Search

Gallbladder rupture caused by blunt abdominal trauma is an uncommon injury, particularly in children. This condition occurs even less frequently in children with common bile duct cysts. The history is difficult to obtain, the clinical symptoms are indistinct, and their assessment is obscured by a slew of other lesions. Radiography cannot produce clear images. Thus, the diagnosis is frequently delayed and confirmed only during surgery. Case reports of gallbladder injury after abdominal trauma are relatively rare and there are only 50 case reports in literature for 100 years. Herein, we present the case of an 18-month-old girl who had a ruptured gallbladder funnel due to blunt abdominal trauma caused by domestic violence, with an early clinical presentation of septic shock and chylous effusion. The patient underwent surgery after being diagnosed with chylous ascites that had not responded to medical treatment. Based on the findings, single-stage laparoscopic surgery is confirmed to aid in the diagnosis and treatment of gallbladder injury in the presence of a common bile duct cyst.

Background: ND2 in Ho Chi Minh City is currently the only public center that performs PLT in Southern Vietnam. In 2005, the first PLT was successfully performed, with support from Belgian experts. This study reviews the implementation of PLT at our center and evaluates the results and challenges. Methods: Implementation of PLT at ND2 required medico‐surgical team building and extensive improvement of hospital facilities. Records of 13 transplant recipients from 2005 to 2020 were studied retrospectively. Short‐ and long‐term complications, as well as the survival rates, were reported. Results: The mean follow‐up time was 8.3 ± 5.7 years. Surgical complications included one case of hepatic artery thrombosis that was successfully repaired, one case of colon perforation resulting in death from sepsis, and two cases of bile leak that were drained surgically. PTLD was observed in five patients, of whom three died. There were no cases of retransplantation. The 1‐year, 5‐year, and 10‐year patient survival rates were 84.6%, 69.2%, and 69.2%, respectively. There were no cases of complication or death among the donors. Conclusion: Living‐donor PLT was developed at ND2 for providing a life‐saving treatment to children with end‐stage liver disease. Early surgical complication rate was low, and the patient survival rate was satisfactory at 1 year. Long‐term survival decreased considerably due to PTLD. Future challenges include surgical autonomy and improvement of long‐term medical follow‐up with a particular emphasis on prevention and management of Epstein–Barr virus‐related disease. [ABSTRACT FROM AUTHOR]

Background In Vietnam, the importance of vivax malaria relative to falciparum during the past decade has steadily increased to 50%. This, together with the spread of multidrug-resistant Plasmodium falciparum, is a major challenge for malaria elimination. A 2-year prospective cohort study to assess P. vivax morbidity after radical cure treatment and related risk factors was conducted in Central Vietnam. Methods and findings The study was implemented between April 2009 and December 2011 in four neighboring villages in a remote forested area of Quang Nam province. P. vivax-infected patients were treated radically with chloroquine (CQ; 25 mg/kg over 3 days) and primaquine (PQ; 0.5 mg/kg/day for 10 days) and visited monthly (malaria symptoms and blood sampling) for up to 2 years. Time to first vivax recurrence was estimated by Kaplan-Meier survival analysis, and risk factors for first and recurrent infections were identified by Cox regression models. Among the 260 P. vivax patients (61% males [159/260]; age range 3-60) recruited, 240 completed the 10-day treatment, 223 entered the second month of follow-up, and 219 were followed for at least 12 months. Most individuals (76.78%, 171/223) had recurrent vivax infections identified by molecular methods (polymerase chain reaction [PCR]); in about half of them (55.61%, 124/223), infection was detected by microscopy, and 84 individuals (37.67%) had symptomatic recurrences. Median time to first recurrence by PCR was 118 days (IQR 59-208). The estimated probability of remaining free of recurrence by month 24 was 20.40% (95% CI [14.42; 27.13]) by PCR, 42.52% (95% CI [35.41; 49.44]) by microscopy, and 60.69% (95% CI [53.51; 67.11]) for symptomatic recurrences. The main risk factor for recurrence (first or recurrent) was prior P. falciparum infection. The main limitations of this study are the age of the results and the absence of a comparator arm, which does not allow estimating the proportion of vivax relapses among recurrent infections. Conclusion A substantial number of P. vivax recurrences, mainly submicroscopic (SM) and asymptomatic, were observed after high-dose PQ treatment (5.0 mg/kg). Prior P. falciparum infection was an important risk factor for all types of vivax recurrences. Malaria elimination efforts need to address this largely undetected P. vivax transmission by simultaneously tackling the reservoir of P. falciparum and P. vivax infections., Author(s): Thanh Vinh Pham 1,2,*, Hong Van Nguyen 1, Angel Rosas Aguirre 2,3,4, Van Van Nguyen 5, Mario A. Cleves 6, Xa Xuan Nguyen 1, Thao Thanh Nguyen 7, Duong [...]

Structure and dynamics of liquid aluminosilicate (Al2O3–2SiO2, abbreviated as AS2) are investigated by molecular dynamics (MD) simulation and visualisation. The local structural characteristics are analysed via topology statistics of basic structural units TOnand OTm(T = Si, Al;n = 3, 4, 5, 6;m = 2, 3, 4, 5). The amount distribution as well as spatial distribution of the basic structural units under compression is also clarified. Regarding the intermediate range order, the amount and spatial distribution of all types of OTmlinkages as well as the bond statistics (corner-, edge-, and face-sharing) between two adjacent TOnunits are investigated in detail. The self-diffusion of Si, Al, and O is calculated via mean square displacement (MSD). The anomalous diffusion is explained in detail in relationship to structural characteristics. The structural and dynamical heterogeneities, micro-phase separation, and liquid–liquid phase transition are also discussed in this work. [ABSTRACT FROM PUBLISHER]

Standard data envelopment analysis (DEA) tends to be sensitive to the number of variables of a chosen sample, and it is unable to account for their random nature. Standard DEA can exhibit statistical inconsistency, biased results, and an arguable inference process. Thus, in this study, an efficiency evaluation method is used to overcome these limitations, especially since no studies of port efficiency have addressed this issue. This study applies bootstrapped DEA to a sample of the 43 largest Vietnamese ports and compares the results with those from stochastic frontier analysis (SFA) and standard DEA. The results show that while the efficiency scores obtained from the three methods provide useful and consistent measures of the ports’ efficiency, they differ significantly. Furthermore, while the efficiency scores produced by bootstrapped DEA are consistent, unbiased, and not sensitive to the sample size, standard DEA and SFA yield efficiency scores that are much larger than bootstrapped DEA. In addition, bootstrapped DEA provides the confidence intervals for efficiency scores and allows for hypothesis tests of port performance. [ABSTRACT FROM AUTHOR]

During the Cold War, there have been such long-lasting debates as: when did the Cold War start? Who started it? Who is responsible for the Cold War? For a long period, Soviet historians maintained their "orthodox" point of view which condemned the US and its allies for having provoked the Cold War under the American traditional imperialism. Recently, Russian historians have revised their point of view, thus no longer interpreted the Cold War in their former "orthodox" perspective which often accused the US the sole instigator. Instead, they also reviewed the Soviet's mistakes and missed opportunities. A new perspective by both Russian and American scholars on this complex theme is growing more flexible. Besides, more and more "confidential" papers are released which also contributes to highlight some mysterious part of the Cold War. [ABSTRACT FROM AUTHOR]

Semiconductor-containing porous materials with a well-defined structure could be unique scaffolds for carrying out selective organic transformations driven by visible light. We herein introduce for the first time a heterostructure of silver indium sulfide (AgInS 2 ) ternary chalcogenide and a highly porous MIL-101(Cr) metal-organic framework (MOF) synthesised from polyethylene terephthalate plastic waste. Our results demonstrate that AgInS 2 nanoparticles were uniformly attached to each lattice plane of the octahedral MIL-101(Cr) structure, resulting in a nanocomposite with a high distribution of semiconductors in a porous media. We also demonstrate that the nanocomposite with up to 40% of AgInS 2 doping exhibited excellent catalytic activity for tetracycline degradation under visible light irradiation (∼99% tetracycline degraded after 4 h) and predominantly maintained its performance after five cycles. These results could promote a new material circularity pathway to develop new semiconductors that can be used to protect water from further pollution., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Training student pharmacists to administer vaccinations requires a substantial investment in vaccines, supplies, and time. Few schools of pharmacy seek out or receive any reimbursement for the provision of vaccines, despite the fact it is a covered service. This study sought to implement, deliver, and demonstrate an innovative, financially sustainable curriculum-based immunization program by trained pharmacy students as part of their experiential learning. Thirty-nine community health clinics targeting Medicare beneficiaries were conducted throughout Northern/Central California during Medicare's fall open enrollment periods between 2014⁻2016. American Pharmacists Association (APhA)-trained student pharmacists (under licensed pharmacist supervision) administered 1777 vaccinations. Vaccines were billed via a secure Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant web-based portal. The total net income was $11,905 and $8032 for 2015 and 2016, respectively. Return on investment was greatest for the influenza vaccine > Tdap > pneumococcal. Pharmacy students are already being trained to provide immunizations and can utilize their skills to deliver financially viable public health programs.

Nociception-evoked prostaglandin E2 (PGE2) release in the spinal cord contributes considerably to the development of hyperalgesia and allodynia. Biosynthesis of PGE2 involves the conversion of arachidonic acid to PGH2 by cyclooxygenases (COXs), followed by an isomerization of PGH2 to PGE2 by PGE2 synthases (PGESs). The roles of COX-1, COX-2, and the inducible microsomal PGES-1 have been studied in models of pain and inflammation. In contrast, in nociceptive processes, very little is known about the role of cytosolic PGES (cPGES), which has been described as being functionally coupled to COX-1. Here we show by in situ hybridization and immunohistological analysis that COX-1 and cPGES are constitutively expressed in neuronal and non-neuronal cells of the dorsal and ventral horns in the spinal cord of adult rats. The protein levels of both enzymes were not regulated by nociceptive stimuli; however, reduction of cPGES in rat spinal cord with intrathecal application of cPGES antisense oligonucleotides reduced the nociceptive behavior in zymosan-evoked thermal hyperalgesia and in the formalin assay. The data indicate that cPGES plays an important role in mediating early responses during spinal nociceptive processing.