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Medication adherence plays a crucial role in effectively managing hypertension, a significant public health concern, especially in regions like Central Vietnam. This study aimed to assess medication adherence levels among hypertensive patients in primary care settings and explore the factors influencing adherence within this specific population. We conducted a cross-sectional study to evaluate medication adherence and its determinants among individuals with hypertension in Central Vietnam. Medication adherence was assessed using the 5-item version of the Medication Adherence Report Scale self-report. We collected data on the demographics, medical history, lifestyle, hypertension knowledge, along with the patient beliefs and perceptions about hypertension. Logistic regression analysis was employed to identify the key factors associated with their medication adherence. Our study revealed that only half of the hypertensive patients adhered to their prescribed medication regimens. Several factors significantly influenced their medication adherence, including age, ethnicity, educational level, home blood pressure monitoring, healthy diet, time since hypertension diagnosis, hypertension knowledge, and patient beliefs. According to the logistic regression analysis, a healthy diet and patient beliefs emerged as primary predictors of medication adherence. Patients who strongly believed in the necessity of medication demonstrated better adherence, while concerns about overuse and harm were linked to lower adherence levels. This study highlighted the suboptimal levels of medication adherence among hypertensive patients in primary care settings in Central Vietnam. It underscored the urgent need for tailored interventions to address this issue. For the sake of better medication adherence, healthcare providers were suggested to prioritize patient education, address patient beliefs and concerns about medication, and promote the practice of home blood pressure monitoring.

Cultural norms diverge substantially across societies, often within the same country. We propose and investigate a self-domestication/selective migration hypothesis, proposing that cultural differences along the individualism–collectivism dimension are driven by the outmigration of individualistic people from collectivist core regions of states to peripheral frontier areas, and that such patterns of historical migration are reflected even in the current distribution of cultural norms. Gaining independence in 939 CE after about a thousand years of Chinese colonization, historical Vietnam emerged in the region that is now north Vietnam with a collectivist social organization. From the eleventh to the eighteenth centuries, historical Vietnam gradually expanded its territory southward to the Mekong River Delta through repeated waves of conquest and migration. Using a nationwide household survey, a population census, and a lab-in-the-field experiment, we demonstrate that areas annexed earlier to historical Vietnam are currently more prone to collectivist norms, and that these cultural norms are embodied in individual beliefs. Relying on many historical accounts, together with various robustness checks, we argue that the southward out-migration of individualistic people during the eight centuries of the territorial expansion is an important driver, among many others, of these cultural differences.

Cardiovascular disease (CVD) being the leading cause of the morbidity and mortality in Vietnam, the objective of this study was to estimate the total 10-year CVD risk among adults aged 40-69 years by utilizing World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in Central Vietnam. In this cross-sectional study, multi-staged sampling was used to select 938 participants from a general population aged from 40 to 69. The CVD risk factors were then collected throughout the interviews with a standardized questionnaire, anthropometric measurements and a blood test. The cardiovascular risk was calculated using the WHO/ISH risk prediction charts. According to the WHO/ISH charts, the proportion of moderate risk (10-20%) and high risk (>20%) among the surveyed participants were equal (5.1%). When \"blood pressure of more than 160/100 mmHg\" was applied, the proportion of moderate risk reduced to 2.3% while the high risk increased markedly to 12.8%. Those proportions were higher in men than in women (at 18.3% and 8.5% respectively, p-value <0.001, among the high-risk group), increasing with age. Male gender, smoking, ethnic minorities, hypertension and diabetes were associated with increased CVD risk. There was a high burden of CVD risk in Central Vietnam as assessed with the WHO/ISH risk prediction charts, especially in men and among the ethnic minorities. The use of WHO/ISH charts provided a feasible and affordable screening tool in estimating the cardiovascular risk in primary care settings.

Erectile dysfunction (ED) shares common risk factors with cardiovascular (CV) disease, such as a sedentary lifestyle, obesity, and metabolic syndrome. However, the relationship between ED and CV risk in Vietnam remains unknown. To investigate this, we conducted a multi-center observational study, randomly selecting 2,936 men aged 40 to 69 years in Vietnam, with 385 participants included after exclusions. The study evaluated the 10-year CV risk using the Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) score and assessed ED using the International Index of Erectile Function (IIEF-5) score. Results showed that men with diabetes mellitus and hypertension had significantly lower IIEF-5 scores compared to healthy individuals (18 [15–22] vs. 23 [20–24], p <  0.001). Additionally, the IIEF-5 score proved effective in identifying patients at very high CV risk, with an area under the curve (AUC) of 0.747, a cutoff point of 18.5, sensitivity of 69.6%, and specificity of 69.9%. Furthermore, we found a significant inverse correlation between SCORE2-Diabetes and IIEF-5 (ρ = -0.45 and p <  0.001). These findings establish a significant connection between ED and CV risk in men with diabetes, underscoring the need for integrated screening and management strategies to address both conditions concurrently.

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Radiotherapy for brain metastases has evolved tremendously over the past four decades, allowing for improved intracranial control of disease with reduced neurotoxicity. The main technological advance was provided by volumetric modulated arc therapy (VMAT), a computer-controlled delivery method that has opened the door for single-isocenter multi-metastases stereotactic radiosurgery (SRS) and hippocampal avoidance whole brain radiation therapy (HA-WBRT). Other notable advances have occurred in the combination of immune checkpoint inhibitors (ICI) and radiosurgery. When these two modalities are combined in the proper sequence (within 30 days from each other), it provides promising results in the treatment of intracranial metastases from melanoma. There is emerging evidence of a synergistic interaction between ICI and SRS, providing better intracranial tumor control and lengthening the survival of patients afflicted by this common complication of cancer.

The mammalian cortex is a laminar structure containing many areas and cell types that are densely interconnected in complex ways, and for which generalizable principles of organization remain mostly unknown. Here we describe a major expansion of the Allen Mouse Brain Connectivity Atlas resource 1 , involving around a thousand new tracer experiments in the cortex and its main satellite structure, the thalamus. We used Cre driver lines (mice expressing Cre recombinase) to comprehensively and selectively label brain-wide connections by layer and class of projection neuron. Through observations of axon termination patterns, we have derived a set of generalized anatomical rules to describe corticocortical, thalamocortical and corticothalamic projections. We have built a model to assign connection patterns between areas as either feedforward or feedback, and generated testable predictions of hierarchical positions for individual cortical and thalamic areas and for cortical network modules. Our results show that cell-class-specific connections are organized in a shallow hierarchy within the mouse corticothalamic network. Using mouse lines in which subsets of neurons are genetically labelled, the authors provide generalized anatomical rules for connections within and between the cortex and thalamus.

Background Chronic temporomandibular disorder (TMD) pain with pain catastrophizing (PC) is associated with altered brain morphology; however, its neuroanatomical underpinnings remain unclear. This study aimed to investigate gray matter volume (GMV) in the brain regions of chronic TMD pain patients with PC using voxel-based morphometry. Methods A case-control study was conducted with 28 participants, including 14 chronic TMD pain patients with high PC and 14 age- and sex-matched healthy controls. T1-weighted magnetic resonance imaging (MRI) data were acquired using a 3-Tesla scanner and analyzed with Statistical Parametric Mapping 12 (SPM12). Whole-brain and Region-of-Interest (ROI) analyses were performed to assess GMV differences and associations between GMV with clinical variables. Results Whole-brain analysis revealed no significant GMV differences between groups. However, ROIs analyses showed significantly smaller GMV in the bilateral hippocampus, left parahippocampal gyrus, and right putamen in the patient group. Additionally, GMV in the orbital part of the inferior frontal gyrus was negatively associated with pain duration. Conclusion This study suggests that central nervous system alterations are linked to chronic TMD pain condition with pain catastrophizing. These findings contribute to understanding the neurobiological basis of chronic musculoskeletal pain and highlight the need for further research into the role of cognitive-emotional factors in pain-related neural adaptations. Clinical trial number Not applicable.

This paper introduces a novel adaptive inverse multilayer T-S fuzzy controller (AIMFC) optimally identified with an optimization soft computing algorithm available for a class of robust control applied in uncertain nonlinear SISO systems. The parameters of multilayer T-S fuzzy model are optimally identified by the differential evolution (DE) algorithm to create offline the inverse nonlinear plant with uncertain coefficients. Then, the adaptive fuzzy-based sliding mode surface is applied to ensure that the closed-loop system is asymptotically stable in which the stability is satisfied using Lyapunov stability concept. The control quality of the proposed AIMFC algorithm is compared with the three recent advanced control algorithms applied in the Spring-Mass-Damper (SMD) benchmark system. Simulation and experiment results with different control parameters show that the proposed algorithm is better than the inverse fuzzy controller and the conventional adaptive fuzzy controller comparatively applied in both SMD system and the coupled-liquid tank system with the performance index using the least mean squares (LMS) error, which is investigated to demonstrate the efficiency and the robustness of the proposed AIMFC control approach.