| 1. |
- Phu, Vu Dinh, et al.
(författare)
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Ventilator-associated respiratory infection in a resource-restricted setting: impact and etiology
- 2017
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Ingår i: Journal of Intensive Care. - : BioMed Central (BMC). - 2052-0492. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Ventilator-associated respiratory infection (VARI) is a significant problem in resource-restricted intensive care units (ICUs), but differences in casemix and etiology means VARI in resource-restricted ICUs may be different from that found in resource-rich units. Data from these settings are vital to plan preventative interventions and assess their cost-effectiveness, but few are available.
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| 2. |
- Chu, Dinh-Toi, et al.
(författare)
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An update on obesity : Mental consequences and psychological interventions
- 2019
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Ingår i: Diabetes & Metabolic syndrome. - : Elsevier. - 1871-4021 .- 1878-0334. ; 13:1, s. 155-160
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Forskningsöversikt (refereegranskat)abstract
- Besides physical consequences, obesity has negative psychological effects, thereby lowering human life quality. Major psychological consequences of this disorder includes depression, impaired body image, low self-esteem, eating disorders, stress and poor quality of life, which are correlated with age and gender. Physical interventions, mainly diet control and energy balance, have been widely applied to treat obesity; and some psychological interventions including behavioral therapy, cognitive behavioral therapy and hypnotherapy have showed some effects on obesity treatment. Other psychological therapies, such as relaxation and psychodynamic therapies, are paid less attention. This review aims to update scientific evidence regarding the mental consequences and psychological interventions for obesity. (c) 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.
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| 3. |
- Minh, Hoang Van, et al.
(författare)
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Tobacco Control Policies in Vietnam : Review on MPOWER Implementation Progress and Challenges
- 2016
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Ingår i: Asian Pacific Journal of Cancer Prevention. - 1513-7368. ; 17, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- In Vietnam, the WHO Framework Convention on Tobacco Control (WHO FCTC) took effect in March 2005 while MPOWER has been implemented since 2008. This paper describes the progress and challenges of implementation of the MPOWER package in Vietnam. We can report that, in term of monitoring, Vietnam is very active in the Global Tobacco Surveillance System, completing two rounds of the Global Adult Tobacco Survey (GATS) and three rounds of the Global Youth Tobacco Survey (GYTS). To protect people from tobacco smoke, Vietnam has issued and enforced a law requiring comprehensive smoking bans at workplaces and public places since 2013. Tobacco advertising and promotion are also prohibited with the exception of points of sale displays of tobacco products. Violations come in the form of promotion girls, corporate social responsibility activities from tobacco manufacturers and packages displayed by retail vendors. Vietnam is one of the 77 countries that require pictorial health warnings to be printed on cigarette packages to warn about the danger of tobacco and the warnings have been implemented effectively. Cigarette tax is 70% of factory price which is equal to less than 45% of retail price and much lower than the recommendation of WHO. However, Vietnam is one of the very few countries that require manufacturers and importers to make "compulsory contributions" at 1-2% of the factory price of cigarettes sold in Vietnam for the establishment of a Tobacco Control Fund (TCF). The TCF is being operated well. In 2015, 67 units of 63 provinces/cities, 22 ministries and political-social organizations and 6 hospitals received funding from TCF to implement a wide range of tobacco control activities. Cessation services have been starting with a a toll-free quit-line but need to be further strengthened. In conclusion, Vietnam has constantly put efforts into the tobacco control field with high commitment from the government, scientists and activists. Though several remarkable achievements have been gained, many challenges remain. To overcome those challenges, implementation strategies that take into account the contextual factors and social determinants of tobacco use in Vietnam are needed.
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| 4. |
- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2019
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480
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Tidskriftsartikel (refereegranskat)abstract
- Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable).Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.Funding: Bill & Melinda Gates Foundation.
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| 5. |
- Giang, Kim Bao, et al.
(författare)
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Relative Importance of Different Attributes of Graphic Health Warnings on Tobacco Packages in Viet Nam
- 2016
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Ingår i: Asian Pacific Journal of Cancer Prevention. - 1513-7368. ; 17, s. 79-84
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Tidskriftsartikel (refereegranskat)abstract
- Graphic health warnings (GHW) on tobacco packages have proven to be effective in increasing quit attempts among smokers and reducing initial smoking among adolescents. This research aimed to examine the relative importance of different attributes of graphic health warnings on tobacco packages in Viet Nam. A discrete choice experimental (DCE) design was applied with a conditional logit model. In addition, a ranking method was used to list from the least to the most dreadful GHW labels. With the results from DCE model, graphic type was shown to be the most important attribute, followed by cost and coverage area of GHW. The least important attribute was position of the GHW. Among 5 graphic types (internal lung cancer image, external damaged teeth, abstract image, human suffering image and text), the image of lung cancer was found to have the strongest influence on both smokers and non-smokers. With ranking method, the image of throat cancer and heart diseases were considered the most dreadful images. GHWs should be designed with these attributes in mind, to maximise influence on purchase among both smokers and non-smokers.
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| 6. |
- Kien, Vu Duy, et al.
(författare)
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Trends in childhood measles vaccination highlight socioeconomic inequalities in Vietnam
- 2017
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Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 62, s. S41-S49
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe trends in measles vaccine coverage rates and their association with socioeconomic characteristics among children from age 12 to 23 months in Vietnam from the year 2000 to 2014.METHODS: Data were drawn from the Vietnam Multiple Indicator Cluster Surveys in years 2000, 2006, 2011, and 2014. Concentration indices were used to determine the magnitude of socioeconomic inequalities in measles vaccine coverage. Associations between measles vaccine coverage and relevant social factors were assessed using logistic regression.RESULTS: Socioeconomic inequalities in measles vaccine coverage rates decreased during 2000-2014. Children belonging to ethnic minority groups, having mothers with lower education, and belonging to the poorest group were less likely to receive measles vaccine; although, their vaccine coverage rates did increase with time. Measles vaccine coverage declined among children of mothers with more education and belonging to the wealthiest socioeconomic group.CONCLUSIONS: Understanding the social factors influencing adherence to recommend childhood vaccination protocols is essential. Attempts to regain and retain herd immunity must be guided by an understanding of these social factors if they are to succeed.
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| 7. |
- Li, Jing-Rebecca, et al.
(författare)
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SpinDoctor : a Matlab toolbox for diffusion MRI simulation
- 2019
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Ingår i: NeuroImage. - : Elsevier BV. - 1053-8119 .- 1095-9572. ; 202
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Tidskriftsartikel (refereegranskat)abstract
- The complex transverse water proton magnetization subject to diffusion-encoding magnetic field gradient pulses in a heterogeneous medium can be modeled by the multiple compartment Bloch-Torrey partial differential equation (BTPDE). A mathematical model for the time-dependent apparent diffusion coefficient (ADC), called the H-ADC model, was obtained recently using homogenization techniques on the BTPDE. Under the assumption of negligible water exchange between compartments, the H-ADC model produces the ADC of a diffusion medium from the solution of a diffusion equation (DE) subject to a time-dependent Neumann boundary condition. This paper describes a publicly available Matlab toolbox called SpinDoctor that can be used 1) to solve the BTPDE to obtain the dMRI signal (the toolbox provides a way of robustly fitting the dMRI signal to obtain the fitted ADC); 2) to solve the DE of the H-ADC model to obtain the ADC; 3) a short-time approximation formula for the ADC is also included in the toolbox for comparison with the simulated ADC. The PDEs are solved by P 1 finite elements combined with built-in Matlab routines for solving ordinary differential equations. The finite element mesh generation is performed using an external package called Tetgen that is included in the toolbox. SpinDoctor provides built-in options of including 1) spherical cells with a nucleus; 2) cylindrical cells with a myelin layer; 3) an extra-cellular space (ECS) enclosed either a) in a box or b) in a tight wrapping around the cells; 4) deformation of canonical cells by bending and twisting. 5) permeable membranes for the BT-PDE (the H-ADC assumes negligible permeability). Built-in diffusion-encoding pulse sequences include the Pulsed Gradient Spin Echo and the Oscillating Gradient Spin Echo.
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| 8. |
- Tran, Ngoc Hieu, et al.
(författare)
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Genetic profiling of Vietnamese population from large-scale genomic analysis of non-invasive prenatal testing data
- 2020
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- The under-representation of several ethnic groups in existing genetic databases and studies have undermined our understanding of the genetic variations and associated traits or diseases in many populations. Cost and technology limitations remain the challenges in performing large-scale genome sequencing projects in many developing countries, including Vietnam. As one of the most rapidly adopted genetic tests, non-invasive prenatal testing (NIPT) data offers an alternative untapped resource for genetic studies. Here we performed a large-scale genomic analysis of 2683 pregnant Vietnamese women using their NIPT data and identified a comprehensive set of 8,054,515 single-nucleotide polymorphisms, among which 8.2% were new to the Vietnamese population. Our study also revealed 24,487 disease-associated genetic variants and their allele frequency distribution, especially 5 pathogenic variants for prevalent genetic disorders in Vietnam. We also observed major discrepancies in the allele frequency distribution of disease-associated genetic variants between the Vietnamese and other populations, thus highlighting a need for genome-wide association studies dedicated to the Vietnamese population. The resulted database of Vietnamese genetic variants, their allele frequency distribution, and their associated diseases presents a valuable resource for future genetic studies.
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| 9. |
- Giang, Kim Bao, et al.
(författare)
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Changes and inequalities in early birth registration and childhood care and education in Vietnam : findings from the Multiple Indicator Cluster Surveys, 2006 and 2011
- 2016
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Early birth registration, childhood care, and education are essential rights for children and are important for their development and education. This study investigates changes and socioeconomic inequalities in early birth registration and indicators of care and education in children aged under 5 years in Vietnam.DESIGN: The analyses reported here used data from the Vietnam Multiple Indicator Cluster Surveys (MICS) in 2006 and 2011. The sample sizes in 2006 and 2011 were 2,680 and 3,678 for children under 5 years of age. Four indicators of childcare and preschool education were measured: birth registration, possession of books, preschool education attendance, and parental support for early childhood education. The concentration index (CI) was used to measure inequalities in gender, maternal education, geographical area, place of residence, ethnicity, and household wealth.RESULTS: There were some improvements in birth registration (86.4% in 2006; 93.8% in 2011), preschool education attendance (57.1% in 2006; 71.9% in 2011), and parental support for early childhood education (68.9 and 76.8%, respectively). However, the possession of books was lower (24.7% in 2006; 19.6% in 2011) and became more unequal over time (i.e. CI=0.370 in 2006; CI=0.443 in 2011 in wealth inequality). Inequalities in the care and education of children were still persistent. The largest inequalities were for household wealth and rural versus urban areas.CONCLUSION: Although there have been some improvements in this area, inequalities still exist. Policy efforts in Vietnam should be directed towards closing the gap between different socioeconomic groups for the care and education of children under 5 years old.
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| 10. |
- Kien, Vu Duy, et al.
(författare)
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Horizontal inequity in public health care service utilization for non-communicable diseases in urban Vietnam
- 2014
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Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A health system that provides equitable health care is a principal goal in many countries. Measuring horizontal inequity (HI) in health care utilization is important to develop appropriate and equitable public policies, especially policies related to non-communicable diseases (NCDs).DESIGN: A cross-sectional survey of 1,211 randomly selected households in slum and non-slum areas was carried out in four urban districts of Hanoi city in 2013. This study utilized data from 3,736 individuals aged 15 years and older. Respondents were asked about health care use during the previous 12 months; information included sex, age, and self-reported NCDs. We assessed the extent of inequity in utilization of public health care services. Concentration indexes for health care utilization and health care needs were constructed via probit regression of individual utilization of public health care services, controlling for age, sex, and NCDs. In addition, concentration indexes were decomposed to identify factors contributing to inequalities in health care utilization.RESULTS: The proportion of healthcare utilization in the slum and non-slum areas was 21.4 and 26.9%, respectively. HI in health care utilization in favor of the rich was observed in the slum areas, whereas horizontal equity was achieved among the non-slum areas. In the slum areas, we identified some key factors that affect the utilization of public health care services.CONCLUSION: Our results suggest that to achieve horizontal equity in utilization of public health care services, policy should target preventive interventions for NCDs, focusing more on the poor in slum areas.
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| 11. |
- Kien, Vu Duy, et al.
(författare)
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Inequalities in Household Catastrophic Health Expenditure and Impoverishment Associated With Noncommunicable Diseases in Chi Linh, Hai Duong, Vietnam
- 2017
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Ingår i: Asia-Pacific journal of public health. - : SAGE Publications. - 1010-5395 .- 1941-2479. ; 29, s. 35S-44S
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Tidskriftsartikel (refereegranskat)abstract
- A costly modern-day double burden, the expenses of noncommunicable diseases (NCDs) are becoming a devastating epidemic. The World Health Organization estimates $7 trillion in economic losses from NCDs in 2011-2025. Although regarded as affluent diseases, the burden of NCDs is shifting into poorer groups. In this study, we assessed the socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with NCDs in Northern Vietnam. We also identified associated factors for catastrophic health expenditure and impoverishment. Households self-reporting NCD diagnoses had the highest association with both catastrophic health expenditure and impoverishment, followed by those in urban areas. Such households were likely poorer according to our calculations estimating socioeconomic inequalities. Households with at least 1 member older than 60 years were also more likely to suffer catastrophic health expenditures. These findings suggest that targeted policy to prevent or subsidize care for NCDs could prevent catastrophic health expenditure and impoverishment among those already most disadvantaged.
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| 12. |
- Kien, Vu Duy, et al.
(författare)
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Socioeconomic inequalities in self-reported chronic non-communicable diseases in urban Hanoi, Vietnam
- 2017
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Ingår i: Global Public Health. - Abingdon : Routledge. - 1744-1692 .- 1744-1706. ; 12:12, s. 1522-1537
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Tidskriftsartikel (refereegranskat)abstract
- This study measures and decomposes socioeconomic inequalities in the prevalence of self-reported chronic non-communicable diseases (NCDs) in urban Hanoi, Vietnam. A cross-sectional survey of 1211 selected households was carried out in four urban districts in both slum and non-slum areas of Hanoi city in 2013. The respondents were asked if a doctor or health worker had diagnosed any household members with an NCD, such as cardiovascular diseases, chronic respiratory, diabetes or cancer, during last 12 months. Information from 3736 individuals, aged 15 years and over, was used for the analysis. The concentration index (CI) was used to measure inequalities in self-reported NCD prevalence, and it was also decomposed into contributing factors. The prevalence of chronic NCDs in the slum and non-slum areas was 7.9% and 11.6%, respectively. The CIs show gradients disadvantageous to both the slum (CI = -0.103) and non-slum (CI = -0.165) areas. Lower socioeconomic status and aging significantly contributed to inequalities in the self-reported NCDs, particularly for those living in the slum areas. The findings confirm the existence of substantial socioeconomic inequalities linked to NCDs in urban Vietnam. Future policies should target these vulnerable areas.
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| 13. |
- Kien, Vu Duy, 1977-, et al.
(författare)
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Trends in socioeconomic inequalities in child malnutrition in Vietnam : findings from the Multiple Indicator Cluster Surveys, 2000-2011
- 2016
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Ingår i: Global Health Action. - : Co-Action Publishing. - 1654-9716 .- 1654-9880. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Child malnutrition is not only a major contributor to child mortality and morbidity, but it can also determine socioeconomic status in adult life. The rate of under-five child malnutrition in Vietnam has significantly decreased, but associated inequality issues still need attention.OBJECTIVE: This study aims to explore trends, contributing factors, and changes in inequalities for under-five child malnutrition in Vietnam between 2000 and 2011.DESIGN: Data were drawn from the Viet Nam Multiple Indicator Cluster Survey for the years 2000 and 2011. The dependent variables used for the study were stunting, underweight, and wasting of under-five children. The concentration index was calculated to see the magnitude of child malnutrition, and the inequality was decomposed to understand the contributions of determinants to child malnutrition. The total differential decomposition was used to identify and explore factors contributing to changes in child malnutrition inequalities.RESULTS: Inequality in child malnutrition increased between 2000 and 2011, even though the overall rate declined. Most of the inequality in malnutrition was due to ethnicity and socioeconomic status. The total differential decomposition showed that the biggest and second biggest contributors to the changes in underweight inequalities were age and socioeconomic status, respectively. Socioeconomic status was the largest contributor to inequalities in stunting.CONCLUSIONS: Although the overall level of child malnutrition was improved in Vietnam, there were significant differences in under-five child malnutrition that favored those who were more advantaged in socioeconomic terms. The impact of socioeconomic inequalities in child malnutrition has increased over time. Multifaceted approaches, connecting several relevant ministries and sectors, may be necessary to reduce inequalities in childhood malnutrition.
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| 14. |
- Kien, Vu Duy, 1977-, et al.
(författare)
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Views by health professionals on the responsiveness of commune health stations regarding non-communicable diseases in urban Hanoi, Vietnam : a qualitative study
- 2018
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Primary health care plays an important role in addressing the burden of non-communicable diseases (NCDs) in low- and middle-income countries. In light of the rapid urbanization of Vietnam, this study aims to explore health professionals' views about the responsiveness of primary health care services at commune health stations, particularly regarding the increase of NCDs in urban settings.METHODS: This qualitative study was conducted in Hanoi from July to August 2015. We implemented 19 in-depth interviews with health staff at four purposely selected commune health stations and conducted a brief inventory of existing NCD activities at these commune health stations. We also interviewed NCD managers at national, provincial, and district levels. The interview guides reflected six components of the WHO health system framework, including service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance. A thematic analysis approach was applied to analyze the interview data in this study.RESULTS: Six themes, related to the six building blocks of the WHO health systems framework, were identified. These themes explored the responsiveness of commune health stations to NCDs in urban Hanoi. Health staff at commune health stations were not aware of the national strategy for NCDs. Health workers noted the lack of NCD informational materials for management and planning. The limited workforce at health commune stations would benefit from more health workers in general and those with NCD-specific training and skills. In addition, the budget for NCDs at commune health stations remains very limited, with large differences in the implementation of national targeted NCD programs. Some commune health stations had no NCD services available, while others had some programming. A lack of NCD treatment drugs was also noted, with a negative impact on the provision of NCD-related services at commune health stations. These themes were also reflected in the inventory of existing NCD related activities.CONCLUSIONS: Health professionals view the responsiveness of commune health stations to NCDs in urban Hanoi, Vietnam as weak. Appropriate policies should be implemented to improve the primary health care services on NCDs at commune health stations in urban Hanoi, Vietnam.
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| 15. |
- Mehta, Raghav, et al.
(författare)
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QU-BraTS : MICCAI BraTS 2020 Challenge on QuantifyingUncertainty in Brain Tumor Segmentation - Analysis of Ranking Scores and Benchmarking Results
- 2022
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Ingår i: Journal of Machine Learning for Biomedical Imaging. - 2766-905X. ; , s. 1-54
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Tidskriftsartikel (refereegranskat)abstract
- Deep learning (DL) models have provided the state-of-the-art performance in a wide variety of medical imaging benchmarking challenges, including the Brain Tumor Segmentation (BraTS) challenges. However, the task of focal pathology multi-compartment segmentation (e.g., tumor and lesion sub-regions) is particularly challenging, and potential errors hinder the translation of DL models into clinical workflows. Quantifying the reliability of DL model predictions in the form of uncertainties, could enable clinical review of the most uncertain regions, thereby building trust and paving the way towards clinical translation. Recently, a number of uncertainty estimation methods have been introduced for DL medical image segmentation tasks. Developing scores to evaluate and compare the performance of uncertainty measures will assist the end-user in making more informed decisions. In this study, we explore and evaluate a score developed during the BraTS 2019-2020 task on uncertainty quantification (QU-BraTS), and designed to assess and rank uncertainty estimates for brain tumor multi-compartment segmentation. This score (1) rewards uncertainty estimates that produce high confidence in correct assertions, and those that assign low confidence levels at incorrect assertions, and (2) penalizes uncertainty measures that lead to a higher percentages of under-confident correct assertions. We further benchmark the segmentation uncertainties generated by 14 independent participating teams of QU-BraTS 2020, all of which also participated in the main BraTS segmentation task. Overall, our findings confirm the importance and complementary value that uncertainty estimates provide to segmentation algorithms, and hence highlight the need for uncertainty quantification in medical image analyses. Our evaluation code is made publicly available at https://github.com/RagMeh11/QU-BraTS
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| 16. |
- Ngan, Tran Thu, et al.
(författare)
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Health-related quality of life among breast cancer patients compared to cancer survivors and age-matched women in the general population in Vietnam
- 2022
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Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 31, s. 777-787
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study compared the health-related quality of life (HRQoL) of breast cancer (BC) patients, survivors, and age-matched women from the general population in Vietnam to address the paucity of HRQoL research and contribute to the robust assessment of BC screening and care in Vietnam.Methods: The standardised EQ-5D-5L instrument was incorporated in an online survey and a hospital-based face-to-face survey, and together with data from the Vietnam EQ-5D-5L norms study. χ2 tests assessed EQ-5D health profile associations and a Tobit regression model investigated the association between overall health status (EQ-VAS/utility scores) and sociodemographic and clinical characteristics.Results: A total of 309 participants (107 patients undergoing treatment and 202 survivors who had completed treatment) provided usable responses. The dimensions that affected mostly the HRQoL of women with BC were pain/discomfort and anxiety/depression. Current patients and survivors differed significantly regarding HRQoL dimensions of mobility, self-care, usual activities, and anxiety/depression. Their health utilities were 0.74 and 0.84, respectively, compared with 0.91 for age-matched Vietnamese women in the general population (p < 0.001). Treatment status (survivor vs patient), younger age, higher monthly household income, and higher education levels were associated with higher health utility.Conclusions: The results point to unmet needs in mental health support and well-being and for attention to be given to the development of a biopsychosocial system of cancer diagnosis, treatment, and care. The results will also inform future assessments of the comparative value for money of interventions intended to impact on breast cancer in Vietnam.
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| 17. |
- Toan, Do Thi Thanh, et al.
(författare)
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Perceptions of climate change and its impact on human health : an integrated quantitative and qualitative approach.
- 2014
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Ingår i: Global Health Action. - 1654-9716 .- 1654-9880. ; 7, s. 23025-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The World Health Organization emphasized that climate change is a significant and emerging threat to public health, especially in lower income populations and tropical/subtropical countries. However, people in Asia and Africa were the least likely to perceive global warming as a threat. In Vietnam, little research has been conducted concerning the perceptions of effects of climate change on human health.OBJECTIVE: The aim of this study was to explore the perceptions on climate change and its impact on human health among people in Hanoi.DESIGN: We applied a combined quantitative and qualitative approach to study perceptions on climate change among people in Hanoi. A total of 1,444 people were recruited, including 754 people living in non-slum areas and 690 people living in slum areas of Hanoi. A structured questionnaire was used to collect quantitative data on their perceptions. In a parallel qualitative study, two focus group discussions and 12 in-depth interviews (IDs) were carried out involving 24 people from both slum and non-slum areas.RESULTS: The majority of the respondents in the study had heard about climate change and its impact on human health (79.3 and 70.1% in non-slum and slum areas, respectively). About one third of the respondents reported that members of their family had experienced illness in the recent summer and winter compared to the same seasons 5 years ago. The most common symptoms reported during hot weather were headaches, fatigue, and dizziness; hypertension and other cardiovascular diseases were also reported. During cold weather, people reported experiencing cough, fever, and influenza, as well as pneumonia and emerging infectious diseases such as dengue and Japanese encephalitis.CONCLUSIONS: The observed high level of awareness on the links between climate change and human health may help to increase the success of the National Prevention Program on Climate Change. Moreover, understanding the concerns of the people may help policy makers to develop and implement effective and sustainable adaptation measures for Hanoi City as well as for Vietnam as a whole.
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| 18. |
- Van Minh, Hoang, et al.
(författare)
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Multiple vulnerabilities and maternal healthcare in Vietnam : findings from the Multiple Indicator Cluster Surveys, 2000, 2006, and 2011
- 2016
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Ingår i: Global Health Action. - : co-action. - 1654-9716 .- 1654-9880. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Knowledge of the aggregate effects of multiple socioeconomic vulnerabilities is important for shedding light on the determinants of growing health inequalities and inequities in maternal healthcare.OBJECTIVE: This paper describes patterns of inequity in maternal healthcare utilization and analyzes associations between inequity and multiple socioeconomic vulnerabilities among women in Vietnam.DESIGN: This is a repeated cross-sectional study using data from the Vietnam Multiple Indicator Cluster Surveys 2000, 2006, and 2011. Two maternal healthcare indicators were selected: (1) skilled antenatal care and (2) skilled delivery care. Four types of socioeconomic vulnerabilities - low education, ethnic minority, poverty, and rural location - were assessed both as separate explanatory variables and as composite indicators (combinations of three and four vulnerabilities). Pairwise comparisons and adjusted odds ratios were used to assess socioeconomic inequities in maternal healthcare.RESULTS: In all three surveys, there were increases across the survey years in both the proportions of women who received antenatal care by skilled staff (68.6% in 2000, 90.8% in 2006, and 93.7% in 2011) and the proportions of women who gave birth with assistance from skilled staff (69.9% in 2000, 87.7% in 2006, and 92.9% in 2011). The receipt of antenatal care by skilled staff and birth assistance from skilled health personnel were less common among vulnerable women, especially those with multiple vulnerabilities.CONCLUSIONS: Even though Vietnam has improved its coverage of maternal healthcare on average, policies should target maternal healthcare utilization among women with multiple socioeconomic vulnerabilities. Both multisectoral social policies and health policies are needed to tackle multiple vulnerabilities more effectively by identifying those who are poor, less educated, live in rural areas, and belong to ethnic minority groups.
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| 19. |
- Vu, Minh Hoang, et al.
(författare)
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A Data-Adaptive Loss Function for Incomplete Data and Incremental Learning in Semantic Image Segmentation
- 2022
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Ingår i: IEEE Transactions on Medical Imaging. - : IEEE. - 0278-0062 .- 1558-254X. ; 41:6, s. 1320-1330
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Tidskriftsartikel (refereegranskat)abstract
- In the last years, deep learning has dramatically improved the performances in a variety of medical image analysis applications. Among different types of deep learning models, convolutional neural networks have been among the most successful and they have been used in many applications in medical imaging.Training deep convolutional neural networks often requires large amounts of image data to generalize well to new unseen images. It is often time-consuming and expensive to collect large amounts of data in the medical image domain due to expensive imaging systems, and the need for experts to manually make ground truth annotations. A potential problem arises if new structures are added when a decision support system is already deployed and in use. Since the field of radiation therapy is constantly developing, the new structures would also have to be covered by the decision support system.In the present work, we propose a novel loss function to solve multiple problems: imbalanced datasets, partially-labeled data, and incremental learning. The proposed loss function adapts to the available data in order to utilize all available data, even when some have missing annotations. We demonstrate that the proposed loss function also works well in an incremental learning setting, where an existing model is easily adapted to semi-automatically incorporate delineations of new organs when they appear. Experiments on a large in-house dataset show that the proposed method performs on par with baseline models, while greatly reducing the training time and eliminating the hassle of maintaining multiple models in practice.
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| 20. |
- Vu, Minh Hoang, et al.
(författare)
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A Question-Centric Model for Visual Question Answering in Medical Imaging
- 2020
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Ingår i: IEEE Transactions on Medical Imaging. - : IEEE. - 0278-0062 .- 1558-254X. ; 39:9, s. 2856-2868
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Tidskriftsartikel (refereegranskat)abstract
- Deep learning methods have proven extremely effective at performing a variety of medical image analysis tasks. With their potential use in clinical routine, their lack of transparency has however been one of their few weak points, raising concerns regarding their behavior and failure modes. While most research to infer model behavior has focused on indirect strategies that estimate prediction uncertainties and visualize model support in the input image space, the ability to explicitly query a prediction model regarding its image content offers a more direct way to determine the behavior of trained models. To this end, we present a novel Visual Question Answering approach that allows an image to be queried by means of a written question. Experiments on a variety of medical and natural image datasets show that by fusing image and question features in a novel way, the proposed approach achieves an equal or higher accuracy compared to current methods.
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| 21. |
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| 22. |
- Vu, Minh Hoang, 1988-, et al.
(författare)
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Ensemble of Streamlined Bilinear Visual Question Answering Models for the ImageCLEF 2019 Challenge in the Medical Domain
- 2019
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Ingår i: CLEF 2019.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper describes the contribution by participants from Umeå University, Sweden, in collaboration with the University of Bern, Switzerland, for the Medical Domain Visual Question Answering challenge hosted by ImageCLEF 2019. We proposed a novel Visual Question Answering approach that leverages a bilinear model to aggregateand synthesize extracted image and question features. While we did not make use of any additional training data, our model used an attention scheme to focus on the relevant input context and was further boosted by using an ensemble of trained models. We show here that the proposed approach performs at state-of-the-art levels, and provides an improvement over several existing methods. The proposed method was ranked 3rd in the Medical Domain Visual Question Answering challenge of ImageCLEF 2019.
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| 23. |
- Vu, Minh Hoang, et al.
(författare)
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Multi-decoder Networks with Multi-denoising Inputs for Tumor Segmentation
- 2021
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Ingår i: Brainlesion: Glioma, Multiple Sclerosis, Stroke and Traumatic Brain Injuries. - Cham : Springer. - 9783030720834 ; , s. 412-423
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Konferensbidrag (refereegranskat)abstract
- Automatic segmentation of brain glioma from multimodal MRI scans plays a key role in clinical trials and practice. Unfortunately, manual segmentation is very challenging, time-consuming, costly, and often inaccurate despite human expertise due to the high variance and high uncertainty in the human annotations. In the present work, we develop an end-to-end deep-learning-based segmentation method using a multi-decoder architecture by jointly learning three separate sub-problems using a partly shared encoder. We also propose to apply smoothing methods to the input images to generate denoised versions as additional inputs to the network. The validation performance indicates an improvement when using the proposed method. The proposed method was ranked 2nd in the task of Quantification of Uncertainty in Segmentation in the Brain Tumors in Multimodal Magnetic Resonance Imaging Challenge 2020.
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| 24. |
- Vu, Minh Hoang, 1988-
(författare)
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Resource efficient automatic segmentation of medical images
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cancer is one of the leading causes of death worldwide. In 2020, there were around 10 million cancer deaths and nearly 20 million new cancer cases in the world. Radiation therapy is essential in cancer treatments because half of the cancer patients receive radiation therapy at some point. During a radiotherapy treatment planning (RTP), an oncologist must manually outline two types of areas of the patient’s body: target, which will be treated, and organs-at-risks (OARs), which are essential to avoid. This step is called delineation. The purpose of the delineation is to generate a sufficient dose plan that can provide adequate radiation dose to a tumor and limit the radiation exposure to healthy tissue. Therefore, accurate delineations are essential to achieve this goal.Delineation is tedious and demanding for oncologists because it requires hours of concentrating work doing a repeated job. This is a RTP bottleneck which is often time- and resource-intensive. Current software, such as atlasbased techniques, can assist with this procedure by registering the patient’s anatomy to a predetermined anatomical map. However, the atlas-based methods are often slowed down and erroneous for patients with abnormal anatomies.In recent years, deep learning (DL) methods, particularly convolutional neural networks (CNNs), have led to breakthroughs in numerous medical imaging applications. The core benefits of CNNs are weight sharing and that they can automatically detect important visual features. A typical application of CNNs for medical images is to automatically segment tumors, organs, and structures, which is assumed to save radiation oncologists much time when delineating. This thesis contributes to resource efficient automatic segmentation and covers different aspects of resource efficiency.In Paper I, we proposed a novel end-to-end cascaded network for semantic segmentation in brain tumors in the multi-modal magnetic resonance imaging challenge in 2019. The proposed method used the hierarchical structure of the tumor sub-regions and was one of the top-ranking teams in the task of quantification of uncertainty in segmentation. A follow-up work to this paper was ranked second in the same task in the same challenge a year later.We systematically assessed the segmentation performance and computational costs of the technique called pseudo-3D as a function of the number of input slices in Paper II. We compared the results to typical two-dimensional (2D) and three-dimensional (3D) CNNs and a method called triplanar orthogonal 2D. The typical pseudo-3D approach considers adjacent slices to be several image input channels. We discovered that a substantial benefit from employing multiple input slices was apparent for a specific input size.We introduced a novel loss function in Paper III to address diverse issues, including imbalanced datasets, partially labeled data, and incremental learning. The proposed loss function adjusts to the given data to use all accessible data, even if some lack annotations. We show that the suggested loss function also performs well in an incremental learning context, where an existing model can be modified to incorporate the delineations of newly appearing organs semi-automatically.In Paper IV, we proposed a novel method for compressing high-dimensional activation maps, which are the primary source of memory use in modern systems. We examined three distinct compression methods for the activation maps to accomplishing this. We demonstrated that the proposed method induces a regularization effect that acts on the layer weight gradients. By employing the proposed technique, we reduced activation map memory usage by up to 95%.We investigated the use of generative adversarial networks (GANs) to enlarge a small dataset by generating synthetic images in Paper V. We use the real and generated data during training CNNs for the downstream segmentation tasks. Inspired by an existing GAN, we proposed a conditional version to generate high-dimensional and high-quality medical images of different modalities and their corresponding label maps. We evaluated the quality of the generated medical images and the effect of this augmentation on the performance of the segmentation task on six datasets.
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| 25. |
- Vu, Minh Hoang, et al.
(författare)
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TuNet: End-to-End Hierarchical Brain Tumor Segmentation Using Cascaded Networks
- 2020
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Ingår i: Brainlesion: Glioma, Multiple Sclerosis, Stroke and Traumatic Brain Injuries. - Cham : Springer. - 9783030466398 - 9783030466404 ; , s. 174-186
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Konferensbidrag (refereegranskat)abstract
- Glioma is one of the most common types of brain tumors; it arises in the glial cells in the human brain and in the spinal cord. In addition to having a high mortality rate, glioma treatment is also very expensive. Hence, automatic and accurate segmentation and measurement from the early stages are critical in order to prolong the survival rates of the patients and to reduce the costs of the treatment. In the present work, we propose a novel end-to-end cascaded network for semantic segmentation in the Brain Tumors in Multimodal Magnetic Resonance Imaging Challenge 2019 that utilizes the hierarchical structure of the tumor sub-regions with ResNet-like blocks and Squeeze-and-Excitation modules after each convolution and concatenation block. By utilizing cross-validation, an average ensemble technique, and a simple post-processing technique, we obtained dice scores of 88.06, 80.84, and 80.29, and Hausdorff Distances (95th percentile) of 6.10, 5.17, and 2.21 for the whole tumor, tumor core, and enhancing tumor, respectively, on the online test set. The proposed method was ranked among the top in the task of Quantification of Uncertainty in Segmentation.
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| 26. |
- Vu Nu, Anh, et al.
(författare)
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A systematic review on the direct approach to elicit the demand-side cost-effectiveness threshold : implications for low- and middle-income countries
- 2024
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 19:2
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Forskningsöversikt (refereegranskat)abstract
- Several literature review studies have been conducted on cost-effectiveness threshold values. However, only a few are systematic literature reviews, and most did not investigate the different methods, especially in-depth reviews of directly eliciting WTP per QALY. Our study aimed to 1) describe the different direct approach methods to elicit WTP/QALY; 2) investigate factors that contribute the most to the level of WTP/QALY value; and 3) investigate the relation between the value of WTP/QALY and GDP per capita and give some recommendations on feasible methods for eliciting WTP/QALY in low- and middle-income countries (LMICs). A systematic review concerning select studies estimating WTP/QALY from a direct approach was carried out in seven databases, with a cut off date of 03/2022. The conversion of monetary values into 2021 international dollars (i$) was performed via CPI and PPP indexes. The influential factors were evaluated with Bayesian model averaging. Criteria for recommendation for feasible methods in LMICs are made based on empirical evidence from the systematic review and given the resource limitation in LMICs. A total of 12,196 records were identified; 64 articles were included for full-text review. The WTP/QALY method and values varied widely across countries with a median WTP/QALY value of i$16,647.6 and WTP/QALY per GDP per capita of 0.53. A total of 11 factors were most influential, in which the discrete-choice experiment method had a posterior probability of 100%. Methods for deriving WTP/QALY vary largely across studies. Eleven influential factors contribute most to the level of values of WTP/QALY, in which the discrete-choice experiment method was the greatest affected. We also found that in most countries, values for WTP/QALY were below 1 x GDP per capita. Some important principles are addressed related to what LMICs may be concerned with when conducting studies to estimate WTP/QALY.
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| 27. |
- Vu Quynh, Mai, et al.
(författare)
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An EQ-5D-5L value set for Vietnam
- 2020
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Ingår i: Quality of Life Research. - : Springer Netherlands. - 0962-9343 .- 1573-2649. ; 29, s. 1923-1933
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The objective of this study was to develop an EQ-5D-5L value set based on the health preferences of the general adult population of Vietnam.METHODS: The EQ-VT protocol version 2.1 was applied. Multi-stage stratified cluster sampling was employed to recruit a nationally representative sample. Both composite time trade-off (C-TTO) and discrete choice experiment (DCE) methods were used. Several modelling approaches were considered including hybrid; tobit; panel and heteroscedastic models. First, models using C-TTO or DCE data were tested separately. Then possibility of combining the C-TTO and DCE data was examined. Hybrid models were tested if it was sensible to combine both types of data. The best-performing model was selected based on both the consistency of the results produced and the degree to which models used all the available data.RESULTS: Data from 1200 respondents representing the general Vietnamese adult population were included in the analyses. Only the DCE Logit model and the regular Hybrid model that uses all available data produced consistent results. As the priority was to use all available data if possible, the hybrid model was selected to generate the Vietnamese value set. Mobility had the largest effect on health state values, followed by pain/discomfort, usual activities, anxiety/depression and self-care. The Vietnam values ranged from - 0.5115 to 1.CONCLUSION: This is the first value set for EQ-5D-5L based on social preferences obtained from a nationally representative sample in Vietnam. The value set will likely play a key role in economic evaluations and health technology assessments in Vietnam.
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| 28. |
- Vu Thi Quynh, Mai, 1991-
(författare)
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A feasibility and applicability study of a health-related quality of life measurement in Vietnam
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: An evidence-based strategy is used the national social health-insurance programme in Vietnam to assess healthcare technologies. Health technology assessments (HTA) have become increasingly important within decision-making processes. This doctoral project involved developing a health-related quality of life (HRQOL) measurement to be used in HTA in Vietnam.Methodology: The doctoral project used a mixed-methods approach, which comprised a health-preference elicitation study using a combination of time-trade-off and discrete choice experiments method for the EQ-5D-5L, as recommended by the EuroQol Group (Objective 1). The project incorporated a validity study that utilised secondary data (Objective 2), a cost-utility analysis that utilised both secondary data and normative costing data (Objective 3), and a qualitative study that utilised empirical data (Objective 4). Additionally, the doctoral project resulted in an EQ-5D-5L reference dataset for the general population of Vietnam.Results: A generic preference-based HRQOL measurement was developed for the Vietnamese population using the EQ-5D-5L instrument. This tool can be utilised not only as an outcome measurement for HTA, but in other health-science disciplines. The EQ-5D-5L comprises a descriptive system with five questions, a visual analogue scale (EQ-VAS), and a value set that facilitates the assignment of health-state values (Sub-study 1). The doctoral project proposed an EQ-5D-5L reference dataset that could serve as a basis for HRQOL comparison in Vietnam (Sub-study 2). It has added evidence on the validity of the EQ-5D-5L for the Vietnamese population through a known-groups validation conducted on individuals with hypertension (Sub-study 2). This validation has facilitated the establishment of a favourable environment for the implementation of this tool in Vietnam. Additionally, the satisfactory performance of the EQ-5D-5L has been shown in producing data that is useful for the cost utility analysis in Vietnam (Sub-study 3). Despite concerns regarding the appropriateness of the EQ-5D-5L in reflecting HRQOL for disease-specific populations, the tool has been accepted and is commonly used in Vietnam (Sub-study 4).Conclusion: The outcomes of the doctoral project are a favourable HTA environment, facilitation of evidence-based decision-making, and contribution to the goal of achieving universal health coverage in Vietnam.
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| 29. |
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| 30. |
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| 31. |
- Vu Thi Quynh, Mai, et al.
(författare)
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Reference data among general population and known-groups validity among hypertensive population of the EQ-5D-5L in Vietnam
- 2022
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Ingår i: Quality of Life Research. - : Springer Nature. - 0962-9343 .- 1573-2649. ; 31, s. 539-550
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aims to provide EQ-5D-5L population norms among the general population in Vietnam and to test EQ-5D-5L’ construction validity among people living with hypertension there.Methods: Descriptive statistics of the five dimensions and five levels, EQ-VAS and EQ-5D-5L indexes were categorised into gender and age groups for the EQ-5D-5L population norms. Known-groups testing was set for lower EQ-5D-5L outcomes among people who were aware of their hypertensive status, females, people with more comorbidities, less education, older ages, and higher body mass indexes. Level of confident interval was 95%.Results: The mean EQ-VAS and EQ-5D-5L indexes were 81.10 (SD: 13.35) and 0.94 (SD: 0.09) among the general population. The EQ-5D-5L outcomes were better among younger people, males, people with more education, employees, and single people. Respondents reported fewer problems with self-care and usual activities and tend to have problems at higher levels across older ages. The known-group testing showed statistically significant results. The mean EQ-VAS and EQ-5D-5L indexes of people in the diagnosed hypertensive group (71.48 and 0.94, respectively) were statistically significantly smaller than they were in the non-hypertensive and undiagnosed hypertensive group (76.65 and 0.97; 76.95 and 0.96 accordingly). Statistically significant associations of lower EQ-5D-5L indexes and EQ-VAS were found among people diagnosed for hypertension, people suffering from an incremental comorbidity, and obese people.Conclusion: This study has provided EQ-5D-5L population norms for the general population and evidence for known-groups validity of the EQ-5D-5L instrument among hypertensive people in Vietnam.
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