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Thi Nhi Ha Tran,1,&ast; Quoc Thanh Pham,2,&ast; Lien Huong Tran,3 Tuan Anh Vu,4 Minh Tu Nguyen,5 Hung Tien Pham,6 Thanh Tong Le,7 Thi Thu Ha Bui8 1Management Board, Department of Health, Hanoi, Vietnam; 2Center of Digital Health, Hanoi University of Public Health, Hanoi, Vietnam; 3Management Board, Saint Paul Hospital, Hanoi, Vietnam; 4Medicine Department, Agriculture General Hospital, Hanoi, Vietnam; 5Management Board, Phuc Tho hospital, Hanoi, Vietnam; 6Faculty of Clinical Medicine, Hanoi University of Public Health, Hanoi, Vietnam; 7Student, Hanoi University of Public Health, Hanoi, Vietnam; 8Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam&ast;These authors contributed equally to this workCorrespondence: Quoc Thanh Pham, Center of Digital health, Hanoi University of Public Health, Hanoi, 100000, Vietnam, Tel +840 978502383, Fax +84 024 62662385, Email pqt@huph.edu.vnIntroduction: Patient safety culture (PSC) is a vital component in ensuring high-quality and safe patient care. Assessment of physicians’ and nurses’ perceptions of existing hospital PSC is the first step to promoting PSC. This paper is aimed to assess physicians’ and nurses’ perceptions of PSC in 5 public general hospitals in Hanoi, Vietnam.Methods: This cross-sectional study surveyed 410 physicians and 824 nurses utilizing the validated Hospital Survey on Patient Safety Culture in an online format.Results: The composite positive physician’s perception of PSC varied from 47.8 to 89.6% with the lowest composite score of patient safety for “staffing” (47.8%) and the highest composite score for “teamwork within units” (89.6%). The composite positive responses for perception among nurses varied from 51.3 to 94.2% with the lowest composite score of patient safety for “staffing” (51.3%) and the highest composite score for “teamwork within units” (94.2%).Conclusion: The mean scores for “supervisor/manager expectations”; “staffing”, “management support for patient safety”, “teamwork across units”, “handoffs and transitions” among nurses were significantly higher than that among physicians (p< 0.05). About two-thirds of physicians and nurses reported no event in the past 12 months (62.8 and 71.7%, respectively). The nurses reported significantly higher patient grades (every good and excellent) than physicians (75% vs 67.1%, p < 0.001). Hospitals could develop and implement intervention programs to improve patient safety, including providing interventions on teamwork and communication, encouraging staff to notify incidents, and avoiding punitive responses.Keywords: patient safety culture, hospital, physicians, nurses

This study deployed ultrasonic-assisted extraction (UAE), combined with natural deep eutectic solvents (NADES), to extract phenolics and flavonoids from the black mulberry fruit, and the antioxidant activity was examined. The extraction yields of NADES-based UAE were assessed based on the yields of phenolics and flavonoids extracted from the black mulberry fruit. This study selected the molar ratios of hydrogen bond acceptors (HBA) and hydrogen bond donors HBD at 1:2 from previous studies. Choline chloride-lactic acid showed the highest solubility with phenolics and flavonoids among NADES systems. One-factor experiments evaluated the effect of UAE conditions (liquid-to-solid ratio (LSR), water content in NADES, temperature, and time) on TPC, TFC, and antioxidant activity. The suitable NADES-based UAE conditions for extracting phenolics and flavonoids from the black mulberry fruit were 60 ml/g of LSR, 40% water content, 70 °C, and 15 min. Response surface methodology with the Box-Behnken design model optimized the NADES-based UAE process based on response (TPC, TFC, ABTS, OH, and DPPH). The optimal conditions for the NADES-based UAE process were 70 ml/g of LSR, 38.9% water content in NADES, 67.9 °C, and 24.2 min of extraction time. The predicted values of the Box-Behnken design were compatible with the experimental results. Moreover, scanning electron microscopy (SEM) was used to survey the surface of black mulberry fruit with and without sonication. SEM can assist in demonstrating the destructive effect of NADES and ultrasonic waves on material surfaces. SEM findings indicated the high surface destruction capacity of NADES, which partially contributed to a superior extraction yield of NADES than conventional organic solvents. The study proposes an efficient and green method for extracting bioactive compounds from black mulberry fruits. The black mulberry fruit extracts can be applied to meat preservation and beverages with high antioxidants., (© 2023. Springer Nature Switzerland AG.)

This research extracted phenolics and terpenoids from Abelmoschus sagittifolius (Kurz) Merr roots using natural deep eutectic solvent-based novel extraction techniques. Twelve natural deep eutectic solvents (NADESs) were produced for recovering phenolics and terpenoids. Citric acid/glucose and lactic acid/glucose, with a molar ratio of 2:1, were determined as the most appropriate NADESs for extracting phenolics and terpenoids, respectively. Afterward, the proper conditions for NADES-based ultrasonic-assisted and microwave-assisted extraction were investigated. Then, the time and liquid-to-solid ratios of ultrasonic- and microwave-combined extraction methods and the sequence of ultrasound and microwave treatments were examined. The conditions of ultrasonic-assisted extraction were 40 mL/g liquid-to-solid ratio, 40% water content, 30°C, 5 min, and 600 W ultrasonic power for the highest terpenoid recovery at 69 ± 2 mg UA/g dw, while 150 W ultrasonic power was suitable for phenolic recovery at 9.56 ± 0.17 mg GAE/g dw. The conditions of microwave-assisted extraction were 50 mL/g liquid-to-solid ratio, 20% water content, 400 W microwave power, and 2 min to acquire the highest phenolics and terpenoids at 22.13 ± 0.75 mg GAE/g dw and 90 ± 1 mg UA/g dw, respectively. Under appropriate conditions, the biological activities, phenolic content, and terpenoid content of obtained extracts from four extraction methods, including ultrasonic-assisted, microwave-assisted, ultrasonic-microwave-assisted, and microwave-ultrasonic-assisted extraction, were compared to select the most proper method. The conditions of ultrasonic-microwave-assisted extraction were 40 mL/g liquid-to-solid ratio, 5 min sonication, and 1 min microwave irradiation to obtain the highest phenolic and terpenoid contents (27.07 ± 0.27 mg GAE/g dw and 111 ± 3 mg UA/g dw, respectively). Ultrasonic-microwave-assisted extraction showed the highest phenolic content, terpenoid content, and biological activities among the four extraction techniques. The changes in the surface morphology were determined using scanning electron microscopy. This study demonstrated that ultrasonic-microwave-assisted extraction was an effective and sustainable method in food and pharmaceutical industries for recovering phenolics and terpenoids from Abelmoschus sagittifolius (Kurz) Merr., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

This research combined ultrasonic-assisted extraction (UAE) and natural deep eutectic solvent (NADES) to recover phenolic and flavonoid components from mangosteen rind. The antioxidant activities were determined using DPPH, ABTS + , and hydroxyl assays. NADES prepared from lactic and 1,2-propanediol had the highest extraction efficiency based on the total flavonoid content (TFC) and phenolic contents (TPC). Single-factor experiments were employed to assess the influence of UAE conditions (liquid-to-solid ratio, temperature, water content in NADES, and time) on TFC, TPC, and antioxidant activities. NADES-based UAE conditions were optimized using response surface methodology with the Box-Behnken design model on five dependent responses (TPC, TFC, DPPH, ABTS, and OH). The optimal conditions for the lactic-1,2-Propanediol-based UAE process were 76.7 ml liquid/g solid with 30.3% of water content at 57.5 °C for 9.1 min. Scanning electron microscopy (SEM) was applied to examine the surface morphology of mangosteen rind before and after sonication. This study proposes an efficient, green, and practical approach for recovering phenolics and flavonoids from mangosteen rinds., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of staff perception on existing hospital patient safety culture (PSC) is the first step to promote PSC. This paper is aimed to assess the patient safety culture in 1 big public autonomous general hospital in Hanoi, Vietnam. This cross-sectional study surveyed 638 healthcare professional utilizing the validated (Hospital Survey on Patient Safety Culture [HSOPSC]) in an online format. This study adhered to STROBE guidelines. The positive response rate was high, with a percentage of 74.2. The strongest areas are teamwork within units (91.3%) and organizational learning/continuous improvement (88.4%). The areas for improvement are staffing (49.4%) and non-punitive response to error (53.1%). Hospital administrators should strengthen the culture of patient safety by formulating strategies and implementing interventions with emphasis on adequate staffing and promoting blame-free working environment., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Objectives: The prevalence of clarithromycin (CLR)-resistant Helicobacter pylori is increasing worldwide, including in Vietnam. The aims of this study were to determine point mutations in the 23S rRNA domain V of clinical H. pylori strains in central Vietnam, to estimate the prevalence of phenotypic CLR resistance and to assess the association between 23S rRNA domain V genotype and CLR-resistant phenotype., Methods: Sequencing of the 23S rRNA domain V of H. pylori strains from gastric biopsy specimens was performed for 185 patients with H. pylori-positive chronic gastritis, of which 104 samples were subjected to susceptibility testing to determine CLR resistance., Results: A total of 24 types of point mutation were detected. A2143G and A2142G mutations were observed in 40.5% and 4.3%, respectively. New point mutations were detected (C2041T, C2083T, C2191T, G2220A, G2225A, G2240A, C2273T, T2276C, G2287A, C2399T, A2445G and C2622T). 23S rRNA domain V genotypes were diversified, with combinations of two or more point mutations as well as single point mutations. The rate of phenotypic CLR resistance was 53.8%, increasing from 40.4% in 2012-2014 to 70.2% in 2015-2017 (P=0.0045). A2143G and A2142G accounted for 89.3% of phenotypically CLR-resistant H. pylori isolates., Conclusions: A diversity of point mutations in the 23S rRNA domain V was observed in clinical H. pylori isolates. The rate of phenotypically CLR-resistant H. pylori is significantly increasing in central Vietnam. Further research is necessary to clarify the role of the combination of 23S rRNA domain V mutations in the molecular mechanism of CLR resistance., (Copyright © 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.)

In Vietnam, the high prevalence of Helicobacter pylori infection represents a serious health problem. Virulence genes of H. pylori have been associated to increased risk of severe gastrointestinal diseases and the genetic background differs in geographical areas. We investigated cagA and vacA genotypes of H. pylori from dyspeptic patients from central Vietnam and the correlation with clinical outcomes; we also performed sequencing analysis of partial cagA gene. Overall, 84% of strains were cagA-positive, 75% were East-Asian type with a prevalence of vacAs1i1m1 and vacAs1i1m2 genotypes (66.7% and 33.3%, respectively) and 9% were Western type vacAs1i1m1 (n=4) and vacAs1i1m2 (n=4); vacAs1i2m2 (n=4) and vacAs2i2m2 (n=2) genotypes were associated to cagA-negative. Strains from gastric ulcer and cancer were of East-Asian type, while cagA-negative or Western strains were from gastritis and duodenal ulcer. H. pylori strains from gastric ulcer patients were predominantly vacAs1i1m1 compared to other vacA genotypes (p<0.05). East-Asian type strains vacAs1i1m1 or vacAs1i1m2 were found in gastric cancer patients and also in less severe disease. Phylogenetic tree analysis of CagA sequences showed the co-circulation of H. pylori of different geographical origins with Western sequences closer related to Cambodia, one of the entry of Western strains in Southeast-Asia through human migrations. Sequence analysis revealed in two Western type strains a chimeric CagA-3' region with identity with East-Asian CagA suggesting recombination event in the process of evolution among East-Asian and Western H. pylori strains. Moreover, polymorphism in CagA multimerization (CM) motif was observed including new East-Asian CM motifs. In conclusion, we have found in central Vietnam a geographically dependent diversity of cagA genotype, with higher rates of cagA-negative and Western-type strains compared with other nation's parts that can partly explain the lower risk of gastric cancer. The polymorphism of CM motifs may explain the variability of disease manifestations of vacAs1i1m1 and s1i1m2 East-Asian isolates., (Copyright © 2017. Published by Elsevier B.V.)