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.

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: 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.

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: Pleural drainage is essential for preventing and managing respiratory complications after video-assisted thoracoscopic esophagectomy (VATE). Conventional largebore drains often cause significant pain. Small-bore drains (e.g., 19F Blake drains) may reduce discomfort; however, evidence regarding their use in VATE is limited. This study compared drainage effectiveness and pain between 19F Blake drains and conventional 28F drains after VATE for esophageal cancer. Methods: This retrospective study included 77 male patients with middle- or lower-third esophageal cancer who underwent VATE with laparoscopic retrosternal tunneling from November 2018 to November 2022. Fifty-five patients received a 28F conventional drain, and 22 received a 19F Blake drain. Outcomes included drainage duration and volume, pain levels (Visual Analog Scale [VAS]), postoperative pneumonia rates, and pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]) on postoperative day 3. Results: The 19F group reported significantly lower pain scores on postoperative days 1–3 (VAS: 2.95–3.25 vs. 4.07–4.62, p<0.001). Drainage duration and pneumonia rates were similar between groups. The 19F group demonstrated a trend toward higher drainage volume and significantly better preservation of pulmonary function, with smaller declines in FVC (ΔFVC: 0.24±0.20 L vs. 0.63±0.17 L, p<0.001) and FEV1 (ΔFEV1: 0.38±0.25 L vs. 0.58±0.25 L, p=0.02). Conclusion 19F Blake drains provide similar drainage effectiveness to that of 28F drains, with reduced postoperative pain and better pulmonary function preservation. These findings support the use of 19F Blake drains to improve patient comfort and recovery following VATE.

Dong Nai province in southern Viet Nam was among the hardest hit in a measles outbreak in 2024–2025 with over 7000 cases. Our analysis outlines major takeaways for measles control in recommending the need for strengthened surveillance, digital communication and intersectoral collaboration to address immunization gaps and build health system resilience in Viet Nam.

Objective: To describe caregiver burden, quality of life, and associated factors among primarycaregivers of cancer patients at Thai Binh General Hospital in 2025.Materials and methods: An analytical cross-sectional study was conducted among 408 primarycaregivers of cancer patients at Thai Binh General Hospital from August 2025 to March 2026.Data were collected using a structured questionnaire including general characteristics; the ZaritBurden Interview (ZBI), the World Health Organization Quality of Life-BREF (WHOQOL-BREF),the Generalized Anxiety Disorder-7 (GAD-7), the Katz Activities of Daily Living (Katz ADL), andthe Multidimensional Scale of Perceived Social Support (MSPSS).Results: The mean caregiver burden score was 36.1 ± 15.3, and 38.2% of caregivers had highcaregiver burden (ZBI 41–88, including moderate-to-severe and severe burden). The meanoverall quality-of-life score was 53.2 ± 8.7, with 35.3% classified as having low quality of life.In multivariable analysis, high caregiver burden was independently associated with higherfinancial stress and greater patient dependence in daily activities, while low quality of lifewas independently associated with caregiver age ≥40 years and greater patient dependence.Conclusion: A notable proportion of primary caregivers of cancer patients had high caregiverburden and low quality of life. Higher financial stress and greater patient dependence were associatedwith high caregiver burden, whereas caregiver age ≥40 years and greater patient dependencewere associated with low quality of life. The findings suggest that oncology services should screencaregiver burden and consider timely financial, practical, and psychosocial support for high-riskcaregivers. (PDF) Caregiving burden, quality of life, and some related factors among primary caregivers of cancer patients at Thai Binh General Hospital in 2025. Available from: https://www.researchgate.net/publication/408219248_Ganh_nang_cham_soc_chat_luong_cuoc_song_va_mot_so_yeu_to_lien_quan_o_nguoi_cham_soc_chinh_nguoi_benh_ung_thu_tai_Benh_vien_Da_khoa_Thai_Binh_nam_2025#fullTextFileContent [accessed Aug 18 2026].

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.

Lysosomal diseases (LDs) are a group of rare inherited disorders belonging to inborn metabolism errors. LDs are characterized by the excessive storage of undegraded substrates, most often due to the enzymatic deficiency resulting from disease-causing gene variants. LDs lead to dysregulated cellular pathways and imbalanced molecular homeostasis and can affect multiple organs and tissues. Despite being rare, LDs account for a significant incidence when considered collectively. Due to complex molecular and genetic fingerprints, considerable challenges in LD management must be overcome. Diagnosis can be significantly delayed due to the broad and nonspecific clinical manifestations and the lack of specific biomarkers. Available treatments fail to fully stop the disease progression and can alter the disease's typical phenotypes with novel manifestations. Therefore, a paradigm shift is crucial to better understand LDs and provide actionable insights. Herein, we comprehensively review the literature to demonstrate that multi-omics approaches are promising for pathophysiology elucidation, biomarker discovery, and precision therapy in LDs. We recommend adopting longitudinal study designs integrated with a multi-omics-empowered framework to facilitate mechanistic delineation, biomarker discovery, and treatment development. Relevant approaches exploring the association between LDs and common neurodegenerative disorders are also discussed, paving a potential path for improved therapeutic development and ultimately improving the patient's quality of life.

Purpose: Corneal melanoma (CM) is a rare malignancy that develops from melanocytes within the cornea, constituting a minority of all ocular tumors. In this study, we sought to investigate the clinicopathological characteristics correlated with the prognosis of CM patients. Methods: We collected patients with CM between 1983 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database. Cox proportional hazards regression was used for univariate analysis to value hazard ratio of malignant CM versus spindle cell melanoma and nodular melanoma subgroups. Kaplan-Meier survival analysis and log-rank test were also performed to identify additional prognostic markers and confirm the findings of the Cox hazard ratio. Results: A total of 29 eligible patients were collected in our study. Age at diagnosis, laterality, primary site, tumor size, the extent of disease, marital status, income, residential area, and treatment showed no significant prognostic factors for CM patients (p > 0.05). However, when concerned with the primary site of malignant melanoma, spindle cell melanoma and nodular melanoma were found to show significantly poorer prognosis in CM patients (both p < 0.05). Conclusions Age at diagnosis, laterality, primary site, tumor size, the extent of disease, and treatment were not significant prognostic indicators for CM patients. Spindle cell melanoma and nodular melanoma were notable for showing worse survival outcomes than malignant melanoma. Although the sample size in the SEER database was limited, our findings may provide motivation for tailoring individualized treatments for patients with CM with different primary sites.