Transitions in diatom assemblages and pigments through dry and wet season conditions in the Red River, Hanoi (Vietnam)

Background and aims – Biomonitoring is an important tool for assessing river water quality, but is not routinely applied in tropical rivers. Marked hydrological changes can occur between wet and dry season conditions in the tropics. Thus, a prerequisite for ecological assessment is that the influence of ‘natural’ hydrological change on biota can be distinguished from variability driven by water quality parameters of interest. Here we aimed to (a) assess seasonal changes in water quality, diatoms and algal assemblages from river phytoplankton and artificial substrates through the dry-wet season transition (February–July 2018) in the Red River close to Hanoi and (b) evaluate the potential for microscopic counts and high-performance liquid chromatography (HPLC) analysis of chlorophyll and carotenoid pigments for biomonitoring in large tropical rivers.Methods – River water (phytoplankton) and biofilms grown on artificial glass substrates were sampled monthly through the dry (February–April) to wet (May–August) season transition and analysed via microscopic and HPLC techniques.Key results – All phototrophic communities shifted markedly between the dry and wet seasons. Phytoplankton concentrations were low (ca. thousands of cells/mL) and declined as the wet season progressed. The dominant phytoplankton taxa were centric diatoms (Aulacoseira granulata and Aulacoseira distans) and chlorophytes (Scenedesmus and Pediastrum spp.), with chlorophytes becoming more dominant in the wet season. Biofilm diatoms were dominated by Melosira varians, and areal densities declined in the wet season when fast-growing pioneer diatom taxa (e.g. Achnanthidium minutissimum, Planothidium lanceolatum) and non-degraded Chlorophyll a concentrations increased, suggesting active phytobenthos growth in response to scour damage. Otherwise, a-phorbins were very abundant in river seston and biofilms indicating in situ Chlorophyll a degradation which may be typical of tropical river environments. The very large range of total suspended solids (reaching > 120 mg L-1) and turbidity appears to be a key driver of photoautotrophs through control of light availability.Conclusions – Hydrological change and associated turbidity conditions exceed nutrient influences on photoautotrophs at inter-seasonal scales in this part of the Red River. Inter-seasonal differences might be a useful measure for biomonitoring to help track how changes in suspended solids, a major water quality issue in tropical rivers, interact with other variables of interest

Evaluation of awake prone positioning effectiveness in moderate to severe COVID-19

Evidence mainly from high income countries suggests that lying in the prone position may be beneficial in patients with COVID-19 even if they are not receiving invasive ventilation. Studies indicate that increased duration of prone position may be associated with improved outcomes, but achieving this requires additional staff time and resources. Our study aims to support prolonged (≥ 8hours/day) awake prone positioning in patients with moderate to severe COVID-19 disease in Vietnam. We use a specialist team to support prone positioning of patients and wearable devices to assist monitoring vital signs and prone position and an electronic data registry to capture routine clinical data

Urinary catecholamine excretion, cardiovascular variability, and outcomes in tetanus

Severe tetanus is characterized by muscle spasm and cardiovascular system disturbance. The pathophysiology of muscle spasm is relatively well understood and involves inhibition of central inhibitory synapses by tetanus toxin. That of cardiovascular disturbance is less clear, but is believed to relate to disinhibition of the autonomic nervous system. The clinical syndrome of autonomic nervous system dysfunction (ANSD) seen in severe tetanus is characterized principally by changes in heart rate and blood pressure which have been linked to increased circulating catecholamines. Previous studies have described varying relationships between catecholamines and signs of ANSD in tetanus, but are limited by confounders and assays used. In this study, we aimed to perform detailed characterization of the relationship between catecholamines (adrenaline and noradrenaline), cardiovascular parameters (heart rate and blood pressure) and clinical outcomes (ANSD, mechanical ventilation required, and length of intensive care unit stay) in adults with tetanus, as well as examine whether intrathecal antitoxin administration affected subsequent catecholamine excretion. Noradrenaline and adrenaline were measured by ELISA from 24-h urine collections taken on day 5 of hospitalization in 272 patients enrolled in a 2 × 2 factorial-blinded randomized controlled trial in a Vietnamese hospital. Catecholamine results measured from 263 patients were available for analysis. After adjustment for potential confounders (i.e., age, sex, intervention treatment, and medications), there were indications of non-linear relationships between urinary catecholamines and heart rate. Adrenaline and noradrenaline were associated with subsequent development of ANSD, and length of ICU stay

Epidemiological urinalysis of children from kindergartens of Can Gio, Ho Chi Minh City - Vietnam

Background Recent studies on Vietnamese children have shown that kidney diseases are not detected early enough to prevent chronic renal failure. The dipstick test is a simple and useful tool for detecting urinary abnormalities, especially in isolated or remote areas of Vietnam, where children have limited access to health care. Methods This cross-sectional study was conducted in 2011 at seven kindergartens in Can Gio district, Ho Chi Minh City, Vietnam. Two thousand and twelve children, aged 3 to 5, were enrolled. Morning mid-stream urine samples were examined by dipstick. Children with abnormal findings were re-examined with a second dipstick and underwent further investigations. Results Urinalysis was available for 1,032 boys and 980 girls. Mean age was 4.4 ± 0.8 years. Urinary abnormalities were detected in 108 (5.5%) of the subjects. Among them, nitrituria and leucocyturia accounted for more than 50%. Positive fractions of proteinuria, hematuria, nitrituria, leucocyturia, and combined nitrituria and leucocyturia after two dipsticks were 0.1%, 0.1%, 2%, 1% and 0.3%, respectively. Abnormal findings were more common in girls than boys (p < 0.001), and higher in communes with very low (< 50 persons/km2) population density (14.3% vs 4.1%, p < 0.001). A renal ultrasound detected four cases of hydronephrosis and one case of duplication of ureter. Conclusions The prevalence of urinary abnormalities in asymptomatic children in South Vietnam demonstrates the need for hygiene education among parents. Training for dipstick usage for all medical staff at health stations, especially in remote areas and in places with very low population density, is also clearly necessary. Routine urinalysis can be set up if a close control is conducted at locations