Prevalence of carbapenem resistance and its potential association with antimicrobial use in humans and animals in rural communities in Vietnam

Background Vietnam and Southeast Asia are hotspots for antimicrobial resistance; however, little is known on the prevalence of carriage of carbapenem resistance in non-hospitalized humans and in animals. Carbapenem-resistant Enterobacteriaceae (CRE), particularly Escherichia coli (CREC) and Klebsiella pneumoniae (CRKP) and also Acinetobacter baumannii (CRAB) are emerging threats worldwide. Methods We investigated healthy humans (n = 652), chickens (n = 237), ducks (n = 150) and pigs (n = 143) in 400 small-scale farms in the Mekong Delta of Vietnam. Samples (rectal swabs, faecal swabs) were investigated for carriage of CRE/CRAB and were further characterized phenotypically and genotypically. Results In the Mekong Delta of Vietnam, the prevalence of CRE isolates in human rectal swabs was 0.6%, including 4 CREC and 1 CRKP. One pig was infected with CREC (prevalence 0.7%). CRAB was isolated from chickens (n = 4) (prevalence 2.1%) and one duck (prevalence 0.7%). CRKP was isolated from a human who was also colonized with CREC. The CRKP strain (ST16), from an 80 year-old person with pneumonia under antimicrobial treatment, genetically clustered with clinical strains isolated in a hospital outbreak in southern Vietnam. The prevalence of CRE was higher among humans that had used antimicrobials within 90 days of the sampling date than those had not (4.2% versus 0.2%) (P = 0.005). All CRE/CRAB strains were MDR, although they were susceptible to colistin and neomycin. The carbapenemase genes identified in study strains were blaNDM and blaOXA. Conclusions The finding of a CRKP strain clustering with previous hospital outbreak raises concerns about potential transmission of carbapenem-resistant organisms from hospital to community settings or vice-versa

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

The Impact of "Doi Moi" Reforms on the Economy in 2004-2014

Cílem práce je analyzovat vliv reforem Doi Moi na ekonomiku Vietnamu v letech 2004-2014 započatých koncem 80. let minulého století. V teoretické části jsou řešeny základní makroekonomické agregáty, alternativní ukazatele životní úrovně, vlivy mezinárodního obchodu na ekonomický růst a zvláštní pozornost je věnována kapitole srovnávající centrálně plánovanou ekonomiku s tržním kapitalismem. Tato teoretická východiska poskytnou praktické části informační základnu při analýze dat. Analytická část zkoumá reformní období a důvody pro realizaci liberalizačních reforem, které ovlivňují ekonomiku země i třicet let po jejich zahájení. Z analýzy vyplývá, že mostem mezi předešlým a současným stoletím jsou pozdější efekty a externality vzniklé z reforem. Tím se myslí rostoucí soukromý sektor, který poslední dekádu minulého století zesílil natolik, že od počátku nového tisíciletí se stal hlavním tahounem ekonomického růstu Vietnamu.The goal of the bachelor thesis is to analyze the impact of the Doi Moi reforms on the Vietnamese economy in 2004-2014, which has started in late 80s of the last century. The theoretical part deals with the basic macroeconomic aggregates, alternative indicators of living standards, the effects of international trade on economic growth and particular attention is given to the chapter comparing centrally planned economy to a market capitalism. This theoretical background will provide information base for the data analysis in the practical part of the bachelor thesis. The analytical part explores the reform period and the reasons for the implementation of liberalization reforms, which affect the country's economy even thirty years after their launch. The analysis shows that the bridge between the previous and present centuries are the later effects and externalities arising from the reforms. That means growing private sector, which has become stronger in the last decade of the last century so from the beginning of the new millennium it has become the main drive of economic growth in Vietnam

Selection of a foreign market for the start of sales of a Czech brand in crossborder e-commerce

Oblast e-commerce je velmi dynmickým odvětvím s mnoha přelívajícími se pozitivními externalitami do mnoha oborů. Pomáhají je inovovat nebo motivovat lidi ke změně nákupních chování jako například nakupovat více na internetu než-li v kamenných pobočkách nebo nakupovat ze zahraničních trhů namísto domácích. Cílem práce je poskytnout vybrané české firmě nástroje a podklady k efektivnímu rozhodnutí o výběru zahraničního trhu k expanzi. Pro dosáhnutí cíle práce vybrat výhodnější variantu byly zvoleny metody vícekriteriálního ohodnocení variant. Po dílčích ohodnocení zvolených dvou variant expanze byly stanoveny celkové ohodnocení, z kterých vyšel finální výsledek pro rozhodnutí.The field of e-commerce is a very dynamic industry with many positive externalities spilling over into many fields. They help them innovate or motivate people to change their shopping behaviors, such as shopping more online than in brick-and-mortar branches or shopping from foreign markets instead of domestic ones. The aim of the thesis is to provide a selected Czech company with tools and materials for an effective decision on the selection of a foreign market for expansion. To achieve the aim of the work to choose a more advantageous variant, methods of multicriteria evaluation of variants were chosen. After partial evaluations of the selected two expansion variants, the overall evaluations were determined, from which the final result for the decision was derived

Outcomes of autologous bone marrow mononuclear cells for cerebral palsy: an open label uncontrolled clinical trial

Abstract Background Stem cell therapy has emerged as a promising method for improving motor function of patients with cerebral palsy. The aim of this study is to assess the safety and effectiveness of autologous bone marrow mononuclear stem cell transplantation in patients with cerebral palsy related to oxygen deprivation. Methods An open label uncontrolled clinical trial was carried out at Vinmec International Hospital. The intervention consisted of two administrations of stem cells, the first at baseline and the second 3 months later. Improvement was monitored at 3 months and 6 months after the first administration of stem cells, using the Gross Motor Function Measure (GMFM) and Modified Ashworth Score which measures muscle tone. Results No severe complications were recorded during the study. After transplantation, 12 patients encountered fever without infections and 9 patients experienced vomiting which was easily managed with medications. Gross motor function was markedly improved 3 months or 6 months after stem cell transplantation than at baseline. The post-transplantation GMFM-88 total score, each of its domains and the GMFM-66 percentile were all significantly higher (p-value  0.05). Conclusion Autologous bone marrow mononuclear cell transplantation appears to be a safe and effective therapy for patients with cerebral palsy. Trial registration ClinicalTrials.gov Identifier: NCT02569775 . Retrospectively registered on October 15, 2015

Association of Lactoferrin and Toll-like Receptor 2 Genotypes with Mastitis and Milk Components in Vietnamese Holstein Cattle

Mastitis is one of the most widespread diseases in dairy cows and causes huge losses for the dairy industry. Molecular markers can be used for the quick diagnosis of mastitis infection, consequently reducing the loss caused by this disease. Lactoferrin (LTF) and Toll-like receptor 2 (TLR2) have been suggested as candidate genes for mastitis; however, their associations with the mastitis incidence and milk components have not been reported in Vietnamese Holstein cows. This study examined the association of TLR2 and LTF polymorphisms with subclinical mastitis and milk components in the Holstein breed raised in Vietnam. Among 192 samples, we identified 44 mastitis-positive samples (22.92%). The mastitis significantly reduced the fat and lactose components in milk (p &lt; 0.001) but increased the protein concentration in milk. A total of 94 (49%) and 98 (51%) cows had AA and AB genotypes for the LTF gene, respectively. No significant association was found between the LTF genotypes and the milk component traits or mastitis incidence (p &gt; 0.05). The interaction between LTF and mastitis incidence was significantly associated with the protein percentage (p = 0.01). A total of 78, 76, and 38 cows had genotypes GG, GT, and TT for the TLR2 gene, respectively. TLR2 genotypes were not significantly associated with mastitis incidence (p &gt; 0.05) but were significantly associated with pH value (p = 0.03). The interaction between TLR2 and mastitis incidence was significantly associated with the fat (p = 0.02) and protein percentage (p = 0.04). Further studies are required to confirm the roles of LTF and TFL2 in mastitis in the Holstein breed in Vietnam

Highly Sensitive Planar Hall Magnetoresistive Sensor for Magnetic Flux Leakage Pipeline Inspection

Magnetic flux leakage (MFL) detection is frequently used for oil and gas pipeline inspection, especially for evaluation of the integrity of pipelines. The success of the MFL technique depends on many parameters. However, a sensitive magnetic sensor is an important requirement. Therefore, magnetic field sensors based on different mechanisms have been developed and applied to the MFL technique. In this paper, we evidence for the first time the capability of an innovative device based on a planar Hall magnetoresistance sensor devoted to MFL detection. This promising prototype combines all the required qualifications such as high sensitivity, low thermal drift, and bipolar and linear responses to the magnetic field. New achievements are carried out on embedded sensors in a testing platform reflecting pipeline environments. The ultrasensitive magnetic mapping concludes to a convincing technical approach with a high potential application toward MFL inspection, especially for the detection of shallow defects appearing at near side, far side, and sub-surface of a pipe wall. © 2018 IEEE.1

Deep learning to assess the effects of land use/land cover and climate change on landslide susceptibility in the Tra Khuc river basin of Vietnam

Understanding the negative effects of climate change and changes to land use/land cover on natural hazards is an important feature of sustainable development worldwide, as these phenomena are inextricably linked with natural hazards such as landslides. The contribution of this study is an attempt to develop a state-of-the-art method to assess the effects of climate change and changes in land use/land cover on landslide susceptibility in the Tra Khuc river basin in Vietnam. The method is based on machine learning and remote sensing algorithms, namely radial basis function neural networks–search and rescue optimization (RBFNN–SARO), radial basis function neural network–queuing search algorithm (RBFNN–QSA), radial basis function neural network–life choice-based optimizer (RBFNN–LCBO), radial basis function neural network–dragonfly optimization (RBFNN–DO). All proposed models performed well, with AUC value of >0.9. The RBFNN–QSA model performed best, with an AUC value of 0.98, followed by RBFNN–SARO (AUC = 0.97), RBFNN–LCBO (AUC = 0.95), RBFNN–DO (AUC = 0.93), and support vector machine (SVM; AUC = 0.92). The results show that both climate and land use/land cover change greatly in the future: Precipitation increases 18% by 2030 and 25.1% by 2050; the total production forest, protected forest and built-up area change considerably between 2010 and 2050. These changes influence landslide susceptibility: The area of high and very high landslide susceptibility decrease by approximately 100 and 300 km2 respectively in the study area from 2010 to 2050. The findings of this study can support decision-makers in formulating appropriate strategies to reduce damage from landslides, such as limiting construction in areas where future landslides are predicted. Although this study applies to a particular region of Vietnam, the findings can be applied in other mountainous regions around the world