Background: s/Aims: The critical view of safety (CVS) prevents bile duct injury, but severe inflammation hinders its achievement.This study evaluated the parkland grading scale (PGS) as a real-time intraoperative predictor of CVS attainment in a Southeast Asian population, establishing standardized clinical data for future artificial intelligence applications. Methods: This prospective observational study (January–June 2025) included 88 consecutive patients undergoing laparoscopic cholecystectomy by a single surgeon. PGS was assessed upon initial laparoscopic inspection. We analyzed correlations between PGS, CVS attainment (Strasberg’s criteria), operative time, and bail-out procedures using Spearman’s correlation and multivariate logistic regression. Results: Severe inflammation (PGS grade 4–5) was observed in 31.8% of patients. PGS exhibited a strong negative correlation with CVS score (p = −0.652; p < 0.001) and strong positive correlations with operative time and blood loss. A PGS threshold of 4 accurately predicted CVS failure (area under the curve = 0.863). Bail-out procedures were necessary in 11 cases (12.5%), all occurring in the PGS ≥ 4 group. Advanced age and diabetes mellitus were independent risk factors for CVS failure. Conclusions The PGS serves as a precise intraoperative early warning system. A score ≥ 4 indicates a significant risk of CVS failure, prompting safer bail-out strategies. Additionally, this study provides a standardized dataset vital for training future autonomous surgical risk assessment models.

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Purpose: To determine the efficacy of apparent diffusion coefficient (ADC) values and ratios (lesion/liver tissue, lesion/splenic tissue, lesion/paraspinal muscle) in differentiating benign from malignant solid liver lesions. Materials and Methods: This study retrospectively analyzed data from 115 patients with solid liver lesions who underwent abdominal magnetic resonance imaging (MRI) at a single institution between January 2023 and December 2024. Lesions were classified as benign or malignant based on biochemical tests as well as radiographic and/or histopathologic findings. ADC values and ratios were determined using a 1.5 T MRI scanner.Quantitative variables are presented as mean ± standard deviation or median (interquartile range). Receiver operating characteristic (ROC) analysis was used to determine the cut-off values for ADC value and ratio, for which associated areas under the ROC curve were calculated. Results: The present analysis included 115 lesions—36 benign and 79 malignant. The median ADC value of the benign lesions was significantly higher than that of malignant lesions: 1744.5 × 10-6 mm2 /s vs. 1168.0 × 10-6 mm2 /s, respectively. The average lesion-toliver ADC (rADC l), lesion-to-spleen ADC (rADCsp), and lesion-to-paraspinal muscle ADC (rADC m) ratios for the benign lesions were significantly higher than those of malignant lesions: 1.79 vs. 1.09, 2.31 vs. 1.44, and 1.19 vs 0.80, respectively. A threshold of 1416 × 10-6 mm2 /s was used to differentiate benign vs. malignant lesions, with a sensitivity of 83.3% and a specificity of 78.5%. The cut-off values for rADC l, rADCsp, and rADC m were 1.55, 1.95, and 0.97, respectively, with sensitivities of 69.4%, 69.4%, and 83.3% and specificities of 87.3%, 91.1%, and 79.9%, respectively. Conclusion ADC metrics obtained from diffusion-weighted MRI effectively distinguished benign from malignant solid liver lesions.

Objective: In Viet Nam, tuberculosis (TB) prevalence surveys revealed that approximately 98% of individuals with pulmonary TB have TB-presumptive abnormalities on chest radiographs, while 32% have no TB symptoms. This prompted the adoption of the “Double X” strategy, which combines chest radiographs and computer-aided detection with GeneXpert testing to screen for and diagnose TB among vulnerable populations. The aim of this study was to describe demographic, clinical and radiographic characteristics of symptomatic and asymptomatic Double X participants and to assess multilabel radiographic abnormalities on chest radiographs, interpreted by computer-aided detection software, as a possible tool for detecting TB-presumptive abnormalities, particularly for subclinical TB. Methods: Double X participants with TB-presumptive chest radiographs and/or TB symptoms and known risks were referred for confirmatory GeneXpert testing. The demographic and clinical characteristics of all Double X participants and the subset with confirmed TB were summarized. Univariate and multivariable logistic regression modelling was used to evaluate associations between participant characteristics and subclinical TB and between computer-aided detection multilabel radiographic abnormalities and TB. Results: From 2020 to 2022, 96 631 participants received chest radiographs, with 67 881 (70.2%) reporting no TB symptoms. Among 1144 individuals with Xpert-confirmed TB, 51.0% were subclinical. Subclinical TB prevalence was higher in older age groups, non-smokers, those previously treated for TB and the northern region. Among 11 computer-aided detection multilabel radiographic abnormalities, fibrosis was associated with higher odds of subclinical TB. Discussion: In Viet Nam, Double X community case finding detected pulmonary TB, including subclinical TB. Computer-aided detection software may have the potential to identify subclinical TB on chest radiographs by classifying multilabel radiographic abnormalities, but further research is needed.

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.

Objectives: We assessed the prevalence of stress, anxiety, and depression among adolescents living in families with separated or divorced parents in Hue City, Vietnam and identified factors associated with these conditions. Methods: This cross-sectional study enrolled 309 adolescents, aged 12 to 17 years, living in families with separated or divorced parents in Hue City, Vietnam. The depression anxiety stress scale-21 (DASS-21) was used to measure stress, anxiety, and depression. Predictors of overall and individual mental health problems were identified using ordered and binary logistic regression, respectively. Results: The DASS-21 scale revealed a 49.2% prevalence of stress, while anxiety and depression had s prevalence rates of 61.5%. Among participants, 42.4% experienced all 3 mental health issues. Several factors were identified as significant predictors of mental health problems, including poor to average economic status (adjusted odds ratio [aOR], 2.00; 95% confidence interval [CI], 1.21–3.31; p=0.007); being in high school (aOR, 5.02; 95% CI, 2.93–8.60; p<0.001); maternal occupation of teacher, healthcare professional, or official (aOR, 2.39; 95% CI, 1.13–5.03; p=0.022); longer duration of family separation or divorce (aOR, 1.24; 95% CI, 1.05–1.45; p=0.009); living with one’s mother (aOR, 1.69; 95% CI, 1.03–2.76; p=0.04); alcohol consumption (aOR, 1.70; 95% CI, 0.99–2.92; p=0.050); and being bullied (aOR, 5.33; 95% CI, 1.10–25.69; p=0.037). Most of these factors were associated with stress, anxiety, and depression. Additionally, smoking was associated with stress. Conclusion Adolescents with separated or divorced parents were at increased risk of stress, anxiety, and depression. The findings of this study provide important implications for prevention programs.