Controllable synthesis of layered double hydroxide nanosheets to build organic inhibitor-loaded nanocontainers for enhanced corrosion protection of carbon steel.

The development of layered double hydroxide (LDH) nanosheets as nanocontainers has been intensively studied in recent years. Despite their potential for application on a large scale, their synthesis in an aqueous medium is rarely reported. Herein, we report a straightforward approach for the controllable synthesis of uniform MgAl-LDH nanosheets by an aqueous nucleation process followed by a hydrothermal treatment. The key to this method relies on the well-dispersed LDH nuclei that are produced by high-speed homogenization. Following the nucleation step, the coalescence of the aggregate hydroxide layers is diminished by hydraulic shear forces, leading to the disaggregation and even distribution of LDH nuclei. As a result, the oriented growth of individual crystals along the horizontal plane becomes predominant, leading to a high surface charge density of the hydroxide sheets and preventing their stacking. The electron microscope virtual proofs showed that the particles had a well-defined circular shape with a thickness of about 2-3 nm. Afterward, for the first time, LDH nanosheets were used to prepare LDH nanocontainers loaded with 2-benzothiazolythio-succinic acid (BTSA) by anion exchange. The incorporation of BTSA into the interlayer region and the emission behavior of the inhibitor were investigated. These results indicate that the prepared nanosheets can be utilized as effective nanocontainers for organic inhibitor loading and anti-corrosion application.

User-Centered Design and Usability of a Culturally Adapted Virtual Survivorship Care App for Chinese Canadian Prostate Cancer Survivors: Qualitative Descriptive Study.

BACKGROUND: Cultural adaptations of digital health innovations are a growing field. However, digital health innovations can increase health inequities. While completing exploratory work for the cultural adaptation of the Ned Clinic virtual survivorship app, we identified structural considerations that provided a space to design digitally connected and collective care. OBJECTIVE: This study used a community-based participatory research and user-centered design process to develop a cultural adaptation of the Ned Clinic app while designing to intervene in structural inequities. METHODS: The design process included primary data collection and qualitative analysis to explore and distill design principles, an iterative design phase with a multidisciplinary team, and a final evaluation phase with participants throughout the design process as a form of member checking and validation. RESULTS: Participants indicated that they found the final adapted prototype to be acceptable, appropriate, and feasible for their use. The changes made to adapt the prototype were not specifically culturally Chinese. Instead, we identified ways to strengthen connections between the survivor and their providers; improve accessibility to resources; and honor participants' desires for relationality, accountability, and care. CONCLUSIONS: We grounded the use of user-centered design to develop a prototype design that supports the acts of caring through digital technology by identifying and designing to resist structures that create health inequities in the lives of this community of survivors. By designing for collective justice, we can provide accessible, feasible, and relational care with digital health through the application of Indigenous and Black feminist ways of being and knowing.

Antimicrobial Resistance Patterns of Staphylococcus Aureus Isolated at a General Hospital in Vietnam Between 2014 and 2021.

Purpose: Staphylococcus aureus is a commensal bacteria species that can cause various illnesses, from mild skin infections to severe diseases, such as bacteremia. The distribution and antimicrobial resistance (AMR) pattern of S. aureus varies by population, time, geographic location, and hospital wards. In this study, we elucidated the epidemiology and AMR patterns of S. aureus isolated from a general hospital in Vietnam. Methods: This was a cross-sectional study. Data on all S. aureus infections from 2014 to 2021 were collected from the Microbiology department of Military Hospital 103, Vietnam. Only the first isolation from each kind of specimen from a particular patient was analyzed using the Cochran-Armitage and chi-square tests. Results: A total of 1130 individuals were diagnosed as S. aureus infection. Among them, 1087 strains were tested for AMR features. Most patients with S. aureus infection were in the age group of 41-65 years (39.82%). S. aureus isolates were predominant in the surgery wards, and pus specimens were the most common source of isolates (50.62%). S. aureus was most resistant to azithromycin (82.28%), erythromycin (82.82%), and clindamycin (82.32%) and least resistant to teicoplanin (0.0%), tigecycline (0.16%), quinupristin-dalfopristin (0.43%), linezolid (0.62%), and vancomycin (2.92%). Methicillin-resistant S. aureus (MRSA) and multidrug-resistant (MDR) S. aureus were prevalent, accounting for 73.02% and 60.90% of the total strains respectively, and the strains isolated from the intensive care unit (ICU) had the highest percentage of multidrug resistance (77.78%) among the wards. Conclusion: These findings highlight the urgent need for continuous AMR surveillance and updated treatment guidelines, particularly considering high resistance in MRSA, MDR strains, and ICU isolates. Future research focusing on specific resistant populations and potential intervention strategies is crucial to combat this rising threat.

Comorbidities of diabetes and hypertension in Vietnam: current burden, trends over time, and correlated factors.

BACKGROUND: Vietnam conducted the national Noncommunicable Disease Risk-Factor Surveillance (STEPs) surveys in the years 2010, 2015, and 2021. This study aims to use STEPs data to assess the burden of comorbidity between diabetes and hypertension, analyze trends over time, and identify factors associated with this comorbidity. METHODS: The study extracted data for the population aged 25-64 years old from three STEPs surveys. Survey weight was used for all estimations of prevalence and 95% CI. Correlated factors with comorbidity were examined by a multivariate logistics model. RESULTS: The prevalence of comorbidity in 2021 was about 3.92% among Vietnamese people aged 25-64. In the last 10 years, this prevalence has increased more than 8 times (from 0.44% to 3.92%). Sub-populations demonstrating the most significant changes included the male population, people living in urban areas, and older people. Significant factors correlated with comorbidity included demographic factors, body mass index (BMI), and clustering of 4 noncommunicable diseases (NCDs) behavioral risk factors (OR = 3.48, p < 0.05). CONCLUSION: The high comorbidity between hypertension and diabetes underscores the imperative for integrated treatment and management approaches in Vietnam. Coordinated care is essential for addressing the complex interplay between these two prevalent conditions.

Honoring the Care Experiences of Chinese Canadian Survivors of Prostate Cancer to Cultivate Cultural Safety and Relationality in Digital Health: Exploratory-Descriptive Qualitative Study.

BACKGROUND: Prostate cancer (PCa) is the most commonly diagnosed nonskin cancer for Canadian men and has one of the highest 5-year survival rates, straining systems to provide care. Virtual care can be one way to relieve this strain, but survivors' care needs and technology use are influenced by intersecting social and cultural structures. Cultural adaptation has been posited as an effective method to tailor existing interventions to better serve racialized communities, including Chinese men. However, cultural adaptations may inadvertently draw attention away from addressing structural inequities. OBJECTIVE: This study used qualitative methods to (1) explore the perceptions and experiences of Chinese Canadian PCa survivors with follow-up and virtual care, and (2) identify implications for the cultural adaptation of a PCa follow-up care app, the Ned (no evidence of disease) Clinic. METHODS: An axiology of relational accountability and a relational paradigm underpinned our phenomenologically informed exploratory-descriptive qualitative study design. A community-based participatory approach was used, informed by cultural safety and user-centered design principles, to invite Chinese Canadian PCa survivors and their caregivers to share their stories. Data were inductively analyzed to explore their unmet needs, common experiences, and levels of digital literacy. RESULTS: Unmet needs and technology preferences were similar to broader trends within the wider community of PCa survivors. However, participants indicated that they felt uncomfortable, unable to, or ignored when expressing their needs. Responses spoke to a sense of isolation and reflected a reliance on culturally informed coping mechanisms, such as "eating bitterness," and familial assistance to overcome systemic barriers and gaps in care. Moreover, virtual care was viewed as "better than nothing;" it did not change a perceived lack of focus on improving quality of life or care continuity in survivorship care. Systemic changes were identified as likely to be more effective in improving care delivery and well-being rather than the cultural adaptation of Ned for Chinese Canadians. Participants' desires for care reflected accessibility issues that were not culturally specific to Chinese Canadians. CONCLUSIONS: Chinese Canadian survivors are seeking to strengthen their connections in a health care system that provides privacy and accessibility, protects relationality, and promotes transparency, accountability, and responsibility. Designing "trickle-up" adaptations that address structural inequities and emphasize accessibility, relationality, and privacy may be more effective and efficient at improving care than creating cultural adaptations of interventions.

Design of a Dyadic Digital Health Module for Chronic Disease Shared Care: Development Study.

BACKGROUND: The COVID-19 pandemic forced the spread of digital health tools to address limited clinical resources for chronic health management. It also illuminated a population of older patients requiring an informal caregiver (IC) to access this care due to accessibility, technological literacy, or English proficiency concerns. For patients with heart failure (HF), this rapid transition exacerbated the demand on ICs and pushed Canadians toward a dyadic care model where patients and ICs comanage care. Our previous work identified an opportunity to improve this dyadic HF experience through a shared model of dyadic digital health. We call this alternative model of care "Caretown for Medly," which empowers ICs to concurrently expand patients' self-care abilities while acknowledging ICs' eagerness to provide greater support. OBJECTIVE: We present the systematic design and development of the Caretown for Medly dyadic management module. While HF is the outlined use case, we outline our design methodology and report on 6 core disease-invariant features applied to dyadic shared care for HF management. This work lays the foundation for future usability assessments of Caretown for Medly. METHODS: We conducted a qualitative, human-centered design study based on 25 semistructured interviews with self-identified ICs of loved ones living with HF. Interviews underwent thematic content analysis by 2 coders independently for themes derived deductively (eg, based on the interview guide) and inductively refined. To build the Caretown for Medly model, we (1) leveraged the Knowledge to Action (KTA) framework to translate knowledge into action and (2) borrowed Google Sprint's ability to quickly "solve big problems and test new ideas," which has been effective in the medical and digital health spaces. Specifically, we blended these 2 concepts into a new framework called the "KTA Sprint." RESULTS: We identified 6 core disease-invariant features to support ICs in care dyads to provide more effective care while capitalizing on dyadic care's synergistic benefits. Features were designed for customizability to suit the patient's condition, informed by stakeholder analysis, corroborated with literature, and vetted through user needs assessments. These features include (1) live reports to enhance data sharing and facilitate appropriate IC support, (2) care cards to enhance guidance on the caregiving role, (3) direct messaging to dissolve the disconnect across the circle of care, (4) medication wallet to improve guidance on managing complex medication regimens, (5) medical events timeline to improve and consolidate management and organization, and (6) caregiver resources to provide disease-specific education and support their self-care. CONCLUSIONS: These disease-invariant features were designed to address ICs' needs in supporting their care partner. We anticipate that the implementation of these features will empower a shared model of care for chronic disease management through digital health and will improve outcomes for care dyads.

Fusarium solani PQF9 Isolated from Podocarpus pilgeri Growing in Vietnam as a New Producer of Paclitaxel.

Endophytic fungi are known as an alternative promising source of anticancer drug, paclitaxel, however fungi inhabiting in medicinal plant Podocarpus pilgeri and their paclitaxel production have not been reported to date. In the present study, a total of 15 culturable fungi classified into 5 genera, were successfully recovered from P. pilgeri collected in Vietnam. Screening fungal dichloromethane extracts for anticancer activity revealed that only PQF9 extract displayed potent inhibitory effects on A549 and MCF7 cancer cell lines with IC50 values of 33.9 ± 2.3 µg/mL and 43.5 ± 1.7 µg/mL, respectively. Through PCR-based molecular screening, the isolate PQF9 was found to possess 3 key genes involved in paclitaxel biosynthesis. Importantly, high-performance liquid chromatography quantification showed that fungal isolate PQF9 was able to produce 18.2 µg/L paclitaxel. The paclitaxel-producing fungus was identified as Fusarium solani PQF9 based on morphological and molecular phylogenetic analysis. Intensive investigations by chromatographic methods and spectroscopic analyses confirmed the presence of paclitaxel along with tyrosol and uracil. The pure paclitaxel had an IC50 value of 80.8 ± 9.4 and 67.9 ± 7.0 nM by using cell viability assay on A549 lung and MCF7 breast cancer cells. In addition, tyrosol exhibited strong antioxidant activity by scavenging 2, 2-diphenyl-picrylhydrazyl (DPPH) (IC50 5.1 ± 0.2 mM) and hydroxyl radical (IC50 3.6 ± 0.1 mM). In contrast, no biological activity was observed for uracil. Thus, the paclitaxel-producing fungus F. solani PQF9 could serve as a new material for large-scale production and deciphering paclitaxel biosynthesis. Supplementary Information: The online version contains supplementary material available at 10.1007/s12088-023-01119-z.

Health staff's job motivation post COVID-19 pandemic: A case study in Vietnam.

Objectives: Vietnam has witnessed a severe shortage of qualified staff in the public health sector after the COVID-19 pandemic. Our cross-sectional study aimed to identify job motivation and associated factors among experienced frontline health staff working in public health in order to have preventive measures in the event of future pandemics. Methods: A cross-sectional study, from March 2022 to November 2022 at a Vietnamese public hospital, on the job motivation and the predicted factors of 381 healthcare workers who participated in the frontlines of the COVID-19 pandemic from 2020 to 2021. The survey tool, developed by Mbindyo Patrick (2009), includes three components: (i) job satisfaction, (ii) organizational commitment, and (iii) conscientiousness. The survey tool was revalidated in our study with structural equation model for the construction of job motivation model and confirmatory factor analysis for certifying the elementary three components (factors) of the tool. And the tool's reliability was evaluated by Cronbach's Alpha. Bivariate analysis and multiple logistic regression were used to identify the predicted factors with the job motivation cutoff of 4.0. Results: The tool for job motivation constructs showed all specifications were good fit indices and the Cronbach's Alpha was 0.85. The job motivation of health staff decreased dramatically in all dimensions post COVID-19 pandemic, with a mean score of 3.26. Job satisfaction and organizational commitment were the most negatively impacted areas, with scores of 3.02 and 3.00, respectively. The predicted factors of low job motivation were young age (less than 30 years old), low monthly income (less than $400), high qualification, and non-managerial positions with odds ratio of 2.27, 2.5, 2.09, and 3.61, respectively. Conclusion: Following the COVID-19 outbreak in Vietnam, healthcare workers who had been in the frontlines of the COVID-19 pandemic, had experienced a significant decline in their job motivation, despite their continued employment at public hospitals.

A qualitative study on healthcare professional and patient perspectives on nurse-led virtual prostate cancer survivorship care.

BACKGROUND: Virtual nurse-led care models designed with health care professionals (HCPs) and patients may support addressing unmet prostate cancer (PCa) survivor needs. Within this context, we aimed to better understand the optimal design of a service model for a proposed nurse-led PCa follow-up care platform (Ned Nurse). METHODS: A qualitative descriptive study exploring follow-up and virtual care experiences to inform a nurse-led virtual clinic (Ned Nurse) with an a priori convenience sample of 10 HCPs and 10 patients. We provide a health ecosystem readiness checklist mapping facilitators onto CFIR and Proctor's implementation outcomes. RESULTS: We show that barriers within the current standard of care include: fragmented follow-up, patient uncertainty, and long, persisting wait times despite telemedicine modalities. Participants indicate that a nurse-led clinic should be scoped to coordinate care and support patient self-management, with digital literacy considerations. CONCLUSION: A nurse-led follow-up care model for PCa is seen by HCPs as acceptable, feasible, and appropriate for care delivery. Patients value its potential to provide role clarity, reinforce continuity of care, enhance mental health support, and increase access to timely and targeted care. These findings inform design, development, and implementation strategies for digital health interventions within complex settings, revealing opportunities to optimally situate these interventions to improve care.

Prostate cancer (PCa) survivors in Canada receive follow-up care after treatment through a specialist-led model, which is currently straining to meet patient needs. We interviewed healthcare providers (HCPs) and patients to investigate the design and development of a healthcare service that uses technology, also known as virtual care, to provide nurse-led follow-up care. Mixed experiences with virtual care informed participant feedback and concerns, including impacts of the pandemic and digital literacy considerations. We show that HCPs and patients see potential benefit in virtual nurse-led follow-up care if it can increase access to resources, clarify patient and provider care roles, and improve access and continuity of care. This type of approach to follow-up care may help to improve survivor quality of life and PCa follow-up care while extending the reach of healthcare systems with limited resources.

Maximizing the value of patient and public involvement in the digital health co-design process: A qualitative descriptive study with design leaders and patient-public partners.

Digital health interventions have enormous potential to support patients and the public in achieving their health goals. Nonetheless, many digital health interventions are failing to effectively engage patients and the public. One solution that has been proposed is to directly involve patients and the public in the design process of these digital health interventions. Although there is consensus that involving patients and the public in collaborative design is valuable, design teams have little guidance on how to maximize the value of their collaborative design work. The main objective of this study was to understand how the value of patient and public involvement in digital health design can be maximized, from the perspective of design leaders and patient-public partners. Using a qualitative descriptive methodology, we conducted semi-structured interviews with 19 design leaders and 9 patient-public partners. Interviewees agreed that involving patients and the public was valuable, however, they questioned if current collaborative methods were optimized to ensure maximal value. Interviewees suggested that patient and public collaborative design can add value through four different mechanisms: (1) by allowing the design process to be an empowering intervention itself, (2) by ensuring that the digital health intervention will be effectively engaging for users, (3) by ensuring that the digital health intervention will be seamlessly implemented in practice, and (4) by allowing patient-public collaborations extend beyond the initial product design. Overall, interviewees emphasized that although collaborative design has historically focused on improving the digital health product itself, patients and the public have crucial insights on implementation planning as well as how collaborative design can be used as its own empowering intervention. The results of this paper provide clarity about the ways that patient and public collaborative design can be made more valuable. Digital health design teams can use these results to be more intentional about their collaborative design approaches.

An Actionable Expert-System Algorithm to Support Nurse-Led Cancer Survivorship Care: Algorithm Development Study.

BACKGROUND: Comprehensive models of survivorship care are necessary to improve access to and coordination of care. New models of care provide the opportunity to address the complexity of physical and psychosocial problems and long-term health needs experienced by patients following cancer treatment. OBJECTIVE: This paper presents our expert-informed, rules-based survivorship algorithm to build a nurse-led model of survivorship care to support men living with prostate cancer (PCa). The algorithm is called No Evidence of Disease (Ned) and supports timelier decision-making, enhanced safety, and continuity of care. METHODS: An initial rule set was developed and refined through working groups with clinical experts across Canada (eg, nurse experts, physician experts, and scientists; n=20), and patient partners (n=3). Algorithm priorities were defined through a multidisciplinary consensus meeting with clinical nurse specialists, nurse scientists, nurse practitioners, urologic oncologists, urologists, and radiation oncologists (n=17). The system was refined and validated using the nominal group technique. RESULTS: Four levels of alert classification were established, initiated by responses on the Expanded Prostate Cancer Index Composite for Clinical Practice survey, and mediated by changes in minimal clinically important different alert thresholds, alert history, and clinical urgency with patient autonomy influencing clinical acuity. Patient autonomy was supported through tailored education as a first line of response, and alert escalation depending on a patient-initiated request for a nurse consultation. CONCLUSIONS: The Ned algorithm is positioned to facilitate PCa nurse-led care models with a high nurse-to-patient ratio. This novel expert-informed PCa survivorship care algorithm contains a defined escalation pathway for clinically urgent symptoms while honoring patient preference. Though further validation is required through a pragmatic trial, we anticipate the Ned algorithm will support timelier decision-making and enhance continuity of care through the automation of more frequent automated checkpoints, while empowering patients to self-manage their symptoms more effectively than standard care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2020-045806.

Controllable Synthesis of Hollow Silica Nanoparticles Using Layered Double Hydroxide Templates and Application for Thermal Insulation Coating.

The innovative hollow silica nanoparticle (HSN) material possesses substantial potential for application in the insulation field. The size and shell thickness of HSN are crucial factors in determining their inherent properties, which, in turn, impact their applicability. This research presents a facile approach to synthesizing HSN in which sodium silicate (Na2SiO3) was utilized as the silica precursor that can be directly deposited onto layered double hydroxide (LDH) nanoparticles without the utilization of any surfactant. A subsequent acid treatment was used to eliminate the templates, resulting in the formation of an HSN devoid of mesopores in silica shells. By utilizing various sizes of LDH cores, obtainable via coprecipitation followed by hydrothermal treatment, we were capable of successfully synthesizing the hollow particles with adjustable diameters ranging from 50 to 200 nm. In addition, the shell thickness is varied from 6.8 to 22.5 nm by varying the silicate solution concentration. Results demonstrate that prepared HSNs have low thermal conductivity and high reflectance in the UV-vis-NIR range (averaging 82.1%). These findings suggest that HSN can be utilized as an effective inorganic filler in the formulation of reflective and thermally insulating coatings.

SELF-EXPANDING FOAM VS PRE-PERITONEAL PACKING FOR EXSANGUINATING PELVIC HEMORRHAGE.

BACKGROUND: Mortality for pelvic fracture patients presenting with hemorrhagic shock ranges from 21-57%. The objective of this study was to develop a lethal and clinically-relevant pelvic hemorrhage animal model with and without bony fracture for evaluating therapeutic interventions. ResQFoam is a self-expanding foam that has previously been described to significantly decrease mortality in large-animal models of abdominal exsanguination. We hypothesized that administration of ResQFoam into the pre-peritoneal space could decrease mortality in exsanguinating pelvic hemorrhage. METHODS: Two pelvic hemorrhage models were developed using non-coagulopathic swine. Pelvic hemorrhage model #1: bilateral, closed-cavity, major vascular retro-peritoneal hemorrhage without bony pelvic fracture. After injury, animals received no treatment (control, n = 10), underwent pre-peritoneal packing using laparotomy pads (n = 11), or received ResQFoam (n = 10) injected into the pre-peritoneal space. Pelvic hemorrhage model #2: unilateral, closed-cavity, retro-peritoneal hemorrhage injury (with intra-peritoneal communication) combined with complex pelvic fracture. After injury, animals received resuscitation (control, n = 12), resuscitation with pre-peritoneal packing (n = 10) or with ResQFoam injection (n = 10) into the pre-peritoneal space. RESULTS: For model #1, only ResQFoam provided a significant survival benefit. The median survival times were 50 and 67 minutes for pre-peritoneal packing and ResQFoam, compared to 6 minutes with controls (p = 0.002 and 0.057, respectively). Foam treatment facilitated hemodynamic stabilization and resulted in significantly less hemorrhage (21.5 ± 5.3 g/kg) relative to controls (31.6 ± 5.0 g/kg, p < 0.001) and pre-peritoneal packing (32.7 ± 5.4 g/kg, p < 0.001). For model #2, both ResQFoam and pre-peritoneal packing resulted in significant survival benefit compared to controls. The median survival times were 119 and 124 minutes for the pre-peritoneal packing and ResQFoam groups, compared to 4 minutes with controls (p = 0.004 and 0.013, respectively). CONCLUSIONS: Percutaneous injection of ResQFoam into the pre-peritoneal space improved survival relative to controls, and similar survival benefit was achieved compared to standard pre-peritoneal pelvic packing. The technology has potential to augment the armamentarium of tools to treat pelvic hemorrhage.Study Type: This is a Basic Science paper and, therefore, does not require level of evidence.

The Complexity of Transferring Remote Monitoring and Virtual Care Technology Between Countries: Lessons From an International Workshop.

International deployment of remote monitoring and virtual care (RMVC) technologies would efficiently harness their positive impact on outcomes. Since Canada and the United Kingdom have similar populations, health care systems, and digital health landscapes, transferring digital health innovations between them should be relatively straightforward. Yet examples of successful attempts are scarce. In a workshop, we identified 6 differences that may complicate RMVC transfer between Canada and the United Kingdom and provided recommendations for addressing them. These key differences include (1) minority groups, (2) physical geography, (3) clinical pathways, (4) value propositions, (5) governmental priorities and support for digital innovation, and (6) regulatory pathways. We detail 4 broad recommendations to plan for sustainability, including the need to formally consider how highlighted country-specific recommendations may impact RMVC and contingency planning to overcome challenges; the need to map which pathways are available as an innovator to support cross-country transfer; the need to report on and apply learnings from regulatory barriers and facilitators so that everyone may benefit; and the need to explore existing guidance to successfully transfer digital health solutions while developing further guidance (eg, extending the nonadoption, abandonment, scale-up, spread, sustainability framework for cross-country transfer). Finally, we present an ecosystem readiness checklist. Considering these recommendations will contribute to successful international deployment and an increased positive impact of RMVC technologies. Future directions should consider characterizing additional complexities associated with global transfer.

Maintaining Engagement in Adults with Neurofibromatosis Type 1 to Use the iCanCope Mobile Application (iCanCope-NF).

INTRODUCTION: Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic condition in which chronic pain is a predominant issue. Given the rarity of the disease, there are limited psychosocial treatments for individuals with NF1 suffering with chronic pain. Using mobile applications can facilitate psychosocial treatments; however, there are consistent issues with engagement. Utilizing a mixed methodology, the current study evaluated the customized iCanCope mobile application for NF1 on increasing engagement through the usage of contingency management. METHODS: A mixed methods study from a subset of data coming from a randomized clinical trial that occurred from January 2021 to August 2022 was undertaken. Two groups (iCC and iCC + CM) were exposed to the customized iCanCope mobile application in which engagement data were captured in real-time with daily check-ins for interference, sleep, mood, physical activity, energy levels, goal setting, and accessing article content (coping strategies). Additionally, semi-structured interviews were conducted to gain insight into the participants' experience at the end of the trial. RESULTS: Adults (N = 72) were recruited via NF patient advocacy groups. Significant differences were noted between the groups in total articles read (p = 0.002), goals achieved (p = 0.017), and goals created (p = 008). Additionally, there were significant differences observed between user-generated goals and those that were app recommended (p < 0.001). Both groups qualitatively reported positive feedback on the customized mobile application, indicating that continued usage and engagement of the mobile application were acceptable. CONCLUSIONS: Employing customized mobile applications for adults with NF1 along with contingency management can leverage self-managed pain treatments while providing auxiliary resources to this population.

Semiconductor and topological phases in lateral heterostructures constructed from germanene and AsSb monolayers.

Two-dimensional (2D) heterostructures have attracted a lot of attention due to their novel properties induced by the synergistic effects of the constituent building blocks. In this work, new lateral heterostructures (LHSs) formed by stitching germanene and AsSb monolayers are investigated. First-principles calculations assert the semimetal and semiconductor characters of 2D germanene and AsSb, respectively. The non-magnetic nature is preserved by forming LHSs along the armchair direction, where the band gap of the germanene monolayer can be increased to 0.87 eV. Meanwhile, magnetism may emerge in the zigzag-interline LHSs depending on the chemical composition. Such that, total magnetic moments up to 0.49 µB can be obtained, being produced mainly at the interfaces. The calculated band structures show either topological gap or gapless protected interface states, with quantum spin-valley Hall effects and Weyl semimetal characters. The results introduce new lateral heterostructures with novel electronic and magnetic properties, which can be controlled by the interline formation.

Novel germanene-arsenene and germanene-antimonene lateral heterostructures: interline-dependent electronic and magnetic properties.

Seamlessly stitching two-dimensional (2D) materials may lead to the emergence of novel properties triggered by the interactions at the interface. In this work, a series of 2D lateral heterostructures (LHSs), namely germanene-arsenene (Gem-As8-m) and germanene-antimonene (Gem-Sb8-m), are investigated using first-principles calculations. The results demonstrate a strong interline-dependence of the electronic and magnetic properties. Specifically, the LHS formation along an armchair line preserves the non-magnetic nature of the original materials. However, this is an efficient approach to open the electronic band gap of the germanene monolayer, where band gaps as large as 0.74 and 0.76 eV are induced for Ge2-As6 and Ge2-Sb6 LHSs, respectively. Meanwhile, magnetism may appear in the zigzag-LHSs depending on the chemical composition (m = 3, 4, 5, and 6 for germanene-arsenene and m = 2, 3, 4, 5, and 6 for germanene-antimonene), where total magnetic moments between 0.13 and 0.50 µB are obtained. Herein, magnetic properties are produced mainly by the spin-up state of Ge atoms at the interface, where a small contribution comes from As(Sb) atoms. Spin-resolved band structures show a multivalley profile in both the valence band and the conduction band with a topological insulator-like behavior, where the interface states are derived mainly from the interface Ge-pz state. The results introduce new 2D lateral heterostructures with novel electronic and magnetic properties to allow new functionalities, which could be further explored for optoelectronic and spintronic applications.

First record of the genus Testudobracon Quicke, 1986 (Hymenoptera: Braconidae: Braconinae) in Vietnam, with description of four new species.

Five species of the genus Testudobracon Quicke, 1986 in Vietnam were recognized, and four new species, viz. Testudobracon alius Long, sp. nov., Testudobracon descensus Long, sp. nov., Testudobracon imitator Long, sp. nov., and Testudobracon phiaoacus Long & PQMai, sp. nov. are described and fully illustrated. Additionally, the genus Testudobracon and one species, Testudobracon flavus Tang, Chen & He, 1997, are newly recorded for the Vietnam's braconid fauna. A checklist of the already known of Testudobracon species is provided, a key to Vietnamese species of the genus Testudobracon in Vietnam, their in-country distribution, and differentiation of the known similar species are also given.

Factors related to intracerebral haematoma in patients with aneurysmal subarachnoid haemorrhage in Vietnam: a multicentre prospective cohort study.

OBJECTIVES: To investigate the impact of intracerebral haematoma (ICH) on the outcomes and the factors related to an ICH in patients with aneurysmal subarachnoid haemorrhage (aSAH) in a low- and middle-income country. DESIGN: A multicentre prospective cohort study. SETTING: Three central hospitals in Hanoi, Vietnam. PARTICIPANTS: This study included all patients (≥18 years) presenting with aSAH to the three central hospitals within 4 days of ictus, from August 2019 to June 2021, and excluded patients for whom the admission Glasgow Coma Scale was unable to be scored or patients who became lost at 90 days of follow-up during the study. OUTCOME MEASURES: The primary outcome was ICH after aneurysm rupture, defined as ICH detected on an admission head CT scan. The secondary outcomes were 90-day poor outcomes and 90-day death. RESULTS: Of 415 patients, 217 (52.3%) were females, and the median age was 57.0 years (IQR: 48.0-67.0). ICH was present in 20.5% (85/415) of patients with aSAH. There was a significant difference in the 90-day poor outcomes (43.5% (37/85) and 29.1% (96/330); p=0.011) and 90-day mortality (36.5% (31/85) and 20.0% (66/330); p=0.001) between patients who had ICH and patients who did not have ICH. The multivariable regression analysis showed that systolic blood pressure (SBP) ≥140 mm Hg (adjusted odds ratio (AOR): 2.674; 95% CI: 1.372 to 5.214; p=0.004), World Federation of Neurosurgical Societies (WFNS) grades II (AOR: 3.683; 95% CI: 1.250 to 10.858; p=0.018) to V (AOR: 6.912; 95% CI: 2.553 to 18.709; p<0.001) and a ruptured middle cerebral artery (MCA) aneurysm (AOR: 3.717; 95% CI: 1.848 to 7.477; p<0.001) were independently associated with ICH on admission. CONCLUSIONS: In this study, ICH was present in a substantial proportion of patients with aSAH and contributed significantly to a high rate of poor outcomes and death. Higher SBP, worse WFNS grades and ruptured MCA aneurysms were independently associated with ICH on admission.

Making Sense of Theories, Models, and Frameworks in Digital Health Behavior Change Design: Qualitative Descriptive Study.

BACKGROUND: Digital health interventions are increasingly being designed to support health behaviors. Although digital health interventions informed by behavioral science theories, models, and frameworks (TMFs) are more likely to be effective than those designed without them, design teams often struggle to use these evidence-informed tools. Until now, little work has been done to clarify the ways in which behavioral science TMFs can add value to digital health design. OBJECTIVE: The aim of this study was to better understand how digital health design leaders select and use TMFs in design practice. The questions that were addressed included how do design leaders perceive the value of TMFs in digital health design, what considerations do design leaders make when selecting and applying TMFs, and what do design leaders think is needed in the future to advance the utility of TMFs in digital health design? METHODS: This study used a qualitative description design to understand the experiences and perspectives of digital health design leaders. The participants were identified through purposive and snowball sampling. Semistructured interviews were conducted via Zoom software. Interviews were audio-recorded and transcribed using Otter.ai software. Furthermore, 3 researchers coded a sample of interview transcripts and confirmed the coding strategy. One researcher completed the qualitative analysis using a codebook thematic analysis approach. RESULTS: Design leaders had mixed opinions on the value of behavioral science TMFs in digital health design. Leaders suggested that TMFs added the most value when viewed as a starting point rather than the final destination for evidence-informed design. Specifically, these tools added value when they acted as a gateway drug to behavioral science, supported health behavior conceptualization, were balanced with expert knowledge and user-centered design principles, were complementary to existing design methods, and supported both individual- and systems-level thinking. Design leaders also felt that there was a considerable nuance in selecting the most value-adding TMFs. Considerations should be made regarding their source, appropriateness, complexity, accessibility, adaptability, evidence base, purpose, influence, audience, fit with team expertise, fit with team culture, and fit with external pressures. Design leaders suggested multiple opportunities to advance the use of TMFs. These included improving TMF reporting, design, and accessibility, as well as improving design teams' capacity to use TMFs appropriately in practice. CONCLUSIONS: When designing a digital health behavior change intervention, using TMFs can help design teams to systematically integrate behavioral insights. The future of digital health behavior change design demands an easier way for designers to integrate evidence-based TMFs into practice.