Extremely Hot Ambient Temperature and Injury-related Mortality

This pilot study aimed to evaluate the effects of extremely hot ambient temperatures on the total number of fatal injuries. Data were collected from a population-based mortality registry of Thanh Hoa, a province in the North Central region of Vietnam. This study qualified the distributed lag non-linear model and calculated the RR and 95% CI adjusted for long-term trend and absolute humidity. For the entire study population with 3,949 registered deaths due to injuries collected during 2005-2007, after the onset of extremely hot ambient temperatures, an increased risk of death was observed on the 9th day RR (95% CI) = 1.44 (1.06–1.97) and reached the peak on the 12th day RR (95% CI) = 1.58 (1.14–2.17), and at the 15th day RR (95% CI) = 1.49 (1.08–2.06). Men and old adults were identified as the most vulnerable groups. This study confirmed a positive association between hot temperatures and injury-related deaths in the province of 3.6 million people. The findings motivated further investigation into the effect of warm climate changes and the risk of deaths related to other specific causes such as road traffic, work-related injury, and etc

Ecological factors associated with dengue fever in a central highlands Province, Vietnam

<p>Abstract</p> <p>Background</p> <p>Dengue is a leading cause of severe illness and hospitalization in Vietnam. This study sought to elucidate the linkage between climate factors, mosquito indices and dengue incidence.</p> <p>Methods</p> <p>Monthly data on dengue cases and mosquito larval indices were ascertained between 2004 and 2008 in the Dak Lak province (Vietnam). Temperature, sunshine, rainfall and humidity were also recorded as monthly averages. The association between these ecological factors and dengue was assessed by the Poisson regression model with adjustment for seasonality.</p> <p>Results</p> <p>During the study period, 3,502 cases of dengue fever were reported. Approximately 72% of cases were reported from July to October. After adjusting for seasonality, the incidence of dengue fever was significantly associated with the following factors: higher household index (risk ratio [RR]: 1.66; 95% confidence interval [CI]: 1.62-1.70 per 5% increase), higher container index (RR: 1.78; 95% CI: 1.73-1.83 per 5% increase), and higher Breteau index (RR: 1.57; 95% CI: 1.53-1.60 per 5 unit increase). The risk of dengue was also associated with elevated temperature (RR: 1.39; 95% CI: 1.25-1.55 per 2°C increase), higher humidity (RR: 1.59; 95% CI: 1.51-1.67 per 5% increase), and higher rainfall (RR: 1.13; 95% CI: 1.21-1.74 per 50 mm increase). The risk of dengue was inversely associated with duration of sunshine, the number of dengue cases being lower as the sunshine increases (RR: 0.76; 95% CI: 0.73-0.79 per 50 hours increase).</p> <p>Conclusions</p> <p>These data suggest that indices of mosquito and climate factors are main determinants of dengue fever in Vietnam. This finding suggests that the global climate change will likely increase the burden of dengue fever infection in Vietnam, and that intensified surveillance and control of mosquito during high temperature and rainfall seasons may be an important strategy for containing the burden of dengue fever.</p

Gut Microbiome of Patients With Breast Cancer in Vietnam

PURPOSE: Gut microbiota play an important role in human health, including cancer. Cancer and its treatment, in turn, may alter the gut microbiome. To understand this complex relationship, we profiled the gut microbiome of 356 Vietnamese patients with breast cancer. MATERIALS AND METHODS: Stool samples were collected before chemotherapy, with 162 pre- and 194 postsurgery. The gut microbiome was measured by shotgun metagenomic sequencing. Associations of gut microbial diversity, taxa abundance, and gut microbiome health index (GMHI) with sociodemographic, clinical factors, and tumor characteristics were evaluated. RESULTS: Postsurgery samples were associated with significantly lower α- and β-diversities ( CONCLUSION: Our study revealed that diagnosis delay, high fiber intake, and breast cancer surgery, which is always followed by antibiotic prophylaxis in Vietnam, led to a less diverse and unhealthy gut microbiome among patients with breast cancer

Understanding the groups of care transition strategies used by U.S. hospitals: An application of factor analytic and latent class methods

BACKGROUND: After activation of the Hospital Readmission Reduction Program (HRRP) in 2012, hospitals nationwide experimented broadly with the implementation of Transitional Care (TC) strategies to reduce hospital readmissions. Although numerous evidence-based TC models exist, they are often adapted to local contexts, rendering large-scale evaluation difficult. Little systematic evidence exists about prevailing implementation patterns of TC strategies among hospitals, nor which strategies in which combinations are most effective at improving patient outcomes. We aimed to identify and define combinations of TC strategies, or groups of transitional care activities, implemented among a large and diverse cohort of U.S. hospitals, with the ultimate goal of evaluating their comparative effectiveness. METHODS: We collected implementation data for 13 TC strategies through a nationwide, web-based survey of representatives from short-term acute-care and critical access hospitals (N = 370) and obtained Medicare claims data for patients discharged from participating hospitals. TC strategies were grouped separately through factor analysis and latent class analysis. RESULTS: We observed 348 variations in how hospitals implemented 13 TC strategies, highlighting the diversity of hospitals\u27 TC strategy implementation. Factor analysis resulted in five overlapping groups of TC strategies, including those characterized by 1) medication reconciliation, 2) shared decision making, 3) identifying high risk patients, 4) care plan, and 5) cross-setting information exchange. We determined that the groups suggested by factor analysis results provided a more logical grouping. Further, groups of TC strategies based on factor analysis performed better than the ones based on latent class analysis in detecting differences in 30-day readmission trends. CONCLUSIONS: U.S. hospitals uniquely combine TC strategies in ways that require further evaluation. Factor analysis provides a logical method for grouping such strategies for comparative effectiveness analysis when the groups are dependent. Our findings provide hospitals and health systems 1) information about what groups of TC strategies are commonly being implemented by hospitals, 2) strengths associated with the factor analysis approach for classifying these groups, and ultimately, 3) information upon which comparative effectiveness trials can be designed. Our results further reveal promising targets for comparative effectiveness analyses, including groups incorporating cross-setting information exchange

Моделирование пропускной способности пунктов сбора электронных бытовых отходов в городах

This paper presents guidelines for modeling the capacity of electronic household waste collection points. These points are used as infrastructure elements with a multi-stage logistic support scheme for the electronic waste disposal process. This paper includes theoretical and methodological information on the procedure for placing points of waste collection in cities using the processes of determining the parameters of waste accumulation, calculating the design capacity of warehouses at these points, and developing routes for the transportation of waste to the places of their disposal. We represent the dependence of the logistic support costs, including the costs of maintaining waste collection points, and waste disposal to utilization facilities, on the duration of the waste accumulation period. A mathematical model for optimizing the logistic support costs is developed, which takes into account the most important parameters of the waste disposal system, namely, the topology of the collection points, the intensity of waste accumulation, the configuration of the routes, and the vehicle carrying capacity. Using the example of the Vietnamese capital, the city of Hanoi, the required number of waste collection points is calculated, the volume of waste accumulation at each point is determined, the optimal period of waste accumulation, in which the total costs for logistic support for the disposal process will be minimal, is determined. Recommendations on the organization of waste transportation, depending on the actual level of filling the capacity of collection and accumulation points, are given.Рассматриваются методические рекомендации по проектированию вместительной способности электронных пунктов по сбору коммунально-бытовых отходов. Данные пункты используются как элементы инфраструктуры с многоступенчатой схемой материально-технического обеспечения процесса вывоза мусора. Работа содержит теоретическую и методическую информацию о процедуре размещения пунктов сбора отходов в городах с помощью установления параметров процесса накопления мусора, расчета проектной емкости мусорохранилищ в установленных пунктах, а также разработки маршрутов транспортировки отходов к месту их захоронения. Представлена зависимость затрат на материально-техническое обеспечение, которое включает затраты на содержание пунктов по сбору коммунально-бытовых отходов и их вывоз на полигоны, от длительности периода накопления отходов. Разработана математическая модель по оптимизации затрат на логистическую поддержку, принимающая во внимание наиболее важные параметры системы вывоза и захоронения мусора, такие как топология пунктов сбора, интенсивность накопления отходов, конфигурация маршрутов, грузовместимость транспорта. На примере столицы Вьетнама – г. Ханой – подсчитано необходимое количество пунктов сбора мусора и рассмотрен объем накопления отходов на каждом из них, установлен оптимальный период накопления мусора, при котором совокупные расходы на логистическую поддержку вывоза и захоронения бытовых отходов минимальны. Выработаны рекомендации по организации транспортировки бытового мусора в зависимости от непосредственного уровня наполняемости емкостей пунктов сбора коммунально-бытовых отходов