A pretest-posttest design to assess the effectiveness of an intervention to reduce HIV-related stigma and discrimination in healthcare settings in Vietnam.

INTRODUCTION: Stigma and discrimination are important barriers to HIV epidemic control. We implemented a multi-pronged facility-level intervention to reduce stigma and discrimination at health facilities across three high-burden provinces. Key components of the intervention included measurement of stigma, data review and use, participatory training of healthcare workers (HCWs), and engagement of people living with HIV and key populations in all stigma reduction activities. METHODS: From July 2018 to July 2019, we assessed HIV-related stigma and discrimination among patients and HCWs at 10 facilities at baseline and 9 months following an intervention. A repeated measures design was used to assess the change in stigma and discrimination among HCWs and a repeated cross-sectional design assessed the change in stigma and discrimination experienced by PLHIV. HCWs at target facilities were invited at random and PLHIV were recruited when presenting for care during the two assessment periods. McNemar's test was used to compare paired proportions among HCWs, and chi-square test was used to compare proportions among PLHIV. Mixed models were used to compare outcomes before and after the intervention. RESULTS: Semi-structured interviews were conducted with 649 and 652 PLHIV prior to and following the intervention, respectively. At baseline, over the previous 12 months, 21% reported experiencing discrimination, 16% reported self-stigma, 14% reported HIV disclosure without consent and 7% had received discriminatory reproductive health advice. Nine months after the intervention, there was a decrease in reported stigma and discrimination across all domains to 15%, 11%, 7% and 3.5%, respectively (all p-values <0.05). Among HCWs, 672 completed the pre- and post-intervention assessment. At baseline, 81% reported fear of HIV infection, 69% reported using unnecessary precautions when caring for PLHIV, 44% reported having observed other staff discriminate against PLHIV, 54% reported negative attitudes towards PLHIV and 41% felt uncomfortable working with colleagues living with HIV. The proportions decreased after the intervention to 52%, 34%, 32%, 35% and 24%, respectively (all p-values <0.05). CONCLUSIONS: A multi-pronged facility-level intervention was successful at reducing healthcare-associated HIV-related stigma in Vietnam. The findings support the scale-up of this intervention in Vietnam and highlight key components potentially applicable in other settings.

A large lipoma of the descending colon: A rare case report.

Colon lipoma is a rare benign disease in the gastrointestinal tract with an incidence rate of approximately 0.035%-4.4%. The disease is often asymptomatic, so it is frequently discovered incidentally through endoscopy, computed tomography , or autopsy. When the tumor is over 2 cm in size, symptoms such as abdominal pain, bowel disorders, and bowel obstruction are common. Surgery is considered the mainstay of treatment for colonic lipomas. Furthermore, surgical (rather than endoscopic) resection is preferred for lipomas >2 cm to avoid complications such as bleeding and perforation. We report on a 61-year-old female patient who was diagnosed with a 4-cm descending colonic fat tumor detected by endoscopy and computed tomography and confirmed by pathology.

Partial replacement of pelvis with the hip joint in osteosarcoma treatment: A case report.

INTRODUCTION: and importance: Pelvic osteosarcoma is quite rare and is a challenging task for orthopedic surgeons. This aim of this study is to present the first case report using customized 3D-printed prosthesis in Vietnam. CASE PRESENTATION: 57-year-old male was diagnosed with pelvic osteosarcoma. After neoadjuvant chemotherapy, we did limb-salvage surgery after partial pelvic resection. He had to undergo another surgery due to an infection complication that exposed part of the prosthesis. At 6 months follow-up, the patient's overall status was stable. VAS score when moving is 2/10. He can walk with one crutch. Patient is still being followed up and treated. CLININCAL DISCUSSION: Management of pelvic osteosarcoma remains a challenging task for orthopedic surgeons. Advancements in customized 3D-printed prosthesis have been applied in treatment of pelvic osteosarcoma. Despite the complications, the results are promising. We believe that this is a new and innovative route in surgery of pelvic osteosarcoma. CONCLUSION: Using customized 3D-printed prosthesis is a good way for management of pelvic osteosarcoma.

Tunable LSPR of silver/gold bimetallic nanoframes and their SERS activity for methyl red detection.

Ag/Au bimetallic nanostructures have received much attention in surface-enhanced Raman scattering (SERS). However, the synthesis of this nanostructure type still remains a challenge. In the present research, Ag/Au nanoframes were synthesized via a simple room temperature solution phase chemical reduction method using pre-synthesized triangular Ag nanoplates as templates in the presence of appropriate amounts of HAuCl4. Controlling experimental parameters was applied for understanding of the growth mechanism. The galvanic exchange reaction resulted in a uniform deposition of the Au shell on the Ag nanoplates and the Ag core was removed which generated triangular hollow nanoframes. It is found that the amount of HAuCl4 added to the growth solution played a key role in controlling the Ag/Au nanoframes. The resultant silver/gold nanoframes with average size of 50 nm were applied in detecting methyl red (MR) in the solution-phase using an excitation wavelength laser of 532 nm. The SERS signal was greatly enhanced owing to the tunable plasmonic peaks in the visible region (400-650 nm). The limit of detection (LOD) of MR in diluted solution was 10-6 M. The enhancement factor (EF) was about 8 × 104 toward 10-5 M of MR. Interestingly, the linear dependence between the logarithm of the SERS signal intensity (log I) and the logarithm of the MR concentration (log C) occurred in the range from 10-6 to 10-4 M. Our work promises the application of Ag/Au nanoframes as a chemical sensor in detecting MR molecules at low concentration with high performance.

The structural transition of bimetallic Ag-Au from core/shell to alloy and SERS application.

It is well-known that Ag-Au bimetallic nanoplates have attracted significant research interest due to their unique plasmonic properties and surface-enhanced Raman scattering (SERS). In recent years, there have been many studies on the fabrication of bimetallic nanostructures. However, controlling the shape, size, and structure of bimetallic nanostructures still has many challenges. In this work, we present the results of the synthesis of silver nanoplates (Ag NPls), and Ag-Au bimetallic core/shell and alloy nanostructures, using seed-mediated growth under green LED excitation and a gold salt (HAuCl4) as a precursor of gold. The results show that the optical properties and crystal structure strongly depend on the amount of added gold salt. Interestingly, when the amount of gold(x) in the sample was less than 0.6 µmol (x < 0.6 µmol), the structural nature of Ag-Au was core/shell, in contrast x > 0.6 µmol gave the alloy structure. The morphology of the obtained nanostructures was investigated using the field emission scanning electron microscopy (FESEM) technique. The UV-Vis extinction spectra of Ag-Au nanostructures showed localized surface plasmon resonance (LSPR) bands in the spectral range of 402-627 nm which changed from two peaks to one peak as the amount of gold increased. Ag-Au core/shell and alloy nanostructures were utilized as surface enhanced Raman scattering (SERS) substrates to detect methylene blue (MB) (10-7 M concentration). Our experimental observations indicated that the highest enhancement factor (EF) of about 1.2 × 107 was obtained with Ag-Au alloy. Our detailed investigations revealed that the Ag-Au alloy exhibited significant EF compared to pure metal Ag and Ag-Au core/shell nanostructures. Moreover, the analysis of the data revealed a linear dependence between the logarithm of concentration (log C) and the logarithm of SERS signal intensity (log I) in the range of 10-7-10-4 M with a correlation coefficient (R 2) of 0.994. This research helps us understand better the SERS mechanism and the application of Raman spectroscopy on a bimetallic surface.

International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module.

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.