Real-world analysis of afatinib as a first-line treatment for patients with advanced stage non-small-cell lung cancer with uncommon EGFR mutations: a multicenter study in Vietnam.

Background: Afatinib is indicated for advanced-stage non-small-cell lung cancer (NSCLC) with Epidermal Growth Factor Receptor (EGFR) and uncommon mutations. However, real-world studies on this topic are limited. This study aimed to evaluate afatinib as first-line therapy for locally advanced and metastatic NSCLC with uncommon EGFR mutations. Patients and methods: A retrospective study included 92 patients with advanced NSCLC with uncommon and compound EGFR mutations, treated with afatinib as first-line therapy. Patients were followed up and evaluated every 3 months or when symptoms of progressive disease arose. The endpoints were objective response rate (ORR), time-to-treatment failure (TTF), and adverse events. Results: The G719X EGFR mutation had the highest occurrence rate (53.3% for both monotherapy and the compound). By contrast, the compound mutation G719X-S768I was observed at a rate of 22.8%. The ORR was 75%, with 15.2% of patients achieving complete response. The overall median TTF was 13.8 months. Patients with the G719X EGFR mutation (single and compound) had a median TTF of 19.3 months, longer than that of patients with other mutations, who had a median TTF of 11.2 months. Patients with compound EGFR mutations (G719X and S768I) demonstrated a median TTF of 23.2 months compared to that of 12.3 months for other mutations. Tolerated doses of 20 or 30 mg achieved a longer median TTF of 17.1 months compared to 11.2 months with 40 mg. Median TTF differed between patients with and without brain metastasis, at 11.2 and 16.9 months, respectively. Rash (55.4%) and diarrhea (53.3%) were the most common adverse events, primarily grades 1 and 2. Other side effects occurred at a low rate. Conclusion: Afatinib is effective for locally advanced metastatic NSCLC with uncommon EGFR mutations. Patients with G719X, compound G719X-S768I mutations, and tolerated doses of 20 or 30 mg had a longer median TTF than those with other mutations.

Diphenyl ethers from the cultured lichen mycobiont of Graphis handelii Zahlbr.

Purpose: Cultured lichen mycobionts are valuable sources of new natural compounds. Mycobiont of Graphis handelii growing in Vietnam was isolated, cultivated and chemically investigated. The crude extract of this cultured mycobiont showed potent alpha-glucosidase inhibition with an IC50 value of 50 µg/mL. Methods: Multiple chromatographic methods were applied to the extract to isolate compounds. The combination of Nuclear Magnetic Resonance analysis and high-resolution mass spectroscopy determined their chemical structures. Electrophilic bromination/chlorination was applied to obtain new derivatives using NaBr/H2O2 and NaCl/H2O2 reagents. Compounds were evaluated for enzyme inhibitory activities, including alpha-glucosidase inhibition, HIV-1 reverse transcriptase inhibition, SARS-CoV-2 main protease (Mpro) inhibition, anti-inflammatory activity, and cytotoxicity against several cancer cell lines. A molecular docking study for anti-SARS-CoV-2 was conducted to understand the inhibitory mechanism. Results: A new diphenyl ether, handelone (1) and a known compound xylarinic acid A (2) were isolated and elucidated. Four synthetic products 6'-bromohandelone (1a), 2'-bromohandelone (1b), 2',6'-dibromohandelone (1c), and 2',6'-dichlorohandelone (1d) were prepared. Compound 1 showed good activity against Mpro with an IC50 value of 5.2 µM but it showed weak or inactive activity in other tests. Other compounds were inactive in all assays. Conclusion: A new compound, handelone (1) was isolated from the cultured mycobiont of Graphis handelii. From these compounds, four new derivatives were prepared. Compound 1 showed good activity against Mpro with an IC50 value of 5.2 µM but it showed weak or inactive activity in other tests. Other compounds were inactive in all assays.

Depression, anxiety and stress among healthcare workers in the context of the COVID-19 pandemic: a cross-sectional study in a tertiary hospital in Northern Vietnam.

Introduction: The outbreak of coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) had significant effects on the mental well-being in general, particularly for healthcare professionals. This study examined the prevalence of depression, anxiety, and stress, and identified the associated risk factors amongst healthcare workers during the COVID-19 outbreak in a tertiary hospital located in Vietnam. Methods: We conducted a cross-sectional study at a tertiary-level hospital, where the Depression Anxiety and Stress Scale 21 (DASS-21) web-based questionnaire was employed. We analyzed the determinant factors by employing multivariate logistic models. Results: The prevalence of depression, anxiety, and stress symptoms were 19.2%, 24.7%, and 13.9%, respectively. Factors such as engaging in shift work during the pandemic, taking care of patients with COVID-19, and staff's health status were associated with mental health issues among health professionals. In addition, having alternate rest periods was likely to reduce the risk of stress. Conclusion: The prevalence of mental health problems in healthcare workers during the COVID-19 pandemic was relatively high. Having resting periods could potentially mitigate the development of stress among health professionals. Our findings could be taken into account for improving mental health of the health professional population.

The Effectiveness of Language-Specific Personal Care Education on Improving the Knowledge and Skills of Vietnamese American In-Home Supportive Service Caregivers.

BACKGROUND: In-Home Supportive-Services (IHSS) caregivers provide personal care assistance to low-income older adults. According to the California Social Service Department, 20.2% of IHSS caregivers spoke Vietnamese in one county. The purpose of this project was to improve the knowledge and skills among these Vietnamese American caregivers by providing a language-specific and culturally appropriate education on personal care. METHODS: The project used a pre- and post-test design. Under the guidance of nursing faculty, four Vietnamese-speaking nursing students provided a 2-hr educational program on personal care (e.g., bathing, oral care) to registered Vietnamese IHSS caregivers. A pre- and post-survey was conducted. RESULTS: Overall, 55 caregivers completed the surveys. The surveys showed significant increases in confidence in knowledge and skills related to personal care topics (all ps < .001). CONCLUSION: The findings demonstrated that the cultural and language-specific education was effective in increasing knowledge and confidence of Vietnamese IHSS caregivers related to personal care for older adults.

The half-life of maternal transplacental antibodies against diphtheria, tetanus, and pertussis in infants: an individual participant data meta-analysis.

AIM: There are few reliable estimates of the half-lives of maternal antibodies to the antigens found in the primary series vaccines. We aimed to calculate the half-lives of passively acquired diphtheria, tetanus and pertussis (DTP) antibodies in infants. We aimed to determine whether decay rates varied according to country, maternal age, gestational age, birthweight, World Bank income classifications, or vaccine received by the mother during pregnancy. METHODS: De-identified data from infants born to women taking part in 10 studies, in 9 countries (UK, Belgium, Thailand, Vietnam, Canada, Pakistan, USA, Guatemala and the Netherlands) were combined in an individual participant data meta-analysis. Blood samples were taken at two timepoints before any DTP-containing vaccines were received by the infant: at birth and at 2-months of age. Decay rates for each antigen were log2-transformed and a mixed effects model was applied. Half-lives were calculated by taking the reciprocal of the absolute value of the mean decay rates. RESULTS: Data from 1426 mother-infant pairs were included in the analysis. The half-lives of the 6 antigen-specific maternal antibodies of interest were similar, with point estimates ranging from 28.7 (95% CI: 24.4 - 35) days for tetanus toxoid antibodies to 35.1 (95% CI: 30.7 - 41.1) days for pertactin antibodies. The decay of maternal antibodies did not significantly differ by maternal age, gestational age, birthweight, maternal vaccination status or type of vaccine administered. CONCLUSION: Maternal antibodies decay at different rates for the different antigens; however, the magnitude of the difference is small. Decay rates are not modified by key demographic or vaccine characteristics.

Corrigendum to 'Adult-onset mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome with progressive sensorineural hearing loss: A case report [Radiology Case Reports 16 (2021) 1865-1869].

[This corrects the article DOI: 10.1016/j.radcr.2021.04.049.].

Prevalence of smoking among health science students in Vietnam in 2018 and associated factors: A cross-sectional study.

Smoking is a global health problem among health science students. The objectives of this study were to estimate the prevalence of smoking and to examine associated factors among health science students from five universities in Vietnam. Among 5946 participants (95.0% response rate), the smoking prevalence was 19.2% (95% CI:17.4-21.0%) among male students and 2.9% (95% CI:2.4-3.5%) among female students. In the multivariable regression models, significant factors for smoking were the perceived financial burden, the respondent's year in university, a non-self-determined motivation profile, self-reported depression and/or anxiety, the level of vigorous physical activity, and alcohol drinking.

Evaluation of Acute Toxicity and Semi-chronic Toxicity of Extract from Celastrus hindsii Benth.

BACKGROUND AND OBJECTIVE: Celastrus hindsii Benth. has been used for generations in Northern Vietnam, for the treatment of disease relating to ulcers, tumors and inflammation without safety evidence. This study's goal is to evaluate the safety of the aqueous extract of leaves of C. hindsii through an acute and semi-chronic toxicity oral administration. MATERIALS AND METHODS: In the acute study, a single oral dose (1000, 3000, 5000 and 15000 mg kg-1) of the aqueous of C. hindsii extract were administered to mice and observed for seven days. In the semi-chronic study, rabbits were administered daily with 1000 and 3000 mg kg-1 of the extract for 35 days. Hematological and biochemical analyzes were carried out on blood and serum samples collected. RESULTS: A single oral administration of 15000 mg kg-1 per day for white mice did not determine the LD50 dose. At doses of 1000 and 3000 mg kg-1 for 35 days, the extract from C. hindsii induced neither clinical symptoms of rabbits nor significant changes in hematological parameters such as; total blood cells, hemoglobin concentration, white blood cells and platelets. The quantity of aspartate transaminase (AST or GOT), alanine transaminase (ALT or GPT) of rabbits in the experimental and control group did not differ (p> 0.05). Liver and kidney organizations were also not affected adversely. CONCLUSION: The results indicate that the oral administration of C. hindsii extract did not produce any significant toxicity in mice, therefore, it is recommended to be used safely for traditional medical practices and modern pharmaceutical applications.

Enhanced optical output power by the silver localized surface plasmon coupling through side facets of micro-hole patterned InGaN/GaN light-emitting diodes.

Light extraction efficiency of GaN-based light emitting diodes were significantly enhanced using silver nanostructures incorporated in periodic micro-hole patterned multi quantum wells (MQWs). Our results show an enhancement of 60% in the wall-plug efficiency at an injection current of 100 mA when Ag nano-particles were deposited on side facet of MQWs passivated with SiO2. This improvement can be attributed to an increase in the spontaneous emission rate through resonance coupling between localized surface plasmons in Ag nano-particles and the excitons in MQWs.

Effect of animal-source food supplement prior to and during pregnancy on birthweight and prematurity in rural Vietnam: a brief study description.

BACKGROUND: Maternal nutritional status is an important predictor of infant birthweight. Most previous attempts to improve birthweight through multiple micronutrient supplementation have been initiated after women are pregnant. Interventions to improve maternal nutritional status prior to conception may be more effective in preventing low birthweight and improving other infant health outcomes. OBJECTIVE: To compare the effects of maternal supplementation with animal-source food from preconception to term or from mid-gestation to term with routine prenatal care on birthweight, the prevalence of preterm births, intrauterine growth restriction, and infant growth during the first 12 months of life and on maternal nutrient status and the incidence of maternal and infant infections. METHODS: Young women from 29 rural communes in northwestern Vietnam were recruited when they registered to marry and were randomized to one of three interventions: animal-source food supplement 5 days per week from marriage to term (approximately 13 months), animal-source food supplement 5 days per week from 16 weeks of gestation to term (approximately 5 months), or routine prenatal care without supplementalfeeding. Data on infant birthweight and gestational age, maternal and infant anthropometry, micronutrient status, and infections in the infant and mother were collected at various time points. RESULTS: In a preliminary study of women of reproductive age in this area of Vietnam, 40% of the women were underweight (body mass index < 18.5) and anemic. About 50% had infections. Rice was the dietary staple, and nutrient-rich, animal-source foods were rarely consumed by women. Iron, zinc, vitamin A, folate, and vitamin B12 intakes were inadequate in about 40% of the women. The study is still ongoing, and further data are not yet available. CONCLUSIONS: The results of this study will provide important data regarding whether improved intake of micronutrient-rich animal-source foods that are locally available and affordable before and during pregnancy improves maternal and infant health and development. This food-based approach may have global implications regarding how and when to initiate sustainable nutritional interventions to improve maternal and infant health.

Elimination of iron deficiency anemia and soil transmitted helminth infection: evidence from a fifty-four month iron-folic acid and de-worming program.

BACKGROUND: Intermittent iron-folic acid supplementation and regular de-worming are effective initiatives to reduce anemia, iron deficiency, iron deficiency anemia, and soil transmitted helminth infections in women of reproductive age. However, few studies have assessed the long-term effectiveness of population-based interventions delivered in resource-constrained settings. METHODOLOGY/PRINCIPAL FINDINGS: The objectives were to evaluate the impact of weekly iron-folic acid supplementation and de-worming on mean hemoglobin and the prevalence of anaemia, iron deficiency, and soil transmitted helminth infection in a rural population of women in northern Vietnam and to identify predictive factors for hematological outcomes. A prospective cohort design was used to evaluate a population-based supplementation and deworming program over 54 months. The 389 participants were enrolled just prior to commencement of the intervention. After 54 months 76% (95% CI [68%, 84%]) were taking the iron-folic acid supplement and 95% (95% CI [93%, 98%]) had taken the most recently distributed deworming treatment. Mean hemoglobin rose from 122 g/L (95% CI [120, 124]) to 131 g/L (95% CI [128, 134]) and anemia prevalence fell from 38% (95% CI [31%, 45%]) to 18% (95% CI [12%, 23%]); however, results differed significantly between ethnic groups. Iron deficiency fell from 23% (95% CI [17%, 29%]) to 8% (95% CI [4%, 12%]), while the prevalence of iron deficiency anemia was reduced to 4% (95% CI [1%, 7%]). The prevalence of hookworm infection was reduced from 76% (95% CI [68%, 83%]) to 11% (95% CI [5%, 18%]). The level of moderate or heavy infestation of any soil-transmitted helminth was reduced to less than 1%. CONCLUSIONS/SIGNIFICANCE: Population-based interventions can efficiently and effectively reduce anemia and practically eliminate iron deficiency anemia and moderate to heavy soil transmitted helminth infections, maintaining them below the level of public health concern.

Change of estrogen concentration in the menstrual cycle

Background: Many research works showed that menstruation is caused by the sudden reduction of the estrogens and progesterone to low levels of secretion at the end of the menstrual cycle. However, it should be investigated to which levels the concentration of these two hormones sharply reduces to cause menstruation. Objective: To determine estradiol concentration at the beginning of menstruation, the second day of menstruation and the ending of menstruation during the menstrual cycle. Subject and methods: 30 women with the normal menstrual cycle and 30 women with the long menstrual cycle were used as subjects to determine estradiol concentration at the day at the beginning of menstruation, the second day of menstruation and the last day of menstruation during the menstrual cycle. Result and Conclusion: In the women group with the normal menstrual cycle, the estradiol concentration: at the day at the beginning of menstruation is 159.93 \xb1 51.29 pmol/L, at the second day of menstruation is 170.58 \xb1 46.54 pmol/L and at the lastday of menstruation is 177.55 \xb1 46.42 pmol/L. In women in the group with long menstrual cycle, the estradiol concentration: at the day of beginning of menstruation is 154.55 \xb1 61.60 pmol/L and at the last day of menstruation is 154.55 \xb1 61.60 pmol/L.

Prenatal diagnosis by FISH technique in fetal cystic hygromas

Background: Cystic hygromas is a common abnormal event in obstetrics ultrasound, which is induced by a chromosome disorder; it is also one of the major causes inducing fetus\u2019s congenital malformation. Objective: Determining chromosomal aberration in nuchal cystic hygromas by FISH technique and outcomes the value of factors in prognosis fetuses with cystic hygroma. Subject and methods: 53 fetuses with cystic hygroma, which are detected by ultrasound scan, are analyzed by FISH technique. Compare results of FISH, band G chromosomal analysis, ultrasonographic abnormalities, followed the fetuses. Results: Chromosomal and FISH analysis give the same detection: abnormal chromosomes: 75.46%, the highest rate is Turner syndrome: 50.94%, normal chromosome: 24.53%. Abnormal chromosomal fetuses: multi-malformation, grim prognosis. Cystic hygroma with other malformation in scan: high rate chromosomal aberrations and septated hygroma, Turner syndrome fetuses have large cystic hygroma, 4/6 fetuses with normal chromosome and without other abnormal result scan have resolutions of hygroma in the second trimester, normal birth. Conclusions: Abnormal chromosomes: 75.46%. Prognosis is grim: abnormal chromosomes, other malformations in scan, large cystic, septated hygroma. Prognosis is better: normal chromosomes, without other ultrasonographic abnormalities, small cystic, nonseptated hygroma, resolution of cystic hygroma.

Prenatal diagnosis of turner syndrome

Background/Introduction:The proportion of TS \u2013 Q96 ranges from 1/1500 \u2013 1.300 female newborns and about 3% of fetuses. In most of the world, TS can be diagnosed and treated at the early stages of pregnancies. In Vietnam, TS patients are frequently detected at the later stages with serious syndromes. TS diagnosis mainly relies on chromosomal analysis of amnion cells. Thus, prenatal diagnosis of TS is the rationale of this study.\r\n', u'Objectives: Utilize chromosomal analysis and FISH methods to diagnose Turner syndrome from amnion cells. \r\n', u'Subject and method: 30 pregnancies (from week 14-22) with high risks of TS, which were detected by ultrasound scan and triple test, 15 mil amnio fluid is withdrawn for the FISH technique from interphase amniocytes and amnio cultures, chromosomal analysis from metaphase cultured cells. \r\n', u'Results/Outcomes: Chromosomal analysis and FISH analysis give the same results: - 12/30 fetus with TS, 5/30 fetus with normal female results, \u2013 4/30 fetus with normal male normal results, \u2013 4/30 fetus with Down syndrome, \u2013 5/30 fetus with Edward syndrome. 11/12 TS fetus have large cystic hygromas, 9/11 cystic hygromas are separated. 12/12 TS fetus have triple test (+) with the threshold: APF \u2264 0.7 MoM, HCG \u2265 2 MoM, uE3 \u2264 0.7 MoM.\r\n', u'Conclusion:Chromosonal analysis and FISH are standards for diagnosing TS fetus. FISH can provide a quick result (48-72h). \r\n', u'

Prenatal diagnosis down syndrome, turner syndrome by using fluorescence in situ hybridization (FISH) technique with chromosome analysis from amniotic cell

Background: FISH can detect number and structural chromosome aberrations in DNA. FISH is new technique in Vietnam, we combine FISH with chromosome analysis to prenatal diagnosis Down syndrome and turner syndrome that are high rate in birth defect.Objectives: To detect Down syndrome and turner syndrome by using FISH technique with chromosome analysis from amniotic cell.Subjects and method: 14amniotic cells samples 15th - 20th week with high risk of birth defects. Advance using FISH and chromosome analysis from amniotic cell. Results: We obtained results as follow: - 14/14 samples: correspondence between FISH and chromosome analysis. \ufffd?Detected 2 Down syndrome (female. Trisomi 21) and 4 Turner syndrome (45, X). Conclusion: Detected Down syndrome and Turner syndrome by using FISH technique with chromosome analysis from amniotic cell.

Evaluation of the documentation for OPV production in the year of 2006

Background: Good Manufacturing Practice (GMP) is a important part of quality assurance (QA). Implementation of GMP request to establish the documentation system and should be reviewed as well as evaluated strictly. Documentation is important because it helps the competent person make decisions whether to finish the product or not and it is used as a base for inspection. In the year of 2006, 100% OPV production line in Center for research and production of vaccines and biologicals (POLYVAC) had established the document system. Objectives: To evaluate of the documentation for OPV production in the year of 2006 in POLYVAC. Subjects and method: Documentation for OPV production in 2006 were evaluated by standard operating procedure (SOP) (recommended by WHO). The standards included blank space; erase; code and unit of measurement; revision; no signage and others. Results and Conclusion: Documentation is different between departments. Onlymonkey ranch in Reu island applied 100% SOP. 776 errors were found. Among them blank space (32.2%), erase (27%), code and unit of measurement (21%), revision (5%), no signage (12%) and others (3.6%). The results were the basis of promoting implementation of GMP in vaccine manufacturing in POLYVAC.