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The cross-talk between immune cells and blood vessel endothelial cells promotes pericyte coverage and decreases hypoxia in mouse tumour models, and correlative evidence suggests that these processes influence cancer prognosis in humans. Normalizing tumour vasculature Tumours often develop with abnormal vasculature, characterized among other things by lower pericyte coverage of blood vessels, as well as leaky vessels that result in a hypoxic environment. Abnormal vessels limit immune infiltration and CD4 T cells can regulate angiogenesis. Using mouse models, the authors further dissect this crosstalk between immune cells and blood vessels in cancer, and describe a role for immune cells in normalizing the vasculature of tumours. The crosstalk between CD4 T cells and endothelial cells promotes pericyte coverage and decreases hypoxia, and correlative evidence suggests that these processes influence cancer prognosis in humans. The authors postulate that interventions that foster CD4 T-cell function, such as immune checkpoint blockade, also have a beneficial effect by normalizing the tumour vasculature. Blockade of angiogenesis can retard tumour growth, but may also paradoxically increase metastasis 1 , 2 . This paradox may be resolved by vessel normalization 3 , which involves increased pericyte coverage, improved tumour vessel perfusion, reduced vascular permeability, and consequently mitigated hypoxia 3 . Although these processes alter tumour progression, their regulation is poorly understood. Here we show that type 1 T helper (T H 1) cells play a crucial role in vessel normalization. Bioinformatic analyses revealed that gene expression features related to vessel normalization correlate with immunostimulatory pathways, especially T lymphocyte infiltration or activity. To delineate the causal relationship, we used various mouse models with vessel normalization or T lymphocyte deficiencies. Although disruption of vessel normalization reduced T lymphocyte infiltration as expected 4 , reciprocal depletion or inactivation of CD4 + T lymphocytes decreased vessel normalization, indicating a mutually regulatory loop. In addition, activation of CD4 + T lymphocytes by immune checkpoint blockade increased vessel normalization. T H 1 cells that secrete interferon-γ are a major population of cells associated with vessel normalization. Patient-derived xenograft tumours growing in immunodeficient mice exhibited enhanced hypoxia compared to the original tumours in immunocompetent humans, and hypoxia was reduced by adoptive T H 1 transfer. Our findings elucidate an unexpected role of T H 1 cells in vasculature and immune reprogramming. T H 1 cells may be a marker and a determinant of both immune checkpoint blockade and anti-angiogenesis efficacy.

Enterovirus-A71 (EV-A71) is a common cause of hand-foot-and-mouth disease (HFMD) and, rarely, causes severe neurological disease. This study aimed to elucidate the epidemiological and genetic characteristics and virulence of EV-A71 strains isolated from children diagnosed with HFMD. Rectal and throat swabs were collected from 488 children with HFMD in Hanoi, Vietnam, in 2015–2016. From 391 EV-positive patients, 15 EVs, including coxsackievirus A6 (CV-A6; 47.1%) and EV-A71 (32.5%, n = 127), were identified. Of the 127 EV-A71 strains, 117 (92.1%) were the B5 subgenotype and 10 (7.9%) were the C4 subgenotype. A whole-genome analysis of EV-A71 strains showed that seven of the eight C4a strains isolated in 2016 formed a new lineage, including two possible recombinants between EV-A71 C4 and CV-A8. The proportion of inpatients among C4-infected children was higher than among B5-infected children (80.0% vs. 27.4%; P = 0.002). The virulence of EV-A71 strains was examined in human scavenger receptor class B2 (hSCARB2)-transgenic mice, and EV-A71 C4 strains exhibited higher mortality than B5 strains (80.0% vs. 30.0%, P = 0.0001). Thus, a new EV-A71 C4a-lineage, including two possible recombinants between EV-A71 C4 and CV-A8, appeared in 2016 in Vietnam. The EV-A71 C4 subgenotype may be more virulent than the B5 subgenotype.

Lower respiratory tract infections are commonly caused by viruses and cause significant morbidity and mortality among children. Early identification of the pathological agent causing these infections is essential to avoid unnecessary antibiotic use and improve patient management. Multiplex PCR techniques were recently developed to detect multiple viral pathogens using a single PCR reaction. In this study, we identify viral pathogens in children with respiratory infections. We collected 194 nasopharyngeal aspirates from infants (2–24 months old) with lower respiratory tract infections treated at the Vietnam National Children’s Hospital between November 2014 and June 2015 and assessed the presence of 16 virus types and subtypes by multiplex PCR using the xTAG Respiratory Viral Panel (RVP) assay. Overall, 73.7% of the samples were positive for at least one virus, and 24.2% corresponded to infections with multiple viruses. The most common viruses were respiratory syncytial virus and enterovirus/rhinovirus. These viruses were more frequent among younger patients (2–5 months old) and caused symptoms similar to those of bronchiolitis and pneumonia. The most common clinical manifestation caused by respiratory tract infection was bronchiolitis. Elevated neutrophils levels were associated with adenovirus infection. Our results showed that the xTAG Respiratory Viral Panel (RVP) can effectively detect multiple viruses causing respiratory infections in children and that the nasopharyngeal aspirates are a good sample choice to detect respiratory viruses in children. Applying this approach in the clinical setting would improve patient management and allow early diagnosis, thus avoiding the unnecessary use of antibiotics.

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 Technology Acceptance Model (TAM) has lately been utilized in a number of studies to investigate why people reject or adopt new technologies like mobile commerce or e-learning. However, several studies have found weaknesses in TAM’s ability to predict consumers’ purchase intention behavior. To compensate for TAM’s weaknesses, this study presents a model that integrates all of TAM’s components with the Value-Based Adoption Model (VAM). The perceived benefits and sacrifices were considered to provide a list of the implications for both researchers and e-learning service providers. Furthermore, the moderating role of e-word of mouth was utilized to examine the relationship between attitude, intention, perceived value, and intention toward e-learning, in order to match the current circumstances with the growing popularity of social networks. This study was conducted with a quantitative analysis by using data collected from survey 417 e-learning consumers. Except for perceived fee, which has a negative effect on perceived value, the results demonstrate that all hypotheses of latent correlations in TAM and VAM were strongly significant. Furthermore, attitude and perceived value have a significant role in determining consumer adoption of e-learning. Consumers’ perceived value will be driven by the high and low levels of the moderating influence of e-word of mouth, influencing their intention toward e-learning. Since e-learning is an effective sustainable education system, the result of this study can provide a good solution to facilitate e-learning in current and future conditions.

Logistics services aid import and export businesses located near ports in terms of ease and efficiency in the globalization era. Furthermore, economic growth and global import–export volumes immediately impact the port industry. This research aims to develop a two-stage Data Envelopment Analysis (DEA) model for measuring the performance efficiency of Vietnam’s top 18 seaports. The DEA resampling technique is used to forecast future performance, and the DEA Malmquist model analyzes efficiency improvement. First, the forecast data for the next three years, from 2021 to 2023, were obtained by resampling Lucas weight prediction with the highest accuracy. The results indicate that 12 out of all ports achieved an average progressive production efficiency over the entire study period of 2018–2023. Further, most ports have advanced slightly in technological efficiency, indicating that the determinants of increased productivity are the technical efficiency change indexes. This work contributes to the body of knowledge by being the first to apply the resampling technique in conjunction with the Malmquist model to forecast performance efficiency in the domain of the seaport sector. Furthermore, the managerial implications serve as a beneficial reference for operation managers, policymakers, and researchers when comparing the operational efficacy of seaports to diverse logistical scenarios.

Strict regulation of proliferation is vital for development, whereas unregulated cell proliferation is a fundamental characteristic of cancer. The polarity protein atypical protein kinase C lambda/iota (aPKCλ) is associated with cell proliferation through unknown mechanisms. In endothelial cells, suppression of aPKCλ impairs proliferation despite hyperactivated mitogenic signaling. Here we show that aPKCλ phosphorylates the DNA binding domain of forkhead box O1 (FoxO1) transcription factor, a gatekeeper of endothelial growth. Although mitogenic signaling excludes FoxO1 from the nucleus, consequently increasing c-Myc abundance and proliferation, aPKCλ controls c-Myc expression via FoxO1/miR-34c signaling without affecting its localization. We find this pathway is strongly activated in the malignant vascular sarcoma, angiosarcoma, and aPKC inhibition reduces c-Myc expression and proliferation of angiosarcoma cells. Moreover, FoxO1 phosphorylation at Ser218 and aPKC expression correlates with poor patient prognosis. Our findings may provide a potential therapeutic strategy for treatment of malignant cancers, like angiosarcoma. The cell polarity regulator aPKC is associated with cell proliferation but the precise mechanism are unknown. Here, the authors find that aPKC lambda phosphorylates the FoxO1 transcription factor, a gatekeeper of endothelial growth, during both angiogenesis and angiosarcomas.

Maritime transport, which includes shipping and port operations, is the fundamental basis of international trade and globalization. In transportation management, efficiency is critical for verifying performance and proposing the best countermeasure to meet predetermined goals. Various efforts in this field have been made to solve this problem satisfactorily. However, the significant proportion of conventional approaches are based on long-term observations and professional expertise, with only a few exceptions based on practice-based historical data. Data Envelopment Analysis (DEA) is a non-parametric technique for analyzing various output and input variables parallelly. The efficiency of maritime transport in European countries is explored using a two-stage DEA approach based on Malmquist and Epsilon-Based Measure (EBM). First, the Malmquist model analyses countries’ total productivity growth rates and their breakdown into technical efficiency (catch-up) and technology change (frontier-shift). Second, the EBM model is used to determine the efficiency and inefficiency of the maritime transportation systems in each European country. Apart from identifying the best-performing countries in specific areas over the study period (2016–2019), the results highlight that the gap in applying the EBM method to maritime transport has been successfully closed and that the emerging paradigm, when combined with the Malmquist model, can be a sustainable and appropriate evaluation model for other research areas.

Sport events of various scales are becoming increasingly popular in modern society, attracting diverse audiences and offering significant entertainment value. This study aims to explore the factors that influence spectators’ intention to attend the stadium, by extending theory of planned behavior model from the perspective of perceived value. Using a quantitative research approach, the study involved a sample size of 334 spectators surveyed from the 2023 Vietnam Student Football Championship and utilized Smart PLS version 4.0 for data analysis. The results indicated that perceived enjoyment significantly affects both attitude (β = 0.358, p = 0.000) and perceived value (β = 0.712, p = 0.000). Perceived fee negatively affects attitude (β = –0.084, p = 0.025) and perceived value (β = –0.068, p = 0.047). Perceived risk negatively affects attitude (β = –0.130, p = 0.001) but does not significantly affect perceived value. Attitude positively influences intention (β = 0.227, p = 0.000), and perceived value significantly influences both attitude (β = 0.293, p = 0.000) and intention (β = 0.437, p = 0.000). Team identification moderates the relationship between attitude and intention (β = 0.128, p = 0.010). The findings highlight the importance of enhancing perceived value to positively shape spectators’ attitude and intention, thereby increasing attendance at sport events.