Perioperative Durvalumab for Resectable Non-Small-Cell Lung Cancer.

BACKGROUND: Neoadjuvant or adjuvant immunotherapy can improve outcomes in patients with resectable non-small-cell lung cancer (NSCLC). Perioperative regimens may combine benefits of both to improve long-term outcomes. METHODS: We randomly assigned patients with resectable NSCLC (stage II to IIIB [N2 node stage] according to the eighth edition of the AJCC Cancer Staging Manual) to receive platinum-based chemotherapy plus durvalumab or placebo administered intravenously every 3 weeks for 4 cycles before surgery, followed by adjuvant durvalumab or placebo intravenously every 4 weeks for 12 cycles. Randomization was stratified according to disease stage (II or III) and programmed death ligand 1 (PD-L1) expression (≥1% or <1%). Primary end points were event-free survival (defined as the time to the earliest occurrence of progressive disease that precluded surgery or prevented completion of surgery, disease recurrence [assessed in a blinded fashion by independent central review], or death from any cause) and pathological complete response (evaluated centrally). RESULTS: A total of 802 patients were randomly assigned to receive durvalumab (400 patients) or placebo (402 patients). The duration of event-free survival was significantly longer with durvalumab than with placebo; the stratified hazard ratio for disease progression, recurrence, or death was 0.68 (95% confidence interval [CI], 0.53 to 0.88; P = 0.004) at the first interim analysis. At the 12-month landmark analysis, event-free survival was observed in 73.4% of the patients who received durvalumab (95% CI, 67.9 to 78.1), as compared with 64.5% of the patients who received placebo (95% CI, 58.8 to 69.6). The incidence of pathological complete response was significantly greater with durvalumab than with placebo (17.2% vs. 4.3% at the final analysis; difference, 13.0 percentage points; 95% CI, 8.7 to 17.6; P<0.001 at interim analysis of data from 402 patients). Event-free survival and pathological complete response benefit were observed regardless of stage and PD-L1 expression. Adverse events of maximum grade 3 or 4 occurred in 42.4% of patients with durvalumab and in 43.2% with placebo. Data from 62 patients with documented EGFR or ALK alterations were excluded from the efficacy analyses in the modified intention-to-treat population. CONCLUSIONS: In patients with resectable NSCLC, perioperative durvalumab plus neoadjuvant chemotherapy was associated with significantly greater event-free survival and pathological complete response than neoadjuvant chemotherapy alone, with a safety profile that was consistent with the individual agents. (Funded by AstraZeneca; AEGEAN ClinicalTrials.gov number, NCT03800134.).

Unsupervised Learning-Based Measurement of Ultrasonic Axial Transmission Velocity in Neonatal Bone.

OBJECTIVES: To develop a robust algorithm for estimating ultrasonic axial transmission velocity from neonatal tibial bone, and to investigate the relationships between ultrasound velocity and neonatal anthropometric measurements as well as clinical biochemical markers of skeletal health. METHODS: This study presents an unsupervised learning approach for the automatic detection of first arrival time and estimation of ultrasonic velocity from axial transmission waveforms, which potentially indicates bone quality. The proposed method combines the ReliefF algorithm and fuzzy C-means clustering. It was first validated using an in vitro dataset measured from a Sawbones phantom. It was subsequently applied on in vivo signals collected from 40 infants, comprising 21 males and 19 females. The extracted neonatal ultrasonic velocity was subjected to statistical analysis to explore correlations with the infants' anthropometric features and biochemical indicators. RESULTS: The results of in vivo data analysis revealed significant correlations between the extracted ultrasonic velocity and the neonatal anthropometric measurements and biochemical markers. The velocity of first arrival signals showed good associations with body weight (ρ = 0.583, P value <.001), body length (ρ = 0.583, P value <.001), and gestational age (ρ = 0.557, P value <.001). CONCLUSION: These findings suggest that fuzzy C-means clustering is highly effective in extracting ultrasonic propagating velocity in bone and reliably applicable in in vivo measurement. This work is a preliminary study that holds promise in advancing the development of a standardized ultrasonic tool for assessing neonatal bone health. Such advancements are crucial in the accurate diagnosis of bone growth disorders.

Understanding the epidemiology, clinical characteristics, knowledge and barriers to treatment and prevention of malaria among returning international laborers in northern Vietnam: a mixed-methods study.

BACKGROUND: With the decline in local malaria transmission in Vietnam as a result of the National Malaria Control Program (NMCP) elimination activities, a greater focus on the importation and potential reintroduction of transmission are essential to support malaria elimination objectives. METHODS: We conducted a multi-method assessment of the demographics, epidemiology, and clinical characteristics of imported malaria among international laborers returning from African or Southeast Asian countries to Vietnam. Firstly, we conducted a retrospective review of hospital records of patients from January 2014 to December 2016. Secondly, we conducted a mixed-methods prospective study for malaria patients admitted to the study sites from January 2017 to May 2018 using a structured survey with blood sample collection for PCR analysis and in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. RESULTS: International laborers were young (median age 33.0 years IQR 28.0-39.5 years), predominantly male (92%) adults returning mostly from the African continent (84%) who stayed abroad for prolonged periods (median time 13.5 months; IQR 6.0-331.5 months) and were involved in occupations that exposed them to a higher risk of malaria infection. Epidemiological trends were also similar amongst study strands and included the importation of Plasmodium falciparum primarily from African countries and P. vivax from Southeast Asian countries. Of 11 P. malariae and P. ovale infections across two study strands, 10 were imported from the African continent. Participants in the qualitative arm demonstrated limited knowledge about malaria prior to travelling abroad, but reported knowledge transformation through personal or co-worker's experience while abroad. Interestingly, those who had a greater understanding of the severity of malaria presented to the hospital for treatment sooner than those who did not; median of 3 days (IQR 2.0-7.0 days) versus 5 days (IQR 4.0-9.5 days) respectively. CONCLUSION: To address the challenges to malaria elimination raised by a growing Vietnamese international labor force, consideration should be given to appropriately targeted interventions and malaria prevention strategies that cover key stages of migration including pre-departure education and awareness, in-country prevention and prophylaxis, and malaria screening upon return.

Signal Processing Techniques Applied to Axial Transmission Ultrasound.

A new application of ultrasonography has been emerging in the bone quantitative ultrasound arena in the last twenty years: cortical bone characterization using axial transmission ultrasound (ATU). Although challenged by the complicated cortical tissue-ultrasonic wave interaction, ATU has proved to have promising potential to be a valuable diagnostic tool in the assessment of cortical bones. This chapter reviews the main landmarks of axial transmission signal processing in the past decade to provide a guide to the diversity of available techniques. In order to increase the readability of the chapter, the signal processing methods are categorized based on the experimental settings: single and multiple transmitter-receiver configuration. The review considers the key stages required for the analysis of bone guided-wave ultrasound data namely dispersion energy imaging, modal filtering, dispersion curve inversion, and measurement automation with integrated artificial intelligence concepts. Besides discussing the recent signal processing advances in the field of bone assessment by axial transmission, this communication offers developments that might be anticipated in the near future.

Ambient air pollution, meteorology, and COVID-19 infection in Korea.

The outbreak of novel pneumonia coronavirus disease has become a public health concern worldwide. Here, for the first time, the association between Korean meteorological factors and air pollutants and the COVID-19 infection was investigated. Data of air pollutants, meteorological factors, and daily COVID-19 confirmed cases of seven metropolitan cities and nine provinces were obtained from 3 February 2020 to 5 May 2020 during the first wave of pandemic across Korea. We applied the generalized additive model to investigate the temporal relationship. There was a significantly nonlinear association between daily temperature and COVID-19 confirmed cases. Each 1°C increase in temperature was associated with 9% (lag 0-14; OR = 1.09; 95% CI = 1.03-1.15) increase of COVID-19 confirmed cases when the temperature was below 8°C. A 0.01 ppm increase in NO2 (lag 0-7, lag 0.14, and lag 0-21) was significantly associated with increases of COVID-19 confirmed cases, with ORs (95% CIs) of 1.13 (1.02-1.25), 1.19 (1.09-1.30), and 1.30 (1.19-1.41), respectively. A 0.1 ppm increase in CO (lag 0-21) was associated with the increase in COVID-19 confirmed cases (OR = 1.10, 95% CI = 1.04-1.16). There was a positive association between per 0.001 ppm of SO2 concentration (lag 0, lag 0-7, and lag 0-14) and COVID-19 confirmed cases, with ORs (95% CIs) of 1.13 (1.04-1.22), 1.20 (1.11-1.31), and 1.15 (1.07-1.25), respectively. There were significantly temporal associations between temperature, NO2 , CO, and SO2 concentrations and daily COVID-19 confirmed cases in Korea.

Short-term exposure to ambient air pollution in association with COVID-19 of two clusters in South Korea.

OBJECTIVES: This study aimed to examine the association between six air pollutants and COVID-19 infection in two main clusters, which accounted for 83% of total confirmed cases in Korea. METHODS: We collected the data on daily confirmed cases between February 24, 2020 and September 12, 2020. Data on six air pollutants (PM2.5 , PM10 , O3 , NO2 , CO and SO2 ) and four meteorological factors (temperature, wind speed, humidity and air pressure) were obtained on seven days prior to the research period. The generalised additive model and the distributed lag nonlinear model were applied to generate the relative risks (RRs) and 95% confidence intervals (CIs) for the associations. Pooled estimates for clusters were obtained by applying a random-effects model. RESULTS: We found that NO2 concentration was positively associated with daily confirmed cases in both Seoul-Gyeonggi and Daegu-Gyeongbuk clusters, with RRs (95% CIs) of 1.22 (1.03-1.44) and 1.66 (1.25-2.19), respectively. However, SO2 concentration was observed to be associated with daily confirmed cases in the Seoul-Gyeonggi cluster only (RR = 1.30, 95% CI = 1.10-1.54), whereas PM2.5 and CO concentrations were observed to be associated with daily confirmed cases in the Daegu-Gyeongbuk cluster only (RR = 1.14, 95% CI = 1.02-1.27 and RR = 1.30, 95% CI = 1.15-1.48, respectively). CONCLUSIONS: Our data found that NO2 concentration was positively associated with daily confirmed cases in both clusters, whereas the effect of PM2.5 , CO and SO2 on COVID-19 infection in two clusters was different.

Single Versus Multi-channel Dispersion Analysis of Ultrasonic Guided Waves Propagating in Long Bones.

Ultrasonic guided wave techniques have been applied to characterize cortical bone for osteoporosis assessment. Compared with the current gold-standard X-ray-based diagnostic methods, ultrasound-based techniques pose some advantages such as compactness, low cost, lack of ionizing radiation, and their ability to detect the mechanical properties of the cortex. Axial transmission technique with a source-receiver offset is employed to acquire the ultrasound data. The dispersion characteristics of the guided waves in bones are normally analyzed in the transformed domains using the dispersion curves. The transformed domain can be time-frequency map using a single channel or wavenumber-frequency (or phase velocity-frequency) map with multi-channels. In terms of acquisition effort, the first method is more cost- and time-effective than the latter. However, it remains unclear whether single-channel dispersion analysis can provide as much quantitative guided-wave information as the multi-channel analysis. The objective of this study is to compare the two methods using numerically simulated and ex vivo data of a simple bovine bone plate and explore their advantages and disadvantages. Both single- and multi-channel signal processing approaches are implemented using sparsity-constrained optimization algorithms to reinforce the focusing power. While the single-channel data acquisition and processing are much faster than those of the multi-channel, modal identification and analysis of the multi-channel data are straightforward and more convincing.

A multi-directional backlight for a wide-angle, glasses-free three-dimensional display.

Multiview three-dimensional (3D) displays can project the correct perspectives of a 3D image in many spatial directions simultaneously. They provide a 3D stereoscopic experience to many viewers at the same time with full motion parallax and do not require special glasses or eye tracking. None of the leading multiview 3D solutions is particularly well suited to mobile devices (watches, mobile phones or tablets), which require the combination of a thin, portable form factor, a high spatial resolution and a wide full-parallax view zone (for short viewing distance from potentially steep angles). Here we introduce a multi-directional diffractive backlight technology that permits the rendering of high-resolution, full-parallax 3D images in a very wide view zone (up to 180 degrees in principle) at an observation distance of up to a metre. The key to our design is a guided-wave illumination technique based on light-emitting diodes that produces wide-angle multiview images in colour from a thin planar transparent lightguide. Pixels associated with different views or colours are spatially multiplexed and can be independently addressed and modulated at video rate using an external shutter plane. To illustrate the capabilities of this technology, we use simple ink masks or a high-resolution commercial liquid-crystal display unit to demonstrate passive and active (30 frames per second) modulation of a 64-view backlight, producing 3D images with a spatial resolution of 88 pixels per inch and full-motion parallax in an unprecedented view zone of 90 degrees. We also present several transparent hand-held prototypes showing animated sequences of up to six different 200-view images at a resolution of 127 pixels per inch.

Receptiveness and preferences of health-related smartphone applications among Vietnamese youth and young adults.

BACKGROUND: As smartphone becomes increasingly prevalent and affordable, more youths today can own a smartphone device and download applications in various application stores. Smartphone applications have been proven to be useful for youths in various aspects. However, there has been a paucity of data looking into the preferences of Vietnamese youths and adolescents with regards to health-related applications and their receptiveness towards smartphone apps. Therefore, this study aimed to determine the receptiveness and preferences of health-related smartphone applications (mHealth apps) among online Vietnamese youths and adolescents. METHODS: An online cross-sectional study was conducted between the periods of August till October 2015 in Vietnam. Respondent-driven sampling technique (RDS) was utilized to recruit participants. Participants were asked questions about their history of downloading and using health-related smartphone applications and their receptiveness when using these applications. Moreover, socio-demographic characteristics and health status were also self-reported. Multivariate logistic regression was employed to determine associated factors. RESULTS: Among 1028 participants, 57.4% owned a smartphone and only 14.1% of smartphone users have used a health-related smartphone application, and most of these individuals downloaded the applications for disease prevention (66.3%). 66.4% of the participants who owned these applications reported that health applications were useful and 92.8% reported being satisfied with the functionalities of the applications which they owned. Among smartphone users, people who were employed (OR = 15.46; 95%CI = 4.93-48.47) were more likely to download mHealth apps. Meanwhile, youths with higher EQ-5D index had a lower likelihood of downloading healthcare-related smartphone applications (OR = 0.17; 95%CI = 0.04-0.81). CONCLUSIONS: This study highlighted a low rate of mHealth apps utilization among online Vietnamese youths and adolescents but a high acceptance of individuals who already used these apps. Developing mHealth apps or interventions towards the disease prevention and quality of life improvement could be feasible to proliferate the benefits of such applications in youths and adolescents in Vietnam. Further research should be conducted to optimize the contents and interfaces of mHealth apps that meet the needs of these populations.

Psychological Distress Among Methadone Maintenance Patients in Vietnamese Mountainous Areas.

We conducted a cross-sectional study in Tuyen Quang Province, a mountainous province in northern Vietnam, to examine rates of psychological distress among 241 patients receiving methadone maintenance treatment (MMT). Using the Kessler psychological distress Scale, we found that approximately one-fourth (26.8%) of respondents suffered from mental health pathologies. Physical health problems, current drug use, and alcohol abuse were found to be associated with mental health problems among the participants. Our findings highlight the high prevalence of psychological distress among MMT patients in northern Vietnam, and the need to integrate mental and physical health care services, as well as behavioral health counseling, into currently existing MMT clinics in this region.

Quality of life and healthcare service utilization among methadone maintenance patients in a mountainous area of Northern Vietnam.

BACKGROUND: The expansion of methadone maintenance treatment in mountainous areas in still limited and little is known about its health impacts on drug users. This study aimed to examine health-related quality of life (HRQOL) and health care access among patients engaging in methadone maintenance treatment (MMT) in Tuyen Quang, a mountainous province in Vietnam. METHODS: We conducted a cross-sectional survey with 241 patients conveniently recruited in two MMT clinics (Son Duong and Tuyen Quang). EuroQol-5 Dimensions - 5 levels (EQ-5D-5 L) and Visual analogue scale (VAS) were employed to measure HRQOL. Multivariate logistic and tobit regressions were used to determine the factors associated with HRQOL and health care utilization. RESULTS: The overall mean score of the EQ-5D index and EQ-VAS were 0.88 (SD = 0.20) and 81.8% (SD = 15.27%), respectively. Only 8.7% utilized inpatient services, and 14.9% used outpatient services. Being more highly educated, suffering acute diseases, and using health service within the last 12 months were associated with a decreased EQ-5D index. Individuals who were multiple substance abusers and those who recently had inpatient care were more likely to have a lower VAS. Older respondents, those taking their medications at the more impoverished clinic, substance abusers, and individuals who were struggling with anxiety/depression or their usual daily activities were more likely to use both inpatient and outpatient care. CONCLUSIONS: In summary, we observed good HRQOL, but high prevalence of anxiety/depression and low rates of service utilization among MMT patients in Tuyen Quang province. To improve the outcomes of MMT services in mountainous areas, it is necessary to introduce personalized and integrative services models with counseling and interventions on multiple substance use.

Expanding co-payment for methadone maintenance services in Vietnam: the importance of addressing health and socioeconomic inequalities.

BACKGROUND: Ensuring high enrollment while mobilizing resources through co-payment services is critical to the success of the methadone maintenance treatment (MMT) program in Vietnam. This study assessed the willingness of patients to pay (WTP) for different MMT services delivery models and determined its associated factors. METHODS: A facility based survey was conducted among 1016 MMT patients (98.7% male, 42% aged 35 or less, and 67% living with spouse) in five MMT clinics in Hanoi and Nam Dinh province in 2013. Socioeconomic, HIV and health status, history of drug use and rehabilitation, and MMT experience were interviewed. WTP was assessed using contingent valuation method, including a set of double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay. RESULTS: 95.5% patients were willing to pay for MMT at the monthly mean price of US$ 32 (95%CI = 28-35). Higher WTP was associated with higher level of educational attainment, higher income, male sex, and had high expenses on opiates prior to MMT. Patients who reported having any problem in Pain/ Discomfort, and who did not have outpatient care last year were willing to pay less for MMT than others. CONCLUSION: High level of WTP supports the co-payment policies as a strategy to mobilize resources for the MMT program in Vietnam. However, it is necessary to ensure equalities across patient groups by acknowledging socioeconomic status of different settings and providing financial supports for disadvantaged patients with severe health status.

Stigmatization among methadone maintenance treatment patients in mountainous areas in northern Vietnam.

BACKGROUND: Stigma and discrimination may adversely affect the benefits of methadone maintenance treatment (MMT) for drug users, especially in disadvantaged settings. This study assessed stigma and discrimination against MMT patients in the mountainous and rural areas in Vietnam and explored their associated factors to inform implementation strategies. METHODS: We interviewed 241 MMT patients in two clinics: one in Tuyen Quang Province's inner city and the other in Son Duong District, to assess stigma and discrimination that patients perceived and experienced. Socioeconomic status, health behaviors, health status, and history of drug abuse were examined. Multivariate linear and logistic regression models were used to explore factors associated with stigma and discrimination. RESULTS: The majority of respondents reported experiencing stigma and discrimination including blame/judgment (95.1%), shame (95.1%), disclosure (71.4%), and the fear of human immunodeficiency virus (HIV) transmission by others (74.1%). Unemployed patients were more likely to experience discrimination (Coef = -1.18, 95% CI = -1.87; -0.89). Those who were taking an antiretroviral were more likely to disclose their health status (Coef = 2.27, 95% CI = 0.6; 3.94). In addition, a higher likelihood of being blamed/judged and shamed was associated with those who suffered from anxiety/depression (Coef = 1.59, 95% CI = 0.24; 2.93 and Coef = 1.07, 95% CI = 0.36; 1.79, respectively). CONCLUSIONS: MMT patients in these mountainous areas perceived high levels of stigma and discrimination which were associated with mental health disorders, unemployment, and HIV infection. These findings highlighted the importance of reducing drug use and HIV-related stigma against high-risk populations. Besides, psychosocial and familial supports, as well as job referrals, also play crucial roles in terms of promoting quality of life among MMT patients.

Multichannel filtering and reconstruction of ultrasonic guided wave fields using time intercept-slowness transform.

Multichannel ultrasonic axial-transmission data are multimodal by nature. As guided waves are commonly used in nondestructive material testing, wave field filtering becomes important because the analysis is usually limited to a few lower-order modes and requires their extraction. An application of the Radon transform to enhance signal-to-noise ratio and separate wave fields in ultrasonic records is presented. The method considers guided wave fields as superpositions of plane waves defined by ray parameters (p) and time intercepts (τ) and stacks the amplitudes along linear trajectories, mapping time-offset (t - x) data to a τ - p or Radon panel. The transform is implemented using a least-squares strategy with Cauchy-norm regularization that serves to enhance the focusing power. The method was verified using simulated data and applied to an uneven spatially sampled bovine-bone-plate data set. The results demonstrate the Radon panels show isolated amplitude clusters and the Cauchy-norm constraint provides a more focused Radon image than the damped least-squares regularization. Wave field separation can be achieved by selectively windowing the τ - p signals and inverse transformation, which is illustrated by the successful extraction of the A0 mode in bone plate. In addition, the method effectively attenuates noise, enhances the coherency of the guided wave modes, and reconstructs the missing records. The proposed transform presents a powerful signal-enhancement tool to process guided waves for further analysis and inversion.

Comparison of continuous versus pulsed ultraviolet light emitting diode use for the inactivation of Bacillus globigii spores.

Light emitting diodes (LEDs) in the ultraviolet (UV) range offer a promising alternative for the disinfection of water. LEDs have many advantages over conventional UV lamps but there are concerns related to the operating life of the LED lamps. In this project Bacillus globigii was inactivated using UV LED technology. The experimental strategy included using pulsed ultraviolet (PUV) output rather than continuous UV (CUV) current in order to reduce the power requirements and extend the life of the lamps. The kinetic profiles for CUV experiments reached 6-log inactivation faster than PUV at 9.1% duty cycle (approx. 840 vs. 5,000 s) but the PUV required lower fluence (365 vs. 665 J/m²). In addition, the inactivation rate constants associated with PUV were generally higher than those of CUV (4.6-5.1 vs. 3.6-4.4 m²/J), which supports the notion that high energy bursts are more effective at causing cellular damage. Multi-target kinetics applied to most of the kinetic observations and tailing effects were generally observed. PUV LED appears to have potential to extend the lifetime of the LEDs for inactivation of spore-forming pathogens.

Prediction of arsenic retention in vadose zone based on empirical relationship between soil properties and segmented retardation factors.

Arsenic (As) is a widespread environmental contaminant that poses a significant threat to ecosystems and human health. Although previous studies have qualitatively revealed the effects of individual soil properties on the transport and fate of As in the vadose zone, their integrated impacts remain obscure. Moreover, studies investigating the retardation factor therein, which is a key parameter for comprehending As transport in the vadose zone, are extremely limited. In this study, we investigated the interplay of soil properties with As transport and retention within the vadose zone, while focusing on the retardation factor of As. We employed steady-state unsaturated water-flow soil column experiments coupled with a mobile-immobile model and multiple linear regression analysis to elucidate the dependence of As retardation factors on the soil properties. In the mobile water zone, iron and organic matter contents emerged as the two most influential properties that impedes As mobility. Whereas, in the immobile water zone, the coefficient of uniformity and bulk density were the most influential factors that enhanced As retention. Finally, we derived an empirical equation for calculating the As retardation factors in each zone, offering a valuable tool for describing and predicting As behavior to protect the groundwater resources underneath.

Molecular findings in myeloid neoplasms.

The proliferation of new molecular technologies in recent years has greatly advanced our knowledge of the genetics that underlie hematologic cancers. Particularly, with the advent and wide-implementation of next-generation sequencing (NGS), a host of somatic (and some germline) gene mutations have been identified as significant in the classification, prognostication, and treatment of the spectrum of myeloid neoplasms. These driver and disease modifier mutations now play a prominent role in the updated international diagnostic guidelines of acute myeloid leukemia (AML), myelodysplastic syndromes/neoplasms (MDS), and myeloproliferative neoplasms (MPN). As high-throughput technologies such as NGS increasingly become standard in the genetic evaluation of myeloid disorders, it is critical that clinicians understand the clinical relevance of these mutations in order to further personalize patient care. In this review we discuss some of the most essential somatic and cytogenetic findings.

The impact of green intellectual capital on green innovation in Vietnamese textile and garment enterprises: mediate role of environmental knowledge and moderating impact of green social behavior and learning outcomes.

The knowledge economy system shifts focus on the significance of intellectual capital. Moreover, the concept itself has gained generous amount of recognition at global level due to the increasing pressure from competitors, stakeholders, and environmental forces. Indeed, its antecedents and consequences have been assessed by scholars. However, the assessment appears to be inexhaustive with respect to meaningful frameworks. With the help of preceding literature, the present paper designed a model which involves green intellectual capital, green innovation, environmental knowledge, green social behavior, and learning outcomes. The model stipulates that green intellectual capital makes green innovation possible which further results in competitive advantage in the presence of environmental knowledge as a mediator as green social behavior and learning outcomes as a moderator. Interestingly the model acknowledges the proposed relationship through the empirical evidence collected from 382 Vietnamese textile and garment enterprises. The findings provide deeper insights regarding the issue that how firms could extract maximum benefits from their green assets and capabilities in the form of intellectual capital and green innovation.

Variable effects of soil organic matter on arsenic behavior in the vadose zone under different bulk densities.

The nonstationary nature of water and oxygen content in the vadose zone determines various biogeochemical reactions regarding arsenic (As) therein, which affects the groundwater vulnerability to As contamination at a site. In the present study, we evaluated the effect of soil organic matter (OM) on the behavior of As using specifically designed soil columns that simulated the vadose zone. Three wet-dry cycles were applied to each of the four columns with different OM contents and bulk densities. OM was found to exhibit variable effects, either inhibiting or accelerating the mobilization of As, depending on bulk density. At a moderate bulk density (< 1.27 g/cm3), OM slightly lowered the pH of pore water, which enhanced the sorption of As onto the iron (Fe) oxides, promoting the retention of As in soil. In the soil column with a relatively higher bulk density (1.36 g/cm3), however, the dissimilatory reduction of iron oxides was triggered by rich OM under oxygen-limited conditions. X-ray absorption spectroscopy analysis revealed that alternate wetting and drying transformed the Fe oxides in the soil by reductive dissolution and subsequent re-precipitation. Consequently, As was not stably retained in the soil, and its mobilization downwards was further accelerated.

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

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