Current medical product development for diagnosis, surgical planning and treatment in the areas of Neurosurgery, Orthopeadic and Dental-Cranio-Maxillofacial surgery in Vietnam

With the population of 86 million and good GDP growth in recent decades, the medical market in Vietnam is growing fast. However, most of the medical technology products are imported, and the number of locally manufactured ones is limited and they do not have the high competition capability in term of quality, quantity and types. In this paper, the current product development in Vietnam for diagnosis, surgical planning and treatment in the areas of Rehabilitation, Neurosurgery, Orthopeadic and Dental-Cranio-Maxillofacial surgery is presented. A roadmap for medical technology development in Vietnam is propose

FIRST RECORD OF CANTHARELLUS MINOR IN VIETNAM

This species of mushroom with orange fruiting bodies and yellow flesh grows in clumps on the forest land in the coordinates 11o56'34.45" N, 108o28'33.56" E in the pine (Pinus kesiya) forest, Da Lat City, Lam Dong Province, Vietnam. The results of analysis on the morphology, both macro- and micro-morphological characteristics of this mushroom showed that, pileus: 5-15 mm wide, infundibuliform; yellowish to orange; margin incurred, wavy-liked margin, non-striate; Pileus surface: smooth, scaleless, yellowish; Lamellae: distant, decurrent, not intervenose, concolorous to pileus; Context: concolourous to the pileus, slight sweetness, aromatic flavor; Stipe: cylindrical shape, surface smooth, concolourous to pileus, 1-2 mm diameter, 20-50 mm length; Basidiospores: 6-11.5 x 4-6.5 μm, ovoid-ellipsoid with smooth surface; Basidia: 65 x 10 μm, cornuted 4-6 spores per basidium. Phylogenetic analysis of nrLSU sequence yielded consistent topology in different taxa of Cantharellus. The phylogenetic position of XC02 was obtained and accepted at sub-generic level: subgenus Parvocantharellus. This clade was suggested to be monophyletic, and separated from other sub-generic levels. Morphologically phylogenetically distinct from the other species of clade 4, such as C. appalachiensis, C. tabernensis, C. aff. Congolensis. The highly supported monophyletic group with referent Cantharellus minor was obtained with the bootstrap value of 99, indicated that XC02 was significant closely to Cantharellus minor. Phylogenetic of nrLSU analysis revealed clades with statistical support corresponding to morphological observation, thus, XC2 was concluded as Cantharellus minor

Multifunctional nanocarriers of Fe3O4@PLA-PEG/curcumin for MRI, magnetic hyperthermia and drug delivery

Background: Despite medicinal advances, cancer is still a big problem requiring better diagnostic and treatment tools. Magnetic nanoparticle (MNP)-based nanosystems for multiple-purpose applications were developed for these unmet needs. Methods: This study fabricated novel trifunctional MNPs of Fe3O4@PLA-PEG for drug release, MRI and magnetic fluid hyperthermia. Result: The MNPs provided a significant loading of curcumin (∼11%) with controllable release ability, a high specific absorption rate of 82.2 W/g and significantly increased transverse relaxivity (r2 = 364.75 mM-1 s-1). The in vivo study confirmed that the MNPs enhanced MRI contrast in tumor observation and low-field magnetic fluid hyperthermia could effectively reduce the tumor size in mice bearing sarcoma 180. Conclusion: The nanocarrier has potential for drug release, cancer treatment monitoring and therapy.The authors are grateful for the financial support by AOARD under award FA2386-17-1-4042. The Spanish government is acknowledged for the “Nanotechnology in translational hyperthermia (HIPERNANO)” research network (RED2018102626-T) and for funding under the project number MAT2017-83631-C3. NTK Thanh thanks EPSRC (EP/M015157/1). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed

Acceptance and user experiences of a wearable device for the management of hospitalized patients in COVID-19–designated wards in Ho Chi Minh City, Vietnam: action learning project

Background: Wearable devices have been used extensively both inside and outside of the hospital setting. During the COVID-19 pandemic, in some contexts, there was an increased need to remotely monitor pulse and saturated oxygen for patients due to the lack of staff and bedside monitors. Objective: A prototype of a remote monitoring system using wearable pulse oximeter devices was implemented at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam, from August to December 2021. The aim of this work was to support the ongoing implementation of the remote monitoring system. Methods: We used an action learning approach with rapid pragmatic methods, including informal discussions and observations as well as a feedback survey form designed based on the technology acceptance model to assess the use and acceptability of the system. Based on these results, we facilitated a meeting using user-centered design principles to explore user needs and ideas about its development in more detail. Results: In total, 21 users filled in the feedback form. The mean technology acceptance model scores ranged from 3.5 (for perceived ease of use) to 4.4 (for attitude) with behavioral intention (3.8) and perceived usefulness (4.2) scoring in between. Those working as nurses scored higher on perceived usefulness, attitude, and behavioral intention than did physicians. Based on informal discussions, we realized there was a mismatch between how we (ie, the research team) and the ward teams perceived the use and wider purpose of the technology. Conclusions: Designing and implementing the devices to be more nurse-centric from their introduction could have helped to increase their efficiency and use during the complex pandemic period

Wearable devices for remote monitoring of hospitalized patients with COVID-19 in Vietnam

Patients with severe COVID-19 disease require monitoring with pulse oximetry as a minimal requirement. In many low- and middle- income countries, this has been challenging due to lack of staff and equipment. Wearable pulse oximeters potentially offer an attractive means to address this need, due to their low cost, battery operability and capacity for remote monitoring. Between July and October 2021, Ho Chi Minh City experienced its first major wave of SARS-CoV-2 infection, leading to an unprecedented demand for monitoring in hospitalized patients. We assess the feasibility of a continuous remote monitoring system for patients with COVID-19 under these circumstances as we implemented 2 different systems using wearable pulse oximeter devices in a stepwise manner across 4 departments

Heart rate variability measured from wearable devices as a marker of disease severity in tetanus

Tetanus is a disease associated with significant morbidity and mortality. Heart rate variability (HRV) is an objective clinical marker with potential value in tetanus. This study aimed to investigate the use of wearable devices to collect HRV data and the relationship between HRV and tetanus severity. Data were collected from 110 patients admitted to the intensive care unit in a tertiary hospital in Vietnam. HRV indices were calculated from 5-minute segments of 24-hour electrocardiogram recordings collected using wearable devices. HRV was found to be inversely related to disease severity. The standard deviation of NN intervals and interquartile range of RR intervals (IRRR) were significantly associated with the presence of muscle spasms; low frequency (LF) and high frequency (HF) indices were significantly associated with severe respiratory compromise; and the standard deviation of differences between adjacent NN intervals, root mean square of successive differences between normal heartbeats, LF to HF ratio, total frequency power, and IRRR, were significantly associated with autonomic nervous system dysfunction. The findings support the potential value of HRV as a marker for tetanus severity, identifying specific indices associated with clinical severity thresholds. Data were recorded using wearable devices, demonstrating this approach in resource-limited settings where most tetanus occurs

Urinary catecholamine excretion, cardiovascular variability, and outcomes in tetanus

Severe tetanus is characterized by muscle spasm and cardiovascular system disturbance. The pathophysiology of muscle spasm is relatively well understood and involves inhibition of central inhibitory synapses by tetanus toxin. That of cardiovascular disturbance is less clear, but is believed to relate to disinhibition of the autonomic nervous system. The clinical syndrome of autonomic nervous system dysfunction (ANSD) seen in severe tetanus is characterized principally by changes in heart rate and blood pressure which have been linked to increased circulating catecholamines. Previous studies have described varying relationships between catecholamines and signs of ANSD in tetanus, but are limited by confounders and assays used. In this study, we aimed to perform detailed characterization of the relationship between catecholamines (adrenaline and noradrenaline), cardiovascular parameters (heart rate and blood pressure) and clinical outcomes (ANSD, mechanical ventilation required, and length of intensive care unit stay) in adults with tetanus, as well as examine whether intrathecal antitoxin administration affected subsequent catecholamine excretion. Noradrenaline and adrenaline were measured by ELISA from 24-h urine collections taken on day 5 of hospitalization in 272 patients enrolled in a 2 × 2 factorial-blinded randomized controlled trial in a Vietnamese hospital. Catecholamine results measured from 263 patients were available for analysis. After adjustment for potential confounders (i.e., age, sex, intervention treatment, and medications), there were indications of non-linear relationships between urinary catecholamines and heart rate. Adrenaline and noradrenaline were associated with subsequent development of ANSD, and length of ICU stay

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Existence des solutions des problèmes d'équilibre et des problèmes généralisés.

Blum et Oettli (1994) ont introduit les problèmes d'équilibre comme des généralisations directes des inéquations variationnelles et des problèmes d'optimisation. Ce problème général contient plusieurs problèmes liés au problème d'optimisation, par exemple, le problème de complémentarité, le problème de point fixe, le problème de point de coúncidence, le problème de minimax, etc. Pour les problèmes mentionnés ci-dessus, bien des efforts ont été consacrés à l'e tude de l'existence de solutions. Le but de cette thèse est de développer des conditions suffisantes pour l'existence de solutions exactes et de solutions approchées des problèmes de quasi-équilibre et des problèmes d'inclusion quasi-variationnelles. La thèse est divisée en deux parties. La première partie est constituée des trois chapitres 1-3 sur les problèmes de quasi-équilibre et la deuxième partie est constituée des chapitres restants sur les problèmes d'inclusions quasivariationnelles. Dans le Chapitre 1, nous établissons quelques conditions pour l'existence de solutions de problèmes de quasi-équilibre. Dans le Chapitre 2, nous abordons la question de l'existence pour des systèmes de problèmes de quasiéquilibre. Les solutions approchées sont étudiées au Chapitre 3. Ensuite, dans le Chapitre 4, nous proposons un problème général d'inclusion quasi-variationelle qui contient tous les problèmes connus de ce type, ainsi que tous les problèmes de quasi-équilibre. Nous obtenons des conditions suffisantes pour l'existence de solutions de ces problèmes. Dans le dernier chapitre, nous traitons un système de problèmes d'inclusions quasi-variationnelles dans un espace produit.Blum and Oettli (1994) introduced the equilibrium problem as a direct generalization of the variational inequality and the optimization problem. This new general problem setting proved to contain also many other optimizationrelated problems such as the complementarity problem, the fixed-point and coincidence-point problems, the minimax problem, the Nash equilibrium, the traffic network problem. As in many research field in mathematics, for the mentioned problems most of efforts have been devoted to the solution existence, The purpose of our thesis is to develop sufficient conditions for the existence of solutions to quasiequilibrium problems and systems of such problems and to propose more general definitions of quasivariational inclusion problems and of systems of these problems. We also consider the existence of approximate solutions. So the thesis includes two parts. Part 1, which includes three chapters, is devoted to quasiequilibrium problems and Part 2, with two chapters, considers quasivariational inclusion problems. In Chapter 1 we obtain some existence conditions for quasiequilibrium problems and show that they not only contain recent results but also sharpen some recent existence conditions even for particular cases. Chapter 2 is devoted to developing existence results for systems of quasiequilibrium problems in product spaces. Approximate solutions to quasiequilibrium problems is provided in Chapter 3. In Chapter 4, we propose general quasivariational inclusion problems to include all the previously existing problems of this kind and then all quasiequilibrium problems. We investigate sufficient conditions for the existence of solutions to these problems.In the final Chapter 5 we introduce systems of quasivariational inclusion problems in product spaces which contain most of the above-encountered problems.PAU-BU Sciences (644452103) / SudocPAU-Bibliothèque de l'IPRA (644452204) / SudocSudocFranceF

Optimality conditions and the solution uniqueness in nonsmooth optimization

The results of the thesis are concerned with optimality conditions in vector optimization and the uniqueness of solutions of equilibrium problems. The first chapter deals with vector optimization problems whose objective functions are nonsmooth and constraints are given by a general set. The optimality conditions are obtained in terms of approximations of first and second-order (notions introduced by Jourani-Thibault in 1993 and Allali-Amahroq in 1997). The particular case where the constraints are given by inequality with respect to a convex cone is treated in chapter 2. For these problems, the Hadamard directional derivatives of Penot (1983) are quite suitable to establish optimality conditions. Set-valued vector optimization problems are mainly studied in chapter 3. We develop the notion of variational sets of higher-order to replace usual higher-order derivatives. These sets permit us to establish necessary and sufficient optimality conditions for efficient solutions, weakly efficient solutions and properly efficient solutions. The obtained results generalize and unify many known ones in this domain. Examples are given to show advantages of our approaches. The final chapter of the thesis is devoted to the application of notions of approximate Jacobian (or pseudo-Jacobian) by Jeyakumar-Luc (1998) to the study of the uniqueness of solutions of equilibrium problems and variational inequality problems. Our results in this chapter are useful for those continuous problems whose data are nondifferentiable, or even not locally Lipschitz, and for certain problems with locally Lipschitz data, they are sharper than those conditions expressed in terms of Clarke's generalized JacobiansLes résultats présentés dans cette thèse portent sur les conditions d'optimalité en programmation vectorielle et sur l'unicité des solutions des problèmes d'équilibre. Le premier chapitre est relatif aux problèmes d'optimisation vectorielle dont la fonction objectif est univoque non lisse et la contrainte est ensembliste. Les conditions d'optimalité sont obtenues à l'aide des approximations du premier et second ordre (notions introduites par Jourani et Thibault en 1993 et par Allali et Amahroq en 1997). Le cas particulier où la contrainte est donnée sous la forme d'inégalité par un cône convexe est traité dans le chapitre 2. Pour ces problèmes les dérivées directionnelles de Penot (1983) semblent être les plus adaptées à produire des conditions d'efficacité. Les problèmes avec des données multivoques font l'objet principal de notre étude dans le chapitre 3. Nous développons la notion d'ensembles variationnels d'ordre supérieur pour remplacer les dérivées d'ordre supérieur usuelles. Celle-ci nous permet d'établir des conditions d'optimalité nécessaires et suffisantes pour les solutions efficaces, faiblement efficaces et proprement efficaces qui généralisent et unifient plusieurs résultats connus dans ce domaine. De nombreux exemples sont fournis pour illustrer l'avantage de l'approche choisie. Le dernier volet de la thèse est consacré à l'application de concepts de Jacobien approché (ou encore pseudo-Jacobien) de Jeyakumar et Luc (1998) pour étudier l'unicité des solutions des problèmes d'équilibre et des problèmes d'inégalité variationnelle. Les résultats de ce chapitre sont applicables aux problèmes continus, non lisses. Pour certains problèmes localement lipschitziens ils sont plus fins que ceux exprimés en terme du Jacobien généralisé de ClarkeAVIGNON-BU Centrale (840072102) / SudocSudocFranceViet-NamFRV