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.

Autophagy is a conserved catabolic process that degrades proteins and damaged organelles to maintain cellular homeostasis, and its role in cancer depends on stage and context. Farnesyl-diphosphate farnesyltransferase 1 (FDFT1) is an essential enzyme in the sterol branch of the mevalonate pathway, but its functions in hepatocellular carcinoma (HCC) and in the regulation of autophagy remain poorly understood. In this study, we show that FDFT1 acts as a negative regulator of autophagy in HCC cells. Loss of FDFT1 led to increased autophagosome formation and fusion with lysosomes, whereas its overexpression suppressed both basal and induced autophagy. These changes were associated with AMPK–ULK1 signaling, suggesting that FDFT1 influences a central pathway controlling autophagy. Our findings connect cholesterol metabolism with autophagy regulation and tumor growth, highlighting FDFT1 as a potential prognostic marker and therapeutic target in liver cancer.

BACKGROUND: Acellular tubular artery scaffolds offer structural support for vascular regeneration but are inherently limited by poor anticoagulant properties, which increases the risk of thrombus formation following implantation. This thrombogenicity remains a major obstacle to their clinical application, particularly in small-diameter vascular grafts. METHODS: To address this challenge, the present study investigates the use of the Layer-by-Layer (LbL) assembly technique for heparin immobilization under low-speed rotation. Utilizing a roller tube system, heparin was immobilized onto decellularized scaffolds through electrostatic interactions facilitated by a DHI-based linker. This low-speed rotation LbL approach enhanced the uniformity and stability of heparin deposition compared to traditional static methods. One, 4, 7, 10, 13 deposition cycles were performed to achieve optimal heparin loading, resulting in scaffolds capable of sustained heparin release over 28 days. RESULTS: The heparinized scaffolds exhibited an initial burst release (approximately 80%), followed by a sustained phase with 18.24% ± 0.242 remaining to support prolonged anticoagulant activity. Importantly, the modified scaffolds significantly reduced thrombus formation and exhibited minimal hemolytic activity, indicating improved hemocompatibility. In addition to their antithrombotic properties, the scaffolds also promoted endothelial cell adhesion, which is critical for restoring vascular integrity, regulating vascular tone, and maintaining long-term patency. CONCLUSION These findings highlight the efficacy of roller-assisted LbL heparinization as a practical and scalable strategy to enhance the blood compatibility of acellular vascular grafts. This method holds considerable promise for addressing thrombogenicity in vascular tissue engineering and advancing the clinical translation of bioengineered vascular constructs.

Background: Catecholamines play a crucial role in muscle biogenesis, but their persistent elevation is linked to muscle wasting, which is poorly understood. This study aimed to investigate the association between catecholamine levels and age-related muscle loss. Methods: This retrospective study evaluated the plasma levels of two catecholamines, metanephrine and normetanephrine, and the clinical characteristics of 830 patients with adrenal incidentaloma on computed tomography (CT). Cross-sectional CT data at the L3 lumbar vertebrae were used to measure muscle areas. In vitro studies on C2C12 myotubes were conducted to examine β-adrenergic receptor signaling pathways and their role in myogenesis. Results: Men had significantly higher mean metanephrine levels of 0.17 nmol/L and normetanephrine levels of 0.63 nmol/L than women (P<0.05). Total abdominal muscle area was negatively correlated with catecholamine levels in both men and women, with the strongest negative correlation between normetanephrine levels and total abdominal muscle area in men (r=–0.31, P<0.001). Similarly, the strongest negative correlation between visceral fat area and metanephrine was observed in men (r=–0.25, P=0.004). Clenbuterol, a β-adrenergic receptor agonist, inhibited myogenesis, including myotube formation by extracellular signal-regulated kinase (ERK) suppression in C2C12 myoblasts. Conversely, β-blockers increased myogenesis via increasing ERK phosphorylation in C2C12 cells. These findings suggest that β-adrenergic modulation influences skeletal muscle differentiation, with ERK phosphorylation. Conclusion Catecholamine levels are associated with age, sex, muscle mass, and fat mass. Monitoring catecholamine levels, particularly in older men and in individuals with reduced muscle mass, may help manage age-related muscle loss and lead to individualized treatment strategies.

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.

Objectives: The rapid and widespread development of social networking sites has created a potential venue for an increase in cyberbullying among adolescents. While much research has been done on middle school/high school students, this issue for college/university students has yet to receive much attention. The present study described the prevalence of cyberbullying and associated factors among Hanoi Medical University students. Methods: Data were obtained from an online survey of conveniently selected Hanoi Medical University students. A total of 736 students participated and finished a structured questionnaire based on the Cyberbullying Victimization Scale (CVS). Results: The prevalence of cyberbullying victims among Hanoi Medical University students was 17.4%, and 9.0% of the students had engaged in cyberbullying behaviors. Research also indicated that there is an association between cyberbullying behavior and factors such as internet usage duration and frequency of monitoring violent information. Gender didn't have any relationship with cyberbullying victimization but had a significant association with cyberbullying perpetration (OR = 2.37, 95%CI = 1.42 – 3.96). Conclusion: Cyberbullying has become an important phenomenon related to internet usage duration and violent information among students of Hanoi Medical University. Therefore, it is necessary to build healthy internet habits and manage online information to reduce cyberbullying prevalence and promote student health in the digital age.

Background: Patients with beta-thalassemia major are susceptible to malnutrition, yet limited evidence exists in Vietnam. This study aims to identify factors associated with underweight status among adults with beta-thalassemia major in Vietnam. Methods: This cross-sectional study included 201 adults (≥18 years) with beta-thalassemia major. Underweight was defined as BMI < 18.5 kg/m². Logistic regression was used to examine factors associated with underweight status, including age, sex, ethnicity, place of residence, educational level, marital status, and employment status. Results: Over half of the participants (54.2%) were underweight. Female (aOR = 0.30, 95% CI: 0.12–0.73, p-value=0.008) and married patients (aOR = 0.32, 95% CI: 0.13–0.79, p-value=0.013) were significantly associated with lower odds of underweight status compared to male and unmarried counterparts. Underweight patients had significantly lower fat mass, muscle mass, and bone mineral content, but higher total body water percentage compared to those with normal weight. Conclusion: Underweight status is highly prevalent among adults with beta-thalassemia major in Vietnam, particularly among males and unmarried individuals. These findings underscore the need for targeted nutritional and psychosocial support strategies to improve care and quality of life for this vulnerable population. We recommend implementing tailored nutritional interventions to improve their nutritional status.

Six coumarins were isolated from two bioactive fractions of the 70% ethanol extract from the twigsand leaves of Wikstroemia indica (L.) C.A. Mey. (Thymelaeaceae), namely the ethyl acetate fraction (WIE) and the water fraction (WIW). These compounds were identified as umbelliferone (1), daphnoretin (2), daphnorin (3), adicardin (4), wikstronutin (5), and triumbelletin-7-O-β-D-glucoside (6). Compound 4 is reported for the first time in the genus Wikstroemia, whereas compound 5 is newly identified in this species. All six compounds were evaluated for their effects on Interleukin-1 beta (IL-1β) and IL-10 secretion in Lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages, among which compounds 1, 2, 5, and 6 showed stronger activity. These four coumarin derivatives further suppressed the production of Foxp3, Interferon-alpha (IFN-α), IFN-γ, and IL-17 in LPSstimulated CD4+ T cells. The IC50 values ranged from 18.84 ± 1.16 to 43.45 ± 5.34 μM for Foxp3, 8.96 ± 1.45 to 22.42 ± 4.12 μM for IFN-α, 9.28 ± 1.23 to 16.83 ± 2.15 μM for IFN-γ, and 12.62 ± 2.57 to 22.92 ± 4.41 μM for IL-17. Notably, compound 6 exhibited the strongest immunomodulatory effect. Overall, the findings suggest that coumarins from W. indica possess promising immunomodulatory and anti-inflammatory potential.

Objective: The risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from schoolchildren to their household and the protective effects of vaccination in these settings remain poorly understood. We assessed the transmission dynamics of schoolchildren with SARS-CoV-2 within their households and the protective effects of coronavirus disease (COVID-19) vaccination among household members in Viet Nam. Methods: We estimated the attack rate, vaccine effectiveness and adjusted risk ratio (aRR) of factors associated with SARS-CoV-2 transmission to household contacts of children confirmed to have COVID-19 who attended three schools in Ha Nam, Phu Tho and Thanh Hoa provinces between September and December 2021 using multivariable regression with household-level random effects. Results: This retrospective cohort study included 157 children infected with SARS-CoV-2 and their 540 household contacts. The attack rate among household contacts was 24.6% (133/540). Overall, vaccine effectiveness among household contacts was 39% (95% confidence interval [CI]: -1 to -63), higher among males than females and higher in adults aged >40 years. COVID-19 transmission was greater among female household contacts compared with males (aRR: 1.35, 95% CI: 0.94 to 1.95), although not statistically significant, and highest among those aged 19–39 years (aRR: 2.51, 95% CI: 1.50 to 4.21). Fully vaccinated household contacts had significantly lower infection risk (aRR: 0.46, 95% CI: 0.26 to 0.84). Discussion: We found substantial onward transmission of SARS-CoV-2 from schoolchildren to household members, and older people were more likely to be protected by vaccination. We recommend that schoolchildren and all household members living with schoolchildren receive at least two doses of a COVID-19 vaccine. Recognizing the role of schoolchildren in the onward transmission of COVID-19 is an important lesson learned by Viet Nam that can help not only in managing other outbreaks but also in protecting schoolchildren by predicting the progress of the outbreak and preparing for a timely response.

VIETNAMESE STUDENTS’ AWARENESS OF MENTAL HEALTH ISSUES AND ACADEMIC BURNOUT This study explores the mental health status of high school students in Hanoi, Vietnam, focusing on depression, anxiety, stress, and academic burnout. Using the Burnout Assessment Tool (BAT-S-23) scale, the study assesses the prevalence of these conditions among students and their awareness of these issues. The findings reveal significant levels of depression, anxiety, stress, and burnout risk, with notable differences based on gender and grade level. The study underscores the importance of mental health interventions and burnout prevention programs in schools. It also highlights the potential of the BAT-S-23 scale as a tool for assessing burnout. The results are expected to contribute to the development of effective strategies for promoting student mental health and managing burnout, thereby holding significant implications for the future of mental health management in the Vietnamese educational setting. Future research should focus on identifying the specific factors contributing to these mental health issues among high school students in Vietnam and developing targeted interventions to address them. Despite some limitations, the study offers important contributions to the ongoing efforts to promote mental health and academic success among students. ASEAN Journal of Psychiatry, Vol. 25 (3) April, 2024;1-11.