Objectives: This study aims to analyze how the narrative representation of toothache in literary works has evolved in conjunction with the history of dental anesthetics development. By examining literary texts that reflect the discourse of their respective times, this study seeks to investigate the implications inherent in the shifting meaning of toothache. Methods: The study categorized time periods based on the history of anesthetic development and analyzed passages describing toothache in approximately 30 literary works corresponding to each period. The concepts of ‘Embodiment’ and ‘Suffering’ were utilized as theoretical frameworks for the textual analysis. Results: The analysis revealed that in pre-anesthesia literature, toothache was depicted as ‘Pain’itself—focusing on the unresolvable extremity of physical agony and the terror it invoked. However, with the advancement and widespread application of anesthetic technologies such as ether and lidocaine, the literary depiction of toothache shifted. It evolved from a mere physical sensation into a metaphor for ‘Suffering’, where social and personal repression or internal anxiety is embodied through the physical body. Conclusions The representation of toothache in literature has transitioned from biological ‘Pain’ to an embodiment of social suffering, paralleling advancements in dentistry. While dentists diagnose biological ‘Disease’, patients experience subjective ‘Illness.’ This study suggests that the indirect experience of toothache through literature enables dentists to gain a deeper understanding of the patient’s ‘embodied suffering’, thereby contributing to bridging the communication gap in clinical practice.

Objectives: The purpose of this study was to examine the influence of the local Vietnamese government initiative, the ‘invisible healthcare system’, on the activities of Organization A, which focuses on oral health projects. Methods: Since 2000, Organization A has conducted preventive care and oral health-focused activities in central Vietnam, with formal and informal interventions from local Vietnamese governments. This study conducts an in-depth analysis of the relationship between local Vietnamese governments and oversea non-government organizations (NGOs) from the perspective of the recipient country. Results: First, the initial step involves aligning intentions with the local Vietnamese government through negotiations, such as reaching agreements on the operation of oral health programs. Second, efforts should be made to understand the implicit aspects of Vietnamese policies regarding oversea NGO activities. For instance, it can be the People’s Aid Coordination Committee (PACCOM), which has a policy to manage oversea NGOs. The policies of PACCOM inherently reflect an ‘invisible healthcare system’ and a ‘nationalist-oriented character’. Conclusions Finally, oversea NGO activities in Vietnam increasingly require a focus on ‘localization’and ‘Vietnamization’ to effectively achieve the desired outcomes.

Objectives: The purpose of this study was to examine the influence of the local Vietnamese government initiative, the ‘invisible healthcare system’, on the activities of Organization A, which focuses on oral health projects. Methods: Since 2000, Organization A has conducted preventive care and oral health-focused activities in central Vietnam, with formal and informal interventions from local Vietnamese governments. This study conducts an in-depth analysis of the relationship between local Vietnamese governments and oversea non-government organizations (NGOs) from the perspective of the recipient country. Results: First, the initial step involves aligning intentions with the local Vietnamese government through negotiations, such as reaching agreements on the operation of oral health programs. Second, efforts should be made to understand the implicit aspects of Vietnamese policies regarding oversea NGO activities. For instance, it can be the People’s Aid Coordination Committee (PACCOM), which has a policy to manage oversea NGOs. The policies of PACCOM inherently reflect an ‘invisible healthcare system’ and a ‘nationalist-oriented character’. Conclusions Finally, oversea NGO activities in Vietnam increasingly require a focus on ‘localization’and ‘Vietnamization’ to effectively achieve the desired outcomes.

Objectives: The purpose of this study was to examine the influence of the local Vietnamese government initiative, the ‘invisible healthcare system’, on the activities of Organization A, which focuses on oral health projects. Methods: Since 2000, Organization A has conducted preventive care and oral health-focused activities in central Vietnam, with formal and informal interventions from local Vietnamese governments. This study conducts an in-depth analysis of the relationship between local Vietnamese governments and oversea non-government organizations (NGOs) from the perspective of the recipient country. Results: First, the initial step involves aligning intentions with the local Vietnamese government through negotiations, such as reaching agreements on the operation of oral health programs. Second, efforts should be made to understand the implicit aspects of Vietnamese policies regarding oversea NGO activities. For instance, it can be the People’s Aid Coordination Committee (PACCOM), which has a policy to manage oversea NGOs. The policies of PACCOM inherently reflect an ‘invisible healthcare system’ and a ‘nationalist-oriented character’. Conclusions Finally, oversea NGO activities in Vietnam increasingly require a focus on ‘localization’and ‘Vietnamization’ to effectively achieve the desired outcomes.

Objectives: The purpose of this study was to examine the influence of the local Vietnamese government initiative, the ‘invisible healthcare system’, on the activities of Organization A, which focuses on oral health projects. Methods: Since 2000, Organization A has conducted preventive care and oral health-focused activities in central Vietnam, with formal and informal interventions from local Vietnamese governments. This study conducts an in-depth analysis of the relationship between local Vietnamese governments and oversea non-government organizations (NGOs) from the perspective of the recipient country. Results: First, the initial step involves aligning intentions with the local Vietnamese government through negotiations, such as reaching agreements on the operation of oral health programs. Second, efforts should be made to understand the implicit aspects of Vietnamese policies regarding oversea NGO activities. For instance, it can be the People’s Aid Coordination Committee (PACCOM), which has a policy to manage oversea NGOs. The policies of PACCOM inherently reflect an ‘invisible healthcare system’ and a ‘nationalist-oriented character’. Conclusions Finally, oversea NGO activities in Vietnam increasingly require a focus on ‘localization’and ‘Vietnamization’ to effectively achieve the desired outcomes.

Background/Aims: Combination immunotherapy, exemplified by atezolizumab plus bevacizumab, has become the standard of care for inoperable hepatocellular carcinoma (HCC). However, the lack of predictive biomarkers and limited understanding of response mechanisms remain a challenge. Methods: Using data from the IMbrave150plus cohort, we applied an immune signature score (ISS) predictor to stratify HCC patients treated with atezolizumab plus bevacizumab or with sorafenib alone into potential high and low response groups. By applying multiple statistical approaches including a Bayesian covariate prediction algorithm, we refined the signature to 10 key genes (ISS10) for clinical use while maintaining similar predictive power to the full model. We further validated ISS10 in an independent HCC cohort treated with nivolumab plus ipilimumab. Results: The study identified a significant association between the ISS and treatment response. Among patients classified as high responders, those treated with the atezolizumab plus bevacizumab combination exhibited improved overall and progression-free survival as well as better objective response rate compared to those treated with sorafenib. We also observed a significant correlation between ISS10 and response to nivolumab plus ipilimumab treatment. Analysis of immune cell subpopulations revealed distinct characteristics associated with ISS subtypes. In particular, the ISS10 high subtype displayed a more favorable immune environment with higher proportions of antitumor macrophages and activated T-cells, potentially explaining its better response. Conclusions Our study suggests that ISS and ISS10 are promising predictive biomarkers for enhanced therapeutic outcomes in HCC patients undergoing combination immunotherapy. These markers are crucial for refining patient stratification and personalized treatment approaches to advance the effectiveness of standard-of-care regimens.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.