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Nguyen Huu Dung,1 Nguyen Trung Kien,2 Nguyen Thi Thu Hai,1 Phan The Cuong,1 Nguyen Thi Thu Huong,3 Dao Bui Quy Quyen,4 Nguyen Minh Tuan,4 Do Manh Ha,2 Truong Quy Kien,2 Nguyen Thi Thuy Dung,2 Pham Quoc Toan,2 Hoang Trung Vinh,2 Tomoko Usui,5 Le Viet Thang21Bach Mai Hospital, Ha Noi, Vietnam; 2Military Hospital 103, Ha Noi, Vietnam; 3Ha Noi Kidney Hospital, Ha Noi, Vietnam; 4Cho Ray Hospital, Ho Chi Minh, Vietnam; 5University of Tokyo Hospital, Tokyo, JapanPurpose: Beta2-microglobulin (β2-M) is recognized as a surrogate marker relating to the mechanisms of dialysis-associated amyloidosis. Few studies have evaluated the association of serum β2-M with clinical outcome in hemodialysis patients using high-flux type. However, study on patients using low-flux dialyzer reuse has not been done yet.Patients and methods: Using serum β2-M level on predicting long-term mortality of hemodialysis patients was examined in 326 prevalent hemodialysis patients (45.59±14.46 years, hemodialysis duration of 47.5 (26–79) months, 186 males and 140 females). The patients were divided into 3 groups with equal number of patients, according to their serum β2-M levels: group A (n=109, serum β2-M concentration ≤55.7 mg/L), group B (n=109, serum β2-M level from 55.8 mg/L to 75.4 mg/L) and group C (n=108, serum β2-M concentration >75.4 mg/L).Results: During the follow-up period of 5 years, there were 75 all-cause deaths (23.0%). Kaplan–Meier analysis revealed that all-cause mortality in the higher β2-M group was significantly higher compared to that in the lower β2-M groups (p

Objectives: To assess the folate and vitamin B12 status of a group of Vietnamese women of reproductive age and to estimate the rate of neural tube defects (NTD) based on red blood cell (RBC) folate concentrations.Design and Subjects: A representative sample of non-pregnant women (15-49 years) living in Hanoi City (n 244) and Hai Duong Province (n 245).Measures: RBC folate, plasma vitamin B12 and plasma holo-transcobalamin (holoTC), a sensitive indicator of vitamin B12 status.Results: Mean (95% CI) concentrations of RBC folate, plasma B12 and plasma holoTC were 856 (837, 876) nmol/l, 494 (475, 513) pmol/l and 78 (74, 82) pmol/l, respectively. Only 3% and 4% of women had plasma B12 and holoTC concentrations indicative of deficiency. No woman had an RBC folate concentration indicative of deficiency (<317 nmol/l). Only 47% of women had an RBC folate concentration > or = 905 nmol/l. Accordingly, we predict the NTD rate in these regions of Vietnam to be 14.7 (14.2, 15.1) per 10,000 pregnancies.Conclusion: There was no evidence of folate and vitamin B12 deficiency among this population of Vietnamese women. However, suboptimal folate status may be placing three out of five women at increased risk of NTD. Reductions in NTD rates are still possible and women would benefit from additional folic acid during the periconceptional period from either supplements or fortified foods. [ABSTRACT FROM AUTHOR]

A prospective study to investigate first aid and initial management for 247 paediatric burn patients from 1 June, 2004 to 31 June, 2006 at the Burn Intensive Care Unit, National Institute of Burns (NIB), Hanoi. Data were collected from documents from referring hospitals and direct interview of patients, relative and transport team as guided by the International Society for Burn Injury (ISBI) and the World Health Organization (WHO). Results showed that cooling the burn surface by cold water was applied in 27.17%. Among 132 patients transferred from other hospitals, fluid resuscitation was given in 102 patients (77.28%) before transferring and over a half of these patients were not given intravenous fluid during the time of transfer, especially for children under 1 year of age (p<0.05). Dressings were applied in 36.36% of transferred patients. Burn surface area was accurately diagnosed in only 21.90% of total cases. In conclusion, first aid and initial management in Vietnam are still far from ideal. Further public education and continuing medical education should be applied in Vietnam. [ABSTRACT FROM AUTHOR]

Background: Tuberculous meningitis kills or disables more than half of those affected with the disease. Previous studies have been too small to determine whether adjunctive treatment with corticosteroids can reduce the risk of disability or death among adults with tuberculous meningitis, and the effect of coinfection with the human immunodeficiency virus (HIV) is unclear.Methods: We performed a randomized, double-blind, placebo-controlled trial in Vietnam in patients over 14 years of age who had tuberculous meningitis, with or without HIV infection, to determine whether adjunctive treatment with dexamethasone reduced the risk of death or severe disability after nine months of follow-up. We conducted prespecified subgroup analyses and intention-to-treat analyses.Results: A total of 545 patients were randomly assigned to groups that received either dexamethasone (274 patients) or placebo (271 patients). Only 10 patients (1.8 percent) had been lost to follow-up at nine months of treatment. Treatment with dexamethasone was associated with a reduced risk of death (relative risk, 0.69; 95 percent confidence interval, 0.52 to 0.92; P=0.01). It was not associated with a significant reduction in the proportion of severely disabled patients (34 of 187 patients [18.2 percent] among survivors in the dexamethasone group vs. 22 of 159 patients [13.8 percent] in the placebo group, P=0.27) or in the proportion of patients who had either died or were severely disabled after nine months (odds ratio, 0.81; 95 percent confidence interval, 0.58 to 1.13; P=0.22). The treatment effect was consistent across subgroups that were defined by disease-severity grade (stratified relative risk of death, 0.68; 95 percent confidence interval, 0.52 to 0.91; P=0.007) and by HIV status (stratified relative risk of death, 0.78; 95 percent confidence interval, 0.59 to 1.04; P=0.08). Significantly fewer serious adverse events occurred in the dexamethasone group than in the placebo group (26 of 274 patients vs. 45 of 271 patients, P=0.02).Conclusions: Adjunctive treatment with dexamethasone improves survival in patients over 14 years of age with tuberculous meningitis but probably does not prevent severe disability. [ABSTRACT FROM AUTHOR]

Background: Southeast Asia has the most resistant malaria parasites in the world, which severely limits treatment options. There is general acceptance that to combat resistance, combinations of antimalarial drugs that include an artemisinin derivative should be used, and, if possible, these should be formulated in a single tablet.Methods: We did a pilot randomised study in a tertiary referral hospital in Vietnam to compare the efficacy of 3-day regimens of dihydroartemisinin-trimethoprim-piperaquine (DHA-TP total dose 4.8/13.6/48 mg/kg, respectively) with the standard antimalarial regimen in Vietnam, artesunate-mefloquine (A3M total dose 12/25 mg/kg, respectively) in non-immune patients with uncomplicated Plasmodium falciparum malaria. 114 patients were randomised, 76 to DHA-TP and 38 to A3M. The subsequent open randomised trial at a Provincial Health Station compared DHA-TP, dihydroartemisinin-piperaquine, and A3M in 400 patients. In both studies all patients received directly observed therapy and were followed up for 56 days. The primary endpoint was reappearance of P falciparum malaria within 56 days of treatment. Analysis was by intention to treat.Findings: The 56-day cure rate in the pilot study, adjusted for reinfections identified by PCR genotyping, was 97.4% (74/76) in the DHA-TP group and 100% (38/38) in the A3M group. In the second study, cure rates were similar in the three groups; DHA-TP 97.4% (153/157), dihydroartemisinin-piperaquine 98.7% (164/166), and A3M 98.7% (76/77). The DHA-TP and dihydroartemisinin-piperaquine regimens were well tolerated; fewer than 3% of patients had side-effects that might have been related to treatment, compared with 16% of A3M patients (p<0.001). No patients were lost to follow-up.Interpretation: Dihydroartemisinin-piperaquine is an inexpensive, safe, highly efficacious fixed-dose antimalarial combination treatment that could make an important contribution to the control of multidrug-resistant falciparum malaria. [ABSTRACT FROM AUTHOR]

We studied a community cluster of 25 mpox cases in Vietnam caused by emerging monkeypox virus sublineage C.1 and imported into Vietnam through 2 independent events; 1 major cluster carried a novel APOBEC3-like mutation. Three patients died; all had advanced HIV co-infection. Viral evolution and its potential consequences should be closely monitored.

Objectives: We studied the immunogenicity after primary and booster vaccinations of the Abdala COVID-19 vaccine, a receptor-binding domain protein subunit vaccine, in Vietnamese people by determining the level of neutralization and cross-neutralization activities against the ancestral SARS-CoV-2 and its variants and SARS-CoV-1., Methods: We performed a prospective observational study, enrolling adults aged 19-59 years in Dong Thap province, southern Vietnam, and collected blood samples from baseline until 4 weeks after the booster dose. We measured anti-nucleocapsid, anti-spike, and neutralizing antibodies against SARS-CoV-2 and assessed the cross-neutralization against 14 SARS-CoV-2 variants and SARS-CoV-1. Complementary antibody data came from Vietnamese health care workers fully vaccinated with ChAdOx1-S., Results: After primary vaccination, anti-spike antibody and neutralizing antibodies were detectable in 98.4% and 87% of 251 study participants, respectively, with neutralizing antibody titers similar to that induced by ChAdOx1-S vaccine. Antibody responses after a homologous (Abdala COVID-19) or heterologous (messenger RNA BNT162b2) booster could neutralize 14 SARS-CoV-2 variants (including Omicron) and SARS-CoV-1., Conclusions: Abdala COVID-19 vaccine is immunogenic in Vietnamese people. Enhanced antibody response after a booster dose could cross-neutralize 14 SARS-CoV-2 variants and SARS-CoV-1. Our results have added to the growing body of knowledge about the contribution of protein subunit vaccine platforms to pandemic control., Competing Interests: Declarations of competing interest The authors have no competing interests to declare., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The integration of artificial intelligence (AI) into healthcare systems within low-middle income countries (LMICs) has emerged as a central focus for various initiatives aiming to improve healthcare access and delivery quality. In contrast to high-income countries (HICs), which often possess the resources and infrastructure to adopt innovative healthcare technologies, LMICs confront resource limitations such as insufficient funding, outdated infrastructure, limited digital data, and a shortage of technical expertise. Consequently, many algorithms initially trained on data from non-LMIC settings are now being employed in LMIC contexts. However, the effectiveness of these systems in LMICs can be compromised when the unique local contexts and requirements are not adequately considered. In this study, we evaluate the feasibility of utilizing models developed in the United Kingdom (a HIC) within hospitals in Vietnam (a LMIC). Consequently, we present and discuss practical methodologies aimed at improving model performance, emphasizing the critical importance of tailoring solutions to the distinct healthcare systems found in LMICs. Our findings emphasize the necessity for collaborative initiatives and solutions that are sensitive to the local context in order to effectively tackle the healthcare challenges that are unique to these regions., (© 2024. The Author(s).)

(1) Background: Atrial fibrillation (AF) poses a growing cardiovascular challenge globally, with significant implications in Vietnam. This study aimed to investigate the impact of AF on ischemic stroke/transient ischemic attack (TIA) and clinical outcomes, as well as the utilization of oral anticoagulation (OAC) therapy in Vietnam. (2) Methods: Data from the Registry of Stroke Care Quality (RES-Q) across 66 hospitals in Vietnam between 2017 and 2023 were utilized. Patients diagnosed with ischemic stroke or TIA were included, and clinical characteristics, pre- and post-hospitalization medication, and hospitalized outcomes were examined. (3) Results: Of 94,144 patients, 15.1% had AF. Patients with AF were older and had a higher prevalence of heart failure and more severe strokes. AF was associated with increased mortality during hospitalization and a poorer prognosis. In AF patients, anticoagulation therapy utilization increased from 15.8% pre-hospitalization to 82.4% at discharge, with a preference for direct oral anticoagulants. (4) Conclusions: AF significantly impacts ischemic stroke/TIA outcomes in Vietnam. Pre-hospitalization and anticoagulation therapy utilization were low but improved at discharge. These findings emphasize the need for improved AF management and stroke prevention strategies in developing countries.

CuCoFe-LDO/BCD was successfully synthesized from CuCoFe-LDH and biochar derived from durian shell (BCD). Ciprofloxacin (CFX) degraded more than 95% mainly by O 2 •- and 1 O 2 in CuCoFe-LDO/BCD(2/1)/PMS system within 10 min with a rate constant of 0.255 min -1 , which was 14.35 and 2.66 times higher than those in BCD/PMS and CuCoFe-LDO/PMS systems, respectively. The catalytic system exhibited good performance over a wide pH range (3-9) and high degradation efficiency of other antibiotics. Built-in electric field (BIEF) driven by large difference in the work function/Fermi level ratio between CuCoFe-LDO and BCD accelerated continuous electron transfer from CuCoFe-LDO to BCD to result in two different microenvironments with opposite charges at the interface, which enhanced PMS adsorption and activation via different directions. As a non-radical, 1 O 2 was mainly generated via PMS activation by C=O in BCD. The presence of C=O in BCD resulted in an increase in atomic charge of C in C=O and redistributed the charge density of other C atoms. As a result, strong adsorption of PMS at C atom in C=O and other C with a high positive charge was favorable for 1 O 2 generation, whereas an enhanced adsorption of PMS at negatively charged C accounted for the generation of • OH and SO 4 •- . After adsorption, electrons in C of BCD became deficient and were fulfilled with those transferred from CuCoFe-LDO driven by BIEF, which ensured the high catalytic activity of CuCoFe-LDO/BCD. O 2 •- , on the other hand, was generated via several pathways that involved in the transformation of • OH and SO 4 •- originated from PMS activation by the transition of metal species in CuCoFe-LDO and negatively charged C in BCD. This study proposed a new idea of fabricating a low-cost metal-LDH and biomass-derived catalyst with a strong synergistic effect induced by BIEF for enhancing PMS activation and antibiotic degradation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Collaborative efforts in artificial intelligence (AI) are increasingly common between high-income countries (HICs) and low- to middle-income countries (LMICs). Given the resource limitations often encountered by LMICs, collaboration becomes crucial for pooling resources, expertise, and knowledge. Despite the apparent advantages, ensuring the fairness and equity of these collaborative models is essential, especially considering the distinct differences between LMIC and HIC hospitals. In this study, we show that collaborative AI approaches can lead to divergent performance outcomes across HIC and LMIC settings, particularly in the presence of data imbalances. Through a real-world COVID-19 screening case study, we demonstrate that implementing algorithmic-level bias mitigation methods significantly improves outcome fairness between HIC and LMIC sites while maintaining high diagnostic sensitivity. We compare our results against previous benchmarks, utilizing datasets from four independent United Kingdom Hospitals and one Vietnamese hospital, representing HIC and LMIC settings, respectively., (© 2024. The Author(s).)

In this study, CoCr layered double hydroxide material (CoCr-LDH) was prepared and used as an effective catalyst for peroxymonosulfate (PMS) activation to degrade organics in water. The prepared CoCr-LDH material had a crystalline structure and relatively porous structure, as determined by various surface analyses. In Rhodamine B (RhB) removal, the most outstanding PMS activation ability belongs to the material with a Co:Cr molar ratio of 2:1. The removal of RhB follows pseudo-first-order kinetics (R 2 > 0.99) with an activation energy of 38.23 kJ/mol and efficiency of 98% after 7 min of treatment, and the total organic carbon of the solution reduced 47.2% after 10 min. The activation and oxidation mechanisms were proposed and the RhB degradation pathways were suggested with the key contribution of O 2 •- and 1 O 2 . Notably, CoCr-LDH can activate PMS over a wide pH range of 4 - 9, and apply to a wide range of organic pollutants and aqueous environments. The material has high stability and good recovery, which can be reused for 5 cycles with a stable efficiency of above 88%, suggesting a high potential for practical recalcitrant water treatment via PMS activation by heterogeneous catalysts., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Phytochemical study on the rhizomes of Kaempferia parviflora led to the isolation of twenty-three compounds including six phenolic glycosides ( 1 - 6 ), thirteen flavones ( 7 - 19 ), and five phenolic compounds ( 20 - 23 ). Of these, the new compounds were determined to be 2,4-dihydroxy-6-methoxyacetophenone-2 -β- D-apiofuranosyl-(1→6) -β- D-glucopyranoside ( 1 ), 2-hydroxy-4-propionyl-phenyl O-β- D-glucopyranoside ( 2 ), and 4-hydroxy-3,5-dimethoxyacetophenone 8- O-α- L-rhamnopyranosyl-(1→6) -β- D-glucopyranoside ( 3 ) and named as kaempanosides A-C, respectively. Their chemical structures were established based on HR-ESI-MS, 1D and 2D NMR spectra. All compounds 1 - 23 exhibited acetylcholinesterase inhibitory activity with IC 50 values ranging from 57.76 to 253.31 µM.

We report on a 2023 outbreak of severe hand, foot, and mouth disease in southern Vietnam caused by an emerging lineage of enterovirus A71 subgenogroup B5. Affected children were significantly older than those reported during previous outbreaks. The virus should be closely monitored to assess its potential for global dispersal.

Background: The early establishment of prophylaxis and immediate administration of anticoagulant therapy upon the diagnosis of venous thromboembolism should be the treatment objectives in these patients., Objective: The study aimed to determine the optimal cut-off point of Calprotectin, IL-6 (interleukin-6), CRP (C reactive protein) to differentiate UC, IBS-D., Methods: A cross-sectional descriptive study of 335 individuals ≥15 years old was performed, including 31 healthy controls, 215 with IBS-D, 71 diagnosed with UC, and 18 diagnosed with CD. Receiver Operating Characteristics (ROC), sensitivity, specificity, and area under curve (AUC) were computed., Results: The results showed that the median value of calprotectin (IQR) in healthy participants was 20.0 (6.0 - 34.0) µg/g; 17,7 (8,7-38,9) µg/g in IBS-D group; 1710.0 (588 - 4260,0) µg/g in UC group; and 560.5 (177.8 - 1210.0) µg/g in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of CRP (range IQR) was 1,3 (0,9 - 2,3) mg/L in IBS-D group; 7.0 (2.4 -16.6) mg/L in UC group; and 10.1 (2.2 - 42.5) mg/L in CD group. CRP concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of IL-6 (range IQR) was 2.3 (1.6 - 5.7) pg/mL in IBS-D group; 16.8 (9.4 - 47.0) pg/mL in UC group; and 9.4 (7.9 - 11.0) pg/mL in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The optimal cut-off point of calprotectin that differentiated IBS-D from IBD was 110.5 µg/g, with sensitivity and specificity of 93.3% and 91.4%, respectively; of IL-6 was 7.2 pg/mL with sensitivity and specificity of 92.0% and 78.0%, respectively; of CRP of 2.4 mg/L had specific sensitivities of 83.3% and 86.0%, respectively., Conclusion: The Calprotectin immunoassay has the best value in discriminating between IBD and IBS-D., Competing Interests: There are no conflicts of interest., (© 2024 Bui-Thi Thu Huong,, Nguyen Minh Hien, Nguyen Tien Dung*, Dao Minh Quang, Nguyen Thanh Vinh, Tran Thanh Tu, Tran Khanh Chi, Le-Thi Bich Phuong, Nguyen-Thi Nhan.)

(1) Background: Although the important role of dietary energy intake in regulating both cancer progression and host immunity has been widely recognized, it remains unclear whether dietary calorie restriction (CR) has any impact on anti-tumor immune responses. (2) Methods: Using an immunogenic B16 melanoma cell expressing ovalbumin (B16-OVA), we examined the effect of the CR diet on B16-OVA tumor growth and host immune responses. To further test whether the CR diet affects the efficacy of cancer immunotherapy, we examined the effect of CR against anti-PD-1 monoclonal antibody (anti-PD-1 Ab) treatment. (3) Results: The CR diet significantly slowed down the tumor growth of B16-OVA without affecting both CD4 + and CD8 + T cell infiltration into the tumor. Although in vivo depletion of CD8 + T cells facilitated B16-OVA tumor growth in the control diet group, there was no significant change in the tumor growth in the CR diet group with or without CD8 + T cell-depletion. Anti-PD-1 Ab treatment lost its efficacy to suppress tumor growth along with the activation and metabolic shift of CD8 + T cells under CR condition. (4) Conclusions: Our present results suggest that a physical condition restricted in energy intake in cancer patients may impair CD8 + T cell immune surveillance and the efficacy of immunotherapy.

CuO/ZnO nanocomposites with different components can overcome the drawbacks of previously used photocatalysts owing to their promotion in charge separation and transportation, light absorption, and the photo-oxidation of dyes. In this study, CuO nanoplates were synthesized by the hydrothermal method, while ZnO nanoparticles were fabricated by the precipitation method. A series of CuO/ZnO nanocomposites with different ZnO-to-CuO weight ratios, namely, 2 : 8, 4 : 6, 5 : 5, 6 : 4, and 8 : 2 were obtained via a mixing process. X-ray diffraction patterns confirmed the presence of hexagonal wurtzite ZnO and monoclinic CuO in the synthesized CuO/ZnO nanocomposites. Scanning electron microscopy showed the dispersion of ZnO nanoparticles on the surface of CuO nanoplates. Ultraviolet-visible absorption spectra exhibited a slight red-shift in the absorption edge of binary oxides relative to pure ZnO or CuO. All samples were employed for the photocatalytic degradation of methylene blue (MB) under visible light irradiation. The composite samples exhibited enhanced photocatalytic performance compared with pristine CuO or ZnO. This study aimed to examine the effect of the ZnO-to-CuO weight ratio on their photocatalytic performance. The results indicated that among all the synthesized nanocomposites and pristine oxides, the nanocomposite with ZnO and CuO in a proportion of 4 : 6 shows the highest photodegradation activity for the removal of MB with 93% MB photodegraded within 60 min at an initial MB concentration of 5 ppm. The photocatalytic kinetic data were described well by the pseudo-first-order model with a high correlation coefficient of 0.95. The photocatalytic mechanism of the mixed metal oxide was proposed and discussed in detail. The photodegradation characteristic of CuO/ZnO nanostructures is valuable for methylene blue degradation from aqueous solutions as well as environmental purification in various fields., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)

Background: Stroke recurrence and disability are important challenges to overcome in patients with minor ischemic stroke. The aim of our study was to determine the factors associated with unfavorable outcomes in patients with minor ischemic stroke., Methods: This was a prospective cohort study including patients with minor ischemic stroke with a National Institutes of Health Stroke Scale (NIHSS) score ≤ 4 who were treated at the Bach Mai Hospital stroke center from June 15, 2021, to September 15, 2022. Unfavorable outcome was defined as mRS 2-6 at 90 days. Multivariable logistic regression analysis was conducted to assess risk factors related to clinical outcomes., Results: Of 678 patients presenting with minor ischemic stroke, there were 90 (13.3%, 90/678) patients with no intracranial artery imaging. Hence, 588 were patients analyzed, of whom 6.0% received thrombolytic therapy, 8.5% developed NIHSS > 4 in 24 hours, and 30.4% had intracranial stenosis > 50%. Compared with the group of unfavorable outcomes, the favorable outcome group had more NIHSS 0-1 (29.9% vs.8.7%, P<0.001), lower cardioembolic (3.2% vs.7.9%, P=0.021), low IV-tPA ratio (4.8% vs.10.3%, P=0.019), lower NIHSS progression > 4 in the first 24 hours (3.9% vs.25.4%, P<0.001), and lower ICAS rate (28.1% vs.38.9%, P=0.02). Multivariable regression analysis of factors affecting unfavorable outcomes included baseline NIHSS 2-4 (OR, 3.85; 95% CI, 1.97-7.52), NIHSS progression > 4 (OR, 7.57; 95% CI, 3.80-15.10), and ICAS (OR 1.68; 95%CI, 1.07-2.64)., Conclusions: In patients with minor ischemic stroke, unfavorable outcomes were associated with baseline NIHSS 2-4, NIHSS progression > 4 points in 24 hours, and ICAS. These factors may identify a patient population in need of close monitoring and at higher risk of adverse outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

A comprehensive research of the polycyclic aromatic hydrocarbons (PAHs) emission from domestic waste incinerators in northern areas of Vietnam, were investigated. Sixty-four samples from two domestic waste incinerators were collected and analyzed for PAHs. The PAHs concentrations in the samples were determined using gas chromatography coupled with mass spectrometry. In April, June, September, and November 2021, Σ 16 PAHs mean concentrations in chimney air samples were 970.9 ± 57.4, 1061.9 ± 49.8, 1070.7 ± 41.3 and 1136.1 ± 136.5 µg m -3 , respectively. The mean emission factors of Σ 16 PAHs were 7.5 mg/kg. The mean percentages of low molecular weight PAHs were predominant in the analyzed air samples. The toxic equivalent quotient of samples ranged from 30.7 to 41.7 mg/kg, whereas the incremental lifetime cancer risk exceeded 10 - 3 . This results implied a high level of concern with potentially negative health consequences. The four diagnostic ratios of PAHs were found and can be used for identification of sources markers from domestic waste incinerators., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Patients with severe COVID-19 disease require monitoring with pulse oximetry as a minimal requirement. In many low- and middle- income countries, this has been challenging due to lack of staff and equipment. Wearable pulse oximeters potentially offer an attractive means to address this need, due to their low cost, battery operability and capacity for remote monitoring. Between July and October 2021, Ho Chi Minh City experienced its first major wave of SARS-CoV-2 infection, leading to an unprecedented demand for monitoring in hospitalized patients. We assess the feasibility of a continuous remote monitoring system for patients with COVID-19 under these circumstances as we implemented 2 different systems using wearable pulse oximeter devices in a stepwise manner across 4 departments., Competing Interests: Competing interests: CLT PNQK, PTHN, HMTV, HCH, PAL, JM are recipients of Wellcome Trust funding investigating wearable devices (217650/Z/19/Z) for ICU care and CLT for subsequent development of the monitoring platform Wellcome Trust 225437/Z/22/Z, (Copyright: © 2023 Chau NVV et al.)

Background: There is limited data on antibiotic treatment in hospitalized neonates in low- and middle-income countries (LMICs). We aimed to describe patterns of antibiotic use, pathogens, and clinical outcomes, and to develop a severity score predicting mortality in neonatal sepsis to inform future clinical trial design., Methods and Findings: Hospitalized infants <60 days with clinical sepsis were enrolled during 2018 to 2020 by 19 sites in 11 countries (mainly Asia and Africa). Prospective daily observational data was collected on clinical signs, supportive care, antibiotic treatment, microbiology, and 28-day mortality. Two prediction models were developed for (1) 28-day mortality from baseline variables (baseline NeoSep Severity Score); and (2) daily risk of death on IV antibiotics from daily updated assessments (NeoSep Recovery Score). Multivariable Cox regression models included a randomly selected 85% of infants, with 15% for validation. A total of 3,204 infants were enrolled, with median birth weight of 2,500 g (IQR 1,400 to 3,000) and postnatal age of 5 days (IQR 1 to 15). 206 different empiric antibiotic combinations were started in 3,141 infants, which were structured into 5 groups based on the World Health Organization (WHO) AWaRe classification. Approximately 25.9% (n = 814) of infants started WHO first line regimens (Group 1-Access) and 13.8% (n = 432) started WHO second-line cephalosporins (cefotaxime/ceftriaxone) (Group 2-"Low" Watch). The largest group (34.0%, n = 1,068) started a regimen providing partial extended-spectrum beta-lactamase (ESBL)/pseudomonal coverage (piperacillin-tazobactam, ceftazidime, or fluoroquinolone-based) (Group 3-"Medium" Watch), 18.0% (n = 566) started a carbapenem (Group 4-"High" Watch), and 1.8% (n = 57) a Reserve antibiotic (Group 5, largely colistin-based), and 728/2,880 (25.3%) of initial regimens in Groups 1 to 4 were escalated, mainly to carbapenems, usually for clinical deterioration (n = 480; 65.9%). A total of 564/3,195 infants (17.7%) were blood culture pathogen positive, of whom 62.9% (n = 355) had a gram-negative organism, predominantly Klebsiella pneumoniae (n = 132) or Acinetobacter spp. (n = 72). Both were commonly resistant to WHO-recommended regimens and to carbapenems in 43 (32.6%) and 50 (71.4%) of cases, respectively. MRSA accounted for 33 (61.1%) of 54 Staphylococcus aureus isolates. Overall, 350/3,204 infants died (11.3%; 95% CI 10.2% to 12.5%), 17.7% if blood cultures were positive for pathogens (95% CI 14.7% to 21.1%, n = 99/564). A baseline NeoSep Severity Score had a C-index of 0.76 (0.69 to 0.82) in the validation sample, with mortality of 1.6% (3/189; 95% CI: 0.5% to 4.6%), 11.0% (27/245; 7.7% to 15.6%), and 27.3% (12/44; 16.3% to 41.8%) in low (score 0 to 4), medium (5 to 8), and high (9 to 16) risk groups, respectively, with similar performance across subgroups. A related NeoSep Recovery Score had an area under the receiver operating curve for predicting death the next day between 0.8 and 0.9 over the first week. There was significant variation in outcomes between sites and external validation would strengthen score applicability., Conclusion: Antibiotic regimens used in neonatal sepsis commonly diverge from WHO guidelines, and trials of novel empiric regimens are urgently needed in the context of increasing antimicrobial resistance (AMR). The baseline NeoSep Severity Score identifies high mortality risk criteria for trial entry, while the NeoSep Recovery Score can help guide decisions on regimen change. NeoOBS data informed the NeoSep1 antibiotic trial (ISRCTN48721236), which aims to identify novel first- and second-line empiric antibiotic regimens for neonatal sepsis., Trial Registration: ClinicalTrials.gov, (NCT03721302)., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Members of the funder (MB, NK, SE) participated as authors on the study, reviewed the manuscript, and approved the final manuscript as submitted. All other authors have declared that no competing interests exist., (Copyright: © 2023 Russell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The aims of this study were to describe and evaluate the effectiveness of combined flaps, a modification of the Nagata technique, for providing a reasonable projection for reconstructed auricles., Methods: The authors modified the Nagata method for covering the cartilage block by introducing a new combined flap technique, including the temporoparietal skin flap and retroauricular flap. The authors compared the shape, size, and position of the reconstructed ear to the opposite ear, and we evaluated postoperative complications and patient satisfaction levels. They verified the effectiveness of the combined flap by assessing flap necrosis, skin color, thickness, hair in the auricular area, and scars., Results: A total of 38 consecutive patients (39 ears) with microtia, aged 6 to 34 years, underwent reconstruction using the modified method and were followed up for 33.6 months on average. The reconstructed auricle's shape was well defined, with 41.0% having good and 15.4% having excellent results. Most cases achieved good and acceptable levels in size, position, medial longitudinal axis angle, and auriculocephalic angles, and 79.9% of patients/their families were satisfied. The authors observed no cases of flap necrosis or hypertrophic scarring, and there were low rates of flap complications, such as unmatched skin color (7.7%), unacceptable thickness (5.1%), or hair and stretch marks (10.3%)., Conclusions: The modified method's reconstructed ear achieved stable projection, symmetric appearance, and obvious anatomical landmarks with high patient satisfaction. The combined flap method showed certain advantages: high survival rate, less skin contrast, no hypertrophic scars, and fewer complications., Clinical Question/level of Evidence: Therapeutic, IV., (Copyright © 2022 by the American Society of Plastic Surgeons.)

We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions.

Microplastics (MPs) are increasingly being studied because they have become ubiquitous in aquatic and terrestrial environments. However, little is known about the negative effects of co-contamination by polypropylene microplastic (PP MPs) and heavy metal mixtures on terrestrial environment and biota. This study assessed the adverse effects of co-exposure to PP MPs and heavy metal mixture (Cu 2+ , Cr 6+ , and Zn 2+ ) on soil quality and the earthworm Eisenia fetida. Soil samples were collected in the Dong Cao catchment, near Hanoi, Vietnam, and analyzed for changes in extracellular enzyme activity and carbon, nitrogen, and phosphorus availability in the soil. We determined the survival rate of earthworms Eisenia fetida that had ingested MPs and two doses of heavy metals (the environmental level - 1 × - and its double - 2 ×). Earthworm ingestion rates were not significantly impacted by the exposure conditions, but the mortality rate for the 2 × exposure conditions was 100%. Metal-associated PP MPs stimulated the activities of β-glucosidase, β-N-acetyl glucosaminidase, and phosphatase enzymes in soil. Principle component analysis showed that these enzymes were positively correlated with Cu 2+ and Cr 6+ concentrations, but negatively correlated with microbial activity. Zn 2+ showed no correlation with soil extracellular enzyme activity or soil microbial activity. Our results showed that co-exposure of earthworms to MPs and heavy metals had no impact on soil nitrogen and phosphorus but caused a decrease in total soil carbon content, with a possible associated risk of increased CO 2 emissions., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The trend of the treatment of solid domestic waste by the domestic waste incinerator system is an option to improve waste management and to reduce the negative impacts on the environment and human health. Benzene, toluene, ethylbenzene, and xylenes (o-, m- and p-) (BTEX) are toxic chemical environmental contaminants that are released from different sources such as the domestic waste incinerator system. To determine the concentration of BTEX in the ambient air from these incinerator areas, the research team conducted four sampling campaigns in April, June, September, and November 2021, with a total of 80 samples collected. Concentrations of benzene, toluene, (m,p)-xylenes, o- xylenes and ethylbenzene ranged from 4.53 to 36.75 µg/m 3 , from 16.29 µg/m 3 to 125.36 µg/m 3 , from 2.82 µg/m 3 to 31.45 µg/m 3 , from 1.42 µg/m 3 to 25.61 µg/m 3 , from 1.32 µg/m 3 to 10.79 µg/m 3 , respectively. As a result of the risk assessment, it was determined that the incinerator's exhaust gas caused secondary environmental damage, impacting the health of not only workers but also people living in nearby communities. On that basis, the article recommends applying a number of management measures to minimize the negative impacts of the operation of the solid waste incinerator on the environment and the health of the workers operating the incinerator., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Mpox was diagnosed in 2 women returning to Vietnam from the United Arab Emirates. The monkeypox viruses belonged to an emerging sublineage, A.2.1, distinct from B.1, which is responsible for the ongoing multicountry outbreak. Women could contribute to mpox transmission, and enhanced genomic surveillance is needed to clarify pathogen evolution.

Purpose: The purpose of this study was to develop a semi-supervised segmentation and classification deep learning model for the diagnosis of anterior cruciate ligament (ACL) tears on MRI based on a semi-supervised framework, double-linear layers U-Net (DCLU-Net)., Materials and Methods: A total of 297 participants who underwent of total of 303 MRI examination of the knee with fat-saturated proton density (PD) fast spin-echo (FSE) sequence in the sagittal plane were included. There were 214 men and 83 women, with a mean age of 37.46 ± 1.40 (standard deviation) years (range: 29-44 years). Of these, 107 participants had intact ACL (36%), 98 had partially torn ACL (33%), and 92 had fully ruptured ACL (31%). The DCLU-Net was combined with radiomic features for enhancing performances in the diagnosis of ACL tear. The different evaluation metrics for both classification (accuracy, sensitivity, accuracy) and segmentation (mean Dice similarity coefficient and root mean square error) were compared individually for each image class across the three phases of the model, with each value being compared to its respective value from the previous phase. Findings at arthroscopic knee surgery were used as the standard of reference., Results: With the addition of radiomic features, the final model yielded accuracies of 90% (95% CI: 83-92), 82% (95% CI: 73-86), and 92% (95% CI: 87-94) for classifying ACL as intact, partially torn and fully ruptured, respectively. The DCLU-Net achieved mean Dice similarity coefficient and root mean square error of 0.78 (95% CI: 0.71-0.80) and 0.05 (95% CI: 0.06-0.07), respectively, when segmenting the three ACL conditions with pseudo data (P < 0.001)., Conclusion: A dual-modules deep learning model with segmentation and classification capabilities was successfully developed. In addition, the use of semi-supervised techniques significantly reduced the amount of manual segmentation data without compromising performance., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)