Hanoi Medical University, Hanoi, Vietnam; 13Cardiovascular Laboratories, Methodist Hospital, Merrillville, Indiana, USA; 14Medical Testing Center, Medlatec Group, Hanoi, Vietnam; 15Respiratory Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 16Department of Infectious diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 17Department of Bacteriology, National of Hygiene and Epidemiology, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Le Huy Hoang, Department of Bacteriology, National of Hygiene and Epidemiology, Hanoi, 100000, Vietnam, Tel + 84 977 803 986, Email lehuyhoang2010@gmail.comPurpose: Staphylococcus aureus is a commensal bacteria species that can cause various illnesses, from mild skin infections to severe diseases, such as bacteremia. The distribution and antimicrobial resistance (AMR) pattern of S. aureus varies by population, time, geographic location, and hospital wards. In this study, we elucidated the epidemiology and AMR patterns of S. aureus isolated from a general hospital in Vietnam.Methods: This was a cross-sectional study. Data on all S. aureus infections from 2014 to 2021 were collected from the Microbiology department of Military Hospital 103, Vietnam. Only the first isolation from each kind of specimen from a particular patient was analyzed using the Cochran–Armitage and chi-square tests.Results: A total of 1130 individuals were diagnosed as S. aureus infection. Among them, 1087 strains were tested for AMR features. Most patients with S. aureus infection were in the age group of 41– 65 years (39.82%). S. aureus isolates were predominant in the surgery wards, and pus specimens were the most common source of isolates (50.62%). S. aureus was most resistant to azithromycin (82.28%), erythromycin (82.82%), and clindamycin (82.32%) and least resistant to teicoplanin (0.0%), tigecycline (0.16%), quinupristin-dalfopristin (0.43%), linezolid (0.62%), and vancomycin (2.92%). Methicillin-resistant S. aureus (MRSA) and multidrug-resistant (MDR) S. aureus were prevalent, accounting for 73.02% and 60.90% of the total strains respectively, and the strains isolated from the intensive care unit (ICU) had the highest percentage of multidrug resistance (77.78%) among the wards.Conclusion: These findings highlight the urgent need for continuous AMR surveillance and updated treatment guidelines, particularly considering high resistance in MRSA, MDR strains, and ICU isolates. Future research focusing on specific resistant populations and potential intervention strategies is crucial to combat this rising threat.Keywords: Staphylococcus aureus, antimicrobial resistance, methicillin-resistant S. aureus, multidrug resistance, Hanoi, Vietnam

Teacher feedback is the key to online collaborative discussion. To investigate the effects of different forms of teacher feedback intervention on learners' cognitive and emotional interactions in online collaborative discussion, this study collected collaborative discussion text data of online collaborative learners. Based on the framework of Community of Inquiry theory, naive Bayes algorithm for automatic coding of collaborative discussion text data was adopted. A bivariate (with or without emotion/guidance) experiment was designed based on teacher feedback. The participants of this study were college students (N = 109, average age = 20) of normal major participating in Teaching System Design. They were randomly divided into four experimental groups. In each experimental group, 4-5 people work in a group for collaborative learning. This study adopts quasi experimental research method, and the experiment period is 10 class hours. Reliability analysis, automatic text coding and ANOVA of cognitive-affective variables were used to conduct process mining for the collaborative discussion of four groups of learners by using heuristic mining algorithms. It found that different forms of teacher feedback have different effects on learners' cognitive emotion. Teachers' emotional feedback promotes learners' emotional interaction and cognitive interaction, whiccoch is easier to promote learners' cognitive interaction. Different forms of teacher feedback promote four types of cognitive emotion interaction process. This suggests that the multi-branch type of voice prompt feedback group has the best effect on learners' cognitive and emotional impact.

The production of prompt D + and Ds+ mesons is studied in proton-lead collisions at a centre-of-mass energy of sNN = 5.02 TeV. The data sample corresponding to an integrated luminosity of (1.58 ± 0.02)nb −1 is collected by the LHCb experiment at the LHC. The differential production cross-sections are measured using D + and Ds+ candidates with transverse momentum in the range of 0 < p T < 14 GeV/c and rapidities in the ranges of 1.5 < y ∗ < 4.0 and –5.0 < y ∗ < –2.5 in the nucleon-nucleon centre-of-mass system. For both particles, the nuclear modification factor and the forward-backward production ratio are determined. These results are compared with theoretical models that include initial-state nuclear effects. In addition, measurements of the cross-section ratios between D +, Ds+ and D 0 mesons are presented, providing a baseline for studying the charm hadronization in lead-lead collisions at LHC energies. [Figure not available: see fulltext.].

The first measurement of the Z boson production cross-section at centre-of-mass energy s = 5.02 TeV in the forward region is reported, using pp collision data collected by the LHCb experiment in year 2017, corresponding to an integrated luminosity of 100 ± 2 pb−1. The production cross-section is measured for final-state muons in the pseudorapidity range 2.0 < η < 4.5 with transverse momentum pT> 20 GeV/c. The integrated cross-section is determined to be (Formula presented.) for the di-muon invariant mass in the range 60 < Mμμ< 120 GeV/c2. This result and the differential cross-section results are in good agreement with theoretical predictions at next-to-next-to-leading order in the strong coupling constant. Based on a previous LHCb measurement of the Z boson production cross-section in pPb collisions at sNN = 5.02 TeV, the nuclear modification factor RpPb is measured for the first time at this energy. The measured values are 1.2−0.3+0.5 (stat) ± 0.1(syst) in the forward region (1.53

A model-independent study of CP violation in B0→DK∗0 decays is presented using data corresponding to an integrated luminosity of 9\,fb-1 collected by the LHCb experiment at centre-of-mass energies of s=7,8 and 13\,TeV. The CKM angle γ is determined by examining the distributions of signal decays in phase-space bins of the self-conjugate D→KS0h+h- decays, where h=π,K. Observables related to CP violation are measured and the angle γ is determined to be γ=(49-19+22)∘. Measurements of the amplitude ratio and strong-phase difference between the favoured and suppressed B0 decays are also presented.

The ratios of branching fractions R(D^{*})≡B(B[over ¯]→D^{*}τ^{-}ν[over ¯]_{τ})/B(B[over ¯]→D^{*}μ^{-}ν[over ¯]_{μ}) and R(D^{0})≡B(B^{-}→D^{0}τ^{-}ν[over ¯]_{τ})/B(B^{-}→D^{0}μ^{-}ν[over ¯]_{μ}) are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0  fb^{-1} of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode τ^{-}→μ^{-}ν_{τ}ν[over ¯]_{μ}. The measured values are R(D^{*})=0.281±0.018±0.024 and R(D^{0})=0.441±0.060±0.066, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is ρ=-0.43. The results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the standard model.

Background and purposeIntracranial vessel wall MR imaging is an emerging technique for intracranial vasculopathy assessment. Our aim was to investigate intracranial vessel wall MR imaging use by the American Society of Neuroradiology (ASNR) members at their home institutions, including indications and barriers to implementation.Materials and methodsThe ASNR Vessel Wall Imaging Study Group survey on vessel wall MR imaging use, frequency, applications, MR imaging systems and field strength used, protocol development approaches, vendor engagement, reasons for not using vessel wall MR imaging, ordering-provider interest, and impact on clinical care, was distributed to the ASNR membership between April 2 and August 30, 2019.ResultsThere were 532 responses; 79 were excluded due to nonresponse and 42 due to redundant institutional responses, leaving 411 responses. Fifty-two percent indicated that their institution performs vessel wall MR imaging, with 71.5% performed at least 1-2 times/month, most frequently on 3T MR imaging, and 87.7% using 3D sequences. Protocols most commonly included were T1-weighted pre- and postcontrast and TOF-MRA; 60.6% had limited contributions from vendors or were still in protocol development. Vasculopathy differentiation (94.4%), cryptogenic stroke (41.3%), aneurysm (38.0%), and atherosclerosis (37.6%) evaluation were the most common indications. For those not performing vessel wall MR imaging, interpretation (53.1%) or technical (46.4%) expertise, knowledge of applications (50.5%), or limitations of clinician (56.7%) or radiologist (49.0%) interest were the most common reasons. If technical/expertise obstacles were overcome, 56.4% of those not performing vessel wall MR imaging indicated that they would perform it. Ordering providers most frequently inquiring about vessel wall MR imaging were from stroke neurology (56.5%) and neurosurgery (25.1%), while 34.3% indicated that no providers had inquired.ConclusionsMore than 50% of neuroradiology groups use vessel wall MR imaging for intracranial vasculopathy characterization and differentiation, emphasizing the need for additional technical and educational support, especially as clinical vessel wall MR imaging implementation continues to grow.

Ngo Van Thanh,1 Nguyen Sinh Hien,1 Pham Nguyen Son,2 Dinh Cong Pho,3 Pham Truong Son3 1Hanoi Heart Hospital, Hanoi, Vietnam; 2 108 Military Central Hospital, Hanoi, Vietnam; 3Department of Cardiology, Heart Institute, 108 Military Central Hospital, Hanoi, VietnamCorrespondence: Pham Truong Son, Email ptson108@gmail.comBackground: An association between heart rate variability (HRV) and cardiac events in certain diseases has been demonstrated. However, the association with new-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is still controversial. This study aimed to investigate the association between HRV and new-onset AF in patients undergoing CABG during a 6-month follow-up.Methods: This prospective study included 119 consecutive patients who underwent off-pump CABG. All patients were assessed using 24-hour Holter recordings 2 days before CABG and 1 week, 3 months, and 6 months postoperatively. HRV was analyzed, and AF was detected from its recordings.Main results: In patients undergoing CABG, NYHA III increased the AF rate 7 days postoperatively, and advanced age and diabetes were associated with AF 6 months postoperatively. A reduction in time-domain measurements before surgery was significantly associated with a higher risk of developing AF seven days postoperatively; no association between preoperative HRV and AF was found at six months. Reduced preoperative HRV (SDNN (standard deviation of all normal-to-normal intervals [) < 50 ms) was an independent predictor of AF at 3 (AUC = 0.65) and 6 months (AUC = 0.62) following surgery.Conclusion: A reduction in the time domain measurements before CABG was associated with a higher risk of new-onset AF at 7 days postoperatively but not at 6 months. An SDNN < 50 ms was a weak independent predictor of a higher incidence of AF at 3 and 6 months post-surgery.Keywords: heart rate variability, coronary artery bypass graft, atrial fibrillation, standard deviation of all normal-to-normal intervals

ABSTRACT: Background: In microsurgical tissue transfer, skin flap transplantation is frequently used to heal the surface of a wound. Effective microcirculation surveillance of the skin flap is crucial. However, with traditional monitoring methods—that is, clinical observation—vascular crisis can still occur, thereby impairing postoperative recovery. A smartphone application is required to assist health care professionals in the standardized collection of flap perfusion parameters for flap management. Methods: The Vascular Crisis Prewarning Application was created using a design science research methodology that prioritizes users and problems. The system usability scale was used to assess the application's usability among medical practitioners. The application was used at the clinic from December 2020 to September 2022. The unplanned return to the operating room, time to diagnose vascular crisis, and flap survival rate were compared with and without the application. Results: The application consisted of 5 modules: patient addition and basic information entry, flap labeling, flap observation, crisis warning, and case archiving. The average rating for the application's usability among medical practitioners was 97.95 score (SD 2.36). With the application, the time to detect vascular crisis reduced from 26.71 to 16.26 h (P < 0.001), the unplanned return to the operation room increased from 8.18% to 10.24% (P = 0.587), and the flap survival rate went from 94.55% to 99.21% (P = 0.083). Conclusions: An easy-to-use flap perfusion monitoring and prewarning application for medical practitioners was produced using a user-centered development method. The application provided a more standardized and accurate platform for data collection in flap management and reduced the time to detect vascular crisis. Larger cohort studies are required in the future to better assess the full potential of the application.