Access route selection for percutaneous coronary intervention among Vietnamese patients: Implications for in-hospital costs and outcomes

Background:Little is known about rates of access site (transradial (TRI) or transfemoral (TFI)) preference for percutaneous coronary intervention (PCI) and in-hospital costs of patients undergoing these procedures in lower-and middle-countries. Here, we report on access site use, in-hospital costs and outcomes of patients undergoing PCI in Vietnam.Methods:Information from 868 patients were included in the cohort of 1022 patients recruited into the first PCI registry in Vietnam. The total hospital costs and in-hospital outcomes of patients undergoing TRI and TFI were compared. Hospital costs were obtained from the hospital admission system, and major adverse cardiac events, major bleeding events and length of stay were identified through review of medical records.Findings:TRI was the dominant access site for interventionists (694/868 patients). The TFI group reported more lesions of the left main artery, more previous coronary artery bypass grafts and previous PCI in comparison with the TRI group (all p Interpretations:Among patients undergoing PCI, TRI was associated with lower costs and favourable clinical outcomes relative to TFI

A phase IV, multi-centre, randomized clinical trial comparing two pertussis-containing vaccines in pregnant women in England and vaccine responses in their infants.

BACKGROUND: Pertussis vaccines containing three or five pertussis antigens are recommended in pregnancy in many countries, but no studies have compared the effect on infants' antigen-specific immunoglobulin G (IgG) concentrations. The aim of this study was to compare anti-pertussis IgG responses following primary immunization in infants of mothers vaccinated with TdaP5-IPV (low dose diphtheria toxoid, tetanus toxoid, acellular pertussis [five antigens] and inactivated polio) or TdaP3-IPV in pregnancy (three pertussis antigens). METHODS: This multi-centre phase IV randomized clinical trial was conducted in a tertiary referral centre and primary care sites in England. Women were randomized to receive TdaP5-IPV (n = 77) or TdaP3-IPV (n = 77) at 28-32 gestational weeks. A non-randomized control group of 44 women who had not received a pertussis-containing vaccine in pregnancy and their 47 infants were enrolled post-partum. RESULTS: Following infant primary immunization, there was no difference in the geometric mean concentrations (GMCs) of anti-pertussis toxin, filamentous haemagglutinin or pertactin IgG between infants born to women vaccinated with TdaP5-IPV (n = 67) or TdaP3-IPV (n = 63). However, the GMC of anti-pertussis toxin IgG was lower in infants born to TdaP5-IPV- and TdaP3-IPV-vaccinated mothers compared to infants born to unvaccinated mothers (n = 45) (geometric mean ratio 0.71 [0.56-0.90] and 0.78 [0.61-0.98], respectively); by 13 months of age, this difference was no longer observed. CONCLUSION: Blunting of anti-pertussis toxin IgG response following primary immunization occurs in infants born to women vaccinated with TdaP5-IPV and TdaP3-IPV, with no difference between maternal vaccines. The blunting effect had resolved by 13 months of age. These results may be helpful for countries considering which pertussis-containing vaccine to recommend for use in pregnancy. TRIAL REGISTRATION: ClinicalTrials.gov , NCT02145624 , registered 23 May 2014

Greenhouse gas emissions from passive composting of manure and digestate with crop residues and biochar on small-scale livestock farms in Vietnam

This study investigated the effects of different mixing ratios of crop residues and biochar with liquid digestate from anaerobically treated pig manure on CH4, CO2, and N2O emissions over 84 days in a system of passive aeration composting, resembling typical Vietnamese solid manure storage conditions. Two treatments with solid manure were included for comparison. The results showed that C losses through CH4 and CO2 emissions accounted for 0.06–0.28% and 1.9–26.7%, respectively, of initial total C. CH4 losses accounted for just 0.4–4.0% of total C losses. Total N losses accounted for 27.1–40% of initial total N in which N2O emissions corresponded to 0.01–0.57% of initial total N, and hence accounted for only 0.1–1.8% of total N losses. It is assumed that the remainder was either the result of denitrification losses to N2 or ammonia volatilization. The composting of biochar (B) or crop residue with digestate (D) showed significantly lower CH4 and N2O emissions compared with composting manure (M) (p < .05). The composting of digestate with biochar showed significantly lower CO2 and CH4 emissions and significantly higher N2O emissions compared to the composting of digestate with rice straw (RS) (p < .05). The combined composting of digestate with biochar and rice straw (D + B + RS5:0.3:1) showed significantly reduced N2O emissions compared with composting digestate with biochar with alone (p < .05). Composting sugar cane bagasse (SC) with digestate (D + SC) significantly reduced CH4 and N2O emissions compared with the composting of rice straw with digestate (D + RS3.5:1 and D + RS5:1) (p < .05)

The application of sample pooling for mass screening of SARS-CoV-2 in an outbreak of COVID-19 in Vietnam

We sampled nasal–pharyngeal throat swabs from 96,123 asymptomatic individuals at risk of SARS-CoV-2 infection, and generated 22,290 pools at collection, each containing samples from two to seven individuals. We detected SARS-CoV-2 in 24 pools, and confirmed the infection in 32 individuals after resampling and testing of 104 samples from positive pools. We completed the testing within 14 days. We would have required 64 days to complete the screening for the same number of individuals if we had based our testing strategy on individual testing. There was no difference in cycle threshold (Ct) values of pooled and individual samples. Thus, compared with individual sample testing, our approach did not compromise PCR sensitivity, but saved 77% of the resources. The present strategy might be applicable in settings, where there are shortages of reagents and the disease prevalence is low, but the demand for testing is high