Statistical evaluation of the geochemical data for prospecting polymetallic mineralization in the Suoi Thau – Sang Than region, Northeast Vietnam

In Northeast Vietnam, Suoi Thau-Sang Than is considered as a high potential area of polymetallic deposits. 1,720 geochemical samples were used to investigate polymetallic mineralization; thereby polymetallic ore occurrences in this study region were discovered and the statistical and multivariate analysis helps to define geochemical anomalies in some northeastern regions, namely Suoi Thau, Sang Than, and Ban Kep. The statistical method and cluster analysis of geochemical data indicate that the Cu, Pb, and Zn elements are good indicators, and most of them comply with the lognormal or gamma distribution. Based on the third-order threshold, the geochemical anomalies of the content of the Cu, Pb, and Zn elements reflect the concentration of copper forming ore bodies in the mineralized zone, and clearly show the concentration in three distinct zones. The trend surface analysis which was employed to determine spatial variations and relationships among these good indicator elements and anomalous areas revealed relative changes in the content of the indicator elements, and they can be considered as regular. Moreover, the goodness of fit obtained trend functions of Pb and Zn, and Cu elements is a third-degree trend surface model. These results indicate that the models can be useful in studying geochemical anomalies and analyzing the tendency of the concentration of indicator elements in the Suoi Thau-Sang Than region. Additionally, it is suggested that the statistical analysis shows a remarkable potential to use the bottom river sediments in the region to investigate polymetallic mineralization. Moreover, geochemical data can help to evaluate geochemical anomalies of the pathfinder elements and potential mineral mapping of the Suoi Thau-Sang Than region in Northeast Vietnam

Interventional Treatment of Lymphatic Leakage Post Appendectomy: Case Report

BACKGROUND: Postoperative lymphatic complications are not common, and lymphatic leakage complication post appendectomy (LLCPC) is even rarer. However, the number of this operation is high so LLCPC can occur. CASE REPORT: Here, we report a female patient post appendectomy with severe chylous ascites. This patient underwent six operations. A leakage point at the right iliac-fossa, which was embolized successfully after two sessions, was spotted during intranodal lymphangiography. After 6 months, the ascites were significantly reduced while some lymphatic aneurysms still existed in the lumbar-retroperitoneal region. CONCLUSIONS: Basing the knowledge of this clinical case and literature, we have concluded that lymphatic leakage can be diagnosed and embolized by percutaneous intervention

Expansion of KPC-producing Enterobacterales in four large hospitals in Hanoi, Vietnam

Objectives : The incidence of carbapenem resistance among nosocomial Gram-negative bacteria in Vietnam is high and increasing, including among Enterobacterales. In this study, we assessed the presence of one of the main carbapenemase genes, blaKPC, among carbapenem-resistant Enterobacterales (CRE) from four large hospitals in Hanoi, Vietnam, between 2010 and 2015, and described their key molecular characteristics. Methods : KPC-producing Enterobacterales were detected using conventional PCR and were further analysed using S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), Southern blotting and whole-genome sequencing (WGS) for sequence typing and genetic characterisation. Results : blaKPC genes were detected in 122 (20.4%) of 599 CRE isolates. blaKPC-carrying plasmids were diverse in size. Klebsiella pneumoniae harbouring blaKPC genes belonged to ST15 and ST11, whereas KPC-producing Escherichia coli showed more diverse sequence types including ST3580, ST448, ST709 and ST405. Genotypic relationships supported the hypothesis of circulation of a population of ‘resident’ resistant bacteria in one hospital through the years and of transmission among these hospitals via patient transfer. WGS results revealed co-carriage of several other antimicrobial resistance genes and three different genetic contexts of blaKPC-2. Among these, the combination of ISEcp1–blaCTX-M and ISKpn27–blaKPC–ΔISKpn6 on the same plasmid is reported for the first time. Conclusion : We describe the dissemination of blaKPC-expressing Enterobacterales in four large hospitals in Hanoi, Vietnam, since 2010, which may have started earlier, along with their resistance patterns, sequence types, genotypic relationship, plasmid sizes and genetic context, thereby contributing to the overall picture of the antimicrobial resistance situation in Enterobacterales in Vietnam

Spatiotemporal evolution of SARS-CoV-2 Alpha and Delta variants during large nationwide outbreak of COVID-19, Vietnam, 2021

We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions

Surveillance and treatment of primary hepatocellular carcinoma (aka. STOP HCC): protocol for a prospective cohort study of high-risk patients for HCC using GALAD-score.

Vietnam and Saudi Arabia have high disease burden of primary hepatocellular carcinoma (HCC). Early detection in asymptomatic patients at risk for HCC is a strategy to improve survival outcomes in HCC management. GALAD score, a serum-based panel, has demonstrated promising clinical utility in HCC management. However, in order to ascertain its potential role in the surveillance of the early detection of HCC, GALAD needs to be validated prospectively for clinical surveillance of HCC (i.e., phase IV biomarker validation study). Thus, we propose to conduct a phase IV biomarker validation study to prospectively survey a cohort of patients with advanced fibrosis or compensated cirrhosis, irrespective of etiologies, using semi-annual abdominal ultrasound and GALAD score for five years. We plan to recruit a cohort of 1,600 patients, male or female, with advanced fibrosis or cirrhosis (i.e., F3 or F4) and MELD ≤ 15, in Vietnam and Saudi Arabia (n = 800 each). Individuals with a liver mass ≥ 1 cm in diameter, elevated alpha-fetoprotein (AFP) (≥ 9 ng/mL), and/or elevated GALAD score (≥ -0.63) will be scanned with dynamic contrast-enhanced magnetic resonance imaging (MRI), and a diagnosis of HCC will be made by Liver Imaging Reporting and Data System (LiRADS) assessment (LiRADS-5). Additionally, those who do not exhibit abnormal imaging findings, elevated AFP titer, and/or elevated GALAD score will obtain a dynamic contrast-enhanced MRI annually for five years to assess for HCC. Only MRI nearest to the time of GALAD score measurement, ultrasound and/or AFP evaluation will be included in the diagnostic validation analysis. MRI will be replaced with an abdominal computed tomography scan when MRI results are poor due to patient conditions such as movement etc. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI will not be carried out in study sites in both countries. Bootstrap resampling technique will be used to account for repeated measures to estimate standard errors and confidence intervals. Additionally, we will use the Cox proportional hazards regression model with covariates tailored to the hypothesis under investigation for time-to-HCC data as predicted by time-varying biomarker data. The present work will evaluate the performance of GALAD score in early detection of liver cancer. Furthermore, by leveraging the prospective cohort, we will establish a biorepository of longitudinally collected biospecimens from patients with advanced fibrosis or cirrhosis to be used as a reference set for future research in early detection of HCC in the two countries. Name of the registry: ClinicalTrials.gov Registration date: 22 April 2022 Trial registration number: NCT05342350 URL of trial registry record

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

Hybrid machine learning with Bayesian optimization methods for prediction of patch load resistance of unstiffened plate girders

This paper aims to propose a new hybrid Machine Learning (ML) with Bayesian Optimization (BO) methods for predicting the patch loading resistance, P u of longitudinally unstiffened plate girders. A total of 354 tests of the unstiffened plate girder under patch loading are collected and used for the training and testing to establish the proposed models. Five ML models including Support Vector Machines (SVM), Decision Tree (DT), Gradient Boosted Tree (GBT), Extreme Gradient Boosting algorithm (XGBoost), and CatBoost regression (CAT) are employed, and the BO method is used to optimize the hyperparameters of these ML models, in order to show which of them is best-suited for prediction of the PLR of longitudinally unstiffened plate girders. It was found that the BO-GBT presents the best accuracy compared to others. The performance of the BO-GBT model is validated by comparing its predictive results with the current design standards and the existing formulae. Additionally, the Shapley Additive Explanations (SHAP) method is employed to evaluate the importance and contributions of each input variable on the proposed model, and a Graphical User Interface (GUI) tool is developed to conveniently estimate the P u of the unstiffened plate girders. Finally, the BO-GBT model is used to develop a support tool for finding suitable geometric dimensions and material properties of longitudinally unstiffened girder under patch loading in the preliminary design stage. The optimization tool is accessible online for the users for more convenient use in practical design purposes

An Adaptive Hierarchical Sliding Mode Controller for Autonomous Underwater Vehicles

The paper addresses a problem of efficiently controlling an autonomous underwater vehicle (AUV), where its typical underactuated model is considered. Due to critical uncertainties and nonlinearities in the system caused by unavoidable external disturbances such as ocean currents when it operates, it is paramount to robustly maintain motions of the vehicle over time as expected. Therefore, it is proposed to employ the hierarchical sliding mode control technique to design the closed-loop control scheme for the device. However, exactly determining parameters of the AUV control system is impractical since its nonlinearities and external disturbances can vary those parameters over time. Thus, it is proposed to exploit neural networks to develop an adaptive learning mechanism that allows the system to learn its parameters adaptively. More importantly, stability of the AUV system controlled by the proposed approach is theoretically proved to be guaranteed by the use of the Lyapunov theory. Effectiveness of the proposed control scheme was verified by the experiments implemented in a synthetic environment, where the obtained results are highly promising