Prehabilitation in patients undergoing surgery for hepatobiliary or pancreatic cancer

In patients with hepatobiliary and pancreatic cancers, surgery is the only potential curative treatment for resection candidates (Benson et al., 2009; Freelove & Walling, 2006). A five-year research experience in patients undergoing surgery for colorectal cancer found that prehabilitation led to faster return to preoperative walking capacity than rehabilitation (Minnella et al., 2017). There has been no studies thus far evaluating the impact of a trimodal prehabilitation program on functional recovery in patients undergoing hepatobiliary or pancreatic cancer surgery. Our goal was to determine the impact of prehabilitation on the functional exercise capacity of these patients. We performed a randomized controlled pilot trial comparing the impact of a prehabilitation program begun four weeks before surgery, to the same program (rehabilitation) initiated right after surgery. The program was maintained by both groups until eight weeks postoperatively. We hypothesized our prehabilitation program would improve 6-minute walk test performance preoperatively. Furthermore, at eight weeks post-surgery, we hypothesized greater 6-minute walk performance in the prehabilitation group compared to the rehabilitation group. Thirty-five participants were randomized to receive prehabilitation or rehabilitation. We found that preoperatively, the prehabilitation group demonstrated a clinically meaningful improvement in 6-minute walk distance. At four-weeks after surgery, the rehabilitation group experienced a statistically and clinically significant decrease in mean 6-minute walk distance from baseline, whereas the prehabilitation group was able to maintain its baseline walking capacity. Our findings suggest that a prehabilitation program in hepatobiliary and pancreatic cancer patients can deliver meaningful changes in pre- and postoperative functional exercise capacity

IMPROVING PUBLIC SPEAKING SKILLS FOR UNIVERSITY STUDENTS: CHALLENGES AND SOLUTIONS

This study explores English as a foreign language students’ challenges and investigates solutions for students to improve their public speaking skills at a university campus in the South of Vietnam. A descriptive mixed-method approach is used in this investigation allowing data to be quantitatively and qualitatively collected through questionnaires and interviews. The findings showed that English as a foreign language students faced several problems in public speaking as well as a lack of confidence. Many methods to improve public speaking skills were found, including making presentations, creating video blogs, and implementing circumlocution, methods that helped students increase their confidence in speaking and using effective body language. The findings of this study can be applied to help students overcome their challenges with public speaking

Studying Magnetic Fields and Dust in M17 Using Polarized Thermal Dust Emission Observed by SOFIA/HAWC

We report on the highest spatial resolution measurement to date of magnetic fields (B-fields) in M17 using thermal dust polarization measurements taken by SOFIA/HAWC+ centered at a wavelength of 154 μm. Using the Davis–Chandrasekhar–Fermi method, in which the polarization angle dispersion calculated using the structure function technique is the quantity directly observed by SOFIA/HAWC+, we found the presence of strong B-fields of 980 ± 230 and 1665 ± 885 μG in the lower-density M17-N and higher-density M17-S regions, respectively. The B-field morphology in M17-N possibly mimics the fields in gravitationally collapsing molecular cores, while in M17-S the fields run perpendicular to the density structure. M17-S also displays a pillar feature and an asymmetric large-scale hourglass-shaped field. We use the mean B-field strengths to determine Alfvénic Mach numbers for both regions, finding that B-fields dominate over turbulence. We calculate the mass-to-flux ratio, λ, finding λ = 0.07 for M17-N and 0.28 for M17-S. These subcritical λ values are consistent with the lack of massive stars formed in M17. To study dust physics, we analyze the relationship between dust polarization fraction, p, emission intensity, I, gas column density, N(H2), polarization angle dispersion function, S, and dust temperature, T d. p decreases with intensity as I −α with α = 0.51. p tends to first increase with T d, but then decreases at higher T d. The latter feature, seen in M17-N at high T d when N(H2) and S decrease, is evidence of the radiative torque disruption effect

Blood pressure percentiles and systemic hypertension-associated factors among children aged between 6 and 15 years in Southern Vietnam

Background: The present study determined blood pressure percentiles in children aged between 6 and 15 years in Southern Vietnam. Material and methods: Blood pressure was measured in a random sample of 1080 students aged 6–15 years who was studying at primary and secondary high schools in My Tho city, Vietnam. A descriptive cross-sectional study was conducted from November 2019 to June 2020. To diagnose children systemic hypertension, the blood pressure must be above the 95th percentile. Data were analyzed by IBM SPSS statistics software version 20.0. The Chi-squared test was employed to evaluate the relationship between systemic hypertension and child demographic characteristics including gender and obesity. Results: The results showed that the 95th percentiles of systolic and diastolic blood pressure of the children was 110/70 mm Hg in the 6-year-old group, 120/75 mm Hg in the 7 to12-year-old group and 125/80 mm Hg in the 13 to 15-year-old group, respectively. The rate of systemic hypertension in the children was 10% whereas boys had a 1.2 time higher risk of systemic hypertension than girls (p > 0.05). Obese children had an 8.6 time higher risk of systemic hypertension than non-obese ones (p < 0.001). Conclusion: The blood pressure percentile chart of school children aged 6–15 years were reported here for the first time in Vietnam. The results provided useful information in early diagnosis and timely treatment of systemic hypertension in children

Bringing social and cultural considerations into environmental management for vulnerable coastal communities: Responses to environmental change in Xuan Thuy National Park, Nam Dinh Province, Vietnam

This paper elaborates the importance of considering social and cultural factors within management responses to environmental change in coastal areas. The case study taken is Xuan Thuy National Park in Nam Dinh Province, Vietnam. This is a marginalised coastal area where rising sea levels, increasing storm surges and saltwater intrusion place pressure on coastal ecosystems, yet where communities continue to rely on these same ecosystems for agriculture- and aquaculture-related livelihoods. We interview stakeholders in Xuan Thuy National Park, connecting these with a narrative review of existing research into social and environmental change in the park to understand research gaps and challenges for vulnerable coastal areas like the Nam Dinh coast. Based on our findings, we suggest that whilst the effects of a changing environment on physical health and economic activity are increasingly well understood, effects on wellbeing and social relations can be even more immediate and profound in daily living. In turn, we argue environmental management has a crucial role to play not only for ecosystem-based adaptation, but also in sustaining wellbeing and allowing culturally meaningful practices to continue – especially in coastal regions where changes can be even more intense and immediate. However, we caution that whilst techno-scientific solutions grounded in environmental management do have significant potential in reducing impacts of extreme events and slower-onset environmental changes, they must not divert attention away from structural issues that can make some people or areas more vulnerable in the first instance

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

Water photolysis via multi-junction perovskite solar cell and highly active catalyst

Production of sustainable and renewable hydrogen fuel has attracted more and more attentions recently. Amongst the production methods, sunlight-driven water splitting is known as the most popular way to obtain hydrogen from water. This field has gained a significant development rate with the emergence of lead halide perovskite sensitizer (CH3NH3PbI3) as a promising material for photovoltaics cells, which can drive the water splitting experiment. In this project, water splitting was successfully processed with the introduction of multi-junction perovskite solar cells system combined with an efficient catalyst. Specifically, the catalyst electrode deposited with a RuO2 layer exhibits a high catalytic activity toward the oxygen evolution reaction in alkaline electrolyte. We have achieved a photocurrent of 9.45×〖10〗^(-3) milliamperes per square centimeters, which is not satisfied enough, however this result is believed to be further improved in the future. The current limitation is the short life span of perovskite solar cells, which leads to its degradation after few hours and hence requires more researches to reach better stability. Although the result is not totally satisfying, this is the starting point for future researches on water photolysis derived from the method combining tandem solar cells and electrocatalysts.Bachelor of Science in Physic

The asymmetric ARDL findings.

The sustainable development goal seems challenging for governments worldwide, including Indonesia, which has faced an ecological deficit due to rapid economic development and population growth since 1999. The study aims to probe the potential asymmetric effects of foreign direct investment and globalization on ecological footprint in Indonesia from 1971 to 2019, which was ignored by previous studies. By adopting the autoregressive distributed lags (ARDL) and nonlinear autoregressive distributed lags (NARDL) approaches, the results clearly reveal that (i) The positive shock of globalization has a positive and statistically significant impact on the ecological footprint; (ii) the impact of foreign direct investment on the ecological footprint is asymmetric in the long run. Accordingly, the study found that the influence of negative changes in foreign direct investment is larger than positive changes. Based on the findings, the study recommends that the Indonesian government carefully consider the long-term consequences of globalization on the environment and reasonable control of foreign direct investment inflows.</div

The BDS test.

The sustainable development goal seems challenging for governments worldwide, including Indonesia, which has faced an ecological deficit due to rapid economic development and population growth since 1999. The study aims to probe the potential asymmetric effects of foreign direct investment and globalization on ecological footprint in Indonesia from 1971 to 2019, which was ignored by previous studies. By adopting the autoregressive distributed lags (ARDL) and nonlinear autoregressive distributed lags (NARDL) approaches, the results clearly reveal that (i) The positive shock of globalization has a positive and statistically significant impact on the ecological footprint; (ii) the impact of foreign direct investment on the ecological footprint is asymmetric in the long run. Accordingly, the study found that the influence of negative changes in foreign direct investment is larger than positive changes. Based on the findings, the study recommends that the Indonesian government carefully consider the long-term consequences of globalization on the environment and reasonable control of foreign direct investment inflows.</div

The Wald test results.

The sustainable development goal seems challenging for governments worldwide, including Indonesia, which has faced an ecological deficit due to rapid economic development and population growth since 1999. The study aims to probe the potential asymmetric effects of foreign direct investment and globalization on ecological footprint in Indonesia from 1971 to 2019, which was ignored by previous studies. By adopting the autoregressive distributed lags (ARDL) and nonlinear autoregressive distributed lags (NARDL) approaches, the results clearly reveal that (i) The positive shock of globalization has a positive and statistically significant impact on the ecological footprint; (ii) the impact of foreign direct investment on the ecological footprint is asymmetric in the long run. Accordingly, the study found that the influence of negative changes in foreign direct investment is larger than positive changes. Based on the findings, the study recommends that the Indonesian government carefully consider the long-term consequences of globalization on the environment and reasonable control of foreign direct investment inflows.</div