Hai phong University Of Medicine and Pharmacy

This study aimed to assess the lasting effects of early-life dioxin exposure via breastfeeding on the endocrine and reproductive health of children at 14years of age, continuing a Vietnamese longitudinal cohort started in 2008. The participants were 68 mother-child pairs (38 from a dioxin hotspot and 30 from a non-exposure area). Serum steroid hormones in adolescents were quantified by liquid chromatography-tandem mass spectrometry and linked to their mother's breast milk dioxin congener levels collected within 4-16weeks postpartum. Secondary sexual characteristics in girls and testicular volume in boys were clinically assessed. The results showed sex-specific differences. In girls from the hotspot, body weight and head circumference were significantly lower than those in the non-exposure area and showed negative correlations with specific dioxin congeners and steroid hormones. Hormonal analysis revealed significantly lower levels of estrone and estradiol, but higher cortisol levels, in both exposed genders. Estrone and estradiol displayed negative correlations with dioxins, stronger in girls. Conversely, cortisol showed positive correlations with most dioxin congeners and total toxic equivalents (TEQs) in boys only. Additionally, allopregnanolone levels were higher and positively correlated with dioxin in boys, while androstenedione and androstanediol were significantly lower in hotspot girls. Notably, testicular volume in boys did not differ or correlate with dioxin exposure. In conclusion, lactational dioxin exposure might associated with long-term, sex-specific disruption of steroid hormone homeostasis and impaired physical growth during puberty, particularly in girls.

Objective Human provocation models are widely used to investigate migraine mechanisms and validate therapeutic targets. Despite well-known sex differences in migraine, concerns persist regarding sex representation and reporting in experimental research. This systematic review evaluated sex distribution, sex-specific analyses, and the consideration of female-specific biological factors in randomized, placebo-controlled migraine provocation studies. Methods PubMed and Embase were systematically searched for randomized, placebo-controlled provocation studies in adults with migraine, following PRISMA 2020 guidelines. Data were extracted on participant sex distribution, sex-stratified outcome reporting, and consideration of female-specific variables, including menstrual cycle, hormonal contraception, and pregnancy status. Results Fifty-eight studies published between 1972 and 2025 were included. Women represented 82% of participants, while men accounted for 18%. No study performed sex-stratified analyses of provoked headache or migraine outcomes. Sex was rarely discussed as a biological variable or limitation. Female-specific factors were largely overlooked, with menstrual cycle phase unreported in over 90% of studies and inconsistent reporting of hormonal contraception and pregnancy status. Conclusions Migraine provocation studies show marked sex imbalance and a systematic lack of sex-disaggregated analyses. Although these models have demonstrated substantial translational relevance, particularly in supporting the development of anti-CGRP therapies, the absence of sex-disaggregated analyses and limited consideration of biological sex constrain the assessment of translational applicability across sexes.

Abstract This study evaluates metal-free lignin-derived activated carbons (L-ACs) as a processing aid to reduce fluoroquinolone residues in milk without compromising product quality. Two carbons prepared via K 2 CO 3 (L-AC-K 2 CO 3 -1.0) or KOH (L-AC-KOH-2.0) activation were characterised; the KOH sample showed higher surface area and microporosity ( S BET 1,480 m 2 g −1 ; V mic 0.62 cm 3 g −1 ) than the K 2 CO 3 analogue (1,120 m 2 g −1 ; 0.48 cm 3 g −1 ). In buffer, Langmuir fits yielded q max (mg g −1 ) of 182/156 for ciprofloxacin/ofloxacin on L-AC-KOH-2.0 and 135/118 on L-AC-K 2 CO 3 -1.0; pseudo-second-order kinetics indicated rapid uptake. In milk (0.5 g L −1 , 30 min), removals reached 76/71% in raw and 84/79% in skim matrices (CIP/OFL). In a minicolumn (EBCT ≈30 s), breakthrough occurred at ∼4 × 10 2 bed volumes at C / C 0 = 0.1. Post-treatment quality shifts were small (Δfat/protein/lactose ≤0.05%, ΔpH ∼0.01, ΔE* ∼0.3–0.7). Ethanol (70%) regeneration preserved >90% capacity over five cycles. These results highlight L-ACs as practical, food-compatible sorbents for antibiotic mitigation in dairy processing.

BackgroundChronic pain is a common and burdensome condition among older adults, significantly impacting their quality of life and increasing interest in complementary and alternative medicine (CAM) approaches to pain management.ObjectivesThis study aimed to describe the prevalence of CAM use and attitudes toward CAM for self-managing chronic pain among older adults, and to examine the associations between chronic pain characteristics, CAM use, and attitudes toward CAM.MethodsA cross-sectional study was conducted among 289 hospitalized patients aged ≥60 years with chronic pain at a general hospital in Da Nang, Vietnam, in 2025. Data were collected using a structured questionnaire that included the Pain Disability Index (PDI) and the Attitudes towards CAM scale. Statistical analyses included t-tests, ANOVA, chi-square tests, and Pearson’s correlation.ResultsCAM use was reported by 92.7% of participants, with biologically based therapies (e.g., herbal remedies) being the most common (81.3%). The average attitude score toward CAM was 28.7 (SD = 3.2), indicating generally favorable views. CAM use was more frequently reported among participants experiencing pain in specific anatomical locations, including the arm/hand, neck, upper back, and lower back (all p <0.008 after Bonferroni correction). Attitudes toward CAM were modestly associated with perceived pain control ability (p = 0.031) and with the impact of chronic pain on daily life (r = 0.206; p <0.001), while other pain characteristics showed no significant associations.ConclusionCAM is widely used and positively perceived among older Vietnamese adults with chronic pain. Associations were observed between certain pain characteristics and CAM use, as well as between pain-related interference and attitudes toward CAM. These findings highlight the importance of routinely assessing CAM use in older adults and providing guidance on safe, evidence-based options within comprehensive pain management, while recognizing the observational nature of the data.

Obstructive sleep apnea (OSA) is increasingly recognized as a major comorbidity in chronic respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD). The coexistence of OSA with asthma or COPD significantly complicates the clinical course, leading to poorer disease control, more frequent exacerbations, reduced lung function, impaired sleep quality, and increased cardiovascular and overall mortality. In asthma, OSA exacerbates airway inflammation, enhances bronchial hyperresponsiveness, and decreases responsiveness to standard therapies. In COPD, the “overlap syndrome” is associated with profound nocturnal hypoxemia, chronic hypercapnia, pulmonary hypertension, and a markedly elevated risk of hospitalization and death. Underlying mechanisms include chronic airway inflammation, oxidative stress induced by intermittent hypoxia, instability of ventilatory control (high loop gain), structural upper-airway alterations, and the burden of obesity and metabolic dysfunction. These interactions highlight the urgent need for integrated and proactive management strategies. Thus, we propose an Asthma–COPD–OSA Outpatient Unit (ACOSOU)—a care-delivery model, not a disease entity—designed to integrate systematic screening, diagnosis, treatment initiation, and long-term follow-up of OSA in patients with asthma and COPD. Optimal care requires systematic screening in respiratory outpatient settings, appropriate diagnostic pathways using polysomnography or home sleep apnea testing, and individualized treatment approaches. Continuous positive airway pressure (CPAP) remains the cornerstone therapy for OSA–asthma and OSA–COPD overlap, improving gas exchange, reducing exacerbations, and enhancing disease control. Comprehensive management also includes optimization of inhaled therapies, pulmonary rehabilitation, weight reduction, sleep hygiene, and multidisciplinary collaboration. This review proposes an integrated ACOSOU model to streamline screening, diagnosis, CPAP titration, and long-term follow-up. However, implementation in low- and middle-income countries faces challenges including limited trained sleep-medicine personnel, unequal access to diagnostic tools, and high CPAP costs without insurance coverage. Strengthening infrastructure, training, and policy support will be essential to improve outcomes for patients with chronic respiratory diseases and OSA comorbidity.

Purpose To detect academic misconduct in students' assessment score trajectories under severe class imbalance. The paper compares tabular learners, gradient-boosting models, and sequence-aware deep networks, and proposes a precision–recall–centric evaluation and deployment protocol (calibration, threshold selection and Recall@Top-k%) tailored to rare-event screening in educational settings. Design/methodology/approach A cohort of 1,527 students (2021–2024) is modeled using ten algorithms: LR, DT, RF, SVM, MLP, XGBoost, CatBoost, LightGBM, GRU-RNN and 1D-CNN. Features encode sequential score dynamics and metadata. Models are tuned via cross-validation; probabilities are calibrated (Platt/Isotonic); operating thresholds are chosen on validation to maximize minority-class F1 or a cost-sensitive utility. Performance is assessed on a hold-out test set with PR-AUC (headline), F1(+), Recall@Top-k%, ROC-AUC, calibration curves, Brier, and bootstrap CIs. Findings Sequence-aware models dominate: GRU-RNN and 1D-CNN achieve ROC-AUC ˜0.97–0.98 and the highest F1(+) and Recall@Top-5%. Tabular/boosting baselines show ˜0.90 accuracy yet miss most positives at the default 0.5 threshold, highlighting the necessity of calibration and threshold optimization. With PR-centric selection and tuned operating points, deep temporal models yield strong screening utility for limited human review budgets. Research limitations/implications Labels reflect suspected–not adjudicated–cheating, introducing noise. The single-institution cohort may limit external validity; temporal shift across semesters can degrade performance. Future work should include multi-site evaluation, collusion/graph modeling, semi-/weak-supervision for noisy labels and governance topics (fairness audits, drift monitoring and uncertainty reporting). Practical implications This study highlights how educational institutions can leverage machine learning for early detection of academic dishonesty based on historical performance data. CNN and RNN models are promising tools for identifying anomalous learning patterns. However, practical deployment requires preprocessing techniques to manage class imbalance and threshold optimization to reduce false negatives. The findings provide a roadmap for building automated cheating detection systems in both online and traditional assessment environments. Social implications By improving the ability to detect cheating, this research contributes to fairer academic environments, upholding educational integrity and credibility of credentials. However, ethical considerations must be taken into account to avoid false accusations and ensure student rights. Human-in-the-loop systems are crucial for verifying algorithmic predictions before disciplinary action, thereby fostering transparency and accountability in automated decision-making processes. Originality/value The study unifies a minority-focused evaluation protocol with a comprehensive comparison of tabular, boosting, and sequence-aware models for cheating detection from score trajectories. It demonstrates the decisive value of temporal representation learning and provides a reproducible pipeline and operational metrics that align model performance with real investigative workflows.

To investigate the association between tumor morphology and muscle-invasive bladder cancer (MIBC) in patients with newly diagnosed bladder cancer (BC). This retrospective study included 416 patients who underwent transurethral resection of a bladder tumor for newly diagnosed BC between January 2018 and December 2023 at a tertiary hospital in Vietnam. Multivariable logistic regression analysis was applied to assess the adjusted association between the sessile morphology of BC on cystoscopy and the risk of muscle invasion. Age, sex, tumor size, number of tumors, and pathological grade were considered confounders. Stratified analysis by tumor size and number of tumors was performed to clarify the effect modification. Patients with MIBC had a significantly higher prevalence of sessile morphology (68.8% vs. 28.4%, p<0.001). After controlling for confounders, patients with sessile tumors were three times more likely to have MIBC than those with papillary tumors (OR = 3.1, 95% CI = [1.8-5.3], p < 0.001). The association of sessile tumor with MIBC was higher in patients with tumor ≤3 cm (about 25%, OR = 3.9, 95% CI = [1.9-7.8]) and having >3 tumors (about 64%, OR = 5.1, 95% CI = [2.1-12.4]). Sessile morphology is associated with the risk of MIBC in patients newly diagnosed with BC. This association was more pronounced in patients with tumor ≤3 cm and >3 tumors.

<title>Abstract</title> This study aimed to quantify the biomechanical effects of varying extents of facet joint resection during cervical foraminotomy using finite element analysis (FEA), and to compare outcomes under open versus minimally invasive surgical conditions. A validated cervical spine model (C3–C6) was used to simulate unilateral foraminotomy at C4–C5 with progressive left facet joint resection from 0% to 100% in 12.5% increments. Biomechanical parameters, including range of motion (ROM), intradiscal pressure (IDP), and annular peak von Mises stress (PVMS), were analyzed to evaluate spinal stability and degeneration risk. Resection beyond 62.5% resulted in marked increases in ROM (2–18% in left lateral bending, 6–26% in right axial rotation). IDP rose by up to 23% in left lateral bending and 38% in right axial rotation at ≥ 87.5% resection, while PVMS increased sharply in right axial rotation and moderately in extension beyond 50%. These findings identify 62.5% as a critical instability threshold. While our current analysis focused on osseoligamentous structures, future work will incorporate the effects of paraspinal musculature to better reflect minimally invasive surgical conditions. Our results provide quantitative evidence to guide surgical decision-making in balancing adequate decompression with the preservation of cervical stability.

Older adults receiving home care often face complex decisions. This study explored how home care nurses in South Korea perceive these decisions and their involvement in shared decision-making (SDM), aiming to inform better support strategies for both clients and care providers. A cross-sectional study was conducted with 154 home care nurses between August and September 2023. Descriptive statistics, ANOVA, Pearson correlation and multiple linear regression analyses were used, with significance set at p < 0.05. Nurses identified 'whether to stay at home or move' as the most difficult decision faced by older adults. Although nurses reported a moderate-to-high level of self-perceived SDM involvement (3.73 ± 0.80), they were less involved than family caregivers. Factors significantly predicting higher SDM involvement included job field (β = 0.31, p < .001), duration of home care experience (β = 0.17, p = .04) and the frequency of decisions encountered by older adults (β = 0.27, p < 0.001). Results highlighted the need for support for nurses to address the difficulties faced by older adults in making healthcare-related decisions about their place of residence and indicated comparable involvement in SDM between nurses working in long-term care centres and hospital home visiting centres.