Patient sentiment regarding stroke: Analysis of 2,992 social media posts.

INTRODUCTION: Social media reflects personalized sentiment toward disease and increasingly impacts perceptions of treatment options. This study aims to assess patients experience with and perception of stroke through an analysis of social media posts. METHODS: A variety of terms ("stroke", "stroke survivor", "stroke rehab", "stroke recovery") were used to search for possible qualified posts on Twitter and Instagram. Twitter posts containing "#stroke" and "@stroke" were identified, yielding 2,506 Twitter posts relating to the patient's own experience. Four hundred sixty-eight public Instagram posts marked under "#stroke" and "@stroke," including direct references to the patient's own experience, were analyzed. First vs. recurrent stroke was identified when possible. The posts were coded for themes relating to patient experience with the disease. RESULTS: The most common Twitter theme was raising stroke awareness (23.4 %), while spreading positivity was the most common Instagram theme (66.7 %). Most Twitter posts (93.9 %) were from patients experiencing their first stroke, with only 6.1 % of the posts being about recurrent strokes. Women created the majority of Instagram (75.7 %) and Twitter (77.3 %) posts. Men were more likely to discuss mobility/functional outcomes (p = 0.001) and survival/death (p = 0.014), while women were more likely to recount symptoms (p = 0.014), depression (p = 0.002), fear (p<0.001), and mental health (p = 0.006). CONCLUSION: Stroke patients most often describe their quality of life and discuss raising awareness via social media. Men and women differ in the most commonly shared aspects of their stroke experience. Gauging social media sentiment may guide physicians toward better counseling and psychosocial management of stroke patients.

Prevalence and Risk Factors of Mortality in Emphysematous Pyelonephritis Patients: A Meta-Analysis.

BACKGROUND: Emphysematous pyelonephritis (EP) is a severe necrotizing infection of the renal parenchyma which is associated with significant case mortality. We sought to identify the incidence and predictive risk factors associated with EP mortality. METHODS: Two electronic databases, PubMed and Web of Science, were searched from their inception until June 06, 2021 for relevant articles. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. RESULTS: Of the 1080 retrieved abstracts, 79 underwent full-text review and 45 studies were included in the final analysis, comprising a total cohort of 1303 patients and 177 mortalities. The pooled prevalence of mortality among the patients with EP disease was 13%. Our analysis found a significantly decreasing trend in mortality rates, an increasing trend in minimally invasive intervention and decreasing trends in emergency nephrectomy in the EP studies from 1985 to 2020. Significant risk factors that were associated with a negative impact on survival of EP patients included sepsis (OR = 15.99), shock (OR = 15.57), disturbance of consciousness (OR = 12.11), thrombocytopenia (OR 7.85), acute renal failure (OR = 5.41), Wan classification I (OR = 4.57), emergency nephrectomy (OR = 3.73), Huang-Tseng classification III-IV (OR = 2.4) and medical management alone (OR = 2.04). Female sex (OR = 0.52) and minimally invasive intervention (OR = 0.47) (percutaneous nephrostomy or ureteral stent placement) were associated with decreased mortality rates. CONCLUSIONS: Our study results demonstrated several significant risk factors that could help guide treatment to reduce the mortality risk of EP patients. Clinically, early treatment with a combination of minimally invasive intervention and appropriate medical management may be protective for reducing mortality risk in EP patients.

Enzymatic Treatment of Spent Green Tea Leaves and Their Use in High-Fibre Cookie Production.

Research background: By-products of food industry have been studied as sources of high fibre and antioxidant ingredients for healthy food products, because of their economic and environmental benefits. However, the soluble dietary fibre content of these materials is usually lower than the recommended value that is claimed to bring positive health effects. Enzymatic treatment could be an efficient method for modifying insoluble and soluble dietary fibre contents of these materials. The purpose of this study is to investigate the effects of enzymatic treatment conditions on soluble, insoluble and total dietary fibre mass fractions in spent green tea leaves, and evaluate the quality of dough and cookies when different mass fractions of untreated and treated leaves were added to the recipe. Experimental approach: The mass fractions of soluble, insoluble and total dietary fibre in spent tea leaf powder was evaluated after the leaves were treated with cellulase amount of 0-25 U/g for 0 to 2 h. Wheat flour was replaced by untreated and treated spent tea leaf powder at 0, 10, 20, 30 and 40% in cookie formulation. Textural properties of dough, proximate composition, physical properties and overall acceptability of cookies were analysed. Results and conclusions: The appropriate conditions for enzymatic treatment were enzyme loading of 20 U/g and biocatalytic time of 1.5 h, under which the mass fraction of soluble dietary fibre in spent tea leaves increased by 144.5% compared to that of the control sample. The addition of spent tea leaves led to the increase in dough hardness. Increase in the spent tea leaf amount also enhanced fibre mass fraction, antioxidant activity and hardness of cookies but reduced their overall acceptability. Moreover, the enzymatic treatment of spent tea leaves improved the soluble to total dietary fibre ratio of the cookies, which influenced their textural properties and health benefits. The cookies with added 20% untreated or treated spent tea leaves were overall accepted by the panel. Novelty and scientific contribution: For the first time, spent tea leaves have been treated with enzymes to improve their soluble to total dietary fibre ratio. The treated spent tea leaves are a new promising high-fibre antioxidant ingredient for cookie preparation.

Impact of Clinical Decision Support on Antibiotic Prescribing for Acute Respiratory Infections: a Cluster Randomized Implementation Trial.

BACKGROUND: Clinical decision support (CDS) is a promising tool for reducing antibiotic prescribing for acute respiratory infections (ARIs). OBJECTIVE: To assess the impact of previously effective CDS on antibiotic-prescribing rates for ARIs when adapted and implemented in diverse primary care settings. DESIGN: Cluster randomized clinical trial (RCT) implementing a CDS tool designed to guide evidence-based evaluation and treatment of streptococcal pharyngitis and pneumonia. SETTING: Two large academic health system primary care networks with a mix of providers. PARTICIPANTS: All primary care practices within each health system were invited. All providers within participating clinic were considered a participant. Practices were randomized selection to a control or intervention group. INTERVENTIONS: Intervention practice providers had access to an integrated clinical prediction rule (iCPR) system designed to determine the risk of bacterial infection from reason for visit of sore throat, cough, or upper respiratory infection and guide evidence-based evaluation and treatment. MAIN OUTCOME(S): Change in overall antibiotic prescription rates. MEASURE(S): Frequency, rates, and type of antibiotics prescribed in intervention and controls groups. RESULTS: 33 primary care practices participated with 541 providers and 100,573 patient visits. Intervention providers completed the tool in 6.9% of eligible visits. Antibiotics were prescribed in 35% and 36% of intervention and control visits, respectively, showing no statistically significant difference. There were also no differences in rates of orders for rapid streptococcal tests (RR, 0.94; P = 0.11) or chest X-rays (RR, 1.01; P = 0.999) between groups. CONCLUSIONS: The iCPR tool was not effective in reducing antibiotic prescription rates for upper respiratory infections in diverse primary care settings. This has implications for the generalizability of CDS tools as they are adapted to heterogeneous clinical contexts. TRIAL REGISTRATION: Clinicaltrials.gov (NCT02534987). Registered August 26, 2015 at https://clinicaltrials.gov.

Knowledge, Attitude, and Practice Regarding Breast Cancer Early Detection Among Women in a Mountainous Area in Northern Vietnam.

Breast cancer is the most common cancer in women all over the world, also in Vietnam. In recent years, the incidence of breast cancer has been increasing in Vietnam, and most cases are diagnosed at late stages, making treatment more difficult. More and better early detection could help more women to survive. The aim of this study was to identify the current knowledge, attitude and practice about early detection of breast cancer as well as potential predictors of breast cancer screening among women aged 20 to 49 year in a mountainous commune in Thanh Hoa Province, Vietnam, in a largely ethnic Muong population. Women aged 20 to 49 years were selected by systematic random sampling to participate in a cross sectional study in October 2017. They were interviewed with a closed questionnaire about their knowledge of breast cancer, its risk factors, and warning signs. A checklist for performance of breast self-examination was also applied. Three hundred six women agreed to participate in the study. More than half had a low level of knowledge, and were weak in attitude and practice about breast self-examination, clinical breast examination, breast ultrasound, and mamography. Among women who had practiced at least 1 screening method, 17.0% mentioned clinical breast examination, and only 13.8% reported practicing breast self-examination. Factors associated with practice included knowledge about breast cancer early detection (BCED), ethnicity, income, the BCED information approach, and the BCED screening programs approach. The finding of a very low proportion of women in the mountainous setting with good awareness and practice on early detection of breast cancer is important evidence to inform the BCED intervention program developers about where and how to target which information, especially to reach more ethnic minority women.

Radiofrequency Ablation for Benign Thyroid Nodules: 1-Year Follow-Up in 184 Patients.

BACKGROUND: Benign thyroid nodules are common, and must be treated when symptomatic. Non-surgical minimally invasive modalities, including radiofrequency ablation (RFA), have been widely used with good results. The factors related to the efficacy of RFA are still debated. This study was to evaluate the safety, efficacy and related factors of RFA in the treatment of benign thyroid nodules. METHODS: A retrospective single-center study was conducted on 251 benign thyroid nodules in 184 patients treated with RFA. The procedure was performed under ultrasound (US) guidance using the trans-isthmic approach and the moving-shot technique. Clinical and US examinations were performed at 1, 3, 6, 12 months, and then at 6 month intervals. Study outcomes were volume reduction ratio (VRR) and complications. RESULTS: There were 153 women and 31 men included in the study. The mean age was 43.9 years. The median initial largest diameter and volume of nodules were 30 mm and 6.18 ml. The median length of follow-up was 12 months. Two minor complications were found. The mean VRR was 66.8; 74.3; and 81% after 3, 6, and 12 months, respectively. Initial solidity was a factor related to the efficacy: cystic nodules had higher VRR compared to solid ones. CONCLUSIONS: RFA is safe, effective and can be used as a routine treatment for benign thyroid nodules. More prospective multicenter studies with long-term follow-up are required to improve the safety and efficacy of RFA.

A systematic review of effort-reward imbalance among health workers.

The purpose of this article is to systematically collate effort-reward imbalance (ERI) rates among health workers internationally and to assess gender differences. The effort-reward (ER) ratio ranges quite widely from 0.47 up to 1.32 and the ERI rate from 3.5% to 80.7%. Many studies suggested that health workers contribute more than they are rewarded, especially in Japan, Vietnam, Greece, and Germany-with ERI rates of 57.1%, 32.3%, 80.7%, and 22.8% to 27.6%, respectively. Institutions can utilize systems such as the new appraisal and reward system, which is based on performance rather than the traditional system, seniority, which creates a more competitive working climate and generates insecurity. Additionally, an increased workload and short stay patients are realities for workers in a health care environment, while the structure of human resources for health care remains inadequate. Gender differences within the ER ratio can be explained by the continued impact of traditional gender roles on attitudes and motivations that place more pressure to succeed for men rather than for women. This systematic review provides some valued evidence for public health strategies to improve the ER balance among health workers in general as well as between genders in particular. An innovative approach for managing human resources for health care is necessary to motivate and value contributions made by health workers.

Development of hyaluronic acid based polysaccharide-protein composite edible coatings for preservation of strawberry fruit.

With the growing demand for extending the shelf-life of perishable goods such as fruits and vegetables, there is continued interest towards the development of edible coatings derived from natural sources. To avoid rapid dissolution, water insoluble polysaccharide such as chitosan has been widely explored. In this work, we developed robust hyaluronic acid-based edible polysaccharide-protein coatings by combining it (hyaluronic acid) with chitosan and gelatin to introduce additional antioxidant properties. This work is the first example of using hyaluronic acid in edible coatings for fruit preservation. The effect of developed edible composite coatings on the quality of coated strawberries was investigated over a 15 day storage period with 3-day examination intervals. The obtained results revealed hyaluronic acid dose-dependent improvement in intrinsic properties of coated strawberries including weight loss, pH, titratable acidity (TA) and total solids content (TSS). Furthermore, the inclusion of hyaluronic acid significantly enhanced the antioxidant properties of developed edible coatings as measured using total phenolic content, change in ascorbic acid content and DPPH assay prolonging the shelf-life of coated strawberries.

High-throughput experimentation for photocatalytic water purification in practical environments.

High-throughput screening instrument was developed for photocatalytic water purification, enabling the simultaneous testing of 132 photocatalytic reactions under uniform visible light irradiation, temperature control, and stirring. The instrument was used to investigate the effects of different catalysts (TiO2, ZnO, α-Fe2O3) and environmental waters (seawater, urban wastewater, and industrial wastewater) on dye degradation. It was observed environmental ions, particularly carbonate and phosphate ions, significantly reduced catalyst activity by inhibiting the adsorption of dye molecules. To develop effective catalysts for dye degradation in industrial wastewater, 15 types of noble metal nanoparticles (NPs) were supported on photocatalysts. The study found that noble metal NPs with high work functions and oxidation resistance, such as Au and Pt, exhibited higher activity even in the industrial wastewater, likely converting environmental ions into active species. These findings, based on 432 test results, demonstrate the effectiveness of the developed high-throughput screening instrument for optimizing photocatalytic water purification.

A 15-Year Experience With Total Anomalous Pulmonary Venous Connection in Vietnam.

BACKGROUND: This article aims to demonstrate the morphology of 261 total anomalous pulmonary venous connection (TAPVC) cases operated at Children's Hospital 1 with in-hospital mortality of 19.5% (51/261). METHODS: All the surgical protocols of TAPVC cases repaired between 2008 and June 2023 were reviewed. The descriptions of TAPVC were based on operative findings by surgeons. RESULTS: A total of 261 TAPVC patients were operated, including 124 (47.5%) supra, 83 (31.8%) intra, 41 (15.7%) infra, and 13 (5%) mixed cases. The in-hospital mortality was 19.5% (51/261). Fifteen cases are associated with other anomalies of the heart. Four subtypes of 124 supra TAPVC were found, with 42 (33.9%) obstructed cases. The standard was all pulmonary veins (PVs) forming a common vein (CV) and draining into the innominate veins, then going to the superior vena cava (SVC) (100/124, 80.6%). Eleven supra TAPVC cases were vascular vise type. Ten cases had the vertical vein running from the right of the CV and draining directly into the SVC. Of 83 intracardiac TAPVCs with 9 (10.8%) obstructed cases, the most common was all PVs draining directly into the coronary sinus (60/83, 72.3%). The second was all PVs draining directly into the right atrium (RA) via separated ostia or forming a CV before entering the RA (17/83, 20.5%). Also, there were three cases with rare variants and 100% obstruction when the diagnosis was explored. The in-hospital mortality of intracardiac type was 13.3% (11/83) 41 infra TAPVC with obstructed rate of 61% (25/41) and in-hospital mortality of 29.3% (12/41). Thirteen mixed TAPVCs were repaired, with most cases having three PVs forming a CV. CONCLUSION: This article provides valuable information about the morphology of TAPVC types in Asian patients.

Study on the clinical and electrophysiological characteristics of nerve function in myasthenia gravis patients in Vietnam.

Background: In Vietnam, there is limited research on the role of nerve conduction in myasthenia gravis and its association with clinical features. Objective: This study aims to describe the electrophysiological features in patients with myasthenia gravis. Methods: This descriptive study was conducted from September 2019 to December 2021. The study included 33 myasthenia gravis patients who sought medical consultation or received inpatient treatment during this period. The Myasthenia Gravis Foundation of America classifies myasthenia gravis into five groups: I, IIa, IIb, IIIa, IIIb, IVa, IVb, and V. Notably, Group I involves pure ocular weakness, whereas Group a primarily impacts limb and axial muscles, and Group b mainly affects bulbar and respiratory muscles. Results: The study revealed that motor and sensory nerve conduction in the upper and lower limbs were within normal limits for the patient group under evaluation. Repetitive nerve stimulation testing at a frequency of 3 Hz showed positive results in 66.7% of myasthenia gravis patients. Myasthenia gravis patients displayed distinct clinical symptoms, with ptosis being the most common (87.9%). Myasthenia Gravis Foundation of America classification indicated the highest proportion in subgroup IIa (24.2%), with myasthenia gravis predominating in limb and axial muscles (Group a) observed in 51.5% of cases. Needle electromyography showed no abnormalities in myasthenia gravis patients. There was an association between acetylcholine receptor antibody titers and the results of the 3 Hz repetitive nerve stimulation test in myasthenia gravis patients, with a significance of p = 0.002. Conclusion: Nerve conduction studies should be performed in patients with suspected neuromuscular disorders to aid in differential diagnosis and definitive diagnosis of myasthenia gravis.

Changes in the levels of serum glial fibrillary acidic protein and the correlation with outcomes in severe traumatic brain injury patients.

Purpose: Glial fibrillary acidic protein serves as a biomarker indicative of astroglial injury, particularly following instances of severe traumatic brain injury. This study aims to evaluate variations in serum glial fibrillary acidic protein levels within the first 3 days and their correlation with outcomes in patients with severe traumatic brain injury. Subjects and methods: Thirty-nine patients with severe traumatic brain injury were enrolled in the study. Their blood samples were collected at six distinct time points: T0 (upon admission), T1, T2, T3, T4, and T5 (6-, 12-, 24-, 48-, and 72-h post-admission, respectively). The blood samples were run for the quantification of serum glial fibrillary acidic protein levels and other biochemical tests. All patients were closely watched and the outcomes at discharge were evaluated. Results: Glial fibrillary acidic protein levels tend to increase gradually from the time of admission to 48 h post-admission and then decrease at 72 h post-admission. Glial fibrillary acidic protein T2 is correlated with Acute Physiology and Chronic Health Evaluation II score, lactate, Simplified Acute Physiology Score II score and outcome. Glial fibrillary acidic protein max correlated with lactate, Acute Physiology and Chronic Health Evaluation II score, Simplified Acute Physiology Score II score, and outcome. Glasgow Coma Score at admission and glial fibrillary acidic protein T2 (OR = 1.034; p = 0.025), T3 (OR = 1.029; p = 0.046), T4 (OR = 1.006; p = 0.032), T5 (OR = 1.012; p = 0.048) and glial fibrillary acidic protein max (OR = 1.005; p = 0.010) were independent factors that have significant prognostic value in mortality in patients with severe traumatic brain injury. The predictive model in predicting mortality had the highest area under the curve based on glial fibrillary acidic protein T2 and Glasgow Coma Score T0 with an area under the curve of 0.904 and p < 0.001. In the multivariable regression model, glial fibrillary acidic protein max was associated with Glasgow score (p < 0.001; VIF = 1.585), lactate T0 (p = 0.024; VIF = 1.163), Acute Physiology and Chronic Health Evaluation II score (p = 0.037; VIF = 1.360), and Rotterdam score (p = 0.044; VIF = 1.713). Conclusion: Glial fibrillary acidic protein levels tend to increase gradually from the time of admission to 48 h post-admission then decreases at 72 h post-admission. Glial fibrillary acidic protein T2, T3, T4, T5, and glial fibrillary acidic protein max were independent factors with significant prognostic mortality values in patients with severe traumatic brain injury.

Relationship between financial inclusion, monetary policy and financial stability: An analysis in high financial development and low financial development countries.

This article studies the linkage between financial inclusion, monetary policy and financial stability in 58 countries including 31 high financial development countries (HFDCs) and 27 low financial development countries (LFDCs) from 2004 to 2020 using the PVAR method. Results of impulse - response function suggest that in LFDCs, while financial inclusion and financial stability are positively correlated, they are negatively correlated with the inflation rate and the money supply growth rate. In HFDCs, financial inclusion is positively corelated with inflation rate and money supply growth rate, while financial stability is negatively correlated with financial inclusion, inflation rate and money supply growth rate. These findings imply that in LFDCs, financial inclusion increases financial stability and reduces inflation. In HFDCs, on the contrary, financial inclusion increases financial instability, leading to long-term inflation. The results of the variance decomposition confirm the above outcomes, specifically, this relationship is clearer in HFDCs. From the above findings, we propose some policy recommendations on financial inclusion and monetary policy for financial stability for each group of countries.

Breast cancer molecular subtype and relationship with clinicopathological profiles among Vietnamese women: A retrospective study.

BACKGROUND: Molecular subtypes play an important role in predicting prognosis and guiding treatment for breast cancer. Having a better knowledge of ethnic molecular features is essential. OBJECTIVES: Determining the distribution of various breast cancer molecular subtypes and investigating the relationship between these subtypes and clinicopathological features. METHODS: Retrospective data was collected from Hanoi National Cancer Hospital and Bach Mai Hospital that included 274 women diagnosed with invasive breast cancer between January 2017 and June 2019. Patients were categorized into five subtypes according to the 2015 St. Gallen molecular classification. The variables analyzed were molecular subtypes and tumor-related characteristics. To evaluate the relationship between these subtypes and clinicopathological features, a Chi-squared test and Fisher exact test were performed. RESULTS: The most prominent subtype was Luminal A (33.2%), followed by Luminal B/Her2- (19.7%) and Luminal B/Her2 + (17.5%), then HER2 overexpression (16.4%), whereas triple negative was the least popular subtype (13.1%). Particularly, 33.9% of all patients, including the Luminal B/Her2 + and the HER2 overexpressing groups, were Her2 positive. There was a statistically significant difference between molecular subtypes and histological type (p = 0.01), tumor grade (p < 0.001), but it was independent of age, tumor size, lymph node metastasis, and lymphovascular invasion. CONCLUSIONS: In contrast to the triple negative variant, the Luminal A variant is the most common among Vietnamese women. The rate of positive tests for HER2 was rather high. These subtypes were closely related to tumor grade and histopathological type. Understanding the molecular subtypes and their relation to clinicopathological features helps clinicians with patient treatment, and prognosis. The application of the 2015 St. Gallen molecular classification should be recommended for use in clinical practice.

Schwann cell-matrix coated PCL-MWCNT multifunctional nanofibrous scaffolds for neural regeneration.

Nerve tissue engineering aims to create scaffolds that promote nerve regeneration in the damaged peripheral nervous system. However, there remain some challenges in the construction of scaffolds in terms of mechanical properties and cellular behaviour. The present work aims to develop multifunctional implantable nanofibrous scaffolds for nerve regeneration. Using electrospinning, nanofibrous neat polycaprolactone (PCL) and PCL/multiwalled carbon nanotubes (PCL-MWCNT) composite scaffolds were prepared in random and aligned morphology. Schwann cells and their secreted biochemical factors are responsible for neuronal survival in the peripheral nervous system. Therefore, the acellular matrix of Schwann cells was spin-coated on the PCL-MWCNT scaffolds to aid nerve regeneration. Physicochemical and mechanical properties, and the in vitro cellular response of the developed nanofibrous were investigated. We observed no significant change in fibre diameter between neat PCL and PCL-MWCNT scaffolds regardless of the morphology. However, the inclusion of MWCNT reduced the mechanical strength of nanocomposite scaffolds compared to neat PCL. In vitro study revealed biocompatibility of the developed scaffolds both with and without an acellular matrix. Gene expression study revealed a significant increase in peripheral myelin protein (PMP22) expression on acellular matrix-coated PCL-MWCNT scaffolds compared to neat PCL counterparts. Overall, the results suggested Schwann cell matrix-coated PCL-MWCNT nanofibers as a promising conduit for peripheral nerve regeneration.

Secondary Mediastinal Bleeding Caused by Parathyroid Adenocarcinoma: A Case Report.

Introduction: The clinical picture of parathyroid tumors is mainly related to hypercalcemia such as kidney stones and bone and muscle pain. However, spontaneous cervical hemorrhage due to parathyroidoma bleeding is rare with clinical manifestations of the painful swelling and bruising of the neck accompanied by dysphagia and dyspnea. Case presentation: We report a case of a 71-year-old female patient who presented with acute cervical swelling and extensive bleeding spreading from the neck to the abdomen and 2 flanks. Investigation of patients revealed increased parathyroid hormone levels and hypercalcemia. The neck ultrasound showed the thyroid nodules in 2 lobes, and goiter plongeant on the right. Computed tomography scan images showed a hematoma spreading from the right side of the neck to the mediastinum. Result: The patient required emergency surgery due to dyspnea and hemodynamic instability. The preoperative diagnosis was cervical bleeding with the likely cause being thyroid nodule rupture. However, during the surgery, the bleeding source was determined to be the right parathyroid tumor located deeply below the superior mediastinum. The patient's histopathological result of the tumor is parathyroid adenocarcinoma. Conclusion: From our experience, the hemorrhage from parathyroid tumor should be considered as a cause of acute neck bleeding when no history of trauma or surgery is identified. Post-surgery histopathological analyses of the tumor are very important to detect parathyroid adenocarcinoma.

Microbial contamination in the coastal aquaculture zone of the Ba Lat river mouth, Vietnam.

Contamination of aquaculture products by pathogenic organisms is a major concern in areas where this activity is of high economic importance. The abundances of total coliforms (TC), Escherichia coli (EC) and faecal streptococci (FS) (in CFU.100 mL-1) in seawater in the Red River coastal aquaculture zone were determined. The results showed TC numbers (200 to 9100; average 1822), EC (<100 to 3400; average 469) and FS (<100 to 2100; average 384), of which TC exceeded the allowable threshold of the Vietnam regulation for coastal aquaculture water. TC and EC numbers in 4 wastewater types (domestic, livestock farming sewage, agricultural runoff, and mixed sewage canals) were investigated and revealed the importance of point sources of faecal contamination in seawater. These results underline the need to reduce the release of untreated wastewater and to put into place seawater microbial quality monitoring in areas where the development of sustainable aquaculture is an objective.

Laparoscopic retroperitoneal heminephrectomy for renal cell carcinoma in horseshoe kidney: a case report and review of the literature.

INTRODUCTION: In this case report, we demonstrate our technique of a retroperitoneal laparoscopic heminephrectomy for a T1b right hilar tumor in a horseshoe kidney. CASE PRESENTATION: A 77-year-old Vietnamese woman presented to the hospital because of right flank pain. On presentation, her serum creatinine was 0.86 mg/dL and glomerular filtration rate was 65.2 mL/minute/1.73 m2. According to her renal scintigraphy, glomerular filtration rates of the right and left moieties were 24.2 and 35.5 mL/minute, respectively. Computed tomography imaging demonstrated a 5.5 × 5.0 cm solid hilar mass with a cT1bN0M0 tumor stage was in the right moiety. After discussion, the patient elected a minimally invasive surgery to treat her malignancy. The patient was placed in a flank position. We used Gaur's balloon technique to create the retroperitoneal working space, and four trocar ports were planned for operation. Three arteries were dissected, including two arteries feeding the right moiety, one artery feeding the isthmus, and one vein, which was clipped and divided by Hem-o-lok. The isthmusectomy was performed with an Endostapler. Consequently, the ureter was clipped and divided. Finally, the whole right segment of the horseshoe kidney was mobilized and taken out via the flank incision. RESULTS: The total operative time was 250 min with an estimated blood loss of 200 mL. The patient's serum creatinine after surgery was 1.08 mg/dL, and glomerular filtration rate was 49.47 mL/minute/1.73 m2. The patient was discharged on postoperative day #4 without complication. Final pathologic examination of the tumor specimen revealed a Fuhrman grade II clear cell renal cell carcinoma, capsular invasion, with negative surgical margins. After a three-month follow-up, the serum creatinine was 0.95 mg/dL, and glomerular filtration rate was 57.7 mL/minute/1.73 m2. Local recurrence or metastasis was not detected by follow-up computed tomography imaging. CONCLUSIONS: Retroperitoneal laparoscopic heminephrectomy is a safe and feasible technique for patients with renal cell carcinoma in a horseshoe kidney and may be particularly useful in low income settings without access to robotic technology.

Relationship Between Maternal Serum Cortisol and Maternal Insulin Resistance and Fetal Ultrasound Characteristics in Gestational Diabetes Mellitus.

Introduction: Cortisol is proven to play a crucial role in hyperglycemia and fetal development in gestational diabetes mellitus (GDM). This research aims to investigate the relationship between maternal serum cortisol and insulin resistance indices and fetal ultrasound characteristics in women with GDM. Methods: A cross-sectional and descriptive study on 144 GDM in Vietnam from January 2015 to December 2020. Serum cortisol was measured using electrochemiluminescence immunoassay at 8 a.m. on the examination day in the vicinity of the 24th gestational week. Fetal ultrasound was performed by an experienced person who was blind to the study. Results: The mean cortisol level in the GDM group was 627.04 nmol/L. Serum cortisol levels positively correlated with abdominal circumference (AC), fasting plasma glucose (FPG), insulin, triglycerides, HOMA2-IR, and Mathew indices (with r of 0.18, 0.22, 0.18, 0.17, 0.18, and 0.22, respectively). Serum cortisol levels negatively correlated with QUICKI and McAuley indices (with r of -0.19 and -0.21), respectively. In a univariate linear regression, maternal serum cortisol positively correlated with fetal AC, head circumference (HC), and biparietal diameter (BPD) (with r of 0.21; 0.23; and 0.25, respectively). In a multivariate linear regression analysis, cortisol positively correlated with fetal AC, HC, and BPD after adjusting to maternal McAuley index. Conclusion: Serum cortisol levels in GDM correlated with fasting blood glucose, triglycerides, and insulin resistance. Besides, serum cortisol levels in GDM positively correlated with fetal development.

Relationship Between Metacognitive Awareness of Undergraduate Students and Students' Academic Performance at Vietnam Military Medical University.

Introduction: Metacognition plays an essential role in competency-based medical education. Metacognitive skills consist of knowledge and regulation metacognition. This study was conducted to investigate the metacognition of undergraduate students and its correlation with students' academic performance. Methods: The metacognitive skills inventory comprised 52 binary-scale items administered to 202 Vietnam Military Medical University medical students. The entire semester and clinical results were used to measure their academic performance. Results: Medical students' total metacognitive awareness score was high (median 0.8). The median metacognitive knowledge score was significantly lower than the metacognitive regulation score (0.7 vs 0.8, respectively). The participants with a total metacognition score ≥0.8 had significantly higher academic results (full semester exam results of 7.4 and clinical exam of 7.5). The group of participants in the military, having sports habits and usually searching academic documents in English, had a higher proportion of total metacognitive awareness score ≥0.8 than the group without these above characteristics (with the percentages of 53.3%, 59%, and 64.3%, respectively; p < 0.05). The number of books read by participants with a total metacognitive awareness score ≥ 0.8 was significantly higher than those with a total metacognitive awareness score <0.8 (3.5 compared to 2.4 books). Conclusion: Metacognitive awareness of Vietnam Military Medical University medical students was likely to be high. A high score of metacognitive awareness could predict high academic performance. Being a military student, playing sports, reading books, and searching English documents were predictors of better metacognitive awareness.