ViCLEVR: A Visual Reasoning Dataset and Hybrid Multimodal Fusion Model for Visual Question Answering in Vietnamese

In recent years, Visual Question Answering (VQA) has gained significant attention for its diverse applications, including intelligent car assistance, aiding visually impaired individuals, and document image information retrieval using natural language queries. VQA requires effective integration of information from questions and images to generate accurate answers. Neural models for VQA have made remarkable progress on large-scale datasets, with a primary focus on resource-rich languages like English. To address this, we introduce the ViCLEVR dataset, a pioneering collection for evaluating various visual reasoning capabilities in Vietnamese while mitigating biases. The dataset comprises over 26,000 images and 30,000 question-answer pairs (QAs), each question annotated to specify the type of reasoning involved. Leveraging this dataset, we conduct a comprehensive analysis of contemporary visual reasoning systems, offering valuable insights into their strengths and limitations. Furthermore, we present PhoVIT, a comprehensive multimodal fusion that identifies objects in images based on questions. The architecture effectively employs transformers to enable simultaneous reasoning over textual and visual data, merging both modalities at an early model stage. The experimental findings demonstrate that our proposed model achieves state-of-the-art performance across four evaluation metrics. The accompanying code and dataset have been made publicly accessible at \url{https://github.com/kvt0012/ViCLEVR}. This provision seeks to stimulate advancements within the research community, fostering the development of more multimodal fusion algorithms, specifically tailored to address the nuances of low-resource languages, exemplified by Vietnamese.Comment: A pre-print version and submitted to journa

Midterm results of the Ross procedure in children: an appraisal of the subannular implantation with interrupted sutures technique

OBJECTIVES: The support of the pulmonary autograft root by the fibromuscular left ventricular outflow tract is emphasized to address the concern related to the dilatation of the pulmonary autograft structures in the paediatric population. METHODS: This retrospective study analyses the outcomes of 75 children who were operated between 1998 and 2012 with the subannular interrupted sutures technique at a median age of 10.2 years (range, 5.3 months–18.0 years). Median follow-up time was 5.2 years (range, 3 days–13.2 years). RESULTS: There were no deaths, but there were 3 reinterventions on the autograft for regurgitation and 2 resections of left ventricular outflow tract obstruction. There was no significant autograft stenosis, and freedom from moderate-to-severe regurgitation was 95% (95% confidence interval: 89–100) and 88% (95% confidence interval: 77–99) at 5 and 10 years, respectively. Median z-scores at the latest follow-up examination were, at the annulus, 0.31 [interquartile range (IQR) = −0.81 to 1.2]; at the sinus of Valsalva, 2.7 (IQR = 1.5–3.5); and at the sinotubular junction, 3.1 (IQR = 1.7–4.2). The correlation between z-scores and time after the operation was negative at the level of the annulus (r = −0.29, P = 0.034) but positive at the level of the sinus (r = +0.37, P = 0.005) and the sinotubular junction (r = +0.26, P = 0.068). The median rate of change in the z-score at the annulus was low, 0.065 z-score/year (IQR = −0.13 to 0.43). CONCLUSIONS: The subannular interrupted sutures implantation technique is associated with acceptable risks and, in the midterm, delivers limited annular dilatation, autograft regurgitation and delayed need for autograft reintervention

Evaluation of microscopic observation drug susceptibility assay for diagnosis of multidrug-resistant Tuberculosis in Viet Nam

<p>Abstract</p> <p>Background</p> <p>Early diagnosis of tuberculosis (TB) and multidrug resistant tuberculosis (MDR TB) is important for the elimination of TB. We evaluated the microscopic observation drug susceptibility (MODS) assay as a direct rapid drug susceptibility testing (DST) method for MDR-TB screening in sputum samples</p> <p>Methods</p> <p>All adult TB suspects, who were newly presenting to Pham Ngoc Thach Hospital from August to November 2008 were enrolled into the study. Processed sputum samples were used for DST by MODS (DST-MODS) (Rifampicin (RIF) 1 μg/ml and Isoniazid (INH) 0.4 μg/ml), MGIT culture (Mycobacterial Growth Indicator Tube) and Lowenstein Jensen (LJ) culture. Cultures positive by either MGIT or LJ were used for proportional DST (DST-LJ) (RIF 40 μg/ml and INH 0.2 μg/ml). DST profiles on MODS and LJ were compared. Discrepant results were resolved by multiplex allele specific PCR (MAS-PCR).</p> <p>Results</p> <p>Seven hundred and nine TB suspects/samples were enrolled into the study, of which 300 samples with DST profiles available from both MODS and DST-LJ were analyzed. Cording in MODS was unable to correctly identify 3 Mycobacteria Other Than Tuberculosis (MOTT) isolates, resulting in 3 false positive TB diagnoses. None of these isolates were identified as MDR-TB by MODS. The sensitivity and specificity of MODS were 72.6% (95%CI: 59.8, 83.1) and 97.9% (95%CI: 95.2, 99.3), respectively for detection of INH resistant isolates, 72.7% (95%CI: 30.9, 93.7) and 99.7% (95%CI: 98.1, 99.9), respectively for detecting RIF resistant isolates and 77.8% (95%CI: 39.9, 97.1) and 99.7% (95%CI: 98.1, 99.9), respectively for detecting MDR isolates. The positive and negative predictive values (PPV and NPV) of DST-MODS were 87.5% (95%CI: 47.3, 99.6) and 99.3% (95%CI: 97.5, 99.9) for detection of MDR isolates; and the agreement between MODS and DST-LJ was 99.0% (kappa: 0.8, <it>P </it>< 0.001) for MDR diagnosis. The low sensitivity of MODS for drug resistance detection was probably due to low bacterial load samples and the high INH concentration (0.4 μg/ml). The low PPV of DST-MODS may be due to the low MDR-TB rate in the study population (3.8%). The turnaround time of DST-MODS was 9 days and 53 days for DST-LJ.</p> <p>Conclusion</p> <p>The DST-MODS technique is rapid with low contamination rates. However, the sensitivity of DST-MODS for detection of INH and RIF resistance in this study was lower than reported from other settings.</p

Complete genome characterization of two wild-type measles viruses from Vietnamese infants during the 2014 outbreak

A large measles virus outbreak occurred across Vietnam in 2014. We identified and obtained complete measles virus genomes in stool samples collected from two diarrheal pediatric patients in Dong Thap Province. These are the first complete genome sequences of circulating measles viruses in Vietnam during the 2014 measles outbreak

Perlecan in vascular disease

Atherosclerosis has become the most common cause of death in the world. The development of the disease involves accumulation of lipids in the inner layer of the vessel wall, the intima, and recruitment of inflammatory cells and smooth muscle cells (SMCs). A plaque that protrude into the lumen develops that may affect blood flow and ultimately rupture, thereby initiating thrombosis, vessel occlusion, and subsequent heart infarction and stroke. Surgical treatment of occlusive atherosclerotic lesions cause mechanical injury to the arterial wall, which triggers a healing response, intimal hyperplasia and may result in a renarrowing of arterial lumen, so-called restenosis. SMC proliferation in the intima is part of a healing process in the intima that contributes stability to atherosclerotic plaques but is also the main feature of intimal hyperplasia. A well-controlled intimal hyperplasia in the healing response of SMCs is therefore desirable in order to control restenosis as well as in the preventing the devastating clinical consequences of plaque rupture. Heparin, and heparan sulfate proteoglycans are established inhibitors of SMC proliferation based on studies using exogenous sources of heparin or heparan sulfate molecules. In addition, heparan sulfate is also expressed at low levels in atherosclerotic lesions. However, the role of heparan sulfate proteoglycans normally expressed in the vascular wall in the regulation of SMC proliferation as well as the identity of the proteoglycan down-regulated in human atherosclerosis were previously unknown. Here, the role of the heparan sulfate proteoglycan perlecan, in the regulation of SMC proliferation and in human atherosclerosis was examined. First, perlecan was identified as the major heparan sulfate proteoglycan in the vessel wall in mice. In the formation of intimal hyperplasia in rats, an inverse correlation between the accumulation of perlecan and SMC proliferation was found. Transgenic mice expressing a heparan sulfate-deficient perlecan were shown to develop larger intimal lesions, due to increased SMC proliferation. In addition, perlecan was demonstrated to inhibit SMC adhesion to fibronectin in vitro. We propose that perlecan may regulate the healing response of SMCs by binding and sequestering of heparin-binding growth factors and thereby limit interactions with receptors at the surface of SMCs. Perlecan may also influence SMC activation, migration and proliferation by modulating interactions with other matrix molecules such as fibronectin. With respect to atherogenesis, SMCs from mice and rats were shown to produce more heparan sulfate proteoglycans than human SMCs. In addition, the expression of perlecan was reduced in symptomatic carotid plaques from humans. The low production of heparan sulfate by human SMCs together with the lack of perlecan in human atherosclerosis may be key components in the atherogenicity of human arteries

When and How to Enlarge the Small Aortic Root

Successful enlargement of the small aortic root in children has remained a management challenge, particularly in the neonates and small infants. Achieving this aim requires thorough understanding of the anatomic features of the left ventricular outflow tract, careful patient selection, and skilful execution of complex surgery. This article reviews the anatomical principles upon which the surgical techniques rely, the decision-making, the timing of surgery, the surgical options, and the outcomes

Technological Innovation Adoption Among Swedish Healthcare Professionals : A Contingency Technology Adoption Framework

Technological innovation adoption by healthcare professionals directly impacts enhanced patient care and overall community well-being. However, the perspective of healthcare professionals in evaluating and adopting these technological innovations should be addressed. Drawing on innovation adoption and resistance theories, in this article, we aim to capture their perceptions of the barriers they face and the adoption behaviors they express through a technology adoption contingency framework. The qualitative investigation on Swedish healthcare professionals shows that healthcare innovations are multistakeholder systems where the healthcare-professional's perception of multiple individual, organizational, and administrative barriers causes hesitancy in adopting technologies. However, hesitancy does not always lead to complete resistance; sometimes, it can lead to partial or complete adoption of the technology, contingent on the severity of the barriers and their interrelationship. The findings, summarized in a contingency framework for evaluating barriers to adoption and hesitancy behaviors, highlight the importance of individual perceptions in the adoption and success of complex healthcare innovations. They show why empowering adopters to choose how and when to use the innovation can be a powerful tool in reducing hesitancy.©2023 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.fi=vertaisarvioitu|en=peerReviewed

Pulmonary Vasodilator Therapy in Children with Single Ventricle Physiology : Effects on Saturation and Pulmonary Arterial Pressure

In children with single ventricle physiology, increased pulmonary vascular resistance may impede surgical progression or result in failing single ventricle physiology. The use of pulmonary vasodilators has been suggested as a potential therapy. However, knowledge on indication, dosage, and effect is limited. A retrospective case notes review of all (n = 36) children with single ventricle physiology, treated with pulmonary vasodilators by the UK Pulmonary Hypertension Service for Children 2004–2017. Therapy was initiated in Stage 1 (n = 12), Glenn (n = 8), or TCPC (n = 16). Treatment indications were high mean pulmonary arterial pressure, cyanosis, reduced exercise tolerance, protein-losing enteropathy, ascites, or plastic bronchitis. Average dose of sildenafil was 2.0 mg/kg/day and bosentan was 3.3 mg/kg/day. 56% had combination therapy. Therapy was associated with a reduction of the mean pulmonary arterial pressure from 19 to 14 mmHg (n = 17, p < 0.01). Initial therapy with one or two vasodilators was associated with an increase in the mean saturation from 80 to 85%, (n = 16, p < 0.01). Adding a second vasodilator did not give significant additional effect. 5 of 12 patients progressed from Stage 1 to Glenn, Kawashima, or TCPC, and 2 of 8 from Glenn to TCPC during a mean follow-up time of 4.7 years (0–12.8). Bosentan was discontinued in 57% and sildenafil in 14% of treated patients and saturations remained stable. Pulmonary vasodilator therapy was well tolerated and associated with improvements in saturation and mean pulmonary arterial pressure in children with single ventricle physiology. It appears safe to discontinue when no clear benefit is observed