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Spontaneous thrombosis of an unruptured large or giant saccular intracranial aneurysm is a well-known phenomenon and can cause ischemic stroke (IS), which is a rare event. The possible pathogenic mechanisms of IS include distal embolic occlusion secondary to migration of the intra-aneurysmal thrombus, occlusion of the parent artery lumen caused by the retrograde extension of the aneurysmal thrombosis, external compression of the parent artery due to the increased aneurysmal mass effect. Among these, IS due to simultaneous thromboses of the aneurysm and its parent artery is extremely rare, with only a few cases reported in the literature. Herein, we present a case of a 18-year-old woman who suffered an acute IS, attribute to spontaneous complete thrombosis of an unruptured large saccular aneurysm of the right middle cerebral artery with occlusion of the parent artery, and we review the literature simultaneously.

The discourse that revolves around the Fourth Industrial Revolution in Vietnam has witnessed participation from policy makers, business circles, and academics. This study sought to explore the future of Vietnamese workforce's awareness and competencies in meeting labour market needs in the Fourth Industrial Revolution. To capture these awareness and competencies, the study used the mixed method. Questionnaires were initially conducted with 800 third- and fourth-year students who were studying in four fields: social sciences and humanities, science and technology, natural sciences, and finance and banking in public and private universities in Ho Chi Minh City. Thirty lecturers and managers from private and state-owned enterprises were then invited to participate in interviews to gain a multidimensional perspective. Analyses showed the large proportion of students had heard of the Fourth Industrial Revolution primarily from the media, which led to a difference in both awareness and behaviour towards the Fourth Industrial Revolution. The survey students had a positive outlook on employment trends, but felt doubtful and diffident about job-seeking after graduation. From a multidimensional perspective, the study also pointed out obsolete knowledge, traditional teaching, and the shortage of connection between universities and enterprises. The present study provided significant implications for higher educational institutions in the development of future training programmes to prepare the future workforce for the digital economy.

PurposeProgrammed death-1 immune checkpoint blockade improves survival of patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC), but the benefits of addition to (chemo)radiation for newly diagnosed patients with HNSCC remain unknown.Methods and materialsWe evaluated the safety of nivolumab concomitant with 70 Gy intensity modulated radiation therapy and weekly cisplatin (arm 1), every 3-week cisplatin (arm 2), cetuximab (arm 3), or alone for platinum-ineligible patients (arm 4) in newly diagnosed intermediate- or high-risk locoregionally advanced HNSCC. Patients received nivolumab from 2 weeks prior to radiation therapy until 3 months post-radiation therapy. The primary endpoint was dose-limiting toxicity (DLT). If ≤2 of the first 8 evaluable patients experienced a DLT, an arm was considered safe. Secondary endpoints included toxicity and feasibility of adjuvant nivolumab to 1 year, defined as all 7 additional doses received by ≥4 of the first 8 evaluable patients across arms.ResultsOf 39 patients (10 in arms 1, 3, 4 and 9 in arm 2), 72% had T3-4 tumors, 85% had N2-3 nodal disease, and 67% had >10 pack-years of smoking. There were no DLTs in arms 1 and 2, 1 in arm 3 (mucositis), and 2 in arm 4 (lipase elevation and mucositis in 1 and fatigue in another). The most common grade ≥3 nivolumab-related adverse events were lipase increase, mucositis, diarrhea, lymphopenia, hyponatremia, leukopenia, fatigue, and serum amylase increase. Adjuvant nivolumab was feasible as defined in the protocol.ConclusionsConcomitant nivolumab with the 4 tested regimens was safe for patients with intermediate- and high-risk HNSCC, and subsequent adjuvant nivolumab was feasible as defined (NCT02764593).

The purpose of this study was to determine the negative predictive value (NPV) of a 12- to 14-wk posttreatment PET/CT for 2-y progression-free survival (PFS) and locoregional control (LRC) in patients with p16-positive locoregionally advanced oropharyngeal cancer (LA-OPC). Study was a secondary endpoint in NRG-HN002, a noncomparative phase II trial in p16-positive LA-OPC, stage T1-T2, N1-N2b or T3, N0-N2b, and ≤10 pack-year smoking. Patients were randomized in a 1:1 ratio to reduced-dose intensity-modulated radiotherapy (IMRT) with or without cisplatin. Methods: PET/CT scans were reviewed centrally. Tumor response evaluations for the primary site, right neck, and left neck were performed using a 5-point ordinal scale (Hopkins criteria). Overall scores were then assigned as negative, positive, or indeterminate. Patients with a negative score for all 3 evaluation sites were given an overall score of negative. The hypotheses were NPV for PFS and LRC at 2-y posttreatment ≤ 90% versus >90% (1-sided P value, 0.10). Results: A total of 316 patients were enrolled, of whom 306 were randomized and eligible. Of these, 131 (42.8%) patients consented to a posttherapy PET/CT, and 117 (89.3%) patients were eligible for PET/CT analysis. The median time from the end of treatment to PET/CT scan was 94 d (range, 52-139 d). Estimated 2-y PFS and LRC rates in the analysis subgroup were 91.3% (95% CI, 84.6, 95.8%) and 93.8% (95% CI, 87.6, 97.5%), respectively. Posttreatment scans were negative for residual tumor for 115 patients (98.3%) and positive for 2 patients (1.7%). NPV for 2-y PFS was 92.0% (90% lower confidence bound [LCB] 87.7%; P = 0.30) and for LRC was 94.5% (90% LCB 90.6%; P = 0.07). Conclusion: In the context of deintensification with reduced-dose radiation, the NPV of a 12- to 14-wk posttherapy PET/CT for 2-y LRC is estimated to be >90%, similar to that reported for patients receiving standard chemoradiation. However, there is insufficient evidence to conclude that the NPV is >90% for PFS.

Abstract Introduction In Viet Nam, key populations (KPs) face barriers accessing HIV services. Virtual platforms can be leveraged to increase access for KPs, including for HIV self‐testing (HIVST). This study compares reach and effectiveness of a web‐based HIVST intervention from pilot to scale‐up in Viet Nam. Methods A mixed‐methods explanatory sequential design used cross‐sectional and thematic analysis. The pilot launched in Can Tho in November 2020, followed by Hanoi and Nghe An in April 2021. Scale‐up included Can Tho and Nghe An, with 21 novel provinces from April to December 2022. After risk assessment, participants registered on the website, receiving HIVST (OraQuick®) by courier, peer educator or self‐pick‐up. Test result reporting and completing satisfaction surveys were encouraged. Intervention reach was measured through numbers accessing the testing, disaggregated by demographics, and proportion of individuals reporting self‐testing post‐registration. Effectiveness was measured through numbers reporting self‐test results, testing positive and linking to care, and testing negative and using HIVST to manage pre‐exposure prophylaxis (PrEP) use. Thematic content analysis of free‐text responses from the satisfaction survey synthesized quantitative outcomes. Results In total, 17,589 participants registered on the HIVST website; 11,332 individuals ordered 13,334 tests. Participants were generally young, aged

The teaching and learning of Communication English for adult learners is unlike that for children. Understanding of the differences between adult learners' and young learners' traits is considered a must for all English teachers so as to provide appropriate teaching methods and materials for adult learners in Communication English learning. Thus, this mixed-methods survey was conducted to investigate adult learners' perks and perils in Communication English learning and suggested solutions for their better communicative performance. The sample of this study consisted of 148 adult learners from the five selected language centers in Ho Chi Minh City, Vietnam. Data were collected from questionnaire copies. The findings revealed that the adult learners had some perks including strong motivation, clear learning goal, good learner autonomy and able technology use for learning, or positive attitudes towards the existing teachers' quality. Besides, some perils among these adult learners were sought, including low self-confidence, short time investment, and limited speaking practice environment. At last, they expected their teachers to make the lessons more interesting and realistic, and hoped their language centers to invite native language teachers.

The current study adopted features of a survey research design to examine the EFL high school teachers' beliefs about writing and its teaching, their actual classroom practices, and the interplays between their beliefs and practices in the realm of EFL writing instruction. A sample of seventy-six EFL teachers from the eight selected high schools situated in Ho Chi Minh City was recruited for the current survey. The beliefs and practices of EFL writing instruction of these studied teachers were elicited through a thirty-nine-item questionnaire, which was qualitatively analyzed by SPSS 20.0. The study results showed that most of the participants held different views/orientations about writing skills and teaching writing, consisting of form-based, cognitive process-based, functional social-based, and interactive social-based views; nevertheless, the form-based orientation was still most dominant in their beliefs. On the contrary, in practice, most high school teachers followed the product approach, which underlies form-based orientation in lieu of different approaches, explicitly interpreting the writing section's low results in the Vietnamese National GCSE examination in recent years.

Given that Vietnamese high school students continue to be passive knowledge receivers in their learning of writing although learner autonomy can make these students more active and independent writers, this qualitative study was conducted to explore six EFL teachers' beliefs about the necessity and viability of developing learner autonomy in writing classrooms at one public high school in Vietnam. Results from seven interview questions showed that all the teachers recognised the necessity of building up learner autonomy in EFL writing learning, and appreciated the potential contribution of learner autonomy to writing skills development. However, only half of the teachers saw positively the viability of promoting writing autonomy, while the other half was sceptical about its feasibility. The teachers elucidated the advantages and barriers in fostering learner autonomy in EFL writing learning pertaining to teachers' roles, learners' responsibilities, and school environment. Based upon the findings, recommendations are made for teachers to promote learner autonomy in writing skills development.

In order to evaluate the success of integrating the Interactive Whiteboard into vocabulary lessons in terms of developing the fifth graders' vocabulary achievement, retention and learning attitudes, the thirteen-week quasi-experimental study was conducted in two classes with the participation of 40 fifth graders as the control group and another 40 from the same grade as the experimental group, respectively. The instruments included three vocabulary tests (e.g. one pre-test, one posttest and one delayed post-test); and the attitude questionnaire. The quantitative data obtained from these measurement tools were analyzed by SPSS. The findings of the study indicated that the Interactive Whiteboard activities positively contributed to the fifth graders' vocabulary achievement and retention of form, meaning and use. Besides, the fifth graders' level of motivation, interest, and active behavioural intentions increased via the Interactive Whiteboard.

Learner autonomy, which places the great emphasis on the learners' independent roles and responsibilities in their learning process, has become the main concern of language education for over three past decades. It is important to investigate the language learners' self-perception of their autonomous responsibilities, their possession of autonomous abilities, and their enactment of autonomous in-class and out-of-class behaviors. Thereby, the current study adopted features of a mixed-methods research design to examine these autonomous dimensions as perceived by university learners. A sample of eighty English-majored sophomores from Hung Vuong University, Vietnam was recruited for the current study. Their self-perception of autonomous language learning was elicited through two instruments of a thirty-two-item questionnaire and a nine-question semi-structured interview. Then the questionnaire data were quantitatively analyzed and the interview data were qualitatively analyzed. The results of this study indicated that the majority of the participants positively acknowledged the importance of learner autonomy, discerned their gained autonomous learning responsibilities, recognized their existing autonomous abilities, and unveiled some enacted autonomous learning behaviors inside and outside class.

Introduction The Strengthen the Management of Multidrug-Resistant Tuberculosis in Vietnam (V-SMART) trial is a randomised controlled trial of using mobile health (mHealth) technologies to improve adherence to medications and management of adverse events (AEs) in people with multidrug-resistant tuberculosis (MDR-TB) undergoing treatment in Vietnam. This economic evaluation seeks to quantify the cost-effectiveness of this mHealth intervention from a healthcare provider and societal perspective.Methods and analysis The V-SMART trial will recruit 902 patients treated for MDR-TB across seven participating provinces in Vietnam. Participants in both intervention and control groups will receive standard community-based therapy for MDR-TB. Participants in the intervention group will also have a purpose-designed App installed on their smartphones to report AEs to health workers and to facilitate timely management of AEs. This economic evaluation will compare the costs and health outcomes between the intervention group (mHealth) and the control group (standard of care). Costs associated with delivering the intervention and health service utilisation will be recorded, as well as patient out-of-pocket costs. The health-related quality of life (HRQoL) of study participants will be captured using the 36-Item Short Form Survey (SF-36) questionnaire and used to calculate quality-adjusted life-years (QALYs). Incremental cost-effectiveness ratios (ICERs) will be based on the primary outcome (proportion of patients with treatment success after 24 months) and QALYs gained. Sensitivity analysis will be conducted to test the robustness of the ICERs. A budget impact analysis will be conducted from a payer perspective to provide an estimate of the total budget required to scale-up delivery of the intervention.Ethics and dissemination Ethical approval for the study was granted by the University of Sydney Human Research Ethics Committee (2019/676), the Scientific Committee of the Ministry of Science and Technology, Vietnam (08/QD-HDQL-NAFOSTED) and the Institutional Review Board of the National Lung Hospital, Vietnam (13/19/CT-HDDD). Study findings will be published in peer-reviewed journals and conference proceedings.Trial registration number ACTRN12620000681954.

PurposeReducing radiation treatment dose could improve the quality of life (QOL) of patients with good-risk human papillomavirus-associated oropharyngeal squamous cell carcinoma (OPSCC). Whether reduced-dose radiation produces disease control and QOL equivalent to standard chemoradiation is not proven.Patients and methodsIn this randomized, phase II trial, patients with p16-positive, T1-T2 N1-N2b M0, or T3 N0-N2b M0 OPSCC (7th edition staging) with ≤ 10 pack-years of smoking received 60 Gy of intensity-modulated radiation therapy (IMRT) over 6 weeks with concurrent weekly cisplatin (C) or 60 Gy IMRT over 5 weeks. To be considered for a phase III study, an arm had to achieve a 2-year progression-free survival (PFS) rate superior to a historical control rate of 85% and a 1-year mean composite score ≥ 60 on the MD Anderson Dysphagia Inventory (MDADI).ResultsThree hundred six patients were randomly assigned and eligible. Two-year PFS for IMRT + C was 90.5% rejecting the null hypothesis of 2-year PFS ≤ 85% (P = .04). For IMRT, 2-year PFS was 87.6% (P = .23). One-year MDADI mean scores were 85.30 and 81.76 for IMRT + C and IMRT, respectively. Two-year overall survival rates were 96.7% for IMRT + C and 97.3% for IMRT. Acute adverse events (AEs) were defined as those occurring within 180 days from the end of treatment. There were more grade 3-4 acute AEs for IMRT + C (79.6% v 52.4%; P < .001). Rates of grade 3-4 late AEs were 21.3% and 18.1% (P = .56).ConclusionThe IMRT + C arm met both prespecified end points justifying advancement to a phase III study. Higher rates of grade ≥ 3 acute AEs were reported in the IMRT + C arm.

In this paper, the effect of temperature on the refractive index of Carbon disulfide liquid based on the influence of temperature on the Sellmeier coefficient has been presented. The effect of temperature on the liquid refractive index of Carbon disulfide in the visible and infrared regions according to the expression of M. Chemnitz was also investigated. From the survey results, it is concluded that as the wavelength increases, the refractive index of Carbon disulfide decreases, but when the temperature is increased then the refractive index of Carbon disulfide decreases faster.

BackgroundThe aims of this systematic review are to (a) evaluate the current literature on the impact of postoperative therapy for resected squamous cell carcinoma of the head and neck (SCCHN) on oncologic and non-oncologic outcomes and (b) identify the optimal evidence-based postoperative therapy recommendations for commonly encountered clinical scenarios.MethodsAn analysis of the medical literature from peer-reviewed journals was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Prospective studies and methodology-based systematic reviews and meta-analyses of postoperative therapy for SCCHN were identified by searching Medline (OVID) and EMBASE (Elsevier) using controlled vocabulary terms (ie, National Library of Medicine Medical Subject Headings [MeSH], EMTREE). Study screening and selection was performed with Covidence software and full-text review. The RAND/UCLA appropriateness method was used by the expert panel to rate the appropriate use of postoperative therapy, and the modified Delphi method was used to come to consensus.ResultsA total of 5660 studies were identified and screened using the title and abstract, leading to 201 studies assessed for relevance using full-text review. After limitation to the eligibility criteria, 101 studies from 1977 to 2020 were identified, including 77 with oncologic endpoints and 24 with function and quality of life endpoints. All studies reported staging prior to the implementation of American Joint Committee on Cancer (AJCC-8).ConclusionsProspective clinical studies and systematic reviews identified through the PRISMA systematic review provided good evidence for consensus statements regarding the appropriate use of postoperative therapy for resected SCCHN. Further research is needed in domains where consensus by the expert panel could not be achieved for the appropriateness of specific postoperative therapeutic interventions.

BackgroundWe conducted the current systemic review to provide up-to-date literature summary and optimal evidence-based recommendations for ipsilateral radiation for squamous cell carcinoma of the tonsil.MethodsWe performed literature search of peer-reviewed journals through PubMed. The search strategy and subject-specific keywords were developed based on the expert panel's consensus. Articles published from January 2000 to May 2020 with full text available on PubMed and restricted to the English language and human subjects were included. Several prespecified search terms were used to identify relevant publications and additional evidence published since the initial American College of Radiology Appropriateness Criteria Ipsilateral Tonsil Radiation recommendation was finalized in 2012. The full bibliographies of identified articles were reviewed and irrelevant studies were removed.ResultsThe initial search and review returned 46 citations. The authors added three citations from bibliographies, websites, or books not found in the literature search. Of the 49 citations, 30 citations were retained for further detailed review, and 14 of them were added to the evidence table. Articles were removed from the bibliography if they were not relevant or generalizable to the topic, or focused on unknown primary disease. Several commonly encountered clinical case variants were created and panelists anonymously rated each treatment recommendation. The results were reviewed and disagreements discussed.ConclusionsThe panel provided updated evidence and recommendations for ipsilateral radiation for squamous cell carcinoma of the tonsil in the setting of primary radiation-based therapy and postoperative adjuvant radiotherapy. This committee did not reach agreements for some case variants due to a lack of strong evidence supporting specific treatment decisions, indicating a further need for research in these topics.

We design and implement parallel graph coloring algorithms on the GPU using two different abstractions—one datacentric (Gunrock), the other linear-algebra-based (GraphBLAS). We analyze the impact of variations of a baseline independent-set algorithm on quality and runtime. We study how optimizations such as hashing, avoiding atomics, and a max-min heuristic affect performance. Our Gunrock graph coloring implementation has a peak 2x speed-up, a geomean speed-up of 1.3x and produces 1.6x more colors over previous hardwired state-of-theart implementations on real-world datasets. Our GraphBLAS implementation of Luby’s algorithm produces 1.9x fewer colors than the previous state-of-the-art parallel implementation at the cost of 3x extra runtime, and 1.014x fewer colors than a greedy, sequential algorithm with a geomean speed-up of 2.6x.

Summary:. We present an original technique for reconstruction of the right forefoot after Chopart’s amputation. The case report was of a 20-year-old man who was a nonsmoker without comorbidities. He was referred to our department because of equinus deformity, pain, and prominence of the cuboid under the skin, leading to chronic ulceration at the stump. We performed flow through free latissimus dorsi flap including the eighth and tenth ribs to reconstruct the stump. Results were assessed at 18 months after operation, showing good stability and normal functional outcome of the foot. The patient is satisfied with the results achieved.