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Abstract Background Myasthenia gravis (MG) patients interact unpredictably with anesthetic agents, including neuromuscular blocking agents. Here, we investigate the effectiveness of general anesthesia without muscle relaxants using either propofol via target-controlled infusion systems (TCI) or sevoflurane in MG patients undergoing thoracoscopic thymectomy. Methods This prospective, open-label, observational study was conducted in a university hospital. We included 90 myasthenic patients undergoing thoracoscopic thymectomy with general anesthesia. Patients received induction and maintenance anesthesia with propofol TCI (group P, n = 45) or induction with propofol 2–3 mg.kg−1 and maintenance anesthesia with sevoflurane (group S, n = 45). In both groups, the procedure was performed under the guidance of entropy with sufentanil but not a muscle relaxant. Intubation conditions, hemodynamic changes, respiratory function, neuromuscular transmission, arterial blood gas, and complications were evaluated. Results All patients achieved good intubation conditions. Hemodynamic instability was more frequent in group S than in group P, mostly in the induction stage, and was controllable. The reduction in the intraoperative train-of-four ratio from baseline at 30 min, 60 min, and 90 min in group S was 10.3%, 14.2%, and 14.3%, respectively, significantly higher than that in group P (6.8%, 7.2%, and 8.4%, respectively), which completely recovered at the end of the surgery. All patients were extubated in the operating room without complications. No other significant differences between the groups were observed. Conclusions Anesthesia with propofol TCI or sevoflurane without muscle relaxants in MG patients offered safe and effective conditions for thoracoscopic thymectomy. Sevoflurane achieved higher levels of intraoperative muscular relaxation than propofol TCI. Postoperative neuromuscular function was not affected by these anesthetics.

In an aging society, healthcare professionals and students face increasing demands to actively involve patients in the decision-making process regarding their health conditions and lifestyles. Self-management support is considered a best practice that aligns with the patient-centered care paradigm in Bangladesh. However, there is currently no instrument available to assess healthcare professionals’ competencies in this field, particularly during their early education and training period. The aim of this study was to translate the Self Efficiency and Performance in Self-management Support (SEPSS) instrument into Bangla and validate its psychometric properties in a sample of undergraduate healthcare students in Bangladeshi higher education institutions. A cross-sectional study was conducted to assess the reliability, validity, and cultural appropriateness of the Bangla version of SEPSS-36 among 486 nursing and medical students. Confirmatory factor analysis was carried out using the chi-square model fit index (CMIN), comparative fit index (CFI), and Root Mean Square Error of Approximation (RMSEA) as fit indices. The internal consistency was estimated by the Cronbach alpha coefficient. The results indicate that the CMIN (2.658) and RMSEA (.058) values suggest that the sample data and hypothetical model are an acceptable fit in the analysis, with satisfactory CFI values (.895). The reliability for all SEPSS dimensions was acceptable. The Bangla version of the SEPSS questionnaire is a valid and reliable instrument that can assist healthcare educators and researchers in determining students’ competencies within this domain.

Oral cancer patients suffer pain at the site of the cancer. Calcitonin gene related polypeptide (CGRP), a neuropeptide expressed by a subset of primary afferent neurons, promotes oral cancer growth. CGRP also mediates trigeminal pain (migraine) and neurogenic inflammation. The contribution of CGRP to oral cancer pain is investigated in the present study. The findings demonstrate that CGRP-immunoreactive (-ir) neurons and neurites innervate orthotopic oral cancer xenograft tumors in mice. Cancer increases anterograde transport of CGRP in axons innervating the tumor, supporting neurogenic secretion as the source of CGRP in the oral cancer microenvironment. CGRP antagonism reverses oral cancer nociception in preclinical oral cancer pain models. Single-cell RNA-sequencing is used to identify cell types in the cancer microenvironment expressing the CGRP receptor components, receptor activity modifying protein 1 Ramp1 and calcitonin receptor like receptor (CLR, encoded by Calcrl). Ramp1 and Calcrl transcripts are detected in cells expressing marker genes for Schwann cells, endothelial cells, fibroblasts and immune cells. Ramp1 and Calcrl transcripts are more frequently detected in cells expressing fibroblast and immune cell markers. This work identifies CGRP as mediator of oral cancer pain and suggests the antagonism of CGRP to alleviate oral cancer pain.

BackgroundThe COVID-19 pandemic and governments' response lead to dramatical change in quality of life worldwide. However, the extent of this change in Vietnamese medical and nursing students has not been documented.ObjectivesThe study aims to describe the quality of life and changes in quality of life of medical and nursing students during the COVID-19 pandemic and examine the association of quality of life and changes in quality of life with fear of COVID-19 and other socio-economic and demographic factors.MethodsThe study was a cross-sectional study on all students of Hanoi Medical University from 3 majors: General Medicine, Preventive Medicine, Nursing (3672 invited students); from 7th to 29th of April 2020; using an online questionnaire that included demographic and academic information, the Vietnamese version of the SF-36 Quality of Life questionnaire and the Fear of COVID-19 Scale (FCV-19S). Linear and modified Poisson regression was used to examine the association between quality of life, changes in quality of life and other factors.ResultsThe number of participants was 1583 (response rate 43%). Among 8 dimensions of the SF-36 (ranged 0-100), Vitality had the lowest score with a median score of 46. The median physical composite score (PCS) of the sample was 40.6 (IQR:20.8-53.2), 33.5% of the sample had an above-population average PCS score. The median mental composite score (MCS) of the sample was 20.3 (IQR:3.8-31.7), and 98.2% had an MCS score below average. 9.9% (95%CI:8.5%-11.4%) of the population reported a significant negative change in the quality of life. Fear of COVID-19 was not associated with significant changes in quality of life, nor MCS while having some association with PCS (Coef:-5.39;95%CI:-3to-7.8). Perceived reduction in quality of life was also associated with: being on clinical rotation COVID-19 (PR:1.5;95%CI:1.05-2.2), difficulties affording health services (PR:1.4;95%CI:1.02-1.95), obesity (PR:2.38;95%CI:1.08-5.25) and chronic disease (PR:1.92;95%CI:1.23-3), typical symptoms (PR:1.85; 95%CI:1.23-2.78) and atypical symptoms of COVID-19 (PR:2.32;95%CI:1.41-3.81).ConclusionThe majority of medical and nursing students had below average quality of life, with lower vitality and mental composite health score in the settings of COVID-19. Perceived decrease in quality of life was associated with clinical rotation, difficulties affording healthcare services and was not associated with Fear of COVID-19.

Smoking is a global health problem among health science students. The objectives of this study were to estimate the prevalence of smoking and to examine associated factors among health science students from five universities in Vietnam. Among 5946 participants (95.0% response rate), the smoking prevalence was 19.2% (95% CI:17.4–21.0%) among male students and 2.9% (95% CI:2.4–3.5%) among female students. In the multivariable regression models, significant factors for smoking were the perceived financial burden, the respondent’s year in university, a non-self-determined motivation profile, self-reported depression and/or anxiety, the level of vigorous physical activity, and alcohol drinking.

This study aimed to describe the status of antenatal depression and its associated factors among pregnant women in Vietnam. A cross-sectional study was conducted in four obstetric hospitals in Vietnam from January to September 2019. A total of 1260 pregnant women were interviewed using a structured questionnaire. A Tobit regression model was used to determine factors associated with antenatal depression. Results showed that pregnant women were at high risk of antenatal depression (24.5%). Women with fetus abnormalities and higher education were at higher risk of antenatal depression. We highlighted the need for implementing formal screening programs to early detect antenatal depression.

Oral squamous cell carcinoma (SCC) pain is more prevalent and severe than pain generated by any other form of cancer. We previously showed that protease-activated receptor-2 (PAR2) contributes to oral SCC pain. Cathepsin S is a lysosomal cysteine protease released during injury and disease that can activate PAR2. We report here a role for cathepsin S in PAR2-dependent cancer pain. We report that cathepsin S was more active in human oral SCC than matched normal tissue, and in an orthotopic xenograft tongue cancer model than normal tongue. The multiplex immunolocalization of cathepsin S in human oral cancers suggests that carcinoma and macrophages generate cathepsin S in the oral cancer microenvironment. After cheek or paw injection, cathepsin S evoked nociception in wild-type mice but not in mice lacking PAR2 in Nav1.8-positive neurons (Par2Nav1.8), nor in mice treated with LY3000328 or an endogenous cathepsin S inhibitor (cystatin C). The human oral SCC cell line (HSC-3) with homozygous deletion of the gene for cathepsin S (CTSS) with CRISPR/Cas9 provoked significantly less mechanical allodynia and thermal hyperalgesia, as did those treated with LY3000328, compared to the control cancer mice. Our results indicate that cathepsin S is activated in oral SCC, and that cathepsin S contributes to cancer pain through PAR2 on neurons.

ObjectivesThe average alcohol consumption per capita among Vietnamese adults has consistently increased. Although alcohol-related disorders have been extensively studied, there is a paucity of research shedding light on this issue among Internet users. The study aimed to examine the severity of alcohol-related disorders and other associated factors that might predispose individuals towards alcohol usage in a sample of youths recruited online.MethodsAn online cross-sectional study was conducted with 1,080 Vietnamese youths. A standardized questionnaire was used. Respondent-driven sampling was applied to recruit participants. Multivariate logistic and Tobit regressions were utilized to identify the associated factors.ResultsAbout 59.5% of the males and 12.7% of the total youths declared that they were actively using alcohol. From the total sample, a cumulative total of 32.3% of the participants were drinking alcohol, with 21.8% and 25.0% of the participants being classified as drinking hazardously and binge drinkers, respectively. The majority of the participants (60.7%) were in the pre-contemplative stage.ConclusionsA high prevalence of hazardous drinking was recognized among online Vietnamese youths. In addition, we found relationships between alcohol use disorder and other addictive disorders, such as tobacco smoking and water-pipe usage. Our results highlighted that the majority of the individuals are not receptive to the idea of changing their alcohol habits, and this would imply that there ought to be more government effort towards the implementation of effective alcohol control policies.

Abstract Background Chronic limb-threatening ischemia (CLTI) is the most severe clinical form of peripheral artery disease (PAD), accounting for approximately 11%, and is strongly associated with the incidence of amputation, cardiovascular events, and mortality. The Global Vascular Guideline (GVG) proposed a new Global Anatomic Staging System (GLASS) for evaluating the anatomic complexity of arterial lesions. However, more research is required to evaluate outcomes after endovascular intervention in CLTI patients using the GLASS. Objective Our study aimed to describe clinical characteristics, arterial lesions, and endovascular interventions according to three grades of GLASS in the Vietnamese population. We evaluated the technical success, mortality rate, and probability to preserve the limb according to the GLASS. Methods All patients were diagnosed with CLTI and underwent infrainguinal endovascular intervention at the Department of Thoracic and Vascular Surgery, University Medical Center, Ho Chi Minh City from June 2020 to June 2022. All patients were evaluated before intervention and follow-up at 6 and 12 months after intervention. Patients were divided into three groups according to the GLASS, thereby comparing the technical success, mortality, and amputation rates. This retrospective study describes a series of cases. Results The study sample evaluated 82 lower limbs of 82 patients, in which GLASS class I, II, and III lesions accounted for 36.6%, 43.9%, and 19.5% of the patients, respectively. The rates of technical success in the groups gradually decreased according to the complexity of the lesions (90%, 86.11%, and 56.25% for GLASS I, II, and III, respectively; p = 0.012). Notably, limb-based patency (LBP) at 12 months was significantly lower in the GLASS III group than in the GLASS I and II groups (22.22% vs 88.89% and 67.74%, respectively; p = 0.001). The amputation rates at 12 months in GLASS groups I, II, and III were 13.3%, 22.2%, and 50%, respectively (p = 0.021), while the mortality rates at 12 months were 0%, 8.33%, and 25%, respectively (p = 0.015). Conclusion In patients with CLTI of higher GLASS stages, the rates of technical success were lower and the amputation and mortality rates were higher.

Mode-I stress intensity factors are estimated for 28 buckled two-dimensional hexagonal materials, including 6 mono-elemental (silicene, indiene, blue phosphorene, arsenene, antimonene and bismuthene) and 22 binary (CS, CSe, CTe, SiO, SiS, SiSe, SiTe, SiGe, GeO, GeS, GeSe, GeTe, SnO, SnS, SnSe, SnTe, SnGe, SnSi, InAs, InSb, GaAs and AlSb) two-dimensional materials. The crack-tip displacement field revealed from linear elastic fracture mechanics is adopted to find the stress intensity factor. Atomic-scale finite element method with Stillinger-Weber potentials is used to simulate the tensile tests. Mode-I stress intensity factors of these 28 two-dimensional materials appear ≤ 0.8 MPa m , which are very small in comparison with boronitrene and graphene. Most of them exhibit their fracture toughness below 0.5 MPa m. Our findings are helpful in the design of nano-devices with these two-dimensional materials. [ABSTRACT FROM AUTHOR]

Abstract Background The erythrocytic stage of the life cycle of the malaria parasite, Plasmodium falciparum, consists of trophozoite, schizont and gametocyte stages in humans. Various anti-malarial agents target different stages of the parasite to produce treatment outcomes. This study reports on the stage-specific anti-malarial activity of heptaphylline and imperatorin against human P. falciparum in addition to their cytotoxicity and selectivity indices (SI). Methods The compounds were isolated from Clausena anisata using column chromatography and their structures elucidated using NMR spectroscopy. The anti-malarial activity was determined by measuring the trophozoitocidal, schizonticidal and gametocytocidal activities of the compounds using the SYBR green assay. Cytotoxicity was evaluated using the tetrazolium-based colorimetric assay. Results Heptaphylline and imperatorin produced trophozoitocidal, schizonticidal and gametocytocidal activities with IC50s of 1.57 (0.2317)–26.92 (0.3144) µM with those of artesunate (the standard drug) being 0.00024 (0.0036)–0.0070 (0.0013) µM. In the cytotoxicity assay, the compounds produced CC50S greater than 350 µM and SI of 13.76–235.90. Also, the trophozoitocidal and schizonticidal activities of the compounds were more pronounced than their gametocytocidal activity. Imperatorin was 42.04% more trophozoitocidal than hepthaphyline. However, hepthaphyline has more schizonticidal and gametocytocidal properties than imperatorin. Conclusion Heptaphylline and imperatorin are promising anti-malarial agents, since they possess potent anti-malarial activity with weak cytotoxicity on RBCs. However, imperatorin is a better anti-malarial prophylactic agent whereas heptaphylline is a better malaria treatment agent.

The root bark of Capparis erythrocarpos (CERB) is employed to treat rheumatoid arthritis (RA) in Africa, particularly in Ghana. However, there was no isolation and characterization of the bioactive constituents responsible for the pharmacological actions of this plant. The aim of this study is to isolate, characterize and evaluate the anti-arthritic activity of the constituents of CERB. CERB was soxhleted and partitioned into various fractions. The constituents were isolated using column chromatography and characterized by 1D and 2D NMR spectroscopy. The precise carboxylic acid residues of the esters were determined using saponification, derivatization and GC–MS analysis. Anti-arthritic activity was evaluated in the CFA-induced arthritic model. Two triterpenoid esters namely, sitosterol 3-hexadecanoate or sitosterol 3-palmatate (1) and sitosterol 3-tetradecanoate or sitosterol 3-myristate (2) in addition to beta sitosterol (3) were isolated and characterized. Compounds 1 and 2 administered at 3 µmol/kg (p.o.) produced anti-inflammatory activity (P

Berberin là một alkaloid có nguồn gốc từ thực vật, được dùng nhiều trong y học cổ truyền. Berberin có khả năng kháng khuẩn, kháng viêm, ức chế tế bào gây ung thư,... Tuy nhiên, berberin lại ít tan trong nước và có tính sinh khả dụng thấp. Nghiên cứu được thực hiện nhằm khảo sát tỉ lệ chất hoạt động bề mặt Tween 80 : Sodium Laureth Sulfate để tạo ra hệ nano berberin ổn định, đồng nhất và đánh giá khả năng vi khuẩn gây sâu răng của nano berberin. Nano berberin được chế tạo bằng phương pháp nghiền bi với các tỉ lệ chất hoạt động bề mặt Tween 80 và Sodium Laureth Sulfate khác nhau. Các mẫu được kiểm tra đặc tính hóa, lý bằng phương pháp XRD, FE-SEM và UV-Vis. Bước đầu đánh giá khả năng ức chế vi khuẩn gây sâu răng của mẫu nano berberin bằng phương pháp khuếch tán qua thạch và phương pháp pha loãng vi lượng. Kết quả cho thấy, mẫu có tỉ lệ chất hoạt động bề mặt Tween 80 : Sodium Laureth Sulfate là 3:1 tạo ra hạt nano berberin có cấu trúc tinh thể với kích thước hạt nano trung bình là 40 – 65 nm. Nano berberin có khả năng ức chế mạnh sự phát triển của vi khuẩn S. mutans – tác nhân chính gây nên sâu răng.

This study aimed to describe mental health service utilization and examine associated factors among students in Vietnam. Data were collected at eight universities in Hanoi, Vietnam, in 2018 using an administered questionnaire. The total number of participants was 9,120 (95.1% response rate). Among students participating in our survey, 12.5% (95% CI: 10.9–14.1) with depression and/or anxiety symptoms used mental health service in the last 12 months. In the multivariable regression models, significant factors associated with mental health service utilization were marital status, types of housemate, mental health problems, physical activity, smoking status, and alcohol drinking. Our study made recommendations to stakeholders for improving mental health services utilization among students in Vietnam. These findings had important implications for future research on factors associated with mental health service utilization among university students. [ABSTRACT FROM AUTHOR]

Oral squamous cell carcinoma (OSCC) is one of the most painful cancers, which interferes with orofacial function including talking and eating. We report that legumain (Lgmn) cleaves protease-activated receptor-2 (PAR2) in the acidic OSCC microenvironment to cause pain. Lgmn is a cysteine protease of late endosomes and lysosomes that can be secreted; it exhibits maximal activity in acidic environments. The role of Lgmn in PAR2-dependent cancer pain is unknown. We studied Lgmn activation in human oral cancers and oral cancer mouse models. Lgmn was activated in OSCC patient tumors, compared with matched normal oral tissue. After intraplantar, facial or lingual injection, Lgmn evoked nociception in wild-type (WT) female mice but not in female mice lacking PAR2 in NaV1.8-positive neurons (Par2Nav1.8), nor in female mice treated with a Lgmn inhibitor, LI-1. Inoculation of an OSCC cell line caused mechanical and thermal hyperalgesia that was reversed by LI-1. Par2Nav1.8 and Lgmn deletion attenuated mechanical allodynia in female mice with carcinogen-induced OSCC. Lgmn caused PAR2-dependent hyperexcitability of trigeminal neurons from WT female mice. Par2 deletion, LI-1, and inhibitors of adenylyl cyclase or protein kinase A (PKA) prevented the effects of Lgmn. Under acidified conditions, Lgmn cleaved within the extracellular N terminus of PAR2 at Asn30↓Arg31, proximal to the canonical trypsin activation site. Lgmn activated PAR2 by biased mechanisms in HEK293 cells to induce Ca2+ mobilization, cAMP formation, and PKA/protein kinase D (PKD) activation, but not β-arrestin recruitment or PAR2 endocytosis. Thus, in the acidified OSCC microenvironment, Lgmn activates PAR2 by biased mechanisms that evoke cancer pain. [ABSTRACT FROM AUTHOR]

Mg3Sb2-based Zintl compounds are well known as an intrinsic p-type narrow bandgap semiconductor which can be considered as promising candidates because of their non-toxic and inexpensive elements. In this study, Mg3Sb2 compounds doped with Si and co-doped with Fe and Si have been successfully prepared by solid phase reaction method (Combination of high energy ball milling, hot pressing, and sintering). The thermoelectric properties of Si-doped and (Fe, Si) co-doped on the Sb sites of Mg3Sb2 compounds were investigated in the temperature range of 300-673K. The secondary phases of SiSb3 and FeSb were found in the doping samples. The thermoelectric results showed that the electrical conductivity strongly increased in Si-doped sample, while the additional Fe doping further enhanced the Seebeck coefficient compared to undoped Mg3Sb2 sample. The highest power factor value was observed in co-doped Fe, Si sample. Maximum value of the power factor in Mg3Sb1.4Fe0.5Si0.1 was 1.8 μWcm-1K-2 at 673K, which is around ~ 2.2 times higher than that of the undoped sample.

Thóc lép ba hoa (Desmodium triflorum) là cây thuốc nam được sử dụng phổ biến và rộng rãi trong y học dân gian. Thử nghiệm in vivo và in vitro của các cao chiết và hoạt chất rutin từ cây thóc lép ba hoa với một số nấm gây bệnh thực vật đã được tiến hành. Các cao chiết từ cây thóc lép ba hoa thể hiện hoạt tính in vitro ức chế nấm Magnaporthe grisea, Sclerotium rolfsii (SR), Fusarium oxysporum và các chủng Colletotrichum sp. ở 1000 µg/mL. Ngoài ra, cao methanol ức chế bệnh đạo ôn do M. grisea gây ra trên cây lúa 50% ở 1000 và 3000 µg/mL in vivo. Sự hiện diện của rutin trong cây được tiến hành bằng phân tách và HPLC. Hoạt tính in vitro của rutin và nanorutin (kích thước hạt 669,3 nm và thế zeta -18,5 mV) được đánh giá với SR và Colletotrichum sp. Cả rutin và nanorutin đều ức chế nấm SR và nanorutin thể hiện hoạt tính tốt hơn khi thử với SR và Colletotrichum gloeosporioides. Các kết quả nghiên cứu đã xác nhận hoạt tính kháng nấm của thóc lép ba hoa và hoạt chất từ...