Clinical features, antimicrobial susceptibility patterns and genomics of bacteria causing neonatal sepsis in a children's hospital in Vietnam: protocol for a prospective observational study.

INTRODUCTION: The clinical syndrome of neonatal sepsis, comprising signs of infection, septic shock and organ dysfunction in infants ≤4 weeks of age, is a frequent sequel to bloodstream infection and mandates urgent antimicrobial therapy. Bacterial characterisation and antimicrobial susceptibility testing is vital for ensuring appropriate therapy, as high rates of antimicrobial resistance (AMR), especially in low-income and middle-income countries, may adversely affect outcome. Ho Chi Minh City (HCMC) in Vietnam is a rapidly expanding city in Southeast Asia with a current population of almost 8 million. There are limited contemporary data on the causes of neonatal sepsis in Vietnam, and we hypothesise that the emergence of multidrug resistant bacteria is an increasing problem for the appropriate management of sepsis cases. In this study, we aim to investigate the major causes of neonatal sepsis and assess disease outcomes by clinical features, antimicrobial susceptibility profiles and genome composition. METHOD AND ANALYSIS: We will conduct a prospective observational study to characterise the clinical and microbiological features of neonatal sepsis in a major children's hospital in HCMC. All bacteria isolated from blood subjected to whole genome sequencing. We will compare clinical variables and outcomes between different bacterial species, genome composition and AMR gene content. AMR gene content will be assessed and stratified by species, years and contributing hospital departments. Genome sequences will be analysed to investigate phylogenetic relationships. ETHICS AND DISSEMINATION: The study will be conducted in accordance with the principles of the Declaration of Helsinki and the International Council on Harmonization Guidelines for Good Clinical Practice. Ethics approval has been provided by the Oxford Tropical Research Ethics Committee 35-16 and Vietnam Children's Hospital 1 Ethics Committee 73/GCN/BVND1. The findings will be disseminated at international conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER: ISRCTN69124914; Pre-results

Transmission studies of explosive vaporization of a transparent liquid film on an opaque solid surface induced by excimer-laser-pulsed irradiation

Examines the dynamics of the explosion of a liquid film by an ultraviolet excimer pulsed laser studied experimentally on top of an amorphous silicon film deposited on fused quartz. Background on thermal physics of superheated pure or mixed liquids; Techniques for surface temperature measurement; Experimental of probe laser and pulsed excimer laser

Explosion of a liquid film in contact with a pulse-heated solid surface detected by the probe-beam deflection method

The threshold for explosive vaporization of a liquid layer on an opaque solid surface heated by an ultraviolet excimer pulsed laser is studied by a photoacoustic probe-beam deflection method. The probe beam traverses the liquid in the vicinity of the laser-heated liquid-solid interface. Below the explosion threshold, photoacoustic generation in the solid occurs only through a thermoelastic mechanism, which results mainly in shear waves that do not couple well into the liquid. Above the explosion threshold, photoacoustic pulses in the solid are also produced by explosive recoil, hence producing longitudinal pulses in the solid that couple well into the liquid after reflections. By setting the probe-beam refraction to detect longitudinal pulse echoes coupled back into the liquid, a sensitive detection of the explosive threshold can be established

Photodeflection probing of the explosion of a liquid film in contact with a solid heated by pulsed excimer laser irradiation

The explosion or rapid vaporization of a liquid film on an opaque surface by a pulsed laser is studied experimentally. Using a probe-beam deflection sensing (PDS) scheme, together with a previously developed transmission monitor, the distortion of the PDS signal due to the generation of shock waves by the exploding liquid is investigated. Various liquids, including alcohols and pure water in contact with substrates such as polyimide, amorphous carbon, and silicon, are studied for a wide range of excimer laser fluences. It is concluded that the present PDS technique is highly sensitive to the explosion threshold

Fabrication of mesenchymal stem cell sheets for tendon/ligament tissue engineering

Transactions - 7th World Biomaterials Congress894

Kino

The temperature dependence of the optical properties for amorphous silicon is studied at wavelengths of 632.8 and 752 nm. Both the refractive index and extinction coefficient increase linearly with temperature for 752 nm, while the refractive index decreases and the extinction coefficient increases for 632.8 nm. The rate of increase of the extinction coefficient at 632.8 nm is twice as much as that for 752 nm

Identifying new resistance to Cassava Mosaic Disease and validating markers for the CMD2 locus

Open Access Journal; Published online: 30 Aug 2021Cassava (Manihot esculenta Crantz) is a crucial staple crop, and provides carbohydrate energy to more than half a billion people in the tropics. Cassava mosaic disease (CMD) is the most important disease of cassava in Africa. Since Sri Lanka Cassava Mosaic Virus (SLCMV) was first reported in South East Asia in 2015, establishing sustainable solutions to CMD has become a top priority for the cassava program at the International Center for Tropical Agriculture (CIAT) and its partners. In the present study, we screened two populations for CMD resistance: VNM142, 142 clones collected from farms throughout Vietnam, and CIAT102, 102 clones resistant to CMD or mites, which were introduced from CIAT. High broad-sense heritability was observed in all the trials (>0.80). From the population VNM142, eight clones showed high CMD resistance with CMD severity scores less than 2.0. Two resistant clones had the same DNA fingerprinting with the accessions CR63 (PER262 or TAI9) and KM57 (VNM8) in the genebank, respectively. To our knowledge, this is the first report of CMD resistance in the genebank at CIAT. We also used the two populations to validate the CMD markers S12_7926132 and S14_4626854. Both markers explained 51% of the population variance in the segregating population CIAT102, but only 11% in the diverse population VNM142. Thus, we concluded that the two CMD markers could not be used to select for CMD resistance in diverse populations, but could predict the CMD resistance in segregating populations when the susceptible parents do not have resistant marker alleles and the resistance of the CMD2 donors is confirmed

A Trial of Itraconazole or Amphotericin B for HIV-Associated Talaromycosis

BACKGROUND: Talaromyces marneffei infection is a major cause of human immunodeficiency virus (HIV)-related death in South and Southeast Asia. Guidelines recommend initial treatment with amphotericin B deoxycholate, but this drug has substantial side effects, a high cost, and limited availability. Itraconazole is available in oral form, is associated with fewer unacceptable side effects than amphotericin, and is widely used in place of amphotericin; however, clinical trials comparing these two treatments are lacking. METHODS: In this open-label, noninferiority trial, we randomly assigned 440 HIV-infected adults who had talaromycosis, confirmed by either microscopy or culture, to receive either intravenous amphotericin B deoxycholate (amphotericin) (219 patients), at a dose of 0.7 to 1.0 mg per kilogram of body weight per day, or itraconazole capsules (221 patients), at a dose of 600 mg per day for 3 days, followed by 400 mg per day, for 11 days; thereafter, all the patients received maintenance therapy with itraconazole. The primary outcome was all-cause mortality at week 2. Secondary outcomes included all-cause mortality at week 24, the time to clinical resolution of talaromycosis, early fungicidal activity, relapse of talaromycosis, development of the immune reconstitution inflammatory syndrome (IRIS), and the side-effect profile. RESULTS: The risk of death at week 2 was 6.5% in the amphotericin group and 7.4% in the itraconazole group (absolute risk difference, 0.9 percentage points; 95% confidence interval [CI], -3.9 to 5.6; P<0.001 for noninferiority); however, the risk of death at week 24 was 11.3% in the amphotericin group and 21.0% in the itraconazole group (absolute risk difference, 9.7 percentage points; 95% CI, 2.8 to 16.6; P=0.006). Treatment with amphotericin was associated with significantly faster clinical resolution and fungal clearance and significantly lower rates of relapse and IRIS than itraconazole. The patients who received amphotericin had significantly higher rates of infusion-related reactions, renal failure, hypokalemia, hypomagnesemia, and anemia than patients in the itraconazole group. CONCLUSIONS: Amphotericin was superior to itraconazole as initial treatment for talaromycosis with respect to 6-month mortality, clinical response, and fungicidal activity. (Funded by the Medical Research Council and others; IVAP Current Controlled Trials number, ISRCTN59144167 .)