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In international trade, exporters prefer to receive payments as quickly as possible, and importers want to make payments as late as possible. In this respect, the payment field, an essential condition for trade transactions, also represents the positions of exporters and importers conflict. In addition, there are many cases in which various variables must be considered rather than only one specific variable representatively affecting payment, particularly in the case of import-export Small and Medium-Sized Enterprises (SMEs) from emerging countries. A selection of proper payment methods can be categorized as a Multi-Criteria Decision-Making (MCDM) issue. Therefore, this study aims to propose a novel and efficient Spherical Fuzzy Weighted Aggregated Sum Product Assessment based Entropy Objective Weighting method (SF-EW and WASPAS-SF) to evaluate international payment methods with uncertain information. First, SF-EW model is applied to determine the relative weights of critical factors. Second, international payment method alternatives are prioritized by the WASPAS-SF approach. Five essential factors for four international payment methods are proposed based on experts’ opinions and the existing literature. A real-world case study from Vietnamese import-export SMEs is presented to validate the applicability of the proposed framework. The results indicated that “Characteristics of payment method (PA)” had the most significant impact on international payment method selection. In comparison, “Letters of Credit (L/C)” was the most reliable payment method with the highest ranking available to international traders. Furthermore, a sensitivity analysis was performed to examine the validity and robustness of the proposed decision support model. Consequently, this study could contribute to international payment services and in the context of globalization and international trade.

Delivering high-quality service to passengers can be critical for an airport’s survival, competitiveness, profitability, and long-term growth in a highly competitive environment. The present study aims to examine the relationship between airport service attributes and passenger satisfaction. To this end, we conducted multi-method research consisting of symmetric (multiple regression analysis—MRA) and asymmetric (necessary condition analysis—NCA) approaches. The research data consists of 1463 valid online reviews (n = 1463) of the top 50 busiest airports in Europe retrieved from Skytrax. The MRA was employed to examine the net effect of the eight airport service attributes on passenger satisfaction, while the NCA was used to explore the necessary conditions and level of necessity to achieve passenger satisfaction. Using MRA, the findings reveal that airport staff is the most influential predictor of passenger satisfaction, whereas airport shopping and airport Wi-Fi connectivity do not have a significant effect on passenger satisfaction. Moreover, the NCA results found that six of the eight conditions are necessary to achieve passenger satisfaction at the airport. To complement and comprehend the findings, this study also sheds light on the antecedents underlying airport passenger satisfaction in the post-COVID-19 era using NCA.

Supply chain sustainability, which takes environmental, economic, and social factors into account, was recently recognized as a critical component of the supply chain (SC) management evaluation process and known as a multi-criteria decision-making problem (MCDM) that is heavily influenced by the decision-makers. While some criteria can be analyzed numerically, a large number of qualitative criteria require expert review in linguistic terms. This study proposes an integration of Data Envelopment Analysis (DEA), spherical fuzzy analytic hierarchy process (SF-AHP), and spherical fuzzy weighted aggregated sum product assessment (SF-WASPAS) to identify a sustainable supplier for the steel manufacturing industry in Vietnam. In this study, both quantitative and qualitative factors are considered through a comprehensive literature review and expert interviews. The first step employs DEA to validate high-efficiency suppliers based on a variety of quantifiable criteria. The second step evaluates these suppliers further on qualitative criteria, such as economic, environmental, and social factors. The SF-AHP was applied to obtain the criteria’s significance, whereas the SF-WASPAS was adopted to identify sustainable suppliers. The sensitivity analysis and comparative results demonstrate that the decision framework is feasible and robust. The findings of this study can assist steel industry executives in resolving the macrolevel supplier selection problem. Moreover, the proposed method can assist managers in selecting and evaluating suppliers more successfully in other industries.

The unprecedented coronavirus pandemic (COVID-19) is fluctuating worldwide. Since the COVID-19 epidemic has a negative impact on all countries and has become a significant threat, it is necessary to determine the most effective strategy for governments by considering a variety of criteria; however, few studies in the literature can assist governments in this topic. Selective governmental intervention during the COVID-19 outbreak is considered a Multi-Criteria Decision-Making (MCDM) problem under a vague and uncertain environment when governments and medical communities adjust their priorities in response to rising issues and the efficacy of interventions applied in various nations. In this study, a novel hybrid Spherical Fuzzy Analytic Hierarchy Process (SF-AHP) and Fuzzy Weighted Aggregated Sum Product Assessment (WASPAS-F) model is proposed to help stakeholders such as governors and policymakers to prioritize governmental interventions for dealing with the COVID-19 outbreak. The SF-AHP is implemented to measure the significance of the criteria, while the WASPAS-F approach is deployed to rank intervention alternatives. An empirical case study is conducted in Vietnam. From the SF-AHP findings, the criteria of “effectiveness in preventing the spread of COVID-19”, “ease of implementation”, and “high acceptability to citizens” were recognized as the most important criteria. As for the ranking of strategies, “vaccinations”, “enhanced control of the country’s health resources”, “common health testing”, “formation of an emergency response team”, and “quarantining patients and those suspected of infection” are the top five strategies. Aside from that, the robustness of the approach was tested by performing a comparative analysis. The results illustrate that the applied methods reach the general best strategy rankings. The applied methodology and its analysis will provide insight to authorities for fighting against the severe pandemic in the long run. It may aid in solving many complicated challenges in government strategy selection and assessment. It is also a flexible design model for considering the evaluation criteria. Finally, this research provides valuable guidance for policymakers in other nations.

The relationship between age and seroprevalence can be used to estimate the annual attack rate of an infectious disease. For pathogens with multiple serologically distinct strains, there is a need to describe composite exposure to an antigenically variable group of pathogens. In this study, we assay 24,402 general-population serum samples, collected in Vietnam between 2009 to 2015, for antibodies to eleven human influenza A strains. We report that a principal components decomposition of antibody titer data gives the first principal component as an appropriate surrogate for seroprevalence; this results in annual attack rate estimates of 25.6% (95% CI: 24.1% – 27.1%) for subtype H3 and 16.0% (95% CI: 14.7% – 17.3%) for subtype H1. The remaining principal components separate the strains by serological similarity and associate birth cohorts with their particular influenza histories. Our work shows that dimensionality reduction can be used on human antibody profiles to construct an age-seroprevalence relationship for antigenically variable pathogens. Multi-strain pathogens, such as influenza, present challenges for interpretation of seroprevalence data as estimates may vary by strain. Here, the authors develop a method for estimating age-specific seroprevalence based on principal components analysis and apply it to influenza data from Vietnam.

Targeted therapy with tyrosine kinase inhibitors (TKI) provides survival benefits to a majority of patients with non-small cell lung cancer (NSCLC). However, resistance to TKI almost always develops after treatment. Although genetic and epigenetic alterations have each been shown to drive resistance to TKI in cell line models, clinical evidence for their contribution in the acquisition of resistance remains limited. Here, we employed liquid biopsy for simultaneous analysis of genetic and epigenetic changes in 122 Vietnamese NSCLC patients undergoing TKI therapy and displaying acquired resistance. We detected multiple profiles of resistance mutations in 51 patients (41.8%). Of those, genetic alterations in EGFR , particularly EGFR amplification (n = 6), showed pronounced genome instability and genome-wide hypomethylation. Interestingly, the level of hypomethylation was associated with the duration of response to TKI treatment. We also detected hypermethylation in regulatory regions of Homeobox genes which are known to be involved in tumor differentiation. In contrast, such changes were not observed in cases with MET (n = 4) and HER2 (n = 4) amplification. Thus, our study showed that liquid biopsy could provide important insights into the heterogeneity of TKI resistance mechanisms in NSCLC patients, providing essential information for prediction of resistance and selection of subsequent treatment.

Streptococcus suis is a pathogen of major economic significance to the swine industry and is increasingly recognized as an emerging zoonotic agent in Asia. In Vietnam, S. suis is the leading cause of bacterial meningitis in adult humans. Zoonotic transmission is most frequently associated with serotype 2 strains and occupational exposure to pigs or consumption of infected pork. To gain insight into the role of pigs for human consumption as a reservoir for zoonotic infection in southern Vietnam, we determined the prevalence and diversity of S. suis carriage in healthy slaughterhouse pigs. Nasopharyngeal tonsils were sampled from pigs at slaughterhouses serving six provinces in southern Vietnam and Ho Chi Minh City area from September 2006 to November 2007. Samples were screened by bacterial culture. Isolates of S. suis were serotyped and characterized by multi locus sequence typing (MLST) and pulse field gel electrophoresis (PFGE). Antibiotic susceptibility profiles and associated genetic resistance determinants, and the presence of putative virulence factors were determined. 41% (222/542) of pigs carried S. suis of one or multiple serotypes. 8% (45/542) carried S. suis serotype 2 which was the most common serotype found (45/317 strains, 14%). 80% of serotype 2 strains belonged to the MLST clonal complex 1,which was previously associated with meningitis cases in Vietnam and outbreaks of severe disease in China in 1998 and 2005. These strains clustered with representative strains isolated from patients with meningitis in PFGE analysis, and showed similar antimicrobial resistance and virulence factor profiles. Slaughterhouse pigs are a major reservoir of S. suis serotype 2 capable of causing human infection in southern Vietnam. Strict hygiene at processing facilities, and health education programs addressing food safety and proper handling of pork should be encouraged.

The identification and quantification of actionable mutations are of critical importance for effective genotype-directed therapies, prognosis and drug response monitoring in patients with non-small-cell lung cancer (NSCLC). Although tumor tissue biopsy remains the gold standard for diagnosis of NSCLC, the analysis of circulating tumor DNA (ctDNA) in plasma, known as liquid biopsy, has recently emerged as an alternative and noninvasive approach for exploring tumor genetic constitution. In this study, we developed a protocol for liquid biopsy using ultra-deep massively parallel sequencing (MPS) with unique molecular identifier tagging and evaluated its performance for the identification and quantification of tumor-derived mutations from plasma of patients with advanced NSCLC. Paired plasma and tumor tissue samples were used to evaluate mutation profiles detected by ultra-deep MPS, which showed 87.5% concordance. Cross-platform comparison with droplet digital PCR demonstrated comparable detection performance (91.4% concordance, Cohen's kappa coefficient of 0.85 with 95% CI = 0.72-0.97) and great reliability in quantification of mutation allele frequency (Intraclass correlation coefficient of 0.96 with 95% CI = 0.90-0.98). Our results highlight the potential application of liquid biopsy using ultra-deep MPS as a routine assay in clinical practice for both detection and quantification of actionable mutation landscape in NSCLC patients.

Background: In patients with locally advanced lung cancer treated with concurrent chemoradiation, outcome measurements have been mostly limited to survival. Objectives: We aimed to measure outcomes that matter to these patients beyond survival in a general clinical practice. Methods: In a prospective single-centre study, consecutive patients with locally advanced non-small cell lung cancer reported their own outcomes using the EORTC Quality of Life Questionnaire Core 30 at baseline, during therapy, at therapy stop and till 1 year after therapy end every 3 months. Survival, complications, quality of death and case-mix variables were measured. Results: There were 32 consecutive patients included prospectively from June 2013 until September 2016. Median overall survival was 24.3 months (95% CI 12.7–35.9). Severe toxicity (grade III–IV) was frequent (haematologic toxicity III–IV in 59%). Patient-reported outcomes (PROs) documented the burden on global health status and on functional domains (physical, role, social, emotional and cognitive functioning). Deterioration was pronounced during and after treatment with drops over 20 up to 40% points from baseline for physical, role and social functioning. Clinically meaningful negative effects did persist up to 6 and 9 months for physical and role functioning. Fifty-six percent of the deceased patients died in hospital. Conclusions: The assault on health-related quality of life during concurrent chemoradiation for locally advanced lung cancer is considerable. Loss of physical and role functioning persists up to 6 and 9 months after therapy end, respectively. Measuring PROs can help to identify issues for improvement of the value of care delivered.

Seroepidemiological studies aim to understand population-level exposure and immunity to infectious diseases. Their results are normally presented as binary outcomes describing the presence or absence of pathogen-specific antibody, despite the fact that many assays measure continuous quantities. A population’s natural distribution of antibody titers to an endemic infectious disease may include information on multiple serological states – naiveté, recent infection, non-recent infection, childhood infection – depending on the disease in question and the acquisition and waning patterns of immunity. In this study, we investigate 20,152 general-population serum samples from southern Vietnam collected between 2009 and 2013 from which we report antibody titers to the influenza virus HA1 protein using a continuous titer measurement from a protein microarray assay. We describe the distributions of antibody titers to subtypes 2009 H1N1 and H3N2. Using a model selection approach to fit mixture distributions, we show that 2009 H1N1 antibody titers fall into four titer subgroups and that H3N2 titers fall into three subgroups. For H1N1, our interpretation is that the two highest-titer subgroups correspond to recent and historical infection, which is consistent with 2009 pandemic attack rates. Similar interpretations are available for H3N2, but right-censoring of titers makes these interpretations difficult to validate.