Atlantoaxial dislocation due to Os odontoideum in down syndrome: Literature review and case reports.

INTRODUCTION AND IMPORTANCE: Os odontoideum is a rare condition commonly associated with atlantoaxial instability (AAI) and leading to atlantoaxial dislocation. The incidence of Os odontoideum is higher in patients with Down syndrome. Similar to odontoid fractures, atlantoaxial dislocation in patients with Os odontoideum can result in neurological deficits, disability, and even mortality. CASE PRESENTATION: We present two cases of Os odontoideum accompanied by Down syndrome. Both patients were hospitalized due to progressive tetraparesis after falls several months prior. Upon examination, the patients exhibited myelopathy and were unable to walk or stand. MRI revealed spinal stenosis at the C1-C2 level due to atlantoaxial dislocation. C1-C2 fixation using Harms' technique was performed in both cases. One case experienced a complication involving instrument failure, necessitating revision surgery. CLINICAL DISCUSSION: Due to the characteristics of transverse ligament laxity, low muscle tone, excessive joint flexibility, and cognitive impairment, children with both Down syndrome and Os odontoideum are at a high risk of disability and even mortality from spinal cord injury. Most authors recommend surgical management when patients exhibit atlantoaxial instability. Additional factors such as low bone density, cognitive impairment, and a high head-to-body ratio may increase the risk of surgical instrument failure and nonunion postoperatively in patients with Down syndrome. CONCLUSION: Os odontoideum is a cause of AAI in patients with DS. Indication of surgery in the presence of AAI helps to resolve neurological injury and prevent further deterioration. The use of a cervical collar is considered to prevent instrument failure postoperatively.

Fabrication of a ternary biocomposite film based on polyvinyl alcohol, cellulose nanocrystals, and silver nanoparticles for food packaging.

Silver nanoparticles (AgNPs) were loaded on deprotonated cellulose nanocrystals (CNCd) and incorporated into polyvinyl alcohol (PVA) to develop novel active food packaging films. The AgNPs were fabricated using the liquid phase chemical reduction method using the sodium borohydride reductant of AgNO3. The analysis using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), Thermogravimetric analysis (TGA), Differential scanning calorimetry (DSC), and Ultraviolet-visible spectroscopy (UV-Vis) showed that the CNCd surface had a homogeneous distribution of AgNPs with a diameter of about 100 nm. Additionally, CNCd/Ag was successfully incorporated into the PVA film. The developed PVA/CNCd/Ag film showed significantly improved mechanical properties, thermal stability, and UV barrier properties compared to a neat PVA film. The PVA/CNCd/Ag composite film could significantly preserve bananas for 14 days, preventing deterioration and allowing extended storage periods. This composite film generally shows promise in food packaging and prolongs food's shelf life.

Preferences for childbirth delivery and pain relief methods among pregnant women in Vietnam.

Background: Understanding childbirth delivery and pain relief method preferences is important as a part of the shared decision-making process between pregnant women and health professionals. This study aimed to examine the preferences for childbirth delivery modes and pain relief methods and factors related to these preferences among pregnant women in Vietnam. Methods: A cross-sectional survey on pregnant women was conducted in two obstetrics hospitals in Vietnam. Face-to-face interviews using a structured questionnaire were performed to collect information about sociodemographic characteristics, pregnancy characteristics, preferences for different childbirth delivery modes, and pain relief methods. Multivariate logistic regression was employed for determining associated factors with the preferences. Results: Of 576 pregnant women, 34% of participants preferred cesarean section. Most of the sample did not have any preferences for specific pharmacological pain relief methods (70.1%), while support from partner/relatives was the most preferable non-pharmacological method (61.3%), following by water birth (11.1%) and acupuncture (9.9%). Desire to have another baby, relatives' experience, selection date of birth, and instrumental social support were major drivers of the cesarean section selection. This preference was an important factor in the preference for pharmacological pain relief. Meanwhile, high levels of informational and emotional support were associated with non-pharmacological method preference. Conclusion: This study highlighted a high preference rate for cesarean section in urban pregnant women in Vietnam. Holistic approaches from family, health facility, and policy should be performed to diminish the cesarean rate preference and promote the use of non-pharmacological pain relief methods during birth.

Cellulose nanocrystals extracted from rice husk using the formic/peroxyformic acid process: isolation and structural characterization.

Cellulose derived from biomass is a renewable resource with numerous applications. Using formic/peroxyformic acid at atmospheric pressure, cellulose nanocrystals (CNC) were isolated from rice husk (RH) in this study. This method was an excellent way to get rid of lignin and hemicelluloses from RH. The cellulose was subsequently acid hydrolyzed by H2SO4 (64%) for 30 minutes at 45 °C. The chemical and microstructure analysis showed that the lignin and hemicellulose contents of raw RH had been eliminated, and the crystallinity content of CNC was 67.16%. According to transmission electron microscopy (TEM) morphological analysis, CNC measured 19 ± 3.3 nm in diameter, 195 ± 24 nm in length, and 10.2 ± 6.8 in aspect ratio. The thermal stability of RH and CNC was also investigated using thermogravimetric analysis (TGA). These encouraging findings demonstrated the potential for reusing RH agricultural waste to create CNC and include nanocomposites as a reinforcing material.

Preference and willingness to pay for reproductive health services among adults in Urban-Rural transition settings of a developing country: evidence from a cross-sectional study in a rural district of Hanoi, Vietnam.

BACKGROUND: Since the introduction of fee-for-service models in public hospitals and the legalization of private health services in Vietnam in 1989, the price of reproductive health services has risen. These changes have exacerbated inequities in accessing reproductive health services. This study examines potential disparities in willingness to pay for reproductive health services among adults in a rural district of Hanoi. METHODS: A cross-sectional study was conducted at 9 communes in Thanh Oai district, a rural district of Hanoi, Vietnam, in July 2019. Face-to-face interviews were conducted using a structured questionnaire to collect self-reported data. The contingent valuation was used to examine willingness to pay for reproductive health services with a starting price of 2 million VND (~ US$86.2, July 2019 exchange rate), which is the average price of all RHS in public facilities in Vietnam. Multiple Logistic regression and Multiple Interval regression models were used to identify factors associated with willingness to pay and the amount that people were willing to pay for reproductive health services. RESULTS: Among 883 participants, this study found 59.1% of them willing to pay for reproductive health services at an average maximum amount of US$36.2, significantly less than the current average price of US$86.2. Occupation, number of sex partners, perception towards the necessity of reproductive health services, and prior use of reproductive health services were found to significantly influence willingness to pay for reproductive health services, while age, income level, gender, occupation, perception towards the necessity of reproductive health services and prior use of reproductive health services were reportedly correlated with the amount participants were willing to pay for reproductive health services. CONCLUSION: Lower willingness to pay for reproductive health services compared to the current prices (US$36.2 vs. US$86.2) is likely related to an overall low awareness of the necessity of reproductive health services, and future education campaigns should specifically target those from lower-income backgrounds. Financial subsidization should also be provided, especially for those from the low-income group, to ensure equitable access to reproductive health services. Given the heterogeneity of reproductive health services, further studies should examine the willingness to pay for each type of service independently.

Toward sustainable development goals in gender inequality: an analysis of gender preferences among urban pregnant women in a Southeast Asian country.

BACKGROUND: Gender-biased discrimination and preferences are global phenomena, particularly son preferences. However, updated evidence about this issue in Vietnam has not yet been provided. Therefore, this study aimed to examine the gender preferences among pregnant women and identify associated factors of such preferences. METHODS: A cross-sectional survey was conducted in two hospitals in Vietnam with 732 pregnant women. Gender preferences for their child were asked, along with socio-demographic (e.g., education, occupation) and pregnancy characteristics (e.g., pressure to have a son, gender of first child, the importance to have a son of family members, and information sources on pregnancy care) by using face-to-face interviews and a structured questionnaire. Multinomial logistic regression was performed to determine factors associated with gender preferences. RESULTS: About 51.9% of the participants had no gender preference, while, among those who had a gender preference, 26.5% preferred sons, and 21.6% preferred daughters. Only 6.2% had pressure to have a son. Having the first child who was female (OR = 4.16, 95%CI = 1.54-11.25), having the pressure to have a son (OR = 6.77, 95%CI = 2.06-22.26), and higher self-perceived importance to have a son (OR = 3.05, 95%CI = 1.85-5.02) were positively associated with son preference. Otherwise, women having partners with high school education or above (OR = 2.04, 95%CI = 1.06-3.91), living with parents-in-law (OR = 2.33; 95%CI = 1.25-4.34), the higher number of pregnancies, and a higher degree of importance in having a son regarding parents-in-law (OR = 2.15, 95%CI = 1.38-3.35) associated with higher odds of preferring daughter. CONCLUSION: This study showed that gender preference was common among pregnant women, but the pressure to have a son was low. Further education programs and legal institutions should be implemented to improve gender inequality and gender preference in society.

1 Year-follow-up of transforaminal surgical approach in the management of migrated disc herniation: a cross-sectional study.

Transforaminal percutaneous endoscopic lumbar discectomy (TPELD) recently confirms its superiority compared to typical open discectomy in the treatment of very high-grade migrated disk herniation. In Vietnam, this technique has been applied in recent years; however; lack of reports and evidence. Objectives: In this study, the authors would like to share their surgical experience and report the initial results in their center, after successfully performing TPELD for very high-grade migrated disk herniation in 40 patients. Patients and methods: Forty patients, who underwent TPELD to remove the nucleus of very high-grade migrated disk herniation, were enrolled in this study. The study was carried out from April 2019 to April 2021. Preoperative and postoperative MRI were compared to demonstrate the removed disk. Postoperative visual analog score, oswestry disability index, and modified Macnab criteria were obtained after 1 month, 6 months, and 1 year and were compared. Results: There were no major complications related directly to this technique. Seven patients were operated at L3-4, 28 patients at L4-5, and 5 patients at l5-S1. Mean visual analog score for leg pain improved from 7.36±0.64 preoperatively to 1.22±1.16 at 6 months postoperatively and 1.34±1.47 at 1 year postoperatively (P<0.01). The mean preoperative oswestry disability index improved from 67.1±8.79 preoperatively to 12.1±13.48 at 1 year postoperatively (P<0.01). Excellent or good global outcomes were obtained in 95%. Conclusions: TPELD is a minimally invasive treatment with effective and safe results of very high-grade migrated disk herniation. Improvement of several pain scores can be observed in the 12-month follow-up after surgery.

Factors correlated with neuropathic pain among industrial workers in Vietnam: a multi-site cross-sectional study.

Introduction: Neuropathic pain is a debilitating condition resulting from various etiologies such as diabetes, multiple sclerosis, and infection, and is associated with decreased quality of life, poor health outcomes, and increased economic burden. However, epidemiological studies on neuropathic pain have been largely limited in Vietnam. Methods: A cross-sectional study was conducted on adult Vietnamese industrial workers across three manufacturing plants. Demographic, socioeconomic, occupational and health data were collected. Prevalence of neuropathic pain was assessed using the Douleur Neuropathique 4 (DN4) scale. Regression modeling was utilized to identify predictors of pain. Results: Among 276 workers, 43.1 and 24.3% reported that they had suffered from spinal pain and osteoarthritis pain, respectively. In terms of work conditions, people maintaining constant posture when working from 30 to 60 min (OR = 3.15, 95% CI = 1.07; 9.29), or over 60 min (OR = 2.59; 95% CI = 1.12; 5.98) had a higher risk of suffering from spinal pain. People who worked in conditions lacking adequate lighting and with exposures to toxic chemicals were also likely to be suffering from osteoarthritis pain with OR = 4.26, 95% CI = 1.02; 17.74 and Coef. = 1.93; 95% CI = 1.49; 2.50, respectively. Regular health examinations and higher expenditure for healthcare were correlated with a lower prevalence of neuropathic pain. Discussion: These results may inform the adoption of pain screening and other programs that increase health care access for this population, as well as more stringent occupational health and safety standards.

A global bibliometric analysis of intimate partner violence in the field of HIV/AIDS: implications for interventions and research development.

This study aimed to explore the research landscape of intimate partner violence (IPV)-harm-induced behavior in an intimate relationship and HIV/AIDS to determine lessons learnt and gaps that may be filled by future research. Publications related to IPV, and HIV/AIDS published from 1997 to 2019 were collected from Web of Science (WoS). STATA and VOSviewer software tools were used for bibliometric analysis. Content analysis, common topics, and the map of co-occurrence terms were structured by Latent Dirichlet allocation and VOSviewer software tool. 941 studies were included. Factors associated with domestic violence and interventions to reduce IPV were the two most common themes. Meanwhile, mental health illness among pregnant women affected by HIV and IPV, and HIV-risk among youth suffering from IPV have not received adequate attention. We suggest that more research focusing on adolescents and pregnant women affected by HIV and IPV. In addition, the development of collaborative networks between developed and developing countries should also be addressed.

Changes in Quality of life Outcomes of Patients with HIV/AIDS Under a Theory-based Mobile Health Intervention.

This study examined the effectiveness of a theory-based mHealth intervention on the quality of life (QOL) of people living with HIV. A randomized controlled trial was performed at two outpatient clinics in Hanoi, Vietnam. There were 428 patients with HIV/AIDs in selected clinics and were divided into the intervention arm (receiving HIV-assisted smartphone application and usual care) and the control arm (receiving only usual care). The WHOQOLHIV-BREF instrument was utilized to measure QOL. An intention-to-treat approach using Generalized Linear Mixed Model analysis was performed. The trial showed significant improvements in Physical health, Psychological health, and Level of Dependence among patients in the intervention arm compared to the control arm. However, the Environment and Spirituality/Personal beliefs improvements would require additional interventions, both individual, organizational, or governmental. This study explored the utility of a smartphone mobile application for individuals with HIV, and how the resultant application could improve the overall QOL.

A cross-sectional study of MIS TLIF in treatment of spondylolisthesis: initial good results from 92 Vietnamese patients.

Minimally invasive transforaminal lumbar interbody fusion has proven effectiveness in treating spondylolisthesis, but there were few reports applying the technique from scarce resourcing developing countries. In this study, the authors report the results and share our experience of minimally invasive spinal transforaminal lumbar interbody fusion in spondylolisthesis treatment in Vietnamese patients. Materials and methods: In this study, the authors enroled 92 patients diagnosed with single-level, grade I or grade II lumbar spondylolisthesis from January 2019 to October 2022. Results: The median age in our study was 47.79±12.61 (range 15-75), the male/female ratio was 1/2.3. The mean disease duration was 28.57 months. Conventional X-ray images showed that there were 74 patients (80.43%) with spondylolisthesis grade I, 18 patients (19.57%) with grade II. Spondylolisthesis occured mainly in L4-L5 with 53 patients (57.61%). The isthmic sign was recorded in 16 patients (31.4%). The mean blood loss was 149.46 ml. Patients walked on average of 3.22 days after surgery. VAS score reduced significantly in both back and leg. Spinal function improved significantly with a preoperative Owestry Disability Index of 48.18% decrease to 15.18% 12 months after surgery. The surgical results were good and excellent at 95.00% after 12 months of surgery according to Macnab scale. The fusion rate reached 97.50%. Conclusions: The results of this Macnab's classification study show that minimally invasive spinal transforaminal lumbar interbody fusion is an effective treatment for spondylolisthesis with less pain, less blood loss after surgery, and high fusion rate.

Efficacy of a Mobile Phone-Based Intervention on Health Behaviors and HIV/AIDS Treatment Management: Randomized Controlled Trial.

BACKGROUND: Antiretroviral therapy (ART) is considered the most important intervention for HIV-positive patients; thus, encouraging the use of and adherence to ART are vital to HIV treatment outcomes. Advances in web and mobile technologies hold potential in supporting HIV treatment management. OBJECTIVE: The aim of this study was to evaluate the feasibility and efficacy of a theory-based mobile health (mHealth) intervention on health behaviors and HIV treatment adherence among patients with HIV/AIDS in Vietnam. METHODS: We performed a randomized controlled trial on 425 HIV patients in two of the largest HIV clinics in Hanoi, Vietnam. Both the intervention group (238 patients) and the control group (187 patients) received regular consultations with doctors and then participated in 1-month and 3-month follow-up visits. Patients in the intervention group received a theory-driven smartphone app to facilitate medication adherence and self-efficacy in HIV patients. Measurements were developed based on the Health Belief Model, which included the visual analog scale of ART Adherence, HIV Treatment Adherence Self-Efficacy Scale, and HIV Symptom Management Self-Efficacy Scale. We also included the 9-item Patient Health Questionnaire (PHQ-9) to assess patients' mental health throughout treatment. RESULTS: In the intervention group, the adherence score increased significantly (ß=1.07, 95% CI .24-1.90) after 1 month, whereas the HIV adherence self-efficacy was significantly higher after 3 months (ß=2.17, 95% CI 2.07-2.27) compared to the control group. There was a positive but low level of change in risk behaviors such as drinking, smoking, and drug use. Factors related to positive change in adherence were being employed and having stable mental well-being (lower PHQ-9 scores). Factors associated with self-efficacy in treatment adherence and symptom management were gender, occupation, younger age, and having no other underlying conditions. A longer duration of ART increased treatment adherence but decreased self-efficacy in symptom management. CONCLUSIONS: Our study demonstrated that the mHealth app could improve the overall ART adherence self-efficacy of patients. Further studies with larger sample sizes and longer follow-up periods are needed to support our findings. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20220928003; https://www.thaiclinicaltrials.org/show/TCTR20220928003.

Scholarly literature in HIV-related lesbian, gay, bisexual, and transgender studies: A bibliometric analysis.

Introduction: Lesbian, gay, bisexual, and transgendered (LGBT) people are marginalized and understudied. Analyzing research activity worldwide is vital to better understand their needs in confronting the HIV epidemic. This study aimed to evaluate the global literature to identify the research collaboration, content, and tendency in HIV-related issues among the LGBT populations. Methods: Peer-reviewed original articles and reviews were achieved from the Web of Science Core Collection database. Country's collaborations and co-occurrence of most frequent terms were illustrated by VOSviewer software. The Latent Dirichlet Allocation (LDA) and the linear regression model were utilized to uncover the hidden topics and examine the research trend. Results: From 1990 to 2019, a total of 13,096 publications were found. Stigma, sexual risk behaviors and HIV testing were the major topics in the LGBT research during the study period. Among 15 topics, topics about HIV/Sexually transmitted infections (STIs) prevalence, Outcomes of HIV/AIDS care and treatment, and Opportunistic infections in HIV-positive LGBT people showed decreasing attention over years, while other topics had a slight to moderate increase. Discussion: Our study underlined the exponential growth of publications on the LGBT population in HIV research, and suggested the importance of performing regional collaborations in improving research capacity. Moreover, further research should focus on examining the manner to increase the coverage of HIV testing and treatment, as well as implement HIV-interventions with low cost and easy to scale-up.

Depressive symptoms are associated with immunological failure among HIV-positive patients in Vietnam.

As the lives of people living with HIV (PLWH) become increasingly normalized, more focus is being given to the associated comorbidities of HIV, including those related to mental health such as depression. This study aims to evaluate the correlation between depressive symptoms and HIV outcomes in Vietnam through the measurement of CD4 cell count. A mixed design was utilized, in which both a longitudinal assessment of CD4 cell counts and a cross-sectional survey of depressive symptoms were conducted on 481 patients in the Bach Mai and Ha Dong HIV clinics (Hanoi, Vietnam). CD4 cell count data was extracted from the medical records of participants, and depressive symptoms were screened using the Patient Health Questionnaire (PHQ-9). The results illustrate that the presence of moderately severe to severe depressive symptoms is associated with lower CD4 cell counts, indicating poorer HIV outcomes resulting from comorbid depression. This correlation was especially noticeable in the PHQ-9 items for psychomotor agitation/retardation (p < 0.05) and suicidal ideation (p < 0.05). Future policy and treatment options for HIV in Vietnam should consider the presence of comorbid mental health conditions in order to provide more suitable and effective treatment in the goal of providing a higher quality of life for PLWH.

Determinants of mental health among youths and adolescents in the digital era: Roles of cyber and traditional bullying, violence, loneliness, and environment factors.

Introduction: Although the pathogenesis of depressive disorders is not fully elucidated, untreated adolescent depression can lead to serious sequelae such as impaired academic performance and social functioning, substance use disorders, poor self-esteem, and increased risk for suicidal ideation and attempts. Literature on adolescent mental health in Vietnam is limited, despite increased international awareness of this critical issue. This study aimed to investigate the prevalence and associations of depressive symptoms in Vietnamese adolescents. Methods: A cross-sectional, self-administered survey was conducted in five provinces of Vietnam among adolescents aged 14 to 24 years. In addition to collecting participants' demographics, a structured questionnaire was developed to examine depressive symptoms, suicidal ideation, loneliness, and cyberbullying victimization. Depressive symptoms and loneliness were assessed via the PHQ-9 and UCLA Loneliness Scale, respectively. Two-tailed Chi-squared, Mann-Whitney, and Kruskal-Wallis tests were performed to examine associations between variables. Multivariate Logistic regression models were conducted to examine the associations between prior-defined variables and positive depressive symptoms. Results: Among 1,600 respondents, 31.8% of participants reported having mild-moderate or severe depressive symptoms. Participants within the moderate-severe depressive symptom group had significantly lower community cohesion scores than those of participants in normal and mild depressive symptom groups (p < 0.05). Youths living alone were more likely to have moderate-severe depressive symptoms (OR 2.16; 95% CI: 1.09-4.25). Cyberbullying had significant associations with depressive severity (OR 1.93; 95% CI 1.38-2.70). Conclusion: The findings of this study characterize various risk and protective factors for depression in Vietnamese youths and adolescents. The results highlight the importance of raising awareness and increasing access to educational resources for depression and other mental health illnesses. With the rising prevalence of depression, parents, teachers, and community leaders play a vital role in addressing mental health problems in adolescents.

Social network and HIV/AIDS: A bibliometric analysis of global literature.

Social networks (SN) shape HIV risk behaviors and transmission. This study was performed to quantify research development, patterns, and trends in the use of SN in the field of HIV/AIDS, and used Global publications extracted from the Web of Science Core Collection database. Networks of countries, research disciplines, and most frequently used terms were visualized. The Latent Dirichlet Allocation method was used for topic modeling. A linear regression model was utilized to identify the trend of research development. During the period 1991-2019, in a total of 5,698 publications, topics with the highest volume of publications consisted of (1) mental disorders (16.1%); (2) HIV/sexually transmitted infections prevalence in key populations (9.9%); and (3) HIV-related stigma (9.3%). Discrepancies in the geographical distribution of publications were also observed. This study highlighted (1) the rapid growth of publications on a wide range of topics regarding SN in the field of HIV/AIDS, and (2) the importance of SN in HIV prevention, treatment, and care. The findings of this study suggest the need for interventions using SN and the improvement of research capacity via regional collaborations to reduce the HIV burden in low- and middle-income countries.

Resource mobilization for tetanus vaccination in Vietnam: Uptake, demand and willingness to pay among women of reproductive age.

Introduction: Tetanus vaccine coverage in Vietnam has been declining in recent years due to a rapid population growth rate, shrinking budget, and inefficient resource mobilization strategy. This study examined the uptake, demand, and willingness to pay (WTP) for tetanus vaccines in Vietnamese women of reproductive age as well as determined associated factors and assessed the feasibility of the long-term tetanus vaccine resource mobilization scheme. Methods: Cross-sectional data were obtained on 807 women of childbearing age in Hanoi, Vietnam in 2016. Tetanus vaccine uptake, demand, and willingness to pay were collected by using a structured questionnaire. Multivariable logistic and interval regression models were used to examine associated factors with vaccine uptake, demand, and WTP. Results: Of 807 participants, 42.4 and 64.8% had sufficient tetanus vaccination (i.e., received at least three doses of vaccine) and were willing to pay for tetanus vaccination. The mean amount of WTP for one dose of tetanus was US$ 7.3 (95% CI = 6.7-7.9). Having children or being aware that the tetanus vaccine was free-of-charge were negatively associated with WTP for tetanus vaccine. Having a high school education, living in a rural area, and not being aware of vaccine prices or being aware that vaccines were provided freely reduced the amount of WTP. WTP increased among women receiving information from friends and relatives. Conclusion: Despite of exemption from the tetanus vaccination programs, this study indicated a low tetanus vaccination coverage and a moderate degree of WTP for tetanus vaccine among Vietnamese women of childbearing age. Target-specific educational and financial support interventions, along with efforts to reduce vaccination costs are critical to improving the vaccine uptake, demand, and WTP for tetanus immunization among women.

ICARUS-Q: Integrated control and readout unit for scalable quantum processors.

We present a control and measurement setup for superconducting qubits based on the Xilinx 16-channel radio-frequency system-on-chip (RFSoC) device. The proposed setup consists of four parts: multiple RFSoC boards, a setup to synchronize every digital to analog converter (DAC) and analog to digital converter (ADC) channel across multiple boards, a low-noise direct current supply for tuning the qubit frequency, and cloud access for remotely performing experiments. We also designed the setup to be free of physical mixers. The RFSoC boards directly generate microwave pulses using sixteen DAC channels up to the third Nyquist zone, which are directly sampled by its eight ADC channels between the fifth and the ninth zones.