Early outcomes of total hip arthroplasty using point-of-care manufactured patient-specific instruments: a single university hospital's initial experience.

BACKGROUND: The use of 3D-printed Patient-Specific Instruments (PSI) has been investigated to enhance the postoperative functional results in total hip arthroplasty (THA) and has been recognized as an innovative approach for the optimal alignment of hip implant components. Point-of-care production is gradually becoming the norm for PSI manufacturing. The purpose of this article is to assess the accuracy and safety of PSI for total hip arthroplasty performed at the point-of-care in Vietnam. METHODS: 34 THA cases were assessed in this prospective study. A template for the size and orientation of the implant and the design of the PSI was generated using data from preoperative 3D computed tomography (CT) scanning of the lower limb. The principal surgeon determined the implants' position and PSI design directly using the software. The PSI is then produced using a 3D-compatible resin printer in our manufacturing hospital. The PSI, consisting of an acetabulum and a femoral component placed press-fit on the bony surface, guided surgeons to precisely ream the acetabulum and cut the femoral neck according to the pre-planned plane. Postoperative CT scanning was obtained and superimposed onto the 3D model of the implant to evaluate the accuracy of the procedure by comparing the orientation values of the cup and the alignment of the stem between the planned and the actual results. Intra- and postoperative clinical parameters of surgery, including surgical time, intra-operative blood loss, complications, and the first ambulation, were also recorded to evaluate the safety of the surgery. RESULTS: The preparation for PSI required an average of 3 days. 94% of cup size and 91% of stem size were correctly selected. The mean values of postoperative inclination and anteversion were 44.2° ± 4.1° and 19.2° ± 5.6°, respectively. 64.7% of cases deviated from planned within the ± 50 range and 94.1% within the ± 10° range. There was no significant statistical difference between the planned and the achieved values of stem anteversion, osteotomy height, and leg length discrepancy (p > 0.05). The average surgical time was 82.5° ± 10.8 min, and the intraoperative blood loss was estimated at 317.7° ± 57.6 ml. 64.7% of patients could walk on the day of surgery. There were no complications reported. CONCLUSIONS: The point-of-care manufactured PSI is a useful solution for improving the accuracy of total hip arthroplasty surgery, especially in restoring implant orientation and reducing leg length discrepancy. However, long-term clinical follow-up evaluation is needed to confirm the efficacy and safety of this approach.

Interactions between climate change, urban infrastructure and mobility are driving dengue emergence in Vietnam.

Dengue is expanding globally, but how dengue emergence is shaped locally by interactions between climatic and socio-environmental factors is not well understood. Here, we investigate the drivers of dengue incidence and emergence in Vietnam, through analysing 23 years of district-level case data spanning a period of significant socioeconomic change (1998-2020). We show that urban infrastructure factors (sanitation, water supply, long-term urban growth) predict local spatial patterns of dengue incidence, while human mobility is a more influential driver in subtropical northern regions than the endemic south. Temperature is the dominant factor shaping dengue's distribution and dynamics, and using long-term reanalysis temperature data we show that warming since 1950 has expanded transmission risk throughout Vietnam, and most strongly in current dengue emergence hotspots (e.g., southern central regions, Ha Noi). In contrast, effects of hydrometeorology are complex, multi-scalar and dependent on local context: risk increases under either short-term precipitation excess or long-term drought, but improvements in water supply mitigate drought-associated risks except under extreme conditions. Our findings challenge the assumption that dengue is an urban disease, instead suggesting that incidence peaks in transitional landscapes with intermediate infrastructure provision, and provide evidence that interactions between recent climate change and mobility are contributing to dengue's expansion throughout Vietnam.

Genotype and Phenotype Characterization of Rhinolophus sp. Sarbecoviruses from Vietnam: Implications for Coronavirus Emergence.

Bats are a major reservoir of zoonotic viruses, including coronaviruses. Since the emergence of SARS-CoV in 2002/2003 in Asia, important efforts have been made to describe the diversity of Coronaviridae circulating in bats worldwide, leading to the discovery of the precursors of epidemic and pandemic sarbecoviruses in horseshoe bats. We investigated the viral communities infecting horseshoe bats living in Northern Vietnam, and report here the first identification of sarbecoviruses in Rhinolophus thomasi and Rhinolophus siamensis bats. Phylogenetic characterization of seven strains of Vietnamese sarbecoviruses identified at least three clusters of viruses. Recombination and cross-species transmission between bats seemed to constitute major drivers of virus evolution. Vietnamese sarbecoviruses were mainly enteric, therefore constituting a risk of spillover for guano collectors or people visiting caves. To evaluate the zoonotic potential of these viruses, we analyzed in silico and in vitro the ability of their RBDs to bind to mammalian ACE2s and concluded that these viruses are likely restricted to their bat hosts. The workflow applied here to characterize the spillover potential of novel sarbecoviruses is of major interest for each time a new virus is discovered, in order to concentrate surveillance efforts on high-risk interfaces.

Investigating individual intention to make money: can motivation of wealth be a socio-economic leverage?

Wealth is an indicator of individual well-being. Increasing wealth is a pathway to achieving socio-economic development. Thus, it is imperative to shed light on factors that induce individual intention to increase wealth. This study investigates the effects of perception of wealth, perception of the rich, and behavioral control on personal intention to make money. A stratified sampling method was employed to obtain a sample of 991 respondents from Northern, Central, and Southern Vietnam who were invited to participate in a structured questionnaire survey in 2021. We utilized the Confirmatory Factor Analysis to validate the proposed model and tested the hypotheses using the Partial Least Squared-SEM. Empirical results highlight that individual behavioral control, explicit perception of the rich, and perception of wealth are essential determinants of individual intention to make money. Interestingly, motivation of wealth positively moderates the relationship between the perception of wealth and personal intention to make money. In addition, post-Covid-19 opportunities positively moderate two-pair relationships: perception of wealth-individual intention to make money and explicit perception of the rich-individual intention to make money. Insights from this study imply appropriate policies for the government to enhance the inspiration of people to work harder, leading to sustainable development.

Probing spin dynamics of ultra-thin van der Waals magnets via photon-magnon coupling.

Layered van der Waals (vdW) magnets can maintain a magnetic order even down to the single-layer regime and hold promise for integrated spintronic devices. While the magnetic ground state of vdW magnets was extensively studied, key parameters of spin dynamics, like the Gilbert damping, crucial for designing ultra-fast spintronic devices, remains largely unexplored. Despite recent studies by optical excitation and detection, achieving spin wave control with microwaves is highly desirable, as modern integrated information technologies predominantly are operated with these. The intrinsically small numbers of spins, however, poses a major challenge to this. Here, we present a hybrid approach to detect spin dynamics mediated by photon-magnon coupling between high-Q superconducting resonators and ultra-thin flakes of Cr2Ge2Te6 (CGT) as thin as 11 nm. We test and benchmark our technique with 23 individual CGT flakes and extract an upper limit for the Gilbert damping parameter. These results are crucial in designing on-chip integrated circuits using vdW magnets and offer prospects for probing spin dynamics of monolayer vdW magnets.

One Health Surveillance Highlights Circulation of Viruses with Zoonotic Potential in Bats, Pigs, and Humans in Viet Nam.

A One Health cross-sectoral surveillance approach was implemented to screen biological samples from bats, pigs, and humans at high-risk interfaces for zoonotic viral spillover for five viral families with zoonotic potential in Viet Nam. Over 1600 animal and human samples from bat guano harvesting sites, natural bat roosts, and pig farming operations were tested for coronaviruses (CoVs), paramyxoviruses, influenza viruses, filoviruses and flaviviruses using consensus PCR assays. Human samples were also tested using immunoassays to detect antibodies against eight virus groups. Significant viral diversity, including CoVs closely related to ancestors of pig pathogens, was detected in bats roosting at the human-animal interfaces, illustrating the high risk for CoV spillover from bats to pigs in Viet Nam, where pig density is very high. Season and reproductive period were significantly associated with the detection of bat CoVs, with site-specific effects. Phylogeographic analysis indicated localized viral transmission among pig farms. Our limited human sampling did not detect any known zoonotic bat viruses in human communities living close to the bat cave and harvesting bat guano, but our serological assays showed possible previous exposure to Marburg virus-like (Filoviridae), Crimean-Congo hemorrhagic fever virus-like (Bunyaviridae) viruses and flaviviruses. Targeted and coordinated One Health surveillance helped uncover this viral pathogen emergence hotspot.

The Genus Haemaphysalis (Acari: Ixodidae) in Laos: An Update of Species Records and a Review of Taxonomic Challenges.

Haemaphysalis Koch, 1844, is the largest genus of ticks in Southeast Asia, but little information is available concerning the species present in Laos. Recent research has yielded records for 10 Haemaphysalis species in Laos, including 5 new records, as well as 3 morphological entities of uncertain status. Further morphological and molecular studies are needed to clarify our taxonomic understanding of this genus in Southeast Asia.

Transient Introgression of Wolbachia into Aedes aegypti Populations Does Not Elicit an Antibody Response to Wolbachia Surface Protein in Community Members.

Wolbachia is an endosymbiotic bacterium that can restrict the transmission of human pathogenic viruses by Aedes aegypti mosquitoes. Recent field trials have shown that dengue incidence is significantly reduced when Wolbachia is introgressed into the local Ae. aegypti population. Female Ae. aegypti are anautogenous and feed on human blood to produce viable eggs. Herein, we tested whether people who reside on Tri Nguyen Island (TNI), Vietnam developed antibodies to Wolbachia Surface Protein (WSP) following release of Wolbachia-infected Ae. aegypti, as a measure of exposure to Wolbachia. Paired blood samples were collected from 105 participants before and after mosquito releases and anti-WSP titres were measured by ELISA. We determined no change in anti-WSP titres after ~30 weeks of high levels of Wolbachia-Ae. aegypti on TNI. These data suggest that humans are not exposed to the major Wolbachia surface antigen, WSP, following introgression of Wolbachia-infected Ae. aegypti mosquitoes.

Tenosynovial giant cell tumor of cruciate ligament: A case report and review.

INTRODUCTION: Tenosynovial giant cell tumor (TSGCT) is a slow-growing soft tissue tumor that develops from the synovial tissue of tendon sheaths, joints, or bursae. In the knee, this type of tumor is uncommon. Giant cell tumors of the cruciate ligaments' tendon sheath are far more infrequent. Only 16 localized TSGCTs of the cruciate ligaments have been recorded in the literature to our knowledge, with 9 involving the anterior cruciate ligament (ACL) and 7 involving the posterior cruciate ligament (PCL). CASE PRESENTATION: We present a rare case of localized TSGCT arising from the PCL's femoral insertion in a 44-year-old male, as well as a literature review on localized TSGCT of cruciate ligaments in the knee. The diagnosis of tumor's presence was made using MRI while the definitive diagnosis was obtained through intraoperative evaluation and postoperative pathology. CONCLUSION: Arthroscopic tumor resection was an effective and safe treatment option based on the available data.

Preoperative Determination of the Size of the Semitendinosus and Gracilis Tendon by Multidetector Row CT Scanner for Anterior Cruciate Ligament Reconstruction.

Accurately measuring the length and diameter of the hamstring tendon autograft preoperatively is important for planning anterior cruciate ligament (ACL) reconstructive surgery. The purpose of this study was to assess the reliability of three-dimensional computed tomography (3D CT) scanning technique to produce the actual measurement of the gracilis and semitendinosus (GT and ST, respectively) tendon grafts' length and diameter for surgery. Ninety patients were scheduled for ACL reconstruction with hamstring autograft. Before the surgery, patients were examined under the multidetector row CT scanner and the ST and GT tendons were qualitatively measured by a volume-rendering technique. The length of ST and GT was measured with 3D CT compared with the length of the harvested ST and GT. The cross-sectional area (CSA) of ST and GT measured with 3D CT compared with the ST and GT graft diameter. Tendon size measured preoperatively and during surgery were statistically compared and correlated. The GT tendons length and cross-sectional area measured during surgery was both shorter and smaller compared with the ST tendon. GT and ST tendon length were correlated to patients' body index such as the height and weight (p < 0.05). However, the correlation levels were low to medium (r = 0.23-0.49). There was strong correlation between the lengths of GT (r = 0.76; p < 0.001) and ST (r = 0.87; p < 0.001) measured with the 3D CT and tendon length at surgery. There was a moderate correlation between graft diameter measured at surgery and 3D CT cross-sectional area (r = 0.31; p < 0.05). A multidetector row CT scanner can determine the ST and GT tendons' length and diameter. These measurements can be used for preoperative planning to help determine the surgical method and counsel patients on appropriate graft choices prior to surgery.

Partial replacement of pelvis with the hip joint in osteosarcoma treatment: A case report.

INTRODUCTION: and importance: Pelvic osteosarcoma is quite rare and is a challenging task for orthopedic surgeons. This aim of this study is to present the first case report using customized 3D-printed prosthesis in Vietnam. CASE PRESENTATION: 57-year-old male was diagnosed with pelvic osteosarcoma. After neoadjuvant chemotherapy, we did limb-salvage surgery after partial pelvic resection. He had to undergo another surgery due to an infection complication that exposed part of the prosthesis. At 6 months follow-up, the patient's overall status was stable. VAS score when moving is 2/10. He can walk with one crutch. Patient is still being followed up and treated. CLININCAL DISCUSSION: Management of pelvic osteosarcoma remains a challenging task for orthopedic surgeons. Advancements in customized 3D-printed prosthesis have been applied in treatment of pelvic osteosarcoma. Despite the complications, the results are promising. We believe that this is a new and innovative route in surgery of pelvic osteosarcoma. CONCLUSION: Using customized 3D-printed prosthesis is a good way for management of pelvic osteosarcoma.

Probabilistic seasonal dengue forecasting in Vietnam: A modelling study using superensembles.

BACKGROUND: With enough advanced notice, dengue outbreaks can be mitigated. As a climate-sensitive disease, environmental conditions and past patterns of dengue can be used to make predictions about future outbreak risk. These predictions improve public health planning and decision-making to ultimately reduce the burden of disease. Past approaches to dengue forecasting have used seasonal climate forecasts, but the predictive ability of a system using different lead times in a year-round prediction system has been seldom explored. Moreover, the transition from theoretical to operational systems integrated with disease control activities is rare. METHODS AND FINDINGS: We introduce an operational seasonal dengue forecasting system for Vietnam where Earth observations, seasonal climate forecasts, and lagged dengue cases are used to drive a superensemble of probabilistic dengue models to predict dengue risk up to 6 months ahead. Bayesian spatiotemporal models were fit to 19 years (2002-2020) of dengue data at the province level across Vietnam. A superensemble of these models then makes probabilistic predictions of dengue incidence at various future time points aligned with key Vietnamese decision and planning deadlines. We demonstrate that the superensemble generates more accurate predictions of dengue incidence than the individual models it incorporates across a suite of time horizons and transmission settings. Using historical data, the superensemble made slightly more accurate predictions (continuous rank probability score [CRPS] = 66.8, 95% CI 60.6-148.0) than a baseline model which forecasts the same incidence rate every month (CRPS = 79.4, 95% CI 78.5-80.5) at lead times of 1 to 3 months, albeit with larger uncertainty. The outbreak detection capability of the superensemble was considerably larger (69%) than that of the baseline model (54.5%). Predictions were most accurate in southern Vietnam, an area that experiences semi-regular seasonal dengue transmission. The system also demonstrated added value across multiple areas compared to previous practice of not using a forecast. We use the system to make a prospective prediction for dengue incidence in Vietnam for the period May to October 2020. Prospective predictions made with the superensemble were slightly more accurate (CRPS = 110, 95% CI 102-575) than those made with the baseline model (CRPS = 125, 95% CI 120-168) but had larger uncertainty. Finally, we propose a framework for the evaluation of probabilistic predictions. Despite the demonstrated value of our forecasting system, the approach is limited by the consistency of the dengue case data, as well as the lack of publicly available, continuous, and long-term data sets on mosquito control efforts and serotype-specific case data. CONCLUSIONS: This study shows that by combining detailed Earth observation data, seasonal climate forecasts, and state-of-the-art models, dengue outbreaks can be predicted across a broad range of settings, with enough lead time to meaningfully inform dengue control. While our system omits some important variables not currently available at a subnational scale, the majority of past outbreaks could be predicted up to 3 months ahead. Over the next 2 years, the system will be prospectively evaluated and, if successful, potentially extended to other areas and other climate-sensitive disease systems.

Evaluation of Ni-Based Flexible Resistance Temperature Detectors Fabricated by Laser Digital Pattering.

Temperature sensors are ubiquitous in every field of engineering application since temperature control is vital in operating, testing and monitoring various equipment systems. Herein, we introduce a facile and rapid laser digital patterning (LDP) process to fabricate low-cost, Ni-based flexible resistance temperature detectors (RTDs). Ni-based RTDs are directly generated on a thin flexible polyimide substrate (thickness: 50 µm) by laser-induced reductive sintering of a solution-processed nonstoichiometric nickel oxide (NiOx) nanoparticle thin film under ambient conditions. The shape of RTDs can be easily adjusted by controlling computer-aided design (CAD) data without using the physical patterning mask while the sensitivity (temperature coefficient of resistance (α) ~ 3.52 × 10-3 °C-1) of the sensors can be maintained regardless of shape and size of the sensor electrodes. The flexible Ni-based RTDs can operate over a wide temperature range up to 200 °C with excellent repeatability. Additionally, the Ni-based RTDs respond quickly to the temperature change and can operate in corrosive environments including water and seawater. Moreover, the Ni-based RTDs show a superior mechanical and electrical stability with a negligible resistance change up to a radius of curvature of 1.75 mm. Finally, a tape-pull test demonstrates the robust adhesion of Ni-based RTDs on the substrate.

The Pandemic Experience in Southeast Asia: Interface Between SARS-CoV-2, Malaria, and Dengue.

Southeast Asia (SEA) emerged relatively unscathed from the first year of the global SARS-CoV-2 pandemic, but as of July 2021 the region is experiencing a surge in case numbers primarily driven by Alpha (B.1.1.7) and subsequently the more transmissible Delta (B.1.617.2) variants. While initial disease burden was mitigated by swift government responses, favorable cultural and societal factors, the more recent rise in cases suggests an under-appreciation of prior prevalence and over-appreciation of possible cross-protective immunity from exposure to endemic viruses, and highlights the effects of vaccine rollout at varying tempos and of variable efficacy. This burgeoning crisis is further complicated by co-existence of malaria and dengue in the region, with implications of serological cross-reactivity on interpretation of SARS-CoV-2 assays and competing resource demands impacting efforts to contain both endemic and pandemic disease.

Environmental factors influence the local establishment of Wolbachia in Aedes aegypti mosquitoes in two small communities in central Vietnam.

Background: The wMel strain of Wolbachia has been successfully introduced into Aedes aegypti mosquitoes and subsequently shown to reduce transmission of dengue and other pathogens, under both laboratory and field conditions. Here we describe the entomological outcomes of wMel Wolbachia mosquito releases in two small communities in Nha Trang City in central Vietnam. Methods: The wMel strain of Wolbachia was backcrossed into local Aedes aegypti genotype and mosquito releases were undertaken by community members or by staff. Field monitoring was undertaken to track Wolbachia establishment in local Ae. aegypti mosquito populations. Ecological studies were undertaken to assess relationships between environmental factors and the spatial and temporal variability in Wolbachia infection prevalence in mosquitoes. Results: Releases of wMel Wolbachia Ae. aegypti mosquitoes in two small communities in Nha Trang City resulted in the initial establishment of Wolbachia in the local Ae. aegypti mosquito populations, followed by seasonal fluctuations in Wolbachia prevalence. There was significant small-scale spatial heterogeneity in Wolbachia infection prevalence in the Tri Nguyen Village site, resulting in the loss of wMel Wolbachia infection in mosquitoes in north and center areas, despite Wolbachia prevalence remaining high in mosquitoes in the south area. In the second site, Vinh Luong Ward, Wolbachia has persisted at a high level in mosquitoes throughout this site despite similar seasonal fluctuations in wMel Wolbachia prevalence. Conclusion: Seasonal variation in Wolbachia infection prevalence in mosquitoes was associated with elevated temperature conditions, and was possibly due to imperfect maternal transmission of Wolbachia. Heterogeneity in Wolbachia infection prevalence was found throughout one site, and indicates additional factors may influence Wolbachia establishment.

Flexible Ni/NiOx-Based Sensor for Human Breath Detection.

We developed a simple methodology to fabricate an Ni/NiOx-based flexible breath sensor by a single-step laser digital patterning process of solution-processed NiOx thin-film deposited using NiOx nanoparticle ink. Laser-induced reductive sintering phenomenon enables for the generation of three parts of Ni electrodes and two narrow NiOx-sensing channels in between, defined on a single layer on a thin flexible polymer substrate. The Ni/NiOx-based breath sensor efficiently detects human breath at a relatively low operating temperature (50 °C) with fast response/recovery times (1.4 s/1.7 s) and excellent repeatability. The mechanism of the gas-sensing ability enhancement of the sensor was investigated by X-ray photoelectron spectroscopy analysis. Furthermore, by decoupling of the temperature effect from the breathing gas, the response of the sensor due to the temperature alone and due to the chemical components in the breathing gas could be separately evaluated. Finally, bending and cyclic bending tests (10,000 cycles) demonstrated the superior mechanical stability of the flexible breath sensor.

Laser digital patterning of conductive electrodes using metal oxide nanomaterials.

As an alternative approach to the conventional deposition and photolithographic processes, the laser digital patterning (LDP) process, which is also known as the laser direct writing process, has attracted considerable attention because it is a non-photolithographic, non-vacuum, on-demand, and cost-effective electrode fabrication route that can be applied to various substrates, including heat-sensitive flexible substrates. The LDP process was initially developed using noble metal nanoparticles (NPs) such as Au and Ag because such materials are free from oxidation even in a nanosize configuration. Thus, the NPs must be fused together to form continuous conductive structures upon laser irradiation. However, common metals are easily oxidized at the nanoscale and exist in oxidized forms owing to the extremely large surface-to-volume ratio of NPs. Therefore, to fabricate conductive electrodes using common metal NPs via the LDP process, laser irradiation should be used to sinter the NPs and simultaneously induce additional photochemical reactions, such as reduction, and defect structure modification to increase the conductivity of the electrodes. This review summarizes recent studies on the LDP process in which metal oxide NPs, such as ITO, ZnO, CuO, and NiO, were exclusively utilized for fabricating conductive electrodes. The outlook of the LDP process for these materials is also discussed as a method that can be used together with or as a replacement for conventional ones to produce next-generation transparent conductors, sensors, and electronics.

Spatiotemporal and Socioeconomic Risk Factors for Dengue at the Province Level in Vietnam, 2013-2015: Clustering Analysis and Regression Model.

Dengue is a serious infectious disease threat in Vietnam, but its spatiotemporal and socioeconomic risk factors are not currently well understood at the province level across the country and on a multiannual scale. We explore spatial trends, clusters and outliers in dengue case counts at the province level from 2011-2015 and use this to extract spatiotemporal variables for regression analysis of the association between dengue case counts and selected spatiotemporal and socioeconomic variables from 2013-2015. Dengue in Vietnam follows anticipated spatial trends, with a potential two-year cycle of high-high clusters in some southern provinces. Small but significant associations are observed between dengue case counts and mobility, population density, a province's dengue rates the previous year, and average dengue rates two years previous in first and second order contiguous neighbours. Significant associations were not found between dengue case counts and housing pressure, access to electricity, clinician density, province-adjusted poverty rate, percentage of children below one vaccinated, or percentage of population in urban settings. These findings challenge assumptions about socioeconomic and spatiotemporal risk factors for dengue, and support national prevention targeting in Vietnam at the province level. They may also be of wider relevance for the study of other arboviruses, including Japanese encephalitis, Zika, and Chikungunya.