Khanh Hoa General Hospital

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.

Public WiFi networks deployed across high-density transit environments — such as train stations, bus terminals, and airports — present a largely unaddressed frontier in network intrusion detection research. These venues collectively serve tens of millions of users monthly yet exhibit extreme traffic heterogeneity, continuous attack pattern drift, and strict data privacy constraints that preclude centralized detection paradigms. Existing federated learning-based intrusion detection systems (FL-IDS) fail to simultaneously address the spatiotemporal dynamics of evolving network topologies, the interpretability requirements of operational security teams, the concept drift inherent to live deployments, and the fairness disparities that arise across heterogeneous venue types. We propose ST-FedXIDS, a Spatiotemporal Federated Explainable Intrusion Detection System that unifies five technical contributions: (1) a heterogeneous dynamic graph construction pipeline that models multi-protocol WiFi traffic as sliding temporal-window graphs; (2) ST-GraphSAGE with multi-head temporal self-attention, replacing the LSTM/GRU paradigm used in all prior spatiotemporal GNN-IDS works; (3) Drift-Adaptive Federated Averaging (DA-FedAvg) that embeds ADWIN-based graph embedding drift detection directly into the federated aggregation protocol; (4) a GNN-Explainer module that produces subgraph-level attack attribution explanations for operational incident response; and (5) a venue-type fairness regularizer that minimizes the maximum inter-venue false positive rate gap across heterogeneous deployment sites. Extensive experiments on three public benchmarks — CSE-CIC-IDS2018, TON_IoT, and UNSW-NB15 — against four 2025 state-of-the-art baselines demonstrate that ST-FedXIDS achieves 98.21%–99.13% accuracy, outperforming all competitors by 0.9–2.4 percentage points, reduces the inter-venue FPR gap from 8.5–12.3% to 2.1%, and recovers from concept drift in 8 federation rounds versus 19–25 rounds for competing methods. An ablation study validates the independent contribution of each component.

Mục tiêu: Báo cáo một trường hợp thai ngoài tử cung hai bên (Bilateral ectopic pregnancy - BTP) hiếm gặp ở bệnh nhân tiến hành thụ tinh ống nghiệm (IVF). Phương pháp: Mô tả ca bệnh hiếm gặp. Kết quả: Bệnh nhân vô sinh do yếu tố nam giới, chuyển phôi trữ lạnh. Ngày thứ 20 sau chuyển phôi bệnh nhân vào viện vì đau bụng và ra máu âm đạo, β-hCG huyết thanh là 5.897 mIU/ml, siêu âm đầu dò âm đạo không phát hiện túi thai trong buồng tử cung, theo dõi 02 khối bát thường cạnh hai bên buồng trứng. Phẫu thuật nội soi thấy khối chửa ở 2 vòi tử cung, tiến hành cắt cả 2 vòi tử cung. Kết luận: Thai ngoài tử cung hai bên là biến chứng sản khoa cực kỳ hiếm gặp ở bệnh nhân có đau bụng và ra máu âm đạo bất thường sau IVF.

This study aims to describe the feasibility of inserting an oblique lumbar interbody fusion (OLIF) cage through biportal endoscopic lumbar interbody fusion (BE-LIF) and to illustrate the key surgical steps through a case-based video demonstration. BE-LIF is a safe and effective minimally invasive fusion technique. Among the factors influencing successful fusion, the cage footprint plays a critical role—a larger cage increases endplate contact area, maintains disc height, and enhances segmental stability. The OLIF cage offers these biomechanical advantages; however, inserting it through a biportal endoscopic approach is technically demanding and requires several strategic considerations. These include meticulous preoperative planning of portal positions to optimize visualization and working angles, adequate preparation of the disc space window for cage insertion, precise endplate preparation, and safe neural manipulation within a confined surgical field. A 56-year-old female presented with chronic low back pain and bilateral leg symptoms unresponsive to conservative treatment. Imaging revealed severe L4–5 central canal stenosis, foraminal narrowing, and instability. She underwent BE-LIF with OLIF cage insertion and percutaneous pedicle screw fixation. The step-by-step surgical video demonstrates portal placement, decompression, endplate preparation, bone grafting, and cage insertion under combined endoscopic and fluoroscopic guidance. The operation lasted 180 minutes, with an estimated blood loss of 150 mL. The patient was mobilized on postoperative day 1 and discharged on day 5 with marked improvement. Follow-up radiographs confirmed restoration of disc height, correct cage positioning, and adequate decompression. This case demonstrates that BE-LIF with OLIF cage insertion is feasible and may enhance fusion potential by combining the minimally invasive benefits of biportal endoscopy with the biomechanical advantages of a large-footprint cage. However, the procedure remains technically demanding and is best suited for experienced endoscopic spine surgeons.

The time limits for disciplining officials and public servants are an important aspect of the laws governing these individuals. In practice, whenever there are adjustments to the laws concerning officials and public servants, the time limits for disciplinary actions are also subject to change. This article analyzes the recent changes in these regulations, highlights the existing limitations and shortcomings, and provides several recommendations for improvement.

Cây Bạc hà (Mentha piperita L.) là loại cây thân thảo thuộc chi Mentha và họ Lamiaceae. Tinh dầu bạc hà được sử dụng trong công nghệ dược phẩm, mỹ phẩm và hương liệu. Nhằm đánh giá khả năng sinh trưởng và chất lượng tinh dầu bạc hà trồng trong nhà màng tại TP. Hồ Chí Minh, thí nghiệm hai yếu tố được bố trí theo kiểu khối hoàn toàn ngẫu nhiên (RCBD), trong đó, yếu tố C là số lần thu hái, yếu tố M là mật độ. Kết quả nghiên cứu cho thấy mật độ trồng 25 cây/m2 (20 cm × 20 cm) cho kết quả tốt nhất, khi thu hoạch lần 1 cây đạt 467,2 lá, năng suất tươi đạt 3.492,3 kg/ha, thành phần tinh dầu có Menthol (83,3%), Pulegone (7,2%), Isomenthone (6,4%), khi thu hoạch lần 2 cây đạt 365,4 lá, năng suất tươi đạt 3.314,8 kg/ha, thành phần tinh dầu có Menthol (83,7%), Pulegone (6,8%), Isomenthone (4,7%).

Trong bài này, vi điểu khiển ESP8266 được dùng để điều khiển cửa cuốn bằng ứng dụng Blynk và bằng nút nhấn cơ. Chương trình điều khiển được lập trình trên phần mềm mã nguồn mở Arduino IDE, có tích hợp chức năng tự động mở cửa cuốn khi cảm biến khí gas nhận được nồng độ định trước. Kết quả nghiên cứu là tạo ra bộ điều khiển cửa cuốn thay thế bộ điều khiển cơ được sử dụng trong các hộ gia đình hiện nay.

Morphological assessment is still the gold standard for embryo selection. Artificial Intelligence (AI) has been developed for embryo selection. However, AI is still a complementary method of supporting humans. This study aims to investigate a combination of the Early Embryo Viability Assessment (EEVA) AI and blastocyst morphological assessment as a predictor of pregnancy outcomes of single vitrified-warmed blastocyst transfer. The retrospective cohort study was conducted in a single center from 2020 to 2023 and included 511 single vitrified-warmed blastocyst transfer cycles. Blastocyst transfer quality was based on morphology. Embryos on Day 3 were evaluated using the EEVA system. The correlation between the EEVA system alone, blastocyst morphological assessment alone or a combination of the EEVA system and blastocyst morphological assessment, and pregnancy outcomes was qualified by GEEs. Comparison of 3 methods to evaluate the results of predicting pregnancy outcomes using the area under the curve (AUC): performed on the prediction probability scale of the model rule. The GEE model using the EEVA system showed a negative association between higher EEVA scores and the likelihood of achieving pregnancy outcomes. Embryos with the highest EEVA score (EEVA 5) have substantially lower odds of achieving successful implantation and ongoing pregnancy compared with those with the lowest score (EEVA 1). The OR of Score 5 vs 1 was 0.282 (95% CI 0.125–0.636, p < 0.001) for implantation and 0.228 (95% CI 0.092-0.563, p < 0.001) for ongoing pregnancy. The AUC of the GEE model using the EEVA system for implantation and ongoing pregnancy potential was 0.651 and 0.655, respectively. The AUC of the GEE model using the blastocyst morphological assessment for implantation and ongoing pregnancy potential was 0.703 and 0.700, respectively. The AUC of the GEE model combining both systems for implantation and ongoing pregnancy potential was 0.730 and 0.726. The differences were statistically significant (p < 0.001). The EEVA system can predict the success rates, especially when combining EEVA with blastocyst morphological assessment in blastocyst selection for transfer.

Professional development of nurses plays a crucial role in improving the quality of nursing services. The implementation of continuing competency development programs has not been optimal due to the absence of structured guidelines and programs at Hospital This lack of structure results in low consistency and uniformity in program implementation across nursing units. This study aims to develop a structured and sustainable professional development guideline and program for nurses that can serve as a reference for systematic and targeted implementation within the hospital environment. The study was conducted through a nursing management residency program held from May 27 to June 30, 2025. Data were collected through interviews, observations, and questionnaires distributed to nursing staff and nursing leadership. The questionnaire used the Q-PDN to measure various aspects of Continuing Professional Development (CPD) among nurses, with a Cronbach’s alpha reliability value of 0.89. Data analysis involved the Ishikawa diagram approach, SWOT analysis, and problem prioritization using the USG method. The analysis identified the absence of CPD guidelines and programs as the main problem, with the highest priority score. A draft guideline and CPD program were developed, covering staffing standards, facilities, implementation procedures, quality control, reporting, and follow-up mechanisms. Initial evaluation showed that 91% of stakeholders had a strong understanding of the document and provided positive feedback on its usefulness. The development of CPD guidelines and programs is a strategic step to strengthen the implementation of continuous professional development for nurses.