Exploring cellular immunotherapy platforms in multiple myeloma.

Despite major advances in therapeutic platforms, most patients with multiple myeloma (MM) eventually relapse and succumb to the disease. Among the novel therapeutic options developed over the past decade, genetically engineered T cells have a great deal of potential. Cellular immunotherapies, including chimeric antigen receptor (CAR) T cells, are rapidly becoming an effective therapeutic modality for MM. Marrow-infiltrating lymphocytes (MILs) derived from the bone marrow of patients with MM are a novel source of T cells for adoptive T-cell therapy, which robustly and specifically target myeloma cells. In this review, we examine the recent innovations in cellular immunotherapies, including the use of dendritic cells, and cellular tools based on MILs, natural killer (NK) cells, and CAR T cells, which hold promise for improving the efficacy and/or reducing the toxicity of treatment in patients with MM.

Chronic subdural hematoma associated with type II and type III Galassi arachnoid cysts: illustrative cases.

BACKGROUND: Arachnoid cysts (ACs) are congenital abnormalities that can be located anywhere within the subarachnoid space along the cerebrospinal axis, although they are most often found on the left side in the temporal fossa and sylvian fissure. ACs comprise approximately 1% of all intracranial space-occupying lesions and are considered potential risk factors for subdural hematoma (SDH) in individuals of all age groups who have experienced traumatic brain injury. Although it is uncommon for an intracystic hemorrhage of an AC to occur without evidence of head trauma, it may be more common among children and young adults. Here, the authors present three cases of spontaneous AC intracystic hemorrhage with chronic SDH. Additionally, they provide a thorough review of the existing literature. OBSERVATIONS: All three patients with AC were adolescent males. In all cases, AC was identified using the Galassi classification (type II or III) and associated with spontaneous intracystic hemorrhage and chronic SDH as seen on imaging. LESSONS: Spontaneous intracystic hemorrhage is a rare complication and occurs most commonly on the left side. Surgery is the definitive treatment, requiring either craniotomy or burr hole for hematoma evacuation and microsurgical fenestration to drain the cyst into the subarachnoid cisterns.

Temporal Lobe Surgery for Epilepsy in a Resource-Limited Vietnamese Cohort.

BACKGROUND: Epilepsy surgery is traditionally difficult to pursue in resource-limited countries but is nevertheless essential in the treatment of medication-refractory, surgically amenable epilepsy. METHODS: With the help of international collaboration, a successful epilepsy program was started in Vietnam. This article comprises a retrospective chart review, combined with prospective longitudinal follow-up of 35 cases of unilateral drug-resistant epilepsy in the temporal lobe who underwent temporal lobectomy, in Viet Duc University Hospital from May 2018 to September 2022. RESULTS: The female/male ratio was 0.6:1, and focal seizures with impaired awareness accounted for 97.14% of patients. Of patients with focal awareness seizures, 51.41% were localized and detected by electroencephalography. Postoperatively, 80% of patients were seizure free (Engel I) at 1 year, and the remaining 20% had worthwhile seizure improvement (Engel II). Postoperative temporal lobe pathology was categorized as follows: mesial temporal sclerosis (48.57%), focal cortical dysplasia (25.71%), and low-grade neoplasms (25.71%). Of patients, 17.14% had postoperative complications (5 infections and 1 transient extremity paresis), and there were no deaths. CONCLUSIONS: Even in low-resource environments, effective and safe surgical care can be provided for drug-resistant epilepsy caused by temporal lobe disease. This study serves as a model of international collaboration and support for future hospitals in low-resource environments to replicate.

Microsurgery for drug resistance epilepsy due to temporal lobe lesions in a resource limited condition: a cross-sectional study.

Epilepsy is a prevalent neurological condition that affects individuals of all ages and genders worldwide. Surgical intervention for drug-resistant epilepsy has been found to improve quality of life, with patient independence being of utmost importance. Methods: The study was a retrospective and prospective cross-sectional study of 35 cases of drug-resistant temporal lobe epilepsy. All patients were operated on by the primary author between May 2018 and September 2022. The study evaluated various factors including clinical characteristics, electroencephalogram, magnetic resonance imaging, surgical outcomes, and histopathology. Results: The success rate of the surgeries (74.3%) is similar to those reported in high-income countries. 51.4% underwent selective amygdalohippocampectomy for cases that localized to the mesial temporal lobe. Lateral/neocortical lesions underwent lesionectomy (48.6%). Our study found a complication rate of 17.1%: meningitis (8.5%), trainset focal paralysis (2.9%), and soft tissue infection (5.7%). There were no mortalities. Conclusions: The article showcases an international collaborative effort that demonstrates the possibility of providing highly effective and safe surgical care for temporal lobe epilepsy even in low-resource environments. The authors hope that this model can be replicated in other areas with similar resource limitations.

A case-control study of agricultural and behavioral factors associated with leptospirosis in Vietnam.

INTRODUCTION: Leptospirosis is a neglected disease in Vietnam. Until now, there has been limited knowledge about risk factors of this disease in Vietnam. The study was carried out to identify agricultural and behavioral factors associated with the transmission of leptospirosis in Vietnam. METHODS: This matched retrospective hospital-community-based case-control study was conducted from 1 October 2018 to 31 October 2019. We recruited cases from 11 selected government hospitals in three provinces of Vietnam, while controls were selected from the same communes of cases and matched by age (± 2 years) and sex. Microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA) were applied to determine confirmed cases, while only MAT was used to identify controls with a single high MAT titer < 1:100. RESULTS: 504 participants (252 cases and 252 controls) were identified. Cultivating (OR 2.83, CI 1.38-5.79), animal farming (OR 8.26, CI 2.24-30.52), pig owners (OR 10.48, CI 5.05-21.73), cat owners (OR 2.62, CI 1.49-4.61) and drinking unboiled water (OR 1.72, CI 1.14 -2.59, p = 0.010) were significantly associated with human leptospirosis in Vietnam. Hand washing after farming/ gardening (OR 0.57, CI 0.38-0.86, p = 0.007) and bathing after farming, gardening, contact with cattle and poultry (OR 0.33, CI 0.19-0.58, p = 0.000) were determined as protective factors for this disease. CONCLUSIONS: In short, the case-control study has revealed the risks in agricultural and animal practices and protective behavioral factors related to human leptospirosis in Vietnam. The findings suggested promotion of communication and health education programs targeting health behaviors in daily life and agricultural practices. Using personal protective equipment such as gowns, gloves, and boots during agricultural practices, especially cultivating and animal farming, is most recommended.

Characteristics of human leptospirosis in three different geographical and climatic zones of Vietnam: a hospital-based study.

BACKGROUND: To our knowledge, this study is the first report on the seroprevalence of human leptospirosis and its epidemiological profile in 3 different geographical and climatic zones of Vietnam. METHODOLOGY: A hospital-based surveillance in 11 public hospitals in 3 provinces in Vietnam enrolled 3,815 patients with suspected leptospirosis. Two consecutive enzyme-linked immunosorbent assay IgM and a single microscopic aggregation test were applied at a 1:100 to 1:800 dilution for probable or confirmed cases. RESULTS: The findings showed that of the 3,815 suspected cases, 68 (1.8%) were Leptospira-confirmed and 248 (6.5%) probable cases, whereas more than a third were positive for acute ELISA-IgM sera. Furthermore, 20 different serovars were found, of which Wolffi (14.2%), Hebdomadis (13.8%), and Icterohaemorrhagiae (12.6%) were the most predominant. The ratio of probable and confirmed cases of leptospirosis between females and males was 1.4:1, and their clinical manifestation was not specific. Cases were more likely to be detected in groups that are farmers, pet raising or livestock farming, of working age, practicing either wading in mud or walking barefoot, or exposed to heavy rainfall. CONCLUSIONS: Analysis of human leptospirosis has indicated fairly high seroprevalence and diversity of Leptospira serovars circulating in all studied geographical zones in Vietnam. The findings suggest an imperative need for effective measures of disease prevention, especially in high-risk groups.

Investigation of SARS-CoV-2 presence on environmental surfaces and waste in healthcare and non-healthcare facilities.

Objective: The objective of the paper is to investigate the presence of SARS-CoV-2 on inanimate surfaces in four healthcare facilities treating patients with COVID-19 and four quarantine regiments of provincial military commands. Methods: From August to October 2020, a total of 468 one-off environmental samples consisting of inanimate surfaces, garbage, and wastewater were collected. The real-time RT-PCR assay targeting E and RdRp genes to detect SARS-CoV-2 and checklist and questionnaire of disinfection practices were employed. If detected by RT-PCR, then positive samples are subjected to cell culture to determine viability. Results: The test results showed all samples (100%) to be negative with SARS-CoV-2 resulting in unperformed virus culture. As for recent disinfection practices, chlorine-based products dissolved at a concentration of 0.1% (1000 ppm) in the general context or 0.5% (5000 ppm) for blood and body fluid spills are routinely applied twice a day and at the discharge of patients or quarantined people. Conclusions: The finding may illustrate the importance of disinfection practices in removing pathogens or significantly reducing SARS-CoV-2 contamination on environmental surfaces and waste.

RNAProt: an efficient and feature-rich RNA binding protein binding site predictor.

BACKGROUND: Cross-linking and immunoprecipitation followed by next-generation sequencing (CLIP-seq) is the state-of-the-art technique used to experimentally determine transcriptome-wide binding sites of RNA-binding proteins (RBPs). However, it relies on gene expression, which can be highly variable between conditions and thus cannot provide a complete picture of the RBP binding landscape. This creates a demand for computational methods to predict missing binding sites. Although there exist various methods using traditional machine learning and lately also deep learning, we encountered several problems: many of these are not well documented or maintained, making them difficult to install and use, or are not even available. In addition, there can be efficiency issues, as well as little flexibility regarding options or supported features. RESULTS: Here, we present RNAProt, an efficient and feature-rich computational RBP binding site prediction framework based on recurrent neural networks. We compare RNAProt with 1 traditional machine learning approach and 2 deep-learning methods, demonstrating its state-of-the-art predictive performance and better run time efficiency. We further show that its implemented visualizations capture known binding preferences and thus can help to understand what is learned. Since RNAProt supports various additional features (including user-defined features, which no other tool offers), we also present their influence on benchmark set performance. Finally, we show the benefits of incorporating additional features, specifically structure information, when learning the binding sites of an hairpin loop binding RBP. CONCLUSIONS: RNAProt provides a complete framework for RBP binding site predictions, from data set generation over model training to the evaluation of binding preferences and prediction. It offers state-of-the-art predictive performance, as well as superior run time efficiency, while at the same time supporting more features and input types than any other tool available so far. RNAProt is easy to install and use, comes with comprehensive documentation, and is accompanied by informative statistics and visualizations. All this makes RNAProt a valuable tool to apply in future RBP binding site research.

CRISPRloci: comprehensive and accurate annotation of CRISPR-Cas systems.

CRISPR-Cas systems are adaptive immune systems in prokaryotes, providing resistance against invading viruses and plasmids. The identification of CRISPR loci is currently a non-standardized, ambiguous process, requiring the manual combination of multiple tools, where existing tools detect only parts of the CRISPR-systems, and lack quality control, annotation and assessment capabilities of the detected CRISPR loci. Our CRISPRloci server provides the first resource for the prediction and assessment of all possible CRISPR loci. The server integrates a series of advanced Machine Learning tools within a seamless web interface featuring: (i) prediction of all CRISPR arrays in the correct orientation; (ii) definition of CRISPR leaders for each locus; and (iii) annotation of cas genes and their unambiguous classification. As a result, CRISPRloci is able to accurately determine the CRISPR array and associated information, such as: the Cas subtypes; cassette boundaries; accuracy of the repeat structure, orientation and leader sequence; virus-host interactions; self-targeting; as well as the annotation of cas genes, all of which have been missing from existing tools. This annotation is presented in an interactive interface, making it easy for scientists to gain an overview of the CRISPR system in their organism of interest. Predictions are also rendered in GFF format, enabling in-depth genome browser inspection. In summary, CRISPRloci constitutes a full suite for CRISPR-Cas system characterization that offers annotation quality previously available only after manual inspection.

Surgical management of cerebral peduncle neurocysticercosis: A case report of decision making in a resource-restricted environment.

BACKGROUND: Diagnosis and treatment of neurocysticercosis have always been a challenge, especially in Vietnam, a resource-restricted environment. Here, we reported successful surgical management of cerebral peduncle neurocysticercosis. PRESENTATION OF CASE: A 65-year-old man with no medical history complained of headache and progressive right-sided hemiparesis for one month prior to admission. On examination, his muscle strength was 3/5 (Frankel grade) with positive Hoffmann and Babinski's signs on the right side. His brain's magnetic resonance imaging suggested a cystic brain tumor (29 × 18 mm) situated in the left cerebral peduncle and hypothalamus region. Enzyme-linked immunoassays (ELISA) of serum for Cysticercus cellulosae, Echinococcus, Toxocara, and Amebiasis were negative. The operation was performed with the modified frontotemporal-orbitozygomatic approach. We extirpated both the cysts. Histopathological examination revealed the larva of Taenia solium. Postoperatively, the hemiplegia was completely recovered, and no complication was reported DISCUSSION: The most recent revised diagnostic criteria of neurocysticercosis emphasised that neuroimaging studies play the most crucial role while clinical manifestations and exposure criteria were only indirect proofs of neurocysticercosis. Neuroimaging and clinical evidence in this patient, however, were more suggestive of cystic brain tumor, which was our most likely preoperative diagnosis. Consequently, total tumor resection required for both histopathological examination and alleviating his hemiplegia. CONCLUSIONS: Preoperative diagnosis of neurocysticercosis has always been a challenge. Total resection of the cerebral peduncle neurocysticercosis was adequate when the patient had localized neurological deficits.

Casboundary: automated definition of integral Cas cassettes.

MOTIVATION: CRISPR-Cas are important systems found in most archaeal and many bacterial genomes, providing adaptive immunity against mobile genetic elements in prokaryotes. The CRISPR-Cas systems are encoded by a set of consecutive cas genes, here termed cassette. The identification of cassette boundaries is key for finding cassettes in CRISPR research field. This is often carried out by using Hidden Markov Models and manual annotation. In this article, we propose the first method able to automatically define the cassette boundaries. In addition, we present a Cas-type predictive model used by the method to assign each gene located in the region defined by a cassette's boundaries a Cas label from a set of pre-defined Cas types. Furthermore, the proposed method can detect potentially new cas genes and decompose a cassette into its modules. RESULTS: We evaluate the predictive performance of our proposed method on data collected from the two most recent CRISPR classification studies. In our experiments, we obtain an average similarity of 0.86 between the predicted and expected cassettes. Besides, we achieve F-scores above 0.9 for the classification of cas genes of known types and 0.73 for the unknown ones. Finally, we conduct two additional study cases, where we investigate the occurrence of potentially new cas genes and the occurrence of module exchange between different genomes. AVAILABILITY AND IMPLEMENTATION: https://github.com/BackofenLab/Casboundary. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Improving CLIP-seq data analysis by incorporating transcript information.

BACKGROUND: Current peak callers for identifying RNA-binding protein (RBP) binding sites from CLIP-seq data take into account genomic read profiles, but they ignore the underlying transcript information, that is information regarding splicing events. So far, there are no studies available that closer observe this issue. RESULTS: Here we show that current peak callers are susceptible to false peak calling near exon borders. We quantify its extent in publicly available datasets, which turns out to be substantial. By providing a tool called CLIPcontext for automatic transcript and genomic context sequence extraction, we further demonstrate that context choice affects the performances of RBP binding site prediction tools. Moreover, we show that known motifs of exon-binding RBPs are often enriched in transcript context sites, which should enable the recovery of more authentic binding sites. Finally, we discuss possible strategies on how to integrate transcript information into future workflows. CONCLUSIONS: Our results demonstrate the importance of incorporating transcript information in CLIP-seq data analysis. Taking advantage of the underlying transcript information should therefore become an integral part of future peak calling and downstream analysis tools.

Successful Endoscopic Disconnection for Hypothalamic Hamartomas in a Child with Gelastic Seizures: An Unusual Case in a Resource-Scare Setting.

Although the endoscopic disconnection surgery for the hamartomas was previously shown as a safe and effective treatment strategy in eliminating gelastic epilepsy, to date, there was no convincing evidence with this procedure in the resource-scare settings. We discuss an unusual case of a 7-year-old child who suffered from pharmacoresistant gelastic seizures was surgically treated with the endoscopic disconnection of the hypothalamic hamartomas. The patient underwent endoscopic surgery through the left ventricle approach to disconnect the lesion of the hypothalamus. Immediately after surgery, the patient's clinical laughter was eliminated with no complications. From the initial experience at our center, successful outcome of this case contributes to supporting the solid evidence in choosing the right treatment approach for the hypothalamus in subsequent cases, towards not only Vietnam but also the countries having similar resource-scare conditions.

Long-term sustainability of a physical activity and nutrition intervention for rural adults with or at risk of metabolic syndrome.

OBJECTIVE: To determine longer-term (18-month) sustainability of a six-month physical activity and nutrition intervention for 50-69-year-olds with or at risk of metabolic syndrome residing in a rural Australian community. METHODS: Participants (n=151) were followed-up at 12 and 18 months post-intervention. Changes in nutrition behaviours (fat and fibre barometer); physical activity behaviours (IPAQ); anthropometry (waist-hip ratio, weight, BMI), blood pressure, blood parameters (triglycerides, glucose, LDL-, HDL-, non-HDL, total-cholesterol) were analysed using t-tests and repeated measures ANOVA. RESULTS: Across three time points (6, 12 and 18 months) marginal decrease was observed for waist circumference (p=0.001), a modest increase was observed for diastolic blood pressure (p=0.010) and other outcome measures remained stable. CONCLUSION: Maintenance and ongoing improvement of health behaviours in the longer-term is challenging. Future studies must look for ways to embed interventions into communities so they are sustainable and investigate new approaches to reduce the risk of chronic disease. Implications for public health: Metabolic syndrome is a major health issue in Australia and worldwide. Early identification and management are required to prevent the progression to chronic disease. This 18-month follow-up showed that outcomes measures remained relatively stable; however, there is a need to investigate opportunities for embedded community interventions to support long-term health behaviour change.

Validity of the International Physical Activity Questionnaire-Short Form for Application in Asian Countries: A Study in Vietnam.

This is the first study in the Asia-Pacific region to examine the criterion validity of the self-reported International Physical Activity Questionnaire-Short form (IPAQ-SF) using accelerometers, in terms of achieving the World Health Organization's (WHO) recommended physical activity guidelines for health benefits. Vietnamese adults aged 40-65 years (n = 240) wore an ActiGraph GT3X+ accelerometer for at least 5 days and completed the Vietnamese version of the IPAQ-SF. Correlations between IPAQ-SF and accelerometer-measured physical activity intensities varied from .087 to .232. Mean difference in moderate-vigorous physical activity was 0.699 min/day (95% limits: [-107, 109]). Agreement on the classification of achieving the WHO's physical activity guidelines was 69.16%. The IPAQ-SF identified 71.86% of adults who met the guidelines, whereas 56.09% of those not meeting the guidelines were classified correctly. The IPAQ-SF was found to have acceptable criterion validity and is a useful instrument to classify Vietnamese adults as achieving or not achieving the WHO's physical activity guidelines for health benefits.

Heterogeneous networks integration for disease-gene prioritization with node kernels.

MOTIVATION: The identification of disease-gene associations is a task of fundamental importance in human health research. A typical approach consists in first encoding large gene/protein relational datasets as networks due to the natural and intuitive property of graphs for representing objects' relationships and then utilizing graph-based techniques to prioritize genes for successive low-throughput validation assays. Since different types of interactions between genes yield distinct gene networks, there is the need to integrate different heterogeneous sources to improve the reliability of prioritization systems. RESULTS: We propose an approach based on three phases: first, we merge all sources in a single network, then we partition the integrated network according to edge density introducing a notion of edge type to distinguish the parts and finally, we employ a novel node kernel suitable for graphs with typed edges. We show how the node kernel can generate a large number of discriminative features that can be efficiently processed by linear regularized machine learning classifiers. We report state-of-the-art results on 12 disease-gene associations and on a time-stamped benchmark containing 42 newly discovered associations. AVAILABILITY AND IMPLEMENTATION: Source code: https://github.com/dinhinfotech/DiGI.git. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Physical activity and nutrition behaviour outcomes of a cluster-randomized controlled trial for adults with metabolic syndrome in Vietnam.

BACKGROUND: Metabolic syndrome is prevalent among Vietnamese adults, especially those aged 50-65 years. This study evaluated the effectiveness of a 6 month community-based lifestyle intervention to increase physical activity levels and improve dietary behaviours for adults with metabolic syndrome in Vietnam. METHODS: Ten communes, involving participants aged 50-65 years with metabolic syndrome, were recruited from Hanam province in northern Vietnam. The communes were randomly allocated to either the intervention (five communes, n = 214) or the control group (five communes, n = 203). Intervention group participants received a health promotion package, consisting of an information booklet, education sessions, a walking group, and a resistance band. Control group participants received one session of standard advice during the 6 month period. Data were collected at baseline and after the intervention to evaluate programme effectiveness. The International Physical Activity Questionnaire - Short Form and a modified STEPS questionnaire were used to assess physical activity and dietary behaviours, respectively, in both groups. Pedometers were worn by the intervention participants only for 7 consecutive days at baseline and post-intervention testing. To accommodate the repeated measures and the clustering of individuals within communes, multilevel mixed regression models with random effects were fitted to determine the impacts of intervention on changes in outcome variables over time and between groups. RESULTS: With a retention rate of 80.8%, the final sample comprised 175 intervention and 162 control participants. After controlling for demographic and other confounding factors, the intervention participants showed significant increases in moderate intensity activity (P = 0.018), walking (P < 0.001) and total physical activity (P = 0.001), as well as a decrease in mean sitting time (P < 0.001), relative to their control counterparts. Significant improvements in dietary behaviours were also observed, particularly reductions in intake of animal internal organs (P = 0.001) and in using cooking oil for daily meal preparation (P = 0.001). CONCLUSIONS: The prescribed community-based physical activity and nutrition intervention programme successfully improved physical activity and dietary behaviours for adults with metabolic syndrome in Vietnam. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12614000811606 . Registered on 31 July 2014.

Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation.

INTRODUCTION: The Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50-65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN. METHODS: Data were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n=163); qualitative data via face-to-face exit interviews with intervention program completers (n=10) and non-completers (n=10), and brief post education session discussions. RESULTS: Most participants (87%-96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy. CONCLUSION: The evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population.

Effectiveness of a Community-Based Physical Activity and Nutrition Behavior Intervention on Features of the Metabolic Syndrome: A Cluster-Randomized Controlled Trial.

BACKGROUND: Metabolic syndrome (MetS) and its subclinical diseases are now public health problems in Vietnam. This study aimed at determining the effectiveness of a physical activity and nutrition program for reducing MetS proportion and its components among adults with MetS in Hanam province, Vietnam. METHODS: A total of 417 volunteers aged 50-65 years with MetS were recruited from 10 communes. The communes were randomly allocated to an intervention group (five communes, n = 214) and a control group (five communes, n = 203). The participants in the intervention group received a nutrition and physical activity program for 6 months, whereas participants in the control group received standard diet and physical activity advice on only one occasion. Anthropometry, lipid profiles, glycemic status, and blood pressure were measured at baseline and at 6 months to evaluate program effectiveness. RESULTS: In total, 175 intervention (81.8%) and 162 control (79.8%) participants completed the post-program evaluation. After controlling for the effects of clustering and confounding factors, the intervention group showed significant improvements in high-density lipoprotein cholesterol (+0.42 mM, P < 0.001), waist circumference (-1.63 cm, P < 0.001), waist-to-hip ratio (-0.024, P < 0.001), weight (-1.44 kg, P < 0.001), and body mass index (-0.59 kg/m2, P < 0.001) when compared with the control group. A reduction in the MetS proportion was found in both intervention and control groups (P < 0.001), decreasing to 56.0% and 75.9%, respectively, but the post-program proportion was significantly lower among the intervention participants (P < 0.001). Furthermore, the mean number of MetS components exhibited by individuals decreased significantly in the intervention group (P < 0.001). CONCLUSIONS: The community-based physical activity and nutrition program reduced MetS proportion, with significant improvements in several metabolic and anthropometric parameters for Vietnamese adults with MetS.

Community-based physical activity and nutrition programme for adults with metabolic syndrome in Vietnam: study protocol for a cluster-randomised controlled trial.

INTRODUCTION: Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular diseases and type II diabetes. In Vietnam, more than one-quarter of its population aged 50-65 have MetS. This cluster-randomised controlled trial aims to evaluate the effectiveness of interventions to increase levels of physical activity and improve dietary behaviours among Vietnamese adults aged 50-65 years with MetS. METHOD AND ANALYSIS: This 6-month community-based intervention includes a range of strategies to improve physical activity and nutrition for adults with MetS in Hanam, a province located in northern Vietnam. 600 participants will be recruited from 6 communes with 100 participants per commune. The 6 selected communes will be randomly allocated to either an intervention group (m=3; n=300) or a control group (m=3; n=300). The intervention comprises booklets, education sessions, resistance bands and attending local walking groups that provide information and encourage participants to improve their physical activity and healthy eating behaviours during the 6-month period. The control group participants will receive standard and 1-time advice. Social cognitive theory is the theoretical concept underpinning this study. Measurements will be taken at baseline and postintervention to evaluate programme effectiveness. ETHICS AND DISSEMINATION: The research protocol was approved by the Curtin University Human Research Ethics Committee (approval number: HR139/2014). The results of the study will be disseminated through publications, reports and conference presentations. TRIAL REGISTRATION NUMBER: ACTRN12614000811606.