Changes in Quality of life Outcomes of Patients with HIV/AIDS Under a Theory-based Mobile Health Intervention.

This study examined the effectiveness of a theory-based mHealth intervention on the quality of life (QOL) of people living with HIV. A randomized controlled trial was performed at two outpatient clinics in Hanoi, Vietnam. There were 428 patients with HIV/AIDs in selected clinics and were divided into the intervention arm (receiving HIV-assisted smartphone application and usual care) and the control arm (receiving only usual care). The WHOQOLHIV-BREF instrument was utilized to measure QOL. An intention-to-treat approach using Generalized Linear Mixed Model analysis was performed. The trial showed significant improvements in Physical health, Psychological health, and Level of Dependence among patients in the intervention arm compared to the control arm. However, the Environment and Spirituality/Personal beliefs improvements would require additional interventions, both individual, organizational, or governmental. This study explored the utility of a smartphone mobile application for individuals with HIV, and how the resultant application could improve the overall QOL.

Efficacy of a Mobile Phone-Based Intervention on Health Behaviors and HIV/AIDS Treatment Management: Randomized Controlled Trial.

BACKGROUND: Antiretroviral therapy (ART) is considered the most important intervention for HIV-positive patients; thus, encouraging the use of and adherence to ART are vital to HIV treatment outcomes. Advances in web and mobile technologies hold potential in supporting HIV treatment management. OBJECTIVE: The aim of this study was to evaluate the feasibility and efficacy of a theory-based mobile health (mHealth) intervention on health behaviors and HIV treatment adherence among patients with HIV/AIDS in Vietnam. METHODS: We performed a randomized controlled trial on 425 HIV patients in two of the largest HIV clinics in Hanoi, Vietnam. Both the intervention group (238 patients) and the control group (187 patients) received regular consultations with doctors and then participated in 1-month and 3-month follow-up visits. Patients in the intervention group received a theory-driven smartphone app to facilitate medication adherence and self-efficacy in HIV patients. Measurements were developed based on the Health Belief Model, which included the visual analog scale of ART Adherence, HIV Treatment Adherence Self-Efficacy Scale, and HIV Symptom Management Self-Efficacy Scale. We also included the 9-item Patient Health Questionnaire (PHQ-9) to assess patients' mental health throughout treatment. RESULTS: In the intervention group, the adherence score increased significantly (ß=1.07, 95% CI .24-1.90) after 1 month, whereas the HIV adherence self-efficacy was significantly higher after 3 months (ß=2.17, 95% CI 2.07-2.27) compared to the control group. There was a positive but low level of change in risk behaviors such as drinking, smoking, and drug use. Factors related to positive change in adherence were being employed and having stable mental well-being (lower PHQ-9 scores). Factors associated with self-efficacy in treatment adherence and symptom management were gender, occupation, younger age, and having no other underlying conditions. A longer duration of ART increased treatment adherence but decreased self-efficacy in symptom management. CONCLUSIONS: Our study demonstrated that the mHealth app could improve the overall ART adherence self-efficacy of patients. Further studies with larger sample sizes and longer follow-up periods are needed to support our findings. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20220928003; https://www.thaiclinicaltrials.org/show/TCTR20220928003.

Fuzzy-Assisted Mobile Edge Orchestrator and SARSA Learning for Flexible Offloading in Heterogeneous IoT Environment.

In the era of heterogeneous 5G networks, Internet of Things (IoT) devices have significantly altered our daily life by providing innovative applications and services. However, these devices process large amounts of data traffic and their application requires an extremely fast response time and a massive amount of computational resources, leading to a high failure rate for task offloading and considerable latency due to congestion. To improve the quality of services (QoS) and performance due to the dynamic flow of requests from devices, numerous task offloading strategies in the area of multi-access edge computing (MEC) have been proposed in previous studies. Nevertheless, the neighboring edge servers, where computational resources are in excess, have not been considered, leading to unbalanced loads among edge servers in the same network tier. Therefore, in this paper, we propose a collaboration algorithm between a fuzzy-logic-based mobile edge orchestrator (MEO) and state-action-reward-state-action (SARSA) reinforcement learning, which we call the Fu-SARSA algorithm. We aim to minimize the failure rate and service time of tasks and decide on the optimal resource allocation for offloading, such as a local edge server, cloud server, or the best neighboring edge server in the MEC network. Four typical application types, healthcare, AR, infotainment, and compute-intensive applications, were used for the simulation. The performance results demonstrate that our proposed Fu-SARSA framework outperformed other algorithms in terms of service time and the task failure rate, especially when the system was overloaded.

Pressure effects on the EXAFS Debye-Waller factor of iron.

The pressure effects on atomic mean-square relative displacement characterizing the extended X-ray absorption fine structure (EXAFS) Debye-Waller factor of iron metal have been investigated based on the Debye model. The analytical expressions of the Debye frequency and EXAFS Debye-Waller factor have been derived as functions of crystal volume compressibility. Based on the well established equation-of-state including the contributions of the anharmonic and electronic thermal pressures, numerical calculations have been performed for iron up to a pressure of 220 GPa and compared with experimental data when possible. These results show that the Debye frequency increases rapidly with compression, and beyond 150 GPa it behaves as a linear function of pressure. Meanwhile the mean-square relative displacement curve drops robustly with pressure, especially at pressures smaller than 100 GPa. This phenomenon causes the enhancement of EXAFS signals at high pressure. Reversely, the increasing of temperature will reduce the amplitude of EXAFS spectra.

Screening and Characterization of Novel Polyesterases from Environmental Metagenomes with High Hydrolytic Activity against Synthetic Polyesters.

The continuous growth of global plastics production, including polyesters, has resulted in increasing plastic pollution and subsequent negative environmental impacts. Therefore, enzyme-catalyzed depolymerization of synthetic polyesters as a plastics recycling approach has become a focus of research. In this study, we screened over 200 purified uncharacterized hydrolases from environmental metagenomes and sequenced microbial genomes and identified at least 10 proteins with high hydrolytic activity against synthetic polyesters. These include the metagenomic esterases MGS0156 and GEN0105, which hydrolyzed polylactic acid (PLA), polycaprolactone, as well as bis(benzoyloxyethyl)-terephthalate. With solid PLA as a substrate, both enzymes produced a mixture of lactic acid monomers, dimers, and higher oligomers as products. The crystal structure of MGS0156 was determined at 1.95 Å resolution and revealed a modified α/ß hydrolase fold, with a lid domain and highly hydrophobic active site. Mutational studies of MGS0156 identified the residues critical for hydrolytic activity against both polyester and monoester substrates, with two-times higher polyesterase activity in the MGS0156 L169A mutant protein. Thus, our work identified novel, highly active polyesterases in environmental metagenomes and provided molecular insights into their activity, thereby augmenting our understanding of enzymatic polyester hydrolysis.

Clown knifefish (Chitala ornata) oxygen uptake and its partitioning in present and future temperature environments.

It has been argued that tropical ectotherms are more vulnerable to the projected temperature increases than their temperate relatives, because they already live closer to their upper temperature limit. Here we examine the effects of a temperature increase in environmental temperature to 6°C above the present day median temperature (27°C) in the freshwater air-breathing fish Chitala ornata, on aspects of its respiratory physiology in both normoxia and in hypoxia. We found no evidence of respiratory impairment with elevated temperature. The standard metabolic rate (SMR) and routine metabolic rate (RMR) in the two temperatures in normoxia and hypoxia increased with Q10 values between 2.3 and 2.9, while the specific dynamic action (SDA) and its coefficient increased from 7.8 to 14.7% in 27°C and 33°C, respectively. In addition, Chitala ornata exhibited significantly improved growth at the elevated temperature in both hypoxic and normoxic water. While projected temperature increases may negatively impact other essential aspects in this animal's environment, we see no evidence of a negative impact on this species itself.

Biochemical and Structural Insights into Enzymatic Depolymerization of Polylactic Acid and Other Polyesters by Microbial Carboxylesterases.

Polylactic acid (PLA) is a biodegradable polyester derived from renewable resources, which is a leading candidate for the replacement of traditional petroleum-based polymers. Since the global production of PLA is quickly growing, there is an urgent need for the development of efficient recycling technologies, which will produce lactic acid instead of CO2 as the final product. After screening 90 purified microbial α/ß-hydrolases, we identified hydrolytic activity against emulsified PLA in two uncharacterized proteins, ABO2449 from Alcanivorax borkumensis and RPA1511 from Rhodopseudomonas palustris. Both enzymes were also active against emulsified polycaprolactone and other polyesters as well as against soluble α-naphthyl and p-nitrophenyl monoesters. In addition, both ABO2449 and RPA1511 catalyzed complete or extensive hydrolysis of solid PLA with the production of lactic acid monomers, dimers, and larger oligomers as products. The crystal structure of RPA1511 was determined at 2.2 Å resolution and revealed a classical α/ß-hydrolase fold with a wide-open active site containing a molecule of polyethylene glycol bound near the catalytic triad Ser114-His270-Asp242. Site-directed mutagenesis of both proteins demonstrated that the catalytic triad residues are important for the hydrolysis of both monoester and polyester substrates. We also identified several residues in RPA1511 (Gln172, Leu212, Met215, Trp218, and Leu220) and ABO2449 (Phe38 and Leu152), which were not essential for activity against soluble monoesters but were found to be critical for the hydrolysis of PLA. Our results indicate that microbial carboxyl esterases can efficiently hydrolyze various polyesters making them attractive biocatalysts for plastics depolymerization and recycling.

Pressure adaptation is linked to thermal adaptation in salt-saturated marine habitats.

The present study provides a deeper view of protein functionality as a function of temperature, salt and pressure in deep-sea habitats. A set of eight different enzymes from five distinct deep-sea (3040-4908 m depth), moderately warm (14.0-16.5°C) biotopes, characterized by a wide range of salinities (39-348 practical salinity units), were investigated for this purpose. An enzyme from a 'superficial' marine hydrothermal habitat (65°C) was isolated and characterized for comparative purposes. We report here the first experimental evidence suggesting that in salt-saturated deep-sea habitats, the adaptation to high pressure is linked to high thermal resistance (P value = 0.0036). Salinity might therefore increase the temperature window for enzyme activity, and possibly microbial growth, in deep-sea habitats. As an example, Lake Medee, the largest hypersaline deep-sea anoxic lake of the Eastern Mediterranean Sea, where the water temperature is never higher than 16°C, was shown to contain halopiezophilic-like enzymes that are most active at 70°C and with denaturing temperatures of 71.4°C. The determination of the crystal structures of five proteins revealed unknown molecular mechanisms involved in protein adaptation to poly-extremes as well as distinct active site architectures and substrate preferences relative to other structurally characterized enzymes.

Conversion of Uric Acid into Ammonium in Oil-Degrading Marine Microbial Communities: a Possible Role of Halomonads.

Uric acid is a promising hydrophobic nitrogen source for biostimulation of microbial activities in oil-impacted marine environments. This study investigated metabolic processes and microbial community changes in a series of microcosms using sediment from the Mediterranean and the Red Sea amended with ammonium and uric acid. Respiration, emulsification, ammonium and protein concentration measurements suggested a rapid production of ammonium from uric acid accompanied by the development of microbial communities containing hydrocarbonoclastic bacteria after 3 weeks of incubation. About 80 % of uric acid was converted to ammonium within the first few days of the experiment. Microbial population dynamics were investigated by Ribosomal Intergenic Spacer Analysis and Illumina sequencing as well as by culture-based techniques. Resulting data indicated that strains related to Halomonas spp. converted uric acid into ammonium, which stimulated growth of microbial consortia dominated by Alcanivorax spp. and Pseudomonas spp. Several strains of Halomonas spp. were isolated on uric acid as the sole carbon source showed location specificity. These results point towards a possible role of halomonads in the conversion of uric acid to ammonium utilized by hydrocarbonoclastic bacteria.

Diversity of hydrolases from hydrothermal vent sediments of the Levante Bay, Vulcano Island (Aeolian archipelago) identified by activity-based metagenomics and biochemical characterization of new esterases and an arabinopyranosidase.

A metagenomic fosmid expression library established from environmental DNA (eDNA) from the shallow hot vent sediment sample collected from the Levante Bay, Vulcano Island (Aeolian archipelago) was established in Escherichia coli. Using activity-based screening assays, we have assessed 9600 fosmid clones corresponding to approximately 350 Mbp of the cloned eDNA, for the lipases/esterases/lactamases, haloalkane and haloacid dehalogenases, and glycoside hydrolases. Thirty-four positive fosmid clones were selected from the total of 120 positive hits and sequenced to yield ca. 1360 kbp of high-quality assemblies. Fosmid inserts were attributed to the members of ten bacterial phyla, including Proteobacteria, Bacteroidetes, Acidobateria, Firmicutes, Verrucomicrobia, Chloroflexi, Spirochaetes, Thermotogae, Armatimonadetes, and Planctomycetes. Of ca. 200 proteins with high biotechnological potential identified therein, we have characterized in detail three distinct α/ß-hydrolases (LIPESV12_9, LIPESV12_24, LIPESV12_26) and one new α-arabinopyranosidase (GLV12_5). All LIPESV12 enzymes revealed distinct substrate specificities tested against 43 structurally diverse esters and 4 p-nitrophenol carboxyl esters. Of 16 different glycosides tested, the GLV12_5 hydrolysed only p-nitrophenol-α-(L)-arabinopyranose with a high specific activity of about 2.7 kU/mg protein. Most of the α/ß-hydrolases were thermophilic and revealed a high tolerance to, and high activities in the presence of, numerous heavy metal ions. Among them, the LIPESV12_24 was the best temperature-adapted, retaining its activity after 40 min of incubation at 90 °C. Furthermore, enzymes were active in organic solvents (e.g., >30% methanol). Both LIPESV12_24 and LIPESV12_26 had the GXSXG pentapeptides and the catalytic triads Ser-Asp-His typical to the representatives of carboxylesterases of EC 3.1.1.1.

An OFDM Receiver with Frequency Domain Diversity Combined Impulsive Noise Canceller for Underwater Network.

In order to explore marine natural resources using remote robotic sensor or to enable rapid information exchange between ROV (remotely operated vehicles), AUV (autonomous underwater vehicle), divers, and ships, ultrasonic underwater communication systems are used. However, if the communication system is applied to rich living creature marine environment such as shallow sea, it suffers from generated Impulsive Noise so-called Shrimp Noise, which is randomly generated in time domain and seriously degrades communication performance in underwater acoustic network. With the purpose of supporting high performance underwater communication, a robust digital communication method for Impulsive Noise environments is necessary. In this paper, we propose OFDM ultrasonic communication system with diversity receiver. The main feature of the receiver is a newly proposed Frequency Domain Diversity Combined Impulsive Noise Canceller. The OFDM receiver utilizes 20-28 KHz ultrasonic channel and subcarrier spacing of 46.875 Hz (MODE3) and 93.750 Hz (MODE2) OFDM modulations. In addition, the paper shows Impulsive Noise distribution data measured at a fishing port in Okinawa and at a barge in Shizuoka prefectures and then proposed diversity OFDM transceivers architecture and experimental results are described. By the proposed Impulsive Noise Canceller, frame bit error rate has been decreased by 20-30%.

Halorhabdus tiamatea: proteogenomics and glycosidase activity measurements identify the first cultivated euryarchaeon from a deep-sea anoxic brine lake as potential polysaccharide degrader.

Euryarchaea from the genus Halorhabdus have been found in hypersaline habitats worldwide, yet are represented by only two isolates: Halorhabdus utahensis AX-2(T) from the shallow Great Salt Lake of Utah, and Halorhabdus tiamatea SARL4B(T) from the Shaban deep-sea hypersaline anoxic lake (DHAL) in the Red Sea. We sequenced the H. tiamatea genome to elucidate its niche adaptations. Among sequenced archaea, H. tiamatea features the highest number of glycoside hydrolases, the majority of which were expressed in proteome experiments. Annotations and glycosidase activity measurements suggested an adaptation towards recalcitrant algal and plant-derived hemicelluloses. Glycosidase activities were higher at 2% than at 0% or 5% oxygen, supporting a preference for low-oxygen conditions. Likewise, proteomics indicated quinone-mediated electron transport at 2% oxygen, but a notable stress response at 5% oxygen. Halorhabdus tiamatea furthermore encodes proteins characteristic for thermophiles and light-dependent enzymes (e.g. bacteriorhodopsin), suggesting that H. tiamatea evolution was mostly not governed by a cold, dark, anoxic deep-sea habitat. Using enrichment and metagenomics, we could demonstrate presence of similar glycoside hydrolase-rich Halorhabdus members in the Mediterranean DHAL Medee, which supports that Halorhabdus species can occupy a distinct niche as polysaccharide degraders in hypersaline environments.

Evaluation of Selective Culling as a Containment Strategy for African Swine Fever at a Vietnamese Sow Farm.

Selective culling, also known as the "tooth extraction approach", is a strategy for controlling African swine fever (ASF) by removing only sick and suspect animals instead of the entire herd in Vietnam. This method prioritizes preserving healthy animals, particularly valuable breeding pigs. Despite its implementation in various forms, no standardized protocol based on scientific principles has been established. Farms typically adapt this strategy based on their understanding, which can vary significantly. In implementing of selective culling that is not based on scientific principles, there is a significant risk of spreading the disease. The aim of this study is to evaluate the consequences of selective culling as currently implemented in Vietnam. Our analysis on a large sow farm revealed that current practices rely heavily on clinical observations without laboratory confirmations. This approach allows ASF-infected animals to remain on the farm longer, potentially exacerbating the spread of the virus. Thus, selective culling poses a substantial risk by potentially exacerbating the spread of disease. Our findings emphasize that early diagnosis of ASF and systematic removal of infected pigs are critical components for the effective implementation of selective culling strategies and that a high level of fragmentation to minimize contact between animals plays a key role. The optimal approach is to test conspicuous animals and separate them. Under no circumstances should suspect animals be left in the herd for several days before they become severely ill and succumb to the disease.

Transarterial doxorubicin-eluting beads embolization for the treatment of desmoid fibromatosis in the pubic region.

Desmoid fibromatosis (DFs) is rare, low-grade neoplasm. Although it poses no risk of metastasis, DFs exhibits a range of clinical manifestations characterized by local infiltrative growth tendencies and a propensity for recurrence. Despite its nonmalignant nature, DFs can be highly debilitating and occasionally life-threatening, causing severe pain and functional limitations. Traditionally, surgery served as the conventional primary treatment approach; nevertheless, a recent shift in paradigm towards a more conservative management has emerged, accompanied by efforts to standardize the strategy among clinicians. Systemic doxorubicin has been demonstrated to be effective in treating DFs; however, it carries potential risks of adverse effects on the cardiovascular, digestive, and hematologic systems. The novel intravascular intervention employing drug-eluting beads loaded with doxorubicin represents an effective treatment for DFs, optimizing drug delivery to the target lesion and reducing systemic toxicity. In this article, we present a rare case of DFs in the right pubic region treated with transarterial doxorubicin-eluting beads embolization.

Potential uses of gut weed Enteromorpha spp. as a feed for herbivorous fish.

Three separate experiments were performed to assess the potential use of gut weeds Enteromorpha spp. as a food source for herbivorous fish. The fresh or dried gut weeds were used as a direct feed to replace commercial feed in an alternative approach for feeding spotted seat (Scatophagus argus), red tilapia (Oreochromis sp.), and giant gourami (Osphronemus goramy) juveniles for 60 days, 45 days, and 56 days, respectively. Four feeding regimes were applied to triplicate tanks and fish was fed daily either commercial feed or gut weed: (1) single commercial feed everyday as a control treatment, (2) single gut weed daily and 2 alternative feeding regimes where (3) 1 day commercial feed and 1 consecutive day gut weed or and (4) 2 consecutive days gut weed. The results indicated that survival of experimental fish was not affected by the feeding treatments. Growth performance of the S. argus fed single gut weed was not significantly different from the control group (P>0.05). Growth rates of Oreochromis sp. and O. goramy in the alternative feeding treatments were comparable to the control treatment. Application of the combined feeding regimes, feed conversion ratio could be reduced from 26.1 to 57.8%. These results indicated that fresh and dried gut weed can be used as a feed to substitute commercial feed for herbivorous fish. Moreover, using gut weeds as a feed could improve water quality in the rearing tanks.

Large intra-abdominal venous malformations in associated with inferior vena cava aneurysm.

Intra-abdominal venous malformations and inferior vena cava aneurysms are rare and difficult to diagnose because of their nonspecific clinical symptoms. These vascular anomalies are important entities due to the risk of thrombosis or rupture. According to the classification of International Society for the Study of Vascular Anomalies, venous malformations are classified as low-flow vascular anomalies, showing absence of arterial and early venous enhancement and slow gradual filling with contrast on delayed venous imaging. Phleboliths related to thrombosis and calcifications, are the key finding of venous malformations. In this article, we report an exceptional case of large intra-abdominal venous malformations in associated with an inferior vena cava aneurysm.

Cushing's syndrome due to atypical carcinoid of the mediastinum.

Ectopic Cushing's syndrome, caused by a neuroendocrine tumor (NET), is a rare finding. NETs of the mediastinum are extremely rare. NETs arising from the anterior mediastinum are generally aggressive. They are widely characterized at clinical presentations, and may be asymptomatic or present with atypical symptoms. Prognosis is often poor due to their local recurrence and distant metastasis despite a multimodal approach. A 33-year-old male patient was admitted to our department with a femoral soft tissue abscess, diabetes, and hypokalemia. He had no typical features of Cushing's syndrome. However, with a few simple tests, that is, a basal hormone profile, and low-dose and high-dose dexamethasone suppression tests, we diagnosed this complicated condition of ectopic adrenocorticotrophic hormone (ACTH) secretion. Thoracic computed tomography revealed an anterior mediastinal mass of 35 × 22 mm. A surgical excision of the tumor was proposed, and intra-operative pathology consultation returned positive for the suspected NET. Immunohistochemically, the tumor cells were positive for CK, CD56, Chromogranin, Synaptophysin, S100, and CD117. No thymic tissue was found. The Ki-67 was 4%. A diagnosis of primary NETs of the mediastinum, intermediate grade (G2), of atypical carcinoids according to WHO 2015 was established. This patient survived with no sequelae, no distant metastasis, no recurrence, and without adjuvant radiotherapy or chemotherapy 2 years after surgery thanks to earlier diagnosis and prompt surgical intervention. Mediastinum ectopic ACTH-secreting tumors are a rare type of cancer. According to recent research, these tumors frequently display more aggressive behavior and are linked to endocrinopathies. It is noted that patient might have a better outcome and a longer survival time due to earlier detection and complete resection of malignancies.

Crucial choices in a global health crisis: Revealing the demand and willingness to pay for a hypothetical monkeypox vaccine - the PREVENT study.

Background: The latent monkeypox outbreak has become the most emergent public health challenge globally. This study was conducted to assess the acceptability, and willingness to take and pay for a hypothetical Monkeypox vaccine among the Vietnamese general public as well as investigate preference for individual vaccine attributes. Methods: An online cross-sectional study was conducted using snowball sampling among 842 respondents in Vietnam in 2022. A Discrete choice experiment (DCE) on preference for six major attributes of vaccine: effectiveness, immunity duration, side effects, mortality rate, restriction, and the cost was applied. Results: Fear of the impact of monkeypox on public health and the economy, vaccine service satisfaction and responsibility to the community were the most weighted factors in the decision to take a hypothetical monkeypox vaccine. Two-thirds of participants were willing to take the vaccine, while insufficient information on monkeypox and the vaccine were the main reasons for vaccine hesitancy. For vaccine attributes, the mortality rate after seven days of vaccination was the most weighted while cost was the least influential attribute. Factors associated with willingness to take and to pay for the monkeypox vaccine included knowledge of transmission, geographical location, service satisfaction, and risk of infection, while financial burden and fear of vaccine were major drivers of hesitancy. Conclusion: Our findings underline an urgent need for effective information dissemination through social media and counseling. The implementation of nationwide monkeypox vaccination requires prioritization and support for high-risk groups as well as consideration for the country's financial resources.

A novel machine learning approach to predict the export price of seafood products based on competitive information: The case of the export of Vietnamese shrimp to the US market.

Predicting the export price of shrimp is important for Vietnam's fisheries. It not only promotes product quality but also helps policy makers determine strategies to develop the national shrimp industry. Competition in global markets is considered to be an important factor, one that significantly influences price. In this study, we predicted trends in the export price of Vietnamese shrimp based on competitive information from six leading exporters (China, India, Indonesia, Thailand, Ecuador, and Chile) who, alongside Vietnam, also export shrimp to the US. The prediction was based on a dataset collected from the US Department of Agriculture (USDA), the Food and Agriculture Organization of the United Nations (FAO), and the World Trade Organization (WTO) (May-1995 to May-2019) that included price, required farming certificates, and disease outbreak data. A super learner technique, which combined 10 single algorithms, was used to make predictions in selected base periods (3, 6, 9, and 12 months). It was found that the super learner obtained results in all base periods that were more accurate and stable than any candidate algorithms. The impacts of variables in the predictive model were interpreted by a SHapley Additive exPlanations (SHAP) analysis to determine their influence on the price of Vietnamese exports. The price of Indian, Thai, and Chinese exports highlighted the advantages of being a World Trade Organization member and the disadvantages of the prevalence of shrimp disease in Vietnam, which has had a significant impact on the Vietnamese shrimp export price.

Elevated congenital heart disease birth prevalence rates found in Central Vietnam and dioxin TCDD residuals from the use of 2, 4, 5-T herbicides (Agent Orange) in the Da Nang region.

Congenital heart disease (CHD) birth prevalence rate in Da Nang City and two adjacent provinces in Central Vietnam reported by Giang et al. in 2019 was 20.09/1000 births, much higher than any CHD birth rates previously reported. In this current study, three physicians trained in pediatric cardiology reanalyzed and reclassified the Giang et al 2019 cardiac anomalies data, eliminating singular small PDAs and separating cardiac defects into 27 contemporary CHD subgroups. These CHD subgroups were then statistically compared with Liu et al. 2019 Global CHD birth prevalence study of Asian Low-Middle Income Countries (LMIC) CHD subgroup rate of 9.34/1000 births (95% CI 8.07-10.70). Despite applying newer diagnostic criteria and refining the cardiac anomalies data, the Da Nang region continued to show significantly (p<0.0001) elevated total CHD birth prevalence rates at 14.71/1000 births (95% CI 12.74-16.69) compared to the Asian LMIC CHD birth prevalence rate 9.34/1000 births. This finding raises the question of whether environmental persistence of the contaminant dioxin TCDD from 2,4,5-T herbicides (Agent Orange) used during the Vietnam War (1961-1971) in the Da Nang region might be a factor associated with elevated CHD birth prevalence, as it is not present in other LMIC surrounding Vietnam. We recommend testing of soils and sediments in rural and agricultural areas in Central Vietnam that received high volume applications of contaminated herbicides to assess the relationship of the higher CHD birth prevalence rate and the presence of residual dioxin TCDD. Enhanced fetal cardiac echocardiograpy in the region to screen for CHD would enable early interventions and could improve outcomes for infants and children.