STRESS AND COPING STRATEGIES OF SECONDARY SCHOOL TEACHERS IN TRA CU DISTRICT, TRA VINH PROVINCE, VIETNAM

By using a cross-sectional study, this study aimed to determine the ratio of occupational stress, stress levels and the relationship between stress status and social characteristics of the sample, factors at work, as well as how secondary school teachers respond to stress in Tra Cu District, Tra Vinh Province. The study conducted a survey to investigate 466 teachers currently teaching at 14 secondary schools in Tra Cu District, Tra Vinh Province, from May 2020 to June 2020. Research results showed that the percentage of teachers who suffered mild stress and severe stress was 18.9% and 8.1%, respectively. The signs of stress in teachers correlated with several factors such as job demand, work control and ways of coping at work. When the average score of the assessment “job demand” or “work control” increased by one point, the rate of stress on teachers was reduced by 23% (95% CI: 0.73 – 0.81) and 12% (95% CI: 0.84 – 0.93) respectively. By contrast, the average score of “confrontation” increased by one point  leading to 3.21 times higher (95% CI: 2.61 – 3.96) possibility of causing stress. As well as the average score of "avoidance" increased by one point, the possibility of causing stress in teachers increased 3.03 times (95% CI: 2.45 – 3.74). The findings showed that mental health problems in teachers at secondary schools, in general and in Tra Cu District, Tra Vinh Province in particular, had not received sufficient attention. Therefore, the problems should be taken seriously not only by teachers school administration

Prognostic Values of Serum Lactate-to-Bicarbonate Ratio and Lactate for Predicting 28-Day IN-Hospital Mortality in Children With Dengue Shock Syndrome

This study aimed to assess the clinical utility of blood lactate-to-bicarbonate (L/B) ratio, as a prognostic factor for 28-day in-hospital mortality in children with dengue shock syndrome (DSS), admitted to the pediatric intensive care unit (PICU). This single-center retrospective study was conducted at a tertiary children hospital in southern Vietnam from 2013 to mid-2022. Prognostic models for DSS mortality were developed, using a predefined set of covariates in the first 24 hours of PICU admission. Area under the curves (AUCs), multivariable logistic and Least Absolute Shrinkage and Selection Operator (LASSO) regressions, bootstrapping and calibration slope were performed. A total of 492 children with DSS and complete clinical and biomarker data were included in the analysis, and 26 (5.3%) patients died. The predictive values for DSS mortality, regarding lactate showing AUC 0.876 (95% CI, 0.807-0.944), and that of L/B ratio 0.867 (95% CI, 0.80-0.934) (P values of both biomarkers \u3c .001). The optimal cutoff point of the L/B ratio was 0.25, while that of lactate was 4.2 mmol/L. The multivariable model showed significant clinical predictors of DSS fatality including severe bleeding, cumulative amount of fluid infused and vasoactive-inotropic score (\u3e30) in the first 24 hours of PICU admission. Combined with the identified clinical predictors, the L/B ratio yielded higher prognostic values (odds ratio [OR] = 8.66, 95% confidence interval [CI], 1.96-38.3; P \u3c .01) than the lactate-based model (OR = 1.35, 95% CI, 1.15-1.58; P \u3c .001). Both the L/B and lactate models showed similarly good performances. Considering that the L/B ratio has a better prognostic value than the lactate model, it may be considered a potential prognostic biomarker in clinical use for predicting 28-day mortality in PICU-admitted children with DSS

Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia.

OBJECTIVES: Antimicrobial-resistant infections are a major global health issue. Ease of antimicrobial access in developing countries is proposed to be a key driver of the antimicrobial resistance (AMR) epidemic despite a lack of community antimicrobial usage data. METHODS: Using a mixed-methods approach (geospatial mapping, simulated clients, healthcare utilization, longitudinal cohort) we assessed antimicrobial access in the community and quantified antimicrobial usage for childhood diarrhoea in an urban Vietnamese setting. RESULTS: The study area had a pharmacy density of 15.7 pharmacies/km2 (a pharmacy for every 1316 people). Using a simulated client method at pharmacies within the area, we found that 8% (3/37) and 22% (8/37) of outlets sold antimicrobials for paediatric watery and mucoid diarrhoea, respectively. However, despite ease of pharmacy access, the majority of caregivers would choose to take their child to a healthcare facility, with 81% (319/396) and 88% (347/396) of responders selecting a specialized hospital as one of their top three preferences when seeking treatment for watery and mucoid diarrhoea, respectively. We calculated that at least 19% (2688/14427) of diarrhoea episodes in those aged 1 to <5 years would receive an antimicrobial annually; however, antimicrobial usage was almost 10 times greater in hospitals than in the community. CONCLUSIONS: Our data question the impact of community antimicrobial usage on AMR and highlight the need for better education and guidelines for all professionals with the authority to prescribe antimicrobials

Excess body weight and age associated with the carriage of fluoroquinolone and third-generation cephalosporin resistance genes in commensal Escherichia coli from a cohort of urban Vietnamese children.

PURPOSE: Antimicrobial-resistant bacterial infections in low- and middle-income countries (LMICs) are a well-established global health issue. We aimed to assess the prevalence of and epidemiological factors associated with the carriage of ciprofloxacin- and ceftriaxone-resistant Escherichia coli and associated resistance genes in a cohort of 498 healthy children residing in urban Vietnam. METHODOLOGY: We cultured rectal swabs onto MacConkey agar supplemented with resistant concentrations of ciprofloxacin and ceftriaxone. Additionally, we screened meta-E. coli populations by conventional PCR to detect plasmid-mediated quinolone resistance (PMQR)- and extended-spectrum β-lactamase (ESBL)-encoding genes. We measured the associations between phenotypic/genotypic resistance and demographic characteristics using logistic regression.Results/Key findings. Ciprofloxacin- and ceftriaxone-resistant E. coli were cultured from the faecal samples of 67.7 % (337/498) and 80.3 % (400/498) of children, respectively. The prevalence of any associated resistance marker in the individual samples was 86.7 % (432/498) for PMQR genes and 90.6 % (451/498) for β-lactamase genes. Overweight children were significantly more likely to carry qnr genes than children with lower weight-for-height z-scores [odds ratios (OR): 1.24; 95 % confidence interval (CI): 10.5-1.48 for each unit increase in weight for height; P=0.01]. Additionally, younger children were significantly more likely to carry ESBL CTX-M genes than older children (OR: 0.97, 95 % CI: 0.94-0.99 for each additional year, P=0.01). CONCLUSION: The carriage of genotypic and phenotypic antimicrobial resistance is highly prevalent among E. coli in healthy children in the community in Vietnam. Future investigations on the carriage of antimicrobial resistant organisms in LMICs should focus on the progression of carriage from birth and structure of the microbiome in obesity

The influence of human genetic variation on early transcriptional responses and protective immunity following immunization with Rotarix vaccine in infants in Ho Chi Minh City in Vietnam : a study protocol for an open single-arm interventional trial [awaiting peer review]

Background: Rotavirus (RoV) remains the leading cause of acute gastroenteritis in infants and children aged under five years in both high- and low-middle-income countries (LMICs). In LMICs, RoV infections are associated with substantial mortality. Two RoV vaccines (Rotarix and Rotateq) are widely available for use in infants, both of which have been shown to be highly efficacious in Europe and North America. However, for unknown reasons, these RoV vaccines have markedly lower efficacy in LMICs. We hypothesize that poor RoV vaccine efficacy across in certain regions may be associated with genetic heritability or gene expression in the human host. Methods/design: We designed an open-label single-arm interventional trial with the Rotarix RoV vaccine to identify genetic and transcriptomic markers associated with generating a protective immune response against RoV. Overall, 1,000 infants will be recruited prior to Expanded Program on Immunization (EPI) vaccinations at two months of age and vaccinated with oral Rotarix vaccine at two and three months, after which the infants will be followed-up for diarrheal disease until 18 months of age. Blood sampling for genetics, transcriptomics, and immunological analysis will be conducted before each Rotarix vaccination, 2-3 days post-vaccination, and at each follow-up visit (i.e. 6, 12 and 18 months of age). Stool samples will be collected during each diarrheal episode to identify RoV infection. The primary outcome will be Rotarix vaccine failure events (i.e. symptomatic RoV infection despite vaccination), secondary outcomes will be antibody responses and genotypic characterization of the infection virus in Rotarix failure events. Discussion: This study will be the largest and best powered study of its kind to be conducted to date in infants, and will be critical for our understanding of RoV immunity, human genetics in the Vietnam population, and mechanisms determining RoV vaccine-mediated protection. Registration: ClinicalTrials.gov, ID: NCT03587389. Registered on 16 July 2018

Platelet-rich plasma as an ideal biomaterial for improving pregnancy of infertility mice

Abstracts: Uterine implantation failure can be caused by uterine pathologies, including endometrial thinning or adhesions. This investigation aims to evaluate the effect of platelet-rich plasma (PRP) on endometrial regeneration. In this study, a double-dose non-activated PRP therapy was administered by repeatedly infusing a similar volume of non-activated PRP 24 h after the first dose in the in vitro damaged endometrial tissue models and in vivo injured uterine models. Histology, implantation, and pregnancy assessments of endometrial structure and function were performed. We discovered that in the in vitro models, the treated endometrial tissues appeared to have endometrial epithelium, uterine glands, pinopodes, and embryos that were able to implant on the endometrium. The rate of implanted embryos in the treated models was 18.89% ± 0.02 higher than those in the non-treated group with no embryo implantation (P-value <0.05). Animal models also showed similar results. The uterine structure was restored, the number of glands (143.3 ± 9.815) and the thickness (rate of endometrial area (EA)/total horn area (THA) was 0.4013 ± 0.0344) were increased in the treated models (P-value <0.05). The number of pregnancies (implantation sites) in the treated mouse models was 10.33 ± 1.53. In conclusion, double-dose non-activated PRP could effectively promote endometrial regeneration

XÁC ĐỊNH SỰ CÓ MẶT CỦA CÁC GEN ĐỘC TỐ Ở CÁC CHỦNG Vibrio GÂY BỆNH HOẠI TỬ GAN TỤY CẤP TÍNH TRÊN TÔM THẺ CHÂN TRẮNG TẠI THỪA THIÊN HUẾ

Acute hepatopancreatic necrosis disease (AHPND) is a disease caused by bacteria, with the death ratio up to 100% in the population of Litopenaeus vannamei and Penaeus monodon, and causes great economic losses to many shrimp‐producing countries in Asia. Previous studies have shown that not all strains of Vibrio can cause AHPND because they contain different toxin genes, such as pirAvp, pirBvb, tlh, trh, and tdh. In this study, we evaluate the presence of several toxic genes on Vibrio isolates from Thua Thien Hue province and analyze the sequence of these genes. The results show that in 14 Vibrio strains carrying pirABvp gene, the tlh and toxR genes occur in 14/14 and 7/14 strains, respectively, while none of them have the two genes of trh and tdh. Analyzing the sequence of four DNA fragments shows that these genes have high similarity (98–100%) compared with the genes announced on the Genbank. Genes pirAvp and pirBvp are less different, while tlh and toxR genes are more different. The results could be used for further studies in the production of bioproducts for the prevention and treatment of acute hepatopancreatic necrosis disease in shrimp.Bệnh hoại tử gan tụy cấp tính (Acute Hepatopancreatic Necrosis Disease – AHPND) là một bệnh do vi khuẩn gây ra. Bệnh này dẫn đến tỷ lệ chết lên đến 100% trong quần thể tôm thẻ chân trắng, tôm sú và gây những tổn thất kinh tế đáng kể cho ngành nuôi tôm ở nhiều nước châu Á. Các nghiên cứu trước đây cho thấy không phải chủng Vibrio nào cũng có khả năng gây bệnh do chúng mang các gen độc tố khác nhau. Chúng tôi đã đánh giá sự có mặt của các gen độc tố trên các chủng Vibrio phân lập tại Thừa Thiên Huế đồng thời phân tích trình tự các gen này. Kết quả cho thấy trong 14 chủng Vibrio mang gen pirABvp nghiên cứu, gen tlh xuất hiện ở tất cả các chủng, gen toxR xuất hiện ở 7/14 chủng trong khi đó các gen trh và tdh không xuất hiện trong các chủng vi khuẩn Vibrio phân lập được. Giải trình tự đoạn chỉ thị các gen độc tố cho thấy các gen này đều có độ tương đồng khá cao (98–100%) so với các gen đã công bố trên ngân hàng gen, trong đó 2 gen pirAvp và pirBvp ít sai khác còn các gen tlh và toxR có sự sai khác nhiều hơn. Đây là cơ sở để thực hiện các nghiên cứu tiếp theo trong việc sản xuất các chế phẩm phòng và trị bệnh hoại tử gan tụy cấp tính trên tôm

#230 : The Effectiveness of Spermatid Injection (ROSI, ELSI) Versus Spermatozoa Injection (ICSI) in Infertility Treatment for Men with Non-Obstructive Azoospermia (NOA)

Background and Aims: About 1% of men suffer from azoospermia, a condition of having no sperm in the ejaculate. Non-obstructive azoospermia, which affects 60% of azoospermia patients, is the most severe form of male infertility and requires testicular sperm extraction for sperm retrieval. Despite a 50% success rate, if no mature sperm is found, NOA men have no choice become biological fathers. To overcome this, researchers have attempted to use spermatid injection techniques, such as round spermatid injection (ROSI) or elongating/elongated spermatid injection (ELSI), to give hope for pregnancy. Spermatids are immature sperm but contain a haploid genome as spermatozoa. The aim of this prospective cohort study was to evaluate the effectiveness of ROSI and ELSI in cases where spermatozoa were unavailable. Method: Ninety-nine men diagnosed with NOA were recruited for the study. When the male partners lack spermatozoa in the testicular biopsy but have normal good-looking spermatids, they are consulted to join in the research. The intervention group received ROSI and ELSI, while the control group received spermatozoa injection into oocytes (ICSI). The primary outcome measures were fertilization, embryo development, clinical pregnancy, and live birth rate. Results: The overall fertilization rate (2PN) per MII oocyte injected after ROSI was low at 31.0% compared to ELSI and ICSI at 67.7% and 77.2%, respectively. The pregnancy rate after ROSI was also low, with 3.3% per transferred cycle and 2.2% per embryo transferred. The pregnancy rate of ROSI was much lower than ELSI (42.9%) and ICSI (55.6%). Normal pregnancy and live birth resulted in three groups (Table 1). Conclusion: ROSI and ELSI can be considered alternative methods of infertility treatment in cases where spermatozoa are unavailable

#347 : Factors Related to Mosaicism of Human Embryo: Conventional Statistics and Machine Learning Analysis

Background and Aims: Mosaicism arises from errors in the cell division process and can lead to cells containing a combination of normal and mutated genes. Mosaic embryos can produce healthy babies. However, it may be associated with a lower implantation and a higher miscarriage rate. Despite extensive research, the scientific understanding of the underlying causes of embryonic mosaicism remains limited, and conclusions remain subject to ongoing debate. Machine learning (ML) can capture complex relationships and automatically learn the most informative features, while conventional statistics (CS) are simple to understand. We aimed to apply both ML and CS to determine the critical factors that may be associated with mosaicism. Method: A retrospective analysis was conducted at the Infertility Department of Hung Vuong Hospital between 2018 and 2022 using medical data from 51 IVF couples. The study utilized both machine learning and conventional statistical methods to identify possible factors associated with mosaicism in human embryos. Results: Out of the 246 embryos studied, 84 (32%) were found to be mosaic. The performance of the classifiers in the machine learning analysis was relatively poor when using all features, with F1-scores ranging from 0.08 to 0.26. While feature selection helped to improve performance, the F1-scores remained low. On the other hand, the conventional statistical analysis revealed that patients with cryptozoospermia showed a positive association with mosaicism (OR 2.68, 95% CI 1.08 to 6.66, p=0.033). Conclusion: According to the machine learning algorithms, the current set of clinical features has no relation to the incidence of mosaicism. However, the conventional statistical analysis suggests that patients with cryptozoospermia may contribute to a higher risk of mosaicism. Further research is needed to fully understand the mechanisms underlying mosaicism in human embryos

#256 : Reproductive Outcomes and Satisfaction Among Patients Using Telemedicine During Assisted Reproduction: A Meta-Analysis

Background and Aims: Telemedicine refers to the delivery of healthcare services through the use of information and communication technology, across distances. There has been a significant increase in the demand for infertility treatment and virtual consultations from home after the COVID-19 pandemic. Despite this, due to a lack of sufficient data, and concerns about patient compliance, telemedicine has struggled to gain widespread acceptance. Our aim was to compare the success of treatment between telemedicine and in-office care during assisted reproduction treatment. Additionally, we evaluated patient satisfaction with telemedicine. Method: We conducted a literature search of published articles in the PubMed/MEDLINE, EMBASE, Scopus, and Web of Science databases up to November 30, 2022. We used the keywords “telemedicine” or “telehealth” and “in vitro fertilization” or “assisted reproduction”. Both randomized controlled trials and observational studies were included in the search. We registered our protocol on PROSPERO (Registration number: CRD42022379428). Results: We identified 14 studies that reported data on 5182 patients. Quality assessment revealed an acceptable risk of bias for both randomized controlled trials and observational studies. The data showed that telemedicine was non-inferior to in-person care in terms of pregnancy rate achieved (OR 1.02, 95% CI: 0.83–1.25, p = 0.84). The Q test p-value of 0.99 and I2 statistic of 0% indicated that all the included studies were homogeneous. Patients who received telemedicine follow-ups during fertility treatment reported adequate satisfaction (88%, 95% CI: 77%-94%). Eggers’ test did not indicate the presence of Deek’s funnel plot asymmetry (p = 0.62), confirming that no publication bias was found. Conclusion: Telemedicine use has resulted in a comparable treatment success rate in terms of pregnancy rate, when compared to face-to-face consultation. These emerging tools also yielded a high level of patient satisfaction