Regional prediction of landslide hazard using probability analysis of intense rainfall in the Hoa Binh province, Vietnam.

The main objective of this study is to assess regional landslide hazards in the Hoa Binh province of Vietnam. A landslide inventory map was constructed from various sources with data mainly for a period of 21 years from 1990 to 2010. The historic inventory of these failures shows that rainfall is the main triggering factor in this region. The probability of the occurrence of episodes of rainfall and the rainfall threshold were deduced from records of rainfall for the aforementioned period. The rainfall threshold model was generated based on daily and cumulative values of antecedent rainfall of the landslide events. The result shows that 15-day antecedent rainfall gives the best fit for the existing landslides in the inventory. The rainfall threshold model was validated using the rainfall and landslide events that occurred in 2010 that were not considered in building the threshold model. The result was used for estimating temporal probability of a landslide to occur using a Poisson probability model. Prior to this work, five landslide susceptibility maps were constructed for the study area using support vector machines, logistic regression, evidential belief functions, Bayesian-regularized neural networks, and neuro-fuzzy models. These susceptibility maps provide information on the spatial prediction probability of landslide occurrence in the area. Finally, landslide hazard maps were generated by integrating the spatial and the temporal probability of landslide. A total of 15 specific landslide hazard maps were generated considering three time periods of 1, 3, and 5 years

Intensified antituberculosis therapy in adults with tuberculous meningitis

BACKGROUND: Tuberculous meningitis is often lethal. Early antituberculosis treatment and adjunctive treatment with glucocorticoids improve survival, but nearly one third of patients with the condition still die. We hypothesized that intensified antituberculosis treatment would enhance the killing of intracerebral Mycobacterium tuberculosis organisms and decrease the rate of death among patients. METHODS: We performed a randomized, double-blind, placebo-controlled trial involving human immunodeficiency virus (HIV)–infected adults and HIV-uninfected adults with a clinical diagnosis of tuberculous meningitis who were admitted to one of two Vietnamese hospitals. We compared a standard, 9-month antituberculosis regimen (which included 10 mg of rifampin per kilogram of body weight per day) with an intensified regimen that included higher-dose rifampin (15 mg per kilogram per day) and levofloxacin (20 mg per kilogram per day) for the first 8 weeks of treatment. The primary outcome was death by 9 months after randomization. RESULTS: A total of 817 patients (349 of whom were HIV-infected) were enrolled; 409 were randomly assigned to receive the standard regimen, and 408 were assigned to receive intensified treatment. During the 9 months of follow-up, 113 patients in the intensified-treatment group and 114 patients in the standard-treatment group died (hazard ratio, 0.94; 95% confidence interval, 0.73 to 1.22; P=0.66). There was no evidence of a significant differential effect of intensified treatment in the overall population or in any of the subgroups, with the possible exception of patients infected with isoniazid-resistant M. tuberculosis. There were also no significant differences in secondary outcomes between the treatment groups. The overall number of adverse events leading to treatment interruption did not differ significantly between the treatment groups (64 events in the standard-treatment group and 95 events in the intensified-treatment group, P=0.08). CONCLUSIONS: Intensified antituberculosis treatment was not associated with a higher rate of survival among patients with tuberculous meningitis than standard treatment. (Funded by the Wellcome Trust and the Li Ka Shing Foundation; Current Controlled Trials number, ISRCTN61649292. opens in new tab.)</p