Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients with Cancer.

Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients. Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cutoff scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking. Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female sex, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (32.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT. Conclusions: FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.

Role of Calprotectin, IL-6, and CRP in Distinguishing Between Inflammatory Bowel Disease and Diarrhea Predominant Irritable Bowel Syndrome.

Background: The early establishment of prophylaxis and immediate administration of anticoagulant therapy upon the diagnosis of venous thromboembolism should be the treatment objectives in these patients. Objective: The study aimed to determine the optimal cut-off point of Calprotectin, IL-6 (interleukin-6), CRP (C reactive protein) to differentiate UC, IBS-D. Methods: A cross-sectional descriptive study of 335 individuals ≥15 years old was performed, including 31 healthy controls, 215 with IBS-D, 71 diagnosed with UC, and 18 diagnosed with CD. Receiver Operating Characteristics (ROC), sensitivity, specificity, and area under curve (AUC) were computed. Results: The results showed that the median value of calprotectin (IQR) in healthy participants was 20.0 (6.0 - 34.0) µg/g; 17,7 (8,7-38,9) µg/g in IBS-D group; 1710.0 (588 - 4260,0) µg/g in UC group; and 560.5 (177.8 - 1210.0) µg/g in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of CRP (range IQR) was 1,3 (0,9 - 2,3) mg/L in IBS-D group; 7.0 (2.4 -16.6) mg/L in UC group; and 10.1 (2.2 - 42.5) mg/L in CD group. CRP concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of IL-6 (range IQR) was 2.3 (1.6 - 5.7) pg/mL in IBS-D group; 16.8 (9.4 - 47.0) pg/mL in UC group; and 9.4 (7.9 - 11.0) pg/mL in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The optimal cut-off point of calprotectin that differentiated IBS-D from IBD was 110.5 µg/g, with sensitivity and specificity of 93.3% and 91.4%, respectively; of IL-6 was 7.2 pg/mL with sensitivity and specificity of 92.0% and 78.0%, respectively; of CRP of 2.4 mg/L had specific sensitivities of 83.3% and 86.0%, respectively. Conclusion: The Calprotectin immunoassay has the best value in discriminating between IBD and IBS-D.

Study on the concentration, composition, and recovery rate of bacterial bioaerosols after rainfall in Ho Chi Minh City.

Aerosolized microorganisms have become an important factor in assessing air quality. To determine the characteristics of bacterial bioaerosols in air and rainwater, as well as calculate the recovery rate of bacteria after rains in Ho Chi Minh City, our study was performed using the SKC Biostage sampler for airborne bacteria and Plate Count Agar (PCA) medium for bacterial concentration. Subsequently, the study determined the bacterial community composition at the phylum and order levels using the 16S rRNA (16S metabarcoding) method. Before the rain, bacterial concentrations in the air ranged from 263.39 ± 21.00 to 277.39 ± 78.99 CFU/m3, and in rainwater 264.89 ± 51.17 to 285.72 ± 28.00 CFU/m3. Following rains, the bacterial concentrations decreased to their lowest levels within the first 1-2 h and gradually increased thereafter, reaching their peak after 9 h for heavy rain and after 12 h for light and moderate rains. The bacterial bioaerosols recovery rate was determined to be 100% for light and moderate rains and 94.6% for heavy rain. The change in bacterial concentration after rainfall showed a positive correlation with temperature (r = 0.85) and CO2 concentration (r = 0.70) and a negative correlation with relative humidity (r = - 0.79). Bacterial composition analysis revealed that the Actinobacteria, Firmicutes, and Proteobacteria phyla were dominant and characteristic of the humid tropical climate in Vietnam. Notably, Firmicutes were the most prevalent phylum both before and after rains. The increased prevalence of certain bacterial orders, particularly Staphylococcus, could contribute to the spread of pathogens, particularly foodborne pathogens. In addition to rain, relative humidity contributed to reducing bacterial bioaerosols concentration and their recovery rate after the rain.

Clinical Characteristics and Outcomes of Long COVID-19 Hospitalized Children in Vietnam.

A cross-sectional study was conducted on 205 pediatric patients, including 150 post-COVID-19 patients and 55 noninfected patients. The study identified 10 common respiratory symptoms in post-COVID-19 patients, with significant differences in clinical symptoms between the 2 groups. Post-COVID-19 pediatric patients had a lower lymphocyte count and a higher rate of pneumonia diagnosis, which can persist for up to 16 weeks after discharge. The study's findings can help monitor and manage the clinical burden of post-COVID-19 symptoms in the pediatric population.

Peptide-Based Agents for Cancer Treatment: Current Applications and Future Directions.

Peptide-based strategies have received an enormous amount of attention because of their specificity and applicability. Their specificity and tumor-targeting ability are applied to diagnosis and treatment for cancer patients. In this review, we will summarize recent advancements and future perspectives on peptide-based strategies for cancer treatment. The literature search was conducted to identify relevant articles for peptide-based strategies for cancer treatment. It was performed using PubMed for articles in English until June 2023. Information on clinical trials was also obtained from ClinicalTrial.gov. Given that peptide-based strategies have several advantages such as targeted delivery to the diseased area, personalized designs, relatively small sizes, and simple production process, bioactive peptides having anti-cancer activities (anti-cancer peptides or ACPs) have been tested in pre-clinical settings and clinical trials. The capability of peptides for tumor targeting is essentially useful for peptide-drug conjugates (PDCs), diagnosis, and image-guided surgery. Immunomodulation with peptide vaccines has been extensively tested in clinical trials. Despite such advantages, FDA-approved peptide agents for solid cancer are still limited. This review will provide a detailed overview of current approaches, design strategies, routes of administration, and new technological advancements. We will highlight the success and limitations of peptide-based therapies for cancer treatment.

Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report.

INTRODUCTION AND IMPORTANCE: Management of cranial and scalp defects is always challenging. Complication rates following cranioplasty are still high (10-40 %), including bone graft resorption, infection, and T-mesh implant exposure due to thinning of soft tissue (Yeap et al., 2019; Alkhaibary et al., 2020; Cho and Kang, 2017 [1-3]). CASE PRESENTATION: We present a case of a 38-year-old male with autologous bone graft resorption accompanied by thinning of the forehead skin. He underwent cranioplasty with titanium mesh (T-mesh) and scalp reconstruction with an anterolateral thigh (ALT) flap in a single-stage operation. A 2-component ALT flap was used: the skin paddle covered the scalp defect to reduce closure tension, and especially the adipofascial flap lining beneath the forehead skin to increase thickness. Postoperative results were great in terms of coverage function and aesthetics. CLINICAL DISCUSSION: The phenomenon of soft tissue thinning causing titanium mesh exposure is a common complication with a rate of 10-14 % (Yeap et al., 2019; Dong et al., 2020; Maqbool et al., 2018 [1, 4, 5]). Using adipofascial ALT flap as a sub-scalp filler material has many advantages over the latissimus dorsi (LD) flap to increase scalp thickness but still ensure aesthetics. CONCLUSION: The results suggest a new direction in using adipofascial ALT flap as filler material to increase scalp thickness to reduce T-mesh exposure following cranioplasty.

Bioimpedance-Measurement-Based Non-Invasive Method for In Ovo Chicken Egg Sexing.

Day-old male chick culling is one of the world's most inhumane problems in the poultry industry. Every year, seven billion male chicks are slaughtered in laying-hen hatcheries due to their higher feed exchange rate, lower management than female chicks, and higher production costs. This study describes a novel non-invasive method for determining the gender of chicken eggs. During the incubation period of fourteen days, four electrodes were attached to each egg for data collection. On the last day of incubation, a standard polymerase chain reaction (PCR)-based chicken gender determination protocol was applied to the eggs to obtain the gender information. A relationship was built between the collected data and the egg's gender, and it was discovered to have a reliable connection, indicating that the chicken egg gender can be determined by measuring the impedance data of the eggs on day 9 of incubation with the four electrodes set and using the self-normalization technique. This is a groundbreaking discovery, demonstrating that impedance spectroscopy can be used to sex chicken eggs before they hatch, relieving the poultry industry of such an ethical burden.

Ocular Delivery of Therapeutic Agents by Cell-Penetrating Peptides.

Cell-penetrating peptides (CPPs) are short peptides with the ability to translocate through the cell membrane to facilitate their cellular uptake. CPPs can be used as drug-delivery systems for molecules that are difficult to uptake. Ocular drug delivery is challenging due to the structural and physiological complexity of the eye. CPPs may be tailored to overcome this challenge, facilitating cellular uptake and delivery to the targeted area. Retinal diseases occur at the posterior pole of the eye; thus, intravitreal injections are needed to deliver drugs at an effective concentration in situ. However, frequent injections have risks of causing vision-threatening complications. Recent investigations have focused on developing long-acting drugs and drug delivery systems to reduce the frequency of injections. In fact, conjugation with CPP could deliver FDA-approved drugs to the back of the eye, as seen by topical application in animal models. This review summarizes recent advances in CPPs, protein/peptide-based drugs for eye diseases, and the use of CPPs for drug delivery based on systematic searches in PubMed and clinical trials. We highlight targeted therapies and explore the potential of CPPs and peptide-based drugs for eye diseases.

Spatiotemporal Evolution of SARS-CoV-2 Alpha and Delta Variants during Large Nationwide Outbreak of COVID-19, Vietnam, 2021.

We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions.

KIF13B mediates VEGFR2 recycling to modulate vascular permeability.

Excessive vascular endothelial growth factor-A (VEGF-A) signaling induces vascular leakage and angiogenesis in diseases. VEGFR2 trafficking to the cell surface, mediated by kinesin-3 family protein KIF13B, is essential to respond to VEGF-A when inducing angiogenesis. However, the precise mechanism of how KIF13B regulates VEGF-induced signaling and its effects on endothelial permeability is largely unknown. Here we show that KIF13B-mediated recycling of internalized VEGFR2 through Rab11-positive recycling vesicle regulates endothelial permeability. Phosphorylated VEGFR2 at the cell-cell junction was internalized and associated with KIF13B in Rab5-positive early endosomes. KIF13B mediated VEGFR2 recycling through Rab11-positive recycling vesicle. Inhibition of the function of KIF13B attenuated phosphorylation of VEGFR2 at Y951, SRC at Y416, and VE-cadherin at Y685, which are necessary for endothelial permeability. Failure of VEGFR2 trafficking to the cell surface induced accumulation and degradation of VEGFR2 in lysosomes. Furthermore, in the animal model of the blinding eye disease wet age-related macular degeneration (AMD), inhibition of KIF13B-mediated VEGFR2 trafficking also mitigated vascular leakage. Thus, the present results identify the fundamental role of VEGFR2 recycling to the cell surface in mediating vascular permeability, which suggests a promising strategy for mitigating vascular leakage associated with inflammatory diseases.

Antimicrobial resistance in commensal Escherichia coli from humans and chickens in the Mekong Delta of Vietnam is driven by antimicrobial usage and potential cross-species transmission.

Objectives: To investigate phenotypic antimicrobial resistance (AMR) in relation to antimicrobial use (AMU) and potential inter-species transmission among Escherichia coli from humans and chickens located in the same households in the Mekong Delta of Vietnam. Methods: We collected data on AMU and faecal swabs from humans (N = 426) and chickens (N = 237) from 237 small-scale farms. From each sample, one E. coli strain was isolated and tested for its susceptibility against 11 antimicrobials by Sensititre AST. The association between AMR and AMU was investigated by logistic regression modelling. Using randomization, we compared the degree of similarity in AMR patterns between human and chicken E. coli from the same farms compared with isolates from different farms. Results: The AMU rate was ∼19 times higher in chickens (291.1 per 1000 chicken-days) than in humans (15.1 per 1000 person-days). Isolates from chickens also displayed a higher prevalence of multidrug resistance (63.3%) than those of human origin (55.1%). AMU increased the probability of resistance in isolates from human (ORs between 2.1 and 5.3) and chicken (ORs between 1.9 and 4.8). E. coli from humans and chickens living on same farms had a higher degree of similarity in their AMR patterns than isolates from humans and chicken living on different farms. Conclusions: We demonstrated the co-influence of AMU and potential transmission on observed phenotypic AMR patterns among E. coli isolates from food-producing animals and in-contact humans. Restricting unnecessary AMU alongside limiting interspecies contact (i.e. increasing hygiene and biocontainment) are essential for reducing the burden of AMR.

Maternal and neonatal outcomes related to Zika virus in pregnant women in Southern Vietnam: An epidemiological and virological prospective analysis.

BACKGROUND: In 2016-2017, 68 women in Southern Vietnam had RT-PCR confirmed Zika virus (ZIKV) infection during pregnancy. We report here the outcomes of the pregnancies and the virological analyses related to this outbreak. METHODS: We collected clinical and epidemiological information from the women who were enrolled in the study. Medical records related to the pregnancy in 2016-2017 were retrieved for those who were not able to be enrolled in the study. Children born to women with ZIKV infection during pregnancy were also enrolled. Serum samples were evaluated for presence of ZIKV antibodies. Phylogenetic analyses were performed on Zika virus genomes sequenced from the 2016-2017 serum samples. FINDINGS: Of the 68 pregnancies, 58 were livebirths and 10 were medically terminated. Four of the medical records from cases of fetal demise were able to be retrieved, of which one was consistent with congenital ZIKV infection. Of the 58 women with a livebirth, 21 participated in the follow-up investigation. All but two women had serologic evidence of ZIKV infection. Of the 21 children included in the study (mean age: 30.3 months), 3 had microcephaly at birth. No other clinical abnormalities were reported and no differences in neurodevelopment were observed compared to a control group. Phylogenetic analysis revealed a clade within the ZIKV Asian lineage and branch at the root of samples from the 2013-2014 French Polynesian outbreak. The prM S139N mutation was not observed. INTERPRETATION: We have been able to demonstrate a clade within the ZIKV Asian lineage implicated in adverse pregnancy outcomes in Southern Vietnam. FUNDING: INCEPTION project (PIA/ANR-16-CONV-0005) and a grant received from BNP Paribas Simplidon.

Relationship between plumage color and eggshell patterns with egg production and egg quality traits of Japanese quails.

AIM: This study was conducted to identify the diversity of feather color and to determine the relationship between plumage color and egg yield as well as eggshell patterns and internal egg quality traits of Japanese quails. MATERIALS AND METHODS: For investigating phenotypic diversity, a total of 600 quails from five breeding farms were evaluated to record head feather, shank, and plumage color. An on-station experiment was also conducted on 360 laying quails to examine the relationship between plumage color and egg production and egg weight during 24 weeks of laying. Eggs collected during this period were also used for identifying eggshell patterns and examining their relationship with internal egg quality characteristics. RESULTS: Plumage color was primarily wild-type, with the highest proportion being 56.3% (p<0.001). Brown color was also found at a relatively high proportion in the population (16.7%), followed by black color (11.3%). The egg production and laying rate of quails with wild-type and brown plumage colors also significantly (p=0.001) differed from those of quails with other plumage types. Egg weight was also higher in these quail groups, especially than that of quails with yellow plumage color. Four patterns of eggshell were identified, among which spotted and dark eggshells were predominant (45.2% and 43.1%, respectively); however, patterns did not affect internal egg quality characteristics. CONCLUSION: Plumage color was primarily wild-type in both male and female quails. Egg yield over a 24-week laying period was superior in quails with wild-type and brown plumage colors, whereas a relationship between eggshell patterns and egg quality traits could not be established.

G-patch domain-containing protein 4 localizes to both the nucleoli and Cajal bodies and regulates cell growth and nucleolar structure.

Ribosome formation occurs in the nucleolus through interaction with various trans-acting factors. Therefore, hundreds of nucleolar proteins have a function in ribosome formation, although the precise function of each nucleolar protein in ribosome formation is largely unclear. We have previously identified an uncharacterized protein, G-patch domain-containing protein 4 (GPATCH4 or G4), as a component of the pre-ribosomes purified with either nucleolin (NCL) or NPM1. In this present study, we sought to clarify the localization and function of G4. We identified that G4 localizes to both the nucleolus and the Cajal body. Although knockdown of G4 did not have a significant effect on pre-ribosomal RNA processing, cell growth did decrease. Interestingly, G4 knockdown also decreased the number of fibrillar center and dense fibrillar component regions inside the nucleolus. This data has identified G4 as a novel nucleolar protein involved in the regulation of cell growth and nucleolar structure.

Hypovascular pancreatic neuroendocrine tumor with hepatic metastases: A case report and literature review.

Hypovascular pancreatic neuroendocrine tumors are uncommon pancreatic tumors and commonly misdiagnosed as pancreatic ductal adenocarcinoma or chronic mass-forming pancreatitis. The liver is the organ most commonly affected by neuroendocrine tumor metastases but hepatic neuroendocrine tumor metastases are quite difficult to discriminate from other hepatic metastases and primary hepatic tumors. We describe a case of a 47-year-old man with incidentally detected multiple hepatic lesions on ultrasound. On further imaging technique including computed tomography and magnetic resonance imaging, the patient had an abnormal hypoenhancing lesion at the pancreatic tail and multiple hyperenhancing hepatic metastases that were diagnosed as hypovascular pancreatic well-differentiated neuroendocrine tumor Grade 2 with multiple hypervascular hepatic metastases after liver biopsy and surgery. Neuroendocrine tumor is a rare etiology among hypoenhancing pancreatic tumors, and must be considered to discriminate from pancreatic adenocarcinomas in cases there are multiple hyperenhancing hepatic metastases on the arterial phase without typical washout on the portal venous phase.

Coverage Path Planning Using Reinforcement Learning-Based TSP for hTetran-A Polyabolo-Inspired Self-Reconfigurable Tiling Robot.

One of the critical challenges in deploying the cleaning robots is the completion of covering the entire area. Current tiling robots for area coverage have fixed forms and are limited to cleaning only certain areas. The reconfigurable system is the creative answer to such an optimal coverage problem. The tiling robot's goal enables the complete coverage of the entire area by reconfiguring to different shapes according to the area's needs. In the particular sequencing of navigation, it is essential to have a structure that allows the robot to extend the coverage range while saving energy usage during navigation. This implies that the robot is able to cover larger areas entirely with the least required actions. This paper presents a complete path planning (CPP) for hTetran, a polyabolo tiled robot, based on a TSP-based reinforcement learning optimization. This structure simultaneously produces robot shapes and sequential trajectories whilst maximizing the reward of the trained reinforcement learning (RL) model within the predefined polyabolo-based tileset. To this end, a reinforcement learning-based travel sales problem (TSP) with proximal policy optimization (PPO) algorithm was trained using the complementary learning computation of the TSP sequencing. The reconstructive results of the proposed RL-TSP-based CPP for hTetran were compared in terms of energy and time spent with the conventional tiled hypothetical models that incorporate TSP solved through an evolutionary based ant colony optimization (ACO) approach. The CPP demonstrates an ability to generate an ideal Pareto optima trajectory that enhances the robot's navigation inside the real environment with the least energy and time spent in the company of conventional techniques.

Co-Encapsulation of Lycopene and Resveratrol in Polymeric Nanoparticles: Morphology and Lycopene Stability.

Lycopene and resveratrol are well-known for their high bioactivity, anti-inflammatory effects, and strong antioxidant properties. The combination of lycopene and resveratrol was synergistic in the potentializing immunity of the mammal body. In this study, the scalable co-encapsulation of lycopene and resveratrol into polymeric nanoparticles was performed using lycopene extracted from ripe gac fruit. These nanoparticles exhibited excellent water dispersion and spherical morphology with average particle diameters of 66.102 nm. The particle size was proportional to the lycopene/resveratrol ratio. The combinative use of lecithin and Tween® as surfactants and the use of a polylactide-polyethylene glycol copolymer as an encapsulation agent generated well-defined lycopene/resveratrol nanoparticles although the total content of these active compounds reached 12%. The stability of lycopene was enhanced when combined with resveratrol and antioxidants such as vitamin E and butylated hydroxytoluene. After 3 months of storage at -16 °C, the lycopene content in the lycopene/resveratrol nanopowder remained at ∼95%.

Novel Mutation of SARS-CoV-2, Vietnam, July 2020.

A cluster of severe acute respiratory syndrome coronavirus 2 infections in Danang, Vietnam, began July 25, 2020, and resulted in 551 confirmed cases and 35 deaths as of February 2021. We analyzed 26 sequences from this cluster and identified a novel shared mutation in nonstructural protein 9, suggesting a single introduction into Vietnam.

The Application of Sample Pooling for Mass Screening of SARS-CoV-2 in an Outbreak of COVID-19 in Vietnam.

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.