Background: While advanced age is a known risk factor for postoperative complications following hip arthroplasty, its role as an independent predictor versus a surrogate for comorbidity remains unclear, particularly in developing countries. This study aimed to investigate the independent impact of age on postoperative outcomes and explore the mediating role of key comorbidities in a resource-limited setting. Methods: We retrospectively reviewed 769 adult patients undergoing hip arthroplasty at a Vietnamese tertiary hospital (2021–2024), categorized into three groups: younger adults (18–64 years), older adults (65–79 years), and oldest old (≥80 years). The primary outcome was a composite of major postoperative complications. Multivariable logistic regression and structural equation modeling were used to identify independent predictors and assess mediation effects. Results: Among 769 patients, 363 were younger (47.2%), 241 older adults (31.3%), and 165 oldest old (21.5%). Complication rates increased significantly with age (18.7%, 36.9%, and 60.0%, respectively; p<0.001). However, multivariable adjustment showed that age was not an independent predictor. Instead, heart failure (adjusted odds ratio [aOR]=5.49, 95% confidence interval [CI] 2.19–13.74) and preoperative anemia (aOR=1.77, 95% CI 1.21– 2.59) were identified as independent risk factors. Mediation analysis revealed that the effect of age on complications was significantly mediated through preoperative anemia. Conclusion Increased postoperative risk in older adults is driven by comorbidity burden rather than chronological age. Preoperative anemia and heart failure are critical, independent predictors, with anemia acting as a key mediator for the effects of age. Individualized correction of modifiable comorbidities may be more beneficial than using age alone to assess surgical risk.

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.

A 47-year-old female was admitted with progressive exertional dyspnea and diagnosed with anomalous drainage of the left pulmonary veins into the coronary sinus (CS), combined with an intact interatrial septum and a small patent ductus arteriosus (PDA). Multimodal imaging, including echocardiography, computed tomography, and cardiac catheterization, helps diagnosis, optimal management and monitoring. The patient successfully underwent surgical repair, which involved rerouting the left anomalous pulmonary veins into the left atrium through a surgically created atrial septal defect, while the CS continued to drain into the right atrium and the PDA was closed directly via a transpulmonary approach. The postoperative course was uneventful.

Background: s/Aims: Hepatolithiasis and choledocholithiasis are frequent pathologies and unfortunately, with the current treatment strategies, the recurrence incidence is still high. This study aimed to assess the outcomes of laparoscopic choledochotomy using cholangioscopy via the percutaneous-choledochal tube for the treatment of hepatolithiasis and choledocholithiasis in Vietnamese patients. Methods: A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at the Department of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020. Results: A total of 84 patients were analyzed. Most patients were females (56.0%) with a median age of 55.56 years. Among them, 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) had both intrahepatic and extrahepatic stones. The rate of stones ≥ 10 mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. Intraoperative complications were encountered in two patients, but there was no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes.The early postoperative complication rate was 9.6%, and all patients were managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%. Conclusions Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube is a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with a previous choledochotomy.

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.

Artichoke (Cynara scolymus L.) is a perennial plant belonging to the Asteraceae family originating from the Mediterranean region. In Vietnam, there are some varieties of artichoke which are extensively cultivated and propagated in highland areas, however, there have been limited detailed scientific publications on the chemical composition and biological activity of artichoke grown in Vietnam. Therefore, this study provides a detailed description of the extraction, isolation, and structural determination of 20 natural secondary metabolites present in harvested artichoke. The antioxidant activity of the extract and the 9 isolated compounds are tested in 1,1-diphenyl-2-picrylhydrazyl radical scavenging and ex vivo malondialdehyde model. Among the selected compounds, 1-caffeoylquinic acid, 3-caffeoylquinic acid, chlorogenic acid, 4-caffeoylquinic acid, cynarin, 1,5-dicaffeoylquinic acid, 4,5-di-caffeoylquinic acid, cynaroside, and scolymoside exhibited strong radical scavenging activity with IC50 values ranging from 5.7 to 61.6 µM. In the malondialdehyde assay, 1,3-dicaffeoylquinic acid (or cynarin) showed the strongest activity with an IC50 value of 24.7 µM, followed by 1,5-di-caffeoylquinic acid (66.8 µM), and 4,5-di-caffeoylquinic acid (127.3 µM). This outcome contributes to establishing a database on the phytochemical and antioxidant activity of the Vietnamese artichoke.

FACTORS ASSOCIATED WITH VIETNAMESE STUDENTS’ SELF-PERCEIVED MENTAL HEALTH PROBLEMS DURING THE COVID-19 LOCKDOWN: A CROSS-SECTIONAL STUDY Abstract The COVID-19 pandemic has stated the critical importance of addressing the mental health care needs of students. With the abrupt and extensive changes brought about by the pandemic, such as lockdowns and shifts to online learning, students worldwide faced significant psychological challenges. This context led to a comprehensive study focusing on Vietnamese students, aiming to understand their perceptions of mental health amidst these unprecedented times. The research specifically targeted the initial lockdown phase, seeking to describe the prevalence of mental health issues and identify the factors contributing to these problems among students in Vietnam. By examining these aspects, the study aimed to provide insights into the mental well-being of students during a major global crisis. A cross-sectional study was conducted among 1889 students in North and South Vietnam from 30 August, 2021 to 5 September, 2021. Socio-demographic information was collected via an online survey and the SF-12 Mental Composite Score (MCS) was used to assess self-perceived mental health problems. The study results show that the prevalence of selfperceived mental health problems, defined by an MCS<1st quartile, was 21.9% (95%CI: 20%-23.8%) among students during the COVID-19 lockdown. Regression models indicated that the following factors were significantly related to self-perceived mental health problems: Female sex, not living with family, financial difficulty, decreased health status, decreased academic performance and decreased social relationships during the COVID-19 lockdown. The study showed that many factors related to student’s self-perceived mental health problems during COVID-19, affecting a significant number of students. Suggestions for teachers and university administrators were also discussed. ASEAN Journal of Psychiatry, Vol. 25 (8) October, 2024;1-9.

In the present study, bioactivity-guided extraction and isolation of the n-hexane fraction of the fruits of Vietnamese Schisandra sphenanthera led to the isolation of five dibenzocyclooctadiene lignans as gomisin N (1), schisandrin C (2), gomisin H (3), gomisin D (4), and gomisin C (5). All the isolates were tested for their inhibition of NO production in LPS-induced RAW 264.7 cells. Among them, compounds 4 and 5 showed weak inhibition of NO production with IC 50 values of 25.0 ± 1.6 and 24.8 ± 2.0 µM, respectively. Compound 1 exhibited NO production inhibition with an IC 50 value of 15.8 ± 2.1 µM, meanwhile, schisandrin C (2) showed the most potent inhibition with an IC 50 value of 8.5 ± 0.5 µM. In addition, compound 2 had a concentrationdependent inhibitory effect on the protein expression of the inflammatory enzymes iNOS and COX-2. Their physicochemical properties and ADMET data were predicted by in silico, indicating favorable drug-like properties as well as low acute oral toxicity. The results suggest that the fruit of S. sphenanthera and its phytochemical constituents might be used as anti-inflammatory agents.

Understanding of nonalcoholic fatty liver disease (NAFLD) continues to expand, but the relationship between race and ethnicity and NAFLD outside the use of cross-sectional data is lacking. Using longitudinal data, we investigated the role of race and ethnicity in adverse outcomes in NAFLD patients. Methods: Patients with NAFLD confirmed by imaging via manual chart review from any clinics at Stanford University Medical Center (1995–2021) were included. Primary study outcomes were incidence of liver events and mortality (overall and non-liver related). Results: The study included 9,340 NAFLD patients: White (44.1%), Black (2.29%), Hispanic (27.9%), and Asian (25.7%) patients. For liver events, the cumulative 5-year incidence was highest among White (19.1%) patients, lowest among Black (7.9%) patients, and similar among Asian and Hispanic patients (~15%). The 5-year and 10-year cumulative overall mortality was highest for Black patients (9.2% and 15.0%, respectively, vs. 2.5–3.5% and 4.3–7.3% in other groups) as well as for non-liver mortality. On multivariable regression analysis, compared to White patients, only Asian group was associated with lower liver-related outcomes (aHR: 0.83, P=0.027), while Black patients were at more than two times higher risk of both non-liver related (aHR: 2.35, P=0.010) and overall mortality (aHR: 2.13, P=0.022) as well as Hispanic patients (overall mortality: aHR: 1.44, P=0.022).Conclusions: Compared to White patients, Black patients with NAFLD were at the highest risk for overall and non-liver-related mortality, followed by Hispanic patients with Asian patients at the lowest risk for all adverse outcomes. Culturally sensitive and appropriate programs may be needed for more successful interventions.

Ho Chi Minh City, Viet Nam undertook a series of measures in response to the fourth and largest wave of COVID-19. The care pathway was continuously reconfigured through leadership from all levels of government and engagement of the community. This resulted in a shift towards integrated severity-based care consisting of multiple levels of health-care facilities and home care. This flexible approach based on the rapidly changing local context enabled Ho Chi Minh City to limit the extent to which health-care capacity was overwhelmed.