Sex Differences in Clustering Unhealthy Lifestyles Among Survivors of COVID-19: Latent Class Analysis.

BACKGROUND: The COVID-19 pandemic has underscored the significance of adopting healthy lifestyles to mitigate the risk of severe outcomes and long-term consequences. OBJECTIVE: This study focuses on assessing the prevalence and clustering of 5 unhealthy lifestyle behaviors among Vietnamese adults after recovering from COVID-19, with a specific emphasis on sex differences. METHODS: The cross-sectional data of 5890 survivors of COVID-19 in Vietnam were analyzed from December 2021 to October 2022. To examine the sex differences in 5 unhealthy lifestyle behaviors (smoking, drinking, unhealthy diet, physical inactivity, and sedentary behavior), the percentages were plotted along with their corresponding 95% CI for each behavior. Latent class analysis was used to identify 2 distinct classes of individuals based on the clustering of these behaviors: the "less unhealthy" group and the "more unhealthy" group. We examined the sociodemographic characteristics associated with each identified class and used logistic regression to investigate the factors related to the "more unhealthy" group. RESULTS: The majority of individuals (male participants: 2432/2447, 99.4% and female participants: 3411/3443, 99.1%) exhibited at least 1 unhealthy behavior, with male participants being more susceptible to multiple unhealthy behaviors. The male-to-female ratio for having a single behavior was 1.003, but it escalated to 25 for individuals displaying all 5 behaviors. Male participants demonstrated a higher prevalence of combining alcohol intake with sedentary behavior (949/2447, 38.8%) or an unhealthy diet (861/2447, 35.2%), whereas female participants tended to exhibit physical inactivity combined with sedentary behavior (1305/3443, 37.9%) or an unhealthy diet (1260/3443, 36.6%). Married male participants had increased odds of falling into the "more unhealthy" group compared to their single counterparts (odds ratio [OR] 1.45, 95% CI 1.14-1.85), while female participants exhibited lower odds (OR 0.65, 95% CI 0.51-0.83). Female participants who are underweight showed a higher likelihood of belonging to the "more unhealthy" group (OR 1.11, 95% CI 0.89-1.39), but this was not observed among male participants (OR 0.6, 95% CI 0.41-0.89). In both sexes, older age, dependent employment, high education, and obesity were associated with higher odds of being in the "more unhealthy" group. CONCLUSIONS: The study identified notable sex differences in unhealthy lifestyle behaviors among survivors of COVID-19. Male survivors are more likely to engage in unhealthy behaviors compared to female survivors. These findings emphasize the importance of tailored public health interventions targeting sex-specific unhealthy behaviors. Specifically, addressing unhealthy habits is crucial for promoting post-COVID-19 health and well-being.

Boosting the catalytic activity of nanostructured ZnFe2O4 spinels incorporating with Cu2+ for photo-Fenton degradation under visible light.

Methylene blue (MB) is hazardous in natural water because this dye causes serious diseases that endangers public health and ecosystems. Photocatalytic degradation is a prominent technique for achieving the effective elimination of dye pollutants from wastewater and contribute vitally to ecology and environmental safety. Herein, Cu2+-substituted ZnFe2O4 nanomaterials (CuxZn1-xFe2O4; x = 0, 0.1, 0.2, 0.3, 0.4, 0.6) were synthesized, characterized, and applied for the photocatalytic degradation of MB dye beneath visible light with the assistance of hydrogen peroxide (H2O2). The feature of the photo-catalysts was determined by XRD, EDX, FTIR, DRS, BET, SEM, and TEM techniques. Incorporation of Cu2+ ions changed the crystalline phase, particle size, morphology, and surface area. The photocatalysis condition was optimized with the following major factors, the amout of doping Cu2+ ions, H2O2 concentration, adsorbent dosage, and MB concentration. As a result, the photocatalytic MB degradation efficiency by Cu0.6Zn0.4Fe2O4 catalyst was 99.83% within 90 min under LED light (λ ≥ 420 nm), which was around 4 folds higher than that of pure ZnFe2O4. The photo-Fenton kinetics were in accordance with the pseudo-first-order kinetic model (R2 = 0.981), giving the highes rate constant of 0.034 min-1. It can be, therefore, concluded that Cu2+ substitution considerably boosted the photocatalytic activity of CuxZn1-xFe2O4 ZnFe2O4, suggesting a bright prospect of Cu0.6Zn0.4Fe2O4 as a photo-catalyst in the dyes wastewater treatment.

Digital Healthy Diet Literacy and Fear of COVID-19 as Associated with Treatment Adherence and Its Subscales among Hemodialysis Patients: A Multi-Hospital Study.

Treatment adherence (TA) is a critical issue and is under-investigated in hemodialysis patients. A multi-center study was conducted from July 2020 to March 2021 on 972 hemodialysis patients in eight hospitals in Vietnam to explore the factors associated with TA during the COVID-19 pandemic. Data were collected, including socio-demographics, an End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), 12-item short-form health literacy questionnaire (HLS-SF12), 4-item digital healthy diet literacy scale (DDL), 10-item hemodialysis dietary knowledge scale (HDK), 7-item fear of COVID-19 scale (FCoV-19S), and suspected COVID-19 symptoms (S-COVID19-S). Bivariate and multivariate linear regression models were used to explore the associations. Higher DDL scores were associated with higher TA scores (regression coefficient, B, 1.35; 95% confidence interval, 95%CI, 0.59, 2.12; p = 0.001). Higher FCoV-19S scores were associated with lower TA scores (B, -1.78; 95%CI, -3.33, -0.24; p = 0.023). In addition, patients aged 60-85 (B, 24.85; 95%CI, 6.61, 43.11; p = 0.008) with "very or fairly easy" medication payment ability (B, 27.92; 95%CI, 5.89, 44.95; p = 0.013) had higher TA scores. Patients who underwent hemodialysis for ≥5 years had a lower TA score than those who received <5 years of hemodialysis (B, -52.87; 95%CI, -70.46, -35.28; p < 0.001). These findings suggested that DDL and FCoV-19S, among other factors, should be considered in future interventions to improve TA in hemodialysis patients.

Association between Hypertension and Stroke Recurrence as Modified by Pro-oxidant-Antioxidant Balance: A Multi-Center Study.

BACKGROUND: Hypertension and oxidative stress are involved in the pathophysiological mechanism of stroke. We aimed to investigate the modification impact of the pro-oxidant-anti-oxidant balance (PAB) on the association between hypertension and stroke recurrence (SR). METHODS: A cross-sectional design was conducted from December 2019 to December 2020 in 951 stroke patients in six hospitals across Vietnam. Hypertension was defined using antihypertensive medication or systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg. PAB was estimated using weighting methods based on smoking, drinking, and overweight/obesity with pro-oxidant capacity, diet quality, fruit intake, vegetable intake, and physical activity with antioxidant capacity. The higher PAB scores indicated a beneficial balance shifting toward antioxidant dominance. SR was diagnosed by neurologists. Moreover, sociodemographic and health conditions were included as covariates. Multiple logistic regression analyses were used to explore the associations and interactions. RESULTS: The hypertension and SR proportions were 72.8% and 17.5%, respectively. hypertension was associated with an increased SR likelihood (odds ratio (OR) = 1.93; p = 0.004), whereas a higher PAB score was associated with a lowered SR likelihood (OR = 0.87; p = 0.003). Moreover, hypertension interacting with every one-point increment of PAB was associated with a lowered SR likelihood (OR = 0.83; p = 0.022). CONCLUSIONS: The harmful impact of hypertension on SR could be alleviated by PAB. The interplay of health behaviors should be highlighted in the intervention strategies for stroke prevention.

Efficient and recyclable Nd3+-doped CoFe2O4 for boosted visible light-driven photocatalytic degradation of Rhodamine B dye.

Rare earth metal doping spinel ferrites offer excellent electronic, magnetic, and photocatalytic properties, but they have not been well explored for environmental mitigation. Herein, we report the facile fabrication of novel CoNd x Fe2-x O4 (x = 0-0.05) photocatalysts based on Nd3+ incorporated into CoFe2O4 for the degradation of Rhodamine B under visible light irradiation. The Nd3+ dopant considerably increased the specific surface area (35 m2 g-1) and enhanced the degradation performance (94.7%) of CoNd x Fe2-x O4 catalysts. Nd3+-doped CoFe2O4 played a role in the formation of radicals, including ˙OH, h+, and ˙O2 -. With high recyclability and performance, CoNd0.05Fe1.95O4 nanoparticles can be efficient and reusable photocatalysts for degrading organic dyes, including Rhodamine B from wastewaters.

Osteoporosis Risk in Hemodialysis Patients: The Roles of Gender, Comorbidities, Biochemical Parameters, Health and Diet Literacy.

Osteoporosis is a common bone health disorder in hemodialysis patients that is linked with a higher morbidity and mortality rate. While previous studies have explored the associated factors of osteoporosis, there is a lack of studies investigating the impacts of health literacy (HL) and digital healthy diet literacy (DDL) on osteoporosis. Therefore, we aimed to investigate the associations of HL, DDL, and other factors with osteoporosis among hemodialysis patients. From July 2020 to March 2021, a cross-sectional study was conducted on 675 hemodialysis patients in eight hospitals in Vietnam. The data were collected by using the osteoporosis self-assessment tool for Asians (OSTA) and the 12-item short form of the health literacy questionnaire (HLS-SF12) on digital healthy diet literacy (DDL) and hemodialysis dietary knowledge (HDK). In addition, we also collected information about the socio-demographics, the clinical parameters, the biochemical parameters, and physical activity. Unadjusted and adjusted multinomial logistic regression models were utilized in order to investigate the associations. The proportion of patients at low, medium, and high levels of osteoporosis risk was 39.6%, 40.6%, and 19.8%, respectively. In the adjusted models, women had a higher likelihood of osteoporosis risk than men (odds ratio, OR, 3.46; 95% confidence interval, 95% CI, 1.86, 6.44; p < 0.001; and OR, 6.86; 95% CI, 2.96, 15.88; p < 0.001). The patients with rheumatoid arthritis (OR, 4.37; 95% CI, 1.67, 11.52; p = 0.003) and stomach ulcers (OR, 1.95; 95% CI, 1.01, 3.77; p = 0.048) were more likely to have a higher likelihood of osteoporosis risk than those without. The patients who had a higher waist circumference (WC), HL, and DDL were less likely to have a medium level of osteoporosis risk (OR, 0.95; 95% CI, 0.92, 0.98; p = 0.004; OR, 0.92; 95% CI, 0.88, 0.96; p < 0.001; OR, 0.96; 95% CI, 0.93, 0.99; p = 0.017, respectively) and a high level of osteoporosis risk (OR, 0.93; 95% CI, 0.89, 0.97; p = 0.001; OR, 0.89; 95% CI, 0.84, 0.94; p < 0.001; OR, 0.95; 95% CI, 0.91, 0.99; p = 0.008, respectively) compared with a low level of osteoporosis risk and to those with a lower WC, HL, and DDL. In addition, higher levels of hemoglobin (Hb) (OR, 0.79; 95% CI, 0.66, 0.95; p = 0.014), hematocrit (Hct) (OR, 0.95; 95% CI, 0.92, 0.99; p = 0.041), albumin (OR, 0.91; 95% CI, 0.83, 0.99; p = 0.030), and education (OR, 0.37; 95% CI, 0.16, 0.88; p = 0.025) were associated with a lower likelihood of a high level of osteoporosis risk. In conclusion, osteoporosis risk is highly prevalent in hemodialysis patients. Improved HL, DDL, education, WC, albumin, Hb, and Hct levels should be considered in preventing hemodialysis patients from developing osteoporosis.

Ce3+/Ce4+-Doped ZrO2/CuO Nanocomposite for Enhanced Photocatalytic Degradation of Methylene Blue under Visible Light.

In recent years, photocatalysis has been used as an environmentally friendly method for the degradation of organic pigments in water. In this study, Ce3+/Ce4+-doped ZrO2/CuO as a mixed semiconductor oxide was successfully prepared by a one-step hydrothermal method. The Ce3+/Ce4+-doped ZrO2/CuO has shown high degradation efficiency of methylene blue (MB), and the maximum degradation percentage was observed to be 94.5% at 180 min under irradiation visible light. The photocatalytic activity increases significantly by doping Ce3+/Ce4+ in ZrO2/CuO for MB degradation. Ce3+/Ce4+ doping is shown to reduce the (e-/h+) recombination rate and improve the charge transfer, leading to enhanced photocatalytic activity of materials. The materials were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), FTIR, EDS, BET and diffuse reflectance spectroscopy (DRS).

Toward enhanced visible-light photocatalytic dye degradation and reusability of La3+ substituted ZnFe2O4 nanostructures.

The present work focused on the synthesis of novel ZnLaxFe2-xO4 catalysts (x = 0, 0.01, 0.03, 0.05) and their utilization for the photocatalytic degradation of Rhodamine B dye. Structurally, the band gap energy of the catalysts tended to decrease (1.94-1.70 eV) with increasing the amount of La3+ dopant. ZnLa0.05Fe1.95O4 had an average particle size (40 nm), high surface area (41.07 m2 g-1) and large pore volume (0.186 cm3 g-1). Moreover, the effect of doping ratio, reaction time, H2O2 concentration, catalyst loading on the treatment performance of La3+ substituted ZnFe2O4 nanocomposites was investigated. ZnLa0.05Fe1.95O4/H2O2 system exhibited the highest degradation efficiency of 99.5% and nonlinear pseudo first-order kinetic reaction rate (14.8 × 10-3 min-1) in the presence of visible light irradiation. The key role of reactive oxygen species involving •O2- and •OH radicals was well explained through the scavenger study. A plausible mechanism of the degradation of Rhodamine B dye was also proposed. Due to two advantageous points including high recyclability (up to 4 cycles) and stability, La3+ substituted ZnFe2O4 nanocomposites can be an effective and competitive catalyst for the visible light-driven photodegradation of toxic dyes in the real wastewaters.

Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam.

Melioidosis is a fatal infectious disease in the tropics and subtropics. Currently, bacterial culture is the gold standard for diagnosis of the disease, but its sensitivity is relatively low. In this study, we evaluated four ELISAs using sera collected from culture-confirmed cases of melioidosis (n = 63), cases with other bacterial infections (n = 62), and healthy donors (n = 60). Antigens used for ELISAs were the whole-cell (WC) antigens and recombinant proteins of hemolysis co-regulated protein 1 (Hcp1), GroEL1, and alkyl hydroperoxide reductase subunit C (AhpC). Using the cutoff values for optical density at 490 nm defined at a specificity of > 95%, the sensitivity of the WC, Hcp1, GroEL1, and AhpC ELISAs was 93.7%, 87.3%, 61.9%, and 57.1%, respectively. The combined WC/Hcp1 ELISA showed the greatest sensitivity and specificity of 98.4% and 95.1%, respectively. Of 511 and 500 sera collected from clinically suspected febrile patients admitted to the General Hospital of Ha Tinh Province and the Hue Central Hospital, respectively, combined WC/Hcp1 ELISAs showed 52 (10.2%) and 41 (8.2%) patients positive for melioidosis, respectively. The assay detected 14 of 14 (100%) and 21 of 23 (91.3%) culture-confirmed cases of melioidosis at Ha Tinh and Hue, respectively. A follow-up study of 38 patients positive for melioidosis by combined WC/Hcp1 ELISAs but negative for Burkholderia pseudomallei by culture method or not assigned to examine for bacterial culture resulted in 2 (5.3%) culture-reconfirmed patients with melioidosis, 9 (23.7%) deaths, 17 (44.7%) unhealthy patients, and 10 (26.3%) healthy persons. Combined WC/Hcp1 ELISA was a reliable serological method to detect underdiagnosed cases of melioidosis. Further investigations are needed to estimate the true sensitivity and specificity of the assay and the true number of cases of melioidosis.

Expanding RNAi therapeutics to extrahepatic tissues with lipophilic conjugates.

Therapeutics based on short interfering RNAs (siRNAs) delivered to hepatocytes have been approved, but new delivery solutions are needed to target additional organs. Here we show that conjugation of 2'-O-hexadecyl (C16) to siRNAs enables safe, potent and durable silencing in the central nervous system (CNS), eye and lung in rodents and non-human primates with broad cell type specificity. We show that intrathecally or intracerebroventricularly delivered C16-siRNAs were active across CNS regions and cell types, with sustained RNA interference (RNAi) activity for at least 3 months. Similarly, intravitreal administration to the eye or intranasal administration to the lung resulted in a potent and durable knockdown. The preclinical efficacy of an siRNA targeting the amyloid precursor protein was evaluated through intracerebroventricular dosing in a mouse model of Alzheimer's disease, resulting in amelioration of physiological and behavioral deficits. Altogether, C16 conjugation of siRNAs has the potential for safe therapeutic silencing of target genes outside the liver with infrequent dosing.

Impacts of Digital Healthy Diet Literacy and Healthy Eating Behavior on Fear of COVID-19, Changes in Mental Health, and Health-Related Quality of Life among Front-Line Health Care Workers.

BACKGROUND: We aimed to examine the impacts of digital healthy diet literacy (DDL) and healthy eating behaviors (HES) on fear of COVID-19, changes in mental health, and health-related quality of life (HRQoL) among front-line healthcare workers (HCWs). METHODS: An online survey was conducted at 15 hospitals and health centers from 6-19 April 2020. Data of 2299 front-line HCWs were analyzed-including socio-demographics, symptoms like COVID-19, health literacy, eHealth literacy, DDL, HES, fear of COVID-19, changes in mental health, and HRQoL. Regression models were used to examine the associations. RESULTS: HCWs with higher scores of DDL and HES had lower scores of FCoV-19S (regression coefficient, B, -0.04; 95% confidence interval, 95% CI, -0.07, -0.02; p = 0.001; and B, -0.10; 95% CI, -0.15, -0.06; p < 0.001); had a higher likelihood of stable or better mental health status (odds ratio, OR, 1.02; 95% CI, 1.00, 1.05; p = 0.029; and OR, 1.04; 95% CI, 1.00, 1.07; p = 0.043); and HRQoL (OR, 1.02; 95% CI, 1.01, 1.03; p = 0.006; and OR, 1.04; 95% CI, 1.02, 1.06; p = 0.001), respectively. CONCLUSIONS: DDL and HES were found as independent predictors of fear of COVID-19, changes in mental health status, and HRQoL in front-line HCWs. Improving DDL and HES should be considered as a strategic approach for hospitals and healthcare systems.

Enhanced Photocatalytic Activity of Spherical Nd3+ Substituted ZnFe2O4 Nanoparticles.

In this study, nanocrystalline ZnNdxFe2-xO4 ferrites with x = 0.0, 0.01, 0.03 and 0.05 were fabricated and used as a catalyst for dye removal potential. The effect of Nd3+ ions substitution on the structural, optical and photo-Fenton activity of ZnNdxFe2-xO4 has been investigated. The addition of Nd3+ ions caused a decrease in the grain size of ferrites, the reduction of the optical bandgap energies and thus could be well exploited for the catalytic study. The photocatalytic activity of the ferrite samples was evaluated by the degradation of Rhodamine B (RhB) in the presence of H2O2 under visible light radiation. The results indicated that the ZnNdxFe2-xO4 samples exhibited higher removal efficiencies than the pure ZnFe2O4 ferrites. The highest degradation efficiency was 98.00%, attained after 210 min using the ZnNd0.03Fe1.97O4 sample. The enhanced photocatalytic activity of the ZnFe2O4 doped with Nd3+ is explained due to the efficient separation mechanism of photoinduced electron and holes. The effect of various factors (H2O2 oxidant concentration and catalyst loading) on the degradation of RhB dye was clarified.

[Risk factor analysis of perioperative complications in patients with radical gastrectomy for gastric cancer].

Objective: To identify the risk factors of perioperative complications after radical gastrectomy for gastric cancer. Methods: A retrospective case-control study was performed. Case inclusion criteria: (1) patients undergoing radical gastrectomy (D2); (2) primary gastric cancer without distant organ metastasis confirmed by postoperative pathology; (3) no neoadjuvant chemotherapy before surgery. Patients with peritoneal tumor dissemination found during operation, undergoing palliative operation due to distant metastasis, and undergoing combined organ resection and those without complete clinicopathological data were excluded. According to the above criteria, 426 patients with gastric cancer at our department from January 2015 to June 2017 were included in this study. Of 426 patients, 285 were male and 141 were female with a mean age of (55.4±9.7) years. According to the "Japan Clinical Cancer Research Group (JCOG) classification criteria for postoperative complications of gastric cancer", patients with grade II and higher complications were classified as complication group, and patients with no complication or grade I complication were classified as non-complication group. Baseline data were compared between two groups. Associations of perioperative complication with gender, age, body mass index, preoperative routine laboratory test, American Society of Anesthesiologists (ASA) classification, activities of daily living (ADL) assessment, past medical history as well as preoperative conditions (hypertension and/or diabetes), surgical resection procedure, incision type, operation time, intraoperative blood loss/body mass ratio were examined. Univariate analysis was performed using χ(2) test and the Wilcoxon rank sum test to screen the statistically significant variables associated with perioperative complications. The significant variables were included in multivariate logistic regression analysis to identify risk factors of perioperative complication. Results: Grade II or higher complications after surgery were developed in 97 patients (22.8%), which included anastomotic leakage in 18 cases (4.2%), postoperative bleeding in 9 cases (2.1%), abdominal abscess in 5 cases (1.2%), intestinal obstruction in 5 cases (1.2%), pancreatic leakage in 1 case (0.2%), and other adverse events in 59 cases (13.8%). Univariate analysis suggested that the gender, age, ADL, incision type, intraoperative blood loss/body mass ratio, and operation time were associated with perioperative complication (all P<0.05). Multivariate analysis revealed that elder age (OR=1.033, 95% CI:1.013-1.053, P=0.013), incision type of laparotomy (OR=2.091, 95% CI:1.247-3.508, P=0.004), longer operation time (OR=1.004, 95% CI:1.001-1.007, P=0.001) and higher ratio of intraoperative blood loss/body mass (OR=1.100, 95% CI: 1.039-1.163, P=0.031) were risk factors for postoperative complications. Conclusion: Attention should be paid to those cases with elder age, laparotomy incision, longer operation time and higher ratio of intraoperative blood loss/body mass, and perioperative management after gastrectomy should be improved.

Preparation, Characterization and Photocatalytic Activity of La-Doped Zinc Oxide Nanoparticles.

Lanthanum (La)-doped zinc oxide nanoparticles were synthesized with different La concentrations by employing a gel combustion method using poly(vinyl alcohol) (PVA). The as-synthesized photocatalysts were characterized using various techniques, including X-ray diffraction (XRD), transmission electron microscopy (TEM), energy dispersive X-ray analysis (EDX), photoluminescence (PL) spectroscopy, and UV-visible absorption spectroscopy. The average size of ZnO nanoparticles decreased from 34.3 to 10.3 nm with increasing concentrations of La, and the band gap, as evaluated by linear fitting, decreased from 3.10 to 2.78 eV. Additionally, it was found that the photocatalytic activity of doped samples, as investigated by using methyl orange dye under visible lights, improved in response to the increase in La concentration. The decomposition of methyl orange reached 85.86% after 150 min in visible light using La0.1Zn0.9O as the photocatalyst.

Community-Based Screening for Cervical Cancer Using Visual Inspection With Acetic Acid: Results and Lessons Learned From a Pilot Study in Vietnam.

CONTEXT: Vietnam still applies the opportunistic cytology-based screening model, which failed to have an impact on the increasing burden of cervical cancer in Vietnam. OBJECTIVES: To pilot a community-based screening model for cervical cancer using visual inspection with acetic acid (VIA) in Vietnam by training midwife and assistant physician working at grassroots level of health care system. DESIGN: The study employed a pre-experimental design. SETTING: Cases from 2 provinces of Vietnam. PARTICIPANTS: The study trained 36 assistant physicians/midwives working at commune health centers to do VIA screening for cervical cancer and provided screening services for 1945 women 30 to 65 years of age. INTERVENTION: The pilot intervention had 2 aims: train health care workers to do VIA screening and assess the quality of screening services provided by the trained staffs by examining the diagnostics value of VIA. RESULTS: All selected health care workers were able to perform VIA screening method after training. Their VIA services had high diagnostic value: positive predicted value of 11.5% and negative predicted value of 99%; for the detection of cervical intraepithelial neoplasia (CIN) 2, the sensitivity of VIA is 100%, specificity of 67.0%, positive predicted value of 5.7%, and negative predicted value of 100%; for the detection of CIN 3, the sensitivity of VIA is 100%, specificity of 66.5%, positive predicted value of 3.8%, and negative predicted value of 100%. The diagnostic value of VIA is comparable with Papanicolaou test but requires far fewer resources and suitable with community-based setting. CONCLUSION: Local midwives and assistant physicians who currently work at commune health centers and district health centers can be trained to do VIA efficiently. Regarding to implications for policy and practice, VIA can offer significant advantages over Papanicolaou test in low-resource settings like Vietnam, particularly in terms of increased screening coverage, improved follow-up care, and overall program quality.

Hyperactive FOXO1 results in lack of tip stalk identity and deficient microvascular regeneration during kidney injury.

Loss of the microvascular (MV) network results in tissue ischemia, loss of tissue function, and is a hallmark of chronic diseases. The incorporation of a functional vascular network with that of the host remains a challenge to utilizing engineered tissues in clinically relevant therapies. We showed that vascular-bed-specific endothelial cells (ECs) exhibit differing angiogenic capacities, with kidney microvascular endothelial cells (MVECs) being the most deficient, and sought to explore the underlying mechanism. Constitutive activation of the phosphatase PTEN in kidney MVECs resulted in impaired PI3K/AKT activity in response to vascular endothelial growth factor (VEGF). Suppression of PTEN in vivo resulted in microvascular regeneration, but was insufficient to improve tissue function. Promoter analysis of the differentially regulated genes in KMVECs suggests that the transcription factor FOXO1 is highly active and RNAseq analysis revealed that hyperactive FOXO1 inhibits VEGF-Notch-dependent tip-cell formation by direct and indirect inhibition of DLL4 expression in response to VEGF. Inhibition of FOXO1 enhanced angiogenesis in human bio-engineered capillaries, and resulted in microvascular regeneration and improved function in mouse models of injury-repair.

A final-year nursing student survey: rural attitudes, perceived competencies and intention to work across five Asian countries.

BACKGROUND: Shortages and maldistribution of nurses remain significant problems in many countries. Having appropriate intervention strategies to retain nurses in underserved areas, where they are most needed, are crucial for health system strengthening. This study aimed to quantify attitudes to working in rural areas, perceived competencies, and intention to work among final-year nursing students, and to analyze the associations between those factors and their background characteristics across five countries in the Asia-Pacific Network for Health Professional Education Reforms (ANHER), namely Bangladesh, China, India, Thailand, and Vietnam. METHODS: A descriptive comparative cross-sectional survey was conducted between July 2012 and July 2013, using a self-administered questionnaire to assess students' attitudes towards working in rural areas, their perceived competencies, and their intended job choices. A total of 10,169 final-year nursing students in five countries were selected. Bivariate models were constructed to compare students' characteristics. Statistically significant variables were further analyzed using multivariate models. RESULTS: Most nursing students in five countries had rural backgrounds. Students in India (67.1%) and Thailand (65.1%) held more positive attitudes towards working in rural areas. Students in Bangladesh (78.8%) and India (62.6%) believed that their schools prepared them well, and inspired them, to work in rural areas. The 'Lifelong learning' competency was ranked highest by students in all five countries, ranging from 76.2 to 91.7%. Their perceived competencies were significantly related to their background of having graduated from rural high schools and being admitted to study through rural recruitment. Rural upbringing and rural recruitment were significantly associated with more positive attitudes towards rural areas (p-value < 0.5). A majority of students in China (83.8%), Thailand (67.7%) and Vietnam (86.5%) intended to work in the public sector immediately after graduation. CONCLUSIONS: These findings from five Asian countries confirm that nursing students with rural upbringing and recruitment had more positive attitudes toward rural areas and were more likely to choose working in rural areas after graduation. This study provides additional evidence from country implementation to support the value of WHO recommendations of effective strategies to address issues of rural retention by focusing on the recruitment of students with a rural background.

HIV-related risk behaviors among the general population: a survey using Audio Computer-Assisted Self-Interview in 3 cities in Vietnam.

This study used a confidential survey method-namely, Audio Computer-Assisted Self-Interview (ACASI)-to gather data about HIV-related risk knowledge/behaviors among the general population in Vietnam. The study sample included 1371 people aged 15 to 49 years in 3 cities-Hanoi, Da nang, and Can Tho. Results indicated that 7% of participants had ever had nonconsensual sex, and 3.6% of them had ever had a one-night stand. The percentage of male participants reported to ever have sex with sex workers was 9.6% and to ever inject drugs was 4.3%. The proportion of respondents who had ever tested for HIV was 17.6%. The risk factors and attitudes reported in the survey indicate the importance of analyzing risk behaviors related to HIV infection among the general population. Young people, especially men in more urbanized settings, are engaging in risky behaviors and may act as a "bridge" for the transmission of HIV from high-risk groups to the general population in Vietnam.

Inhibition of apoptosis in human induced pluripotent stem cells during expansion in a defined culture using angiopoietin-1 derived peptide QHREDGS.

Adhesion molecule signaling is critical to human pluripotent stem cell (hPSC) survival, self-renewal, and differentiation. Thus, hPSCs are grown as clumps of cells on feeder cell layers or poorly defined extracellular matrices such as Matrigel. We sought to define a small molecule that would initiate adhesion-based signaling to serve as a basis for a defined substrate for hPSC culture. Soluble angiopoeitin-1 (Ang-1)-derived peptide QHREDGS added to defined serum-free media increased hPSC colony cell number and size during long- and short-term culture when grown on feeder cell layers or Matrigel, i.e. on standard substrates, without affecting hPSC morphology, growth rate or the ability to differentiate into multiple lineages both in vitro and in vivo. Importantly, QHREDGS treatment decreased hPSC apoptosis during routine passaging and single-cell dissociation. Mechanistically, the interaction of QHREDGS with ß1-integrins increased expression of integrin-linked kinase (ILK), increased expression and activation of extracellular signal-regulated kinases 1/2 (ERK1/2), and decreased caspase-3/7 activity. QHREDGS immobilization to polyethylene glycol hydrogels significantly increased cell adhesion in a dose-dependent manner. We propose QHREDGS as a small molecule inhibitor of hPSC apoptosis and the basis of an affordable defined substrate for hPSC maintenance.

Severity of psychosis syndrome and change of metabolic abnormality in chronic schizophrenia patients: severe negative syndrome may be related to a distinct lipid pathophysiology.

BACKGROUND: Metabolic abnormality is common among schizophrenia patients. Some metabolic traits were found associated with subgroups of schizophrenia patients. OBJECTIVES: We examined a possible relationship between metabolic abnormality and psychosis profile in schizophrenia patients. METHOD: Three hundred and seventy-two chronic schizophrenia patients treated with antipsychotics for more than 2 years were assessed with the Positive and Negative Syndrome Scale. A set of metabolic traits was measured at scheduled checkpoints between October 2004 and September 2006. RESULTS: Multiple regressions adjusted for sex showed negative correlations between body mass index (BMI) and total score and all subscales; triglycerides (TG) was negatively correlated with total score and negative syndrome, while HDLC was positively correlated with negative syndrome. When sex interaction was concerned, total score was negatively correlated with BMI but not with others; negative syndrome was negatively correlated with BMI and positively with HDLC. No metabolic traits were correlated with positive syndrome or general psychopathology. CONCLUSIONS: Loss of body weight is a serious health problem in schizophrenia patients with severe psychosis syndrome, especially the negative syndrome. Schizophrenia patients with severe negative syndrome may have a distinct lipid pathophysiology in comparison with those who were less severe in the domain.