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Biomass, one of the renewable resources, is expected to play an important role in the world’s energy future. In Asia, rice straw is an abundant agricultural surplus because rice is one of the leading staple food crops in the region. Often, rice straw is burned directly in the field via uncontrolled combustion methods that emit large amounts of short-lived air pollutants, greenhouse gases, and other pollutants. In Vietnam, the energy and environment protection sectors are facing great challenges because of rapid urbanisation and industrialisation. A national strategic choice is to exploit renewable energy, including biomass-derived energy, to achieve energy security and CO 2 emission reduction. This study investigates the potential of rice straw as an energy source for power plants at a local scale in Vietnam using data derived from satellite Sentinel-1 images. The results show that Vietnam can produce 2,565 MW from rice straw, for which 24 out of 63 provinces have a potential capacity higher than 30 MW, and the Kien Giang province has the highest capacity (245 MW). The study also analyses limitations and obstacles overcoming which can promote the biomass energy sector in the country.

This thesis investigates the problem of regulation-level vehicle control for the automated highway system (AHS). The issue of longitudinal and lateral coupling, as it affects tracking performance and robust stability, is explored in detail. To begin, a 26-state simulation model is proposed. Drawing from a number of earlier modeling results, this model offers the necessary level of fidelity for the study of combined vehicle maneuvers in typical freeway operations, while minimizing the level of complexity. Specifically, it includes descriptions of the vehicle sprung mass, engine, brakes, transmission and drive-train, suspension, and tire behaviors. Further, two simplified control models are also presented that are more amenable to analysis and control design. Utilizing these simplified models, it is shown that the coupling between the lateral and longitudinal dynamics can become appreciable during severe highway maneuvers, such as those encountered during lane changes, emergency obstacle avoidance, or in inclement weather and road conditions. To corroborate this result, various coupled and de-coupled control strategies are used in vehicle simulations over a wide range of maneuvering profiles and operating conditions. The closed-loop results indicate that tracking performance does improve under the coupled control strategy, and that the improvement becomes more pronounced as the maneuvers become more demanding. In order to facilitate coupled control design for multiple input, multiple output (MIMO) systems with unseparable input nonlinearities, sufficient conditions are presented for the existence of an approximate (numerically obtained) control which guarantees bounded tracking. The role of previewed road curvature information in improving lateral tracking performance is also examined. However, due to the abrupt nature of lane changes in US highways, a straightforward application of the previewed information is not desirable, for it leads to excessive steering demands that may result in overshoot or may violate passenger comfort demands. Consequently, a virtual trajectory is computed from the previewed curvature and is referenced to the road centerline. Moreover, this trajectory is optimal in the sense of minimum jerk, minimum error (between virtual trajectory and road centerline). In addition to controller design for individual agents, the issue of vehicle stability within an interconnected system is further investigated. It is known that individually stable constituents may form unstable systems due to the dynamic interaction among the members. Sufficient conditions for the stability of the interconnected system, string stability, are also known. This thesis proposes an analysis strategy and equivalent sufficient string stability conditions for sampled-data controlled systems. The tools are applied to prove the stability ot the proposed hybrid longitudinal vehicle-following, point-following and hybrid lateral heading angle, lane-following algorithms. The hybrid longitudinal scheme is superior to the constant-spacing vehicle-following strategy since it: provides absolute ground-truth referencing; places much less demand on the radios; and is more robust, in string stable sense, to velocity estimation errors. This scheme is also superior to the point-following strategy because vehicles can be much more safely close-packed, i.e. in a platoon, due to its incorporating the dynamics of the preceding vehicle in the control. By the same token, the proposed hybrid lateral strategy is superior to both exclusive vehicle-following and lane-following algorithms because it draws from the advantages of both to buttress their respective weaknesses. (Abstract shortened by UMI.)

Evaluating the prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH) who may be at risk of poor outcomes using grading systems is one way to make a better decision on treatment for these patients. This study aimed to compare the accuracy of the modified World Federation of Neurosurgical Societies (WFNS), WFNS, and Hunt and Hess (H&H) Grading Scales in predicting the outcomes of patients with aSAH. From August 2019 to June 2021, we conducted a multicenter prospective cohort study on adult patients with aSAH in three central hospitals in Hanoi, Vietnam. The primary outcome was the 90-day poor outcome, measured by a score of 4 (moderately severe disability) to 6 (death) on the modified Rankin Scale (mRS). We calculated the areas under the receiver operator characteristic (ROC) curve (AUROCs) to determine how well the grading scales could predict patient prognosis upon admission. We also used ROC curve analysis to find the best cut-off value for each scale. We compared AUROCs using Z-statistics and compared 90-day mean mRS scores among intergrades using the pairwise multiple-comparison test. Finally, we used logistic regression to identify factors associated with the 90-day poor outcome. Of 415 patients, 32% had a 90-day poor outcome. The modified WFNS (AUROC: 0.839 [95% confidence interval, CI: 0.795-0.883]; cut-off value[greater than or equal to]2.50; P.sub.AUROC <0.001), WFNS (AUROC: 0.837 [95% CI: 0.793-0.881]; cut-off value[greater than or equal to]3.5; P.sub.AUROC <0.001), and H&H scales (AUROC: 0.836 [95% CI: 0.791-0.881]; cut-off value[greater than or equal to]3.5; P.sub.AUROC <0.001) were all good at predicting patient prognosis on day 90.sup.th after ictus. However, there were no significant differences between the AUROCs of these scales. Only grades IV and V of the modified WFNS (3.75 [standard deviation, SD: 2.46] vs 5.24 [SD: 1.68], p = 0.026, respectively), WFNS (3.75 [SD: 2.46] vs 5.24 [SD: 1.68], p = 0.026, respectively), and H&H scales (2.96 [SD: 2.60] vs 4.97 [SD: 1.87], p<0.001, respectively) showed a significant difference in the 90-day mean mRS scores. In multivariable models, with the same set of confounding variables, the modified WFNS grade of III to V (adjusted odds ratio, AOR: 9.090; 95% CI: 3.494-23.648; P<0.001) was more strongly associated with the increased risk of the 90-day poor outcome compared to the WFNS grade of IV to V (AOR: 6.383; 95% CI: 2.661-15.310; P<0.001) or the H&H grade of IV to V (AOR: 6.146; 95% CI: 2.584-14.620; P<0.001). In this study, the modified WFNS, WFNS, and H&H scales all had good discriminatory abilities for the prognosis of patients with aSAH. Because of the better effect size in predicting poor outcomes, the modified WFNS scale seems preferable to the WFNS and H&H scales.

Background: Afatinib’s efficacy and dose-adjustment strategies have been validated in clinical trials and increasingly supported by real-world evidence. Objectives: This study aimed to provide additional real-world insights into afatinib use and to assess the impact of initial dosing and subsequent dose modifications on treatment outcomes and tolerability in patients with advanced epidermal-growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). Design: We conducted a multicenter retrospective analysis of patients with advanced EGFR-mutated NSCLC who received first-line afatinib between April 2018 and June 2022. Methods: Patients were categorized into four subgroups based on their starting and optimal afatinib doses. The primary endpoints were to analyze the association between afatinib dosing and time-to-treatment failure (TTF), overall survival (OS), and toxicity. Results: A total of 343 patients were included. The most common starting afatinib dose was 30 mg (58.6%), followed by 40 mg (39.9%). The optimal dose maintained during treatment was 30 mg in 62.1% of patients, 40 mg in 33.2%, and 20 mg in 4.7%. Dose reductions due to toxicity occurred in 23.6% of cases. Regarding four subgroups: 53.1% of patients started and remained on <40 mg, 25.4% started and maintained 40 mg, 14.6% started at 40 mg but de-escalated to <40 mg, and 7.0% started <40 mg and escalated to 40 mg. After a median follow-up of 36.8 months, the median OS for all patients was 31.3 months (95% confidence interval: 29.3–33.1). Multivariate Cox regression analysis identified smoking status, Eastern Cooperative Oncology Group performance status, and EGFR mutation subtype as independent prognostic factors for OS. Notably, patients who initiated treatment at 40 mg but de-escalated to <40 mg had the longest median TTF and OS. In terms of safety, the highest incidence of adverse events was observed in this group, followed by those who started and remained at <40 mg. Conclusion: In this real-world cohort, flexible afatinib dosing—either by initiating at 40 mg followed by dose reduction or starting at <40 mg with later escalation—was associated with favorable survival outcomes and manageable tolerability. These findings support the use of individualized afatinib dosing strategies to optimize both efficacy and safety in patients with EGFR-mutant NSCLC.

Introduction : Patient satisfaction is one of the most important components of measuring healthcare quality.Objectives : The study aimed to evaluate the validity and reliability of the patient satisfaction scale with the quality of health services and its associated factors.Methods: A cross-sectional study was conducted to collect data on patient satisfaction with 301 outpatients at one polyclinic in Hanoi, Vietnam.Results: The overall outpatient satisfaction was 53.5%. There were five factors (facilities, services provision results, information transparency and administrative procedures, accessibility, and interaction and communication of staff) including one major factor with high Eigenvalues coefficient, 22.5 for satisfaction with facility, and four others with lower Eigenvalues coefficient, 3.2, 2.0, 1.5, and 1.2 for satisfaction with service provision results, information transparency and administrative procedures, accessibility, and interaction and communication of staff respectively. All satisfaction-factors show internal consistency reliability, with a Cronbach’s Alpha of over 0.9. The insured are 3.5 times (95% CI: 1.9–6.2) more likely to be satisfied with health services than the uninsured.Conclusion: The patient satisfaction measurement tool should be used for intervention to improve the quality of health services at the clinic.

The selective expression of CD137 on cells of the immune system (e.g., T and DC cells) and oncogenic cells in several types of cancer leads this molecule to be an attractive target to discover cancer immunotherapy. Therefore, specific antibodies against CD137 are being studied and developed aiming to activate and enhance anti-cancer immune responses as well as suppress oncogenic cells. Accumulating evidence suggests that anti-CD137 antibodies can be used separately to prevent tumor in some cases, while in other cases, these antibodies need to be co-administered with other antibodies or drugs/vaccines/regents for a better performance. Thus, in this work, we aim to update and discuss current knowledge about anti-cancer effects of anti-CD137 antibodies as mono- and combined-immunotherapies.

Tuberculosis continues to be a global health challenge. In this report, active case finding was more than twice as likely as standard passive case finding to identify tuberculosis among household contacts of index patients with smear-positive disease.

The overspread of the novel coronavirus—SARS-CoV-2—over the globe has caused significant damage to manufacturing and service businesses, regardless of whether they are commercial, public, or not-for-profit sectors. While both the short-term and long-term impacts of most companies can be approximately measured or estimated, it is challenging to address the enduring effects of COVID-19 on teaching and learning activities. The target of this research is to investigate students’ manners of studying at home during the school suspension time as a result of COVID-19. Through analyzing original survey data from 420 K6–12 students in Hanoi, Vietnam, this work demonstrates the different learning habits of students with different socioeconomic statuses and occupational aspirations during the disease’s outbreak. In particular, we featured the differences in students’ learning behaviors between private schools and public schools, as well as between students who plan to follow STEM-related careers and those who intend to engage in social science-related careers. The empirical evidence of this study can be used for the consideration of the local government to increase the sustainability of coming policies and regulations to boost students’ self-efficacy, as it will affect 1.4 million students in Hanoi, as well as the larger population of nearly 10 million Vietnamese students. These results can also be the foundation for future investigations on how to elevate students’ learning habits toward Sustainable Development Goal 4 (SDG4)—Quality Education—especially in fanciful situations in which the regular school operation has been disrupted, counting with limited observation and support from teachers and parents.

Background This study aimed to evaluate the efficacy and side effects of first-line afatinib treatment in a real-world setting in Vietnam. Methods This retrospective study was conducted across nine hospitals in Vietnam. Advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients who received afatinib as first-line therapy between April 2018 and June 2022 were included, and patient medical records were reviewed. Key outcomes were overall response rate (ORR), time-to-treatment failure (TTF), and tolerability. Results A total of 343 patients on first-line afatinib were eligible for the study. EGFR exon 19 deletion (Del19) alone was detected in 46.9% of patients, L858R mutation alone in 26.3%, and other uncommon EGFR mutations, including compound mutations, in 26.8%. Patients with brain metastases at baseline were 25.4%. Patients who received 40 mg, 30 mg, and 20 mg as starting doses of afatinib were 58.6%, 39.9%, and 1.5%, respectively. The ORR was 78.1% in the overall population, 82.6% in the Del19 mutation subgroup, 73.3% in the L858R mutation subgroup, and 75.0% in the uncommon mutation subgroup ( p  > 0.05). The univariate and multivariate analyses indicate that the ORR increased when the starting dose was 40 mg compared to starting doses below 40 mg (83.9% vs. 74.3%, p  = 0.034). The median TTF (mTTF) was 16.7 months (CI 95%: 14.8–18.5) in all patients, with a median follow-up time of 26.2 months. The mTTF was longer in patients in the common EGFR mutation subgroup (Del19/L858R) than in those in the uncommon mutation subgroup (17.5 vs. 13.8 months, p  = 0.045) and in those without versus with brain metastases at baseline (17.5 vs. 15.1 months, p  = 0.049). There were no significant differences in the mTTF between subgroups based on the starting dose of 40 mg and < 40 mg (16.7 vs. 16.9 months, p  > 0.05). The most common treatment-related adverse events (any grade/grade ≥ 3) were diarrhea (55.4%/3.5%), rash (51.9%/3.2%), paronychia (35.3%/5.0%), and stomatitis (22.2%/1.2%). Conclusions Afatinib demonstrated clinical effectiveness and good tolerability in Vietnamese EGFR-mutant NSCLC patients. In our real-world setting, administering a starting dose below 40 mg might result in a reduction in ORR; however, it might not have a significant impact on TTF.

The prevalence of risk factors for poor outcomes from aneurysmal subarachnoid hemorrhage (SAH) varies widely and has not been fully elucidated to date in Vietnam. Understanding the risk and prognosis of aneurysmal SAH is important to reduce poor outcomes in Vietnam. The aim of this study, therefore, was to investigate the rate of poor outcome at 90 days of ictus and associated factors from aneurysmal SAH in the country. We performed a multicenter prospective cohort study of patients (≥18 years) presenting with aneurysmal SAH to three central hospitals in Hanoi, Vietnam, from August 2019 to August 2020. We collected data on the characteristics, management, and outcomes of patients with aneurysmal SAH and compared these data between good (defined as modified Rankin Scale (mRS) of 0 to 3) and poor (mRS, 4-6) outcomes at 90 days of ictus. We assessed factors associated with poor outcomes using logistic regression analysis. Of 168 patients with aneurysmal SAH, 77/168 (45.8%) were men, and the median age was 57 years (IQR: 48-67). Up to 57/168 (33.9%) of these patients had poor outcomes at 90 days of ictus. Most patients underwent sudden-onset and severe headache (87.5%; 147/168) and were transferred from local to participating central hospitals (80.4%, 135/168), over half (57.1%, 92/161) of whom arrived in central hospitals after 24 hours of ictus, and the initial median World Federation of Neurological Surgeons (WFNS) grading score was 2 (IQR: 1-4). Nearly half of the patients (47.0%; 79/168) were treated with endovascular coiling, 37.5% (63/168) were treated with surgical clipping, the remaining patients (15.5%; 26/168) did not receive aneurysm repair, and late rebleeding and delayed cerebral ischemia (DCI) occurred in 6.1% (10/164) and 10.4% (17/163) of patients, respectively. An initial WFNS grade of IV (odds ratio, OR: 15.285; 95% confidence interval, CI: 3.096-75.466) and a grade of V (OR: 162.965; 95% CI: 9.975-2662.318) were independently associated with poor outcomes. Additionally, both endovascular coiling (OR: 0.033; 95% CI: 0.005-0.235) and surgical clipping (OR: 0.046; 95% CI: 0.006-0.370) were inversely and independently associated with poor outcome. Late rebleeding (OR: 97.624; 95% CI: 5.653-1686.010) and DCI (OR: 15.209; 95% CI: 2.321-99.673) were also independently associated with poor outcome. Improvements are needed in the management of aneurysmal SAH in Vietnam, such as increasing the number of aneurysm repairs, performing earlier aneurysm treatment by surgical clipping or endovascular coiling, and improving both aneurysm repairs and neurocritical care.