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Thoai D Ngo,1,2 Caroline Free,1 Hoan T Le,3 Phil Edwards,1 Kiet HT Pham,4 Yen BT Nguyen,4 Thang H Nguyen5 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, 2Research, Monitoring, and Evaluation Team, Health System Department, Marie Stopes International, London, UK; 3Department of Environmental Health, Hanoi Medical University, 4Department of Health Economics, Hanoi Medical University, 5Research and Metrics Team, Marie Stopes International Vietnam, Hanoi, Vietnam Objective: To explore the perspectives of abortion service users regarding termination methods and abortion service delivery in Vietnam. Materials and methods: Structured exit interviews were conducted between August and November 2011 with women who underwent termination of pregnancy at 62 public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam. All women presenting for termination during the study period were recruited to participate in the study. Following their abortion, women were asked about their perspectives on abortion service delivery and attributes of medical abortion (MA) versus manual vacuum aspiration (MVA). Multiple logistic regression was used to assess the association between current method uptake and each attribute. Results: A total of 1,233 women were included in the survey: 541 (43.9%) from Hanoi, 163 (13.2%) from Khanh Hoa, and 529 (42.9%) from Ho Chi Minh: 23.1% underwent MA; 78.9% reported that women should be given a choice between MA and MVA; and 77.6% thought that abortion services were accessible. Among the 48% who responded, 30.1% thought that MA should be made available at primary/secondary health care facilities. Among women who had previously undergone both methods, women who reported that MA "feels more natural" (like a menstrual regulation/period) were more likely to choose MA for their current abortion (odds ratio 2.15, 95% confidence interval 1.26–3.69). Conclusion: MA uptake is significantly lower than MVA uptake. Further insights to women's perceptions of MA in Vietnam could help improve abortion service delivery in the country. Keywords: Vietnam, medical abortion, misoprostol, mifepristone, manual vacuum aspiration, health service delivery

Thoai D Ngo,1,2 Caroline Free,1 Hoan T Le,3 Phil Edwards,1 Kiet HT Pham,4 Yen BT Nguyen,4 Thang H Nguyen5 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 2Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK; 3Department of Environmental Health, 4Department of Health Economics, Hanoi Medical University, 5Research and Metrics Team, Marie Stopes International Vietnam, Hanoi, Vietnam Background: The purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam. Methods: We conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam's public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods. Results: A total of 905 providers from 62 health facilities were included, comprising 525 (58.0%) from Hanoi, 122 (13.5%) from Khanh Hoa, and 258 (28.5%) from Ho Chi Minh City. The majority of providers were female (96.7%), aged ≥25 years (94%), married (84.4%), and had at least one child (89%); 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%), midwives (21.7%), and nurses (3.9%). Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30) and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79) were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with nursing/midwifery training (odds ratio 22.2; 95% confidence interval 3.81–129.41). The most frequently cited advantages of medical abortion for providers were that no surgical skills are required (61.7%) and client satisfaction is better (61.0%). Conclusion: Provision of medical abortion in Vietnam is lower than provision of manual vacuum aspiration. While the majority of abortion providers are female midwives in Vietnam, medical abortion provision is concentrated in urban settings among physicians. Individuals providing medical abortion found that the method yields high client satisfaction. Keywords: Vietnam, medical abortion, misoprostol, mifepristone, health service delivery, surgical abortion

Alessandra N Bazzano,1 Lea Jones,1 Thoai D Ngo2 1Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; 2Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK Abstract: The study aimed to explore perceptions of stakeholders regarding misoprostol use in Cambodia, a setting with high maternal mortality. Semi-structured expert interviews were conducted with 21 participants in the capital, Phnom Penh. The sample included participants involved in providing reproductive health services through international and local health agencies and the pharmaceutical industry. A theme of controversy over the role of misoprostol in the context of reproductive health services emerged, along with a need to reconcile legitimate viewpoints in order to understand the place of misoprostol in the Cambodian reproductive health setting. Understanding stakeholder perspectives on misoprostol can shed light on the drug's role in reproductive health programming where maternal mortality is high and health facilities are still improving. Keywords: maternal mortality, misoprostol, post-partum hemorrhage, medical abortion, unsafe abortion, Cambodia

Min Hae Park,1 Thang Huu Nguyen,2 Anh Thi Ngoc Dang,2 Thoai Dinh Ngo1 1Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK; 2Research and Metrics Team, Marie Stopes International Vietnam, Ha Noi, Vietnam Objective: To describe medical abortion (MA) practices among private providers in Vietnam. Methods: The study subjects were women (n = 258) undergoing early MA through 12 private providers in Hanoi during February-June 2012. The women were interviewed on the day of their procedure and were followed up by telephone 14 days after mifepristone administration. Results: Of the 258 women in the study, 97% used a regimen of mifepristone plus misoprostol; 80% were instructed to administer misoprostol at home. MA resulted in a complete termination in 90.8% of cases. All women were provided with information on potential complications and were instructed to return for a follow-up visit. We successfully followed up 77.5% (n = 200) of participants by telephone, while nearly two-thirds of women returned to the clinic for a follow-up visit. At follow up, 39.5% of women reported having used a Help line service, while 7% had sought help from a health provider. A high unmet need for postabortion family planning was identified. Conclusion: Follow up of women, postabortion care, and the provision of family planning have been identified as important areas to address for strengthening MA services in the private sector in Vietnam. Keywords: misoprostol, mifepristone, abortion, mhealth, Vietnam

Thoai D Ngo,1,2 Min Hae Park,1 Caroline Free21Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, UK; 2Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UKObjective: Training midlevel providers (MLPs) to conduct surgical abortions and manage medical abortions has been proposed as a way to increase women's access to safe abortion. This paper reviews the evidence that compares the effectiveness and safety of abortion procedures administered by MLPs versus doctors.Methods: A systematic search was conducted of published trials and comparison studies assessing the effectiveness and/or safety of abortion provided by MLPs compared to doctors. The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and Popline were searched. The primary outcomes of interest were: (1) incomplete or failed abortion; and (2) measures of safety (adverse events and complications) of abortion procedures administered by MLPs and doctors. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for each study. Data were synthesized in a narrative fashion.Findings: Five studies were included in this review (n = 8539 women), comprising two randomized controlled trials (RCTs) (n = 3821) and three prospective cohort studies (n = 4718). In total, 4198 women underwent a procedure administered by an MLP, and 4341 women underwent a physician-administered procedure. Studies took place in the US, Nepal, South Africa, Vietnam, and India. Four studies used surgical abortion with maximum gestational ages ranging from 10 to 16+ weeks, while a medical abortion study had gestational ages up to 9 weeks. In RCTs, the effect estimates for incomplete or failed abortion for procedures performed by MLPs compared with doctors were OR = 2.00 (95% CI 0.85–4.68) for surgical abortion, and OR = 0.69 (95% CI 0.34–1.37) for medical abortion. Complications were rare among both provider types (1.2%–3.1%; OR = 1.80, 95% CI 0.83–3.90 for surgical abortions), and no deaths were reported.Conclusion: There were no statistical differences in incomplete abortion and complications for first trimester surgical and medical abortion up to 9 weeks performed by MLPs compared with physicians. Further studies are required to establish more precise effect estimates.Keywords: abortion, misoprostol, manual vacuum aspiration, medical abortion

Thoai D Ngo1, George Obhai21Research and Metrics Team, Health System Department, Marie Stopes International; 2Monitoring and Evaluation Team, Marie Stopes International Kenya, Nairobi, KenyaObjective: The purpose of this study was to assess postoperative complications and patient satisfaction associated with mid-level provision of male circumcision in rural Kenya.Methods: A prospective cohort study was conducted among children, adolescents, and adult men undergoing male circumcision from September 1, 2008 to December 4, 2008 at Marie Stopes International Kenya mobile outreach sites located in eight districts in the Nyanza and Western Provinces, Kenya. Male circumcision procedures were performed by registered nurses, surgical technicians, or nurse aides. Postoperative follow-up visits took place on the day of the procedure and at postoperative days 3, 7, and 30, with additional visits as necessary. Data on adverse events, healing conditions, satisfaction level, and resumption of activities were assessed at each follow-up visit.Results: A total of 285 individuals were screened, and 240 underwent male circumcision procedures. All procedures were performed using the guided forceps technique by mid-level providers. At the first follow-up visit (postoperative day 3), 5.8% (n = 14) individuals did not return for post-surgical assessment. Retention rates at the second (day 7) and third (day 30) follow-up visits were 91.3% (n = 219) and 84.6% (n = 203), respectively. The prevalence of complications (moderate and severe adverse events) was 1.3% (3/240). At the first and second follow-up visits, 91.7% of patients (n = 220) were capable of resuming their daily activities, and 100% by day 30. The majority of patients (>99%) were satisfied with the procedure, counseling, and information received.Conclusion: Male circumcisions can be delivered safely and successfully by mid-level providers in rural settings with high client satisfaction, thereby increasing access to human immunodeficiency virus prevention services in Kenya.Keywords: male circumcision, human immunodeficiency virus, reproductive health, mid-level providers, Kenya

Thoai D Ngo1, Min Hae Park1, Yuanhong Xiao21Research and Metrics Team, Health System Department, Marie Stopes International, London, UK; 2Research and Metrics Team, Marie Stopes International China, Beijing, ChinaObjective: To compare the effectiveness, in terms of complete abortion, of the World Health Organization (WHO)- and the China-recommended protocol for first-trimester medical abortion.Methods: A retrospective analysis of clinical data from women presenting for first trimester medical abortion between January 2009 and August 2010 at reproductive health clinics in Qingdao, Xi’an, Nanjing, Nanning, and Zhengzhou was conducted. One clinic in Qingdao administered the WHO-recommended protocol (200 mg mifepristone orally followed by 0.8 mg misoprostol buccally 36–48 hours later). Four clinics in the other locations provided the China-recommended procedure (Day 1: 50 mg of mifepristone in the morning, 25 mg in the afternoon; Day 2: 50 mg of mifepristone in the morning, 25 mg in the afternoon; Day 3: 0.6 mg oral misoprostol). Data on reproductive and demographic characteristics were extracted from clinic records, and complete termination was determined on day 14 (post-mifepristone administration).Results: A total of 337 women underwent early medical abortion (167 WHO- and 170 China-recommended procedures). Complete abortion was significantly higher among women who had the WHO protocol than those who received the China protocol (91.0% vs 77.7%, respectively; P < 0.001). Women using the China-recommended protocol were three times more likely to require an additional dose of misoprostol than women using the WHO protocol (21.8% vs 7.8%, respectively; P < 0.001), and had significantly more bleeding on the day of misoprostol administration (12.5 mL vs 18.5 mL; P < 0.001).Conclusion: This clinical audit provides preliminary evidence suggesting the WHO-recommended protocol may be more effective than the China-recommended protocol for early medical abortion. A larger scale study is necessary to compare the methods’ effectiveness and acceptability.Keywords: medical abortion, misoprostol, mifepristone, China, first-trimester termination

Min Hae Park1,2, Thang Huu Nguyen3, Thoai Dinh Ngo1,21Research and Metrics Team, Health System Department, Marie Stopes International; 2Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 3Research and Metrics Team, Marie Stopes International Vietnam, Ha Noi, VietnamAbstract: This study describes the dynamics of intrauterine device (IUD) use in Vietnam and implications for family planning services. A retrospective study was conducted among women who received IUD services in 2006–2009 at six commune health stations in three provinces. Women were interviewed about IUD use and switching behaviors. Of 1316 participants, 12.1% had discontinued IUD use at 12 months after insertion, 19.4% at 24 months, and 26.9% at 36 months. The highest rates of discontinuation were among older women and farmers/manual workers. Among 434 women who had an IUD removed, 49% cited health concerns as the main reason. Following removal, 70% switched to another contraceptive method (n = 306); of these, 15% switched to withdrawal, and 12% waited >2 months before adopting a new method. Dissatisfaction with IUD services was associated with high rates of discontinuation. Early discontinuation, delays in adopting new methods, and switching to withdrawal may contribute to unintended pregnancy among commune health station users in Vietnam.Keywords: intrauterine device, contraceptive discontinuation, dissatisfaction

Recently, researchers have been investigating artificial ferroelectricity, which arises when inversion symmetry is broken in certain R-stacked, i.e., zero-degree twisted, van der Waals (vdW) bilayers. Here, the study reports the twist-controlled ferroelectricity in tungsten diselenide (WSe 2 ) bilayers. The findings show noticeable room temperature ferroelectricity that decreases with twist angle within the range 0° < θ < 3°, and disappears completely for θ ≥ 4°. This variation aligns with moiré length scale-controlled ferroelectric dynamics (0° < θ < 3°), while loss beyond 4° may relate to twist-controlled commensurate to non-commensurate transitions. This twist-controlled ferroelectricity serves as a spectroscopic tool for detecting transitions between commensurate and incommensurate moiré patterns. At 5.5 K, 3° twisted WSe 2 exhibits ferroelectric and correlation-driven ferromagnetic ordering, indicating twist-controlled multiferroic behavior. The study offers insights into twist-controlled coexisting ferro-ordering and serves as valuable spectroscopic tools., (© 2024 Wiley‐VCH GmbH.)

The surface oxidation of 2D transition metal dichalcogenides (TMDs) has recently gained tremendous technological and fundamental interest owing to the multi-functional properties that the surface oxidized layer opens up. In particular, when integrated into other 2D materials in the form of van der Waals heterostructures, oxidized TMDs enable designer properties, including novel electronic states, engineered light-matter interactions, and exceptional-point singularities, among many others. Here, the evolving landscapes of the state-of-the-art surface engineering technologies that enable controlled oxidation of TMDs down to the monolayer-by-monolayer limit are reviewed. Next, the use of oxidized TMDs in van der Waals heterostructures for different electronic and photonic device platforms, materials growth processes, engineering concepts, and synthesizing new condensed matter phenomena is discussed. Finally, challenges and outlook for future impact of oxidized TMDs in driving rapid advancements across various application fronts is discussed., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Processing cellulose from 4-methyl morpholine n -oxide (NMMO)-water solutions is a completely circular route that produces biodegradable cellulose fibers or films while recovering reusable NMMO [Guo, Y.; Cai, J.; Sun, T.; Xing, L.; Cheng, C.; Chi, K.; Xu, J.; Li, T. The purification process and side reactions in the N-methylmorpholine-N-oxide (NMMO) recovery system. Cellulose 2021 , 28 (12), 7609-7617]. Despite proven success in two-dimensional applications, challenges in transitioning to three-dimensional objects arise from the critical changes that cellulose undergoes during deposition, regeneration, and postregeneration stages. While emphasizing the critical diffusion-driven precipitation during regeneration, this investigation explores the influence of extrusion temperature, printing alignment, regeneration, and drying processes on interfilament fusion, bonding, shape integrity, and mechanical properties. Three distinct drying processes: ambient, vacuum, and freeze-drying were investigated. Tensile and flexural bending tests provided insight into the delamination of dried specimens. Ambient and vacuum drying enhanced the properties of specimens, while freeze-drying resulted in a more stable shape. The findings contribute to advancing the understanding of 3D-printing cellulose from NMMO solutions, addressing crucial aspects of the extrusion, regeneration, and drying stages for enhanced applications in sustainable manufacturing.

Objectives: Post-operative urinary retention (POUR) is a frequent complication following surgical procedures, characterized by an acute inability to void, leading to additional complications and extended hospitalization. Acupuncture has been shown to be effective in facilitating spontaneous urination and alleviating anxiety in patients experiencing poor urination. The present study aims to evaluate the effectiveness of electroacupuncture in the management of POUR in patients who have undergone lumbar spine surgery., Methods: This retrospective study conducted at the National Hospital of Acupuncture in Vietnam and reviewed the medical records of patients over 18 years old who underwent lumbar spine surgery and were diagnosed with POUR between January to December 2019. Electroacupuncture was administered at five specific acupuncture points Qugu (CV2), Zhongji (CV3), Zhibian (BL54), Pangguanshu (BL28), and Kunlun (BL60). This study monitored key parameters related to the effectiveness of the acupuncture treatment, including the number of acupuncture treatment sessions required until a patient was successfully treated was recorded, with a maximum of three acupuncture treatment sessions per patient, the time elapsed until urination following the treatment (minutes), and urinary bladder volume before and after treatment (mL)., Results: The study demonstrated a 93.3% success rate in treating POUR with electroacupuncture. A significant reduction in post-void residual volume was noted, and patients could void within 30 minutes post-treatment. No significant differences in treatment effectiveness were observed across difference genders and age groups., Conclusion: Electroacupuncture proved to be a highly effective treatment for POUR in patients post-lumbar spine surgery, with a rapid response time and substantial reduction in PVR. However, the retrospective nature of the study and single-center focus limit its generalizability. Future research incorporating randomized controlled trials or multi-center observational studies are recommended to validate these findings and explore the potential of acupuncture in POUR management on a broader scale., Competing Interests: CONFLICT OF INTEREST The authors declare no conflicts of interest in this work., (© 2024 Korean Pharmacopuncture Institute.)

We show that redox active iron can induce a regulated form of non-apoptotic cell death and tissue damage called ferroptosis that can contribute to secondary damage and functional loss in the acute and chronic periods after spinal cord injury (SCI) in young, adult, female mice. Phagocytosis of red blood cells at sites of hemorrhage is the main source of iron derived from hemoglobin after SCI. Expression of hemeoxygenase-1 that induces release of iron from heme, is increased in spinal cord macrophages 7 days after injury. While iron is stored safely in ferritin in the injured spinal cord, it can, however, be released by NCOA4-mediated shuttling of ferritin to autophagosomes for degradation (ferritinophagy). This leads to the release of redox active iron that can cause free radical damage. Expression of NCOA4 is increased after SCI, mainly in macrophages. Increase in the ratio of redox active ferrous (Fe 2+ ) to ferric iron (Fe 3+ ) is also detected after SCI by capillary electrophoresis inductively coupled mass spectrometry. These changes are accompanied by other hallmarks of ferroptosis, i.e., deficiency in various elements of the antioxidant glutathione (GSH) pathway. We also detect increases in enzymes that repair membrane lipids (ACSL4 and LPCAT3) and thus promote on-going ferroptosis. These changes are associated with increased levels of 4-hydroxynonenal (4-HNE), a toxic lipid peroxidation product. Mice with mild SCI (30 kdyne force) treated with the ferroptosis inhibitor (UAMC-3203-HCL) either early or delayed times after injury showed improvement in locomotor recovery and secondary damage. Cerebrospinal fluid and serum samples from human SCI cases show evidence of increased iron storage (ferritin), and other iron related molecules, and reduction in GSH. Collectively, these data suggest that ferroptosis contributes to secondary damage after SCI and highlights the possible use of ferroptosis inhibitors to treat SCI., (© 2024. The Author(s).)

This research presents a dataset consisting of electroencephalogram and eye tracking recordings obtained from six patients with amyotrophic lateral sclerosis (ALS) in a locked-in state and one hundred seventy healthy individuals. The ALS patients exhibited varying degrees of disease progression, ranging from partial mobility and weakened speech to complete paralysis and loss of speech. Despite these physical impairments, the ALS patients retained good eye function, which allowed them to use a virtual keyboard for communication. Data from ALS patients was recorded multiple times at their homes, while data from healthy individuals was recorded once in a laboratory setting. For each data recording, the experimental design involved nine recording sessions per participant, each corresponding to a common human action or demand. This dataset can serve as a valuable benchmark for several applications, such as improving spelling systems with brain-computer interfaces, investigating motor imagination, exploring motor cortex function, monitoring motor impairment progress in patients undergoing rehabilitation, and studying the effects of ALS on cognitive and motor processes., (© 2024. The Author(s).)

This study evaluates the potential use of discarded plasterboard paper as fibers from buildings to reinforce concrete. Various concentrations of wastepaper fibers (0.5%, 1%, 1.5%, 2%, and 2.5% by weight of the binder) were investigated in this research. To mitigate the water absorption effect of the paper fibers, metakaolin was employed as a partial cement replacement. The results demonstrate that the inclusion of the wastepaper fiber enhances the mechanical and durability performance of the concrete. The optimal fiber proportion was identified as 1%, leading to a 29% increase in the compressive strength, a 38% increase in the splitting tensile strength, a 12% decrease in the water absorption, and a 23% decrease in the drying shrinkage with respect to the concrete containing 20% metakaolin. However, exceeding this optimal fiber content results in decreased mechanical and durability properties due to the fiber agglomeration and non-uniform fiber distribution within the concrete matrix. Based on the microstructural analysis, the improved performance of the concrete is ascribed to decreased porosity, more refined pore structure, and reduced propagation of microcracks within the concrete matrix in the presence of wastepaper fiber. According to the results, concrete containing 20% metakaolin and 1% wastepaper fiber exhibits durability and mechanical properties comparable to those of the traditional concrete. This finding highlights the significant promise of reducing dependency on conventional cement and incorporating suitable recycled materials, such as discarded plasterboard, and secondary by-products like metakaolin. Such a strategy encourages the preservation of resources, reduction in carbon dioxide emissions, and a decrease in the ecological footprint resulting from concrete production.

The interplay between strong Coulomb interactions and kinetic energy leads to intricate many-body competing ground states owing to quantum fluctuations in 2D electron and hole gases. However, the simultaneous observation of quantum critical phenomena in both electron and hole regimes remains elusive. Here, we utilize anisotropic black phosphorus (BP) to show density-driven metal-insulator transition with a critical conductance ∼ e 2 / h which highlights the significant role of quantum fluctuations in both hole and electron regimes. We observe a T -linear resistivity from the deep metallic phase to the metal-insulator boundary at moderate temperatures, while it turns to Fermi liquid behavior in the deep metallic phase at low temperatures in both regimes. An analysis of the resistivity suggests that disorder-dominated transport leads to T -linear behavior in the hole regime, while in the electron regime, the T -linear resistivity results from strong Coulomb interactions, suggestive of strange-metal behavior. Successful scaling collapse of the resistivity in the T -linear region demonstrates the link between quantum criticality and the T -linear resistivity in both regimes. Our study provides compelling evidence that ambipolar BP could serve as an exciting testbed for investigating exotic states and quantum critical phenomena in hole and electron regimes of 2D semiconductors.

Doping is one of the most difficult technological challenges for realizing reliable two-dimensional (2D) material-based semiconductor devices, arising from their ultrathinness. Here, we systematically investigate the impact of different types of nonstoichiometric solid MO x (M are W or Mo) dopants obtained by oxidizing transition metal dichalcogenides (TMDs: WSe 2 or MoS 2 ) formed on graphene FETs, which results in p -type doping along with disorders. From the results obtained in this study, we were able to suggest an analytical technique to optimize the optimal UV-ozone (UVO) treatment to achieve high p -type doping concentration in graphene FETs (∼2.5 × 10 13 cm -2 in this study) without generating defects, mainly by analyzing the time dependency of D and D ' peaks measured by Raman spectroscopy. Furthermore, an analysis of the structure of graphene sheets using TEM indicates that WO x plays a better protective role in graphene, compared to MoO x , suggesting that WO x is more effective for preventing the degradation of graphene during UVO treatment. To enhance the practical application aspect of our work, we have fabricated a graphene photodetector by selectively doping the graphene through oxidized TMDs, creating a p - n junction, which resulted in improved photoresponsivity compared to the intrinsic graphene device. Our results offer a practical guideline for the utilization of surface charge transfer doping of graphene toward CMOS applications.

The potential of 2D materials in future CMOS technology is hindered by the lack of high-performance p-type field effect transistors (p-FETs). While utilization of the top-gate (TG) structure with a p-doped spacer area offers a solution to this challenge, the design and device processing to form gate stacks pose serious challenges in realization of ideal p-FETs and PMOS inverters. This study presents a novel approach to address these challenges by fabricating lateral p + -p-p + junction WSe 2 FETs with self-aligned TG stacks in which desired junction is formed by van der Waals (vdW) integration and selective oxygen plasma-doping into spacer regions. The exceptional electrostatic controllability with a high on/off current ratio and small subthreshold swing ( SS ) of plasma doped p-FETs is achieved with the self-aligned metal/hBN gate stacks. To demonstrate the effectiveness of our approach, we construct a PMOS inverter using this device architecture, which exhibits a remarkably low power consumption of approximately 4.5 nW.

Purpose: Studies have documented diverse adverse effects of the COVID-19 pandemic on young people's lives-for instance on mental health, education/employment prospects, and intrafamily violence. We sought to generate much-needed evidence regarding whether, and which, young people are experiencing multiple intersecting effects., Methods: Data come from cross-sectional surveys with young people ages 15-25 years in Mexico (nationwide, n = 55,692), Kenya (four counties, n = 2,750), and India (two states, n = 3,537), collected from late 2020 to early 2022. We used latent class analysis to identify subgroups based on multiple adverse effects, then examined associations between these subgroups and COVID-19 infections/family deaths, and sociodemographic characteristics., Results: We found prevalent adverse impacts overall and two distinct subgroups in each country-one experiencing higher levels of all impacts, such as on mental health (44%-78% across countries), education/employment (22%-84%), intrafamily violence (22%-49%), and friendships (66%-86%). This subgroup comprised 40% of the sample in Mexico, 25% in Kenya, and 35% in India. In multivariate analyses, this group consistently had greater odds of experiencing COVID-19-related infections and deaths of loved ones. They were more likely socioeconomically disadvantaged, older, urban residents. Associations with other characteristics were country-specific., Discussion: This study provides novel cross-country evidence that a subgroup of young people has experienced intersecting adverse impacts of COVID-19 on their lives. Findings also confirm prior evidence of multiple elevated vulnerabilities in general. Expanded provision of multiple layers of support is required, particularly for the most vulnerable subgroup, as are multi-sectoral policies and interventions to prevent intersectional effects in future times of crisis., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

The dual crises of COVID-19 and climate change are impacting the lives of adolescents and young people as they transition to adulthood in an uncertain world, yet they are often excluded from research and political discourse. We surveyed young people about their needs and experiences, critical to engaging them and designing effective programs and policies to address these intersecting harms. The 2022 round of a national online survey through the Violence Outcomes in COVID-19 Epoch (VoCes) Study surveyed 152,088 Mexican youth (15-24 years). Logistic regressions were implemented to identify characteristics associated with four climate responses (economic, work-related, receiving government support, or social network support). Overall, 8.1% of participants experienced a recent climate hazard, with major impacts including housing damage from floods, and crop/livestock losses from drought. Participants who experienced a climate hazard were more likely to have experienced a pandemic-related harm, suggesting a dual impact. Poor youth were more likely to report economic losses from both the pandemic and a climate event but least likely to receive government support. Economic effects from the pandemic are exacerbating climate-related harms, unequally threatening the poorest youth. Engaging young people in decision-making and supporting the most vulnerable youth is critical for the next generation to thrive., (© 2023. Springer Nature Limited.)

Introduction and Importance: Aortic aneurysm is an uncommon but life-threatening cause of hemoptysis. Treatments include surgery and/or endovascular intervention, each with its own advantages and disadvantages. Endovascular intervention is associated with good early and medium-term outcomes., Case Presentations: We report three cases of hemoptysis due to ruptured thoracic aortic aneurysm who underwent endovascular intervention. In all three cases, endovascular grafts were placed in the descending thoracic aorta, the number of grafts used was 1, the average time to stop hemoptysis was 4 to 5 days, and the length of hospital stay was between 6 and 8 days. No intravascular fistula, renal failure, prolonged mechanical ventilation and other major cardiovascular events were reported., Clinical Discussion: Endovascular treatment for descending TAA has been demonstrated to be safe and effective, particularly in emergencies in which patients presented with life-threatening hemoptysis, due to its rapid access to the aorta. In our experience at a tertiary hospital in southern Vietnam, the procedural time for a thoracic endovascular aortic repair is relatively brief and can last between 15 and 30 min. Thus, endovascular treatment for ruptured TAA can substantially improve patient prognosis, reduce mortality and complications., Conclusion: The implementation of endovascular intervention can help improve prognosis, reduce mortality and complications in patients with hemoptysis due to ruptured thoracic aortic aneurysm., Competing Interests: Conflict of interest All authors declare no conflict of interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Intestinal stomas are surgical interventions that have an impact on both physical and psychological health, necessitating patient self-care. Insufficient knowledge regarding peristomal skin care, prevention, and treatment of potential problems can lead to an increase in stoma-related complications., Objective: This study aimed to assess patients' knowledge of self-care for intestinal stomas and examine the relationship between background information and self-care knowledge., Methods: A descriptive cross-sectional study was conducted from December 2021 to December 2022 at the Can Tho University of Medicine and Pharmacy Hospital in Vietnam, involving 74 participants with intestinal stomas. A questionnaire consisting of 24 closed-ended questions was used to evaluate participants' knowledge of self-care for intestinal stomas. Descriptive statistics, Chi-square, and Fisher's exact tests were employed for data analysis., Results: The findings revealed that 54.1% of participants had good knowledge of general self-care for intestinal stomas. The distribution of good knowledge among participants was as follows: basic knowledge (66.2%), self-care practice (56.8%), recognizing and managing complications (31.1%), and dietary knowledge (64.8%). Significant relationships were observed between participants' self-care knowledge and their education level ( p = 0.002), marital status ( p = 0.017), nurses' education ( p = 0.021), and hospitalization ( p = 0.001)., Conclusion: The proportion of participants with good knowledge of self-care for intestinal stomas was relatively low, and it was associated with individuals' education level, marital status, nurses' education, and hospitalization. This study highlights the need for ongoing development of educational programs on self-care for intestinal stomas. These programs should be tailored to address the specific needs of each patient and aim to improve their self-care knowledge in a meaningful and sustainable manner. By investing in patient education, healthcare professionals, particularly nurses, can assist individuals with intestinal stomas in achieving better outcomes and preventing potential complications., Competing Interests: The authors declared no conflict of interest in this study., (© The Author(s) 2023.)

Two-dimensional transition metal dichalcogenides (TMDs) are promising materials for semiconductor nanodevices owing to their flexibility, transparency, and appropriate band gaps. A variety of optoelectronic and electronic devices based on TMDs p-n diodes have been extensively investigated due to their unique advantages. However, improving their performance is challenging for commercial applications. In this study, we propose a facile and doping-free approach based on the contact engineering of a few-layer tungsten di-selenide to form a lateral p-n homojunction photovoltaic. By combining surface and edge contacts for p-n diode fabrication, the photovoltaic effect is achieved with a high fill factor of ≈0.64, a power conversion efficiency of up to ≈4.5%, and the highest external quantum efficiency with a value of ≈67.6%. The photoresponsivity reaches 283 mA/W, indicating excellent photodiode performance. These results demonstrate that our technique has great potential for application in next-generation optoelectronic devices.