Evaluation of liver fibrosis is necessary to make the therapeutic decision and assess the prognosis of CHB patients. The current study aimed to describe the progression and identify some influencing ...factors in patients with chronic hepatitis B at a General Hospital in Northern Vietnam. The longitudinal study included 55 eligible subjects diagnosed Hepatitis-B-virus. Dependent variable was the aspartate aminotransferase/platelet ratio index and we collected some demographic variables and disease related and behaviour variables. Bayesian Model Averaging was used to select variables into model. Mixed-effect linear models were used to evaluate the change of the aspartate aminotransferase/platelet ratio index over time and identify related factors. the aspartate aminotransferase/platelet ratio index differences between examinations, age of participants, working status were statistically significant. This pattern indicated that the average the aspartate aminotransferase/platelet ratio index of the population decreased by 0.005 (95% CI=-0.009; -0.001) after each patient's visit, and increased by 0.013 if the patient's age increased by 1 year (95% CI=0.005; 0.0219). For non-working patients, the aspartate aminotransferase/platelet ratio index was lower, coefficient was -0.054 (95% CI=-0.108; 0.001). Other variables such as gender, education level, time for disease detection, drinking tea, alcohol consumption, forgetting to take medicine and the aspartate aminotransferase/platelet ratio index were not significantly different. The study showed that the majority of study subjects had average the aspartate aminotransferase/platelet ratio index, and were relatively well controlled and treated during the study. Age and working status are factors that influence the the aspartate aminotransferase/platelet ratio index.
In this study, sol–gel combining with hydrothermal methods were successfully used to synthesize N and S co-doped TiO
2
nanotubes (N@S-TiO
2
NTT) for efficient photocatalytic degradation of volatile ...organic compounds (VOCs). The obtained characterization results indicated that the synthesized N@S co-doped TiO
2
existed as nanotubes. Specific surface areas of these synthesized nanotubes was greatly that of these nanoparticles. The largest surface area recorded at N@S-TiO
2
nanotubes was 105.3 m
3
/g. FTIR spectrum results showed that the presence of N–H and S–O bond, which confirmed that nitrogen and sulfur were successfully doped into TiO
2
lattice. We also investigated that N@S dopants significantly improved the photocatalytic activity of TiO
2
nanotubes for efficient degradation of gaseous VOCs. Therefore, photocatalytic activity for VOCs degradation by the N@S-TiO
2
nanotubes was greater than that by the undoped TiO
2
nanotube. Optimized humidity for degradation of VOCs was medium condition (55–70%). Under dry conditions, lack of water for hydroxyl radical production led to decrease in photocatalytic activity. Under humidity conditions, the excess water molecules competed with VOCs for adsorbing on material surface leading to decrease in photocatalytic degradation efficiency. Under the optimized humidity, the highest photocatalytic efficiency of the synthesized N@S-TiO
2
nanotubes for degradation of gaseous VOCs for 3 h was approximately 94%. The VOCs degradation capacity by the synthesized N@S-TiO
2
nanotubes was approximately 90 (ppm/g h).
Abiotic stresses, including drought, detrimentally affect the growth and productivity of many economically important crop plants, leading to significant yield losses, which can result in food ...shortages and threaten the sustainability of agriculture. Balancing plant growth and stress responses is one of the most important functions of agricultural application to optimize plant production. In this study, we initially report that copper nanoparticle priming positively regulates drought stress responses in maize. The copper nanoparticle priming plants displayed enhanced drought tolerance indicated by their higher leaf water content and plant biomass under drought as compared with water-treated plants. Moreover, our data showed that the treatment of copper nanoparticle on plants increased anthocyanin, chlorophyll and carotenoid contents compared to water-treated plants under drought stress conditions. Additionally, histochemical analyses with nitro blue tetrazolium and 3,3′-diaminobenzidine revealed that reactive oxygen species accumulation of priming plants was decreased as a result of enhancement of reactive oxygen species scavenging enzyme activities under drought. Furthermore, our comparative yield analysis data indicated applying copper nanoparticles to the plant increased total seed number and grain yield under drought stress conditions. Our data suggest that copper nanoparticle regulates plant protective mechanisms associated with drought tolerance, which is a promising approach for the production of drought-tolerant crop plants.
Falls in older people are a major public health issue, as they are associated with increased risks of morbidity and mortality. This study aims to investigate the prevalence and factors associated ...with falls among older outpatients. A cross-sectional study was conducted in 539 outpatients aged 60 and over at the National Geriatric Hospital, Hanoi, Vietnam. Falls and their associated factors were analyzed by multivariable logistic regression. The prevalence of falls was 23.7% (single fall 17.9%, recurrent falls 5.8%). The majority of falls occurred at home (69.6%) and were caused by a slippery floor (51.6%). After falling, most patients sustained physical injuries (65.6%); notably, women suffered more severe injuries than men. Alcohol consumption, using psychotropic medications, having three or more comorbidities, hypertension, COPD, urinary incontinence, frailty, fear of falling, ADL/IADL limitation, slow walking speed and mobility impairment were significantly associated with falls. Overall, the data indicated that falls were prevalent among older outpatients. Behavior factors, comorbidities, geriatric syndromes and physical function were substantially associated with falls, suggesting that most falls are preventable. Further longitudinal studies of longer periods are needed to comprehensively investigate the risk factors for falls.
Community health workers (CHWs) provide critical services to underserved populations in low and middle-income countries, but maintaining CHW's clinical knowledge through formal continuing medical ...education (CME) activities is challenging and rarely occurs. We tested whether a Short Message Service (SMS)-based mobile CME (mCME) intervention could improve medical knowledge among a cadre of Vietnamese CHWs (Community Based Physician's Assistants-CBPAs) who are the leading providers of primary medical care for rural underserved populations.
The mCME Project was a three arm randomized controlled trial. Group 1 served as controls while Groups 2 and 3 experienced two models of the mCME intervention. Group 2 (passive model) participants received a daily SMS bullet point, and were required to reply to the text to acknowledge receipt; Group 3 (interactive model) participants received an SMS in multiple choice question format addressing the same thematic area as Group 2, entering an answer (A, B, C or D) in their response. The server provided feedback immediately informing the participant whether the answer was correct. Effectiveness was based on standardized examination scores measured at baseline and endline (six months later). Secondary outcomes included job satisfaction and self-efficacy.
638 CBPAs were enrolled, randomized, and tested at baseline, with 592 returning at endline (93.7%). Baseline scores were similar across all three groups. Over the next six months, participation of Groups 2 and 3 remained high; they responded to >75% of messages. Group 3 participants answered 43% of the daily SMS questions correctly, but their performance did not improve over time. At endline, the CBPAs reported high satisfaction with the mCME intervention, and deemed the SMS messages highly relevant. However, endline exam scores did not increase over baseline, and did not differ between the three groups. Job satisfaction and self-efficacy scores also did not improve. Average times spent on self-study per week did not increase, and the kinds of knowledge resources used by the CBPAs did not differ between the three groups; textbooks, while widely available, were seldom used.
The SMS-based mCME intervention, while feasible and acceptable, did not result in increased medical knowledge. We hypothesize that this was because the intervention failed to stimulate lateral learning. For an intervention of this kind to be effective, it will be essential to find more effective ways to couple SMS as a stimulus to promote increased self-study behaviors.
ClinicalTrials.gov NCT02381743.
Background: For recurrent or metastatic radioactive iodine-refractory (RAI-R) papillary thyroid carcinoma (PTC), repetitive surgery is one form of local therapy that is evolving but hampered by ...technical challenges and complications. The goals of this study were to evaluate the efficacy of reoperations for local relapses of RAI-R PTC and to determine the effect of surgical treatment on disease progression.Methods: We retrospectively reviewed data from patients with recurrent/metastatic RAI-R PTC who underwent revision operations at Hospital 108 between December 2018 and March 2021. We analyzed clinicopathological factors, perioperative features, biochemical and structural outcomes, disease progression, and related risk factors.Results: Of the 71 patients with PTC (64 female, 7 male) enrolled in this study, 91.5% were in initial stages I and II, according to the American Joint Committee on Cancer Classification. All patients had undergone total thyroidectomy, and 61 (85.9%) had also undergone lymph node dissection (LND). The median radioactive iodine course and cumulative radioactive iodine dose were 2 times and 300 mCi, respectively. Surgery was performed in 9 (12.7%) patients for thyroid bed recurrence, 38 (53.5%) for central lymph node recurrence, and 53 (74.6%) for lateral lymph node recurrence. Major complications occurred in 9 (12.7%) patients. 15 (21.1%) patients had excellent responses, 16 (22.5%) had indeterminate responses, 33 (46.5%) had biochemically incomplete responses, and 7 (9.9%) had structurally incomplete responses. During follow-up (median time, 25 months), 21 (29.6%) patients suffered clinical and biochemical progression of disease. The median length of progression-free survival (PFS) was 27 months. Cox multifactor regression analyses revealed that the lymph node ratio and the incomplete (biochemical and structural) response were independent unfavorable prognostic factors for PFS.Conclusions: Repetitive surgery is effective for locoregional RAI-R PTC recurrences/metastases and helps mitigate disease progression.
BACKGROUND: The Global Climate Risk Index 2020 ranked Vietnam as the sixth country in the world most affected by climate variability and extreme weather events over the period 1999-2018. Sea level ...rise and extreme weather events are projected to be more severe in coming decades, which, without additional action, will increase the number of people at risk of climate-sensitive diseases, challenging the health system. This article summaries the results of a health vulnerability and adaptation (V&A) assessment conducted in Vietnam as evidences for development of the National Climate Change Health Adaptation Plan to 2030. METHODS: The assessment followed the first 4 steps outlined in the World Health Organization’s Guidelines in conducting “Vulnerability and Adaptation Assessments.” A framework and list of indicators were developed for semi-quantitative assessment for the period 2013 to 2017. Three sets of indicators were selected to assess the level of (1) exposure to climate change and extreme weather events, (2) health sensitivity, and (3) adaptation capacity. The indicators were rated and analyzed using a scoring system from 1 to 5. RESULTS: The results showed that climate-sensitive diseases were common, including dengue fever, diarrheal, influenza, etc, with large burdens of disease that are projected to increase. From 2013 to 2017, the level of “exposure” to climate change–related hazards of the health sector was “high” to “very high,” with an average score from 3.5 to 4.4 (out of 5.0). For “health sensitivity,” the scores decreased from 3.8 in 2013 to 3.5 in 2017, making the overall rating as “high.” For “adaptive capacity,” the scores were from 4.0 to 4.1, which meant adaptive capacity was “very low.” The overall V&A rating in 2013 was “very high risk” (score 4.1) and “high risk” with scores of 3.8 in 2014 and 3.7 in 2015 to 2017. CONCLUSIONS: Adaptation actions of the health sector are urgently needed to reduce the vulnerability to climate change in coming decades. Eight adaptation solutions, among recommendations of V&A assessment, were adopted in the National Health Climate Change Adaptation Plan.
The pathological outcome of dengue disease results from complex interactions between dengue virus (DENV) and host genetics and immune response. Complement receptor types 1 and 2 (CR1 and CR2) mediate ...complement activation through the alternative pathway. This study investigated the possible association of genetic polymorphisms and plasma levels of CR1 and CR2 with dengue disease. A total of 267 dengue patients and 133 healthy controls were recruited for this study. CR1 and CR2 gene polymorphisms were analyzed by Sanger sequencing, while plasma CR1 and CR2 levels were measured by ELISA. The frequency of the CR1 minor allele rs6691117G was lower in dengue patients and those with severe dengue compared to healthy controls. Plasma CR1 and CR2 levels were decreased in dengue patients compared to healthy controls (P < 0.0001) and were associated with platelet counts. CR1 levels were lower in dengue patients with warning signs (DWS) compared to those without DWS, while CR2 levels were decreased according to the severity of the disease and after 5 days (T1) and 8 days (T2) of follow-up. CR2 levels were decreased in dengue patients positive for anti-DENV IgG and IgM and patients with bleeding and could discriminate DWS and SD from dengue fever patients (AUC = 0.66). In conclusion, this study revealed a reduction in CR2 levels in dengue patients and that the CR1 SNP rs6691117A/G is associated with the dengue severity. The correlation of CR2 levels with platelet counts suggests that CR2 could be an additional biomarker for the prognosis of severe dengue disease.
The current research investigates the role of public-private partnership investment (PPPI) and ecological innovation (ECO) along with economic growth on the environmental abatement (i.e., carbon ...dioxide emission, particulate matters 2.5) in the USA. Quantile autoregressive lagged (QARDL) method was employed during the study period of 1990-2015. The study findings confirm that under long-run estimation, GDP and PPPI are causing more environmental abatement in the form of CO2 emission and haze pollution like PM2.5. The factors like ecological innovation and GDP2 are playing their role towards lowering the CO2 emission and PM2.5 under different quantiles. Furthermore, it is observed that under short-run estimation, past values of the carbon emissions and PM2.5 have their significant and positive relationship with their current values. Besides, the findings through Wald test estimation confirm that parameter constancy of the speed of adjustment parameter is rejected at 1% significance level for the CO2 emission and haze pollution like PM2.5 in USA. Besides, present study also provides some policy implications.
This study aimed to describe knowledge, attitudes, and practices (KAP) in controlling COVID-19 and some related factors among the Vietnamese population in 2020. A cross-sectional study was conducted ...involving 1999 participants aged 18–59 years old, through an online questionnaire. The results showed that 92.2% of the participants had a high knowledge level regarding COVID-19 prevention measures, 68.6% had a positive attitude toward COVID-19 prevention measures, and 75.8% practiced all six measures for preventing the spread of the virus. Age, sex, marital status, knowledge, and fear were significantly associated with the practices aimed at COVID-19 prevention. Married people and participants with high levels of knowledge were more likely to practice all preventive measures. In contrast, young people, men, and those who fear COVID-19 were less likely to practice all preventative measures. Good KAP among Vietnamese people could be an important factor in helping authorities gain initial success in containing the coronavirus and COVID-19. In addition to continuously raising and maintaining the community's awareness, attitude, and practices in disease prevention, the introduction and strict implementation of sanctions and regulations were also important in ensuring good practices were implemented and sustained over time. Groups with lower KAP levels should be provided with more information and support to promote appropriate disease prevention practices.
PDF
