Rural-urban differences in preferences for influenza vaccination among women of childbearing age: implications for local vaccination service implementation in Vietnam.

OBJECTIVES: Pregnant women and new mothers are among the most vulnerable to seasonal influenza; however, little is known about their preferences for flu vaccination. We examined the rural-urban differences in uptake, demand and willingness to pay (WTP) for influenza vaccination among women of childbearing age, to assess the feasibility of implementing locally produced vaccines in Vietnam. METHODS: A cross-sectional study was performed in both urban and rural areas of Hanoi in 2018. Socio-demographic characteristics, history of vaccination, demand and WTP for influenza vaccines were obtained. A multivariate logistic regression model was employed to identify the associated factors. RESULTS: Of 750 participants, 29.9% had had flu shots in the current or previous flu season and 64.3% indicated demand for this vaccine. The median of the maximum amount of WTP for influenza vaccination services was US$ 8.5 (IQR: 8.5-17.0). Women living in rural areas had a significantly lower uptake and higher demand, and were willing to pay less than women in urban locations (21.1% vs. 36.6%; 69% vs. 60.2%; and US $8.5 vs. US $11.7, respectively). For urban participants, factors associated with higher demand and WTP for flu shots included having ANC in health facilities and having been vaccinated against influenza in the past; for rural women, these factors were having suffered from influenza and hearing about it. CONCLUSIONS: This study informs the feasibility of implementing locally produced influenza vaccines in Vietnam. Educational programs, along with counselling services and government subsidies, should be implemented to improve the coverage, demand and WTP for the vaccine.

OBJECTIFS: Les femmes enceintes et les nouvelles mères sont parmi les plus vulnérables à la grippe saisonnière; cependant, on en sait peu sur leurs préférences pour la vaccination contre la grippe. Nous avons examiné les différences entre les zones rurales et urbaines dans l'adoption, la demande et la volonté de payer pour la vaccination antigrippale chez les femmes en âge de procréer, afin d'évaluer la faisabilité de la mise en œuvre de vaccins produits localement au Vietnam. MÉTHODES: Une étude transversale a été réalisée dans les zones urbaines et rurales de Hanoi en 2018. Les caractéristiques sociodémographiques, les antécédents de vaccination, la demande et la volonté de payer pour les vaccins antigrippaux ont été obtenus. Un modèle de régression logistique multivariée a été utilisé pour identifier les facteurs associés. RÉSULTATS: Sur 750 participantes, 29,9% s'étaient fait vacciner contre la grippe au cours de la saison grippale actuelle ou précédente, 64,3% ont indiqué une demande pour ce vaccin. La médiane du montant maximal de la volonté de payer pour les services de vaccination contre la grippe était de 8,5 USD (IQR: 8,5 à 17,0). Les femmes vivant dans les zones rurales avaient une adoption nettement plus faible, une demande plus élevée et étaient prêtes à payer moins que les femmes des zones urbaines (21,1% contre 36,6%; 69% contre 60,2%; et 8,5 USD contre 11,7 USD, respectivement). Pour les participantes urbaines, les facteurs associés à une demande plus élevée et à la volonté de payer pour les vaccins contre la grippe comprenaient le fait d'avoir des soins prénatals dans les établissements de santé et d'avoir été vaccinés contre la grippe dans le passé; pour les femmes rurales, ces facteurs comprenaient, avoir souffert de la grippe et en avoir entendu parler. CONCLUSIONS: Cette étude informe sur la faisabilité de la mise en œuvre de vaccins antigrippaux produits localement au Vietnam. Des programmes éducatifs, ainsi que des services de conseil et des subventions gouvernementales devraient être mis en œuvre pour améliorer la couverture, la demande et la volonté de payer pour le vaccin.

Cosmic Bell Test: Measurement Settings from Milky Way Stars.

Bell's theorem states that some predictions of quantum mechanics cannot be reproduced by a local-realist theory. That conflict is expressed by Bell's inequality, which is usually derived under the assumption that there are no statistical correlations between the choices of measurement settings and anything else that can causally affect the measurement outcomes. In previous experiments, this "freedom of choice" was addressed by ensuring that selection of measurement settings via conventional "quantum random number generators" was spacelike separated from the entangled particle creation. This, however, left open the possibility that an unknown cause affected both the setting choices and measurement outcomes as recently as mere microseconds before each experimental trial. Here we report on a new experimental test of Bell's inequality that, for the first time, uses distant astronomical sources as "cosmic setting generators." In our tests with polarization-entangled photons, measurement settings were chosen using real-time observations of Milky Way stars while simultaneously ensuring locality. Assuming fair sampling for all detected photons, and that each stellar photon's color was set at emission, we observe statistically significant ≳7.31σ and ≳11.93σ violations of Bell's inequality with estimated p values of ≲1.8×10^{-13} and ≲4.0×10^{-33}, respectively, thereby pushing back by ∼600 years the most recent time by which any local-realist influences could have engineered the observed Bell violation.

Detecting Spread of Avian Influenza A(H7N9) Virus Beyond China.

During February 2013-March 2015, a total of 602 human cases of low pathogenic avian influenza A(H7N9) were reported; no autochthonous cases were reported outside mainland China. In contrast, since highly pathogenic avian influenza A(H5N1) reemerged during 2003 in China, 784 human cases in 16 countries and poultry outbreaks in 53 countries have been reported. Whether the absence of reported A(H7N9) outside mainland China represents lack of spread or lack of detection remains unclear. We compared epidemiologic and virologic features of A(H5N1) and A(H7N9) and used human and animal influenza surveillance data collected during April 2013-May 2014 from 4 Southeast Asia countries to assess the likelihood that A(H7N9) would have gone undetected during 2014. Surveillance in Vietnam and Cambodia detected human A(H5N1) cases; no A(H7N9) cases were detected in humans or poultry in Southeast Asia. Although we cannot rule out the possible spread of A(H7N9), substantial spread causing severe disease in humans is unlikely.

A single institutional comparison of endoscopic and open abdominal component separation.

BACKGROUND: The authors analyzed surgical factors and outcomes data in the largest single institutional study comparing endoscopic (ECS) and open component separation (OCS) in ventral hernia repairs (VHR). METHODS: A prospectively maintained database was reviewed, identifying 76 patients who underwent component separation for VHR with mesh from 2010 to 2013: 34 OCS and 42 ECS. Comparisons were made for demographics, surgical risk factors, and peri-operative outcomes. Wound complications and hernia occurrence post-operatively were reviewed. Risk analyses were performed to determine the association of pre-operative risk factors with surgical site occurrences. RESULTS: Twenty-five ECS patients underwent subsequent laparoscopic hernia repair, and 17 underwent open repair. Operative time for ECS was longer than OCS (334 vs. 239 min; P < 0.001); however, there was no difference in length of stay (4 days in both groups, P = 0.64) and estimated blood loss (ECS: 97 vs. OCS: 93 cc, P = 0.847). In a sub-analysis of ECS patients, those who underwent laparoscopic hernia repair had a 96 min shorter operative time (P < 0.001) and lower EBL (63 vs. 147 cc, P < 0.001) than open repair. Wound complications were 24% in the ECS (n = 10) and 32% in OCS group (n = 11). There was one midline hernia recurrence in the ECS group (mean follow-up of 8 months, range 0.5-34.5 months) and no hernia recurrences in the OCS group (mean follow-up 10 months, range 0.5-30 months). Three of the patients in the ECS group developed new lateral abdominal wall hernias post-operatively. CONCLUSIONS: The ECS group had a significantly longer operative time than the OCS group. Post-operative wound complications were similar between ECS and OCS groups. Patients in the ECS group who underwent subsequent laparoscopic VHR had a shorter operative time and blood loss than open repair.

Are Gamers Prone to eThrombosis during Long Gaming Sessions?

During the last two decades, several cases of venous thrombosis (VTE) after a prolonged period at a computer have been described, denominated as "eThrombosis". Video gaming on a computer has become very popular and can be a social activity where several players gather to play against each other or in a virtual environment for several days ("LAN (i.e., Local Area Network) parties") where the participants are sedentary and consuming calorie-rich food items. The aim of this study was to investigate potential coagulation activation during a 42 h LAN party. Nine male gamers volunteered for the LAN party. Citrated blood was sampled before and every 6 h, and plasma was analyzed for thrombin generation, thrombin-antithrombin complexes (TAT), prothrombin fragment 1 + 2 (F1 + 2), and D-dimer. Thrombin generation increased slightly but not significantly during the LAN party, whereas the coagulation activation markers were unchanged. These results do not indicate that the coagulation system is activated significantly during 42 h of gaming with minimal physical activity. Although increased activity cannot be excluded, it does not directly indicate a risk of VTE in general.

Cerebral Venous Sinus Thrombosis Following COVID-19 and Otogenic Infection: A Diagnostic and Therapeutic Dilemma Followed by mRNA COVID-19 Vaccination.

IntroductionCerebral venous sinus thrombosis (CVST) is a rare neurovascular emergency that has been observed following COVID-19 infection, as well as following the use of non-mRNA COVID-19 vaccines. Case PresentationThe authors report a case of CVST in a 67-year-old woman, unvaccinated for COVID-19, who presented with acute otitis externa. It remains unclear whether the CVST was a following COVID-19 infection complication, otogenic CVST, or a combination of both. ConclusionThis case demonstrates the diagnostic and therapeutic dilemmas in managing this patient's challenging anticoagulation and antibiotic duration, as well as subsequent COVID-19 vaccination recommendations.

Changes in the Harpagide, Harpagoside, and Verbascoside Content of Field Grown Scrophularia lanceolata and Scrophularia marilandica in Response to Season and Shade.

Scrophularia lanceolata Pursh and Scrophularia marilandica L. are two common species within the Scrophulariaceae family that are endemic to North America. Historically, these species were used by indigenous peoples and colonialists to treat sunburn, sunstroke, frostbite, edema, as well as for blood purification, and in women's health. Several iridoid and phenylethanoid/phenylpropanoid glycosides detected in these species, such as harpagoside and verbascoside, possess anti-inflammatory and anti-nociceptive properties. Due to the presence of anti-inflammatory metabolites and the historical uses of these species, we performed a two-year field study to determine the optimal production of these important compounds. We subjected the plants to shade treatment and analyzed differences in the metabolite composition between the two species and each of their leaves, stems, and roots at various times throughout the growing seasons. We determined that S. lanceolata plants grown in full sun produced 0.63% harpagoside per dried weight in their leaves compared to shade-grown plants (0.43%). Furthermore, S. lanceolata accumulated more harpagoside than S. marilandica (0.24%). We also found that verbascoside accumulated in the leaves of S. lanceolata and S. marilandica as the growing season progressed, while the production of this metabolite remained mostly seasonally unchanged in the roots of both species.

Concurrent Delusions of Ocular Parasitosis and Complex Visual Hallucinations from Charles Bonnet Syndrome Treated Successfully with Aripiprazole in an Elderly Male: A Case Report.

INTRODUCTION: Delusional parasitosis (DP) has been described as among the most challenging diagnosis to manage in dermatology and psychiatry literature. Patients with this perplexing and enigmatic condition present potentially to a wide range of specialties including primary or emergency care, dermatology, infectious diseases, neurology, and psychiatry. DP is probably underdiagnosed from patients' underreporting of symptoms of being infested with parasites, resulting from the associated social stigma. In addition, specialists who most often encounter these patients often possess low familiarity and comfort level in the diagnosis and therapy of this disorder. To our knowledge, we present only the fifth case of delusional parasitosis that was associated with complex visual hallucinations. Both concurrent conditions were treated successfully with aripiprazole. Interestingly, in all of these prior cases including ours, the patients were elderly (age range, 74-95 years). Delusions of ocular parasitosis has been described in fewer than 11 cases. When delusions occur concurrently with hallucinations, the differential diagnosis becomes even more challenging and may include schizophrenia, drug-induced psychosis, Lewy body dementia, and Charles Bonnet syndrome. Our patient's delusions of ocular parasitosis led to ocular damage and severe visual impairment because of his constant need to extract the parasites from his eyes. We speculate that the subsequent complex visual hallucinations that developed can best be understood as Charles Bonnet syndrome. CASE PRESENTATION: A 78-year-old healthy African American male complained of pests and bugs approximately 2 cm in size that infested the skin of his entire body. He also described the life cycle of these parasites, which jumped onto his eyelids and conjunctiva. He developed functional vision blindness from his unwillingness to open his eyelids as a result of his attempts to block the parasites. He was evaluated by dermatology, infectious diseases, ophthalmology, and psychiatry. All specialists agreed with the diagnosis of DP, and recommended antipsychotic therapy. They consistently dismissed the patient's symptoms as anything more than psychiatric, so the patient did not follow-up for further assessments or other therapies. Even months after the diagnosis of DP, he developed complex visual hallucinations. He described new visions in vivid detail: inanimate objects (buildings, jackhammers, torches, planes), animals (bears, doves, sharks), shapes (triangles, rectangles, omega, and mason signs). The objects interacted on high-definition landscapes such as oceans. He refused further psychiatric assessment because he felt strongly that the symptoms were infectious in nature and not psychiatric. However, a therapeutic relationship with his geriatrician was established through empathic communications, goal setting, and shared decision making. He even agreed to start treatment with aripiprazole 2 mg because the shared goal was symptom management of the concurrent delusional parasitosis and complex visual hallucinations. The slow titration of aripiprazole to 6 mg led to a 75% reduction in the delusions and hallucinations. He initially declined higher dosages of the aripiprazole because of sedation and personal wariness of medications in general. However, a therapeutic relationship was nurtured based on respect, careful listening, and provision of options. Eventually, he agreed to a higher dosage of aripiprazole and thus titrate antipsychotic therapy that he rejected when prescribed by the dermatology and psychiatry specialists. We attempted to approximate the 15-mg dosage that led to remission of symptoms in previous case reports.

Comprehensive Investigation of the Behavior of Polyurethane Foams Based on Conventional Polyol and Oligo-Ester-Ether-Diol from Waste Poly(ethylene terephthalate): Fireproof Performances, Thermal Stabilities, and Physicomechanical Properties.

The chemical recycling of postconsumer poly(ethylene terephthalate) (PET) bottles to produce highly thermally stable polyurethane foam (r-PUF) with excellent flame-retardant (FR) performance could be applied on an industrial scale to create a sustainable recycling industry. The advantage of oligo-ester-ether-diol obtained from waste PET glycolysis is its application in r-PUF, generating a durable foam with excellent fire resistance at rather low loadings of phosphorus-nitrogen FRs (P-N FRs), especially in high moisture environments. Compared to polyurethane foam from commercial polyol (c-PUF), r-PUF is notably more thermally stable and efficient in terms of flame retardancy, even without adding FRs. By incorporating 15 php diammonium phosphate (DAP) as a P-N FR, r-PUF/DAP self-extinguished 5 s after the removal of the 2nd flame application with a limited oxygen index value of 24%. However, for c-PUF, a much higher DAP (30 php) loading did not exhibit any rating in the vertical burning test. The aromatic moiety in the oligo-ester-ether-diol structure strongly enhanced the compressive strength and thermal stability. The positive outcomes of this study also confirmed that the r-PUF/DAP prepared from oligo-ester-ether-diol not only satisfied the fire safety requirements of polymer applications but also contained a high percentage of postconsumer PET, which could help reduce the amount of recycled polymer materials and improve waste management.

Clients of female sex workers as a bridging population in Vietnam.

Understanding bridging behaviors of clients of female sex workers (FSWs) is important for projecting and intervening in the spread of sexually transmitted infections in Vietnam. The goals of the study were to determine HIV/STI prevalence amongst different bridging groups, identify factors associated with being potential and active bridgers, and assess the association of drug use and unsafe sex with HIV and/or STI prevalence. In April, 2007, 292 clients were anonymously interviewed at sex venues in a two-stage time-location cluster sampling survey, followed by HIV, syphilis, and HSV-2 testing. Based on condom use with both high-risk (FSWs) and low-risk (wives/girlfriends) sexual partners, clients were classified as unlikely, potential, or active bridgers. The majority of clients were potential or active bridgers (55.8%) who had a significantly higher prevalence of herpes simplex type 2 (HSV-2) (21% and 33%, respectively) than unlikely bridgers (8.7%). HIV seropositivity was 4.4-fold (95% CI 1.1-17.1) higher among those who were HSV-2-positive. Clients of FSWs may be playing a major bridging role in transmitting HIV and sexually transmitted infections (STIs) in Vietnam. An observed synergistic interaction between drug use and condom slippage/breakage emphasizes the importance of proper condom use, particularly among drug users.

Stakeholder Engagement in Late-Stage Translation Phase 4 Research for Noncommunicable Diseases in Low- and Middle-Income Countries: What Works and Why-The Vietnam Experience (UMMS-Vietnam Team).

BACKGROUND: Stakeholder engagement is crucial for conducting high-quality implementation research as well as for the incorporation and adoption of health interventions and policies in the community. OBJECTIVES: This study sought to build a mutually rewarding collaboration between stakeholders in Vietnam and investigators in the United States. METHODS: A collaboration was established between investigators from several institutions in Vietnam and the University of Massachusetts Medical School that was built on mutual trust, cross-cultural learning, and shared experiences. This collaborative arrangement has led to sustainable stakeholder engagement in Vietnam. We formed a multidisciplinary transnational research team and maintained regular contact both online and in person. We also conducted a needs assessment study, in which several focus group discussions and in-depth interviews of stakeholders in Vietnam were carried out. RESULTS: The formal collaboration between investigators in Vietnam and the University of Massachusetts Medical School began in 2011 and has strengthened over time. The U.S. team provided expertise in study and intervention design, data collection and analysis, and trial implementation, whereas the team in Vietnam brought a deep understanding of local health care delivery systems and expertise in the delivery of health care interventions at the grassroots level. Our initial partnership has now grown to include committed individuals at the government, academic, and community levels including the Vietnam Ministry of Health, key governmental and nongovernmental research institutions and agencies, medical and public health universities, and communities in rural settings. The needs assessment study found that there are important gaps in the delivery of hypertension management practices in many rural communities in Vietnam and that stakeholders are fully engaged in our ongoing, community-based, hypertension-control project. CONCLUSIONS: Multiple layers of stakeholders and communities in Vietnam are fully engaged with, and have contributed significantly to, our ongoing hypertension control research project in Northern Vietnam.

Genetic analysis of influenza A/H3N2 and A/H1N1 viruses circulating in Vietnam from 2001 to 2006.

Influenza A virus has the ability to overcome immunity from previous infections through the acquisition of genetic changes. Thus, understanding the evolution of the viruses in humans is important for the surveillance and the selection of vaccine strains. A total of 30 influenza A/H3N2 viruses and 35 influenza A/H1N1 viruses that were collected in Vietnam from 2001 to 2006 were used to analyze the evolution of the hemagglutinin (HA), neuraminidase (NA), and matrix protein (M) genes. Phylogenetic analysis of individual gene segments revealed that the HA and the NA genes of the influenza A viruses evolved in a sequential way. However, the evolutionary pattern of the M gene proved to be nonlinear and was not linked with that of the HA and NA genes. Genetic drift in HA1 segments, especially in the antigenic sites of A/H3N2 viruses, occurred more frequently in A/H3N2 viruses than it did in A/H1N1 viruses. Two reassortants, one influenza A/H3N2 strain and one A/H1N1 strain, were found on the basis of the phylogenetic analysis of the three genes. While both genetic mutation and reassortment contributed to their evolution, the frequency of genetic changes and reassortment events differs between the two subtypes. As influenza viruses circulate throughout the year, we emphasize the importance of surveillance in tropical and subtropical zones, where the emergence of new strains may be detected earlier than it is in temperate zones.

HIV prevalence and factors associated with HIV infection among male injection drug users under 30: a cross-sectional study in Long An, Vietnam.

BACKGROUND: Sufficient targeted HIV prevention activities aiming at reducing HIV transmission within and from an extremely marginalized population of injection drug users (IDUs) must urgently and efficiently be implemented in Vietnam. This study was conducted to facilitate the development of such activities by describing transmission risks of young IDUs and evaluating factors in association with HIV infection. METHODS: Thirty clusters were selected from 29 hotspot communes in Long An province by probability proportional to size (PPS) sampling method. The snowball technique was used for enrolling participants in each cluster. The cross-sectional association of factors obtained during direct structured interviews to 248 male IDUs aged 14 to 29 years old and with their HIV test results were examined. RESULTS: The HIV prevalence among the studied IDUs was 32%. Age range of 18-20 years old, low educational level, sharing injection equipment or injection drug use in the other cities were independently associated with HIV serostatus in the multivariate analysis. Sexual behaviors did not differ between HIV-positive and -negative IDUs. Among HIV seropositive IDUs who had sexual contact with primary (n = 37), casual (n = 6), and commercial (n = 15) partners, only 5.4% (n = 2), 33.3% (n = 2), and 46.7% (n = 7), respectively, responded that they had used condoms every time. CONCLUSION: About one-third of young IDUs aged less than 30 identified in the hotspot communes in Long An, Vietnam was found to be infected with HIV, and socio-demographic and injection-related factors might account for the infection risk. Prevailing risky sexual behavior of this extremely marginalized population highlights the need to reduce their high transmission risks as a public health priority.

An Interdisciplinary Approach to the Development and Implementation of Electronic Treatment Orders in a Medical Oncology Department.

This article provides a review of the interdisciplinary approach, implementation methods, and subsequent outcomes of transitioning to an electronic-based chemotherapy and biotherapy ordering system in a community hospital-based ambulatory medical oncology department. The electronic medical record solution system platform that was used in this setting was Cerner PowerChart®, which is certified by the Certification Commission for Healthcare Information Technology.
.

A Character Level Based and Word Level Based Approach for Chinese-Vietnamese Machine Translation.

Chinese and Vietnamese have the same isolated language; that is, the words are not delimited by spaces. In machine translation, word segmentation is often done first when translating from Chinese or Vietnamese into different languages (typically English) and vice versa. However, it is a matter for consideration that words may or may not be segmented when translating between two languages in which spaces are not used between words, such as Chinese and Vietnamese. Since Chinese-Vietnamese is a low-resource language pair, the sparse data problem is evident in the translation system of this language pair. Therefore, while translating, whether it should be segmented or not becomes more important. In this paper, we propose a new method for translating Chinese to Vietnamese based on a combination of the advantages of character level and word level translation. In addition, a hybrid approach that combines statistics and rules is used to translate on the word level. And at the character level, a statistical translation is used. The experimental results showed that our method improved the performance of machine translation over that of character or word level translation.

Text normalization for named entity recognition in Vietnamese tweets.

BACKGROUND: Named entity recognition (NER) is a task of detecting named entities in documents and categorizing them to predefined classes, such as person, location, and organization. This paper focuses on tweets posted on Twitter. Since tweets are noisy, irregular, brief, and include acronyms and spelling errors, NER in those tweets is a challenging task. Many approaches have been proposed to deal with this problem in tweets written in English, Germany, Chinese, etc., but none for Vietnamese tweets. METHODS: We propose a method that normalizes a tweet before taking as an input of a learning model for NER in Vietnamese tweets. The normalization step detects spelling errors in a tweet and corrects them using an improved Dice's coefficient or n-grams. A Support Vector Machine learning algorithm is employed to learn a classifier using six different types of features. RESULTS AND CONCLUSION: We train our method on a training set consisting of more than 40,000 named entities and evaluate it on a testing set consisting of 3,186 named entities. The experimental results showed that our system achieves state-of-the-art performance with F1 score of 82.13%.

n-Gram-Based Text Compression.

We propose an efficient method for compressing Vietnamese text using n-gram dictionaries. It has a significant compression ratio in comparison with those of state-of-the-art methods on the same dataset. Given a text, first, the proposed method splits it into n-grams and then encodes them based on n-gram dictionaries. In the encoding phase, we use a sliding window with a size that ranges from bigram to five grams to obtain the best encoding stream. Each n-gram is encoded by two to four bytes accordingly based on its corresponding n-gram dictionary. We collected 2.5 GB text corpus from some Vietnamese news agencies to build n-gram dictionaries from unigram to five grams and achieve dictionaries with a size of 12 GB in total. In order to evaluate our method, we collected a testing set of 10 different text files with different sizes. The experimental results indicate that our method achieves compression ratio around 90% and outperforms state-of-the-art methods.

Inguinal Hernia Repair During Extraperitoneal Robot-Assisted Laparoscopic Radical Prostatectomy.

INTRODUCTION: One third of men undergoing radical prostatectomy have a comorbid inguinal hernia (IH). Previous studies have shown that adding total extraperitoneal (TEP) IH repair to extraperitoneal laparoscopic radical prostatectomy (LRP) lacks adverse effects. However, outcomes of extraperitoneal robot-assisted laparoscopic radical prostatectomy (RALP) and TEP are unknown. We compared RALP+TEP with LRP+TEP and also with RALP alone. METHODS: Eleven RALP+TEP cases were retrospectively compared with 26 LRP+TEP cases and 22 control RALP without TEP. Outcomes compared between groups included operative time, estimated blood loss (EBL), discharge hematocrit (hct), time to diet advancement, length of hospital stay (LOS), postoperative complications, and hernia recurrence. RESULTS: Unilateral TEP added 32 minutes to RALP and 31 minutes to LRP, whereas bilateral TEP added 80 minutes to RALP and 36 minutes to LRP. There were no differences between RALP+TEP and LRP+TEP or RALP without TEP controls in regard to EBL, discharge hct, time to diet advancement, LOS, or postoperative complications. One patient developed an anterior mesh seroma, which resolved without intervention. No IH recurrences were noted on the mean follow-up of 33 months in the RALP group and 50 months in the LRP cohort. CONCLUSIONS: Unilateral and bilateral TEP added operative time to RALP but had equivalent outcomes to both LRP+TEP and RALP alone. This is likely due to the similar surgical space used for RALP and TEP, which obviates the need for substantial further dissection. For men with prostate cancer and comorbid IH, combined RALP+TEP appears to be an appropriate surgical combination.

The genetic match between vaccine strains and circulating seasonal influenza A viruses in Vietnam, 2001-2009.

BACKGROUND: Vietnam is currently developing domestic capability to manufacture influenza vaccines but information on the genetic and antigenic characteristics of locally circulating seasonal influenza viruses is limited. To assess the relevance of WHO recommended vaccine strains to the situation in Vietnam, we analyzed the genetic relatedness of the hemagglutinin (HA) gene of seasonal influenza A viruses circulating in Vietnam from 2001 to 2009 to WHO recommended vaccine strains over the same period. METHODS AND PRINCIPAL FINDINGS: We sequenced the HA gene of 32 H1N1 and 44 H3N2 seasonal influenza A isolates from laboratory-based sentinel surveillance sites in Hanoi from 2001 to 2005 and from a national influenza surveillance system from 2005 to 2009. H1 and H3 HA phylogenetic trees rooted to vaccine strains A/Beijing/295/1995 (H1N1) and A/Moscow/10/1999 (H3N2), respectively, were constructed with contemporary HA sequences of isolates from neighboring countries. We found some genetic differences between seasonal influenza H3N2 viruses and three WHO influenza vaccine strains recommended for use in the Northern and Southern Hemispheres for the 2001-2004 and 2007-2008 seasons and close genetic identity of circulating H3N2 strains with the recommended WHO Southern Hemisphere vaccine strains for 2004 and 2009 seasons. The genetic similarity of circulating H1N1 strains with the WHO recommended vaccine strains are described for the study period 2001-2009. CONCLUSIONS: The HA gene of seasonal influenza virus strains in Vietnam (especially influenza A/H3N2) showed varying degrees of genetic identity compared with those of the Northern or Southern Hemisphere vaccine strains recommended by WHO. The close relatedness of the HA of Vietnamese strains and contemporary strains from nearby countries indicate a good genetic match of circulating strains during study period. Greater representation of virus isolates from South East Asia in the vaccine strain selection process is desirable of influenza vaccine development in Vietnam.