Colorectal cancer is a leading cancer worldwide and in Vietnam. Adenomas (adenomatous polyps) is an important precursor of colorectal cancer. There is currently no study to determine the modifiable ...risk factors for colorectal adenomas, including body mass index (BMI) in Vietnam. We conducted an individually matched case‐control study of 1149 colorectal adenomas and 1145 controls in a large‐scale colorectal screening program involving 103 542 individuals aged 40‐75 years old in Hanoi, Vietnam. Conditional logistic regression was used to evaluate the association between BMI and colorectal adenomas prevalence, after controlling for potential confounders. Overall, comparing to normal weight (ie, 18.5‐22.9 kg/m2), underweight (ie, BMI < 18.5) was associated with a non‐statistically significant increased prevalence of colorectal adenomas (odd ratio OR = 1.29 and 95% confident interval CI: 0.88‐1.87). This association became significant among male (OR = 1.98, 95% CI: 1.20‐3.27), male who were ever smokers (OR = 2.59, 95% CI: 1.33‐5.03), nonregular exercise (OR = 2.44, 95% CI: 1.26‐4.73) and individuals with cardiometabolic disorders (OR = 3.46, 95% CI: 1.19‐10.00). The association between underweight and colorectal adenomas did not vary by smoking status, drinking status, family history of cancer, adenomas types or cardiometabolic disorders. No association was observed among obese individuals (BMI ≥ 25). In the population with low prevalence of obesity, we found that the association between BMI and colorectal adenomas followed a reversed J‐shape that underweight was associated with increased prevalence. Further studies are, therefore, warranted to replicate our results and to investigate the biologic mechanism the effect of underweight on colorectal adenomas prevalence.
What's new?
High body mass index (BMI) has been associated with an increased risk of colorectal adenomas in studies including Asian populations. To date, no study has identified modifiable risk factors for colorectal adenomas in Vietnam, a country with a rising colorectal cancer incidence and low obesity prevalence. This case‐control study based on a large‐scale colorectal cancer screening program in Vietnam reports a potential association between underweight and colorectal adenomas prevalence with an inverse J‐shape. The modification of specific factors such as maintaining a normal BMI range, quitting smoking and exercising regularly showed great potential for colorectal cancer prevention and control programs.
PM
0.1
has been believed to have adverse short- and long-term effects on human health. However, the information of PM
0.1
that is needed to fully evaluate its influence on human health and ...environment is still scarce in many developing countries. This is a comprehensive study on the levels, chemical compositions, and source apportionment of PM
0.1
conducted in Hanoi, Vietnam. Twenty-four-hour samples of PM
0.1
were collected during the dry season (November to December 2015) at a mixed site to get the information on mass concentrations and chemical compositions. Multiple linear regression analysis was utilized to investigate the simultaneous influence of meteorological factors on fluctuations in the daily levels of PM
0.1
. Multiple linear regression models could explain about 50% of the variations of PM
0.1
concentrations, in which wind speed is the most important variable. The average concentrations of organic carbon (OC), elemental carbon (EC), water-soluble ions (Ca
2+
, K
+
, Mg
2+
, Na
+
, NH
4
+
, Cl
−
, NO
3
−
, SO
4
2−
, C
2
O
4
2−
), and elements (Be, Al, V, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Mo, Cd, Sb, Ba, Tl, Pb, Na, Fe, Mg, K, and Ca) were 2.77 ± 0.90 μg m
−3
, 0.63 ± 0.28 μg m
−3
, 0.88 ± 0.39 μg m
−3
, and 0.05 ± 0.02 μg m
−3
, accounting for 51.23 ± 9.32%, 11.22 ± 2.10%, 16.28 ± 2.67%, and 1.11 ± 0.94%, respectively. A positive matrix factorization model revealed the contributions of five major sources to the PM
0.1
mass including traffic (gasoline and diesel emissions, 46.28%), secondary emissions (31.18%), resident/commerce (12.23%), industry (6.05%), and road/construction (2.92%).
Type 2 diabetes mellitus (T2DM) has been increasing rapidly in Vietnam as well as world-wide. One of the major causes of the condition is low fiber intake. It is difficult to eat large amounts of ...vegetables every day to reach a sufficient amount of fiber but Textured Soybean Protein is rich in fiber. The study aimed to examine the effectiveness of Textured Soybean Protein consumption on T2DM patients. In this randomized controlled trial, 47 T2DM patients were divided into an intervention group (n=24) and a control group (n=23). The intervention group were asked to consume 40 g Textured Soybean Protein in 2 dishes for 4 wk. The control group continued their usual diet. Fasting blood samples were drawn before and after intervention to measure fasting plasma glucose (FPG), fructosamine, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), total cholesterol (T-C), and triglycerides (TG). A 3-day food record was conducted at 1 wk before (baseline) and at the last week (final) of the intervention period. In the Textured Soybean Protein consumption group, there was a significant decrease in fructosamine (363±86 μmol/L to 347±82 μmol/L, p=0.03), T-C (5.2±0.9 mmol/L to 4.8±0.8 mmol/L, p=0.02) and TG (3.5±2.2 mmol/L to 2.8±2.0 mmol/L, p=0.02). Total energy intake in the two groups did not change significantly. There was a shift in the dietary pattern of the Textured Soybean Protein consumption group; lipid intake showed a significant decrease (p=0.001) and fiber intake increased by 6 g (p<0.001). The consumption of Textured Soybean Protein in the diet could have favorable effects in improving glycemic and lipid concentrations in T2DM patients.
Abstract
There are growing concerns on stress among nurses in low- and middle-income countries (LMICs) in South-East Asia. It is important to improve mental health among nurses in these countries. ...The objective of this study was to examine the efficacy of two types of newly developed smartphone-based stress management programs in improving depressive and anxiety symptoms among hospital nurses in Vietnam. This study was a three-arm (including two intervention groups and one control group) randomized trial. Participants were recruited from nurses in a large general hospital in Hanoi, Vietnam. Two types (free-choice and fixed sequential order) of smartphone-based stress management programs were developed. Participants were randomly allocated to Program A (a free-choice, multimodule stress management), Program B (a fixed-order, internet cognitive behavioral therapy, iCBT), or a control group (treatment as usual). The depressive and anxiety symptoms were measured by using the Depression Anxiety and Stress Scales at baseline, 3-, and 7-month follow-up surveys. 951 participants were randomly allocated to each of the three groups. Program B showed a statistically significant effect on improving depressive symptoms at 3-month (p = 0.048), but not at 7-month (p = 0.92); Cohen’s d was − 0.18 (95% CI − 0.34 to − 0.02) and 0.03 (95% CI − 1.00 to 1.05), respectively. Program A failed to show a significant intervention effect on any of the outcomes at 3- or 7-month follow-up (p > 0.05). Despite the small effect size, the present fixed-order iCBT program seems effective in improving depression of hospital nurses in Vietnam. A public health impact of the intervention can be scalable, when considering its accessibility and minimal cost.
Trial registration number: The study protocol is registered at the UMIN Clinical Trials Registry (UMINCTR; ID = UMIN000033139). Registered date of the protocol is 1st Jul. 2018.
https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037796
We sampled nasal-pharyngeal throat swabs from 96,123 asymptomatic individuals at risk of SARS-CoV-2 infection, and generated 22,290 pools at collection, each containing samples from two to seven ...individuals. We detected SARS-CoV-2 in 24 pools, and confirmed the infection in 32 individuals after resampling and testing of 104 samples from positive pools. We completed the testing within 14 days. We would have required 64 days to complete the screening for the same number of individuals if we had based our testing strategy on individual testing. There was no difference in cycle threshold (Ct) values of pooled and individual samples. Thus, compared with individual sample testing, our approach did not compromise PCR sensitivity, but saved 77% of the resources. The present strategy might be applicable in settings, where there are shortages of reagents and the disease prevalence is low, but the demand for testing is high.
Japanese encephalitis virus (JEV) is classified into 5 genotypes (GI, GII, GIII, GIV, and GV), and the GI and GIII strains are the most widely distributed in JE endemic areas. In recent years, GV JEV ...has been detected in China and Korea, suggesting that GV JEV may invade other JE endemic areas, including Vietnam, and that more attention should be paid to the JEV strains circulating in these areas. In this study, we investigated the neutralization ability of the sera collected from 22 Vietnamese patients with JE who lived in northern Vietnam against the GI and GV JEV strains. In most cases, the ratios of the titer against GV to that against GI (GV:GI) were equal to or less than 1:4. However, the titer against GV JEV was equivalent (1:1) to that against GI JEV in only a few cases, and no serum had a ratio higher than 1:1. Thus, our results did not show convincing evidence that GV JEV was emerging in northern Vietnam in 2014.
Late detection of hepatocellular carcinoma (HCC) results in an overall 5-year survival rate of less than 16%. Liquid biopsy (LB) assays based on detecting circulating tumor DNA (ctDNA) might provide ...an opportunity to detect HCC early noninvasively. Increasing evidence indicates that ctDNA detection using mutation-based assays is significantly challenged by the abundance of white blood cell-derived mutations, non-tumor tissue-derived somatic mutations in plasma, and the mutational tumor heterogeneity.
Here, we employed concurrent analysis of cancer-related mutations, and their fragment length profiles to differentiate mutations from different sources. To distinguish persons with HCC (PwHCC) from healthy participants, we built a classification model using three fragmentomic features of ctDNA through deep sequencing of thirteen genes associated with HCC.
Our model achieved an area under the curve (AUC) of 0.88, a sensitivity of 89%, and a specificity of 82% in the discovery cohort consisting of 55 PwHCC and 55 healthy participants. In an independent validation cohort of 54 PwHCC and 53 healthy participants, the established model achieved comparable classification performance with an AUC of 0.86 and yielded a sensitivity and specificity of 81%.
Our study provides a rationale for subsequent clinical evaluation of our assay performance in a large-scale prospective study.
Vietnam is an important crossroads within Mainland Southeast Asia (MSEA) and a gateway to Island Southeast Asia, and as such exhibits high levels of ethnolinguistic diversity. However, comparatively ...few studies have been undertaken of the genetic diversity of Vietnamese populations. In order to gain comprehensive insights into MSEA mtDNA phylogeography, we sequenced 609 complete mtDNA genomes from individuals belonging to five language families (Austroasiatic, Tai-Kadai, Hmong-Mien, Sino-Tibetan and Austronesian) and analyzed them in comparison with sequences from other MSEA countries and Taiwan. Within Vietnam, we identified 399 haplotypes belonging to 135 haplogroups; among the five language families, the sequences from Austronesian groups differ the most from the other groups. Phylogenetic analysis revealed 111 novel Vietnamese mtDNA lineages. Bayesian estimates of coalescence times and associated 95% HPD for these show a peak of mtDNA diversification around 2.5-3 kya, which coincides with the Dong Son culture, and thus may be associated with the agriculturally-driven expansion of this culture. Networks of major MSEA haplogroups emphasize the overall distinctiveness of sequences from Taiwan, in keeping with previous studies that suggested at most a minor impact of the Austronesian expansion from Taiwan on MSEA. We also see evidence for population expansions across MSEA geographic regions and language families.
Abstract
Background
An endotracheal tube cuff pressure between 20 and 30 cmH2O is recommended to prevent ventilator-associated respiratory infection (VARI). We aimed to evaluate whether continuous ...cuff pressure control (CPC) was associated with reduced VARI incidence compared with intermittent CPC.
Methods
We conducted a multicenter open-label randomized controlled trial in intensive care unit (ICU) patients within 24 hours of intubation in Vietnam. Patients were randomly assigned 1:1 to receive either continuous CPC using an automated electronic device or intermittent CPC using a manually hand-held manometer. The primary endpoint was the occurrence of VARI, evaluated by an independent reviewer blinded to the CPC allocation.
Results
We randomized 600 patients; 597 received the intervention or control and were included in the intention to treat analysis. Compared with intermittent CPC, continuous CPC did not reduce the proportion of patients with at least one episode of VARI (74/296 25% vs 69/301 23%; odds ratio OR 1.13; 95% confidence interval CI .77–1.67. There were no significant differences between continuous and intermittent CPC concerning the proportion of microbiologically confirmed VARI (OR 1.40; 95% CI .94–2.10), the proportion of intubated days without antimicrobials (relative proportion RP 0.99; 95% CI .87–1.12), rate of ICU discharge (cause-specific hazard ratio HR 0.95; 95% CI .78–1.16), cost of ICU stay (difference in transformed mean DTM 0.02; 95% CI −.05 to .08, cost of ICU antimicrobials (DTM 0.02; 95% CI −.25 to .28), cost of hospital stay (DTM 0.02; 95% CI −.04 to .08), and ICU mortality risk (OR 0.96; 95% CI .67–1.38).
Conclusions
Maintaining CPC through an automated electronic device did not reduce VARI incidence.
Clinical Trial Registration
NCT02966392.
The results of this randomised controlled trial demonstrate that continuous endotracheal cuff pressure control using an electronic automated device does not reduce the occurrence of ventilator-associated respiratory infection (VARI) in intubated patients compared with intermittent control.
BACKGROUND: Achieving access to clean water and basic sanitation remains as major challenges in Vietnam, especially for vulnerable groups such as minority people, despite all the progress made by the ...Millennium Development Goal number 7.C. OBJECTIVES: The study aimed to describe the access to improved water sources and sanitation of the ethnic minority people in Vietnam based on a national survey and to identify associated factors. METHODS: A cross-sectional study was conducted in 2019 with a sample size of 1385 ethnic minority households in 12 provinces in Vietnam. Multivariate logistic regression modeling was performed to examine the probability of having access to improved water sources and sanitation and sociodemographic status at a significance level of P < .05. RESULTS: The access to improved water sources and sanitation was unequal among the ethnic minority people in Vietnam, with the lowest access rate in the northern midland and mountainous and Central Highland areas and the highest access rate in the Mekong Delta region. Some sociodemographic variables that were likely to increase the ethnic minority people’s access to improved water sources and/or sanitation included older age, female household heads, household heads with high educational levels, religious households, and households in not poor status. CONCLUSION AND RECOMMENDATIONS: The study suggested more emphasis on religion for improving the ethnic minority’s access to improved water sources and sanitation. Besides, persons of poor and near-poor status and with low educational levels should be of focus in future water and sanitation intervention programs.
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