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Abstract Introduction Most hospitalized patients required invasive or non-invasive ventilation and High Flow Nasal Cannula (HFNC). Therefore, this study was conducted to describe the characteristics of patients with severe Coronavirus Disease—2019 (COVID-19) treated by HFNC and its effectiveness for reducing the rate of intubated—mechanical ventilation in the Intensive Care Unit (ICU) of Phu Chanh COVID-19 Department—Binh Duong General Hospital. Methods It was a cross-sectional and descriptive study. All severe patients with COVID-19 with acute respiratory failure eligible for the study were included. Patient characteristics, clinical symptoms, laboratory results, and treatment methods were collected for analysis; parameters and data related to HFNC treatment and follow-up were analysed. Results 80 patients, aged of 49.7 ± 16.6 years, were treated with HFNC at admission in ICU. 14 patients had type 2 diabetes (17.5%), 3 patients had chronic respiratory disease (3.8%), 19 patients had high blood pressure (23.8%), and 5 patients with other comorbidities (7.4%). The majority of patients with severe COVID-19 had typical symptoms of COVID-19 such as shortness of breath (97.5%), intensive tired (81.3%), cough (73.7%), anosmia (48.3%), ageusia (41.3%), and fever (26.3%). The results of arterial blood gases demonstrated severe hypoxia under optimal conventional oxygen therapy (PaO2 = 52.5 ± 17.4 mmHg). Respiratory rate, SpO2, PaO2 were significantly improved after using HFNC at 1st day, 3rd day and 7th day (P

Summary: Objective: The aim of this study was to determine factors including biochemical markers, dietary habits, and social-anthropometric associated with uncontrolled hypertension among elderly hypertension in rural regions of Vietnam. Methods: This study included 272 hypertension patients aged over 60 years. Demographic data, anthropometric measurements, and risk factors associated with hypertension were from the cross-sectional study of 272 customers at the Medical Examination Department, Samson General Hospital, Thanh Hoa Province, Vietnam. Biochemical markers including total cholesterol, triglycerides, and fasting blood glucose were measured. Dietary habits were by using a frequency questionnaire. Uncontrolled hypertension was defined as systolic blood pressure of ≥140 mmHg and/or diastolic blood pressure of ≥90 mmHg in a patient taking anti-hypertensive medication.Generalized multiple linear regression was used to assess the impact of related factors on blood pressure, which were used as the dependent variables. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of related factors for hypertension status. Results: The study found that men had more uncontrolled hypertension than women among the elderly population. The prevalences of hyperglycemia, hypertriglyceridemia, and hypercholesterolemia were high in both controlled and uncontrolled groups. There was an inverse association between fruits (p=0.021) and vegetable consumption (p=0.038) and a positive correlation between salty habits (p=0.040) and processed food (p

Tung Nguyen Thanh,1,* Duc Minh Nguyen,2,* Tuan Dinh Le,3 Lan Ngoc Do,1 Son Tien Nguyen,3 Phuong Nguyen Minh,1 Phong Nguyen Van,4 Tien Minh Bui,5 Tuyen Thanh Thi Bui,5 Hung Nguyen Dao,6 Kien Trung Nguyen5 1Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 2Andrology and Fertility Hospital of Hanoi, Hanoi, 10000, Vietnam; 3Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 4Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 5Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam; 6Department of Obstetrics and Gynecology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Kien Trung Nguyen, Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam, Tel +84989281982, Email trungkiendhytb@gmail.comBackground: To assess the relationship between oocytes with smooth endoplasmic reticulum cluster (SERc) and embryological and birth outcomes in infertile couples.Methods: This was a descriptive study that included 231 infertile patients undergoing in vitro fertilization (IVF) with a total of 2447 mature oocytes (MII), of which 279 oocytes with SERc(+) from 100 patients, the remaining 2168 oocytes with SERc(-). Oocytes were evaluated for the presence or absence of the SERc simultaneously with intracytoplasmic sperm injection at 200x magnification using inverted microscopy – Observe D1.Results: The mean age of patients was 32.05 ± 5.56 years. One hundred patients had at least one SERc(+) oocyte (with 279 SERc(+) and 956 SERc(-) oocytes). One hundred and thirty-one patients had 1212 SERc(-) oocytes. Fertilization outcomes and the rates of good-quality embryos on day 2 and day 5 did not differ between the SERc(+) and the SERc(-) groups. In the first frozen embryo transfer cycles, the clinical pregnancy rate in the group of patients with SERc(+) was not different with the SERc(-) group (61.1% vs 48.78%, p = 0.074, respectively). The live birth rate in the SERc(+) group was statistically significantly higher than the SERc(-) group (57.7% vs 43.9%, p = 0.045, respectively).Conclusion: The fertilization rate, the quality of embryos on days 2 and 5 from oocytes with SERc(+) are similar to those with SERc(-). The live birth rate in the patients with SERc(+) group is statistically significantly higher than the SERc(-) group. There is no difference in clinical pregnancy rate between patients with and without SERc. Therefore, the exclusion of oocytes with SERc should not be recommended.Keywords: Smooth reticulum endoplasmic cluster, SERc, Intracytoplasmic sperm injection, In vitro fertilization, IVF

Tung Nguyen Thanh,1 Sang Trieu Tien,2 Phong Nguyen Van,2 Son Dang Thai,3 Thuc Luong Cong,4 Tuan Dinh Le,5 Son Tien Nguyen,5 Tuan Tran Van,1 Hoang Huy Duong,6 Tien Minh Bui,7 Kien Trung Nguyen7 1Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 2Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 3Institute of Biological and Food Technology, Hanoi Open University, Hanoi, 100000, Vietnam; 4Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 5Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 6Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam; 7Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, VietnamCorrespondence: Sang Trieu Tien, Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, 100000, Vietnam, Email trieusangk83@yahoo.com.vnBackground: To optimize the multiplex polymerase chain reaction (M-PCR) technique to diagnose microdeletions of azoospermia factors (AZF) on the Y chromosome and initially apply the technique to diagnose male patients with sperm density less than 5× 106 million sperm/mL was assigned to do a test to check for AZF microdeletions on the Y chromosome.Methods: Based on the positive control samples which belong to male subjects who have had 2 healthy children without any assisted reproductive technologies, the M-PCR method was developed to detect simultaneously and accurately AZF microdeletions on 32 male patients with sperm densities below 5× 106 million sperm/mL of semen at the Department of Biology and Medical Genetics – Vietnam Military Medical University.Results: Successful optimization of the M-PCR technique including 7 reactions arranged according to each AZFabc region using 24 STS/gene on the Y chromosome. Initial application to diagnose AZF deletion on 32 azoospermic and oligospermic men reveals that AZFa deletion accounts for 6.25% (2/32); deletion of all 3 regions AZFa,b,c with 18.75% (6/32 cases); The combined deletion rate of AZFb,c is highest, accounting for 56.24% (18/32 patients).Conclusion: Successfully optimized the M-PCR technique in identifying AZF microdeletions using 24 sequence tagged sites (STS)/gene for azoospermic and oligozoospermic men. The M-PCR technique has great potential in the application of AZF deletion diagnosis.Keywords: male infertility, azoospermia factors, AZF, multiplex polymerase chain reaction, M-PCR, sequence tagged sites, STS

Background. Dementia has emerged as a significant contributor to declining quality of life and stands as a prominent factor in the increase of disability and dependency among elderly populations globally. This study aimed to explore the relationship between cognitive symptoms of dementia and their risk factors in individuals aged 60 years and older among Vietnamese outpatients who visited Geriatrics Clinic at University Medical Center of Ho Chi Minh city, Vietnam. Methods. 387 participants who were aged ≥ 60 years old were included in the cross-sectional study. Cognitive impairment was assessed by using the Mini Mental State Evaluation (MMSE) questionnaire. The functional limitations in activities of daily living (ADL) and Instrumental Activities of Daily Living (IADL), multimorbidity, and polypharmacy were also evaluated. Frailty was determined by The Canadian Study of Health and Aging Clinical Frailty Scale. Suffering dementia was determined when MMSE score was below 24 and IADL score less than 8. Results. People with dementia cognitive symptoms accounted for 22.74 % of the cohort. The percentage increased with age, and was higher in women than in men. Factors that increased the odds of having dementia symptoms were of older age, female, multimorbidity, Frailty Scale > Grade 4 and ADL dependency. Conclusions. Age, female gender, multimorbidity, frailty and ADL dependency were considered as risk factors of dementia cognitive symptoms among the Vietnamese people aged 60 years and older.

TikTok is increasingly influential in promoting brand awareness and boosting purchase intention. From a social media marketing perspective, brand awareness significantly influences consumers’ purchasing decisions. The primary objective of this study is to investigate and measure the factors influencing the brand awareness of TikTok users through social media marketing communications. The paper employs exploratory factor analysis, Cronbach’s Alpha test, and regression analysis to test the hypotheses. 24 observed variables were divided into six groups. Each variable was assessed using a 5-point Likert scale. The sample size includes 240 valid responses from TikTok users collected via convenience sampling. The questionnaire was distributed to TikTok users from Vietnam via the link on Google Forms. The collected data were processed by SPSS 20 software. The results suggest that six independent variables positively affect brand recognition via social media marketing on TikTok, with a 95% confidence interval at Sig. = 0.000 (0.05). Each of the six variables positively impacts initial expectations and is statistically significant at 1%. The results show that trends (Beta = 0.299) are the most decisive factors impacting brand awareness of TikTok users. Besides, electronic word of mouth (Beta = 0.242), influencer (Beta = 0.220), entertainment (Beta = 0.206), interaction (Beta = 0.200), and storytelling (Beta = 0.179) also positively affect the brand awareness of TikTok users. Limitations and further research suggest that marketers should investigate the role of artificial intelligence (AI) in the consumer’s brand awareness-constructing process.

Low-voltage ride-through (LVRT) capability is crucial for wind power plants that are grid-connected. A grid code requires wind farms to remain on-grid and inject a specific reactive current when a grid fault occurs. The requirements are satisfied by a cooperative control scheme of a battery energy storage system (BESS) and grid-side converter (GSC) for improving the LVRT capacity of wind turbine generators using permanent magnet synchronous generators. The proposed approach uses the BESS to absorb a power difference that appears in the back-to-back converters during the LVRT operation. Hence, the DC-link voltage is regulated by the BESS. In addition, the GSC control allows reactive current to be injected into the grid according to the grid code requirements. Finally, the wind turbine generators, which use the proposed approach, are built in MATLAB/Simulink. The theoretical analysis of the proposed method is validated by simulation.

Kien Xuan Nguyen,1,&ast; Tien Viet Tran,2 Thuan Duc Nghiem,3 Tuan Ngoc Tran,1 Thang Ba Ta,4 Ba Van Nguyen,5 Tuan Dinh Le,6,&ast; Son Tien Nguyen,6 Kien Trung Nguyen,7 Hoa Trung Dinh,8 Dinh Cong Pho,9 Toan Nguyen Duy,10,&ast; Pham Quoc Toan11 1Department of Military Medical Command and Organization, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 2Department of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 3Department of Otolaryngology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 4Respiratory Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 5Department of Oncology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 6Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 7Center of Hematology and Blood Transfusion, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 8Department of Requested Treatment, National Hospital of Endocrinology, Hanoi, Vietnam; 9Department of Military Science, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 10Cardiovascular Center, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam; 11Department of Nephrology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam&ast;These authors contributed equally to this workCorrespondence: Pham Quoc Toan, Department of Nephrology, Military Hospital 103, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Email toannephro@gmail.comIntroduction: Metacognition plays an essential role in competency-based medical education. Metacognitive skills consist of knowledge and regulation metacognition. This study was conducted to investigate the metacognition of undergraduate students and its correlation with students’ academic performance.Methods: The metacognitive skills inventory comprised 52 binary-scale items administered to 202 Vietnam Military Medical University medical students. The entire semester and clinical results were used to measure their academic performance.Results: Medical students’ total metacognitive awareness score was high (median 0.8). The median metacognitive knowledge score was significantly lower than the metacognitive regulation score (0.7 vs 0.8, respectively). The participants with a total metacognition score ≥ 0.8 had significantly higher academic results (full semester exam results of 7.4 and clinical exam of 7.5). The group of participants in the military, having sports habits and usually searching academic documents in English, had a higher proportion of total metacognitive awareness score ≥ 0.8 than the group without these above characteristics (with the percentages of 53.3%, 59%, and 64.3%, respectively; p < 0.05). The number of books read by participants with a total metacognitive awareness score ≥ 0.8 was significantly higher than those with a total metacognitive awareness score < 0.8 (3.5 compared to 2.4 books).Conclusion: Metacognitive awareness of Vietnam Military Medical University medical students was likely to be high. A high score of metacognitive awareness could predict high academic performance. Being a military student, playing sports, reading books, and searching English documents were predictors of better metacognitive awareness.Keywords: metacognition, medical student, metacognitive awareness, academic performance

Abstract Introduction The fourth outbreak of COVID-19 with the delta variant in Vietnam was very fierce due to the limited availability of vaccines and the lack of healthcare resources. During that period, the high mortality of patients with severe and critical COVID-19 caused many concerns for the health system, especially the intensive care units. This study aimed to analyze the predictive factors of death and survival in patients with severe and critical COVID-19. Methods We conducted a cross-sectional and descriptive study on 151 patients with severe and critical COVID-19 hospitalized in the Intensive Care Unit of Binh Duong General Hospital. Results Common clinical symptoms of severe and critical COVID-19 included shortness of breath (97.4%), fatigue (89.4%), cough (76.8%), chest pain (47.7%), loss of smell (48.3%), loss of taste (39.1%), and headache (21.2%). The abnormal biochemical features were leukopenia (2.1%), anemia, thrombocytopenia (18%), hypoxia with low PaO2 (34.6%), hypocapnia with reduced PaCO2 (29.6%), and blood acidosis (18.4%). Common complications during hospitalization were septic shock (15.2%), cardiogenic shock (5.3%), and embolism (2.6%). The predictive factors of death were being female, age > 65 years, cardiovascular comorbidity, thrombocytopenia (

Han Thi Ngoc Le,1,&ast; Kien Xuan Nguyen,2,&ast; Toan Duy Nguyen,1 Ho Quang La,3 Xuan Thanh Nguyen,4 Dung Tien Le,5 Huy Quoc Pham,5 Khai Xuan Nguyen,6 Hiep Hoang Nguyen,7 Viet Van Pham,6 Cong Van Pham,5 Dinh Cong Pho,8 Binh Nhu Do,8 Tien Viet Tran,9 Son Tien Nguyen,10 Tuan Dinh Le,10,&ast; Thuc Cong Luong1 1Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 2Department of Military Medical Command and Organization, Vietnam Medical Military University, Hanoi, 10000, Vietnam; 3Hospital Quality Control Division, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 4Senior Officer Department, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 5Intensive Care, Emergency and Poison Control Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 6Interventional Radiology Department, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 7Field Internal Medicine Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 8Department of Military Science, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 9Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam; 10Department of Rheumatology and Endocrinology, Vietnam Military Hospital 103, Medical Military University, Hanoi, 10000, Vietnam&ast;These authors contributed equally to this workCorrespondence: Thuc Cong Luong, Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Email luongcongthuc@vmmu.edu.vnBackground: Personal protective equipment (PPE), an essential shield to protect healthcare workers (HCWs) during the COVID-19 pandemic, has been reported to affect their heart rate variability (HRV).Objective: To investigate the changes of very short-term heart rate variability in HCWs after three hours of wearing PPE to treat COVID-19 patients at different working times and intensities, and related factors.Methods: Sixty-five healthy HCWs were enrolled at the Number 2 Infectious Field Hospital (formed by Military Hospital 103), Vietnam. Two-minute 12-lead electrocardiograms were recorded before wearing and after removing PPE.Results: After three hours of wearing PPE, the mean heart rate of HCWs increased (p = 0.048) meanwhile, the oxygen saturation decreased significantly (p = 0.035). Standard deviation of all normal to normal intervals (SDNN), mean intervals RR (mean NN), and root mean square successive difference (rMSSD) after wearing PPE was also reduced significantly. SDNN, Mean NN, and rMSSD decreased as the working intensity increased (as in mild, moderate, and severe patient departments). In univariate regression analysis, logSDNN, logmean NN and logrMSSD were positively correlated with SpO2 and QT interval (r = 0.14, r = 0.31, r = 0.25; r = 0.39, r = 0.77, r = 0.73, respectively) and were negatively correlated with ambient temperature inside PPE (r = − 0.41, r = − 0.405, r = − 0.25, respectively) while logmean NN and log rMSSD were negatively correlated with diastolic blood pressure (r = − 0.43, r = − 0.39, respectively). In multivariable regression analysis, logSDNN and logmean NN were negatively correlated to ambient temperature inside PPE (r = − 0.34, r = − 0.18, respectively).Conclusion: Time-domain heart rate variability decreased after wearing PPE. Time-domain HRV parameters were related to ambient temperature inside PPE, diastolic blood pressure, QT interval, and SpO2.Keywords: cardiovascular disorders, cardiovascular change, heart rate variability, personal protective equipment, healthcare workers, COVID-19

Droughts have a substantial impact on water supplies, agriculture, and ecosystems worldwide. Agricultural sustainability and production in the Mekong Delta of Vietnam are being jeopardized by droughts caused by climate change. Conventional forecasting methods frequently struggle to comprehend the intricate dynamics of meteorological occurrences connected to drought, necessitating the use of sophisticated prediction techniques. This study assesses the effectiveness of various statistical models (ARIMA), machine learning, and deep learning models (Gradient Boosting, XGBoost, RNN, and LSTM) in forecasting the SPEI over different time periods (1, 3, 6, and 12 months) across six prediction intervals. The models were developed and evaluated using data from 11 meteorological stations spanning from 1985 to 2022. These models incorporated various climatic variables, including precipitation, temperature, humidity, potential evapotranspiration (PET), Southern Oscillation Index (SOI) Anomaly, and sea surface temperature in the NINO4 region (SST_NINO4). The results demonstrate that XGBoost and LSTM models exhibit outstanding performance, showcasing lower error metrics and higher R² values compared to Gradient Boosting and RNN. The performance of the model fluctuated depending on the forecast step, with error metrics often increasing with longer prediction horizons. The use of climatic indices improved the accuracy of the model. These findings are consistent with earlier research on drought episodes in the Mekong Delta and support studies from other areas that show the effectiveness of advanced modeling tools for predicting droughts. The work emphasizes the capacity of machine learning and deep learning models to enhance the precision of drought forecasting, which is vital for efficient water resource management and agricultural planning in places prone to drought.

Kien Xuan Nguyen,1,&ast; Tien Bui Minh,2,&ast; Hoa Trung Dinh,3,4 Tien Viet Tran,5 Tuan Dinh Le,5,&ast; Nga Phi Thi Nguyen,6 Thi Thanh Hoa Tran,3 Trinh Hien Vu,3 Lan Ho Thi Nguyen,3 Kien Trung Nguyen,2 Nguyen Huy Thong,6 Khanh Do,6 Trung Kien Nguyen,7 Hung Nguyen Dao,8 Son Tien Nguyen6,&ast; 1Department of Military Medical Command and Organization, Vietnam Medical Military University, Ha Noi, Vietnam; 2Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 3Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam; 4National Hospital of Endocrinology, Ha Noi, Vietnam; 5Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, Vietnam; 6Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 7Hematology and Blood Transfusion Center, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 8Department of Obstetrics and Gynecology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam&ast;These authors contributed equally to this workCorrespondence: Son Tien Nguyen, Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi City, Vietnam, Email ntson4879@gmail.comIntroduction: Chronic low-grade inflammation (LGI) plays a role in the pathogenesis of gestational diabetes mellitus (GDM). LGI, on the one hand, promotes insulin resistance and at the same time, affects fetal development. The study aimed to use clinically feasible means to evaluate the association between maternal LGI and maternal insulin resistance and fetal growth indices by ultrasound in the third trimester.Methods: A crossectional and descriptive study on 248 first-time diagnosed GDM in Vietnam.Results: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) indices were significantly higher in GDM than in normal glucose-tolerant pregnancies (p = 0.048 and 0.016, respectively). GDM with LGI witnessed significantly higher systolic blood pressure, BMI, HbA1c, and significantly lower quantitative Insulin Sensitivity Check Index (QUICKI) than those without LGI. After adjusting for maternal BMI, fasting plasma glucose (FPG), age, and parity, C-reactive protein (CRP) was positively correlated with HOMA2-IR (B=0.13, p< 0.01) and Mathews index (B=0.29, p< 0.01). Regarding fetal characteristics, LGI was associated with fetal growth indices in the third trimester of GDM. NLR was negatively correlated with estimated fetal weight (EFW) (B=− 64.4, p< 0.05) after adjusting for maternal BMI and FPG. After adjusting for maternal BMI, FPG, age, and parity, PLR was negatively correlated with biparietal diameter (B=− 0.02, p< 0.01) and abdominal circumference (AC) (B=− 0.16, p< 0.05), and EFW (B=− 1.1, p< 0.01), and head circumference (HC) (B=− 0.06, p< 0.01); CRP was negatively correlated with AC (B=− 0.16, p< 0.001), EFW (B=− 85.3, p< 0.001), and HC (B=− 5.0, p< 0.001).Conclusion: In the third trimester, LGI was associated with maternal glucose and insulin resistance in GDM. Moreover, LGI was associated with fetal characteristics in ultrasonic images. There were negative correlations between LGI and fetal developmental characteristics.Keywords: gestational diabetes mellitus, low-grade inflammation, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, fetal ultrasound parameters

Abstract Post-vaccination adverse reactions have been reported with varying symptoms and severity owing to research and production time pressures during the coronavirus disease 2019 (COVID-19) pandemic. In this article, we report a rare case of Guillain–Barré syndrome (GBS) in a patient with COVID-19 with acute respiratory distress syndrome (ARDS) after receiving Sinopharm's Vero Cell vaccine (China). The patient who was initially negative for COVID-19 was diagnosed with GBS based on paralysis that developed from the lower extremities to the upper extremities, as confirmed by cytoalbuminologic dissociation in the cerebrospinal fluid. The patient's condition worsened with ARDS caused by COVID-19 infection during the hospital stay, and SpO2 decreased to 83% while receiving oxygen through a non-rebreather mask (15 l/min) on day 6. The patient was treated with standard therapy for severe COVID-19, invasive mechanical ventilation, and five cycles of therapeutic plasma exchange (TPE) with 5% albumin replacement on day 11 due to severe progression. The patient was weaned off the ventilator on day 28, discharged on day 42, and was completely healthy after 6 months without any neurological sequelae until now. Our report showed the potential of TPE for GBS treatment in critically ill patients with COVID-19 after COVID-19 vaccination.

Son Tien Nguyen,1,&ast; Tien Bui Minh,2,&ast; Hoa Trung Dinh,3,4 Tuan Dinh Le,1 Nga Phi Thi Nguyen,1 Thi Thanh Hoa Tran,3 Trinh Hien Vu,3 Thuc Luong Cong,5 Lan Ho Thi Nguyen,3 Phuong Tuan Pham,3,4 Tien Viet Tran,6 Kien Xuan Nguyen7 1Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 2Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 3Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam; 4National Hospital of Endocrinology, Ha Noi, Vietnam; 5Cardiovascular Center, Military Hospital 103, Vietnam Medical Military University, Ha Noi, Vietnam; 6Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam; 7Department of Military Medical Command and Organization, Vietnam Medical Military University, Ha Noi, Vietnam&ast;These authors contributed equally to this workCorrespondence: Kien Xuan Nguyen, Department of Military Medical Command and Organization, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi city, Vietnam, Email nguyenxuankien@vmmu.edu.vnIntroduction: Cortisol is proven to play a crucial role in hyperglycemia and fetal development in gestational diabetes mellitus (GDM). This research aims to investigate the relationship between maternal serum cortisol and insulin resistance indices and fetal ultrasound characteristics in women with GDM.Methods: A cross-sectional and descriptive study on 144 GDM in Vietnam from January 2015 to December 2020. Serum cortisol was measured using electrochemiluminescence immunoassay at 8 a.m. on the examination day in the vicinity of the 24th gestational week. Fetal ultrasound was performed by an experienced person who was blind to the study.Results: The mean cortisol level in the GDM group was 627.04 nmol/L. Serum cortisol levels positively correlated with abdominal circumference (AC), fasting plasma glucose (FPG), insulin, triglycerides, HOMA2-IR, and Mathew indices (with r of 0.18, 0.22, 0.18, 0.17, 0.18, and 0.22, respectively). Serum cortisol levels negatively correlated with QUICKI and McAuley indices (with r of − 0.19 and − 0.21), respectively. In a univariate linear regression, maternal serum cortisol positively correlated with fetal AC, head circumference (HC), and biparietal diameter (BPD) (with r of 0.21; 0.23; and 0.25, respectively). In a multivariate linear regression analysis, cortisol positively correlated with fetal AC, HC, and BPD after adjusting to maternal McAuley index.Conclusion: Serum cortisol levels in GDM correlated with fasting blood glucose, triglycerides, and insulin resistance. Besides, serum cortisol levels in GDM positively correlated with fetal development.Keywords: gestational diabetes mellitus, serum cortisol, insulin resistance indices, fetal ultrasound parameters

The present paper successfully develops a closed form solution based on a shear deformation theory for elastic lateral-torsional buckling analyses of simply supported thin-walled steel beams. The theory captures the shear effects caused by transverse bending, lateral bending and warping deformations. The closed form solution is successfully validated against 3 dimensional finite element analyses conducted in commercial software. Through various comparisons between the buckling resistances based on a non-shear deformation theory and the buckling resistances based on the present shear deformation theory, the present study finds that (i) the effect of shear deformations on the buckling resistances decreases when the beam span increases, (ii) the effect of shear deformations on the buckling resistance is sensitive with the change of the flange width, and (iii) the effect of shear deformations in general is also influenced by the change of the section depth, and the flange and web thicknesses.

Advanced technologies for muscle tracking provide easy access to identify and track muscle activity, often for the purposes of therapeutic interventions. The necessity of muscle trackers arises from the acute and chronic sources that disrupt neuromuscular control, resulting in an impaired ability to perform daily activities without assistance. In the context of human–machine interfaces, muscle trackers can serve as the “sensory” component, providing real‐time information to machines, such as exoskeletons and prosthetics, that can act upon such information for therapeutic and functional aid. Recently developed devices for muscle tracking rely on combinations of sensor modalities and algorithms to extract information from biosignals track muscle activity, or even extrapolate kinematic information, including gestures. However, a number of obstacles remain to be overcome to further facilitate the practical implementation of muscle‐tracking technologies, the most notable being real‐time analysis of biosignal data and extracting kinematic information from complex movements. This review attempts to cover the mechanisms behind various sensor modalities and algorithms commonly used for muscle tracking, as well as establish the current state of applications within the field. Given its multidisciplinary nature and ability to free users from rehabilitation constraints, the field of muscle tracking holds significant promise for future study.

IntroductionBreast cancer remains one of the major cancers worldwide. In Asia, breast cancer is leading both incidence and mortality rates. Health-related quality of life (HRQoL) studies play an important role in clinical treatment. This systematic review aimed to summarize the evidence of HRQoL and associated factors among patients with breast cancer in low-and-middle-income countries (LMICs) in Asia.MethodPerformed according to PRISMA guidelines for systematic review, the studies were searched from three databases (PubMed, Cochrane, Scopus) up to November 2020. The studies which met the predefined eligibility criteria were selected, extracted, and assessed the quality according to the Newcastle—Ottawa Scale (NOS) tool.Results and DiscussionA total of 2,620 studies were searched on the three databases, of which 28 met the selection criteria, then, were included in the systematic review. The Global Health Status (GHS) score of breast cancer patients based on the EORTC QLQ-C30 questionnaire ranged from 56.32 ± 25.42 to 72.48 ± 15.68. The overall HRQoL scores using the FACT-G and FACT-B instruments ranged from 60.78 ± 13.27 to 82.23 ± 12.55 and from 70.29 ± 13.33 to 108.48 ± 19.82, respectively. Factors affecting HRQoL of patients with breast cancer included age, education level, income, marital status, lifestyle, tumor stage, method, and treatment duration. Patient's income showed a consistent effect on HRQoL while the remaining factors reported inconsistent findings across the studies. In conclusion, the HRQoL of breast cancer patients in LMICs in Asia was low and affected by several sociodemographic factors which should be studied more in future research.

Tuan Dinh Le,1,2,&ast; Hoang Huy Duong,3,&ast; Ly Thi Nguyen,4,5,&ast; Nga Phi Thi Nguyen,2 Son Tien Nguyen,2 Manh Van Ngo6 1Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Rheumatology and Endocrinology,Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 4Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 5Postgraduate Student, Department of Internal Medicine, Hanoi Medical University, Hanoi, Vietnam; 6Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam&ast;These authors contributed equally to this workCorrespondence: Tuan Dinh Le, Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi City, Vietnam, Tel +840388166078, Email letuan985@gmail.com Hoang Huy Duong, Department of Neurology, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, Vietnam, Tel +84 912675919, Email hoangdh@tbmc.edu.vnBackground: Depression is a common mental disorder in people with type 2 diabetes mellitus (T2DM). Depression and T2DM have a reciprocal interaction through many factors, of which the most important is the multifactorial control and microvascular complications of T2DM.Aim: This research aims to determine the rate of depression and the association between depression and multifactorial control and microvascular complications in patients with T2DM aged 30– 60 years in Vietnam.Methods: A cross-sectional and descriptive study was conducted on 231 outpatients with T2DM at Bach Mai hospital, Hanoi, Vietnam. Depression severity was measured with the Patient Health Questionnaire-9 (PHQ-9).Results: The rate of depression in patients with T2DM aged 30– 60 years was 16.9% (in which, the rate of mild depression was 15.2% and moderate depression was 1.7%; no serious depression). The prevalence of depression was higher in female patients than in male patients (p = 0.049). There is a statistically significant difference in the rate of depression by age, duration of diabetes, and treatment method for type 2 diabetes. Poor HbA1c control and microvascular complications increase the risk of depression (OR = 2.37; 95% CI 1.11– 5.02, p = 0.033 and OR = 2.62; 95% CI 1.15– 5.93, p = 0.027, respectively). When the multivariate analysis was performed, it was shown that sex, treatment for glycemic control, and microvascular complications had a statistically significant influence on PHQ-9 score.Conclusion: In Vietnam, there are 16.9% of patients with T2DM aged 30– 60 years suffer from depression. Poor HbA1c control, the presence of microvascular complications, and without antihyperglycemic treatment increase the risk of developing depression.Keywords: type 2 diabetes mellitus aged 30– 60 years, depression, multifactorial control, microvascular complications

Background: The effects of halobetasol propionate (HBP) lotion 0.05% on the hypothalamic-pituitary-adrenal (HPA) axis have not been previously evaluated in adolescents. Objective: To examine the effect of HBP on HPA axis suppression in patients aged

Nga Phi Thi Nguyen,1,2,&ast; Thuc Luong Cong,3,4,&ast; Thi Thanh Hoa Tran,5 Binh Nhu Do,6 Son Tien Nguyen,1,2 Binh Thanh Vu,7,&ast; Lan Ho Thi Nguyen,8 Manh Van Ngo,9 Hoa Trung Dinh,10 Hoang Duong Huy,11 Nghia Xuan Vu,12 Kien Nguyen Trung,13 Duong Ngoc Vu,14 Nghia The Pham,14 Tuan Dinh Le2,15,&ast; 1Department of Endocrinology, Military Hospital 103, Hanoi, Vietnam; 2Department of Rheumatology and Endocrinology, Vietnam Military Medical University, Hanoi, Vietnam; 3Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam; 4Department of Cardiology, Vietnam Military Medical University, Hanoi, Vietnam; 5Emergency Resuscitation Department, National Hospital of Endocrinology, Hanoi, Vietnam; 6Division of Military Science, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 7Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of General Internal Medicine, National Hospital of Endocrinology, Hanoi, Vietnam; 9Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 10Department of Requested Treatment, National Hospital of Endocrinology, Hanoi, Vietnam; 11Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 12Department of Blood Transfusion, 108 Military Central Hospital, Hanoi, Vietnam; 13Department of Science Management, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 14Department of Imaging Diagnosis, Hanoi Medical University, Hanoi, Vietnam; 15Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam&ast;These authors contributed equally to this workCorrespondence: Tuan Dinh Le, Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Tel +84 388166078, Email letuan985@gmail.com Binh Thanh Vu, Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, Vietnam, Tel +84 334588298, Email binhvt@tbump.edu.vnIntroduction: Low albumin levels, high levels of high-sensitivity C-reactive protein (hs-CRP), and high white blood cell count were risk factors for changes in arterial intima-media thickness (IMT). Femoral artery IMT damages were one of the common peripheral artery type 2 diabetes. This study was conducted to determine the association between femoral artery IMT and plasma albumin, hs-CRP levels, and white blood cell count in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Materials and Methods: From January 2015 to May 2020, 306 patients with nT2D were recruited for this cross-sectional descriptive study at Vietnam’s National Endocrinology Hospital. We measured IMT by Doppler ultrasound.Results: There was a statistically significant difference in albumin, hs-CRP levels, hs-CRP-to-albumin ratio, and white blood cell counts between three different IMT groups namely normal IMT, thick IMT, and atherosclerosis (p = 0.003, p = 0.001, p = 0.001 and p = 0.049, respectively). In the multivariate linear regression analysis, white blood cell count, and hs-CRP levels showed a significantly positive correlation to IMT (standardized B and p of 0.17, 0.015 and 0.163, 0.024, respectively), but albumin levels were a significantly negative correlation to IMT (standardized B = – 0.151, p = 0.029). The multivariate logistic regression analysis showed that albumin (OR = 0.79, 95% CI 0.65– 0.90, p = 0.018), hs-CRP (OR = 1.09, 95% CI 1.01– 1.18, p = 0.026), and white blood cell count (OR = 1.36, 95% CI 1.03– 1.81, p = 0.033) had correlation to atherosclerosis of femoral artery.Conclusion: Reduced plasma albumin, elevated hs-CRP, and white blood cell count associated with IMT increased the odds for atherosclerosis of femoral artery among nT2D.Keywords: plasma albumin, high-sensitivity C-reactive protein, white blood cell count, newly diagnosed type 2 diabetes mellitus, intima-media thickness, atherosclerotic plaque, femoral artery

The synthesis of FeO3 and YFe1–xNixO3 (x = 0.1; 0.15; 0.2; 0.3; 0.5) nanocrystals was performed under the conditions of a self-propagating wave of glycine-nitrate combustion and their characterization and determination of the effect of Ni2+ doping of yttrium ferrite on the magnetic properties of nanopowders. The technology for the synthesis of yttrium orthoferrite nanoparticles (with and without doping with Ni2+ ions) by the glycine-nitrate combustion method at a ratio of G/N = 1 and 1.5 without adding a gelling agent to the reaction mixture and using ethylene glycol/glycerol is described. For the characterization of nanopowders based on YFeO3, the following were determined: phase composition and crystal structure (X-ray diffraction (XRD) method); size and structure of nanocrystal particles (transmission electron microscopy (TEM)); elemental composition of the samples (local X-ray spectral microanalysis (LXSMA)); magnetic characteristics (field dependences of specific magnetization). Thermal annealing of the synthesized samples at 800°C for 60 min led to the formation of the о-YFeO3 main phase. Undoped samples of yttrium orthoferrite were characterized by a particle diameter in the range of 5-185 nm, depending on the gelling agent used. YFe1-xNixO3 particles had a predominantly round shape with a size of 24 to 31 nm; the non-monotonic dependence of the average particle diameter on the dopant content was revealed: as the amount of dopant added increased, the average crystallite size tended to decrease. Nanopowders of undoped yttrium orthoferrite exhibit antiferromagnetic behaviour of magnetic susceptibility with temperature. The change in the magnetic properties of the nickel-doped YFeO3 nanocrystalline powders was due to the incorporation of Ni2+ into the Fe3+position, which led to the formation of a material with more pronounced soft magnetic properties at a substitution degree of 0.1. Samples with high degrees of substitution (x = 0.15 and 0.3) were also characterized by paramagnetic behaviour at temperatures above 100 K.

Introduction Venous sinus stenosis (VSS) stenting in medically refractory Idiopathic Intracranial Hypertension (IIH) patients has emerged as an effective treatment with low rates of failure and recurrence. However, the best treatment strategy following recurrence of symptoms in previously stented patients with initial response is unclear and frequently leads to shunt placement. We investigated the role of re‐stenting in patients with recurrence after prior successful stenting. Methods This is a retrospective review of a prospectively maintained IIH registry. Inclusion criteria included patients with confirmed IIH and angiographically demonstrable VSS who underwent interventions from 2012–2022. Patients were divided into those who underwent a single stenting procedure (Group S) and those who underwent placement of an additional stent due to recurrence of clinical symptoms and angiographic stenosis (Group R). All re‐stenting was performed in adjacent or remote regions of stenosis. Bivariate analyses were utilized to compare clinical outcomes. Results 86 patients were included with a median age of 33 [IQR 26‐39] and 94% were females. Group S (79/86) and Group R (7/86) had similar baseline characteristics. There was similar improvement in post‐stenting opening pressure (22.4±6.7 vs. 25.2±4.6 cm H2O, p = 0.35, Group S vs. Group R), change in opening pressure (11.6±10.4 vs. 5.3±12.2 cm H2O, p = 0.20, Group S vs. Group R) and resolution of tinnitus (91.8 vs. 80%, p = 0.28, Group S vs. Group R). Headache improvement was higher in Group S at 6 weeks, but similar at 6 months (92.8 vs. 60%, p = 0.02 and 88.2 vs. 80%, p = 0.59, Group S vs. Group R). Group S also had higher improvement in visual disturbances at 6 months (93.8 vs. 60%, p = 0.01, Group S vs. Group R), but similar improvement in papilledema (92.2 vs 100%, p = 0.68, Group S vs. Group R). None of the re‐stented patients required VPS rescue. Conclusions VSS re‐stenting in IIH patients with recurrence after initial stenting is feasible with similar efficacy in reducing intracranial pressure and symptoms.

Tuan Dinh Le,1,2,&ast; Nga Phi Thi Nguyen,2 Hoa Thanh Thi Tran,3 Thuc Luong Cong,4,&ast; Lan Ho Thi Nguyen,5 Binh Do Nhu,6 Son Tien Nguyen,2 Manh Van Ngo,7 Hoa Trung Dinh,8 Hien Thi Nguyen,9 Kien Trung Nguyen,10 Duc-Cuong Le7,11,&ast; 1Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 2Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 3National Hospital of Endocrinology, Hanoi, Vietnam; 4Department of Cardiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 5Department of General Internal Medicine, National Hospital of Endocrinology, Ha Noi, Vietnam; 6Division of Military Science, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 7Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam; 9Department of Physiology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 10Department of Science Management, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 11Epidemiology-Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam&ast;These authors contributed equally to this workCorrespondence: Tuan Dinh LeCenter of Emergency, Critical Care Medicine and Clinical Toxicology, Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Ward, Ha Dong District, Ha Noi, VietnamTel +840388166078Email letuan985@gmail.comDuc-Cuong LePostgraduate Training Management Department; Epidemiology-Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, VietnamTel +84 93 8042 668Email cuongldvn@gmail.comPurpose: This study was aimed at the prevalence, cardiovascular risk factors of diabetic peripheral neuropathy (DPN), and the relationship between DPN and fasting glucagon-like peptide-1 (fGLP-1) concentrations in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Methods: A cross-sectional descriptive study was conducted from 2015 to 2020 with a population of 473 nT2D. Screening for DPN was based on the United Kingdom screening test. fGLP-1 was measured by enzyme-linked immunosorbent assay.Results: The prevalence of DPN was 26.6%, in which mild grade was 17.3%, moderate grade was 8.2% and severe grade was 1.1% in total. Age (OR = 1.73, 95% CI 1.12– 2.67, p = 0.012), smoking (OR = 1.64, 95% CI 1.03– 2.62, p = 0.037), poor control HbA1c (OR = 2.66, 95% CI 1.23– 5.76, p = 0.01), 24-h urinary albumin (24hUA) (OR = 2.49, 95% CI 1.26– 4.94, p = 0.007), and diabetic retinopathy (OR = 3.17, 95% CI 1.46– 6.89, p = 0.002) significantly increased the risk for DPN. In multivariate logistic regression analysis, hypertension (OR = 2.96, 95% CI 1.16– 7.55, p = 0.023), triglyceride (OR = 1.50, 95% CI 1.11– 2.03, p = 0.009), albumin (OR = 0.85, 95% CI 0.75– 0.95, p = 0.005), and fGLP-1 (OR = 0.79, 95% CI 0.67– 0.93, p = 0.005) correlated with DPN. The fGLP-1 concentrations were reduced significantly in DPN (p < 0.001). In particular, male patients with DPN had a significantly lower fGLP-1 levels than those without DPN (p < 0.001).Conclusion: The prevalence of DPN among nT2D was 26.6%. Age, smoking, hypertension, HbA1c control, triglyceride, albumin, 24hUA, diabetic retinopathy were the associated risk factors of DPN, and fGLP-1 was negatively correlated with DPN (OR = 0.79, 95% CI 0.67– 0.93, p = 0.005).Keywords: newly diagnosed type 2 diabetes mellitus, diabetic peripheral neuropathy, cardiovascular risk factors, glucagon-like peptide-1 concentrations

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been an alarming situation worldwide for the past 2 years. The symptoms of coronavirus disease 2019 (COVID-19) are not only confined to the respiratory system but also affect a multitude of organ systems. Bradycardia associated with Guillain-Barré syndrome (GBS) is a rare autonomic and peripheral neurological complication of COVID-19. In this case report, we present the case of a 26-year-old man diagnosed with bradycardia associated with GBS after contracting COVID-19. Initially, this patient had the classical symptoms of COVID-19 and was hospitalized in the intensive care unit (ICU) for acute respiratory distress syndrome (ARDS). Then, he developed weakness in the lower extremities, diminished tendon reflexes, a loss of sensation without sphincter muscle disorders, and bradycardia. His bradycardia did not respond to atropine. The patient was treated concurrently with a high-flow nasal cannula, systemic corticosteroids, anticoagulation, and therapeutic plasma exchange (TPE) for COVID-19-induced ARDS, bradycardia, and GBS. His ARDS and bradycardia improved after the first cycle of TPE and medical treatment. After three cycles of TPE, the patient progressively recovered his muscle strength in the lower limbs and regained peripheral sensation. He was discharged from the hospital in stable condition after 4 weeks of hospitalization and was followed up after 6 months for cardiorespiratory and neurological complications. This case report elucidates the potential difficulties and challenges that physicians may encounter in diagnosing and treating COVID-19-induced bradycardia and GBS during the pandemic outbreak. However, the patient outcomes with the treatment combining the conventional treatment with therapeutic plasma exchange seem to be optimistic.

In this study, a graphic simulator that is used to simulate problems related to kinematics and dynamics for an exoskeleton robot arm with 5 degrees of freedom (DoF) was presented. The graphic simulator utilized the advantages of design software SolidWorks, Catia, and the computing and simulation power of SimMechanics Toolbox in Matlab. The core of the proposed graphic simulator is algorithm to solve the kinematics and dynamic problems of a developing upper-limb rehabilitation robot. The study used the proposed optimization-based algorithm to solve the inverse kinematics (IK) problem for the redundant robot model. Endpoint trajectories were imported from measurement data. The joints variable solutions obtained before entering the dynamics problem were smoothed to ensure feasibility in the later calculation process. A process to solve the inverse dynamics problem using physical model by combining the power of two software SolidWorks and SimMechanics was also proposed. This process ensured that the Robot’s design could be changed and updated to the kinematics calculation fast and easily. To evaluate this procedure, we also compared these dynamics results with results when applying the Lagrange–Euler formulation. All these calculation and simulation processes have been integrated into the graphic simulator software to show efficiency and user-friendliness.

Heat stress (HS) negatively affects animal productivity and welfare. The usage of wearable sensors to detect behavioral changes in ruminants undergoing HS has not been well studied. This study aimed to investigate changes in sheep’s behavior using a wearable sensor and explore how ambient temperature influenced the algorithm’s capacity to classify behaviors. Six sheep (Suffolk, Dorset, or Suffolk × Dorset) were assigned to 1 of 2 groups in a cross-over experimental design. Groups were assigned to one of two rooms where they were housed for 20d prior to switching rooms. The thermal environment within the rooms was altered five times per period. In the first room, the temperature began at a thermoneutral level and gradually increased before decreasing. Simultaneously, in the second room, the temperature began at hot temperatures and gradually decreased before increasing again. Physiological responses (respiratory rate, heart rate, and rectal temperature) were analyzed using a linear mixed-effects model. A random forest algorithm was developed to classify lying, standing, eating, and ruminating (while lying and standing). Thermal stress shifted daily animal behavior budgets, increasing total time spent standing in hot conditions (p = 0.036). Although models had a similar capacity to classify behaviors within a temperature range, their accuracy decreased when applied outside that range. Although wearable sensors may help classify behavioral shifts indicative of thermal stress, algorithms must be robustly derived across environments.

Abstract Flow conditions have been shown to be important in improving longevity and functionality of primary hepatocytes, but the impact of flow on HepaRG cells is largely unknown. We studied the expression of genes encoding CYP enzymes and transporter proteins and CYP1 and CYP3A4 activity during 8 weeks of culture in HepaRG cells cultured under static conditions (conventional 24-/96-well plate culture with common bicarbonate/CO2 buffering) and under flow conditions in an organ-on-chip (OOC) device. Since the OOC-device is a closed system, bicarbonate/CO2 buffering was not possible, requiring application of another buffering agent, such as HEPES. In order to disentangle the effects of HEPES from the effects of flow, we also applied HEPES-supplemented medium in static cultures and studied gene expression and CYP activity. We found that cells cultured under flow conditions in the OOC-device, as well as cells cultured under static conditions with HEPES-supplemented medium, showed more stable gene expression levels. Furthermore, only cells cultured in the OOC-device showed relatively high baseline CYP1 activity, and their gene expression levels of selected CYPs and transporters were most similar to gene expression levels in human primary hepatocytes. However, there was a decrease in baseline CYP3A4 activity under flow conditions compared to HepaRG cells cultured under static conditions. Altogether, the present study shows that HepaRG cells cultured in the OOC-device were more stable than in static cultures, being a promising in vitro model to study hepatoxicity of chemicals upon chronic exposure.

Since the first case of Guillain-Barré syndrome (GBS)-associated SARS-CoV-2 (COVID-19) infection reported in 2020, a series of cases have been published in some countries. In this case report, we present a young patient with GBS, whose clinical and laboratory data were appropriate for the diagnosis of GBS due to COVID-19 infection. Neurological examination revealed the muscular weakness of lower limbs with Medical Research Council (MRC) scale of 2/5 associated with diminished reflexes. Laboratory studies showed the positive nasal swab RT-PCR test for COVID-19, leukopenia, increased ferritin and LDH levels, normal electrolyte and liver and kidney function, and normal chest X-ray. The result of cerebrospinal fluid showed the albuminocytologic dissociation. The patient was treated with remdesivir, dexamethasone, anticoagulation, and therapeutic plasma exchange (TPE). Patient's muscle weakness was significantly improved after 1 week of admission. He was discharged at 23rd days of hospitalization and followed-up in the out-patients department.

Background Brain imaging and genetics are fields acquiring data at increasing speed, but more information does not always result in a better understanding of the underlying biology. We developed the ProcessGeneLists (PGL) approach to use genetics and mRNA gene expression data to generate regions of interest for imaging studies. Methods We applied PGL to past suicide attempt (ATT): We averaged the mRNA expression levels of genes (n = 130) possibly associated with ATT (p ≤ 10 −3 in a published genome-wide association study, GWAS) in each brain region studied in the Human Allen Brain Atlas (6 ex-vivo brains, 158 to 946 regions/brain have mRNA expression data) and compared that to the averaged mRNA expression levels of all other genes in each region in each brain in the atlas. Results PGL revealed 8 regions where “attempt-related genes” were differentially expressed (Wilcoxon test with Bonferroni correction 8.88 −11 =

Health is gold, and good health is a matter of survival for humanity. The development of the healthcare industry aligns with the development of humans throughout history. Nowadays, along with the strong growth of science and technology, the medical domain in general and the healthcare industry have achieved many breakthroughs, such as remote medical examination and treatment applications, pandemic prediction, and remote patient health monitoring. The advent of 5th generation communication networks in the early 2020s led to the Internet of Things concept. Moreover, the 6th generation communication networks (so-called 6G) expected to launch in 2030 will be the next revolution of the IoT era, and will include autonomous IoT systems and form a series of endogenous intelligent applications that serve humanity. One of the domains that receives the most attention is smart healthcare. In this study, we conduct a comprehensive survey of IoT-based technologies and solutions in the medical field. Then, we propose an all-in-one computing architecture for real-time IoHT applications and present possible solutions to achieving the proposed architecture. Finally, we discuss challenges, open issues, and future research directions. We hope that the results of this study will serve as essential guidelines for further research in the human healthcare domain.

In spite of its immutable susceptibility to penicillin, Treponema pallidum (T. pallidum) subsp. pallidum continues to cause millions of cases of syphilis each year worldwide, resulting in significant morbidity and mortality and underscoring the urgency of developing an effective vaccine to curtail the spread of the infection. Several technical challenges, including absence of an in vitro culture system until very recently, have hampered efforts to catalog the diversity of strains collected worldwide. Here, we provide near-complete genomes from 196 T. pallidum strains-including 191 T. pallidum subsp. pallidum-sequenced directly from patient samples collected from 8 countries and 6 continents. Maximum likelihood phylogeny revealed that samples from most sites were predominantly SS14 clade. However, 99% (84/85) of the samples from Madagascar formed two of the five distinct Nichols subclades. Although recombination was uncommon in the evolution of modern circulating strains, we found multiple putative recombination events between T. pallidum subsp. pallidum and subsp. endemicum, shaping the genomes of several subclades. Temporal analysis dated the most recent common ancestor of Nichols and SS14 clades to 1717 (95% HPD: 1543-1869), in agreement with other recent studies. Rates of SNP accumulation varied significantly among subclades, particularly among different Nichols subclades, and was associated in the Nichols A subclade with a C394F substitution in TP0380, a ERCC3-like DNA repair helicase. Our data highlight the role played by variation in genes encoding putative surface-exposed outer membrane proteins in defining separate lineages, and provide a critical resource for the design of broadly protective syphilis vaccines targeting surface antigens.

The fourth annual summer research summit organized by the Center of Excellence (COE) in Health Equity, Training and Research, Baylor College of Medicine (BCM) was held on May 20, 2021. The theme of this year’s summit was ‘Strengthening Our Commitment to Racial and Social Justice to Improve Public Health.’ Given the ongoing pandemic, the summit was conducted virtually through digital platforms. This program was intended for both BCM and external audiences interested in advancing health equity, diversity and inclusion in healthcare among healthcare providers and trainees, biomedical scientists, social workers, nurses, individuals involved in talent acquisition and development such as hiring managers (HR professionals), supervisors, college and hospital affiliate leadership and administrators, as well as diversity and inclusion excellence practitioners. We had attendees from all regions of the United States, India, Pakistan and the Demographic Republic of the Congo. The content in this Book of Abstracts encapsulates a summary of the research efforts by the BCM COE scholars (which includes post-baccalaureate students, medical students, clinical fellows and junior faculty from BCM) as well as the external summit participants. The range of topics in this year’s summit was quite diverse encompassing disparities in relation to maternal and child health (MCH), immigrant heath, cancers, vaccination uptakes and COVID-19 infections. Various solutions were ardently presented to address these disparities including community engagement and partnerships, improvement in health literacy and development of novel technologies and therapeutics. With this summit, BCM continues to build on its long history of educational outreach initiatives to promote diversity in medicine by focusing on programs aimed at increasing the number of diverse and highly qualified medical professionals ready to introduce effective and innovative approaches to reduce or eliminate health disparities. These programs will improve information resources, clinical education, curricula, research and cultural competence as they relate to minority health issues and social determinants of health. The summit received very positive response in terms of zealous participation and outstanding evaluations; and overall, it was a great success. Copyright © 2021 Lopez et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

The smart electricity grids have been evolving to a more complex cyber-physical ecosystem of infrastructures with integrated communication networks, new carbon-free sources of power generation, advanced monitoring and control systems, and a myriad of emerging modern physical hardware technologies. With the unprecedented complexity and heterogeneity in dynamic smart grid networks comes additional vulnerability to emerging threats such as cyber attacks. Rapid development and deployment of advanced network monitoring and communication systems on one hand, and the growing interdependence of the electric power grids to a multitude of lifeline critical infrastructures on the other, calls for holistic defense strategies to safeguard the power grids against cyber adversaries. In order to improve the resilience of the power grid against adversarial attacks and cyber intrusions, advancements should be sought on detection techniques, protection plans, and mitigation practices in all electricity generation, transmission, and distribution sectors. This survey discusses such major directions and recent advancements from a lens of different detection techniques, equipment protection plans, and mitigation strategies to enhance the energy delivery infrastructure resilience and operational endurance against cyber attacks. This undertaking is essential since even modest improvements in resilience of the power grid against cyber threats could lead to sizeable monetary savings and an enriched overall social welfare.

The surficial hydrothermal sediments of Guaymas Basin harbor complex microbial communities where oxidative and reductive nitrogen, sulfur, and carbon-cycling populations and processes overlap and coexist. Here, we resolve microbial community profiles in hydrothermal sediment cores of Guaymas Basin on a scale of 2 millimeters, using Denaturing Gradient Gel Electrophoresis (DGGE) to visualize the rapid downcore changes among dominant bacteria and archaea. DGGE analysis of bacterial 16S rRNA gene amplicons identified free-living and syntrophic deltaproteobacterial sulfate-reducing bacteria, fermentative Cytophagales, members of the Chloroflexi (Thermoflexia), Aminicenantes, and uncultured sediment clades. The DGGE pattern indicates a gradually changing downcore community structure where small changes on a 2-millimeter scale accumulate to significantly changing populations within the top 4 cm sediment layer. Functional gene DGGE analyses identified anaerobic methane-oxidizing archaea (ANME) based on methyl-coenzyme M reductase genes, and members of the Betaproteobacteria and Thaumarchaeota based on bacterial and archaeal ammonia monooxygenase genes, respectively. The co-existence and overlapping habitat range of aerobic, nitrifying, sulfate-reducing and fermentative bacteria and archaea, including thermophiles, in the surficial sediments is consistent with dynamic redox and thermal gradients that sustain highly complex microbial communities in the hydrothermal sediments of Guaymas Basin.

Background Natural disasters can affect mental health and result in symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD). Playback Theatre (PT) is a form of improvisation where actors play-back personal stories told by audience members. Whether PT can be therapeutic in post-disaster settings is not known. Method We used a series of PT performances and studied levels of depression, anxiety, and PTSD symptoms in a sample of 13 people affected by Hurricane Harvey that happened in Houston, TX, August 2017. Brain imaging, specifically resting state functional connectivity of the amygdala was also studied before and after the PT performances. Results Both anxiety ( p = .001, Cohen’s d = –1.25) and PTSD ( p = .002, Cohen’s d = –1.0) symptoms significantly decreased after a series of 4 PT performances from January 2019 – February 2019. Depression reduction was not significant. We performed resting state functional connectivity (RSFC) MRI before and after the series of performances. We used the right and left amygdala as seeds for RSFC analysis and found that the connectivity between the left amygdala and the bilateral supramarginal gyri was increased after PT. The bilateral supramarginal connectivity with the default mode and the saliency networks increased too, which correlated with reduction in anxiety scores. Conclusions PT may offer a form of intervention for anxiety caused by disasters. An increase in left amygdala/supramarginal gyri connectivity may be the underlying mechanism.

BACKGROUND:Prostate cancer (PC) is the most frequently diagnosed cancer in North American men. Pathologists are in critical need of accurate biomarkers to characterize PC, particularly to confirm the presence of intraductal carcinoma of the prostate (IDC-P), an aggressive histopathological variant for which therapeutic options are now available. Our aim was to identify IDC-P with Raman micro-spectroscopy (RμS) and machine learning technology following a protocol suitable for routine clinical histopathology laboratories. METHODS AND FINDINGS:We used RμS to differentiate IDC-P from PC, as well as PC and IDC-P from benign tissue on formalin-fixed paraffin-embedded first-line radical prostatectomy specimens (embedded in tissue microarrays [TMAs]) from 483 patients treated in 3 Canadian institutions between 1993 and 2013. The main measures were the presence or absence of IDC-P and of PC, regardless of the clinical outcomes. The median age at radical prostatectomy was 62 years. Most of the specimens from the first cohort (Centre hospitalier de l'Université de Montréal) were of Gleason score 3 + 3 = 6 (51%) while most of the specimens from the 2 other cohorts (University Health Network and Centre hospitalier universitaire de Québec-Université Laval) were of Gleason score 3 + 4 = 7 (51% and 52%, respectively). Most of the 483 patients were pT2 stage (44%-69%), and pT3a (22%-49%) was more frequent than pT3b (9%-12%). To investigate the prostate tissue of each patient, 2 consecutive sections of each TMA block were cut. The first section was transferred onto a glass slide to perform immunohistochemistry with H&E counterstaining for cell identification. The second section was placed on an aluminum slide, dewaxed, and then used to acquire an average of 7 Raman spectra per specimen (between 4 and 24 Raman spectra, 4 acquisitions/TMA core). Raman spectra of each cell type were then analyzed to retrieve tissue-specific molecular information and to generate classification models using machine learning technology. Models were trained and cross-validated using data from 1 institution. Accuracy, sensitivity, and specificity were 87% ± 5%, 86% ± 6%, and 89% ± 8%, respectively, to differentiate PC from benign tissue, and 95% ± 2%, 96% ± 4%, and 94% ± 2%, respectively, to differentiate IDC-P from PC. The trained models were then tested on Raman spectra from 2 independent institutions, reaching accuracies, sensitivities, and specificities of 84% and 86%, 84% and 87%, and 81% and 82%, respectively, to diagnose PC, and of 85% and 91%, 85% and 88%, and 86% and 93%, respectively, for the identification of IDC-P. IDC-P could further be differentiated from high-grade prostatic intraepithelial neoplasia (HGPIN), a pre-malignant intraductal proliferation that can be mistaken as IDC-P, with accuracies, sensitivities, and specificities > 95% in both training and testing cohorts. As we used stringent criteria to diagnose IDC-P, the main limitation of our study is the exclusion of borderline, difficult-to-classify lesions from our datasets. CONCLUSIONS:In this study, we developed classification models for the analysis of RμS data to differentiate IDC-P, PC, and benign tissue, including HGPIN. RμS could be a next-generation histopathological technique used to reinforce the identification of high-risk PC patients and lead to more precise diagnosis of IDC-P.

Purpose: The global burden of cancer is slated to reach 21.4 million new cases in 2030 alone, and the majority of those cases occur in under-resourced settings. Formidable changes to health care delivery systems must occur to meet this demand. Although significant policy advances have been made and documented at the international level, less is known about the efforts to create national systems to combat cancer in such settings. Methods: With case reports and data from authors who are clinicians and policymakers in three financially constrained countries in different regions of the world—Guatemala, Rwanda, and Vietnam, we examined cancer care programs to identify principles that lead to robust care delivery platforms as well as challenges faced in each setting. Results: The findings demonstrate that successful programs derive from equitably constructed and durable interventions focused on advancement of local clinical capacity and the prioritization of geographic and financial accessibility. In addition, a committed local response to the increasing cancer burden facilitates engagement of partners who become vital catalysts for launching treatment cascades. Also, clinical education in each setting was buttressed by international expertise, which aided both professional development and retention of staff. Conclusion: All three countries demonstrate that excellent cancer care can and should be provided to all, including those who are impoverished or marginalized, without acceptance of a double standard. In this article, we call on governments and program leaders to report on successes and challenges in their own settings to allow for informed progression toward the 2025 global policy goals.

This paper investigates power allocation for D2D communications in a Heterogeneous Network (HetNet)which includes a macro cell and pico cells, whereas femto cells are distributed inside. The objective is tominimize the total power consumption of D2D transmitter while satisfying a set of Quality of Service inD2D receivers and cellular users communication interference. To this end, we first obtain expression for theformula of signal to interference plus noise ratio (SINR) and spectral efficiency of each D2D receiver. Then,an optimization problem is formulated to minimize the total transmit power of D2D transmitters subject toQoS constraints. It is shown that this optimization problem is linear programming and it can be solved inpolynomial time with standard tools. In addition, the maximization value of D2D pair transmission rates aredetermined with fixed cellular users parameters.

We proposed an approach for temporal event detection using deep learning and multi-embedding on a set of text data from social media. First, a convolutional neural network augmented with multiple word-embedding architectures is used as a text classifier for the pre-processing of the input textual data. Second, an event detection model using a recurrent neural network is employed to learn time series data features by extracting temporal information. Recently, convolutional neural networks have been used in natural language processing problems and have obtained excellent results as performing on available embedding vector. In this article, word-embedding features at the embedding layer are combined and fed to convolutional neural network. The proposed method shows no size limitation, supplementation of more embeddings than standard multichannel based approaches, and obtained similar performance (accuracy score) on some benchmark data sets, especially in an imbalanced data set. For event detection, a long short-term memory network is used as a predictor that learns higher level temporal features so as to predict future values. An error distribution estimation model is built to calculate the anomaly score of observation. Events are detected using a window-based method on the anomaly scores.