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1.
Inorg Chem ; 63(26): 12027-12041, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38897627

RESUMEN

Semiconductor materials based on bismuth metal have been extensively explored for their potential in photocatalytic applications owing to their distinctive crystal structure. Herein, we present the development of a hybrid photocatalyst, CAU-17/BiOCl, featuring a flower-like nanosheet morphology tailored for the photocatalytic degradation of organic contaminants such as rhodamine B (RhB) and tetracycline hydrochloride (TCH). The composite material is obtained by growing thin CAU-17 layers directly onto the host flower-like BiOCl nanosheets under solvothermal conditions. The optimized CAU-17/BiOCl composite possesses excellent photocatalytic performance, achieving a notable 96.0% removal rate for RhB and 78.4% for TCH after 60 and 90 min of LED light irradiation, respectively. This boosted activity is attributed to the heightened absorption of visible light caused by BiOCl and the provision of additional reaction sites due to the thin CAU-17 layers. Furthermore, the establishment of an S-scheme heterojunction mechanism enables efficient charge separation between CAU-17 and BiOCl, facilitating the separation of photoinduced electrons (e-) and holes (h+). Analysis of the degradation mechanism of RhB and TCH reveals the predominant role of superoxide radicals (•O2-), e-, and h+ in the photocatalytic degradation process. Moreover, the removal efficiency of TCH can reach approximately 64.5% after four cycles of recycling of CAU-17/BiOCl. Our work provides a facile, effective solution and a theoretically explained approach for the effective degradation of pollutants using heterojunction photocatalysts.

2.
ACS Appl Mater Interfaces ; 16(23): 30567-30579, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38830119

RESUMEN

Cementation in construction materials primarily relies on the aqueous precipitation of minerals such as carbonates and silicates. The kinetics of nucleation and growth play a critical role in the development of strength and durability, yet our understanding of the kinetic controls governing phase formation and porosity reduction in cements remains limited. In this study, we synthesized bisphosphonate molecules with varying alkyl chain lengths and functional groups to investigate their impact on calcium carbonate precipitation. Through conductivity measurements, infrared spectroscopy, and thermogravimetric analysis, we uncovered the selective formation of polymorphs and the specific incorporation of these molecules within the carbonate matrix. Further, in situ atomic force microscopy revealed that these molecules influenced the morphology of the precipitates, indicating a possible effect on the ionic organization through sorption mechanisms. Interestingly, amorphous calcium carbonate (ACC), when formed in the presence of bisphosphonates, showed metastability for at least seven months without inhibiting further calcium carbonate precipitation. Our research sheds light on the diverse mechanisms by which organic additives can modify mineral nucleation and growth, offering valuable insights for the control and enhancement of carbonate-based cementation processes.

3.
Diagn Interv Radiol ; 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38874163

RESUMEN

In patients with cancer, spontaneous renal bleeding can stem from a range of underlying factors, necessitating precise diagnostic tools for effective patient management. Benign and malignant renal tumors are among the primary culprits, with angiomyolipomas and renal cell carcinomas being the most common among them. Vascular anomalies, infections, ureteral obstructions, and coagulation disorders can also contribute to renal-related bleeding. Cross-sectional imaging techniques, particularly ultrasound and computed tomography (CT), play pivotal roles in the initial detection of renal bleeding. Magnetic resonance imaging and CT are preferred for follow-up evaluations and aid in detecting underlying enhancing masses. IV contrast-enhanced ultrasound can provide additional information for active bleeding detection and differentiation. This review article explores specific disorders associated with or resembling spontaneous acute renal bleeding in patients with renal tumors; it focuses on the significance of advanced imaging techniques in accurately identifying and characterizing renal bleeding in these individuals. It also provides insights into the clinical presentations, imaging findings, and treatment options for various causes of renal bleeding, aiming to enhance the understanding, diagnosis, and management of the issue.

4.
ChemSusChem ; : e202400657, 2024 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-38942726

RESUMEN

Exploring the transformation of carbohydrates into valuable chemicals offers a promising and eco-friendly method for utilizing renewable biomass resources. Developing a bi-functional, sustainable heterogeneous catalyst is of utmost importance to attain a high level of selectivity for the desired product, 2,5-diformylfuran (DFF), in this direct conversion process. In this study, we developed a highly effective catalytic system to convert diverse carbohydrates into DFF. Our approach involved utilizing a MoS2 catalyst supported by amorphous carbon derived from sulfonated sugarcane biomass. The MoS2@SBG-SO3H composite was successfully synthesized using a facile and highly efficient method. The transformation of fructose into DFF achieved a significant yield of 70% for 5 h at 160 °C using a one-step and one-pot reaction through dehydration and oxidation with oxygen. The oxidation of 5-hydroxymethylfurfural (HMF) into DFF using MoS2@SBG-SO3H was obtained at 94% DFF within 5 h; the activation energy was 38.3 kJ.mol-1. The catalyst displayed convenient recovery and reusability. The direct synthesis of DFF from various carbohydrates, such as sucrose, glucose, maltose, and lactose, resulted in favorable yields. Our research provides a quick, green, and efficient process for preparing carbon-based solid acid catalysts and DFF.

5.
Artículo en Inglés | MEDLINE | ID: mdl-38926267

RESUMEN

Transient receptor potential (TRP) channels play key roles in sensory biology as transducers of various stimuli. Although these ion channels are expressed in the cochlea, their functions remain poorly understood. Recent studies by Vélez-Ortega and colleagues indicate that their expression by non-sensory supporting cells helps limit damage from acoustic trauma.

6.
Heliyon ; 10(7): e28118, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38596094

RESUMEN

In this study, a series of secondary metabolites from Ganoderma sp. were screened against Staphylococcus aureus protein targets, including as phosphotransacetylase, clumping factor A, and dihydrofolate reductase, using molecular docking simulations. The chemicals that showed the strongest binding energy with the targeted proteins were ganodermanontriol, lucidumol B, ganoderic acid J, ergosterol, ergosterol peroxide, 7-oxoganoderic acid Z, ganoderic acid AM1, ganosinoside A, ganoderic acid D, and 24R-ergosta-7,2E-diene-3ß,5α,6ß-triol. Interestingly, ganosinoside A showed the greatest affinity for the protein clumping factor A, a result validated by molecular dynamic simulation. Additionally, three natural Ganoderma sp. Strains as Ganoderma lingzhi VNKKK1903, Ganoderma lingzhi VNKK1905A2, and Amauroderma subresinosum VNKKK1904 were collected from Kon Ka Kinh National Park in central land of Vietnam and evaluated for their antibacterial activity against Staphylococcus aureus using an agar well diffusion technique. These results suggest that the fungal extracts and secondary metabolites may serve as valuable sources of antibiotics against Staphylococcus aureus. These findings provided an important scientific groundwork for further exploration of the antibacterial mechanisms of compounds derived from Ganoderma sp. in future research.

7.
Chemosphere ; 357: 142114, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38663679

RESUMEN

The designed synthesis of an S-scheme heterojunction has possessed a great potential for improving photocatalytic wastewater treatment by demonstrating increased the photoredox capacity and improved the charge separation efficiency. Here, we introduce the fabrication of a heterojunction-based photocatalyst comprising bismuth oxychloride (BiOCl) and bismuth-based halide perovskite (BHP) nanosheets, derived from metal-organic frameworks (MOFs). Our composite photocatalyst is synthesized through a one-pot solvothermal strategy, where a halogenation process is applied to a bismuth-based metal-organic framework (CAU-17) as the precursor for bismuth sourcing. As a result, the rod-like structure of CAU-17 transforms into well-defined plate and nanosheet architectures after 4 and 8 h of solvothermal treatment, respectively. The modulation of the solvothermal reaction time facilitates the establishment of an S-scheme heterojunction, resulting in an increase in the photocatalytic degradation efficiency of rhodamine B (RhB) and sulfamethoxazole (SMX). The optimized BiOCl/BHP composite exhibits superior RhB and SMX degradation rates, achieving 99.8% degradation of RhB in 60 min and 75.1% degradation of SMX in 300 min. Also, the optimized BiOCl/BHP composite (CAU-17-st-8h sample) exhibited the highest rate constant (k = 3.48 × 10-3 min-1), nearly 6 times higher than that of the bare BHP in the photocatalytic degradation process of SMX. The enhanced photocatalytic efficiency can be endorsed to various factors: (i) the in-situ formation of two-components BiOCl/BHP photocatalyst, derived from CAU-17, effectively suppresses the aggregation of pristine BHP and BiOCl particles; (ii) the S-scheme heterostructure establishes a closely-knit interfacial connection, thereby facilitating efficient pathways for charge separation/transfer; and (iii) the BiOCl/BHP heterostructure enhances its capacity to absorb visible light. Our investigation establishes an effective strategy for constructing heterostructured photocatalysts, offering significant potential for application in photocatalytic wastewater treatment.


Asunto(s)
Bismuto , Compuestos de Calcio , Estructuras Metalorgánicas , Óxidos , Rodaminas , Titanio , Contaminantes Químicos del Agua , Bismuto/química , Titanio/química , Compuestos de Calcio/química , Óxidos/química , Catálisis , Contaminantes Químicos del Agua/química , Estructuras Metalorgánicas/química , Rodaminas/química , Fotólisis , Aguas Residuales/química , Procesos Fotoquímicos
8.
bioRxiv ; 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38659950

RESUMEN

Voltage imaging enables high-throughput investigation of neuronal activity, yet its utility is often constrained by a low signal-to-noise ratio (SNR). Conventional denoising algorithms, such as those based on matrix factorization, impose limiting assumptions about the noise process and the spatiotemporal structure of the signal. While deep learning based denoising techniques offer greater adaptability, existing approaches fail to fully exploit the fast temporal dynamics and unique short- and long-range dependencies within voltage imaging datasets. Here, we introduce CellMincer, a novel self-supervised deep learning method designed specifically for denoising voltage imaging datasets. CellMincer operates on the principle of masking and predicting sparse sets of pixels across short temporal windows and conditions the denoiser on precomputed spatiotemporal auto-correlations to effectively model long-range dependencies without the need for large temporal denoising contexts. We develop and utilize a physics-based simulation framework to generate realistic datasets for rigorous hyperparameter optimization and ablation studies, highlighting the key role of conditioning the denoiser on precomputed spatiotemporal auto-correlations to achieve 3-fold further reduction in noise. Comprehensive benchmarking on both simulated and real voltage imaging datasets, including those with paired patch-clamp electrophysiology (EP) as ground truth, demonstrates CellMincer's state-of-the-art performance. It achieves substantial noise reduction across the entire frequency spectrum, enhanced detection of subthreshold events, and superior cross-correlation with ground-truth EP recordings. Finally, we demonstrate how CellMincer's addition to a typical voltage imaging data analysis workflow improves neuronal segmentation, peak detection, and ultimately leads to significantly enhanced separation of functional phenotypes.

9.
Dev Sci ; : e13504, 2024 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-38523055

RESUMEN

It is a central tenet of attachment theory that individual differences in attachment representations organize behavior during social interactions. Secure attachment representations also facilitate behavioral synchrony, a key component of adaptive parent-child interactions. Yet, the dynamic neural processes underlying these interactions and the potential role of attachment representations remain largely unknown. A growing body of research indicates that interpersonal neural synchrony (INS) could be a potential neurobiological correlate of high interaction and relationship quality. In this study, we examined whether interpersonal neural and behavioral synchrony during parent-child interaction is associated with parent and child attachment representations. In total, 140 parents (74 mothers and 66 fathers) and their children (age 5-6 years; 60 girls and 80 boys) engaged in cooperative versus individual problem-solving. INS in frontal and temporal regions was assessed with functional near-infrared spectroscopy hyperscanning. Attachment representations were ascertained by means of the Adult Attachment Interview in parents and a story-completion task in children, alongside video-coded behavioral synchrony. Findings revealed increased INS during cooperative versus individual problem solving across all dyads (𝛸2(2) = 9.37, p = 0.009). Remarkably, individual differences in attachment representations were associated with INS but not behavioral synchrony (p > 0.159) during cooperation. More specifically, insecure maternal attachment representations were related to higher mother-child INS in frontal regions (𝛸2(3) = 9.18, p = 0.027). Conversely, secure daughter attachment representations were related to higher daughter-parent INS within temporal regions (𝛸2(3) = 12.58, p = 0.006). Our data thus provide further indication for INS as a promising correlate to probe the neurobiological underpinnings of attachment representations in the context of early parent-child interactions. RESEARCH HIGHLIGHTS: We assessed attachment representations using narrative measures and interpersonal neural synchrony (INS) during parent-child problem-solving. Dyads including mothers with insecure attachment representations showed higher INS in left prefrontal regions. Dyads including daughters with secure attachment representations showed higher INS in right temporo-parietal regions. INS is a promising correlate to probe the neurobiological underpinnings of attachment representations in the context of parent-child interactions, especially within the mutual prediction framework.

11.
Case Rep Dermatol Med ; 2024: 6748340, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38404530

RESUMEN

Pemphigus foliaceus is an uncommon autoimmune intraepidermal blistering disease characterized by immunoglobulin (Ig) G autoantibodies that attack desmoglein-1 in the epidermis. There are two predominant forms of pemphigus foliaceus, sporadic and endemic. Sporadic pemphigus foliaceus is known to be more prevalent in middle-aged and elderly people and to be extremely rare in children. Less than 40 nonendemic pediatric pemphigus foliaceus cases have been documented in the literature. This report documents a case of sporadic pemphigus foliaceus in a 3-year-old Vietnamese girl who presented with generalized scaling and crusted erosions over the body.

12.
Pediatr Blood Cancer ; 71(4): e30879, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38279845

RESUMEN

BACKGROUND: Adequate oxygen saturation (SpO2 ) is crucial for managing sickle cell disease (SCD). Children with SCD are at increased risk for occult hypoxemia; therefore, understanding SpO2 threshold practices would help identify barriers to oxygen optimization in a population sensitive to oxyhemoglobin imbalances. We investigated SpO2 cutoff levels used in clinical algorithms for management of acute SCD events at children's hospitals across the United States, and determined their consistency with recommended national guidelines (SpO2  > 95%). METHODS: Clinical pathways and algorithms used for the management of vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) in SCD were obtained and reviewed from large children's hospitals in the United States. RESULTS: Responses were obtained from 94% (140/149) of eligible children's hospitals. Of these, 63 (45%) had available clinical algorithms to manage VOC and ACS. SpO2 cutoff was provided in 71.4% (45/63) of clinical algorithms. Substantial variation in SpO2 cutoff levels was noted, ranging from ≥90% to more than 95%. Only seven hospitals (5% of total hospitals and 15.6% of hospitals with clinical algorithms available) specified oxygen cutoffs that were consistent with national guidelines. Hospitals geographically located in the South (46.8%; n = 29/62) and Midwest (54.8%; n = 17/31) were more likely to have VOC and ACS clinical algorithms, compared to the Northeast (26.5%; n = 9/34) and West (36.4%; n = 8/22). CONCLUSION: There is inconsistency in the use of clinical algorithms and oxygen thresholds for VOC and ACS across US children's hospitals. Children with SCD could be at risk for insufficient oxygen therapy during adverse acute events.


Asunto(s)
Síndrome Torácico Agudo , Anemia de Células Falciformes , Compuestos Orgánicos Volátiles , Niño , Humanos , Estados Unidos , Saturación de Oxígeno , Anemia de Células Falciformes/terapia , Anemia de Células Falciformes/complicaciones , Síndrome Torácico Agudo/etiología , Síndrome Torácico Agudo/terapia , Oxígeno , Hospitales
13.
Eur J Obstet Gynecol Reprod Biol ; 294: 123-127, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38237310

RESUMEN

OBJECTIVE: This study evaluated embryological and clinical outcomes in couples with severe male factor infertility versus those with normozoospermia undergoing ICSI and in vitro fertilisation. METHODS: This multicentre, retrospective cohort study included all couples who had undergone autologous ICSI cycles at My Duc Hospital and My Duc Phu Nhuan Hospital in Vietnam between January 2018 and January 2021 (female age < 35 years and males with severe male factor or normozoospermia based on the World Health Organization 2010 criteria). The primary outcome was the cumulative live birth rate after the first ICSI cycle. RESULTS: A total of 1296 couples were included, including 648 with severe male factor infertility and 648 with normozoospermia. The number of two pronuclei zygotes, embryos, and frozen embryos was significantly lower in couples with severe male factor infertility compared with normozoospermia (p < 0.05). In contrast, there were no significant differences between the two groups with respect to cumulative pregnancy outcomes, including the live birth rate, and secondary outcomes including clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate. CONCLUSION: Severe male factor infertility appeared to have an impact on the fertilisation and early developmental potential of embryos, but sperm quality did not affect cumulative clinical fertility outcomes.


Asunto(s)
Infertilidad Masculina , Infertilidad , Embarazo , Masculino , Humanos , Femenino , Adulto , Inyecciones de Esperma Intracitoplasmáticas/métodos , Estudios Retrospectivos , Semen , Infertilidad Masculina/terapia , Fertilización In Vitro/métodos , Índice de Embarazo , Tasa de Natalidad , Nacimiento Vivo
14.
Sci Total Environ ; 912: 168985, 2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38056666

RESUMEN

Understanding the regular variations in water levels and identifying the potential drivers under the combined pressures of anthropogenic activities and climate change can offer valuable insights into riverine management. In this study, we analyzed long-term daily observational data, including water levels and water discharge, spanning from the ~1950s to 2021 at seven gauging stations within the Red River basin. We investigated the spatiotemporal variation in mean water levels using standard analytical tools, including the Mann-Kendall (MK) test, rating curves, and Empirical Orthogonal Function (EOF). Specifically, we observed a notable and substantial decline in water levels downstream of the major tributaries, including Da, Red, and Lo Rivers, as well as at their confluence, starting at the end of 2008. Notably, a strong correlation between water levels and discharge is found, highlighting the pivotal role of discharge in influencing water levels. Surprisingly, relationships between water levels and climatic factors such as rainfall and air temperature proved less influential. This suggests that water levels are predominantly shaped by discharge and anthropogenic activities, rather than climate change. The study emphasized the substantial impact of human-induced activities, particularly dam operation and sand mining, on downstream water levels in the Red River basin. An intriguing finding revealed that upstream dynamics, particularly at the Hoa Binh dam, led to significant water level increases with the same discharge, attributed to channel deposition and reservoir water storage. The research's novelty is the comprehensive evaluation of long-term water level trends and its elucidation of the combined effects of anthropogenic activities and climate change, offering valuable insights for riverine management and emphasizing the influence of anthropogenic factors, notably dam regulation and sand mining, in driving shifts in water levels.

15.
Heliyon ; 9(11): e21274, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38027850

RESUMEN

In this study, the conversion of monosaccharides to 5-hydroxymethylfurfural (5-HMF) using different deep eutectic solvents (DESs) was investigated in various conditions. Among all the investigated DESs, [ChCl][trichloroacetic acid], based on choline chloride and trichloroacetic acid with the ratio 1:1, showed the highest catalytic activity. A maximum 5-HMF yield was 82 % for 1 h at 100 °C using [ChCl][trichloroacetic acid] as a catalyst from fructose. [ChCl][trichloroacetic acid] could be recovered and reused three times with a slight loss in activity. Our work demonstrated the low-cost and effective method for the synthesis of 5-HMF from carbohydrates.

17.
J Biol Chem ; 299(12): 105415, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37918803

RESUMEN

Chikungunya virus (CHIKV) nonstructural protein 1 (nsP1) contains both the N7-guanine methyltransferase and guanylyltransferase activities and catalyzes the 5' end cap formation of viral RNAs. To further understand its catalytic activity and role in virus-host interaction, we demonstrate that purified recombinant CHIKV nsP1 can reverse the guanylyl transfer reaction and remove the m7GMP from a variety of capped RNA substrates including host mRNAs. We then provide the structural basis of this function with a high-resolution cryo-EM structure of nsP1 in complex with the unconventional cap-1 substrate RNA m7GpppAmU. We show that the 5'ppRNA species generated by decapping can trigger retinoic acid-inducible gene I-mediated interferon response. We further demonstrate that the decapping activity is conserved among the alphaviral nsP1s. To our knowledge, this is a new mechanism through which alphaviruses activate the antiviral immune response. This decapping activity could promote cellular mRNA degradation and facilitate viral gene expression, which is functionally analogous to the cap-snatching mechanism by influenza virus.


Asunto(s)
Virus Chikungunya , Endorribonucleasas , Caperuzas de ARN , Proteínas no Estructurales Virales , Humanos , Virus Chikungunya/metabolismo , Caperuzas de ARN/genética , Caperuzas de ARN/metabolismo , ARN Mensajero/metabolismo , ARN Viral/genética , ARN Viral/metabolismo , Proteínas no Estructurales Virales/genética , Proteínas no Estructurales Virales/metabolismo , Replicación Viral , Endorribonucleasas/metabolismo
18.
Dev Cogn Neurosci ; 64: 101313, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37879243

RESUMEN

Infant-directed singing has unique acoustic characteristics that may allow even very young infants to respond to the rhythms carried through the caregiver's voice. The goal of this study was to examine neural and movement responses to live and dynamic maternal singing in 7-month-old infants and their relation to linguistic development. In total, 60 mother-infant dyads were observed during two singing conditions (playsong and lullaby). In Study 1 (n = 30), we measured infant EEG and used an encoding approach utilizing ridge regressions to measure neural tracking. In Study 2 (n =40), we coded infant rhythmic movements. In both studies, we assessed children's vocabulary when they were 20 months old. In Study 1, we found above-threshold neural tracking of maternal singing, with superior tracking of lullabies than playsongs. We also found that the acoustic features of infant-directed singing modulated tracking. In Study 2, infants showed more rhythmic movement to playsongs than lullabies. Importantly, neural coordination (Study 1) and rhythmic movement (Study 2) to playsongs were positively related to infants' expressive vocabulary at 20 months. These results highlight the importance of infants' brain and movement coordination to their caregiver's musical presentations, potentially as a function of musical variability.


Asunto(s)
Canto , Lactante , Femenino , Niño , Humanos , Canto/fisiología , Madres , Encéfalo , Movimiento , Cabeza
19.
RSC Adv ; 13(41): 28623-28631, 2023 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-37780732

RESUMEN

In this work, a new procedure for the synthesis of benzo[a]carbazole from 1,3-diketones, primary amines, phenylglyoxal monohydrate, and malononitrile employing a solid acidic catalyst has been developed. The multicomponent reaction provided 3-cyanoacetamide pyrrole as an intermediate and then the formation of benzo[a]carbazole via intramolecular ring closure. The reaction was carried out for 2 h at 240 °C, resulting in the desired product with 73% yield. Acidic sites on the solid acid catalyst, made from rice husk-derived amorphous carbon with a sulfonic acid core (AC-SO3H), provided the best activity. Acidic sites on the surface of the catalyst, including carboxylic, phenolic, and sulfonic acids, were 4.606 mmol g-1 of the total acidity. AC-SO3H demonstrated low cost, low toxicity, porosity, stability, and flexibility of tuning and reusability.

20.
Healthcare (Basel) ; 11(18)2023 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-37761718

RESUMEN

(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to deliver high-quality breastfeeding and early essential newborn care services within a supportive policy environment. The aim of this project report is to outline the steps undertaken to reduce episiotomies, the experience in pilot hospitals, and the process towards changing policy. (3) Results: During the 14 months following the change in episiotomy policy, pilot hospital records showed no infant death or injury. Monthly monitoring data from four pilot hospitals showed that the prevalence of episiotomy was substantially lower than the average in national hospitals in Vietnam. Facilitators to reducing the episiotomy rate include the incentive of Centers of Excellence for Breastfeeding designation and supportive hospital leadership. Challenges include the ambiguity of Vietnam's national guideline on episiotomy and lack of routine monitoring on the episiotomy rate and indications. (4) Discussion: Our experience suggests that through training and routine monitoring hospitals can apply a policy of selective episiotomy and reduce the practice, particularly among multiparous women, and improve breastfeeding rates.(5) Conclusions: Sharing our experience of implementing this process and offering four areas for action will hopefully contribute to expanded use of mother-friendly, evidence-based care as policy and routine practice in Vietnam and similar settings.

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