Cyclotides derived from Viola dalatensis Gagnep: A novel approach for enrichment and evaluation of antimicrobial activity.

Cyclotides, plant-derived cysteine-rich peptides, exhibit a wide range of beneficial biological activities and possess exceptional structural stability. Cyclotides are commonly distributed throughout the Violaceae family. Viola dalatensis Gagnep, a Vietnamese species, has not been well studied, especially for cyclotides. This pioneering research explores cyclotides from V. dalatensis as antimicrobials. This study used a novel approach to enhance cyclotides after extraction. The approach combined 30% ammonium sulfate salt precipitation and RP-HPLC. A comprehensive analysis was performed to ascertain the overall protein content, flavonoids content, polyphenol content, and free radical scavenging capacity of compounds derived from V. dalatensis. Six known cyclotides were sequenced utilizing MS tandem. Semi-purified cyclotide mixtures (M1, M2, and M3) exhibited antibacterial efficacy against Bacillus subtilis (inhibitory diameters: 19.67-23.50 mm), Pseudomonas aeruginosa (22.17-23.50 mm), and Aspergillus flavus (14.67-21.33 mm). The enriched cyclotide precipitate from the stem extract demonstrated a minimum inhibitory concentration (MIC) of 0.08 mg/mL against P. aeruginosa, showcasing significant antibacterial effectiveness compared to the stem extract (MIC: 12.50 mg/mL). Considerable advancements have been achieved in the realm of cyclotides, specifically in their application as antimicrobial agents.

First foods in a packaged world: Results from the COMMIT consortium to protect young child diets in Southeast Asia.

Although commercially produced complementary foods (CPCFs) are increasingly sold throughout Southeast Asia, concerns have been raised about CPCFs nutritional quality, labelling practices and the strength and scope of national CPCF regulations. The Consortium for Improving Complementary Foods in Southeast Asia (COMMIT), composed of UN agencies and civil society organizations, was formed to assess the nutrient gap in the diets of young children and the consumer, product and policy landscapes for CPCFs in seven Southeast Asian countries. Results from a nutrient gap assessment indicate that the diets of children aged 6-23 months are suboptimal and deficient in micronutrients. A consumer survey revealed that caretakers commonly use CPCFs, are conscious of the importance of nutrition and are influenced by label claims. Results from a CPCF benchmarking showed that many products sold in Southeast Asia contained added sugar or sweeteners, had a high total sugar and/or high sodium content and that no CPCF product adhered to all recommended labelling practices. Further, a legal review of national binding legal measures relevant to CPCFs showed minimal alignment with available global guidance. Urgent actions are necessary to strengthen national regulations related to CPCF nutrient composition and labelling practices. To speed progress, COMMIT developed a compendium of existing standards and global guidance to help countries align their national regulations with CPCF composition, labelling and production recommendations. Advocacy to garner public support for new or improved CPCF regulations, as well as strong government monitoring and enforcement of regulations, is crucial to support efforts to safeguard and improve the diets of older infants and young children in Southeast Asia.

Pharmacological Activities and Safety of Ganoderma lucidum Spores: A Systematic Review.

Ganoderma lucidum is traditionally used to prevent and treat some diseases such as liver disorders, hypertension, insomnia, diabetes, and cancer. G. lucidum spore extracts are also reported to share similar bioactivities as extracts from its other parts. However, there is no systematic review that elucidates its pharmacological effect. Our aim is to comprehensively summarise current evidence of G. lucidum spore extracts to clarify its benefits to be applied in further studies. We searched five primary databases: PubMed, Virtual Health Library (VHL), Global Health Library (GHL), System for Information on Grey Literature in Europe (SIGLE), and Google Scholar on September 13, 2021. Articles were selected according to inclusion and exclusion criteria. A manual search was applied to find more relevant articles. Ninety studies that reported the pharmacological effects and/or safety of G. lucidum spores were included in this review. The review found that G. lucidum spore extracts showed quite similar effects as other parts of this medicinal plant including anti-tumor, anti-inflammatory, antioxidant effects, and immunomodulation. G. lucidum sporoderm-broken extract demonstrated higher efficiency than unbroken spore extract. G. lucidum extracts also showed their effects on some genes responsible for the body's metabolism, which implied the benefits in metabolic diseases. The safety of G. lucidum should be investigated in depth as high doses of the extract could increase levels of cancer antigen (CA)72-4, despite no harmful effect shown on body organs. Generally, there is a lot of potential in the studies of compounds with pharmacological effects and new treatments. Sporoderm breaking technique could contribute to the production of extracts with more effective prevention and treatment of diseases. High doses of G. lucidum spore extract should be used with caution as there was a concern about the increase in CA.

Four New Stilbene Derivatives Isolated from Gnetum latifolium var. funiculare Markgr. and Their Inhibition of NO Production in LPS-activated RAW264.7 Cells.

Gnetum latifolium var. funiculare Markgr. is a medicinal plant and widely distributed in mountainous areas of Vietnam. Phytochemical investigation on the trunks of this plant afforded eight stilbene derivatives (1-8) including for new compounds (1-4). Their structures were determined based on extensive analyses of HR-ESI-MS, 1D and 2D NMR spectra. Among the isolates, compounds 1-3 showed moderate NO production inhibition in LPS-activated RAW264.7 cells with the IC50 values ranging from 46.81 to 68.10 µM, compounds 4 and 6 showed weak effects with the IC50 values of 96.57 and 79.46 µM, respectively, compared to that of the positive control compound, dexamethasone (IC50 14.20 µM).

Research evaluating the effectiveness of dementia interventions in low- and middle-income countries: A systematic mapping of 340 randomised controlled trials.

OBJECTIVES: More people with dementia live in low- and middle-income countries (LMICs) than in high-income countries, but best-practice care recommendations are often based on studies from high-income countries. We aimed to map the available evidence on dementia interventions in LMICs. METHODS: We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias. RESULTS: We included 340 RCTs with 29,882 (median, 68) participants, published 2008-2018. Over two-thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%). CONCLUSIONS: Evidence-generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence-generation for LMICs.

Economic Analysis of a Ketoanalogue-supplemented Very Low-protein Diet in Patients With Chronic Kidney Disease in Vietnam.

PURPOSE: The aim of this study was to estimate the cost-effectiveness of a very low-protein diet (VLPD) supplemented with ketoanalogues of essential amino acids compared with a conventional low-protein diet (LPD) in Vietnam. METHODS: The study was conducted from payer (base case), patient, and societal perspectives. A Markov model simulated costs and quality-adjusted life-years (QALYs) for patients with chronic kidney disease stage 4 or 5 (CKD4+) who were followed up during their lifetimes. Patients received a VLPD (0.3- to 0.4-g/kg/d diet) supplemented with ketoanalogues (5 kg/d [1 tablet]) versus LPD (0.6 g/kg/d, mixed proteins). In each model cycle, patient transitions among the health states-CKD4+ (nondialysis), dialysis, and death-were based on transition probabilities taken from the published literature. The time horizon covered the cohort's lifetime. Utilities and costs were estimated from literature review and projected for the lifespan considered in the model. Probabilistic and deterministic sensitivity analyses were performed. FINDINGS: The ketoanalogue-supplemented VLPD increased survival and QALYs compared with the LPD. From a payer's perspective, total cost of care in Vietnam was ₫216,854,268 (€8684/$9242) per patient with LPD versus ₫200,928,819 (€8046/$8563) per patient with a supplemented VLPD (sVLPD) (difference, -₫15,925,449 [-€638/-$679]). From a patient's perspective, total cost of care in Vietnam was ₫217,872,043 (€8724/$9285) per patient with LPD versus ₫116,015,672 (€4646/$4944) per patient with sVLPD (difference, -₫101,856,371 [-€4,079/ -$4341]). From a societal perspective, total cost of care in Vietnam was ₫434,726,312 (€17,408/-$18,527) per patient with LPD versus ₫316,944,491 (€12,692/ $13,508) per patient with sVLPD (difference, -₫117,781,820 [-€4716 €/$5020). IMPLICATIONS: Ketoanalogue-supplemented VLPD lowered costs compared with LPD in all 3 perspectives considered.

Antioxidant and Antimicrobial Properties of Fruiting Body and Submerged Mycelium of Medicinal Mushroom Phellinus robiniae (Agaricomycetes).

This study was conducted to evaluate extraction yield, antioxidant content, antioxidant capacity and antibacterial activity of extracts obtained from submerged mycelium (ME) and fruiting body (FBE) of Phellinus robiniae NTH-PR1. The results showed that yields of ME and FBE reached 14.84 ± 0.63 and 18.89 ± 0.86%, respectively. TPSC, TPC, and TFC were present in both mycelium and fruiting body, and the more contents of them were found in fruiting body. The concentrations of TPSC, TPC and TFC in ME and FBE were 17.61 ± 0.67 and 21.56 ± 0.89 mg GE g-1, 9.31 ± 0.45 and 12.14 ± 0.56 mg QAE g-1, and 8.91 ± 0.53 and 9.04 ± 0.74 mg QE g-1, respectively. EC50 values for DPPH radical scavenging revealed FBE (260.62 ± 3.33 µg mL-1) was more effective than ME (298.21 ± 3.61 µg mL-1). EC50 values for ferrous ion chelating in ME and FBE were 411.87 ± 7.27 and 432.39 ± 2.23 µg mL-1, respectively. Thus, both extracts were able to inhibit Gram-positive and Gram-negative pathogenic bacterial strains, at concentrations ranging in 25-100 mg mL-1 of ME and 18.75-75 mg mL-1 of FBE for Gram-positive bacteria; ranging in 75-100 mg mL-1 of ME and 50-75 of FBE for Gram-negative bacteria. Overall submerged mycelial biomass and fruiting bodies of Ph. robiniae NTH-PR1 can be considered as useful natural sources for development of functional food, pharmaceuticals and cosmetic products or cosmeceuticals.

Sodium removal from bauxite desilication product (sodalite) aided by chelating effects of inorganic and organic acids.

Dealkalization is a prerequisite to converting bauxite residue into non-hazardous materials that can be used for various upcycling applications. Structural alkali (Na+) lodged inside the densely packed aluminosilicate-cages of sodalite, the dominant desilication product from refining alumina, is a common culprit in the persistence of strong alkalinity of bauxite residue. The present study unravelled chemical and mineralogical processes involved in sodalite dealkalization, driven by organic and inorganic acids. These acids have different H+ dissociation coefficients and their anions have different chelation abilities with surface metal atoms of aluminosilicate minerals. The efficacy of sodium removal by exposure to the acids was found not only dependent on the acid strength (pKa), but also on the chelating property of dissociated conjugate anions. Following an initial H+-Na+ exchange, Na+ removal from sodalite was correlated with partial hydrolysis of aluminosilicate network and resultant chelating reactions with acid anions. The selection of organic and inorganic acids whose conjugate bases possess good chelating capability in the pH buffer zone 7-9 (e.g., oxalate or phosphate), would provide significant aid to the dealkalization process. The findings in this study are crucial in understanding the conversion of bauxite residue into a soil-like growth media (technosol) for sustainable mined land rehabilitation.

Differences in the Microbiological Profile of Raw and Pasteurized Breastmilk from Hospital and Community-Based Donors at the First Human Milk Bank in Vietnam.

Background: Microbiological quality is one of the key safety standards in human milk bank (HMB) operations. We describe the profiles of bacteria in donor human milk (DHM) before and after the pasteurization of samples collected from breastfeeding women in the hospital and from the community in the first HMB in Vietnam. Methods: Data were collected between February 2017 and January 2022 from an online HMB monitoring system. First, DHM samples were cultured, and the number of colony-forming units (CFU) were counted before (n = 708) and after pasteurization (n = 1146). The gram-staining method combined with the Vitek 2 Compact system were used to identify types of organisms at the Da Nang Hospital for Women and Children's Laboratory. Passing criteria for DHM included pre-pasteurization samples had a total colony count <105 CFU/mL and post-pasteurization was <10 CFU/mL. Results: During five years of operation, Da Nang HMB had 491 donors (48.7% were hospital and the rest community donors) who donated an average amount of 14.2 L over 45 days. Of this DHM volume, 84.9% of donor samples passed the pre- and post-pasteurization microbiological tests. DHM from community donors had a higher pass rate (87.8%) compared to that from hospital donors (79.5%). Before pasteurization, 15.4% of DHM samples had a bacteria count <103 CFU/mL, 63.0% had 103-<105 CFU/mL, and 21.6% had ≥105 CFU/mL. Most of the unpasteurized DHM samples (93.0%) had microorganism growth: with one organism (16.4%), two (33.9%), three or more (43.6%). After pasteurization, 17.9% samples had a bacteria count of 1−9 CFU/mL and 7.2% had ≥10 CFU/mL. DHM samples from community donors had a lower bacterial count and number of organisms than those from hospital donors both before and after pasteurization. The highest microorganisms from unpasteurized DHM samples were Staphylococcus epidermidis (74.2%), Acinetobacter sp. (52.1%), gram-positive bacillus (51.7%), Staphylococcus coagulase-negative (15.8%), and Staphylococcus aureus (10.5%). Common microorganisms from pasteurized DHM were gram-positive bacillus (21.0%), Staphylococcus epidermidis (3.9%), and Acinetobacter sp. (0.9%). Samples from the hospital tended to have a higher contamination with those microorganisms than those from community donors. Conclusions: The majority of DHM samples in Da Nang passed microbiological testing criteria. DHM from community donors had higher pass rates than hospital donors. Corrective actions are needed to improve HMB operations and hospital microbiological quality standards, as well as general improvements in water and sanitation.

Tecomastane, a new megastigmane from the flowers of Tecoma stans.

Tecoma stans is a tropical plant that is widely used in folk medicine. Little is known about the chemical constituents of flowers of this plant. From flowers of the native plant in Vietnam, 12 compounds were isolated and elucidated, including one new compound tecomastane (1) and eleven known compounds, (3S,5R,6S,7E)-5,6-epoxy-3-hydroxy-7-megastigmane-9-one (2), bosciallin (3), chakyunglupulin B (4), (2S,6R)-2,6-dimethyloctane-1,8-diol (5), cleroindicin F (6), rengyoxide (7), 3,4-dihydroxybenzoic acid (8), methyl 3,4-dihydrobenzoate (9), 3,5-dihydroxybenzoic acid (10), luteolin (11), and indole-3-carboxylic acid (12). Compound 5 was a new natural product. The chemical structures of isolated compounds were identified by interpretation of their spectroscopic data (1D, 2D NMR, and HRESIMS) and by comparison with the literature. Compounds 1-7 and 10-12 were evaluated for alpha-glucosidase inhibition and antimicrobial activity against antibiotic-resistant, pathogenic bacteria Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii.

Bridging the evidence-to-action gap: enhancing alignment of national nutrition strategies in Cambodia, Laos, and Vietnam with global and regional recommendations.

Nutrition policies are critical frameworks for tackling the triple burden of malnutrition, including undernutrition (i.e., stunting and wasting), overweight, and hidden hunger (i.e., micronutrient deficiencies). We examined (1) the alignment of recent National Nutrition Strategies and Action Plans (NNS) in Cambodia, Laos, and Vietnam with recent global and regional recommendations and standards with a focus on maternal, infant, and young child nutrition and (2) changes compared to the previous NNS. We extracted information regarding the context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNSs in Cambodia (2019-2023), Laos (2021-2025), and Vietnam (2021-2030). Recent NNSs aimed to reduce malnutrition among priority populations and described program development, monitoring, and evaluation plans for the following interventions: breastfeeding promotion, improved complementary feeding, dietary diversity, safe water, food security, nutritional/health campaigns, strategies for vulnerable groups, and strengthening of policies related to food and nutrition. Direct interventions to improve women's general nutrition (outside of pregnancy) and adolescent nutrition were not the focus of any NNSs. Although some indicators (e.g., wasting and exclusive breastfeeding) were covered in all recent NNSs, other indicators (e.g., low birth weight and childhood overweight and obesity) were inconsistently incorporated. In comparison to the previous NNS, the following interventions were discontinued in three countries: dietary counseling, maintaining physical activity, monitoring weight gain during pregnancy, maternal micronutrient supplementation, and nutrition and HIV. Despite similarities in structure and content, the recent NNSs of Cambodia, Laos, and Vietnam do not consistently align with global and regional recommendations. Variations in the types of interventions and indicators included may reflect a shift in priorities, attention, or resources. In conclusion, the NNSs of Cambodia, Laos, and Vietnam exhibit both structural and content similarities; however, certain interventions and indicators vary across countries and differ from global and regional recommendations. Enhancing alignment while prioritizing country-specific needs, optimizing coordination, ensuring policy efficacy, and updating nutrition strategy data for cross-country comparisons and knowledge exchange is critical to ensure progress on reducing malnutrition in the region.

Palliative Care: A Concept Analysis Review.

Introduction: Palliative care is critically important for the world's aging population and can change illness trajectories and promote advances in health care technologies. As health care team members, nurses have the most contact with palliative care patients. However, misconceptions about which patients need to receive palliative care may be an obstacle to meeting patients' needs for palliative care. Objectives: This study aimed to describe preceding events, characteristics and outcomes of patients in palliative care according to current concept analysis studies. Methods: A literature review was conducted. Inclusion criteria were: (1) concept analysis studies, (2) use of the term palliative care or palliative nursing care, (3) palliative care explanation including antecedents, attributes, and consequences, and (4) articles written in English published between 2004 and 2021. Results: Four concept analysis studies on palliative care were included in this review. Palliative care was described as an approach to alleviating physical and psychological suffering and improving patients' and families' quality of life in the early stages of diagnosed illness. Terminal illnesses, acute or chronic diseases, and actual or potentially life-threatening illnesses were confirmed as the events preceding palliative care. Characteristics of palliative care include holistic care, interdisciplinary teamwork, and compassionate, patient- and family-centered care. Improved patient and family quality of life, enhanced human dignity, improved self-care, and strengthened coping abilities are outcomes of palliative care. Conclusions/Implications for Practice: Palliative care is a concept that is related to the early stage of an illness, the timing of illness diagnosis, and the onset of symptoms. Including palliative care terms in nursing education and training and developing palliative care models in clinical practice are recommended to ensure nurses understand the services of the palliative care needs of patients and their families. Future reviews, including grounded qualitative studies on the concept of palliative care, are recommended.

Wide bandgap semiconductor nanomembranes as a long-term biointerface for flexible, implanted neuromodulator.

Electrical neuron stimulation holds promise for treating chronic neurological disorders, including spinal cord injury, epilepsy, and Parkinson's disease. The implementation of ultrathin, flexible electrodes that can offer noninvasive attachment to soft neural tissues is a breakthrough for timely, continuous, programable, and spatial stimulations. With strict flexibility requirements in neural implanted stimulations, the use of conventional thick and bulky packages is no longer applicable, posing major technical issues such as short device lifetime and long-term stability. We introduce herein a concept of long-lived flexible neural electrodes using silicon carbide (SiC) nanomembranes as a faradic interface and thermal oxide thin films as an electrical barrier layer. The SiC nanomembranes were developed using a chemical vapor deposition (CVD) process at the wafer level, and thermal oxide was grown using a high-quality wet oxidation technique. The proposed material developments are highly scalable and compatible with MEMS technologies, facilitating the mass production of long-lived implanted bioelectrodes. Our experimental results showed excellent stability of the SiC/silicon dioxide (SiO2) bioelectronic system that can potentially last for several decades with well-maintained electronic properties in biofluid environments. We demonstrated the capability of the proposed material system for peripheral nerve stimulation in an animal model, showing muscle contraction responses comparable to those of a standard non-implanted nerve stimulation device. The design concept, scalable fabrication approach, and multimodal functionalities of SiC/SiO2 flexible electronics offer an exciting possibility for fundamental neuroscience studies, as well as for neural stimulation-based therapies.

Secondary metabolites from Valeriana jatamansi with their anti-inflammatory activity.

Valeriana jatamansi is hired as multiple remedies for treatment of insomnia, blood and circulatory disorders, asthma, dry cough, jaundice, seminal weakness, cardiac debility, and skin diseases in Vietnam. Our research discovered the phytochemical investigation of constituents from this herbal medicine resulted in the isolation of two new compounds (jatamansides A (4) and B (7)) together with 16 known ones from the whole plant. Their structures were established by using spectroscopic techniques (multinuclear and multidimensional nuclear magnetic resonance, infrared, ultraviolet-visible), mass spectrometry, hydrolysis analysis, or comparing their NMR data to those reported in the literature. In addition, all the isolates were evaluated for their inhibitory effect against TNF-α production in LPS-stimulated on RAW264.7 cells with significant inhibition.

Unravelling in-situ hardpan properties and functions in capping sulfidic Cu-Pb-Zn tailings and forming a duplex soil system cover.

Developing alternative approaches to cap and rehabilitate the large areas of tailings landscapes is critical for sustainable development of mining industry. This study revealed the potential of an in-situ hardpan-based duplex soil system as an un-conventional approach to rehabilitate sulfidic Cu-Pb-Zn tailings. Under a shallow silicious soil cover, a massive and consistent hardpan horizon had been formed in-situ at the surface layer of tailings across the trial area, which physically separated root zones (i.e., silica soil cover) from the un-weathered tailings underneath, prevented capillary enrichment of acidity and soluble solutes into the root zones, and sustained native plant growth for more than a decade. Precipitation of Si-rich ferric complexes were attributed to the stabilisation/solidification of the sulfidic tailing. The hardpan layer possesses a highly compacted texture, a low-percolating pore network, and extreme resistance to water movement in the hardpan horizon. Further, the hardpans directly interfacing with plant roots in the soil cover were geochemically stabilised and attenuated, with very low levels of soluble metal(loid)s and a circumneutral pH condition. This case study would serve as a good incentive to develop bio-chemical engineering methodology building on current knowledge for achieving sustainable rehabilitation of sulfidic and metallic tailings in future.

Biochar mediated uranium immobilization in magnetite rich Cu tailings subject to organic matter amendment and native plant colonization.

Organic matter (OM) amendments and plant colonization can accelerate mineral weathering and soil formation in metal mine tailings for ecological rehabilitation. However, the weathering effects may dissolve uranium (U)-bearing minerals (e.g., ianthinite) and increase U dissolution in porewater and seepages. The present study aimed to characterize the U solubility and distribution among different fractions and investigate if biochar (BC) could decrease soluble U levels and facilitate U immobilization in the OM-amended and plant-colonized tailings. A native plant species, Red Flinders grass (Iseilema vaginiflorum) was cultivated in the tailings for four weeks, which were amended with sugarcane residue (SR) with or without BC addition. The results showed that OM amendment and plant colonization increased porewater U concentrations by almost 10 folds from ~ 0.2 mg L-1 to > 2.0 mg L-1. The BC addition decreased porewater U concentrations by 40%. Further micro-spectroscopic analysis revealed that U was immobilized through adsorption onto BC porous surfaces, via possibly complexing with oxygen-rich organic groups. Besides, the BC amendment facilitated U sequestration by secondary Fe minerals in the tailings. These findings provide important information about U biogeochemistry in Cu-tailings mediated by BC, OM and rhizosphere interactions for mitigating potential pollution risks of tailings rehabilitation.

Patient-Centered Care: Transforming the Health Care System in Vietnam With Support of Digital Health Technology.

BACKGROUND: Over the recent decades, Vietnam has attained remarkable achievements in all areas of health care. However, shortcomings including health disparities persist particularly with a rapidly aging population. This has resulted in a shift in the disease burden from communicable to noncommunicable diseases such as dementia, cancer, and diabetes. These medical conditions require long-term care, which causes an accelerating crisis for the health sector and society. The current health care system in Vietnam is unlikely to cope with these challenges. OBJECTIVE: The aim of this paper was to explore the opportunities, challenges, and necessary conditions for Vietnam in transforming toward a patient-centered care model to produce better health for people and reduce health care costs. METHODS: We examine the applicability of a personalized and integrated Bespoke Health Care System (BHS) for Vietnam using a strength, weakness, opportunity, and threat analysis and examining the successes or failures of digital health care innovations in Vietnam. We then make suggestions for successful adoption of the BHS model in Vietnam. RESULTS: The BHS model of patient-centered care empowers patients to become active participants in their own health care. Vietnam's current policy, social, technological, and economic environment favors the transition of its health care system toward the BHS model. Nevertheless, the country is in an early stage of health care digitalization. The legal and regulatory system to protect patient privacy and information security is still lacking. The readiness to implement electronic medical records, a core element of the BHS, varies across health providers and clinical practices. The scarcity of empirical evidence and evaluation regarding the effectiveness and sustainability of digital health initiatives is an obstacle to the Vietnamese government in policymaking, development, and implementation of health care digitalization. CONCLUSIONS: Implementing a personalized and integrated health care system may help Vietnam to address health care needs, reduce pressure on the health care system and society, improve health care delivery, and promote health equity. However, in order to adopt the patient-centered care system and digitalized health care, a whole-system approach in transformation and operation with a co-design in the whole span of a digital health initiative developing process are necessary.

Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss.

OBJECTIVES: Little is known about the long-term skeletal impact of bariatric procedures, particularly the increasingly commonly performed gastric sleeve surgery (GS). We examined bone density (BMD) change following three types of bariatric surgery Roux-en-Y gastric bypass (RYGB), GS and laparoscopic adjustable gastric banding (LAGB), compared with diet, over 36 months. METHODS: Non-randomized, prospective study of participants with severe obesity (n = 52), undergoing weight-loss interventions: RYGB (n = 7), GS (n = 21), LAGB (n = 11) and diet (n = 13). Measurements of calciotropic indices, gut hormones (fasting and post prandial) peptide YY (PYY), glucagon-like peptide 1 (GLP1) and adiponectin together with dual-X-ray absorptiometry and quantitative computed tomography scans were performed thorough the study. RESULTS: All groups lost weight during the first 12 months. Despite weight stability from 12 to 36 months and supplementation of calcium and vitamin D, there was progressive bone loss at the total hip (TH) over 36 months in RYGB -14% (95% CI: -12, -17) and GS -9% (95% CI: -7, -10). In RYGB forearm BMD also declined over 36 months -9% (95% CI: -6, -12) and LS BMD declined over the first 12 months -7% (95% CI: -3, -12). RYGB and GS groups experienced significantly greater bone loss until 36 months than LAGB and diet groups, which experienced no significant BMD loss. These bone losses remained significant after adjustment for weight loss and age. RYGB and GS procedures resulted in elevated postprandial PYY, adiponectin and bone turnover markers up to 36 months without such changes among LAGB and diet participants. CONCLUSIONS: RYGB and GS but not LAGB resulted in ongoing TH bone loss for three postoperative years. For RYGB, bone loss was also observed at LS and non-weight-bearing forearms. These BMD changes were independent of weight and age differences. We, therefore, recommend close monitoring of bone health following RYGB and GS surgeries.

The first cohort of the COVID-19 patients in Vietnam and the national response to the pandemic.

The COVID-19 pandemic is a novel infectious disease pandemic with the agent SARS-CoV-2 virus which is currently affecting and causing damage globally. The outbreak has been crossing over 200 countries in the world. In the situation of the outbreak of COVID-19, Vietnam has first sixteen typical cases confirmed positive updated to Feb 28th, 2020. After completely applying the medical prevention and active control, Vietnam has the ability to take control of the outbreak of COVID-19 as a recent of WHO assessment. Vietnam has been reported as an effective country for prevention and control the outbreak of COVID-19. We retroactive reviewed our experience with 16 positive cases isolation. This article aims to present the first cohort of COVID-19 patients updated to Feb 28th, 2020 in Vietnam and sharing the national response to the pandemic.

National nutrition strategies that focus on maternal, infant, and young child nutrition in Southeast Asia do not consistently align with regional and international recommendations.

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy and support at birth in seven; and school feeding, deworming, and treatment of severe acute malnutrition in six. All NNS contained programme monitoring and evaluation plans with measurable indicators and targets. Not all NNS covered wasting, exclusive breastfeeding, low birthweight, and childhood overweight. Strategies for achieving NNS goals and objectives were health system strengthening (nine), social and behaviour change communication (nine), targeting vulnerable groups (eight), and social or community mobilization (four). All addressed involvement, roles and responsibilities, and collaboration mechanisms among sectors and stakeholders. There was a delay in releasing NNS in Indonesia, Myanmar, and the Philippines. In conclusion, although Southeast Asian NNS have similarities in structure and contents, some interventions and indicators vary by country and do not consistently align with regional and international recommendations. A database with regularly updated information on NNS components would facilitate cross-checking completeness within a country, comparison across countries, and knowledge sharing and learning.