Ho Chi Minh City Medicine and Pharmacy University

BackgroundExtensive evidence links air pollution exposure to cognitive decline; however, it remains unclear whether cognitive reserve and brain reserve modify this association. We examined the moderating roles of cognitive reserve contributors and brain reserve in the association between air pollution and cognitive function in dementia-free adults.MethodsCross-sectional data were obtained from 650 participants who underwent 3T brain magnetic resonance imaging and completed the Montreal Cognitive Assessment (MoCA). Cognitive reserve contributors were assessed based on education, occupation, and social engagement. Brain reserve was quantified using the ventricle-to-brain ratio derived from brain scans. Five-year average concentrations of particulate matter with diameters ≤10 and ≤2.5 μm and nitrogen dioxide were estimated based on residential addresses. Partial least squares structural equation modeling was applied to construct latent variables representing the air pollution mixture and composite cognitive reserve (contributors). Analyses examined whether cognitive reserve contributors and brain reserve modified associations of air pollution with MoCA scores and suspected mild cognitive impairment.ResultsIn individuals with an average level of cognitive reserve, a 1–standard deviation increase in air pollution mixture was associated with a 0.24-point decrease in MoCA scores (95% confidence interval [CI]: −0.31 to −0.16). This association was attenuated in individuals with higher cognitive reserve (β = −0.12; 95% CI: −0.25 to 0.02) and intensified in those with lower cognitive reserve (β = −0.36; 95% CI: −0.37 to −0.35). The moderating effect of brain reserve was not significant.ConclusionsHigher cognitive reserve may mitigate the effects of air pollution on cognitive function.

Dysphagia is a prevalent and debilitating sequela in patients with oral cavity and oropharyngeal cancers undergoing surgery, often complicated by adjuvant radiotherapy or chemoradiotherapy. This prospective cohort study aimed to describe the longitudinal changes in swallowing and oral intake and assess the influence of adjuvant treatment modalities. We included 89 patients with oral cavity or oropharyngeal squamous cell carcinoma. Swallowing was assessed at 1, 3, and 6 months post-surgery using Eating Assessment Tool-10 (EAT-10), Swallowing Ability and Safety Scale (SASS), Functional Oral Intake Scale (FOIS), and Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Patients were stratified by adjuvant treatment: none, radiotherapy, or chemoradiotherapy. Swallowing recovery was dynamic. EAT-10 scores increased from 8.8 at 1 month to peak at 13.5 at 3 months (p < 0.001), before decreasing to 8.3 at 6 months (p < 0.001). Penetration/aspiration for thin liquids significantly increased from 32.6% at 1 month to 44.9% at 3 months (p = 0.034), then decreased to 31.5% at 6 months (p = 0.014). FOIS and SASS scores showed overall improvement from 1 to 6 months (p < 0.001 for both), despite a transient dip in FOIS and a rise in poor SASS scores at 3 months. Patients receiving chemoradiotherapy demonstrated greater perceived dysphagia, lower functional oral intake, and higher rates of thin liquid penetration/aspiration compared to other groups across all time points. In conclusion, chemoradiotherapy is associated with more severe and prolonged dysphagia. These findings underscore the critical need for targeted rehabilitation and comprehensive multidisciplinary care.

Twenty-two new monoterpene-coumarins, comprising the initial disclosure of 11 enantiomeric pairings, were isolated from the rhizomes of Luvunga scandens with the aid of LC-MS/MS based on molecular networking. Luvunscandins A-G (1-7) are dihydrofurancoumarins with a furan ring connection, and luvunscandins H-K (8-11) are dihydrofurancoumarins connected through a pyran ring. Chemical structures and absolute configurations were determined by analysis of spectroscopic data and X-ray diffraction analysis. The neuroprotective effects of all the isolates on LPS-stimulated NO production in BV2 microglia were evaluated. Compounds 6a, 7a, 7b, 8b, 9a, 9b, 11a, and 11b demonstrated more potent inhibitory effects than the positive control PDTC. Structural-activity relationship analysis revealed that neuroprotective activity was primarily associated with pyran-type dihydrofurancoumarins or compounds bearing a C3'R,6'R configuration, whereas furan-type analogs or compounds with a C3'S,6'S configuration exhibited weak or no activity. (+)-Luvunscandin I (9a) showed the most significant inhibitory activity (IC50 = 4.9 ± 0.6 μg/mL) through suppression of the inflammatory transcription factors p65NF-κB and iNOS.

This paradox emphasizes the urgent need to re-engineer transplant systems around pediatric-adult split liver transplantation (SLT). Despite being as effective as whole-liver transplants, SLT remains underutilized due to logistical and policy barriers. We believe that expanding SLT is not only clinically acceptable but a just and effective moral necessity. We propose a five-point action plan, including centralized splitting hubs, NMP-enabled transport, and global pilot programs, to transform SLT from an exception into standard practice.

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.

Adolescents frequently experience symptoms of mental disorders (SOMD) and engage in health risk behaviors (HRB), both of which significantly contribute to global disability and mortality. Despite this, data on these issues remain limited in low- and middle-income countries (LMICs), including Vietnam. This study aims to estimate the prevalence of SOMD and HRB and examine their associations among high school students in Vietnam. A cross-sectional survey was conducted with 3,025 students from four high schools and four continuing education centers across Ho Chi Minh City. Participants completed a self-administered questionnaire capturing demographic information, HRB (using the YBRS scale), and SOMD (using the DASS-21 screening scale). SOMD assessments focused on symptoms of depression, anxiety, and stress rather than clinical diagnoses, while HRB covered substance use, risk-taking, physical fighting, suicidal ideation, unsafe sexual behaviors, unhealthy diet, physical inactivity, and sleep deprivation. Of the 2,631 students included in the analysis, prevalence rates were 42.6% for symptoms of depression, 50.3% for symptoms of anxiety, and 31.1% for symptoms of stress. Engagement in HRB varied widely, from 4.0% for unsafe sexual behaviors to 79.9% for physical inactivity, with 91.6% reporting involvement in multiple HRB. Students experiencing SOMD were significantly more likely to engage in HRB compared to those without SOMD, with odds ratios ranging from 1.24 to 4.64. SOMD and HRB represent dual and interrelated challenges among Vietnamese adolescents, underscored by their high prevalence. These findings emphasize the critical need for integrated interventions addressing both mental health symptoms and health risk behaviors, especially in resource-constrained LMIC settings.

Cancer remains a global health challenge, with conventional treatments limited by toxicity and drug resistance. Propolis, a natural resin with promising anticancer properties but restricted in clinical applications due to low bioavailability and poor solubility. Nanotechnology, offers a potential approach to enhance propolis' therapeutic efficacy through more efficient delivery and improved pharmacokinetics. Propolis-loaded niosomes (PLNs) were prepared using the ethanol injection method, optimized using response surface methodology (RSM) for surfactant type (Tween 80), cholesterol-to-surfactant ratio, and propolis content. Physicochemical properties, including particle size, polydispersity index (PDI), and zeta potential were characterized. Stability was assessed under various storage conditions, and total polyphenol content (TPC) and entrapment efficiency (EE%) were determined. Anticancer activity wasin vitroassessed against MCF7 breast cancer and L929 fibroblast cell lines. The optimized PLN formulation (at a mass ratio 4:1:8 of propolis: cholesterol: Tween 80, respectively) achieved a particle size of 193.5 nm, PDI of 0.123, and zeta potential of -19.6 mV, with a TPC of 21.83 mg GAE g-1and EE% of 57.82%. Stability studies confirmed optimized formulation's robustness at 4 °C, with minimal changes over 42 d, though higher temperatures induced aggregation. PLNs exhibited superior cytotoxicity against MCF7 cells inhibitory concentration (IC50equivalent to 106.85 µg ml-1) compared to L929 cells (IC50equivalent to 127.14 µg ml-1). The formulation's uniformity and moderate stability support its potential for targeted drug delivery. PLNs effectively enhance propolis' anticancer efficacy and bioavailability, offering a promising delivery system for cancer therapy. Future studies should focus on improving zeta potential,in vivovalidation, and encapsulation efficiency to advance clinical translation.