ベトナム中部における稲遺伝資源の探索収集

The exploration of rice germplasm in central Vietnam was carried out from November 7 to December 6, 1997. This exploration was a cooperative project of National Institute of Agrobiological Resources, Japan, and Department of Science Technology and Product Quality, Ministry of Agriculture and Rural Development, Vietnam. Our exploration in 1997 was the sixth mission since 1994. Authors visited five provinces, Quan Nam, Kon Tum, Gia Lai, Dac Lac and Lam Dong. The area we visited in Quan Nam was at an altitude of 200m above sea level, and in mountainous area covered with rich forest along rivers. Only a few paddy fields were along the river, upland rice was cultivated on the slopes of the mountains under the slash-and-burn practice. The villagers were Kinh, the majority people of Vietnam. The other four provinces were in the central highland, which was called as "Red-soil Highland". Provinces of Kon Tum, Gia Lai and Dac Lac are at an altitude of 500 to 700m and Lam Dong, 1,000 to 1,500m. The central highland is an area of relatively dry weather and red soil of poor fertility. In some areas of this highland, the minority peoples accounted for more than half of the population. Based on these environmental conditions and social factors, many local cultivars of rice, especially of upland cultivars, were cultivated in slash-and-burn fields. Most of rice had been harvested by the time when we visited. Therefore we ask the farmers to provide rice samples for our collection. To record the characteristics of the rice cultivars, we interviewed the farmers. In this exploration, 119 local cultivars were collected. As has been reported in previous explorations in Vietnam, most of the paddy fields, if irrigated irrespective of their size and location, improved cultivars are cultivated. Therefore, 98 of the 119 cultivars collected were upland rice cultivars. Also as has been reported in the previous explorations in Vietnam, some minority people in this country have glutinous or low amylose rice cultivars as their staple foods. In our collection, 22 cultivars were glutinous cultivars and 23 cultivars were considered to be low-amylose cultivars from the observation of brown rice grain. It was considered after our exploration that people in this area still had many local cultivars in addition to these we collected. However, with the economy changes underway in Vietnam, their number may decrease. Therefore, the collecting and evaluating the local cultivars in this area might be an urgent task

ベトナムにおけるイネ遺伝資源の探索収集

The mission explored northwest Vietnam which is within the zone of maximum diversity of Asian cultivated rice. We explored four provinces and collected 189 samples of rice. About seventy percent of the collection was glutinous rice. Landraces still remained in upland rice although most of lowland paddy rice had been replaced with improved varieties. Upland rice is cultivated on hilly or mountanious places. The wild species Oryza granulata was observed in the south part of Dien Bien. Some interesting places in genetic diversity of rice could not be explored because of bad road conditions. Further survey and collection are required to understand genetic diversity of cultivated rice in northwest Vietnam

Point-of-care C-reactive protein testing to reduce inappropriate use of antibiotics for non-severe acute respiratory infections in Vietnamese primary health care: a randomised controlled trial

Background Inappropriate antibiotic use for acute respiratory tract infections is common in primary health care, but distinguishing serious from self-limiting infections is diffi cult, particularly in low-resource settings. We assessed whether C-reactive protein point-of-care testing can safely reduce antibiotic use in patients with non-severe acute respiratory tract infections in Vietnam. Method We did a multicentre open-label randomised controlled trial in ten primary health-care centres in northern Vietnam. Patients aged 1–65 years with at least one focal and one systemic symptom of acute respiratory tract infection were assigned 1:1 to receive either C-reactive protein point-of-care testing or routine care, following which antibiotic prescribing decisions were made. Patients with severe acute respiratory tract infection were excluded. Enrolled patients were reassessed on day 3, 4, or 5, and on day 14 a structured telephone interview was done blind to the intervention. Randomised assignments were concealed from prescribers and patients but not masked as the test result was used to assist treatment decisions. The primary outcome was antibiotic use within 14 days of follow-up. All analyses were prespecifi ed in the protocol and the statistical analysis plan. All analyses were done on the intention-totreat population and the analysis of the primary endpoint was repeated in the per-protocol population. This trial is registered under number NCT01918579. Findings Between March 17, 2014, and July 3, 2015, 2037 patients (1028 children and 1009 adults) were enrolled and randomised. One adult patient withdrew immediately after randomisation. 1017 patients were assigned to receive C-reactive protein point-of-care testing, and 1019 patients were assigned to receive routine care. 115 patients in the C-reactive protein point-of-care group and 72 patients in the routine care group were excluded in the intention-to-treat analysis due to missing primary endpoint. The number of patients who used antibiotics within 14 days was 581 (64%) of 902 patients in the C-reactive protein group versus 738 (78%) of 947 patients in the control group (odds ratio [OR] 0·49, 95% CI 0·40–0·61; p<0·0001). Highly signifi cant diff erences were seen in both children and adults, with substantial heterogeneity of the intervention eff ect across the 10 sites (I²=84%, 95% CI 66–96). 140 patients in the C-reactive protein group and 137 patients in the routine care group missed the urine test on day 3, 4, or 5. Antibiotic activity in urine on day 3, 4, or 5 was found in 267 (30%) of 877 patients in the C-reactive protein group versus 314 (36%) of 882 patients in the routine treatment group (OR 0·78, 95% CI 0·63–0·95; p=0·015). Time to resolution of symptoms was similar in both groups. Adverse events were rare, with no deaths and a total of 14 hospital admissions (six in the C-reactive protein group and eight in the control group). Interpretation C-reactive protein point-of-care testing reduced antibiotic use for non-severe acute respiratory tract infection without compromising patients’ recovery in primary health care in Vietnam. Health-care providers might have become familiar with the clinical picture of low C-reactive protein, leading to reduction in antibiotic prescribing in both groups, but this would have led to a reduction in observed eff ect, rather than overestimation. Qualitative analysis is needed to address diff erences in context in order to implement this strategy to improve rational antibiotic use for patients with acute respiratory infection in low-income and middle-income countries

Influenza A H5N1 and HIV co-infection: case report

<p>Abstract</p> <p>Background</p> <p>The role of adaptive immunity in severe influenza is poorly understood. The occurrence of influenza A/H5N1 in a patient with HIV provided a rare opportunity to investigate this.</p> <p>Case Presentation</p> <p>A 30-year-old male was admitted on day 4 of influenza-like-illness with tachycardia, tachypnea, hypoxemia and bilateral pulmonary infiltrates. Influenza A/H5N1 and HIV tests were positive and the patient was treated with Oseltamivir and broad-spectrum antibiotics. Initially his condition improved coinciding with virus clearance by day 6. He clinically deteriorated as of day 10 with fever recrudescence and increasing neutrophil counts and died on day 16. His admission CD4 count was 100/μl and decreased until virus was cleared. CD8 T cells shifted to a CD27⁺CD28^-phenotype. Plasma chemokine and cytokine levels were similar to those found previously in fatal H5N1.</p> <p>Conclusions</p> <p>The course of H5N1 infection was not notably different from other cases. Virus was cleared despite profound CD4 T cell depletion and aberrant CD8 T cell activation but this may have increased susceptibility to a fatal secondary infection.</p

PLoS Med

BACKGROUND: The effect of antiretroviral treatment (ART) eligibility expansions on patient outcomes, including rates of timely ART initiation among those enrolling in care, has not been assessed on a large scale. In addition, it is not known whether ART eligibility expansions may lead to "crowding out" of sicker patients. METHODS AND FINDINGS: We examined changes in timely ART initiation (within 6 months) at the original site of HIV care enrollment after ART eligibility expansions among 284,740 adult ART-naive patients at 171 International Epidemiology Databases to Evaluate AIDS (IeDEA) network sites in 22 countries where national policies expanding ART eligibility were introduced between 2007 and 2015. Half of the sites included in this analysis were from Southern Africa, one-third were from East Africa, and the remainder were from the Asia-Pacific, Central Africa, North America, and South and Central America regions. The median age of patients enrolling in care at contributing sites was 33.5 years, and the median percentage of female patients at these clinics was 62.5%. We assessed the 6-month cumulative incidence of timely ART initiation (CI-ART) before and after major expansions of ART eligibility (i.e., expansion to treat persons with CD4 </= 350 cells/muL [145 sites in 22 countries] and CD4 </= 500 cells/muL [152 sites in 15 countries]). Random effects metaregression models were used to estimate absolute changes in CI-ART at each site before and after guideline expansion. The crude pooled estimate of change in CI-ART was 4.3 percentage points (95% confidence interval [CI] 2.6 to 6.1) after ART eligibility expansion to CD4 </= 350, from a baseline median CI-ART of 53%; and 15.9 percentage points (pp) (95% CI 14.3 to 17.4) after ART eligibility expansion to CD4 </= 500, from a baseline median CI-ART of 57%. The largest increases in CI-ART were observed among those newly eligible for treatment (18.2 pp after expansion to CD4 </= 350 and 47.4 pp after expansion to CD4 </= 500), with no change or small increases among those eligible under prior guidelines (CD4 </= 350: -0.6 pp, 95% CI -2.0 to 0.7 pp; CD4 </= 500: 4.9 pp, 95% CI 3.3 to 6.5 pp). For ART eligibility expansion to CD4 </= 500, changes in CI-ART were largest among younger patients (16-24 years: 21.5 pp, 95% CI 18.9 to 24.2 pp). Key limitations include the lack of a counterfactual and difficulty accounting for secular outcome trends, due to universal exposure to guideline changes in each country. CONCLUSIONS: These findings underscore the potential of ART eligibility expansion to improve the timeliness of ART initiation globally, particularly for young adults

Lavrentiev regularization method for nonlinear ill-posed problems

In this paper we shall be concerned with Lavientiev regularization method to reconstruct solutions x sub 0 of non ill-posed problems F(x)=y sub o , where instead of y sub 0 noisy data y subdelta is an element of X with absolut(y subdelta-y sub 0) X is an accretive nonlinear operator from a real reflexive Banach space X into itself. In this regularization method solutions x subalpha supdelta are obtained by solving the singularly perturbed nonlinear operator equation F(x)+alpha(x-x*)=y subdelta with some initial guess x*. Assuming certain conditions concerning the operator F and the smoothness of the element x*-x sub 0 we derive stability estimates which show that the accuracy of the regularized solutions is order optimal provided that the regularization parameter alpha has been chosen properly

Principles of macroeconomics

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