Fundraising Capacity of HIV/AIDS Community-Based Organizations in 3 Years (2017-2019) in Ho Chi Minh City, Vietnam

HIV/AIDS is still an important public health issue in Vietnam and other developing countries. In Vietnam, Community-based organizations (CBOs) were officially considered as the key partners to approach vulnerable groups at high risks of HIV infection since 2010. Funds for HIV/AIDS prevention and control are facing difficulties due to rapid reduction by international organizations, while domestic funding has not yet met the demand, especially funding for prevention and communication activities. Our study aimed to assess the fundraising capacity of several CBOs in Ho Chi Minh City, Vietnam and analyze the challenges that they are facing now and in future in their work of HIV/AIDS management for community. The 03 typical and representative CBOs (G3VN, Smile and Strong Ladies) were chosen in our cross-sectional descriptive study. The electronic questionnaire was about fundraising reports over 3 years (2017-2019), organization structure (staff, mission, strategies) and the advantages and disadvantages in fundraising. Funds received over the year increased in total, but unstable in each projects. To have more funds, CBOs must invest time and money to have professional staff in fundraising and writing proposals. To meet requirement and survive, some CBO shifted to social enterprises and faced many difficulties in laws when being treated like profit companies. In Vietnam context, the key challenges which affect the role of funding are including: 1) Legal status;2) Small scale;3) Capacity of fundraising (finding calls, writing competence proposals);4) Fewer funds on HIV/AIDS. In future, we should pay attention in scaling up and building fundraising capacity for CBOs in order to help them in applying for international funds in community projects or even in HIV/AIDS research for CBOs, social enterprises in the context of funds for nation-level phased out of Vietnam.

Monkeypox virus(MPXV):A Brief account of global spread,epidemiology,virology,clinical features,pathogenesis,and therapeutic interventions

The largest monkeypox virus(MPXV)outbreak of the 21st century occurred in 2022,which caused epidemics in many countries.According to WHO,physical contact with infected persons,contaminated surfaces,or affected animals might be a source of this virus transmission.A febrile sickness including few symptoms found in MPX disease.Skin rash,lesions,fever,headache,fatigue,and muscle aches symptoms were observed commonly for this disease.Animal and in vitro,studies have shown that the antiviral medications cidofovir and brincidofovir are effective against MPXV.The first-generation vaccinia virus vaccine was developed in 1960,and it helped to protect against MPXV with its side effects.A second-generation vaccination with limitations was launched in 2000.However,the CDC advised vaccinations for risk groups in endemic countries,including positive patients and hospital employees.The JYNNEOS vaccine,administered in 2 doses,also provides protection from MPX.This article presents concisely the most recent findings regarding epidemiology,genomic transmission,signs and symptoms,pathogenesis,diagnosis,and therapeutic interventions for MPXV,which may be helpful to researchers and practitioners.WHO declared that MPX was no longer a global health emergency due to its declining case rate,and a number of countries have reported new incidences.Further research-based investigations must be carried out based on the 2022 outbreak.

实施过程评估量表的汉化及信效度检验

目的 汉化英文版实施过程评估量表并检验其信效度,为测量新型卫生技术或干预措施在临床实施过程中的促进与阻碍因素提供评价工具。方法 基于Brislin翻译模型对实施过程评估量表进行翻译和回译,采用专家咨询及预试验对中文版量表进行初步检验;选取506名临床护士进行信效度验证。结果 中文版实施过程评估量表包含4个维度共26个条目,4个公因子累积方差贡献率为71.284%,量表结构模型适配指标的χ^(2)/df=2.424,RMSEA=0.075,CFI=0.939,TLI=0.932。量表的I-CVI为0.833~1.000,S-CVI/Ave为0.903,Cronbach′sα系数为0.959,重测信度为0.898。结论 中文版实施过程评估量表具有良好的信效度,可用于评估护士应用新型卫生技术或干预措施的促进和阻碍因素。

基于PEAKING队列探讨慢性肾脏病患者运动的促进与阻碍因素

背景运动有利于改善慢性肾脏病(CKD)患者的预后,但运动在CKD患者的普及程度仍较低。目的探索CKD患者进行运动的意愿、动机、促进与障碍等行为改变因素,为未来的运动干预提供基础。方法于2019年3—6月,采用目的抽样法从PEAKING队列中选取不同体力活动水平、不同规律运动情况的CKD患者(n=10)进行半结构式定性访谈。访谈内容主要包括:患者对CKD的认识,日常活动安排,对运动与疾病关系的认识,进行规律运动的促进与阻碍因素等。最后利用内容分析法进行访谈资料分析归纳,按照国际公认的定性研究报告标准(COREQ)进行报告。结果促进CKD患者运动的因素包括:意识到运动可能有益于身心理健康(启动因素);体验到运动带来的益处、自律(坚持运动的内在因素);来自家庭、运动专业人员及社会水平的支持(保持运动的外部因素)。阻碍CKD患者运动的因素有:年老、心肺肾等相关合并症及疲劳感(身体状况因素);担心骨骼及肾脏损伤(运动相关损伤潜在风险的担忧);时间、地方、设施和陪伴不足(缺乏体育锻炼条件)。结论在CKD患者中开展运动干预,需要增加运动获益宣传、增强自我效能及增加外部支持等促进因素,注意预防运动相关损伤和创造锻炼条件以减少阻碍因素。

Deprescribing antihypertensive treatment in nursing home patients and the effect on blood pressure

BackgroundIt 是可争辩的与 antihypertensive 药对待 multimorbid 疗养院病人是否生产有益的效果。最心血管的指南支持治疗；很少有上的忠告到 deprescribe 当治疗可能不再是必要的时。我们在在认知，血压，和 prescribing.MethodsFrom 2014年8月之间的 antihypertensive 药使用和协会上调查了药评论的效果到2015年12月，来自在 32 所挪威的疗养院的 72 个单位(簇)的 765 个病人被包括在一4月， multicentre ，使随机化簇的、控制试用，与9月的后续。病人们有 antihypertensive 治疗的 65 岁(n = 295， 39%) 被使随机化到医生从同伴(启蒙的 collegial ) 得到了支持或象往常一样被给照顾的系统的药评论(控制条件) 。结果措施是 antihypertensive 药，收缩血压，和脉搏的数字。我们把住院和死亡用作标准估计 harm.ResultsAt 基线，每个病人使用了 9.2 吗？？

Laparoscopic complete mesocolic excisions for colonic cancer in the last decade:Five-year survival in a single centre

AIM To analyse clinical and long-term oncologic results after laparoscopic complete mesocolic excision(CME) for colonic cancer over a 10-year period.METHODS Consecutive patients who received laparoscopic CME at our hospital from 2007 to 2017 were prospectively registered and retrospectively analysed. In total, 341 patients were included with tumour-nodal-metastasis(TNM) stages 0-Ⅲ.RESULTS The mean age of the patients was 71.9 years. The median length of stay was 5 d. The mean lymph node harvest was 17.8. The mortality rate was 1.2%. Fifteen patients were reoperated on for anastomotic leaks. The local recurrence rate was 2.3%. Five-year TTR and cancer-specific survival CSS were 83.1% and 90.3%. The location of the tumour was not a significant variable for survival in unadjusted and adjusted survival analysis. TNM stage and anastomotic leaks were significant variables with respect to survival.CONCLUSION Laparoscopic CME results in acceptable complication rates and long-term oncologic results. It is important to avoid anastomotic leaks because of their negative effect on survival.

Assessing the spread risk of COVID-19 associated with multi-mode transportation networks in China

The spatial spread of COVID-19 during early 2020 in China was primarily driven by outbound travelers leaving the epicenter,Wuhan,Hubei province.Existing studies focus on the influence of aggregated out-bound population flows originating from Wuhan;however,the impacts of different modes of transportation and the network structure of transportation systems on the early spread of COVID-19 in China are not well understood.Here,we assess the roles of the road,railway,and air transportation networks in driving the spatial spread of COVID-19 in China.We find that the short-range spread within Hubei province was dominated by ground traffic,notably,the railway transportation.In contrast,long-range spread to cities in other provinces was mediated by multiple factors,including a higher risk of case importation associated with air transportation and a larger outbreak size in hub cities located at the center of transportation networks.We further show that,although the dissemination of SARS-CoV-2 across countries and continents is determined by the worldwide air transportation network,the early geographic dispersal of COVID-19 within China is better predicted by the railway traffic.Given the recent emergence of multiple more transmissible variants of SARS-CoV-2,our findings can support a better assessment of the spread risk of those variants and improve future pandemic preparedness and responses.

Risk of cardiovascular disease among parents of children diagnosed with cancer:a population-based study from Denmark and Sweden

Dear Editor,Receiving a cancer diagnosis is a traumatic life event that impacts not only the patients but also their families[1].Parents of patients with a cancer diagnosed in early life might experience a life crisis with various negative emotions,including the difficult decision-making in cancer treatment,concerns related to the side effects of the treatment and comorbidities,the worry for progression and relapse of the cancer and the risk of loss of the child due to death,as well as the physical demand of caregiving[2,3].

Fur glowing under ultraviolet:in situ analysis of porphyrin accumulation in the skin appendages of mammals

Examples of photoluminescence(PL)are being reported with increasing frequency in a wide range of organisms from diverse ecosystems.However,the chemical basis of this PL remains poorly defined,and our understanding of its potential ecological function is still superficial.Among mammals,recent analyses have identified free-base por-phyrins as the compounds responsible for the reddish ultraviolet-induced photoluminescence(UV-PL)observed in the pelage of springhares and hedgehogs.However,the localization of the pigments within the hair largely remains to be determined.Here,we use photoluminescence multispectral imaging emission and excitation spec-troscopy to detect,map,and characterize porphyrinic compounds in skin appendages in situ.We also document new cases of mammalian UV-PL caused by free-base porphyrins in distantly related species.Spatial distribution of the UV-PL is strongly suggestive of an endogenous origin of the porphyrinic compounds.We argue that reddish UV-PL is predominantly observed in crepuscular and nocturnal mammals because porphyrins are photodegradable.Con-sequently,this phenomenon may not have a specific function in intra-or interspecific communication but rather represents a byproduct of potentially widespread physiological processes.

Treatment quality and outcome for multidrug-resistant tuberculosis patients in four regions of China: a cohort study

Background:China incurs an extremely low treatment coverage of multidrug-resistant tuberculosis(MDR-TB).This study aimed to understand the experience of MDR-TB patients on quality of health care,and the clinical impact through an up to six-year follow-up.Methods:Cohorts of MDR-TB patients were built in TB/MDR-TB designated hospitals in four regions of China from 2014 to 2015.Patients were followed up during treatment course,and yearly confirmation afterward until 2019.Delay in MDR-TB diagnosis and treatment was calculated upon bacteriological confirmation and treatment initiation.Risk factors for unfavourable outcomes were identified by multivariate logistic regression.Results:Among 1168 bacteriological-positive TB patients identified from a 12-million population,58(5.0%)MDR-TB cases were detected.The median delay for MDR-TB diagnosis was 90.0 days,with 13.8%having a delay above 180.0 days.MDR-TB treatment was only recommended to 19(32.8%)participants,while the rest continued with regimen for drug-susceptible TB.In MDR-TB treatment group,36.8%achieved treatment success,while the others had incomplete treatment(21.1%),loss to follow-up(36.8%)and TB relapse(5.3%).For non-MDR-TB treatment group,33.3%succeeded,25.6%relapsed,2.6%failed,23.1%died,and 15.4%were lost to follow-up.Overall,only 35.7%(20/56)of detected MDR-TB patients had favourable outcomes and higher education level was positively associated with it(adjusted odds ratio[aOR]:3.60,95%confidence interval[CI]:1.04-12.5).Conclusions:A large proportion of patients did not receive MDR-TB treatment and had unfavourable outcomes.Delayed MDR-TB diagnosis resulted in poor quality of MDR-TB care.Rapid diagnosis,regulated patient management and high-quality MDR-TB treatment should be enhanced in China.

Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya

Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their households.The study sought to identify the determinants for cata-strophic costs among patients with drug-sensitive TB(DSTB)and their households in Kenya.Methods::The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample(n=1071).Treatment related costs and productivity losses were estimated.Total costs exceeding 20%of household income were defined as catastrophic and used as the outcome.Multivariable Poisson regression analysis was performed to measure the association between selected individual,household and disease characteristics and occurrence of catastrophic costs.A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were explored.Results::The proportion of catastrophic costs among DSTB patients was 27%(n=294).Patients with catastrophic costs had higher median productivity losses,39 h[interquartile range(IQR):20-104],and total median costs of USD 567(IQR:299-1144).The incidence of catastrophic costs had a dose response with household expenditure.The poorest quintile was 6.2 times[95%confidence intervals(CI):4.0-9.7]more likely to incur catastrophic costs compared to the richest.The prevalence of catastrophic costs decreased with increasing household expenditure quintiles(proportion of catastrophic costs:59.7%,32.9%,23.6%,15.9%,and 9.5%)from the lowest quintile(Q1)to the highest quintile(Q5).Other determinants included hospitalization:prevalence ratio(PR)=2.8(95%CI:1.8-4.5)and delayed treatment:PR=1.5(95%CI:1.3-1.7).Protective factors included receiving care at a public health facility:PR=0.8(95%CI:0.6-1.0),and a higher body mass index(BMI):PR=0.97(95%CI:0.96-0.98).Pre TB expenditure,hospitalization and BMI were significant predictors in all sensitivity analysis scenarios.Conclusions::There are significant inequities in the occurrence of catastrophic costs.Social protection interventions in addition to existing medical and public health interventions are important to implement for patients most at risk of incurring catastrophic costs.

Effect of Wuda granule on gastrointestinal function recovery after laparoscopic intestinal resection:a randomized–controlled trial

Background Previous studies have suggested that the Wuda granule(WDG)could promote the recovery of gastrointestinal(GI)function after gynecologic abdominal surgery.This trial aimed to investigate the efficacy and safety of WDG in the rapid recovery of GI function in patients after laparoscopic intestinal resection in the setting of enhanced recovery after surgery(ERAS)-based perioperative care.Methods We performed a randomized,double-blind,placebo-controlled pilot trial.Thirty patients who met the inclusion criteria were randomly assigned to either the WDG group or the placebo group in a 1:1 ratio.The patients received WDG or placebo twice a day in addition to ERAS-based perioperative care,starting on post-operative Day 1 until Day 3.The primary outcomes were time to first bowel movement and time to first tolerance of solid food.The secondary outcomes were time to first flatus,length of hospital stay(LOS),and post-operative ileus-related morbidity.Adverse events were also recorded.Results There were no statistically significant differences in baseline characteristics between the two groups.The median time to first bowel movement was significantly decreased in the WDG group compared with the control group(27.6 vs 50.1 h;P<0.001),but the median times to first flatus(22.9 vs 25.1 h;P>0.05)and LOS(5.0 vs 5.0 days;P>0.05)were not statistically different.The occurrence rates of post-operative nausea,vomiting,abdominal distension,and abdominal pain were similar in the two groups.No adverse events occurred in any patients.Conclusions The addition of WDG to ERAS post-operative care after laparoscopic intestinal resection can safely promote the rapid recovery of GI function.

Psychiatric comorbidities in epilepsy:population co-occurrence,genetic correlations and causal effects

Background Psychiatric comorbidities are common in patients with epilepsy.Reasons for the co-occurrence of psychiatric conditions and epilepsy remain poorly understood.Aim We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these conditions.Methods Using nationwide Swedish health registries,we quantified the lifetime prevalence of psychiatric disorders in patients with epilepsy.We then used summarydata from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score regression.Finally,we assessed the potential bidirectional relationships using two-sample Mendelian randomisation.Results In a cohort of 7628495 individuals,we found that almost half of the 94435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime(adjusted lifetime prevalence,44.09%;95%confidence interval(Cl)43.78%to 44.39%).We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric conditions.For example,we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder(r,=0.18,95%Cl 0.09 to 0.27,p<0.001)—a correlation that was more pronounced in focal epilepsy(r=0.23,95%CI 0.09 to 0.36,p<0.001).Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric conditions.Conclusions Psychiatric comorbidities are common in patients with epilepsy.Genetic correlations may partially explain some comorbidities;however,there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric conditions.These findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psychiatric comorbidities in epilepsy.

Evaluating the yield of systematic screening for tuberculosis among three priority groups in Ho Chi Minh City,Viet Nam

Background: In order to end tuberculosis(TB),it is necessary to expand coverage of TB care services,including systematic screening initiatives.However,more evidence is needed for groups among whom systematic screening is only conditionally recommended by the World Health Organization.This study evaluated concurrent screening in multiple target groups using community health workers(CHW).Methods:: In our two-year intervention study lasting from October 2017 to September 2019,CHWs in six districts of Ho Chi Minh City,Viet Nam verbally screened three urban priority groups:(1)household TB contacts;(2)close TB contacts;and(3)residents of urban priority areas without clear documented exposure to TB including hotspots,boarding homes and urban slums.Eligible persons were referred for further screening with chest radiography and follow-on testing with the Xpert MTB/RIF assay.Symptomatic individuals with normal or without radiography results were tested on smear microscopy.We described the TB care cascade and characteristics for each priority group,and calculated yield and number needed to screen.Subsequently,we fitted a mixed-effect logistic regression to identify the association of these target groups and secondary patient covariates with TB treatment initiation.Results: We verbally screened 321020 people including 24232 household contacts,3182 social and close contacts and 293606 residents of urban priority areas.This resulted in 1138 persons treated for TB,of whom 85 were household contacts,39 were close contacts and 1014 belonged to urban priority area residents.The yield of active TB in these groups was 351,1226 and 345 per 100000,respectively,corresponding to numbers needed to screen of 285,82 and 290.The fitted model showed that close contacts[adjusted odds ratio(aOR)=2.07;95%CI:1.38–3.11;P<0.001]and urban priority area residents(aOR=2.18;95%CI:1.69–2.79;P<0.001)had a greater risk of active TB than household contacts.Conclusions: The study detected a large number of unreached persons with TB,but most of them were not among persons in contact with an index patient.Therefore,while programs should continue to optimize screening in contacts,to close the detection gap in high TB burden settings such as Viet Nam,coverage must be expanded to persons without documented exposure such as residents in hotspots,boarding homes and urban slums.

Quantifying the impacts of human mobility restriction on the spread of coronavirus disease 2019:an empirical analysis from 344 cities of China

Background:Since the outbreak of coronavirus disease 2019(COVID-19),human mobility restriction measures have raised controversies,partly because of the inconsistent findings.An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction.The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19.Methods:Our study applied the difference-in-difference(DID)model to assess the declines of population mobility at the city level,and used the log-log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders.Results:The DID model showed that a continual expansion of the relative declines over time in 2020.After 4 weeks,population mobility declined by-54.81%(interquartile range,-65.50%to-43.56%).The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks(ie,1%decline of population mobility was associated with 0.72%[95%CI:0.50%-0.93%]reduction of cumulative cases for 1 week,1.42%2 weeks,1.69%3 weeks,1.72%4 weeks,1.64%5 weeks,and 1.52%6 weeks).The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter.The effects on cumulative cases differed by cities of different population sizes,with greater effects seen in larger cities.Conclusions:Persistent population mobility restrictions are well deserved.Implementation of mobility restrictions in major cities with large population sizes may be even more important.

Strategy evaluation and optimization with an artificial society toward a Pareto optimum

Strategy evaluation and optimization in response to troubling urban issues has become a challenging issue due to increasing social uncertainty,unreliable predictions,and poor decision-making.To address this problem,we propose a universal computational experiment framework with a fine-grained artificial society that is integrated with data-based models.The purpose of the framework is to evaluate the consequences of various combinations of strategies geared towards reaching a Pareto optimum with regards to efficacy versus costs.As an example,by modeling coronavirus disease 2019 mitigation,we show that Pareto frontier nations could achieve better economic growth and more effective epidemic control through the analysis of real-world data.Our work suggests that a nation’s intervention strategy could be optimized based on the measures adopted by Pareto frontier nations through large-scale computational experiments.Our solution has been validated for epidemic control,and it can be generalized to other urban issues as well.

CONSORT-公平性2017扩展版及解释:在随机对照试验中更好地报告健康公平性

临床试验报告的统一规范(CONSORT)扩展版之CONSORT-公平性(Equity)2017,旨在改善与健康公平性相关的随机对照试验中干预效果的报告质量。健康不公平性是指通过恰当干预可避免的不公平健康差异。健康公平性相关的随机对照试验主要评估对健康公平性的影响,包括评价针对社会弱势群体的干预措施,探索2个(或2个以上有梯度特征的)处于不同水平的社会弱势群体间干预效果的差异,或两者皆有。我们与来自高、中、低收入国家的多种类型的相关人员进行了共识会议,其中包括知识用户(如患者)和方法学家等。我们围绕各条目讨论了来自实证研究、系统评价、方法学研究、关键人物访谈以及在线调查的证据,在提高报告清晰度的同时尽量避免给作者增加不必要的负担。CONSORT-公平性2017对CONSORT 2010声明中的16个条目进行了扩展,补充了1个有关伦理报告的条目,同时就每个条目提供了报告质量好的实例和简要的解释。广泛应用CONSORT-公平性2017来报告健康公平性相关试验,可促进决策者发现有关的随机对照试验证据并加以应用,从而减少健康不公平性。

母亲和父亲患精神疾病与儿童和青少年受伤风险之间的关系:基于瑞典全国登记的队列研究

目的确定父母精神疾病与子女受伤风险之间的关系。设计回顾性队列研究。研究地点基于瑞典登记在册的人口。参与者1996-2011年出生的1542000名儿童和与之关联的89334名母亲和873935名父亲。暴露母亲或父亲的精神疾病(非情感性精神疾病、情感性精神疾病、酒精或药物滥用、情绪障碍、焦虑和压力相关障碍、饮食障碍、人格障碍)通过住院或门诊医疗保健记录确认。

脑瘫的家族风险：基于人群的队列研究

目的调查不同亲缘等级关系的家族成员中脑瘫的再发风险，以阐明其遗传模式。设计基于人群的队列研究。资料数据来自挪威医学出生登记库，其与挪威社会保险计划库相关联以确认脑瘫患者，同时与挪威统计局数据库相关联以确认脑瘫患者的亲属。研究对象出生于1967--2002年的2036741位挪威人，其中3649人诊断脑瘫；确认了22558对双胞胎，1851144对一级亲属，1699856对二级亲属，5165968对三级亲属。