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Thanh Thao Nguyen, Ngoc Thanh Hoang, Thao Van Nguyen, Hien Thi Ha Department of Radiology, University of Medicine and Pharmacy, Hue University, Hue, VietnamCorrespondence: Thanh Thao Nguyen, Department of Radiology, University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen, Hue, 53000, Vietnam, Email ntthao@hueuni.edu.vnAbstract: Radiologic technology training required a substantial amount of practice. The traditional teaching approach includes in-hospital placement along with theory classes. During the COVID-19 outbreaks, clinical rotations become impossible. Direct contact with patients raises safety concerns for staff and students. The COVID-19 pandemic created unprecedented challenges for medical universities worldwide. We developed in-house simulation software that can be used for training in radiologic technology. Our preliminary results yielded good efficacy of this novel teaching approach in training radiologic technology students.Keywords: radiologic technology, simulation-based training, COVID-19

Xuan Thi Dang,1,2 Thanh Xuan Nguyen,3– 5 Thu Thi Hoai Nguyen,3,4 Hung Tran Ha1,2 1Vietnam Poison Control Center, Bach Mai Hospital, Hanoi, 100000, Vietnam; 2Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam; 3Geriatrics Department, Hanoi Medical University, Hanoi, 100000, Vietnam; 4Scientific Research Department, National Geriatric Hospital, Hanoi, 100000, Vietnam; 5Dinh Tien Hoang Institute of Medicine, Hanoi, 100000, VietnamCorrespondence: Xuan Thi DangVietnam Poison Control Center, Bach Mai Hospital, Hanoi, 100000, VietnamTel +84 912260366Email xuandangthi@bachmai.edu.vnBackground: Snakebite envenoming is a potentially life-threatening condition and causes many serious consequences.Subjects and Methods: Therefore, this study aimed to throw some light on coagulopathy after Viperidae envenomations at Vietnam Poison Control Center and the relationship between coagulopathy and time of admission. A prospective, descriptive study was conducted from October 2016 to April 2018. The survey questionnaire included socio-economic characteristics, characteristics of snakebite, signs and clinical symptoms and blood test. Disseminated intravascular coagulation (DIC) condition was diagnosed using the International Society on Thrombosis and Haemostasis (ISTH) criteria. Rotational thromboelastometry was evaluated using ROTEM® delta system.Results: A total of 41 cases of viper snakebite with the mean age of snakebite victims were 41.27 ± 14.72 years old. Mean hospital stay of the patients was 5.63± 3.29 days. The association between coagulation disorder and clotting time (CT) EXTEM prolonged, CT INTEM prolonged, CT FIBTEM prolonged remained significant (multivariable odds ratio MOR=5.81, 95% CI: 1.20– 28.06; MOR= 9.32, 95% CI: 1.001– 84.48; MOR=5.55, 95% CI: 1.12– 27.50, respectively).Conclusion: This study indicates a hypocoagulation status in ROTEM, elevated international normalised ratio (INR), activated partial thromboplastin time (APTT) and D-dimer, decreased fibrinogen concentration and platelet count following envenoming by Viperidae.Keywords: viper, snakebite, Vietnam, coagulopathy, ROTEM

Background: HIV drug resistance (HIVDR) can reduce the effectiveness of antiretroviral (ARV) drugs in preventing morbidity and mortality, limit options for treatment, and prevention. Our study aimed to assess HIV-1 subtypes and HIVDR among key populations in HIV Sentinel Surveillance Plus Behavior (HSS+) in 2018 and 2020., Methods: One-stage venue-based cluster sampling was used to recruit participants at hotspots identified for Men who have sex with men (MSM) in 7 provinces and SEM females and female sex worker (FSW) in 13 provinces. Participants completed a standard questionnaire about risk and preventive behaviors, and ART history, and provided intravenous blood for HIV testing. HIVDR testing was conducted on HIV-positive samples with VL >1,000 copies/ml., Results: A total of 185/435 (42.5%) HIV-positive samples had viral load ≥1,000 copies/ml, of which 130/136 from MSM and 26/49 from FSW, were successfully sequenced. Six HIV-1 subtypes were detected (CRF01_AE, A, CRF07/08_BC, B, C, CRF25_cpx), with CRF01_AE (82.7%, 129/156) the most common. Drug resistance mutations were detected in 16.7% of participants overall (26/156), in 15.4% (20/130) of MSM, and in 23.1% (6/26) of FSW. Mutations associated with resistance to NNRTI were the most frequently detected (73.1%, 19/26). The high level of resistance was presented in NNRTI and NRTI classes. There are 10 major resistance mutations detected with NRTI (M184VI-25.0%, K65KR-50.0%, Y115F-25%), NNRTI (K103N-21.1%, E138A-10.5%, V106M-5.3%, K101E-5.3%, G190A-5.3%) PI (L33F-40.0%, M46L-20.0%)., Conclusions: Vietnam's HSS+ system identified an emerging strain of HIV-1 and mutations associated with resistance to multiple drug classes among MSM and FSW., Competing Interests: Conflicts of Interest and Source of Funding: The authors declared no potential conflicts of interest concerning the research, authorship, or publication of this article. This study has been supported by the Vietnam National Strategy on Prevention and Control HIV/AIDS, the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC) under the terms of GH001016, and The Global Fund to Fight AIDS, Tuberculosis and Malaria. We also acknowledge the support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH123256. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Novel research on the chemical compositions and biochemical activities of Camellia longii Orel and Luu leaf extracts revealed valuable resources with potential applications in Alzheimer's disease treatment. Qualitative phytochemicals detected various compound groups, including polyphenols, saponins, tannins, flavonoids, alkaloids, amino acids, coumarins, and polysaccharides. HPLC-MS identified 23 compounds in C. longii leaves with compounds found at significant levels, including epicatechin gallate (17.12%), tryptophan (13.73%), isovitexin (12.91%), gallic acid (3.06%), and quercetin (3.06%). Interestingly, the ethanol extract (CLL-Ew) exhibited the highest extraction yield (26.6%) and potent antioxidant and acetylcholinesterase (AChE) inhibitory effects in vitro. In the Drosophila melanogaster model, CLL-Ew improved longevity, movement, and memory by reducing malondialdehyde and increasing glutathione levels. Docking simulations suggested that the above compounds bind tightly to AChE's active site, potentially contributing to memory enhancement. Interestingly, observations of male and female mice after administration of a dose of 5000 mg/kg C. longii leaf extract were recorded normally throughout the 14 day experiment. These findings highlight the potential of C. longii leaf extracts in functional foods and therapeutic interventions for memory impairment prevention and treatment., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Early neurological deterioration (END) is progressive neurological deterioration with an increase in NIHSS score of 2 points or more in the first 72 hours from the onset of acute ischemic stroke. END increases the risk of poor clinical outcomes at day 90 of ischemic stroke. We will study the frequency, predictors, and outcomes of patients with END in a case-control study at a comprehensive stroke centre in Vietnam. of the design is a descriptive observational study, longitudinal follow-up of patients with minor stroke hospitalized at the Stroke Center of Bach Mai Hospital from December 1, 2023, to December 1, 2024. Minor stroke patients characterized by NIHSS score ≤ 5 hospitalized within 24 hours of symptom onset will be recruited. The estimated END rate is about 30%, relative accuracy ε = 0.11, 95% reliability, expected 5% of patients lost data or follow-up, and an estimated sample size of 779 patients. This study will help determine the END rate in patients with minor stroke and related factors, thereby building a prognostic model for END. Our study determined the END rate in patients with minor stroke in Vietnam and also proposed risk factors for minor stroke management and treatment., Competing Interests: NO authors have competing interests., (Copyright: © 2024 Nguyen 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.)

Accumulation of sphingolipids, especially sphingosines, in the lysosomes is a key driver of several lysosomal storage diseases. The transport mechanism for sphingolipids from the lysosome remains unclear. Here, we identified SPNS1, which shares the highest homology to SPNS2, a sphingosine-1-phosphate (S1P) transporter, functions as a transporter for lysolipids from the lysosome. We generated Spns1-KO cells and mice and employed lipidomic and metabolomic approaches to reveal SPNS1 ligand identity. Global KO of Spns1 caused embryonic lethality between E12.5 and E13.5 and an accumulation of sphingosine, lysophosphatidylcholines (LPC), and lysophosphatidylethanolamines (LPE) in the fetal livers. Similarly, metabolomic analysis of livers from postnatal Spns1-KO mice presented an accumulation of sphingosines and lysoglycerophospholipids including LPC and LPE. Subsequently, biochemical assays showed that SPNS1 is required for LPC and sphingosine release from lysosomes. The accumulation of these lysolipids in the lysosomes of Spns1-KO mice affected liver functions and altered the PI3K/AKT signaling pathway. Furthermore, we identified 3 human siblings with a homozygous variant in the SPNS1 gene. These patients suffer from developmental delay, neurological impairment, intellectual disability, and cerebellar hypoplasia. These results reveal a critical role of SPNS1 as a promiscuous lysolipid transporter in the lysosomes and link its physiological functions with lysosomal storage diseases.

Background: Colorectal cancer is one of the leading cancers worldwide and in Vietnam. Adenomas are important precursors of colorectal cancer. Study on the association between sleep duration and development of colorectal adenoma (CRA) is limited, particularly among Vietnamese population., Methods: We conducted an individually matched case-control study of 870 CRA cases and 870 controls in a large-scale colorectal screening program involving 103,542 individuals ages ≥40 years old in Hanoi, Vietnam. Sleep duration was categorized in three groups: short: ≤6 hours/day, normal: 7 to 8 hours/day, and long: >8 hours/day. Conditional logistic regression was used to evaluate the association between sleep duration and adenomas risk after controlling for potential confounders., Results: Overall, short-sleep duration was associated with increased risk of having CRA compared with normal duration [OR, 1.48; 95% confidence interval (CI), 1.12-1.97]. This pattern was present in both females (OR, 1.58; 95% CI, 1.14-2.18) and males (OR, 1.45; 95% CI, 1.08-1.93), with advanced adenomas (OR, 1.61; 95% CI, 1.09-2.38) and non-advanced adenomas (OR, 1.66; 95% CI, 1.19-2.32). Furthermore, the association between CRA development and short-sleep duration was more apparent among females who were nondrinker, nonobese, physically active, with proximal or both sided adenomas and with cardiometabolic disorder. Among males, the short-sleep duration was associated with CRA risk among never-smoking, cardiometabolic disorders, and obese., Conclusions: Short-sleep duration was associated with increased prevalence of both advanced and non-advanced CRAs among Vietnamese population., Impact: Findings from this study showed that maintaining an adequate sleep duration may have an important implication for colorectal adenoma prevention and control., (©2023 American Association for Cancer Research.)

Alginate/lignin is a synthetic polymer rich in biological activity and is of great interest. Alginate is extracted from seaweed and lignin is extracted from corn stalks and leaves. In this paper, antioxidant activities of alginate/lignin were evaluated, such as total antioxidant activity, reducing power activity, DPPH free radical scavenging activity, and α-glucosidase inhibition activity. Anticancer activity was evaluated in three cell lines (Hep G2, MCF-7, and NCI H460) and fibroblast. Physico-chemistry characteristics of alginate/lignin were determined through FTIR, DSC, SEM_EDS, SEM_EDS mapping, XRD, XRF, and 1 H-NMR. The acute toxicity of alginate/lignin was studied on Swiss albino mice. The results demonstrated that alginate/lignin possessed antioxidant activity, such as the total antioxidant activity, and reducing power activity, especially the α-glucosidase inhibition activity, and had no free radical scavenging activity. Alginate/lignin was not typical in cancer cell lines. Alginate/lignin existed in a thermally stable and regular spherical shape in the investigated thermal region. Six metals, three non-metals, and nineteen oxides were detected in alginate/lignin. Some specific functional groups of alginate and lignin did not exist in alginate/lignin crystal. Elements, such as C, O, Na, and S were popular in the alginate/lignin structure. LD 0 and LD 100 of alginate/lignin in mice were 3.91 g/kg and 9.77 g/kg, respectively. Alginate/lignin has potential for applications in pharmaceutical materials, functional foods, and supporting diabetes treatment.

In this study, a new approach of machine learning (ML) models integrated with the analytic hierarchy process (AHP) method was proposed to develop a holistic flood risk assessment map. Flood susceptibility maps were created using ML techniques. AHP was utilized to combine flood vulnerability and exposure criteria. We selected Quang Binh province of Vietnam as a case study and collected available data, including 696 flooding locations of historical flooding events in 2007, 2010, 2016, and 2020; and flood influencing factors of elevation, slope, curvature, flow direction, flow accumulation, distance from river, river density, land cover, geology, and rainfall. These data were used to construct training and testing datasets. The susceptibility models were validated and compared using statistical techniques. An integrated flood risk assessment framework was proposed to incorporate flood hazard (flood susceptibility), flood exposure (distance from river, land use, population density, and rainfall), and flood vulnerability (poverty rate, number of freshwater stations, road density, number of schools, and healthcare facilities). Model validation suggested that deep learning has the best performance of AUC = 0.984 compared with other ensemble models of MultiBoostAB Ensemble (0.958), Random SubSpace Ensemble (0.962), and credal decision tree (AUC = 0.918). The final flood risk map shows 5075 ha (0.63%) in extremely high risk, 47,955 ha (5.95%) in high-risk, 40,460 ha (5.02%) in medium risk, 431,908 ha (53.55%) in low risk areas, and 281,127 ha (34.86%) in very low risk. The present study highlights that the integration of ML models and AHP is a promising framework for mapping flood risks in flood-prone areas., (© 2022 Society for Risk Analysis.)

Background: There is an urgent need to identify biomarkers for advanced adenoma, an important precursor of colorectal cancer (CRC). We aimed to determine alterations in ileal juice bile acids associated with colorectal advanced adenoma., Methods: We quantified a comprehensive panel of primary and secondary bile acids and their conjugates using an ultraperformance liquid chromatography triple-quadrupole mass spectrometric assay in ileal juice collected at colonoscopy from 46 study subjects (i.e., 14 biopsy-confirmed advanced adenomas and 32 controls free of adenoma or cancer). Using analysis of covariance (ANCOVA), we examined the differences in bile acid concentrations by disease status, adjusting for age, sex, body mass index, smoking status and type 2 diabetes., Results: The concentrations of hyodeoxycholic acid (HCA) species in ileal juice of the advanced adenoma patients (geometric mean = 4501.9 nM) were significantly higher than those of controls (geometric mean = 1292.3 nM, p = 0.001). The relative abundance of ursodeoxycholic acid (UDCA) in total bile acids was significantly reduced in cases than controls (0.73% in cases vs. 1.33% in controls; p = 0.046). No significant difference between cases and controls was observed for concentrations of total or specific primary bile acids (i.e., cholic acid (CA), chenodeoxycholic acid (CDCA) and their glycine- and taurine-conjugates) and total and specific major secondary bile acids (i.e., deoxycholic acid and lithocholic acid)., Conclusions: Colorectal advanced adenoma was associated with altered bile acids in ileal juice. The HCA species may promote the development of colorectal advanced adenoma, whereas gut microbiota responsible for the conversion of CDCA to UDCA may protect against it. Our findings have important implications for the use of bile acids as biomarkers in early detection of colorectal cancer.

Background: The field of language teaching and learning has long recognized the role of vocabulary knowledge in all aspects of language proficiency and indicated that vocabulary beliefs and learning strategies play a pivotal role in learners' vocabulary development. As a result, understanding learners' beliefs and strategies in vocabulary learning is of paramount importance to language teachers. The Vocabulary Learning Questionnaire (VLQ) developed by Peter Gu in 2018 could be considered the most recent, validated instrument for the measurement of vocabulary learning beliefs and strategies. However, the VLQ contains too many items and is only available in English. The objectives of the study, therefore, are (1) to develop and validate a Vietnamese version of the VLQ which can exclude construct-irrelevant noises related to L2 comprehension, and (2) to reduce the number of items while retaining the key factors in the instruments., Methods: 722 Vietnamese university students took part in the study. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were examined with the free software Jamovi 2.3.13. Both Cronbach's alpha and McDonald's omega were employed to evaluate the factors' internal consistency., Results: Separate EFAs confirmed the two dimensions of vocabulary beliefs, explaining 62.6% of the total variance, and seven factors of vocabulary strategies, predicting 72.1% of the total variance. CFAs confirmed the hypothesized 9-dimensional structures of different vocabulary learning beliefs and strategies and offer cross-validation evidence for the Vietnamese VLQ. Reliability metrics demonstrated acceptable internal reliability for vocabulary belief and strategy sub-scales., Conclusion: The Vietnamese VLQ provides a validated measure of vocabulary beliefs and strategies. The 30-item version of the Vietnamese VLQ serves as a starting point for future research in the field of vocabulary learning and teaching in Vietnam., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (© 2023 The Authors.)

The vocabulary levels tests (VLT) are very powerful instruments for the measurement of learners' vocabulary knowledge and have been widely used by language teachers in the task of matching learners to their reading materials. However, their accompanying score interpretation methods have not been backed by research and concerns have been raised regarding these scoring methods' appropriateness. The study began by looking at the VLTs and their scoring methods since the day they were born and then went on to investigate potential issues in the scoring methods that have been used together with the VLTs: the cut-off score and vocabulary size score. Tests of receptive vocabulary knowledge and English reading proficiency were administered to 234 university students. Research findings problematized the application of VLTs and cut-off scores on the ranking of large groups of students and supported the use of vocabulary size score as a more suitable method for vocabulary knowledge research. Implications for teaching and learning were also provided., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Background: Colorectal cancer is a leading cancer incidence and cause of death worldwide and in Vietnam. Although screening is considered an effective measure to prevent and control colorectal cancer, there is no such effort in Vietnam., Methods: Between 01 January 2018 and 31 October 2019, a population-based colorectal cancer screening program was conducted in Hanoi, Vietnam. A health advocacy campaign and follow-up phone calls were used to enroll residents aged ≥40 years old to complete an immunochemical-fecal occult blood testing. Positive immunochemical-fecal occult blood testing was followed by a colonoscopy. We also conducted a systematic review of the colorectal cancer screening programs in the Asia-Pacific region that used similar approach by searching Ovid Medline and PubMed databases., Results: During study period, 103 542 individuals among 672 742 eligible residents attended the screening of whom 81.5% participants finished immunochemical-fecal occult blood testing test and the positive rate was 6.1%. The coverage rate for immunochemical-fecal occult blood testing test was 11.9%. Among 2278 individuals who underwent colonoscopy, 3.5% were histologically diagnosed with cancer, 17.8% with advanced adenomas, and 23.1% with non-advanced adenomas. Males had significantly higher detection rate of advanced adenomas, cancer or ≥ two polyps/tumor than females (P < 0.0001). The systematic review showed that in two-step modality (i.e. immunochemical-fecal occult blood testing/fecal immunochemical test and colonoscopy), the test positive was from 4.1 to 10.6%. Once colonoscopy was performed subsequently, the rate of cancer among positive participants was from 1.7 to 16.4% and that of advanced adenomas was from 7.1 to 23.1%., Conclusion: We showed that the two-step modality is a promising strategy for colorectal cancer screening in Vietnam that might apply to similar settings with limited resources., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study presents a study on the influence of nano-SiO 2 on the alkaline resistance of waterborne acrylic coating using some analysis methods such as FT-IR and UV-Vis spectroscopy, combined with FE-SEM analysis and monitoring weight and adhesion changes during exposure to the saturated Ca(OH) 2 alkaline environment. The obtained results indicated that the alkaline resistance of acrylic coating enhanced appreciably when adding 2.5 wt% of nano-SiO 2 . Under the impact of the saturated Ca(OH) 2 solution for 20 days of immersion, nanocomposite coating containing 2.5 wt.% of nano-SiO 2 was only decreased by 3.6% of the weight and 15.4% of the adhesion, while the neat acrylic coating (without nano-SiO 2 ) seriously reduced 25.4% of the weight and 39.1% of the adhesion., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Hoang Thi Huong Thuy et al.)

The present study analyzed the vocabulary profile of the News on the Web (NOW) corpus, which contained 12 billion words from online newspapers and magazines in 20 countries to determine the vocabulary knowledge needed to reasonably understand online newspaper and magazine articles. The results showed that, in general, knowledge of the most frequent 4,000 word families in the British National Corpus/Corpus of Contemporary American English (BNC/COCA) wordlist plus proper nouns, marginal words, transparent compounds and acronyms was necessary to gain 95% coverage for the NOW corpus. However, when it came to the 98% coverage, online newspaper and magazine articles from different countries had relatively distinct lexical demands. In-depth analyses were carried out and the findings offered comprehensive insights into the issue. Implications for teaching and learning were also provided., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ha.)

The article presents a methodological update on the lexical profile of informal spoken English with the emphasis on movies, television programs, and soap operas. The study analyzed Mark Davies's mega-corpora with data containing approximately 625 million words and employed Paul Nation's comprehensive and up-to-date British National Corpus/Corpus of Contemporary American English (BNC/COCA) wordlists. Data from the analyses showed that viewers would need a vocabulary knowledge at 3,000 and 5,000 words frequency levels to understand 95 and 98% of the words in scripted dialogs, respectively. Soap operas were found to be less lexically demanding compared to TV programs and movies. Findings are expected to fill in the methodological gaps between vocabulary assessment and vocabulary profiling research., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ha.)

Carrageenan is an anionic sulfated polysaccharide that accounts for a high content of red seaweed Eucheuma gelatinae . This paper focused on the extraction, optimization, and evaluation of antioxidant activity, rheology characteristics, and physic-chemistry characterization of β-carrageenan from Eucheuma gelatinae . The extraction and the optimization of β-carrageenan were by the maceration-stirred method and the experimental model of Box-Behken. Antioxidant activity was evaluated to be the total antioxidant activity and reducing power activity. The rheology characteristics of carrageenan were measured to be gel strength and viscosity. Physic-chemistry characterization was determined, including the molecular weight, sugar composition, function groups, and crystal structure, through GCP, GC-FID, FTIR, and XRD. The results showed that carrageenan possessed antioxidant activity, had intrinsic viscosity and gel strength, corresponding to 263.02 cps and 487.5 g/cm 2 , respectively. Antioxidant carrageenan is composed of rhamnose, mannose, glucose, fucose, and xylose, with two molecular weight fractions of 2.635 × 10 6 and 2.58 × 10 6 g/mol, respectively. Antioxidant carrageenan did not exist in the crystal. The optimization condition of antioxidant carrageenan extraction was done at 82.35 °C for 115.35 min with a solvent-to-algae ratio of 36.42 ( v / w ). At the optimization condition, the extraction efficiency of carrageenan was predicted to be 87.56 ± 5.61 (%), the total antioxidant activity and reducing power activity were predicted to 71.95 ± 5.32 (mg ascorbic acid equivalent/g DW) and 89.84 ± 5.84 (mg FeSO 4 equivalent/g DW), respectively. Purity carrageenan content got the highest value at 42.68 ± 2.37 (%, DW). Antioxidant carrageenan from Eucheuma gelatinae is of potential use in food and pharmaceuticals.

Local item dependence (LID) is one of the most critical assumption in the Rasch model when it comes to the validity of a test. As the field of vocabulary assessment is calling for more clarity and validity for vocabulary tests, such assumption becomes more important than ever. The article offers a Rasch-based investigation into the issue of LID with the focus on the two popular formats of Vocabulary Levels Tests (VLT): multiple-choice and matching. A Listening Vocabulary Levels Test (LVLT) and an Updated Vocabulary Levels Test (UVLT) were given to a single cohort of 311 university students in an English as a Foreign Language (EFL) context. The analyses of raw score and standardized residuals correlations were conducted. The findings found no relationship between the 4-option, multiple-choice format of the LVLT and item local dependence. However, results from score and standardized residuals correlations analyses showed a strong link between the 3-item-per-cluster, matching format and item local dependence. The study calls for greater attention to the format of future vocabulary tests and support the use of meaning-recall formats in vocabulary testing., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ha.)

Background: A high prevalence of venom-induced consumption coagulopathy has been reported in individuals with viper snakebites. Rotational thromboelastometry (ROTEM) is a rapid technique that could be advantageous in assessing and monitoring coagulation disorders., Purpose: To explore correlations between ROTEM and standard coagulation tests., Patients and Methods: This prospective observational study was performed among 41 patients with viper envenomation admitted to the Vietnam Poison Control Center from April 2016 to October 2017. Standard coagulation measurements [platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen level] and ROTEM indicators [clotting time (CT), amplitude (at set time: 5 and 10 minutes), clot information time (CFT) and maximum clot firmness (MCF) for extrinsic (EXTEM), intrinsic (INTEM), and fibrin based (FIBTEM) ROTEM] were obtained., Results: For INTEM, EXTEM, the FIBTEM, proportions of patients with prolonged CT were 34.1%, 63.4%, and 61.0% respectively and the proportions of patients with decreased MCF were 62.2%, 62.2%, and 35.5%, respectively. Moderate correlations were observed between PT and EXTEM CT (r = 0.627), aPTT and INTEM CT (r = 0.626), fibrinogen and FIBTEM MCF (r = 0.723), and platelet count and EXTEM MCF (0.60)., Conclusion: ROTEM indicated a hypocoagulation state in patients with viper snakebite and was moderately correlated with standard coagulation parameters.

Colorectal cancer is a leading cancer worldwide and in Vietnam. Adenomas (adenomatous polyps) is an important precursor of colorectal cancer. There is currently no study to determine the modifiable risk factors for colorectal adenomas, including body mass index (BMI) in Vietnam. We conducted an individually matched case-control study of 1149 colorectal adenomas and 1145 controls in a large-scale colorectal screening program involving 103 542 individuals aged 40-75 years old in Hanoi, Vietnam. Conditional logistic regression was used to evaluate the association between BMI and colorectal adenomas prevalence, after controlling for potential confounders. Overall, comparing to normal weight (ie, 18.5-22.9 kg/m 2 ), underweight (ie, BMI < 18.5) was associated with a non-statistically significant increased prevalence of colorectal adenomas (odd ratio [OR] = 1.29 and 95% confident interval [CI]: 0.88-1.87). This association became significant among male (OR = 1.98, 95% CI: 1.20-3.27), male who were ever smokers (OR = 2.59, 95% CI: 1.33-5.03), nonregular exercise (OR = 2.44, 95% CI: 1.26-4.73) and individuals with cardiometabolic disorders (OR = 3.46, 95% CI: 1.19-10.00). The association between underweight and colorectal adenomas did not vary by smoking status, drinking status, family history of cancer, adenomas types or cardiometabolic disorders. No association was observed among obese individuals (BMI ≥ 25). In the population with low prevalence of obesity, we found that the association between BMI and colorectal adenomas followed a reversed J-shape that underweight was associated with increased prevalence. Further studies are, therefore, warranted to replicate our results and to investigate the biologic mechanism the effect of underweight on colorectal adenomas prevalence., (© 2021 UICC.)

Coffea arabica sediment, a popular agro-by-product from the coffee juice processing industry, contains many phytochemicals, and it is often discarded as waste. The antioxidant and anti-tyrosinase activities of an ethanol extract and its active fractions obtained from Coffea arabica sediment was studied. Additionally, whiteleg shrimp ( Litopenaeus vannamei ) was treated with the extract and fractions, and the quality during refrigerated storage was evaluated. The most active fraction ( P <0.05) fraction III from the Coffea arabica sediment extract showed a total phenolic content of 116.5 mg gallic acid equivalent/g, an inhibitory concentration of 50% value of 27.3 μg/mL in the 2,2-diphenyl-1-picryl hydrazyl test, an absorbance of 3.7 (at 1.0 μg/mL) in the reducing power assay, and 79.5% inhibition for the tyrosinase inhibition test (at 100 μg/mL). Whiteleg shrimp treated with PD-3 and crude extract (CE) retarded the growth of bacteria and spoilage microor-ganisms in comparison to the control ( P <0.05). Lower values in pH, thiobarbituric acid reactive substances, and total volatile base content were enumerated in samples treated with PD-3 and CE ( P <0.05) compared to controls. Loss in freshness, protein content, and melanosis formation declined with CE and PD-3 treatments. Our findings showed that Coffea arabica sediment has antioxidant and antimicrobial properties. Also, it could be a promising treatment in melanosis prevention, and a natural additive for extending the shelf life of whiteleg shrimp during refrigerated storage; thus an alternative to traditional sulfites., Competing Interests: AUTHOR DISCLOSURE STATEMENT The authors declare no conflict of interest., (Copyright © 2021 by The Korean Society of Food Science and Nutrition. All rights Reserved.)

Nitrous oxide (N 2 O) commonly referred to as laughing gas, has significant medical uses. This study aims to describe the neurological disorders associated with N 2 O. We conducted across-sectional study that enrolled patients with nitrous oxide toxicity admitted to Vietnam Poison Control Center, Bach Mai Hospital, Hanoi, Vietnam from June 2018 to July 2019. The questionnaire included demographic characteristics, characteristics of using N 2 O, signs and clinical symptoms, neuroimaging findings, injury on electromyography (EMG) and the Total Neuropathy Score clinical version (TNSc) criteria. A total of 47 participants were included with mean age: 24.38 ± 6.20 years. The number of balloons used per week was 130.59 ± 117.43. The mean duration of N 2 O exposure was 8.79 ± 7.1 months. Multivariate linear logistic regression revealed that the number of N 2 O balloons used per week was significantly associated with TNSc point (Beta: 0.315; 95% CI: 0.001-0.022). We found that myeloneuropathy and peripheral neuropathy were the main neurological disorders related to N 2 O abuse, which should improve the awareness of the appearance of neurological disorders associated with N 2 O abuse.

This work reveals the As(V) adsorption behaviors onto iron oxide (Fe3O4) nanoparticles modified activated carbon (AC), originally developed from biochar (BC), as a green adsorbent denoted by FAC. Since FAC has abundant surface functional groups and a desired porous structure that is favorable for the removal of As(V) in contaminated water, FAC has greatly enhanced the As(V) adsorption capacity of the original BC. Various methods were employed to characterize the FAC characteristics and adsorption mechanism, including pH pzc determination, BET specific surface area, elemental analysis (EA), and scanning electron microscopy (SEM). Results show that the AC surface was successfully modified by iron oxide nanoparticles, enhancing the porosity and specific surface area of original adsorbent. Batch adsorption tests indicated a well-fitted Langmuir model and pseudo-second-order model for As(V) adsorption. Additionally, the highest adsorption capacity ( Q max  = 32.57 mg/g) by FAC was higher than previously reported literature reviews. Until now, no article was conducted to research the effect of carbon surface chemistry and texture on As removal from waters. It is required to obtain a rational view of optimal conditions to remove As from contaminated water., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2021 Hoang Thu Ha et al.)

Calcium (Ca 2 + ) as a signaling ion and intracellular second messenger plays a crucial role in living organisms for various cellular functions. In the present work, we have designed a novel yellow-fluorescent carbon dots (LERCDs) using lanthanum, ethylenediaminetetraacetic acid (EDTA), and rutin as precursors for the sensing of Ca 2 + ions. In this sense, a combination of hydrothermal and reflux methods was adopted. The as-designed LERCDs display bright yellow color emission in the aqueous solutions with a high quantum yield (23.8%). The LERCDs showed excitation-independent emission property along with magnificent photostability and time stability. The LERCDs show potential fluorescence quenching response towards the Ca 2+ ions in the concentration range of 0-25 μM with a detection limit of 2.19 μM. The LERCDs have studied for extracellular sensing of Ca 2 + ions in both melanoma cell lines (A375) and onion epidermal cells by employing fluorescence microscopy. The LERCDs facilitate low cytotoxicity and superior biocompatibility features in A375 cells. The practicality of LERCDs was studied in biological samples like the human serum., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Numerous countries have shown signs of environmental pollution to prioritize economic growth and benefits, leading to seriously contaminated waters. This work indicated the method to synthesize a green material, which could remove contaminants to protect the natural environment. The porosity and functionality effects of amine-functionalized activated carbon (AFAC) enhanced the removal of toxic heavy metals (THMs) in aqueous solution. The raw activated carbon (RAC) was thermally modified with ultrahigh pure nitrogen (UHPN) at 500°C and 1000°C and then amine-functionalized with coupling agent of aminopropyltriethoxysilane (APS). They were denoted as AFAC-5 and AFAC-10, respectively. The data showed an enhanced metal adsorption capacity of the AFACs, because the modification produced more desired porosity and increased amine functional groups. AFAC-10, modified at a higher temperature, showed much higher THM adsorption capacity than AFAC-5, modified at a lower temperature, and RAC. The adsorption capacity decreased in the following order: Ni > Cd > Zn, which was in good agreement with the increasing electronegativity and ionic potential and the decreasing atomic radius. The maximum THM adsorption capacity of AFAC-10 for Ni, Cd, and Zn was 242.5, 226.9, and 204.3 mg/g, respectively., Competing Interests: All authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Hoang Thu Ha et al.)

Introduction: Clinical and bacteriological features of cobra (Naja) bites are still relatively unknown in Vietnam. This study aimed to characterize the clinical and bacteriological characteristics of local wounds in patients with presumed Naja spp bite, as well as their antibiotic treatment., Methods: A cross-sectional study was performed on presumed Naja bite patients who were admitted to Bach Mai Hospital in Hanoi, Vietnam. In vitro bacterial isolation, blood tests, and lesion measure were conducted, and antibiotic susceptibilities of localized bite wounds were assessed. The Mann-Whitney test was used to examine the difference in clinical characteristics between patients experiencing presumed Naja atra bites and Naja kaouthia bites. Data are presented as percentages or median with interquartile range, as appropriate. Statistical significance was accepted at P<0.05., Results: Among 46 patients, all had typical clinical features of Naja bite. The median bite-to-hospital time was 6 h (interquartile range 4.0-11.3). The dominant organisms isolated from local wounds were Morganella morganii (11/36) and Enterococcus faecalis (25/36). All cultures were susceptible to ciprofloxacin. No difference was found with regard to pain, swelling circumference, swelling spread, or necrotic area between patients bitten by presumed Naja atra and Naja kaouthia (P>0.05)., Conclusions: Wound necrosis and infection were important clinical issues in presumed Naja spp snake bites. Morganella morganii and Enterococcus faecalis were dominant in local wound swabs of such cases. Ciprofloxacin should be an effective first-line antibiotic for patients with presumed Naja bite., (Copyright © 2020 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)

Asteraceae species were widely applied in traditional medicines in Asian countries as sources of natural antioxidants and antimicrobial agents. This study aimed to evaluate DPPH-scavenging capacities and antimicrobial activities of nine Asteraceae species collected from Southern Vietnam. Antioxidant and antimicrobial activities were determined by standard protocols. Essential oils from Ageratum conyzoides, Helianthus annuus, and Artemisia vulgaris indicated significant inhibitory effects on Staphylococcus aureus and Candida spp. Crude extracts and fractions from Taraxacum officinale, Chrysanthemum morifolium , A. conyzoides, and Tagetes erecta showed inhibitory ability on at least one testing bacterial strains including S. aureus , Escherichia coli , Klebsiella pneumoniae , and Pseudomonas aeruginosa . In a study on clinical isolates, ethyl acetate fraction from A. conyzoides flower displayed the most potent effect on uropathogenic E. coli and K. pneumoniae with MIC at 1.25-10 mg/ml and 5-12.5 mg/ml, respectively. DPPH-scavenging assay indicated that T. erecta extract had the lowest IC 50 (17.280  μ g/ml) and is 2.4 times higher than vitamin C (7.321  μ g/ml). This study revealed that A. conyzoides has good potential against uropathogenic E. coli and K. pneumoniae, and therefore could be applied for prophylactic treatment of urinary infection., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Phan-Canh Trinh et al.)

Aim: Aberrant microRNA (miR) expression is associated with hepatocellular carcinoma (HCC)., Materials & Methods: Here, we investigated the clinical significance of miR-21 and miR-31 for HCC-specific prognostic effect. HCC patients (n = 93) who underwent liver biopsy or surgical resection were enrolled, and HCC tissues and paired adjacent nontumor liver tissues were collected and analyzed for miRs expression., Results: MiR-21 expression was significantly upregulated in HCC tissues relative to nontumor tissues. Both miR-21 and miR-31 expression in HCC tissues did not predict overall survival; however, miR-21 was considered an independent predictor of disease progression together with portal vein thrombosis and higher Barcelona Clinical Liver Cancer stage., Conclusion: Elevated miR-21 expression might represent a biomarker for HCC prognosis.

Purpose: To compare different dental bonding systems that are currently available on the market., Materials and Methods: A total of 100 extracted, intact third molars were coated in resin, cut, and divided into 10 groups of 10 molars each. Molars were bonded to zirconia blocks with a different bonding system per group. Resistance to shear forces was tested using a universal traction machine. Samples were observed under scanning electron microscopy (SEM) to determine the type of fracture., Results: Statistical analyses showed a significant influence of adhesive on the zirconia-dentin assembly's resistance to shear forces. SEM analysis showed mainly adhesive and mixed fractures., Conclusion: Dentin bonding systems without adhesive capability showed better results than self-etch systems.

In developing countries, the simple biogas digesters installed underground without heating or stirring are seen as a 'green' technology to convert animal waste into biogas, a source of bio-energy. However, quantitative estimates of biogas production of manures from steers fed local feed diets at actual incubation temperatures have yet to be carried out. The aim of this study was to determine the methane (CH 4 ) production potential of manures from steers in Vietnam offered traditional feed rations or supplemental diets. Biochemical CH 4 production (BMP) was measured in batch tests at 30°C using manures collected from two different experiments of steers fed diets containing feed supplements. BMP was 110.1 (NLkg -1 VS) for manure from steers receiving a control diet, significantly lower 79.0 (NL kg -1 VS) for manure from steers fed a diet containing 0.3% tannin (%DM), but then showed an increasing trend to 90.9 and 91.2 (NL kg -1 VS) for manures from steers receiving 0.4 and 0.5% tannin (%DM) supplements, respectively. Similarly, the CH 4 production (NL kg -1 VS) of manure from steers was 174 for control, 142 for control supplemented concentrate (C), 143 for control added rice straw treated with urea (R), and 127 for control supplemented C and R. Our results show there was a decrease in CH 4 emissions from steer manures through using supplemented rations., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Hepatocellular carcinoma (HCC) is a worldwide health problem and it is important to understand the mechanistic roles of the biomolecules involved in its pathogenesis. Long non-coding RNAs (lncRNAs) are frequently and aberrantly expressed in various human cancers and are known to play a role in cancer pathogenesis. The aim of this study was to analyze the expression of lncRNA-ATB in HCC and investigate the implications for prognoses. In total, 100 samples of HCC tissues and their corresponding, adjacent, non-cancerous liver tissues were collected. Total RNAs were extracted and the expression levels of lncRNA-ATB were measured by qRT-PCR. The association of lncRNA expression with clinicopathological features and patient survival were then analyzed. LncRNA-ATB was significantly upregulated in HCC tissues compared with the levels in corresponding non-cancerous tissues. Expression of lncRNA-ATB was significantly associated with portal vein thrombosis, intrahepatic or extrahepatic metastases, mUICC stage, and the BCLC stage. Large tumors (> 5 cm, HR = 3.851, 95% CI = 1.431-10.364, p = 0.008) and higher lncRNA-ATB expression (HR = 4.158, 95% CI = 1.226-14.107, p = 0.022) were the significant prognostic factors for overall survival. With this novel evidence of the involvement of lncRNA-ATB in HCC pathogenesis and clinical features, lncRNA-ATB can be concluded to have potential as a biomarker for the prognosis of HCC and as a targeted therapy for afflicted patients., Competing Interests: CONFLICTS OF INTEREST The authors declare no potential conflicts of interest.

Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization. Although the complex postoperative course after LDLT can obscure the prompt diagnosis of an intrahepatic artery pseudoaneurysm and hemobilia, biliary stenting should be considered as a possible cause., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Aim: Epidermal growth factor receptor (EGFR) mutational status is a crucial biomarker for prediction of response to tyrosine kinase inhibitors in patients with non-small cell lung cancer (NSCLC). Although these mutations have been well characterized in other countries, little is known about the frequency or spectrum of EGFR mutations in Vietnamese NSCLC patients., Methods: Using Sanger DNA sequencing, we investigated mutations in EGFR exons 18-21 from 332 patients diagnosed with NSCLC at University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. DNA was extracted from formalin-fixed, paraffin-embedded tissues, followed by PCR amplification and sequencing., Results: EGFR mutations were detected in 135 samples (40.7%), of which eight samples carried double mutations. In total, 46 different types of EGFR mutations were found, including six novel mutations (p.K713E, p.K714R, p.P794S, p.R803W, p.P848S, and p.K867E). Among the four exons investigated, exon 19 was most frequently mutated (63 out of 332 patients, 19%), with the p.E746&#95;A750del appearing in 43 samples. Exon 21 was mutated in 56 samples (16.9%), of which 47 were p.L858R. Each of exons 18 and 20 was mutated in 12 samples (3.6%). The frequency of EGFR mutations was higher in females than in males (48.9% vs 35%, P = 0.012), but not statistically different between adenocarcinomas and other histological types of NSCLC (41.3% vs 34.5%, P = 0.478)., Conclusion: DNA sequencing detected EGFR mutations with high frequency and revealed a broad spectrum of mutation type in Vietnamese patients with NSCLC., (© 2015 Wiley Publishing Asia Pty Ltd.)

Purpose: Various pancreaticojejunostomy (PJ) techniques have been devised to minimize the rate of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). This study describes a modification of the mattress suture PJ technique, which we call "inverted mattress PJ (IM)". The results of an IM group and a historical consecutive control group were compared to determine how the IM technique affected POPF., Methods: From 2003 to 2010, 186 consecutive patients underwent PD. A former group of 52 consecutive patients who underwent conventional duct-to-mucosa PJ (DM) was used as a historical control group. The IM technique was utilized for the IM group (134 patients). The clinicopathological features and surgical outcomes of the 2 groups were compared, with a particular focus on postoperative POPFs., Results: The average surgery duration was shorter in the IM group (580.3 minutes vs. 471 minutes, P < 0.001). Grades B and C POPFs occurred less frequently in the IM group, but the difference was not statistically significant (17.3% vs. 9.7%, P = 0.200). However, no grade C POPF occurred in the IM group compared with 5.8% of grade C POPFs (3/52) in the DM group (P = 0.020). Three patients died (1 in the DM group and 2 in the IM group). The causes of death were arrhythmia in 2 cases and Candida sepsis in 1 case. POPF was not causally related to the 3 deaths., Conclusion: IM end-to-side PJ shortened operation time and increased safety with no incidence of grade C POPF.

Introduction: Given the overlapping modes of transmission of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV), understanding the burden and relationship of these infections is critical for an effective response. Representative data on these infections among males who inject drugs (MWID), the key high-risk population for HIV in Vietnam, are currently lacking., Methods: Data and stored specimens from Vietnam's 2009-2010 Integrated Biologic and Behavioral Survey, a cross-sectional study among high-risk populations, were used for this analysis. Plasma samples were tested for HIV, HBV, and HCV using commercial assays. A questionnaire was administered to provide demographic, behavior, and service-uptake information. Provincial-level analyses were conducted to profile MWID enrollees and to provide estimates on the prevalence of HIV, HBV, and HCV infection., Results: Among 3010 MWID sampled across 10 provinces, the median (range) HIV prevalence was 28.1% (1.0%-55.5%). Median prevalence for current HBV infection (HBsAg+) was 14.1% (11.7%-28.0%), for previous exposure to HBV (total anti-HBc+) was 71.4% (49.9%-83.1%), and for current or past HCV infection (HCV Ag/Ab+) was 53.8% (10.9%-80.8%). In adjusted analysis, HBsAg+ (aOR: 2.09, 1.01-4.34) and HCV Ag/Ab+ (aOR: 19.58, 13.07-29.33) status were significantly associated with HIV infection; the association with total anti-HBc+ approached significance (aOR: 1.29, 0.99-1.68)., Conclusion: The prevalence and association between HIV, HBV, and HCV are high among MWID in Vietnam. These findings indicate the need for integrated policies and practice that for the surveillance, prevention, screening, and treatment of both HIV and viral hepatitis among MWID in Vietnam.

In this report we describe a new approach in HIV sentinel surveillance that was piloted in Viet Nam in 2009 and is currently being rolled out in all provinces. It comprises a brief behavioural questionnaire added to the HIV sentinel surveillance surveys conducted routinely among people who inject drugs, female sex workers and men who have sex with men. Timely reporting of data from this system has resulted in improvements to HIV prevention efforts for most at-risk populations.

Background: An estimated 120,000 HIV-associated cryptococcal meningitis (CM) cases occur each year in South and Southeast Asia; early treatment may improve outcomes. The World Health Organization (WHO) recently recommended screening HIV-infected adults with CD4<100 cells/mm(3) for serum cryptococcal antigen (CrAg), a marker of early cryptococcal infection, in areas of high CrAg prevalence. We evaluated CrAg prevalence and cost-effectiveness of this screening strategy in HIV-infected adults in northern and southern Vietnam., Methods: Serum samples were collected and stored during 2009-2012 in Hanoi and Ho Chi Minh City, Vietnam, from HIV-infected, ART-naïve patients presenting to care in 12 clinics. All specimens from patients with CD4<100 cells/mm(3) were tested using the CrAg lateral flow assay. We obtained cost estimates from laboratory staff, clinicians and hospital administrators in Vietnam, and evaluated cost-effectiveness using WHO guidelines., Results: Sera from 226 patients [104 (46%) from North Vietnam and 122 (54%) from the South] with CD4<100 cells/mm(3) were available for CrAg testing. Median CD4 count was 40 (range 0-99) cells/mm(3). Nine (4%; 95% CI 2-7%) specimens were CrAg-positive. CrAg prevalence was higher in South Vietnam (6%; 95% CI 3-11%) than in North Vietnam (2%; 95% CI 0-6%) (p = 0.18). Cost per life-year gained under a screening scenario was $190, $137, and $119 at CrAg prevalences of 2%, 4% and 6%, respectively., Conclusion: CrAg prevalence was higher in southern compared with northern Vietnam; however, CrAg screening would be considered cost-effective by WHO criteria in both regions. Public health officials in Vietnam should consider adding cryptococcal screening to existing national guidelines for HIV/AIDS care.

Smad7 has been known as a negative regulator for the transforming growth factor-β (TGF-β) signaling pathway through feedback regulation. However, Smad7 has been suspected to have other biological roles through the regulation of gene transcription. By screening differentially regulated genes, we found that the caspase 8 gene was highly up-regulated in Smad7-expressing cells. Smad7 was able to activate the caspase 8 promoter through recruitment of the interferon regulatory factor 1 (IRF1) transcription factor to the interferon-stimulated response element (ISRE) site. Interaction of Smad7 on the caspase 8 promoter was confirmed with electrophoretic mobility shift assay and chromatin immunoprecipitation experiment. Interestingly, Smad7 did not directly interact with the ISRE site, but it increased the binding activity of IRF1 with ISRE. These results support that Smad7 recruits IRF1 protein on the caspase 8 promoter and functions as a transcriptional coactivator. To confirm the biological significance of caspase 8 up-regulation, we tested tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL)-mediated cell death assay in breast cancer cells. Smad7 in apoptosis-resistant MCF7 cells markedly sensitized the cells to TRAIL-induced cell death by restoring the caspase cascade. Furthermore, restoration of caspase 8-mediated apoptosis pathway repressed the tumor growth in the xenograft model. In conclusion, we suggest a novel role for Smad7 as a transcriptional coactivator for caspase 8 through the interaction with IRF1 in regulation of the cell death pathway.

Background: The epidermal growth factor receptor (EGFR) tyrosine kinase is overexpressed in many sarcoma subtypes. In vitro studies suggest a role of the EGFR pathway in growth and differentiation in some sarcomas. We conducted a phase II trial of cetuximab, a monoclonal antibody to EGFR, in patients with advanced sarcomas., Methods: Cetuximab was administered intravenously as a loading dose on 400 mg/m on day 1, cycle 1 and subsequently 250 mg/m on days 1, 8, 15, and 21 of a 28 day cycle. Using a Simon 2-stage design, 21 EGFR patients were to be accrued in the first stage, with an additional 11 patients if >3 patients met the primary endpoint of 4-month progression-free survival (PFS). An exploratory subgroup of EGFR patients was also included., Results: Twenty-one and 15 evaluable patients enrolled in the EGFR and EGFR subgroup, respectively. One of 21 EGFR patients (4.8%) achieved 4-month PFS. Median PFS and overall survival were 1.7 months [95% confidence interval (CI), 1.6-1.8] and 7.7 months (95% CI, 4.2-10.7), respectively. Three of 15 EGFR patients (20%) achieved 4-month PFS. Median PFS and overall survival were 1.8 months (95% CI, 0.8-2.5) and 15.7 months (95% CI, 7.7-25.3), respectively. No responses were seen in either group. There was no correlation between clinical outcomes and expression of MAP-K, PTEN, and phospho-EGFR., Conclusions: Cetuximab is not an active as a single agent in advanced sarcoma. Further study of anti-EGFR therapy in sarcoma should only be considered after identification of molecular abnormalities predictive of benefit.

Background: Currently, there is no standard treatment for metastatic anaplastic thyroid cancer (ATC). DNA microarray analysis has shown platelet-dervived growth factor receptor (PDGFR) overexpression in ATC relative to well-differentiated thyroid cancer. In p53-mutated/deficient ATC cell lines, cABL is overexpressed, and selective inhibition of cABL results in a cytostatic effect. Imatinib inhibits tyrosine kinase activity of Bcr-ABL and PDGF. We hypothesize that patients with ATC that over-expresses PDGF receptors or cABL will respond to imatinib., Methods: Patients with histologically confirmed ATC who had measurable disease and whose disease expressed PDGF receptors by immunohistochemistry were eligible for study. Imatinib was administered at 400 mg orally twice daily without drug holiday. Response to treatment was assessed every 8 weeks. Patients with complete response, partial responses, or stable disease were treated until disease progression. The study was terminated early due to poor accrual., Results: From February 2004 to May 2007, 11 patients were enrolled and were started on imatinib. At baseline, 4/11 had locoregional disease, 5/11 had distant metastases, and 2/11 had both. Nine of 11 had prior chemoradiation, and 7/11 had thyroidectomy. Eight of 11 were evaluable for response; 4 were excluded for lack of follow-up with radiologic evaluation. The overall response rates at 8 weeks were complete response 0/8, partial response 2/8, and stable disease 4/8. The median time to follow-up was 26 months (ranges 23-30 months). The rate of 6-month progression-free survival was 36% (95% confidence interval, 9%-65%). The rate of 6-month overall survival was 45% (95% confidence interval, 16%-70%). The most common grade 3 toxicity was edema in 25%; other grade 3 toxicities included fatigue and hyponatremia (12.5% each). There were no grade 4 toxicities or treatment related deaths., Conclusions: Imatinib appears to have activity in advanced ATC and is well tolerated. Due to difficulty of accruing patients with a rare malignancy at a single institution, further investigation of imatinib in ATC may be warranted in a multi-institutional setting.

In the human DNA mismatch repair (MMR) system, hMSH2 forms the hMutSalpha and hMutSbeta complexes with hMSH6 and hMSH3, respectively, whereas hMLH1 and hPMS2 form the hMutLalpha heterodimer. These complexes, together with other components in the MMR system, correct single-base mismatches and small insertion/deletion loops that occur during DNA replication. Microsatellite instability (MSI) occurs when the loops in DNA microsatellites are not corrected because of a malfunctioning MMR system. Low-frequency MSI (MSI-L) is seen in some chronically inflamed tissues in the absence of genetic inactivation of the MMR system. We hypothesize that oxidative stress associated with chronic inflammation might damage protein components of the MMR system, leading to its functional inactivation. In this study, we demonstrate that noncytotoxic levels of H2O2 inactivate both single-base mismatch and loop repair activities of the MMR system in a dose-dependent fashion. On the basis of in vitro complementation assays using recombinant MMR proteins, we show that this inactivation is most likely due to oxidative damage to hMutSalpha, hMutSbeta, and hMutLalpha protein complexes. We speculate that inactivation of the MMR function in response to oxidative stress may be responsible for the MSI-L seen in nonneoplastic and cancer tissues associated with chronic inflammation.

We prospectively studied diarrhoea incidence among 1655 children < 5 years of age in northern Vietnam for 1 year using primarily passive surveillance. Standard culture methods were used to detect bacterial pathogens. Overall 2160 cases occurred (13 cases/child per year). Peak rates of diarrhoea occurred in children < 12 months old. Rates ranged from 3.3 cases/child per year in children < 1 year old, to 0.7 cases/child per year in 4-year-olds. Campylobacter, shigella and enterotoxigenic Escherichia coli were most commonly isolated. Rates detected by active surveillance were about twice those detected passively. S. flexneri was the most common shigella serogroup (65 %). S. flexneri serotypes 6, 4, 1 and Y were most common, but 40% were untypable using commercial antisera. The data illustrate important regional differences in pathogen prevalence and shigella serotype distribution. Shigella vaccine development strategies, commonly targeting S. flexneri 2a, S. sonnei and S. dysenteriae 1, will have little impact on diarrhoea rates in Vietnam.

Purpose: This study was designed to evaluate the effectiveness of overlapping anal sphincter reconstruction and to determine the manometric parameters that correlate with a successful functional outcome., Methods: A retrospective review of patients who had undergone overlapping sphincter reconstruction for anal incontinence from 1988 to 1999 was undertaken. Only patients with preoperative and six-months-postoperative anal manometry were included in this study. Standard statistical tests were used to compare pre- and postoperative findings., Results: A total of 52 overlapping sphincter reconstructions were performed on 49 patients (46 females). The mean age was 44 (+/- standard error, 15.8; range, 20-81) years, with follow-up at six months. Forty-two patients had a history of complicated vaginal delivery (episiotomies, tears, forceps delivery); 36 patients had a history of anal or perineal surgery; and two patients had perianal Crohn's disease. Nine patients (17 percent) had undergone prior sphincter repair. Incontinence grade improved in 37 patients (71 percent), and complete continence returned in 21 patients (40 percent). The presence of a rectovaginal fistula, postoperative complications, previous sphincter repair, and increase in pudendal nerve terminal motor latency did not affect functional outcome (P = not significant). Patients older than 50 years had a better functional outcome than their younger counterparts after sphincter repair (P = 0.02). Although mean maximal squeeze pressure and mean anal sphincter length increased significantly after sphincter reconstruction (P = 0.0006 and 0.004, respectively), only squeeze pressure difference correlated with functional outcome (r = 0.37; P = 0.007)., Conclusions: Overlapping sphincter reconstruction improved anal function in the majority of patients. The most important factor in the return to normal sphincter function is an increase in squeeze pressure.