Association of Language Preference with Therapeutic Care for Hospitalized COVID-19 Patients.

INTRODUCTION: There is a paucity of research investigating disparities in utilization of inpatient therapeutics for COVID-19 by language preference. The primary aim of this study was to assess if the likelihood of treatment with novel COVID-19 therapies differed for patients using a language other than English (LOE) relative to English-speaking patients. METHODS: This was a retrospective observational cohort study of COVID-19 patients hospitalized between March 1, 2020, and June 30, 2022, across 11 hospitals within a single not-for-profit health system. Multivariable relative risks were estimated for the impact of preferred language on the receipt of novel COVID-19 therapies: baricitinib, remdesivir, tocilizumab, and convalescent plasma. RESULTS: This study included 12,510 hospitalized adults with English as the most common preferred language (92.3%) followed by Spanish (3.1%), Somali (1.3%), Russian (0.9%), and Hmong (0.6%). Spanish speakers were more likely to receive any of the novel COVID-19 therapies compared to English speakers (RR 1.45; CI 1.32-1.59). Estimates for Hmong, Somali, Russian, and Other language groups were not statistically significant and closer to the null (aRR range, 0.89-1.12). CONCLUSION: Linguistic patterns in health outcomes expose inherent heterogeneity within racial and ethnic groups. Our study found that Spanish speakers were nearly 1.5 times more likely to receive any of the four novel inpatient COVID-19 therapeutics in comparison to English speakers. Future research is needed to explore the reasons for the heterogeneous findings including temporal influence, cultural factors, informed consent comprehension, and therapeutic hesitancy in all groups.

Gene function characterization in Aspergillus niger using a dual resistance marker transformation system mediated by Agrobacterium tumefaciens.

Aspergillus niger is a well-known workhorse for the industrial production of enzymes and organic acids. This fungus can also cause postharvest diseases in fruits. Although Agrobacterium tumefaciens-mediated transformation (ATMT) based on antibiotic resistance markers has been effectively exploited for inspecting functions of target genes in wild-type fungi, it still needs to be further improved in A. niger. In the present study, we re-examined the ATMT in the wild-type A. niger strains using the hygromycin resistance marker and introduced the nourseothricin resistance gene as a new selection marker for this fungus. Unexpectedly, our results revealed that the ATMT method using the resistance markers in A. niger led to numerous small colonies as false-positive transformants on transformation plates. Using the top agar overlay technique to restrict false positive colonies, a transformation efficiency of 87 ± 18 true transformants could be achieved for 106 conidia. With two different selection markers, we could perform both the deletion and complementation of a target gene in a single wild-type A. niger strain. Our results also indicated that two key regulatory genes (laeA and veA) of the velvet complex are required for A. niger to infect apple fruits. Notably, we demonstrated for the first time that a laeA homologous gene from the citrus postharvest pathogen Penicillium digitatum was able to restore the acidification ability and pathogenicity of the A. niger ΔlaeA mutant. The dual resistance marker ATMT system from our work represents an improved genetic tool for gene function characterization in A. niger.

Discovery of urinary biosignatures for tuberculosis and nontuberculous mycobacteria classification using metabolomics and machine learning.

Nontuberculous mycobacteria (NTM) infection diagnosis remains a challenge due to its overlapping clinical symptoms with tuberculosis (TB), leading to inappropriate treatment. Herein, we employed noninvasive metabolic phenotyping coupled with comprehensive statistical modeling to discover potential biomarkers for the differential diagnosis of NTM infection versus TB. Urine samples from 19 NTM and 35 TB patients were collected, and untargeted metabolomics was performed using rapid liquid chromatography-mass spectrometry. The urine metabolome was analyzed using a combination of univariate and multivariate statistical approaches, incorporating machine learning. Univariate analysis revealed significant alterations in amino acids, especially tryptophan metabolism, in NTM infection compared to TB. Specifically, NTM infection was associated with upregulated levels of methionine but downregulated levels of glutarate, valine, 3-hydroxyanthranilate, and tryptophan. Five machine learning models were used to classify NTM and TB. Notably, the random forest model demonstrated excellent performance [area under the receiver operating characteristic (ROC) curve greater than 0.8] in distinguishing NTM from TB. Six potential biomarkers for NTM infection diagnosis, including methionine, valine, glutarate, 3-hydroxyanthranilate, corticosterone, and indole-3-carboxyaldehyde, were revealed from univariate ROC analysis and machine learning models. Altogether, our study suggested new noninvasive biomarkers and laid a foundation for applying machine learning to NTM differential diagnosis.

Assessment of the level and risk of radioactive hazards in coastal sediments in northern Vietnam.

Radioactivity in coastal sediments in northern Vietnam was examined using data from five sediment cores to assess radioactivity concentrations and radiation risk indices. Radiation risk indices included radium equivalent activity (Raeq), the absorbed dose rate (ADR), the annual effective dose equivalent (AEDE), the activity utilization index (AUI), the external hazard index (Hex), the representative level gamma index (Iγr), and the annual gonadal effective dose rate (AGDE). The radioactivity concentrations of 40K, 232Th, 226Ra, 238U, and 137Cs were 567, 56.1, 35.1, 37.9, and 1.18 Bq/kg, respectively. The average concentrations of 40K, 232Th, 226Ra, and 238U were above the global average at five sites, except for 137Cs, which was low. The Raeq, Hex, and AUI indices were below the recommended values, while the AEDE, ADR, AGDE, and Iγr indices were above the recommended values. Moreover, 40K, 232Th, 226Ra, and 238U had significant impacts on the radiation hazard indices Raeq, ADR, AEDE, Iγr, AUI, Hex, and AGDE. There are three coastal sediment groups on the northern coast of Vietnam: Group 1 has a higher radioactivity and radiation risk index than Group 2 but a lower value than Group 3. Group 3 had the highest radioactivity and radiation risk index. The values of 40K, 232Th, 226Ra, and 238U and the ADR, AUI, Iγr, and AGDE indices in the sediment threaten the living environment.

Synthesis, crystal structure and photophysical properties of a dinuclear MnII complex with 6-(di-ethyl-amino)-4-phenyl-2-(pyridin-2-yl)quinoline.

A new quinoline derivative, namely, 6-(di-ethyl-amino)-4-phenyl-2-(pyridin-2-yl)quinoline, C24H23N3 (QP), and its MnII complex aqua-1κO-di-µ-chlorido-1:2κ4 Cl:Cl-di-chlorido-1κCl,2κCl-bis-[6-(di-ethyl-amino)-4-phenyl-2-(pyridin-2-yl)quinoline]-1κ2 N 1,N 2;2κ2 N 1,N 2-dimanganese(II), [Mn2Cl4(C24H23N3)2(H2O)] (MnQP), were synthesized. Their compositions have been determined with ESI-MS, IR, and 1H NMR spectroscopy. The crystal-structure determination of MnQP revealed a dinuclear complex with a central four-membered Mn2Cl2 ring. Both MnII atoms bind to an additional Cl atom and to two N atoms of the QP ligand. One MnII atom expands its coordination sphere with an extra water mol-ecule, resulting in a distorted octa-hedral shape. The second MnII atom shows a distorted trigonal-bipyramidal shape. The UV-vis absorption and emission spectra of the examined compounds were studied. Furthermore, when investigating the aggregation-induced emission (AIE) properties, it was found that the fluorescent color changes from blue to green and eventually becomes yellow as the fraction of water in the THF/water mixture increases from 0% to 99%. In particular, these color and intensity changes are most pronounced at a water fraction of 60%. The crystal structure contains disordered solvent mol-ecules, which could not be modeled. The SQUEEZE procedure [Spek (2015 ▸). Acta Cryst. C71, 9-18] was used to obtain information on the type and qu-antity of solvent mol-ecules, which resulted in 44 electrons in a void volume of 274 Å3, corresponding to approximately 1.7 mol-ecules of ethanol in the unit cell. These ethanol mol-ecules are not considered in the given chemical formula and other crystal data.

Integrating machine learning and geospatial data analysis for comprehensive flood hazard assessment.

Flooding is a major natural hazard worldwide, causing catastrophic damage to communities and infrastructure. Due to climate change exacerbating extreme weather events robust flood hazard modeling is crucial to support disaster resilience and adaptation. This study uses multi-sourced geospatial datasets to develop an advanced machine learning framework for flood hazard assessment in the Arambag region of West Bengal, India. The flood inventory was constructed through Sentinel-1 SAR analysis and global flood databases. Fifteen flood conditioning factors related to topography, land cover, soil, rainfall, proximity, and demographics were incorporated. Rigorous training and testing of diverse machine learning models, including RF, AdaBoost, rFerns, XGB, DeepBoost, GBM, SDA, BAM, monmlp, and MARS algorithms, were undertaken for categorical flood hazard mapping. Model optimization was achieved through statistical feature selection techniques. Accuracy metrics and advanced model interpretability methods like SHAP and Boruta were implemented to evaluate predictive performance. According to the area under the receiver operating characteristic curve (AUC), the prediction accuracy of the models performed was around > 80%. RF achieves an AUC of 0.847 at resampling factor 5, indicating strong discriminative performance. AdaBoost also consistently exhibits good discriminative ability, with AUC values of 0.839 at resampling factor 10. Boruta and SHAP analysis indicated precipitation and elevation as factors most significantly contributing to flood hazard assessment in the study area. Most of the machine learning models pointed out southern portions of the study area as highly susceptible areas. On average, from 17.2 to 18.6% of the study area is highly susceptible to flood hazards. In the feature selection analysis, various nature-inspired algorithms identified the selected input parameters for flood hazard assessment, i.e., elevation, precipitation, distance to rivers, TWI, geomorphology, lithology, TRI, slope, soil type, curvature, NDVI, distance to roads, and gMIS. As per the Boruta and SHAP analyses, it was found that elevation, precipitation, and distance to rivers play the most crucial roles in the decision-making process for flood hazard assessment. The results indicated that the majority of the building footprints (15.27%) are at high and very high risk, followed by those at very low risk (43.80%), low risk (24.30%), and moderate risk (16.63%). Similarly, the cropland area affected by flooding in this region is categorized into five risk classes: very high (16.85%), high (17.28%), moderate (16.07%), low (16.51%), and very low (33.29%). However, this interdisciplinary study contributes significantly towards hydraulic and hydrological modeling for flood hazard management.

Fibrous Dysplasia of the Parietal Bone with Focal Motor Seizures: A Case Report.

BACKGROUND Monostotic fibrous dysplasia is a benign proliferation of fibrous and osseous tissues that expand medullary bone to cause symptoms due to compression of adjacent organs and anatomical structures. Focal seizures are rarely the first sign of this kind of lesion. This report describes a young female patient with left-sided focal motor seizures associated with fibrous dysplasia presenting as a mass in the right parietal bone. CASE REPORT An 18-year-old female student with left-sided focal motor seizures presented with a mass in the right parietal bone. Computed tomography revealed an expansile mixed-density lesion on the right parietal bone, a relatively homogeneous ground-glass appearance in the outer circumferential portion, and a lucent eccentric area with thinned but sclerotic borders. Magnetic resonance imaging revealed a homogeneously hypointense signal on T1WI, a small hyperintense signal on T2WI, and avid enhancement signal intensity on post-contrast T1. Electroencephalogram showed inter-ictal epileptiform activities derived from the right fronto-central lobe. Surgical en bloc resection with a margin of normal bone and cranioplasty were performed. Histopathology showed features indicative of fibrous dysplasia, including osteoid trabeculae arranged haphazardly in a dense fibroblastic stroma, irregular trabeculae lacking conspicuous osteoblastic rimming, and intervening fibrous stroma containing cytologically bland spindle cells. The patient achieved seizure control and has remained neurologically intact. CONCLUSIONS This report has highlighted the importance of early diagnosis of fibrous dysplasia of bone to exclude primary bone malignancy or bone metastasis, to ensure rapid management and symptom control.

Origins of noise in both improving and degrading decision making.

Noise is a fundamental problem for information processing in neural systems. In decision-making, noise is assumed to have a primary role in errors and stochastic choice behavior. However, little is known about how noise arising from different sources contributes to value coding and choice behaviors, especially when it interacts with neural computation. Here we examine how noise arising early versus late in the choice process differentially impacts context-dependent choice behavior. We found in model simulations that early and late noise predict opposing context effects: under early noise, contextual information enhances choice accuracy; while under late noise, context degrades choice accuracy. Furthermore, we verified these opposing predictions in experimental human choice behavior. Manipulating early and late noise - by inducing uncertainty in option values and controlling time pressure - produced dissociable positive and negative context effects. These findings reconcile controversial experimental findings in the literature reporting either context-driven impairments or improvements in choice performance, suggesting a unified mechanism for context-dependent choice. More broadly, these findings highlight how different sources of noise can interact with neural computations to differentially modulate behavior. Significance: The current study addresses the role of noise origin in decision-making, reconciling controversies around how decision-making is impacted by context. We demonstrate that different types of noise - either arising early during evaluation or late during option comparison - leads to distinct results: with early noise, context enhances choice accuracy, while with late noise, context impairs it. Understanding these dynamics offers potential strategies for improving decision-making in noisy environments and refining existing neural computation models. Overall, our findings advance our understanding of how neural systems handle noise in essential cognitive tasks, suggest a beneficial role for contextual modulation under certain conditions, and highlight the profound implications of noise structure in decision-making.

A Study on Yield Criteria Influence on Anisotropic Behavior and Fracture Prediction in Deep Drawing SECC Steel Cylindrical Cups.

The deep drawing process, a pivotal technique in sheet metal forming, frequently encounters challenges such as anisotropy-induced defects. This study comprehensively investigates the influence of various yield criteria on the anisotropic behavior and fracture prediction in SECC steel cylindrical cups. It integrates Hill'48R, Hill'48S, and von Mises yield criteria in conjunction with Swift's hardening law to evaluate material behavior under complex stress states. Experimental and numerical simulations assess the anisotropy effects across multiple orientations (0°, 45°, and 90°), revealing intricate relationships between stress criteria and material response. The findings indicate significant discrepancies between isotropic and anisotropic models in predicting fracture heights, emphasizing the importance of selecting appropriate yield criteria. Notably, the von Mises criterion results in lower fracture heights, suggesting higher susceptibility to fractures, while the Hill'48R model aligns closely with experimental data, validated through variations in punch corner radius and blank holder force parameters, with a maximum deviation of 3.23%. Hill'48S displays moderate plastic deformation characteristics.

Development of an anti-tauopathy mucosal vaccine specifically targeting pathologic conformers.

Alzheimer's disease (AD) and related tauopathies are associated with pathological tau protein aggregation, which plays an important role in neurofibrillary degeneration and dementia. Targeted immunotherapy to eliminate pathological tau aggregates is known to improve cognitive deficits in AD animal models. The tau repeat domain (TauRD) plays a pivotal role in tau-microtubule interactions and is critically involved in the aggregation of hyperphosphorylated tau proteins. Because TauRD forms the structural core of tau aggregates, the development of immunotherapies that selectively target TauRD-induced pathological aggregates holds great promise for the modulation of tauopathies. In this study, we generated recombinant TauRD polypeptide that form neurofibrillary tangle-like structures and evaluated TauRD-specific immune responses following intranasal immunization in combination with the mucosal adjuvant FlaB. In BALB/C mice, repeated immunizations at one-week intervals induced robust TauRD-specific antibody responses in a TLR5-dependent manner. Notably, the resulting antiserum recognized only the aggregated form of TauRD, while ignoring monomeric TauRD. The antiserum effectively inhibited TauRD filament formation and promoted the phagocytic degradation of TauRD aggregate fragments by microglia. The antiserum also specifically recognized pathological tau conformers in the human AD brain. Based on these results, we engineered a built-in flagellin-adjuvanted TauRD (FlaB-TauRD) vaccine and tested its efficacy in a P301S transgenic mouse model. Mucosal immunization with FlaB-TauRD improved quality of life, as indicated by the amelioration of memory deficits, and alleviated tauopathy progression. Notably, the survival of the vaccinated mice was dramatically extended. In conclusion, we developed a mucosal vaccine that exclusively targets pathological tau conformers and prevents disease progression.

Highly Efficient Removal of 2,4,5-Trichlorophenoxyacetic Acid by Adsorption and Photocatalysis Using Nanomaterials with Surface Coating by the Cationic Surfactant.

Extensive removal of 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) using titania (TiO2) nanoparticles by adsorption and photocatalysis with a surface coating by cetyltrimethylammonium bromide (CTAB) is reported. The CTAB-coated TiO2 nanoparticles (CCTN) were characterized by FT-IR, zeta-potential measurements, and UV-vis diffuse reflectance spectroscopy (UV-vis-DRS). 2,4,5-T removal increased significantly after surface modification with CTAB compared with bare TiO2 nanoparticles. Optimal parameters affecting 2,4,5-T removal were found to be pH 4, CCTN dosage 10 mg/mL, and adsorption time 180 min. The maximum adsorptive removal of 2,4,5-T using CCTN reached 96.2% while highest adsorption capacity was 13.4 mg/g. CCTN was also found to be an excellent photocatalyst that achieved degradation efficiency of 99.2% with an initial concentration of 25 mg/L. The removal mechanisms of 2,4,5-T using CCTN by both adsorption and photocatalysis are discussed in detail based on changes in functional group vibrations and surface charge. Our results indicate that CCTN is an excellent material for 2,4,5-T removal in water by both adsorption and photocatalysis.

Citrulline supplementation exacerbates sepsis severity in infected preterm piglets via early induced immunosuppression.

Arginine (ARG)/Citrulline (CIT) deficiency is associated with increased sepsis severity after infection. Supplementation of CIT to susceptible patients with ARG/CIT deficiency such as preterm newborns with suspected infection might prevent sepsis, via maintaining immune and vascular function. Caesarean-delivered, parenterally nourished preterm pigs were treated with CIT (1g/kg bodyweight) via oral or continuous intravenous supplementation, then inoculated with live Staphylococcus epidermidis and clinically monitored for 14 h. Blood, liver, and spleen samples were collected for analysis. In vitro cord blood stimulation was performed to explore how CIT and ARG affect premature blood cell responses. After infection, oral CIT supplementation led to higher mortality, increased blood bacterial load, and systemic and hepatic inflammation. Intravenous CIT administration showed increased inflammation and bacterial burdens without significantly affecting mortality. Liver transcriptomics and data from in vitro blood stimulation indicated that CIT induces systemic immunosuppression in preterm newborns, which may impair resistance response to bacteria at the early stage of infection, subsequently causing later uncontrollable inflammation and tissue damage. The early stage of CIT supplementation exacerbates sepsis severity in infected preterm pigs, likely via inducing systemic immunosuppression.

Real-time diagnosis and monitoring of biofilm and corrosion layer formation on different water pipe materials using non-invasive imaging methods.

Water distribution networks play a crucial role in ensuring a reliable water supply, yet they encounter challenges such as corrosion, scale formation, and biofilm growth due to interactions with environmental elements. Biofilms and corrosion layers are significant contaminants in water pipes, formed by complex interactions with pipe materials. As the structure of these contamination layers varies depending on the pipe material, it is essential to investigate the contamination layer for each material individually. Specifically, biofilm growth is typically investigated concerning organic sources, while the growth of humus layers is examined in relation to inorganic elements such as manganese (Mn), iron (Fe), and aluminum (Al), which are major elements and organic substances found in water pipes. Real-time imaging of recently contaminated layers can provide important insights to improve system performance by optimizing operations and cleaning processes. In this study, cast iron (7.10 ± 0.78 nm) exhibits greater surface roughness compared to PVC (5.60 ± 0.14 nm) and provides favorable conditions for biofilm formation due to its positive charge. Over a period of 425 h, the fouling layer on cast iron and PVC surfaces gradually increased in fouling thickness, porosity, roughness, and density, reaching maximum value of 29.72 ± 3.6 µm, 11.44 ± 1.1%, 41673 ± 1025.6 pixels, and 0.80 ± 0.3 fouling layer pixel/layer pixel for cast iron, and 8.15 ± 0.4 µm, 20.64 ± 0.9%, 35916.6 ± 755.7 pixels, and 0.58 ± 0.1 fouling layer pixel/layer pixel, respectively. Within the scope of the current research, CNN model demonstrates high correlation coefficients (0.98 and 0.91) in predicting biofilm thickness for cast iron and PVC. The model also presented high accuracy in predicting porosity for both materials (over 0.91 for cast iron and 0.96 for PVC). While the model accurately predicted biofilm roughness and density for cast iron (correlation coefficients 0.98 and 0.94, respectively), it had lower accuracy for PVC (correlation coefficients 0.92 for both parameters).

Harnessing iron materials for enhanced decolorization of azo dye wastewater: A comprehensive review.

Highly colored azo dye-contaminated wastewater poses significant environmental threats and requires effective treatment before discharge. The anaerobic azo dye treatment method is a cost-effective and environmentally friendly solution, while its time-consuming and inefficient processes present substantial challenges for industrial scaling. Thus, the use of iron materials presents a promising alternative. Laboratory studies have demonstrated that systems coupled with iron materials enhance the decolorization efficiency and reduce the processing time. To fully realize the potential of iron materials for anaerobic azo dye treatment, a comprehensive synthesis and evaluation based on individual-related research studies, which have not been conducted to date, are necessary. This review provides, for the first time, an extensive and detailed overview of the utilization of iron materials for azo dye treatment, with a focus on decolorization. It assesses the treatment potential, analyzes the influencing factors and their impacts, and proposes metabolic pathways to enhance anaerobic dye treatment using iron materials. The physicochemical characteristics of iron materials are also discussed to elucidate the mechanisms behind the enhanced bioreduction of azo dyes. This study further addresses the current obstacles and outlines future prospects for industrial-scale application of iron-coupled treatment systems.

A rapid and multi-endpoint ecotoxicological test using Mychonastes afer for efficient screening of metals and herbicides.

Microalgal growth-based tests are international standards for ecotoxicity assessment; however, their long exposure times, large sample volumes, and reliance on a single growth-endpoint make them inadequate for rapid toxicity screening. Here, we aimed to develop a rapid and simple ecotoxicological test using the fast-growing green alga Mychonastes afer, with multiple endpoints-growth, lipid content, and photosynthesis. We exposed M. afer to two metals-silver and copper-and two herbicides-atrazine and diuron-for 24 h and identified the most sensitive and reliable endpoints for each toxicant: the maximum electron transport rate (ETRmax) for Ag, Cu and atrazine, and the lipid content for diuron. Lipid content was found to be both a sensitive and reliable biomarker, meeting the effluent limit guidelines in both the Republic of Korea and the USA. The sensitivity of M. afer to Ag and atrazine also closely matched the HC5 values derived from the species sensitivity distribution approach, confirming its reliability for setting regulatory concentrations of these contaminants. Our calculated predicted no-effect concentration (PNEC) values were similar to established European Union PNECs for Ag, Cu, atrazine, and diuron, underlining the utility of these biological endpoints for ecological risk assessment and regulatory decision making. This method required lower sample volume (2 mL vs 100 mL) and exposure time (24 h vs 72-120 h) than conventional green algal tests, and eliminated the need for labour-intensive cell counting, expensive equipment, and chlorophyll fluorescence measurement expertise. Overall, this M. afer test can be a valuable tool for the rapid screening of wastewater for metals and herbicides, contributing to environmental protection and management practices.

Improving Micro-EDM Machining Efficiency for Titanium Alloy Fabrication with Advanced Coated Electrodes.

Enhancing the operational efficacy of electrical discharge machining (EDM) is crucial for achieving optimal results in various engineering materials. This study introduces an innovative solution-the use of coated electrodes-representing a significant advancement over current limitations. The choice of coating material is critical for micro-EDM performance, necessitating a thorough investigation of its impact. This research explores the application of different coating materials (AlCrN, TiN, and Carbon) on WC electrodes in micro-EDM processes specifically designed for Ti-6Al-4V. A comprehensive assessment was conducted, focusing on key quality indicators such as depth of cut (Z), tool wear rate (TWR), overcut (OVC), and post-machining surface quality. Through rigorous experimental methods, the study demonstrates substantial improvements in these quality parameters with coated electrodes. The results show significant enhancements, including increased Z, reduced TWR and OVC, and improved surface quality. This evidence underscores the effectiveness of coated electrodes in enhancing micro-EDM performance, marking a notable advancement in the precision and quality of Ti-6Al-4V machining processes. Among the evaluated coatings, AlCrN-coated electrodes exhibited the greatest increase in Z, the most significant reduction in TWR, and the best OVC performance compared to other coatings and the uncoated counterpart.

Vietnam National Survey on Parenteral Nutrition Practice in Preterm Neonates: Practice Status, Barriers, and Implications.

BACKGROUND: Due to high risks of feeding intolerance, preterm infants often receive parenteral nutrition (PN) to ensure sufficient nutrition and energy intake. However, there is a lack of data on the status of clinical PN practice and barriers among neonatal care units in low- to middle-income countries like Vietnam. This extensive survey explores the status and barriers of PN practice for preterm infants in neonatal units across Vietnam and identifies the practical implications of enhancing nutritional outcomes in preterm infants. METHODS: A multicenter nationwide web-based survey on PN practice in preterm infants was conducted across 114 neonatal units from 61 provinces in Vietnam. RESULTS: Among 114 neonatal units receiving a request for surveys, 104 units (91.2%) from 55 provinces participated. Neonatal units were categorized as level I (2/104, 1.9%), II (39/104, 37.5%), III (56/104, 53.8%), and IV (7/104, 6.8%). We found that the initiations of PN within the first hour and the first two hours of life occurred in 80.8% (84/104) and 95.2% (99/104) of the units, respectively. The early provision of amino acids, or AA (within the first day of life) and lipids (within two days of life) were documented by 85% (89/104) and 82% (84/104) of the respondents, respectively. The initial dose of AA ranged from 0.5 to 3 g/kg/day; the dose of AA less than 1 g/kg/day was reported by 7.7% (8/104) of the respondents; the maximum dose of AA ranged from 2 to over 4.5 g/kg/day, with 4 g/kg/day reported by 47.1% (49/104) of the respondents. The initial dose of lipids was between 0.5 and 2 g/kg/day, frequently 1 g/kg/day, reported by 51.9% (54/104) of the respondents; the target lipid dose ranged from 3 to 4 g/kg/day in 93.3% (97/104) respondents; the maximum target dose for lipid was 4 g/kg/day in 36.5% (38/104) of the respondents. The initial glucose dose was distributed as follows: 46.2% of respondents (48/104) administered 4 mg/kg/minute, 21.2% (22/104) used 5 mg/kg/minute, 28.8% (30/104) used 6 mg/kg/minute, and 3.8% (4/104) used 3 mg/kg/minute. Additionally, 48.1% of respondents (50/104) reported a maximum glucose infusion rate above 13 mg/kg/min and 19.2% (20/104) above 15 mg/kg/min. Nineteen percent (20/104) of the respondents reported a lack of micronutrients. Barriers to PN initiation included difficulty in establishing intravenous lines, the absence of standardized protocols, the lack of lipids and micronutrients, infections, and unavailable software supporting neonatologists in calculating nutrition paradigms. CONCLUSION: This study's findings highlight the highly variable PN practice across neonatal units in Vietnam. Deviations from current practical guidelines can be explained by various barriers, most of which are modifiable. A monitoring network for nutritional practice status and a database to track the nutritional outcomes of preterm infants in Vietnam are needed.