Anastomotic leakage following rectal cancer laparoscopic surgery: can a transanal drainage tube be an alternative to diverting stoma?

OBJECTIVE: Anastomosis leakage in laparoscopic surgery for rectal cancer is still a serious problem affecting the patient's treatment outcome. This study aimed to evaluate the role of a transanal drainage tube compared with a diverting stoma in reducing the rate of anastomosis leakage and limiting surgical complications. PATIENTS AND METHODS: A retrospective study was conducted on 196 rectal cancer patients undergoing laparoscopic low anterior resection from July 2018 to October 2022 at 108 Central Military Hospital. The transanal drainage tube was placed in 133 patients (group A), and diverting stoma was performed in 63 patients (group B). RESULTS: There was no difference between the two groups regarding age, sex, comorbidities, distance from the tumor to the anal verge, and preoperative stage. The amount of blood loss, the method of performing the anastomosis, and the distance from the anastomosis to the anal verge did not differ between the two groups. However, the surgical time was longer in the group with diverting stoma (138.3 ± 25.1 minutes vs. 127.6 ± 31 minutes, p = 0.018). The rate of anastomosis was not significantly different between groups A and B (8.3% in group A and 7.9% in group B, p = 0.936). The proportion of patients with anastomosis requiring reoperation in group A was higher than in group B. However, the difference was not statistically significant (8/11 patients in group A and 2/5 patients in group B, p = 0.29). CONCLUSIONS: Placing a transanal drainage tube in laparoscopic surgery for rectal cancer to reduce the rate of anastomosis can be considered an alternative method for diverting stoma with complications related to the stoma.

Assessment of bowel movement dysfunction following laparoscopic low anterior resection for rectal cancer: a single-center study from Vietnam.

OBJECTIVE: Postoperative bowel movement dysfunction is a challenging problem greatly affecting patients' quality of life after low anterior resection. We aimed to evaluate the bowel movement function of patients undergoing laparoscopic low anterior resection for rectal cancer. PATIENTS AND METHODS: This retrospective study recruited 82 rectal cancer patients undergoing laparoscopic low anterior resection from July 2018 to July 2020 at 108 Military Central Hospital, Hanoi, Vietnam. RESULTS: The patients' mean age was 62.3±11.6 (28-84) years, 54 (65.9%) were males, and 28 (34.1%) were females. Bowel movement function changed significantly after one year: the average score for low anterior resection syndrome (LARS) after three months, six months, and one year was 17.6, 14.0, and 10.6, respectively. The rate of patients with major LARS decreased from 26.8% after three months to 14.6% after one year. The Wexner score also decreased from 5.9 after three months to 3.4 after one year. The rate of patients with normal bowel movement increased from 28.0% after three months to 46.3% after one year. The rate of patients with complete fecal incontinence decreased from 11.0% after three months to 7.3% after one year. Preoperative chemoradiotherapy (p=0.017), tumor location (p=0.02), method of anastomosis (p=0.01), and anastomosis location (p=0.000) were risk factors associated with major LARS after surgery. CONCLUSIONS: Bowel movement dysfunction in rectal cancer patients undergoing laparoscopic low anterior resection is a common and persistent problem after surgery. However, bowel function gradually recovers over time. Therefore, patients should be monitored and supported for a better quality of life.

Sooner is Better: Longitudinal Relations Between Delay Discounting, and Depression and Anxiety Symptoms among Vietnamese Adolescents.

Delay discounting refers to the decline in the present value of an outcome as a function of the delay to its receipt. Research on delay discounting initially focused on substance abuse, generally finding that greater delay discounting is associated with increased risk for and severity of substance abuse. More recently, delay discounting has been linked theoretically and empirically to affective psychopathology, potentially suggesting novel intervention targets for mental health problems such as depression and anxiety. Longitudinal research consequently is critical to determine direction of causality and rule out possible third variable explanations. Only a small number of longitudinal studies have been conducted in this area, however. Furthermore, socio-economic and socio-cultural factors may influence delay discounting and its effects, but thus far the literature is relatively limited in this regard. The present study focused on adolescence, a key time-period for development of delay discounting and emotional problems. Longitudinal relations between delay discounting, and depression and anxiety symptoms were assessed among 414 adolescents in Vietnam, a lower-middle-income Southeast Asian nation with significant cultural divergence from Western countries. In contrast to most cross-sectional studies that have found positive or non-significant correlations, in the present study delay discounting at Time 1 had a negative beta with anxiety and depression symptoms at Time 1, with preference for immediate but smaller rewards (higher discounting) at Time 1 associated with lower anxiety and depression symptoms at Time 2. These results suggest that under certain circumstances, steeper delay discounting may be adaptive and supportive of emotional mental health.

Ganoderma microsporum immunomodulatory protein acts as a multifunctional broad-spectrum antiviral against SARS-CoV-2 by interfering virus binding to the host cells and spike-mediated cell fusion.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible coronavirus that has caused over 6 million fatalities. SARS-CoV-2 variants with spike mutations are frequently endowed with a strong capability to escape vaccine-elicited protection. Due to this characteristic, a broad-spectrum inhibitor against SARS-CoV-2 infection is urgently demanded. Ganoderma microsporum immunomodulatory protein (GMI) was previously reported to alleviate infection of SARS-CoV-2 through ACE2 downregulation whereas the impact of GMI on virus itself was less understood. Our study aims to determine the effects of GMI on SARS-CoV-2 pseudovirus and the more detailed mechanisms of GMI inhibition against SARS-CoV-2 pseudovirus infection. METHODS: ACE2-overexpressing HEK293T cells (HEK293T/ACE2) and SARS-CoV-2 pseudoviruses carrying spike variants were used to study the effects of GMI in vitro. Infectivity was evaluated by fluorescence microscopy and flow cytometry. Fusion rate mediated by SARS-CoV-2 spike protein was examined with split fluorescent protein /luciferase systems. The interactions of GMI with SARS-CoV-2 pseudovirus and ACE2 were investigated by immunoprecipitation and immunoblotting. RESULTS: GMI broadly blocked SARS-CoV-2 infection in various cell lines. GMI effectively inhibited the infection of pseudotyped viruses carrying different emerged spike variants, including Delta and Omicron strains, on HEK293T/hACE2 cells. In cell-free virus infection, GMI dominantly impeded the binding of spike-bearing pseudotyped viruses to ACE2-expressing cells. In cell-to-cell fusion model, GMI could efficiently inhibit spike-mediated syncytium without the requirement of ACE2 downregulation. CONCLUSIONS: GMI, an FDA-approved dietary ingredient, acts as a multifunctional broad-spectrum antiviral against SARS-CoV-2 and could become a promising candidate for preventing or treating SARS-CoV-2 associated diseases.

PEDOT:PSS in Solution Form Exhibits Strong Potential in Inhibiting SARS-CoV-2 Infection of the Host Cells by Targeting Viruses and Also the Host Cells.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic with over 5 million fatalities. Vaccines against this virus have been globally administered; however, SARS-CoV-2 variants with spike protein mutations are continuously identified with strong capability to escape vaccine-elicited protection. Due to the high mutation rate and transmission ability, the development of a broad-spectrum SARS-CoV-2 inhibitor is highly in demand. In this study, the effect of poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) against SARS-CoV-2 was investigated. The treatment of pseudoviruses carrying the SARS-CoV-2 spike protein with PEDOT:PSS strongly blocked SARS-CoV-2 pseudovirus infection in human ACE2-expressing cells without causing cytotoxicity. Specifically, PEDOT:PSS showed great potential in both inactivating viruses and rendering antiviral activity to the treated cells. The effects of other PEDOT:PSS solutions with different chemical ratios and properties were also validated to find the high inhibition capacity against SARS-CoV-2 pseudovirus infection. The transcriptomic data reveal that PEDOT:PSS-treated cells were endowed with transcriptional alteration, and it could be reverted after the removal of PEDOT:PSS from the culture medium. Importantly, PEDOT:PSS also exhibited broad-spectrum inhibition effects on the pseudovirus carrying the spike protein isolated from different variants. In combination with the advantage of high biocompatibility, PEDOT:PSS could thus be considered a potential therapeutic and prophylactic material against SARS-CoV-2.

GMI, a protein from Ganoderma microsporum, induces ACE2 degradation to alleviate infection of SARS-CoV-2 Spike-pseudotyped virus.

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus Type 2 (SARS-CoV-2) induces a global serious pandemic and is responsible for over 4 million human deaths. Currently, although various vaccines have been developed, humans can still get SARS-CoV-2 infection after being vaccinated. Therefore, the blocking of SARS-CoV-2 infection may be potential therapeutic strategies. Ganoderma microsporum immunomodulatory protein (GMI), a small fungal protein, is cloned from Ganoderma microsporum. It exhibits anti-cancer and immunomodulatory functions. Currently, it is still unclear whether GMI involves in interfering with viral infection. PURPOSE: This study aimed to examine the potential functions and mechanisms of GMI on inhibiting SARS-CoV-2 pseudovirus infection. METHODS: The effects of GMI were examined in vitro on ACE2 overexpressing HEK293T (HEK293T/ACE2) cells exposed to SARS-CoV-2 Spike lentiviral pseudovirus encoding a green fluorescent protein (GFP) gene. The infection efficacy was determined using fluorescence microscopy and flow cytometry. The protein level of ACE2 was verified by Western blot. The effects of GMI on cell viability of HEK293T/ACE2 and lung epithelial WI38-2RA cells were determined by MTT assay. Mice received GMI via nebulizer. RESULTS: GMI did not affect the cell viability of HEK293T/ACE2, WI38-2RA and macrophages. Functional studies showed that GMI inhibited GFP expressing SARS-CoV-2 pseudovirus from infecting HEK293T/ACE2 cells. GMI slightly interfered the interaction between ACE2 and Spike protein. GMI interacted with S2 domain of Spike protein. Specifically, GMI dramatically reduced ACE2 expression in HEK293T/ACE2 and WI38-2RA cells. Mechanistically, GMI induced ACE2 degradation via activating protein degradation system, including proteasome and lysosome. Abolishing proteasome and lysosome by MG132 and bafilomycin A1, respectively, rescued GMI-reduced ACE2 levels. In addition, GMI triggered dynamin and lipid raft-mediated ACE2 endocytosis. ACE2 levels were downregulated in the lung tissue after the mice inhaling GMI. CONCLUSIONS: GMI prevents SARS-CoV-2 pseudovirus infection via induction of ACE2 degradation in host cells. Our findings suggest that GMI will be a potential prevention agent to alleviate SARS-CoV-2 infection.

The 'big four' health risk behaviors among Vietnamese adolescents: co-occurrence and socio-cultural risk factors.

Background: Health Risk Behaviors (HRBs) represent significant health threats for adolescents. However, there has been relatively little research on multiple HRBs in low-and-middle-income countries (LMIC), where the majority of the world's youth reside. This study's objective was to investigate common HRB, their co-occurrence, and socio-demographic risk and protective factors among Vietnamese adolescents. Methods: A cross-sectional self-report survey examined four major HRBs (tobacco use, alcohol consumption, physical inactivity, unhealthy diet) among 431 adolescents aged 15-17 years in five Vietnam provinces. Key HRB risk and protective factors assessed included perceived social norms, parental monitoring of adolescents' behavior, and health behavior literacy. Results: Forty-one percent of participants reported no HRB, 39% reported one, and 20% reported two or more HRBs. The four HRBs appeared to be independent, with an exploratory factor analysis indicating no common factors. The most prevalent HRB was unhealthy diet (45%), the least prevalent smoking (1%). The most frequent co-occurring HRBs were unhealthy diet and physical inactivity. Adolescents' perceptions of norms regarding HRBs and related healthy behaviors were the most consistent risk factor for the HRB. Diet was the HRB most influenced by the social variables perceived norms, monitoring, and health literacy. Conclusions: Results highlight the importance of future research identifying the temporal order of co-occurrence of multiple HRB, how differing conceptualizations of socio-cultural roles impact on HRB, and health-related effects of HRB co-occurrence. Such information will be useful for maximizing the efficiency and effectiveness of prevention and intervention programs in LMIC.

Dynamic Behaviors of Mortar Reinforced with NiTi SMA Fibers under Impact Compressive Loading.

In this study, a compressive impact test was conducted using the split Hopkinson pressure bar (SHPB) method to investigate SMA fiber-reinforced mortar's impact behavior. A 1.5% fiber volume of crimped fibers and dog-bone-shaped fibers was used, and half of the specimens were heated to induce recovery stress. The results showed that the appearance of SMA fibers, recovery stress, and composite capacity can increase strain rate. For mechanical properties, the SMA fibers reduced dynamic compressive strength and increased the peak strain. The specific energy absorption of the reinforced specimens slightly increased due to the addition of SMA fibers and the recovery stress; however, the effect was not significant. The composite behavior between SMA fibers and the mortar matrix, however, significantly influenced the dynamic compressive properties. The higher composite capacity of the SMA fibers produced lower dynamic compressive strength, higher peak strain, and higher specific energy absorption. The composite behavior of the dog-bone-shaped fiber was less than that of the crimped fiber and was reduced due to heating, while that of the crimped fiber was not. The mechanical properties of the impacted specimen followed a linear function of strain rate ranging from 10 to 17 s-1; at the higher strain rates of about 49-67 s-1, the linear functions disappeared. The elastic modulus of the specimen was independent of the strain rate, but it was dependent on the correlation between the elastic moduli of the SMA fibers and the mortar matrix.

Straining Behavior of Mortar Reinforced by Cold Drawn Crimped and Dog-Bone-Shaped Fibers under Monotonic and Cyclic Compressions.

The straining behavior of the shape memory alloy (SMA) fibers-reinforced mortar was investigated in this study by the monotonic compressive and cyclic compressive tests. Two types of SMA fibers with a crimped and dog-bone shape were used due to the high pullout resistance capacity, which guaranteed that the fibers and mortar matrix were composited well. The plain mortar was mixed with two different compositions to create the higher elastic modulus mortar matrix and the lower elastic modulus mortar matrix compared with the elastic modulus of SMA fibers. The results of the experimental test indicated that the non-heated SMA fibers could control the strains in both elastic and plastic phases; in which, the crimped fiber was more effective in precracking due to the higher composite capacity while the dog-bone-shaped fiber had a higher effect in post-cracking. After heating, the dog-bone-shaped fiber slipped more than that of the crimped fiber; thus, the heated crimped fiber was more effective than the heated dog-bone-shaped fiber in controlling strains after cracking. The effect of SMA fibers on the elastic modulus depended on both the elastic modulus of mortar matrix and the property of SMA fibers. In the plastic phase, the fibers were effective on reducing the speed of damage in monotonic case. An equation using reinforcing index was suggested for damage evolution in the cyclic case.

Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review.

INTRODUCTION: Starting cancer treatment early can improve outcomes. Psychosocial factors influencing patients' medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment. METHODS: Mixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate. RESULTS: Of 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments. CONCLUSION: Due to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

Active Reinforcing Fiber of Cementitious Materials Using Crimped NiTi SMA Fiber for Crack-Bridging and Pullout Resistance.

This study investigated the recovery stress and bond resistance of cold drawn crimped SMA fiber using two different initial diameters of 1.0 and 0.7 mm. These characteristics are important to the active prestressing effect and crack-closing of the fiber. NiTi SMA fiber was used for the cold drawing, and then crimped shapes were manufactured with various wave heights. After that, tensile, recovery, and pullout tests were conducted. The cold drawn crimped fiber showed softening tensile behavior more clearly than the cold drawn straight fiber when not subjected to heating, whereas they had the same tensile behavior under heating. The recovery stress and the residual stress of the crimped fibers were less than those of the straight fiber with the same diameter. Moreover, crimped fibers with a large diameter and higher wave height would induce more recovery stress and residual stress. The maximum pullout resistance of the crimped fiber was a function of the wave depth, embedded length, yield strength, and flexural rigidity of the fiber.

Impact of Climate Variability and Abundance of Mosquitoes on Dengue Transmission in Central Vietnam.

Dengue fever is an important arboviral disease in many countries. Its incidence has increased during the last decade in central Vietnam. Most dengue studies in Vietnam focused on the northern area (Hanoi) and southern regions but not on central Vietnam. Dengue transmission dynamics and relevant environmental risk factors in central Vietnam are not understood. This study aimed to evaluate spatiotemporal patterns of dengue fever in central Vietnam and effects of climatic factors and abundance of mosquitoes on its transmission. Dengue and mosquito surveillance data were obtained from the Department of Vector Control and Border Quarantine at Nha Trang Pasteur Institute. Geographic Information System and satellite remote sensing techniques were used to perform spatiotemporal analyses and to develop climate models using generalized additive models. During 2005-2018, 230,458 dengue cases were reported in central Vietnam. Da Nang and Khanh Hoa were two major hotspots in the study area. The final models indicated the important role of Indian Ocean Dipole, multivariate El Niño-Southern Oscillation index, and vector index in dengue transmission in both regions. Regional climatic variables and mosquito population may drive dengue transmission in central Vietnam. These findings provide important information for developing an early dengue warning system in central Vietnam.

Cost-effectiveness of treating multidrug- and extensively drug-resistant tuberculosis: A systematic review.

OBJECTIVE: Tuberculosis (TB), along with the human immunodeficiency virus, is one of the leading causes of death from infectious diseases. Its prevalence has rendered the treatment of drug-resistant TB a major public health problem that threatens the progress made in TB care and control worldwide. Our objectives were to conduct a systematic review of the cost-effectiveness of treatment for multidrug-resistant and extensively drug-resistant TB (MDR-TB/XDR-TB) and to synthesise available data from scientific research. METHODS: Using English keywords, we searched for papers over reputable databases, such as Scopus, PubMed, Cochrane and Google Scholar, from Jan. 23 to Mar. 23, 2019. RESULTS: The search and screening yielded 13 articles, whose results were extracted and reviewed to draw conclusions on the cost-effectiveness of MDR-TB/XDR-TB treatment. The data extraction table used to cull and categorise the results comprised the characteristics of a given study, as well as its objectives, the perspectives used to guide the investigation, methods and results (outcome, sensitivity analysis). The measured outcome was the incremental cost-effectiveness ratio. CONCLUSIONS: The review indicated that MDR -TB/XDR-TB treatment can be very cost-effective in countries with low to high incomes, regardless of whether minimal or considerable disease burdens exist.

3D porous metal-organic framework for selective adsorption of methane over dinitrogen under ambient pressure.

We report a highly porous 3D metal-organic framework (MOF) that shows potential for coal mine methane (CMM) capture.

Mental health literacy and intervention program adaptation in the internationalization of school psychology for Vietnam.

This paper discusses how school psychology technology developed in Western countries can be adapted for global contexts and "internationalized." The article reports results of two studies, providing examples of: (a) our school psychology internationalization experiences in Vietnam, as lessons hopefully useful for other professionals interested in international development; and (b) how Western researchers can learn through internalization experiences. Because mental health literacy is foundational for mental health development, Study 1 focused on assessment of mental health literacy among 353 Vietnamese teachers, with findings suggesting overall low mental health literacy among these participants. Study 2 focused on our Vietnam ACES ProS high-school problem-solving therapy program. We discuss the Mental Health Capacity Development Model guiding development of ACES ProS and report positive results of an evaluation of ACES ProS involving 100 Vietnamese high-school students. Program cultural adaptation (e.g., deciding whether teacher classroom praise should be excluded from classroom behavior management due to Vietnamese students' tendency to react to praise with increased competitive behavior) is reviewed as an example of challenges faced in school psychology internationalization. This program of research shows that school psychology internationalization can be successful but requires careful attention and close collaboration.