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Purpose Laparoscopic giant hiatus hernia repair is technically difficult with ongoing debate regarding the most effective surgical technique. Repair of small hernia has been well described but data for giant hernia is variable. This study evaluated trends in outcomes of laparoscopic non-mesh repair of giant paraesophageal hernia (PEH) over 30 years. Methods Retrospective analysis of a single-surgeon prospective database. Laparoscopic non-mesh repairs for giant PEH between 1991 and 2021 included. Three-hundred-sixty-degree fundoplication was performed routinely, evolving into “composite repair” (esophagopexy and cardiopexy to the right crus). Cases were chronologically divided into tertiles based on operation date (Group 1, 1991–2002; Group 2, 2003–2012; Group 3, 2012–2021) with trends in casemix, operative factors and outcomes evaluated. Hernia recurrence was plotted using weighted moving average and cumulative sum (CUSUM) analysis. Results 862 giant PEH repairs met selection criteria. There was an increasing proportion of “composite repair” after the first decade (Group 1, 2.7%; Group 2, 81.9%; Group 3, 100%; p < 0.001). There were less anatomical hernia recurrence (Group 1, 36.6%; Group 2, 22.9%; Group 3, 22.7%; p < 0.001) and symptomatic recurrence (Group 1, 34.2%; Group 2, 21.9%; Group 3, 7%; p < 0.001) over time. The incidence of anatomical recurrence declined over time, decreasing from 30.8% and plateauing below 17.6% near the study’s end. Median followup (months) in the first decade was higher but followup between the latter two decades comparable (Group 1, 49 [IQR 20, 81]; Group 2, 30 [IQR 15, 65]; Group 3, 24 [14, 56]; p < 0.001). There were 10 (1.2%) Clavien–Dindo grade ≥ III complications including two perioperative deaths (0.2%). Conclusion Hernia recurrence rates decreased with increasing case volume. This coincided with the increasing adoption of “composite repair”, supporting the possible improvement in recurrence rates with this approach.

This manuscript introduces a computational approach to micro-damage problems using deep learning for the prediction of loading deflection curves. The location of applied forces, dimensions of the specimen and material parameters are used as inputs of the process. The micro-damage is modelled with a gradient-enhanced damage model which ensures the well-posedness of the boundary value and yields mesh-independent results in computational methods such as FEM. We employ the Adam optimizer and Rectified linear unit activation function for training processes and research into the deep neural network architecture. The performance of our approach is demonstrated through some numerical examples including the three-point bending specimen, shear bending on L-shaped specimen and different failure mechanisms.

AimsTo assess the association between physical activity (PA) during pregnancy and the prevalence of gestational diabetes mellitus (GDM) accounting for sitting time.MethodsThe study used data from a cohort study of 2030 pregnant women in Vietnam. Women were recruited from six hospitals in Ha Noi, Hai Phong, and Ho Chi Minh City. Baseline measurements including PA and GDM were taken at 24–28 weeks of gestation. PA was assessed during the past 3 months before the interview using the interviewer-administered Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24–28 weeks of gestation using the 2013 World Health Organization criteria.Results1987 out of 2030 pregnant women were included in the final analysis, of which 432 had GDM (21.7%). Women undertaking the highest level (upper tertile) of PA during pregnancy appeared to have a lower risk of GDM [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.53–0.94, Ptrend 0.017] when compared to those at the lowest tertile of PA. Similarly, women with increased levels of moderate-intensive activity and household/caregiving activity during pregnancy were associated with reduced risks of GDM (OR 0.66, 95% CI 0.50–0.86, Ptrend 0.002 and OR 0.72, 95% CI 0.55–0.95, Ptrend 0.020, respectively). These apparent inverse associations were not attenuated by their sitting time. There were no significant associations between sitting time, light-intensity activity, vigorous-intensity activity, occupation, sports/exercise, commuting, or meeting exercise guidelines and GDM risk.ConclusionsHigh levels of PA, particularly moderate-intensity and household/caregiving activities during pregnancy were associated with a lower prevalence of GDM independent of sitting time.

This paper focuses on dry port as a key notion in port-hinterland development. We first discuss the concept of dry port by reviewing existing literature. Then, we explore the reasons behind the emergence and development of inland node systems in different geographical, economic and institutional contexts. Next, the paper presents a classification of dry ports based on a multitude of factors and dimensions and the respective benefits to different parties. The study then focuses on the specific characteristics of dry ports and associated transport networks in developing countries. In the last part, we present a case study on the dry port system in Vietnam by reviewing the seaport and inland transport system and analyzing the current status of inland terminals in Vietnam. To conclude, a SWOT analysis is presented with regard to the development of the dry port network in Vietnam, followed by recommendations for policy makers.

This paper focuses on dry port as a key notion in port-hinterland development. We first discuss the concept of dry port by reviewing existing literature. Then, we explore the reasons behind the emergence and development of inland node systems in different geographical, economic and institutional contexts. Next, the paper presents a classification cf dry ports based on a multitude of factors and dimensions and the respective benefits to different parties. The study then focuses on the specific characteristics of dry ports and associated transport networks in developing countries. In the last part, we present a case study on the dry port system in Vietnam by reviewing the seaport and inland transport system and analyzing the current status of inland terminals in Vietnam. To conclude, a SWOT analysis is presented with regard to the development of the dry port network in Vietnam, followed by recommendations for policy makers.

Aim: To determine several clinical and laboratory features as well as the bacterial profile of spontaneous bacterial peritonitis (SBP) in 58 Vietnamese patients admitted to a single center due to liver cirrhosis. Methods: We retrospectively analyzed bacteriological, clinical and laboratory characteristics of patients with SBP admitted to the Gastroenterology and Hepatology Center from July 2019 to July 2020. Results: Out of a total 58 SBP patients, 41 (70.9%) had culture-negative neutrocytic ascites. The majority of patients experienced abdominal pain (93,1%) and large ascites (65,5%). Gram-negative bacteria formed the main pathogens (14/17). Escherichia coli (9/17) was the predominant cause followed by Burkholderia cepacia (2/17). Antibiotic sensitivity rate of E. coli for third generation cephalosporin was low but high for aminoglycoside and carbapenem antibiotics. The resistance of E. coli was significant against fluoroquinolones (100%). All 3 cases of gram-positive bacteria were sensitive to vancomycin. Conclusion: Our study reported the bacteriological and clinical characteristics of patients with SBP and compared these findings between two groups: positive ascitic fluid culture and negative fluid culture. Ascitic fluid culture can guide for the right antibiotic choice since resistance to commonly prescribed antibiotics is common in SBP patients. Keywords: liver cirrhosis, peritonitis, ascitic fluid, antibiotic sensitivity

Adoptive T-cell therapy is clinically efficacious in the treatment of select cancers. However, it is often difficult to obtain adequate numbers of tumor-specific T cells for therapy. One method for overcoming this limitation is to generate tumor-specific T cells by retrovirally mediated T-cell-receptor (TCR) gene transfer. However, despite instances of therapeutic success, major obstacles remain, including attaining the survival of retrovirally modified T cells in vivo as well as inducing long-term and multi-gene retroviral expression. Using a murine model of adoptively transferred retrovirally modified CD8 + T cells, where antitumor immunity was dependent on sustained, multigene expression, we found that in vitro assays are poor indicators of in vivo efficacy. Despite persisting for over 9 months in a nonlymphopenic environment, genetically modified T cells exhibited discordant retrovirally mediated gene expression in vivo not readily evident from initial in vitro assays. In particular, one of the two TCR subunit genes necessary for antigen specificity was selectively lost in vivo . As this discordant gene expression was associated with the loss of antitumor immunity, consideration of these findings may provide guidance in the design, evaluation and application of retroviral vectors for use in the treatment of cancer and other human disease.

Ben Tre, a Mekong Delta Province has dense canal networks with about 6,000km in total extension. There are more than 60 canals having over 50m of width. The river system plays the important role of Ben Tre, providing water for agriculture, drainage, navigation, fisheries and restoration in local area. Data for 44 sites from the main rivers and canals of Ben Tre were collected in April and October from 2015 to 2016 to analyze for pH, total suspended solid (TSS), dissolved oxygen (DO), biochemical oxygen demand (BOD5), chemical oxygen demand (COD), amoni (NH4+), phosphate (PO43-), and coliform. Then data were used for calculation and mapping. The ArcGIS 9.3 software, Inverse Distance Weighting (IDW) interpolation, and hydrologic variables in April and October from 2015 to 2016 were applied to build the maps of water quality for the Ben Tre. This result indicated that the water quality of many sites from the main rivers and canals of Ben Tre in April and October from 2015 to 2016 were polluted with TSS values at 75 − 304 mg/L, BOD5 from 7.0 − 25.0 mg/L; and coliform from 1.1 × 103 to 2.3 × 105 MPN/100 mL. Additionally, the results classified water quality of Ben Tre at 5 classes, as described by The Vietnam Environmental Protection Agency, good quality for water supply (1); use for water supply required appropriate treatment (2); usage for water use for irrigation (3); water use for navigation (4); and, heavy pollution (5). Last but not least, the wastewater control solutions for Ben Tre are also suggested. There were some the prior projects for environmental pollution control these have been implemented to improve the water quality for main river and canals in Ben Tre Province.

Landslide hazards are one of the most common geological disasters due to the impacts of natural factors, mainly rainfall, and human activities, such as the construction of transport infrastructure and mining projects. In Vietnam, most of the landslides and slippage frequently occur in mountainous areas, especially in Lao Cai province during the rainy season. In 2021, a slope failure happened near the Mong Hoa valley, on Road No. 152, sections Km 2+728.26–Km 2+827.04 in Cau May ward, Sapa town, Lao Cai province. In this study, topographical features, geomorphological features, hydrological features, geological investigation, and laboratory tests were performed to analyse the slope stability. This study used the Limit Equilibrium Method (LEM) and the Finite Element Method (FEM) to analyse the slope stability, and several countermeasures were proposed for this slope such as the retaining wall, ground anchors, and soil nails. This numerical result showed that the ground anchors and soil nails are the suitable method to prevent the instability of the slope. This study shows that compared with the traditional LEM method and advanced FEM method is that it can capture more results not only safety factor but also horizontal displacement and load anchor result. As a result, this analysis showed that the safety factor value in the finite element method was greater than that in the limit equilibrium method.

Background: It remains unclear which patients with melanoma will benefit most from lymphatic mapping and sentinel lymphadenectomy. The purpose of this study is to determine whether primary melanoma histopathologic features could be applied to predict sentinel node status. Methods: One hundred twelve patients underwent sentinel node biopsy between May 1995 and August 1999. Reported histologic features were assessed for predictive value by univariate and multivariate logistic regression. Results: The sentinel node was located successfully in 105 of the 112 patients (94%). Twenty-one of these 105 patients (20%) had sentinel nodes that were positive for metastatic disease. Multivariate analyses revealed that tumor thickness greater than 1.5 mm ( P = 0.01), ulceration ( P <0.01), and lymphovascular invasion ( P = 0.05) predicted the presence of micrometastases. Conclusions: The presence of unfavorable histopathology such as ulceration and lymphovascular invasion may identify a group of patients with thin melanomas who would benefit from sentinel lymphadenectomy.