BACKGROUND:The Transverse Preputial Onlay Island Flap (TPOIF) technique is frequently used in cases with mild chordee and small glans. This study's objective was to evaluate the surgical outcomes of this technique at our center. MATERIALS AND METHODS:This study consisted of hypospadias patients diagnosed with small glans (diameter <14 mm) and mild chordee (<30°), underwent TPOIF urethroplasty. RESULTS:A total of 64 cases were included in this study. The mean glans diameter was 10.6 mm. The complication rate was 9.4 %. CONCLUSIONS:The TPOIF technique provides encouraging results for treating hypospadias with small glans, though larger studies are needed.
BACKGROUND:Gestational diabetes mellitus (GDM) affects 15.6% of pregnancies globally, with Vietnam exhibiting one of the highest prevalences at 21%. Current diagnostic approaches at 24-28 weeks limit early intervention opportunities. We developed a multi-modal machine learning framework integrating cell-free DNA (cfDNA) structural features and genetic information for early GDM prediction at 10-12 weeks of gestation in Vietnamese women. METHODS:We analyzed blood samples from 1,086 pregnant women (435 GDM cases, 651 controls) collected at 9-12 weeks. Two parallel analytical pathways were employed: cfDNA profiling extracting cfDNA-specific features (fragment length, end motifs, GC content, nucleosome patterns), and whole-genome imputation generating predictions for ∼19,000 omics traits. Component scores were developed using TabPFN classifier and integrated via logistic regression into a unified master score. RESULTS:Genome-wide analysis identified five omics traits with significant GDM associations: HSD11B1, NEK7, COMMD10, KLRC4, and OCEL1. Component score optimization revealed distinct patterns-cfDNA scores peaked at 200 features (AUC = 71.53), while genetics-based scores improved with up to 2,000 omics traits (AUC = 77.21). The final master score, integrating three components (gbSC2000, gbSCBH, cfSC200), achieved AUCs of 86.82-87.19 across validation cohorts with 70% sensitivity and 89% specificity. Addition-deletion analysis confirmed that both cfDNA and genetic components provided essential, non-redundant contributions. CONCLUSIONS:This multi-modal framework demonstrates superior performance compared to single-biomarker approaches, enabling risk stratification from very low (4% GDM prevalence) to very high risk (90% prevalence). At the cutoff 0.4, the model identifies 78% of future GDM cases at 10-12 weeks while maintaining an 18% false-positive rate, potentially enabling early interventions to prevent GDM development and associated complications.
Background:Enterovirus D68 (EVD68) causes respiratory disease, yet the risk of severe respiratory disease remains incompletely quantified, especially when stratified by comorbidity status. This study aims to describe the clinical features and risk of severe disease in children with EVD68 compared with those with other Rhinoviruses/Enteroviruses, accounting for comorbidity. Methods:We analyzed 1100 pediatric EV-positive cases from surveillance in Vietnam (2019-2022), excluding viral coinfections. EVD68 was confirmed by real-time PCR. We examined clinical features, treatments, and comorbidities. Standardization methods estimated risk differences (RDs) and risk ratios (RRs) stratified by (1) general comorbidity, (2) asthma, and (3) either of these. Time-to-recovery in intensive care unit (ICU) was compared using Kaplan-Meier methods. Results:EVD68 was detected in 55/1100 cases (5.0%). Children with EVD68 more often had wheeze, pneumonia, oxygen therapy, and ICU admission. For wheeze, EVD68 was associated with similar elevated risk with and without general comorbidity (RR 1.40 in both; RD 0.27). Pneumonia risk was likewise elevated with EVD68 (with comorbidity: RR 1.17; RD 0.12; without: RR 1.73; RD 0.14). By asthma status, EVD68 increased wheeze risk in both groups; however, the excess was smaller in asthma (RR 1.10; RD 0.09) than non-asthma (RR 1.43; RD 0.29), consistent with baseline wheeze susceptibility in asthma. Pneumonia risk was similar regardless of asthma status. During ICU stay, wheeze persisted longest in both groups. Time-to-recovery was similar between groups. Conclusions:EVD68 infection was associated with a higher risk of severe disease than Rhinoviruses/Enteroviruses, independent of documented comorbidity, indicating substantial risk even among previously healthy children.
56 Background: Metastatic breast cancer (mBC) imposes a significant burden in lower-middle-income countries, yet data on the specific needs of these patients remain scarce. This study aimed to analyze the unmet needs, quality of life (QoL), and lived experiences of patients with mBC in Central Vietnam. Methods: We conducted a convergent mixed-methods study across eight medical centers in Central Vietnam (Jan-May 2025). The quantitative component involved a cross-sectional survey of 283 mBC patients using the EORTC QLQ-C30, DASS-21, and the adapted Cancer Survivors' Unmet Needs scale (CaSUNE-VN). Concurrent in-depth interviews with a subsample (n=38) were analyzed using thematic analysis. Results: The cohort had a mean age of 56.0 ± 11.0 years, with a high proportion (36.7%) diagnosed with de novo mBC. Quantitative analysis revealed substantial unmet needs, with financial support being the most prevalent (65.4%), followed by sleep improvement (49.8%) and managing fear of recurrence (45.2%). Global QoL was moderately impaired (mean 59.4 ± 19.1). Notably, financial difficulties represented the highest symptom burden (60.4 ± 37.0), surpassing physical symptoms like fatigue and pain. The prevalence of anxiety and depression was 66.1% and 51.6%, respectively. Qualitative analysis identified five core themes: (1) the overwhelming burden of financial toxicity; (2) a duality of positive clinical relationships and negative systemic barriers; (3) the indispensable role of family as a lifeline; (4) a profound psychosocial toll managed by resilience; and (5) a fundamental shift in life perspectives. Conclusions: Patients with mBC in Central Vietnam face a multifaceted burden dominated by severe financial toxicity and psychological distress. While family support serves as a critical buffer, there are urgent unmet needs regarding financial protection, psychological support, and palliative care education. System-level interventions are required to address these gaps. Top 5 most frequently reported unmet needs and mental health prevalence (N=283). Item / Domain Category n (%) / Mean (SD) Top Unmet Needs Help finding financial support Quality of Life 185 (65.4%) Info to improve sleep quality Nutrition & Lifestyle 141 (49.8%) Manage fear of recurrence Emotional 128 (45.2%) Info on balanced diet Nutrition & Lifestyle 124 (43.8%) Advice on supplements Nutrition & Lifestyle 121 (42.8%) Mental Health (DASS-21) Anxiety (Mild to Severe) Clinical Status 187 (66.1%) Depression (Mild to Severe) Clinical Status 146 (51.6%) Quality of Life (QLQ-C30) Financial Difficulties Score Symptom Scale 60.4 (37.0) Data derived from the CaSUNE-VN, DASS-21, and EORTC QLQ-C30 instruments. For QLQ-C30 symptom scales, higher scores indicate greater symptom burden.
