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We consider problem (P) of Kirchhoff-Carrier type with nonlinear terms containing a finite number of unknown values $u(\eta_1,t),\cdots,u(\eta_q,t)$ with $0\leq\eta_1

Sharing-based accommodations services are experiencing rapid global growth, driven by their inherent advantages. Nevertheless, alongside the benefits, these services are also accompanied by costs and potential risks. Intriguingly, the factors impeding or restricting consumer adoption of sharing-based accommodations have not been comprehensively investigated thus far. This study utilized innovation resistance theory (IRT) to investigate the influence of various barriers on the intention to use sharing-based lodgings services. Additionally, this study extended IRT by examining the impact of personal characteristics (innovativeness and compatibility) on consumers’ perceived resistance and intention to use sharing-based accommodations services. A quota sample included 493 individuals who were aware of sharing-based accommodations services and had traveled within the past 6 months. Path analysis utilizing structural equation modeling was used to test the research hypotheses. The study’s findings demonstrated that several barriers have a detrimental impact on individuals’ intentions to engage in sharing-based accommodation, except for image barriers and usage barriers. In addition, consumers’ innovativeness and compatibility characteristics negatively impact barriers and positively impact intention to use sharing-based accommodations. Based on these findings, sharing-based accommodations providers, individuals or businesses providing accommodations, and localities providing tourism services can design more effective strategies to attract users.

The objective of this study was to investigate the mental disturbances among COVID-19 survivors while also examining their quality of life. A retrospective cohort study was conducted among COVID-19 survivors in northern Vietnam. Anxiety, depression, insomnia, cognitive impairment, and quality of life were assessed using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Pittsburgh Sleep Quality Index, Mini-Cog, and Short Form-8 (SF-8), respectively. Information regarding COVID and post-COVID conditions was retrospectively collected through direct interviews. Ordinal logistic regression was employed to identify factors associated with the severity of depression and anxiety; binary logistic regression was used to identify factors associated with the presence of sleep disturbance and cognitive impairment, and linear regression was utilized to identify factors associated with the mental and physical components of the SF-8. A total of 1596 participants were included in this study, with the prevalence of depression, anxiety, sleep disturbance, and cognitive impairment being 8.7%, 16.9%, 23.4%, and 5.6%, respectively. Experiencing discrimination during COVID-19 infection and post-COVID syndrome were both linked to long-term outcomes of depression, anxiety, and insomnia and were also related to a decline in the quality of life. Our study provided initial insights into the mental outcomes and quality of life among COVID-19 survivors over an extended period, with stigmatization and post-COVID syndrome identified as the primary associated factors. A longitudinal study with random sampling, a control group, and measures to better control recall bias is recommended.

This study aims to identify factors affecting working happiness and organizational commitment at tourism enterprises in the Central region, Vietnam. This study used combination method of qualitative and quanitative methods. A 703-tourism-employee survey was conducted at the tourism enterprises, destinations or organizations in the Central region, Vietnam. This research results showed that there were 5 factors affecting directly on working happiness and organizational commitment, including (1) Working environment, (2) Job characteristics, (3) Colleague relationship, (4) Work-life balance, and (5) Income and benefits. This study also examined and showed impact of the 4 factors on organizational commitment through working happiness as mediator factor, excluding working environment. From these results, the study proposed some managerial implications for tourism enterprises in the Central region, Vietnam improve human resource quality through working happiness and organizational commitment.

ObjectiveThis study aimed to measure depression among children and adolescents during the COVID-19 pandemic in Hanoi, Vietnam and its associated factors by using the Short Mood and Feelings Questionnaire (SMFQ) instrument.MethodsWe conducted a cross-sectional study among students from grades 6 to 9 within two secondary schools in Hanoi, the capital of Vietnam. A structured questionnaire was used, including information about personal characteristics, perception of COVID-19, and SMFQ. Factor analysis, Multivariate logistic and Tobit regression models were used.ResultsAmong 2378 students, 8.8% had depressive symptoms. The mean SMFQ score was 4.5 (SD=5.0). Being female, studying in higher grades, perceived low household income, higher perceived impacts of COVID-19 on health and higher perceived impacts of COVID-19-related quarantine on life were positively associated with factors’ scores, SMFQ score and depressive symptoms. Meanwhile, having better academic performance, living with parents and having higher perceived knowledge about COVID-19 were negatively associated with factors scores, SMFQ score and depressive symptoms.ConclusionsDepressive symptoms were common among secondary school students in Hanoi, Vietnam, during the COVID-19 pandemic. Tailored interventions to improve pandemic-related knowledge and family and school support should be warranted for the students to enhance their mental well-being.

This study aims to examine the impact of destination social responsibility on destination brand equity and revisit intention at destinations in the Southeast region, Vietnam. Combining qualitative and quantitative research methods with a 593-tourist survey at the destinations. The results show that destination social responsibility positively affects destination brand equity and the revisit intention at the destinations. Destination social responsibility also affected revisit intention through destination brand equity as a moderating factor. From these findings, some managerial implications were proposed for tourism managers, destinations, and enterprises to be more interested in destination social responsibility activities and destination brand equity to improve the revisit intention of tourists in the Southeast region, Vietnam.

Air service failures and negative customer reactions have been the subjects of increasing media attention in recent years. Drawing upon the expectation disconfirmation theory (EDT), this study investigates the impact of airline service failures on various negative emotions and negative behaviors of customers based on prior expectations and actual experiences after a service failure. The collected data was from 561 customers who experienced an air service failure within the past 6 months. The results show that, consistent with the EDT theory, prior expectations and actual experiences when an airline service failure occurs lead to disconfirmation, and this determines the negative emotions of customers. The results also show that, worry and frustration only lead to negative word-of-mouth intentions. Meanwhile, anger over an airline service failure will affect both complaints, negative word-of-mouth, and intention to switch to another airline. This study contributes by expanding and showcasing the applicability of the EDT theory to the domain of airline service failures.

ABSTRACT: Objective: This study described the rate of suicidal ideation in lung cancer patients and identify associated factors. Method: A cross-sectional study was conducted from August 2021 to October 2022 at the Nuclear Medicine and Oncology Center – Bach Mai Hospital, Hanoi, Vietnam. A total of 256 patients completed the survey. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to measure suicidal ideation. The Hospital Anxiety and Depression Scale (HADS) was utilized to evaluate depression and anxiety. Socio-demographic characteristics, clinical features and pain severity were also measured. Multivariate logistic regression was used to identify factors associated with suicidal ideation. Results: There was 8.2% having suicidal ideation. Among patients with suicidal ideation, the mean score of intensity subscale was 13.33 ± 4.98, and mean scores on intensity scale items were as follows: frequency (mean=2.86 ± 1.32). duration (mean=2.29 ± 1.15), controllability (mean=2.67 ± 1.28), deterrents (mean=2.48 ± 1.21), and reason for ideation (mean=3,05 ± 1,63). Being female (OR=3.36, 95%CI=1.35-8.37), having severxe pain (OR=5.91, 95%CI=1.65-21.18), having depression (OR=10.36, 95%CI=3.93-27.39) and having anxiety (OR=7.81, 95%CI=3.05-20.01) were positively associated with the likelihood of having suicidal ideation among lung cancer patients. Conclusion: Findings revealed the high prevalence of suicidal ideation among individuals diagnosed with lung cancer in Vietnam. Notably, this trend was more pronounced among female patients, those with severe pain, and individuals experiencing mental disorders such as depression and anxiety. Practitioners ought to prioritize the screening and intervention processes for lung cancer patients with a high risk of suicidal tendencies.

We study a system of nonlinear wave equations of the Kirchhoff-Carrier type containing a variant of the Balakrishnan-Taylor damping in nonlinear terms. By the linearization method together with the Faedo-Galerkin method, we prove the local existence and uniqueness of a weak solution. On the other hand, by constructing a suitable Lyapunov functional, a sufficient condition is also established to obtain the exponential decay of weak solutions.

In this article, we consider a system of nonlinear heat equations with viscoelastic terms and Robin-Dirichlet conditions. First, we prove existence and uniqueness of a weak solution. Next, we prove a blow up result of weak solutions with negative initial energy. Also, we give a sufficient condition that guarantees the existence and exponential decay of global weak solutions. The main tools are the Faedo-Galerkin method, a Lyapunov functional, and a suitable energy functional.

Abstract Background Community acquired bloodstream infection (CABSI) in low- and middle income countries is associated with a high mortality. This study describes the clinical manifestations, laboratory findings and correlation of SOFA and qSOFA with mortality in patients with CABSI in northern Vietnam. Methods This was a retrospective study of 393 patients with at least one positive blood culture with not more than one bacterium taken within 48 h of hospitalisation. Clinical characteristic and laboratory results from the first 24 h in hospital were collected. SOFA and qSOFA scores were calculated and their validity in this setting was evaluated. Results Among 393 patients with bacterial CABSI, approximately 80% (307/393) of patients had dysfunction of one or more organ on admission to the study hospital with the most common being that of coagulation (57.1% or 226/393). SOFA performed well in prediction of mortality in those patients initially admitted to the critical care unit (AUC 0.858, 95%CI 0.793–0.922) but poor in those admitted to medical wards (AUC 0.667, 95%CI 0.577–0.758). In contrast qSOFA had poor predictive validity in both settings (AUC 0.692, 95%CI 0.605–0.780 and AUC 0.527, 95%CI 0.424–0.630, respectively). The overall case fatality rate was 28%. HIV infection (HR = 3.145, p = 0.001), neutropenia (HR = 2.442, p = 0.002), SOFA score 1-point increment (HR = 1.19, p

The article concerns the initial boundary value problem for a nonlinear Kirchhoff-Love equation. First, by applying the Faedo-Galerkin, we prove existence and uniqueness of a solution. Next, by constructing Lyapunov functional, we prove a blow-up of the solution with a negative initial energy, and establish a sufficient condition for the exponential decay of weak solutions.

This article concerns the initial-boundary value problem for nonlinear pseudo-parabolic equation $$\displaylines{ u_{t}-u_{xxt}-(1+\mu (u_{x}))u_{xx}+(1+\sigma (u_{x}))u=f(x,t),\quad 0

Abstract In this paper, we consider the Robin problem for a wave equation with nonlinear source containing nonlocal term. Using the Faedo-Galerkin method and the linearization method for nonlinear term, the existence and uniqueness of a weak solution are proved. An asymptotic expansion of high order in a small parameter of a weak solution is also discussed.

Water-soluble low molecular weight β-glucan (WSLMG) was successfully prepared via γ-irradiation of insoluble β-glucan extracted from brewer’s yeast cell walls. The WSLMG content in an irradiated sample increased as the irradiation dose increased. The WSLMGs with a molecular weight (Mw) of 49, 25, and 11 kDa, obtained at correlative doses of 100, 200, and 300 kGy, respectively, were tested using growth promotion and immune stimulant effects in broilers. Supplementation with 500 ppm WSLMGs not only increased the survival rate (33.3%) and average body weight (40%) but also reduced the feed conversion rate (35.4%) in tested broilers. In addition, WSLMGs enhanced both nonspecific and specific immune components in the blood of supplemented broilers. The WSLMG with Mw ~25 kDa showed the highest effect on the growth performance and immunomodulatory capability in the immune systems of the tested broilers. In conclusion, this product demonstrates substantial promise as an immunostimulant and growth-promoting additive for poultry.

MANET (short for Mobile Ad-Hoc Network) consists of a set of mobile network nodes, network configuration changes very fast. In content based routing, data is transferred from source node to request nodes is not based on destination addresses. Therefore, it is very flexible and reliable, because source node does not need to know destination nodes. If We can find multiple paths that satisfies bandwidth requirement, split the original message into multiple smaller messages to transmit concurrently on these paths. On destination nodes, combine separated messages into the original message. Hence it can utilize better network resources, causes data transfer rate to be higher, load balancing, failover. Service Oriented Routing is inherited from the model of content based routing (CBR), combined with several advanced techniques such as Multicast, multiple path routing, Genetic algorithm to increase the data rate, and data encryption to ensure information security. Fuzzy logic is a logical field study evaluating the accuracy of the results based on the approximation of the components involved, make decisions based on many factors relative accuracy based on experimental or mathematical proof. This article presents some techniques to support multiple path routing from one network node to a set of nodes with guaranteed quality of service. By using these techniques can decrease the network load, congestion, use network resources efficiently.

In this paper, we obtain sufficient conditions for the existence of a positive solution, and infinitely many positive solutions, of the m-point boundary-value problem $$displaylines{ x''(t) = f(t, x(t)), quad 0 < t < 1, cr x'(0) = 0, quad x(1)=sum_{i=1}^{m-2}alpha _{i}x(eta _{i}),. }$$ Our main tools are the Guo-Krasnoselskii's fixed point theorem and the monotone iterative technique. We also show that the set of positive solutions is compact.

We study the following initial-boundary value problem {ut − μt+αt(∂/∂t)∂2u/∂x2+(γ/x)(∂u/∂x) + fu = f1x,t, 10; u(1,t)=g1(t), u(R,t)=gR(t); u(x,0)=u~0(x)}, where γ>0,R>1 are given constants and f,f1,g1,gR,u~0,α, and μ are given functions. In Part 1, we use the Galerkin method and compactness method to prove the existence of a unique weak solution of the problem above on (0,T), for every T>0. In Part 2, we investigate asymptotic behavior of the solution as t→+∞. In Part 3, we prove the existence and uniqueness of a weak solution of problem {ut − μt+αt(∂/∂t)∂2u/∂x2+(γ/x)(∂u/∂x) + fu = f1x,t, 10; u(1,t)=g1(t), u(R,t)=gR(t)} associated with a “(η,T)-periodic condition” u(x,0)=ηu(x,T), where 0

We study the initial-boundary value problem for the nonlinear wave equation$$displaylines{ u_{tt} - frac{partial }{partial x} (mu ({x,t})u_x ) + K|u |^{p - 2} u + lambda |u_t |^{q - 2} u_t = f(x,t), cr u(0,t) = 0 cr - mu (1,t)u_x (1,t) = Q(t), cr u(x,0) = u_0 (x),quad u_t (x,0) = u_1 (x), cr}$$ where $pgeq 2$, $q geq 2$, $K, lambda$ are given constants and $u_0, u_1, f,mu$ are given functions. The unknown function $u(x,t)$ and the unknown boundary value $Q(t)$ satisfy the linear integral equation$$ Q(t)=K_1(t)u(1,t)+lambda_1(t)u_t(1,t)-g(t)-int_0^t {k(t-s)u(1,s)ds},$$ where $K_1, lambda_1, g, k$ are given functions satisfying some properties stated in the next section. This paper consists of two main sections. First, we prove the existence and uniqueness for the solutions in a suitable function space. Then, for the case $K_1(t)=K_1geq 0$, we find the asymptotic expansion in $K,lambda, K_1$ of the solutions, up to order $N+1$.

OBJECTIVE: To study patterns and determinants of HIV prevalence and risk-behaviour characteristics in different population groups in four border provinces of Viet Nam. METHODS: We surveyed four population groups during April-June 2002. We used stratified random-cluster sampling and collected data concomitantly on HIV status and risk behaviours. The groups included were female sex workers (n = 2023), injecting drug users (n = 1391), unmarried males aged 15-24 years (n = 1885) and different categories of mobile groups (n = 1923). FINDINGS: We found marked geographical contrasts in HIV prevalence, particularly among female sex workers (range 0-24%). The HIV prevalence among injecting drug users varied at high levels in all provinces (range 4-36%), whereas lower prevalences were found among both unmarried young men (range 0-1.3%) and mobile groups (range 0-2.5%). All groups reported sex with female sex workers. Less than 40% of the female sex workers had used condoms consistently. The strongest determinants of HIV infection among female sex workers were inconsistent condom use (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 2.4-11.8), history of injecting drug use and mobility, and, among injecting drug users, sharing of injection equipment (adjusted OR, 7.3; 95% CI, 2.3-24.0) and sex with non-regular partners (adjusted OR 3.4; 95% CI 1.4-8.5). CONCLUSION: The finding of marked geographical variation in HIV prevalence underscores the value of understanding local contexts in the prevention of HIV infection. Although lacking support from data from all provinces, there would appear to be a potential for sex work to drive a self-sustaining heterosexual epidemic. That the close links to serious injecting drug use epidemics can have an accelerating effect in increasing the spread of HIV merits further study.

In this paper we consider the nonlinear wave equation problem $$displaylines{ u_{tt}-Big(|u|_0^2,|u_{r}|_0^2ig)(u_{rr}+frac{1}{r}u_{r}) =f(r,t,u,u_{r}),quad 0less than r less than 1,; 0 less than t less than T, ig|lim_{ro 0^+}sqrt{r}u_{r}(r,t)ig| less than infty, u_{r}(1,t)+hu(1,t)=0, u(r,0)=widetilde{u}_0(r), u_{t}(r,0)=widetilde{u}_1(r). }$$ To this problem, we associate a linear recursive scheme for which the existence of a local and unique weak solution is proved, in weighted Sobolev using standard compactness arguments. In the latter part, we give sufficient conditions for quadratic convergence to the solution of the original problem, for an autonomous right-hand side independent on $u_{r}$ and a coefficient function $B$ of the form $B=B(|u|_0^2)=b_0+|u|_0^2$ with $b_0$ greater than 0.

We treat an initial boundary value problem for a nonlinear wave equation utt−uxx+K|u|αu+λ|ut|βut=f(x,t) in the domain 0

Highly pathogenic avian influenza (HPAI) H5N1 is endemic in Vietnamese poultry and has caused sporadic human infection in Vietnam since 2003. Human infections with HPAI H5N1 are of concern due to a high mortality rate and the potential for the emergence of pandemic viruses with sustained human-to-human transmission. Viruses isolated from humans in southern Vietnam have been classified as clade 1 with a single genome constellation (VN3) since their earliest detection in 2003. This is consistent with detection of this clade/genotype in poultry viruses endemic to the Mekong River Delta and surrounding regions. Comparison of H5N1 viruses detected in humans from southern Vietnamese provinces during 2012 and 2013 revealed the emergence of a 2013 reassortant virus with clade 1.1.2 hemagglutinin (HA) and neuraminidase (NA) surface protein genes but internal genes derived from clade 2.3.2.1a viruses (A/Hubei/1/2010-like; VN12). Closer analysis revealed mutations in multiple genes of this novel genotype (referred to as VN49) previously associated with increased virulence in animal models and other markers of adaptation to mammalian hosts. Despite the changes identified between the 2012 and 2013 genotypes analyzed, their virulence in a ferret model was similar. Antigenically, the 2013 viruses were less cross-reactive with ferret antiserum produced to the clade 1 progenitor virus, A/Vietnam/1203/2004, but reacted with antiserum produced against a new clade 1.1.2 WHO candidate vaccine virus (A/Cambodia/W0526301/2012) with comparable hemagglutination inhibition titers as the homologous antigen. Together, these results indicate changes to both surface and internal protein genes of H5N1 viruses circulating in southern Vietnam compared to 2012 and earlier viruses.

A high-order iterative scheme is established in order to get a convergent sequence at a rate of order N (N≥1) to a local unique weak solution of a nonlinear Kirchhoff wave equation in the unit membrane. This extends a recent result in (EJDE, 2005, No. 138) where a recurrent sequence converges at a rate of order 2.

The purpose of this paper is to show that the set of weak solutions of the initial-boundary value problem for the linear wave equation is nonempty, connected, and compact.

This paper presents a remark on a fixed point theorem of Krasnosel'skii type. This result is applied to prove the existence of asymptotically stable solutions of nonlinear integral equations.

Abstract Background The global initiative ‘Treatment 2.0’ calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. Methods We developed a new analytical framework of the continuum of prevention and care (COPC). Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related strengths and constraints in improving HIV case detection and retention in care. This was accomplished by reviewing related published and unpublished documents including existing service delivery data. Results Identified strengths included: decentralized HIV outpatient clinics that offer comprehensive care at the district level particularly in high HIV burden provinces; functional chronic care management for antiretroviral treatment (ART) with the involvement of people living with HIV and the links to community- and home-based care; HIV testing and counseling integrated into tuberculosis and antenatal care services in districts supported by donor-funded projects, and extensive peer outreach networks that reduce barriers for the most-at-risk populations to access services. Constraints included: fragmented local coordination mechanisms for HIV-related health services; lack of systems to monitor the expansion of HIV outpatient clinics that offer comprehensive care; underdevelopment of pre-ART care; insufficient linkage from HIV testing and counseling to pre-ART care; inadequate access to HIV-related services in districts not supported by donor-funded projects particularly in middle and low burden provinces and in mountainous remote areas; and no systematic monitoring of referral services. Conclusions Our COPC analytical framework was instrumental in identifying system-related strengths and constraints that contribute to HIV case detection and retention in care. The national HIV program plans to strengthen provincial programming by re-defining various service linkages and accelerate the transition from project-based approach to integrated service delivery in line with the ‘Treatment 2.0’ initiative.

Background/Objectives: This study aimed to investigate pneumothorax risk, focusing on the gravitational effect of pleural pressure caused by specific patient positioning. Methods: We retrospectively analyzed 144 percutaneous CT-guided lung biopsies performed between January 2019 and December 2023. Patients were grouped into those with or without pneumothorax. Variations in patient positioning (prone, supine, lateral, lesion in decubitus biopsy-side-down [LD BSD] and the dependent area [L DA M], and access route beginning in the dependent area [AR LD M]) were compared using the chi-square, Fisher's exact, and Mann–Whitney U tests. Performance metrics were evaluated. Univariate and binomial logistic regression models assessed the influence of these factors and other patient-related and interventional parameters on pneumothorax occurrence. Results: Three positional variants (AR DA M, L DA M, and L LD BSD; p < 0.001), general emphysema (p = 0.009), emphysema in the access route (p = 0.025), greater needle size (18G vs. 20G; p < 0.001), and the use of a side-cut instead of a full-core system (p = 0.002) were significantly linked to lower peri-interventional pneumothorax incidence. Even after adjusting for various factors, AR DA M and general emphysema remained independently associated with a reduced pneumothorax risk (OR 0.168, p < 0.001; OR 2.72, p = 0.034). Assessing the dependent zones showed superior performance regardless of the patient's position, with the best performance demonstrated for AR DA M (AUC 0.705; sensitivity 60%, specificity 81.8%). Conclusions: Focusing on the dependent zones of each lung and adjusting the access route accordingly can significantly reduce the risk of pneumothorax compared to conventional positioning techniques. [ABSTRACT FROM AUTHOR]

The outbreak of COVID-19 has a negative effect on the operational performance of tourism business. Thus, many tourism firms have stopped operating. Therefore, social networks and access to external support resources are crucial in overcoming the crisis. This study, which is grounded in social network theory, attempts to assess how managerial ties affect operational performance through the mediating function of resource access (RA). The study uses the structural equation modelling (SEM) methodology and includes 212 managers from Vietnamese tourism companies in its sample. The findings show a positive and significant relationship between business partner ties (BPT) and government agency ties (GAT) and operational performance (OP). The study also investigates RA's partial mediating function between GAT, BPT and OP. The results are practical for managers in building relationship networks to increase RA and improve OP. Finally, this study suggests certain limitations and outlines directions for further research. [ABSTRACT FROM AUTHOR]

Purpose: Pulmonary sequestration is a rare pulmonary malformation that often necessitates surgical intervention due to potential complications such as recurrent infections or hemoptysis. This case series presents the clinical trajectory of four patients diagnosed with pulmonary sequestration, from initial diagnosis through postoperative care, with a specific focus on the limited arterial supply in two of the cases. Materials and Methods: We conducted a retrospective descriptive analysis of four patients diagnosed with pulmonary sequestration who underwent surgical treatment at our institution between January 2013 and November 2022. The affected lung segments were excised via either thoracoscopy or thoracotomy. We evaluated perioperative and postoperative complications, hospital stay duration, histological findings, and the vascular supply of the affected areas. Results: Thoracoscopic surgery was initially preferred for all patients, though one required conversion to an open procedure due to technical challenges. Perioperative complications included increased pain and atelectasis. Two patients developed pleural empyema postoperatively, necessitating additional surgical intervention. The overall outcomes were favorable, with appropriate management addressing the complications effectively. Conclusions: Pulmonary sequestration, despite its rarity, often requires surgical treatment. Both thoracoscopic and open surgical methods are effective, though thoracoscopic surgery is generally preferred when feasible. The findings underscore the importance of meticulous preoperative planning and vigilant postoperative care to manage and mitigate potential complications. [ABSTRACT FROM AUTHOR]

Author(s): Seon Ah Lim [sup.1] , Jun Wei [sup.1] , Thanh-Long M. Nguyen [sup.1] , Hao Shi [sup.1] , Wei Su [sup.1] , Gustavo Palacios [sup.1] , Yogesh Dhungana [sup.1] [...], Regulatory T cells (T.sub.reg cells) are essential for immune tolerance.sup.1, but also drive immunosuppression in the tumour microenvironment.sup.2. Therapeutic targeting of T.sub.reg cells in cancer will therefore require the identification of context-specific mechanisms that affect their function. Here we show that inhibiting lipid synthesis and metabolic signalling that are dependent on sterol-regulatory-element-binding proteins (SREBPs) in T.sub.reg cells unleashes effective antitumour immune responses without autoimmune toxicity. We find that the activity of SREBPs is upregulated in intratumoral T.sub.reg cells. Moreover, deletion of SREBP-cleavage-activating protein (SCAP)--a factor required for SREBP activity--in these cells inhibits tumour growth and boosts immunotherapy that is triggered by targeting the immune-checkpoint protein PD-1. These effects of SCAP deletion are associated with uncontrolled production of interferon-[gamma] and impaired function of intratumoral T.sub.reg cells. Mechanistically, signalling through SCAP and SREBPs coordinates cellular programs for lipid synthesis and inhibitory receptor signalling in these cells. First, de novo fatty-acid synthesis mediated by fatty-acid synthase (FASN) contributes to functional maturation of T.sub.reg cells, and loss of FASN from T.sub.reg cells inhibits tumour growth. Second, T.sub.reg cells in tumours show enhanced expression of the PD-1 gene, through a process that depends on SREBP activity and signals via mevalonate metabolism to protein geranylgeranylation. Blocking PD-1 or SREBP signalling results in dysregulated activation of phosphatidylinositol-3-kinase in intratumoral T.sub.reg cells. Our findings show that metabolic reprogramming enforces the functional specialization of T.sub.reg cells in tumours, pointing to new ways of targeting these cells for cancer therapy. Identification of a metabolic checkpoint involving lipid signalling that is specific to regulatory T cells (T.sub.reg cells) in the tumour microenvironment raises the possibility of targeting this checkpoint for treatment of cancer.