Additive manufacturing (3D printing) is increasingly used in unicompartmental knee arthroplasty (UKA), including patient-specific instrumentation (PSI)/cutting guides, additively manufactured cementless implants, and fully patient-specific implant workflows. However, these applications differ substantially in purpose, evidence level, cost structure, and implementation burden; therefore, their clinical value should not be inferred from technical feasibility alone. This narrative review was updated through December 2025 and was informed by a structured search of PubMed/MEDLINE, Embase, and the Cochrane Library, supplemented by reference screening. Search concepts combined UKA with 3D printing, additive manufacturing, PSI, patient-specific implants, custom implants, porous cementless fixation, osseointegration, navigation/robotics comparators, cost, and implementation. Study selection, eligibility criteria, evidence domains, outcomes, and anticipated sources of bias were predefined to improve reproducibility. Randomized trials and meta-analyses show that PSI in UKA does not consistently reduce alignment outliers or improve patient-reported outcome measures (PROMs), with recurrent technical vulnerability at tibial registration, slope, and rotation. Cadaveric studies support feasibility but mainly report surrogate technical endpoints. For additively manufactured cementless UKA implants, implant-specific long-term cohort data suggest acceptable survivorship and clinically meaningful PROM improvement, but evidence remains implant-specific. Patient-specific implants may improve anatomic fit in selected morphologies, yet comparative studies have not demonstrated consistent short-term clinical or gait advantages over well-executed standard UKA. Current evidence supports selective, indication-driven adoption rather than routine use of 3D-enabled UKA technologies. PSI is best viewed as an execution aid for specific workflows or training contexts, porous cementless 3D-printed implants require implant-specific survivorship surveillance, and patient-specific implants should be reserved for carefully justified morphology-driven indications. Future research should prioritize standardized reporting, surgeon-volume stratification, long-term failure mechanisms, registry linkage, and cost-effectiveness across the complete care pathway.
Mesenchymal stem cells (MSCs) and their extracellular vesicles (EVs) have both shown promise in spinal cord injury (SCI) treatment. While hypoxia preconditioning significantly enhances the therapeutic potential of both MSCs and EVs, a comparative analysis of safety and efficacy is still lacking. Given that EVs offer several advantages over MSCs - such as lower immunogenicity and ease of storage and delivery - this study aimed to determine whether hypoxic EVs could serve as a potent alternative to hypoxic MSC therapy. SCI rat models were established using the clip compression method and treated with three intrathecal injections of either hypoxia-preconditioned UC-MSCs (1 × 10⁶ cells) or their EVs (300 µg total protein, equivalent to 4.6 × 109 particles). Safety was assessed through clinical observations, biochemical analysis, and histological examination. Therapeutic efficacy was evaluated via behavioral tests, including the BBB score, Rotarod performance, sensory response, bladder function, and spinal cord histopathology. Hypoxic UC-MSCs and their EVs were safe, as no severe side effects were observed in clinical signs, blood parameters, liver and kidney function, or histological evaluations. They were effective in enhancing motor coordination and balance, improving bladder function, reducing spinal cord cavitation, and decreasing inflammatory cell infiltration. Although both treatments contributed to early hindlimb motor function recovery by day 7, only MSCs promoted sustained improvement through day 28. Since hypoxic MSCs demonstrate better effects on hindlimb motor function recovery, EVs may not serve as a complete substitute. Nevertheless, due to their advantages over cell-based therapies, hypoxic MSC-EVs remain strong therapeutic candidates, particularly in situations where cell therapy is not feasible.
OBJECTIVE:To assess levels of health literacy (HL), eHealth literacy (eHL), and online health information-seeking behaviors among Vietnamese adults, and to identify factors associated with HL and eHL. METHODS:A nationwide cross-sectional online survey was conducted in 2025 among 3550 adults. HL and eHL were measured using HLS19-Q12 and eHEALS, respectively. Sociodemographic, health, and digital behavior variables were collected. Tobit regression was used to examine associated factors. RESULTS:Problematic HL was common (67.3%), whereas most participants had sufficient eHL (85.5%). Higher HL and eHL were associated with female gender, higher education, urban residence, and frequent online health information seeking. Several chronic conditions were linked to lower HL, while endocrine disorders showed divergent associations. Use of official health websites was positively associated with literacy outcomes, whereas reliance on social media was negatively associated with HL. CONCLUSION:Despite high digital engagement, substantial gaps in general health literacy persist among among digitally connected Vietnamese adults, particularly across socio-demographic groups. PRACTICE IMPLICATIONS:Public health strategies should prioritize strengthening critical appraisal skills for online health information and expanding access to reliable digital health resources to reduce literacy disparities and support equitable digital health empowerment.
Background:Upper eyelid hollowing is a common manifestation of periorbital aging caused by soft-tissue atrophy and loss of orbital fat volume. Although various corrective techniques have been described, outcome assessment remains largely subjective. High-resolution ultrasonography may provide an objective and quantitative method for evaluating postoperative soft-tissue changes. Objective:The present study aimed to evaluate the effectiveness and stability of combined orbital fat repositioning and microfragmented autologous fat grafting for the correction of moderate upper eyelid hollowing, using high-resolution ultrasonography as an objective assessment tool. Methods:A prospective study was conducted in 35 female patients (70 upper eyelids), aged 40-65 years, with moderate upper eyelid hollowing (Park grade II). All patients underwent combined orbital fat pad repositioning with supplemental microfragmented autologous fat grafting. High-resolution ultrasonography was performed preoperatively and at 1, 3, and 6 months postoperatively to measure the space anterior to the upper eyelid skin (D1) and upper eyelid thickness (D2). Clinical outcomes and patient satisfaction were also evaluated. Results:he mean preoperative hollowing depth was 5.88 ± 0.85 mm, and the mean grafted fat volume was 1.09 ± 0.29 mL. Postoperative ultrasonography demonstrated a significant decrease in D1 and a significant increase in D2 at all postoperative time points compared with baseline (all p < 0.05). No statistically significant differences were observed between the 3- and 6-month follow-up periods (p > 0.05), indicating stabilization of outcomes after 3 months. Overall patient satisfaction was 97.14%. No major complications were observed. Conclusion:Combined orbital fat repositioning and microfragmented autologous fat grafting is a safe and effective technique for correcting moderate upper eyelid hollowing. High-resolution ultrasonography provides an objective, reproducible, and clinically applicable method for postoperative outcome assessment.
Objective This study characterizes the complete genome of an extensively drug-resistant (XDR) P. aeruginosa high-risk clone, ST1971, identified for the first time in Vietnam. Methods A carbapenem- and colistin-resistant P. aeruginosa strain 71 was isolated from an 86-year-old patient with urinary tract infection at a hospital in Hanoi. Antimicrobial susceptibility testing followed CLSI guidelines. Whole-genome sequencing was performed using Illumina NovaSeq and Oxford Nanopore MinION platforms, with hybrid assembly and comprehensive genomic annotation using Bakta, COGclassifier, CARD-RGI, AMRFinderPlus, VFDB, and MobileElementFinder. Comparative genomic analysis was conducted against global ST1971 genomes. Results The 6,589,538 bp complete genome of strain 71 contains 19 mobile genetic elements, six prophages, and three CRISPR arrays. Average nucleotide identity (ANI) analysis delineated six distinct ST1971 clusters, while core-genome single-nucleotide polymorphism (SNP) analysis identified 34-57 SNP differences between strain 71 and ST1971 isolates originating from China. Strain 71 exhibited an XDR phenotype, with resistance to all tested antibiotics, including imipenem (16 mg/L), meropenem (32 mg/L), colistin (32 mg/L), levofloxacin (>128 mg/L) and tigecycline (16 mg/L). The genome carries 18 antimicrobial resistance genes including blaPDC-142, blaPME-1, and blaOXA-395 (carbapenem resistance), and colistin-associated mutations in cprS, pmrB, parR and parS gene. A tmexCD2-toprJ2 efflux cluster was located between two prophage regions, suggesting that bacteriophages may serve as potential vehicles for antibiotic resistance gene dissemination. Conclusions This study provides insight into the genomic characteristics of a XDR Pseudomonas aeruginosa ST1971 isolate in Vietnam, underscoring the need for enhanced surveillance of this genotype across clinical and geographical settings.
