Background: In the targeted therapy era, the indication for stereotactic radiosurgery (SRS) has ex-panded to include patients with multiple brain metastases (BMs). This study aimed to compare treatment outcomes in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients with 1–4 versus 5–10 BMs, all treated with tyrosine kinase inhibitors (TKIs) and upfront Gamma Knife radiosurgery. Methods: We retrospectively reviewed 74 consecutive EGFR-mutant NSCLC patients with 1–10synchronous BMs treated with first-line EGFR-TKIs and upfront Gamma Knife SRS at Vietnam National Cancer Hospital from 2021 to 2024. Patients were divided into 1–4 BMs (n=39) and 5–10 BMs (n=35) groups. Primary endpoints were intracranial progression-free survival (iPFS) and overall survival (OS). Results: Baseline characteristics were balanced between the two groups. Median iPFS wasnot reached in the 1–4 BMs group and 19 months in the 5–10 BMs group (hazard ratio [HR] 1.06, 95% confidence interval [CI] 0.95–1.17; p=0.31). Median OS was not reached in the 1–4 BMs group and was 23 months in the 5–10 BMs group (HR 1.03, 95% CI 0.91–1.16; p=0.41). Multivariate analysis revealed extracranial response (HR 4.30, p<0.01 for iPFS; HR 7.29, p<0.01 for OS) and presence of extracranial metastases (HR 3.20, p=0.01 for iPFS) as the only independent prognostic factors; number of BMs was not prognostic. Radionecrosis occurred in 6.8%, of which 2.7% were symptomatic. Conclusion In EGFR-mutant NSCLC patients receiving TKIs and upfront Gamma Knife radiosur-gery, the survival time in patients with 5–10 BMs was comparable to that with 1–4 BMs. The number of BMs should not be regarded as a contraindication for SRS in this subgroup.

Peptide-based therapeutics hold great promise for the treatment of various diseases; however, their clinical application is often hindered by toxicity challenges. The accurate prediction of peptide toxicity is crucial for designing safe peptide-based therapeutics. While traditional experimental approaches are time-consuming and expensive, computational methods have emerged as viable alternatives, including similarity-based and machine learning (ML)-/deep learning (DL)-based methods. However, existing methods often struggle with robustness and generalizability. To address these challenges, we propose HyPepTox-Fuse, a novel framework that fuses protein language model (PLM)-based embeddings with conventional descriptors. HyPepTox-Fuse integrates ensemble PLM-based embeddings to achieve richer peptide representations by leveraging a cross-modal multi-head attention mechanism and Transformer architecture. A robust feature ranking and selection pipeline further refines conventional descriptors, thus enhancing prediction performance. Our framework outperforms state-of-the-art methods in cross-validation and independent evaluations, offering a scalable and reliable tool for peptide toxicity prediction. Moreover, we conducted a case study to validate the robustness and generalizability of HyPepTox-Fuse, highlighting its effectiveness in enhancing model performance. Furthermore, the HyPepTox-Fuse server is freely accessible at https://balalab-skku.org/HyPepTox-Fuse/ and the source code is publicly available at https://github.com/cbbl-skku-org/HyPepTox-Fuse/. The study thus presents an intuitive platform for predicting peptide toxicity and supports reproducibility through openly available datasets.

Peptide-based therapeutics hold great promise for the treatment of various diseases;however,their clinical application is often hindered by toxicity challenges.The accurate prediction of peptide toxicity is crucial for designing safe peptide-based therapeutics.While traditional experimental approaches are time-consuming and expensive,computational methods have emerged as viable alternatives,including similarity-based and machine learning(ML)-/deep learning(DL)-based methods.However,existing methods often struggle with robustness and generalizability.To address these challenges,we propose HyPepTox-Fuse,a novel framework that fuses protein language model(PLM)-based embeddings with conventional descriptors.HyPepTox-Fuse integrates ensemble PLM-based embeddings to achieve richer peptide representations by leveraging a cross-modal multi-head attention mechanism and Transformer architecture.A robust feature ranking and selection pipeline further refines conventional descriptors,thus enhancing prediction performance.Our framework outperforms state-of-the-art methods in cross-validation and independent evaluations,offering a scalable and reliable tool for peptide toxicity pre-diction.Moreover,we conducted a case study to validate the robustness and generalizability of HyPepTox-Fuse,highlighting its effectiveness in enhancing model performance.Furthermore,the HyPepTox-Fuse server is freely accessible at https://balalab-skku.org/HyPepTox-Fuse/and the source code is publicly available at https://github.com/cbbl-skku-org/HyPepTox-Fuse/.The study thus presents an intuitive platform for predicting peptide toxicity and supports reproducibility through openly available datasets.

This study aims to describe the feasibility of inserting an oblique lumbar interbody fusion (OLIF) cage through biportal endoscopic lumbar interbody fusion (BE-LIF) and to illustrate the key surgical steps through a case-based video demonstration. BE-LIF is a safe and effective minimally invasive fusion technique. Among the factors influencing successful fusion, the cage footprint plays a critical role—a larger cage increases endplate contact area, maintains disc height, and enhances segmental stability. The OLIF cage offers these biomechanical advantages; however, inserting it through a biportal endoscopic approach is technically demanding and requires several strategic considerations. These include meticulous preoperative planning of portal positions to optimize visualization and working angles, adequate preparation of the disc space window for cage insertion, precise endplate preparation, and safe neural manipulation within a confined surgical field. A 56-year-old female presented with chronic low back pain and bilateral leg symptoms unresponsive to conservative treatment. Imaging revealed severe L4–5 central canal stenosis, foraminal narrowing, and instability. She underwent BE-LIF with OLIF cage insertion and percutaneous pedicle screw fixation. The step-by-step surgical video demonstrates portal placement, decompression, endplate preparation, bone grafting, and cage insertion under combined endoscopic and fluoroscopic guidance. The operation lasted 180 minutes, with an estimated blood loss of 150 mL. The patient was mobilized on postoperative day 1 and discharged on day 5 with marked improvement. Follow-up radiographs confirmed restoration of disc height, correct cage positioning, and adequate decompression. This case demonstrates that BE-LIF with OLIF cage insertion is feasible and may enhance fusion potential by combining the minimally invasive benefits of biportal endoscopy with the biomechanical advantages of a large-footprint cage. However, the procedure remains technically demanding and is best suited for experienced endoscopic spine surgeons.

Objective: The purpose of this study was to identify factors associated with twin pregnancy following day 3 double embryo transfer (DET). Methods: This retrospective cohort study incorporated data from 16,972 day 3 DET cycles. The participants were women aged between 18 and 45 years who underwent in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) at My Duc Assisted Reproduction Technique Unit (IVFMD), My Duc Hospital, located in Ho Chi Minh City, Vietnam. Results: Of the 16,972 day 3 DET cycles investigated, 8,812 (51.9%) resulted in pregnancy. Of these, 6,108 cycles led to clinical pregnancy, with 1,543 (25.3% of clinical pregnancies) being twin pregnancies. Factors associated with twin pregnancy included age under 35 years (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.32 to 1.71; p<0.001) and cycles involving the transfer of at least one grade I embryo. Relative to the transfer of two grade III embryos, the risk of twin pregnancy was significantly elevated following the transfer of two grade I embryos (OR, 1.40; 95% CI, 1.16 to 1.69; p<0.001) or a combination of one grade I and one grade II embryo (OR, 1.27; 95% CI, 1.05 to 1.55; p=0.001). Conclusion By analyzing a large number of IVF/ICSI cycles, we identified several predictors of twin pregnancy. These findings can assist medical professionals in tailoring treatment strategies for couples with infertility.

Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients. Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking. Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT. Conclusions FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.

Objectives: This study validated the Vietnamese version of the Disaster Adaptation and Resilience Scale (DARS) for use in vulnerable communities in Vietnam. Methods: This was a cross-sectional study involving 595 adults from 2 identified communities. The original DARS assessment tool was translated, and the validity and reliability of the Vietnamese version of DARS (V-DARS) were assessed. The internal consistency of the overall scale and its subscales was evaluated using Cronbach’s alpha and McDonald’s omega reliability coefficients. Confirmatory factor analysis (CFA) was employed to evaluate its construct validity, building upon the factor structure identified in exploratory factor analysis (EFA). Construct validity was assessed based on convergent and discriminant validity. Results: Following the established criteria for EFA, 8 items were removed, resulting in a refined V-DARS structure comprising 35 items distributed across 5 distinct factors. Both alpha and omega reliability coefficients indicated strong internal consistency for the overall scale (α=0.963, ω=0.963) and for each of the 5 sub-scales (all>0.80). The CFA model also retained the 5-factor structure with 35 items. The model fit indices showed acceptable values (RMSEA: 0.072; CFI: 0.912; TLI: 0.904; chi-square test: <0.01). Additionally, the convergent and discriminant validity of the V-DARS were deemed appropriate and satisfactory for explaining the measurement structure. Conclusions Our findings suggest that the V-DARS is a valid and reliable scale for use within vulnerable communities in Vietnam to assess adaptive responses to natural disasters. It may also be considered for use in other populations.

Objectives: The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a “social vaccine” that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association. Methods: A cross-sectional study was conducted at 18 hospitals and health centers in Vietnamfrom December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (usingthe 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions. Results: Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD.Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63–2.12; p < 0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97–0.99; p = 0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96–0.99; p = 0.001). Conclusion Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.

Vietnam boasts a rich and diverse flora, with many endemic species. Among them, Ngoc Linh ginseng (Vietnamese ginseng; scientific name: Panax vietnamensis Ha et Grushv.), a high-value endemic ginseng species, has been recognized as a national treasure. While numerous studies have been conducted on its rhizomes and roots, research on its leaves remains limited. In this study, six compounds (1–6) were isolated from the methanol extract of the leaves of P. vietnamensis. Their structures were elucidated using ESI-MS, 1D and 2D NMR spectroscopic methods, and comparisons with known literature data. The identified compounds are: 12β,20(R),25-β trihydroxydammara-3-O-β-D-glucopyranoside (1); 12β,20(R),25-trihydroxydammara-3-O-β-D-glucopyranosyl- (1→2)-β-D-glucopyranoside (2); notoginsenoside SFt1 (3); ginsenoside Rh2 (4); ginsenoside Rg3 (5) and notoginsenoside L1 (6). Except for compound 3, which was isolated from the leaves for the first time, the other five compounds are reported from this species for the first time. The α-glucosidase inhibition assay of the pure isolated compounds revealed that compounds 1, 4, and 6 exhibited significant activities, with IC50 values of 133.5, 105.5, and 14.9, respectively. For comparison, the positive control, acarbose, had an IC50 value of 138.2 µM.

Vietnam boasts a rich and diverse flora, with many endemic species. Among them, Ngoc Linh ginseng (Vietnamese ginseng; scientific name: Panax vietnamensis Ha et Grushv.), a high-value endemic ginseng species, has been recognized as a national treasure. While numerous studies have been conducted on its rhizomes and roots, research on its leaves remains limited. In this study, six compounds (1–6) were isolated from the methanol extract of the leaves of P. vietnamensis. Their structures were elucidated using ESI-MS, 1D and 2D NMR spectroscopic methods, and comparisons with known literature data. The identified compounds are: 12β,20(R),25-β trihydroxydammara-3-O-β-D-glucopyranoside (1); 12β,20(R),25-trihydroxydammara-3-O-β-D-glucopyranosyl- (1→2)-β-D-glucopyranoside (2); notoginsenoside SFt1 (3); ginsenoside Rh2 (4); ginsenoside Rg3 (5) and notoginsenoside L1 (6). Except for compound 3, which was isolated from the leaves for the first time, the other five compounds are reported from this species for the first time. The α-glucosidase inhibition assay of the pure isolated compounds revealed that compounds 1, 4, and 6 exhibited significant activities, with IC50 values of 133.5, 105.5, and 14.9, respectively. For comparison, the positive control, acarbose, had an IC50 value of 138.2 µM.