Isolation of dengue serotype 3 virus from the cerebrospinal fluid of an encephalitis patient in Hai Phong, Vietnam in 2013

Dengue encephalitis (DE) is characterized as unusual presentation of dengue infection. Despite the reports that DE accounts for only 1-5% of dengue cases, this disease tends to be increasingly reported to threaten global human health throughout dengue endemic areas particularly in Southeast Asia. The molecular information of clinically characterized, neurotropic dengue virus (DENV) in human beings is extremely scarce despite it playing an important role in deciphering the pathogenesis of dengue-related neurological cases. Here we report a case of DE caused by DENV3 genotype III in a male patient with atypical symptoms of DENV infection in Hai Phong, Vietnam in 2013. The virus isolated from the cerebrospinal fluid of this case-patient was closely related to DENV3 genotype III strains isolated from serum of two other patients, who manifested classical dengue in the same year and residing in the same area as the case-patient. It is noteworthy to mention that in 2013, DENV3 genotype III was detected for the first time in Vietnam

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

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Promoted Hydrogen Peroxide Production from Pure Water on g-C3N4 with Nitrogen Defects Constructed through Solvent-Precursor Interactions: Exploring A Complex Story in Piezo-Photocatalysis

Hydrogen peroxide (H2O2) production via oxygen (O2) reduction reaction (ORR) in pure water (H2O) through graphitic carbon nitrides (g-C3N4)-based piezo-photocatalysts is an exciting approach in many current studies. However, the low Lewis-acid properties of g-C3N4 limited the catalytic performance because of the low O2 adsorption efficacy. To overcome this challenge, we utilized the interaction of g-C3N4 precursors with various solvents to synthesize g-C3N4, possessing multiple nitrogen-vacant species via thermal shocking polymerization. Our results suggest that the lack of nitrogen in g-C3N4 and the incident introduction of oxygen-functional groups enhance the Lewis acid-base interactions and polarize the g-C3N4 lattices, leading to the enormous enhancement, roughly 7 times from the optimal samples compared to pristine g-C3N4 in pure water via piezo-photocatalysis. Meanwhile, we also observed the correlation between the charge separation kinetic and the crystalline degree of the synthesized materials, which can elucidate how the nitrogen defects impacted the catalytic outcomes. Furthermore, the catalytic mechanisms were thoroughly studied, with the formation of H2O2 proceeding via radical and water oxidation pathways, in which the roles of light and ultrasound were carefully investigated. Thus, our findings not only reinforce the potential view of metal-free photocatalysts, accelerating the understanding of g-C3N4 working principles to generate H2O2 based on the oxygen reduction and water oxidation reactions, but also propose a facile one-step way for fabricating highly efficient and scalable photocatalysts to produce H2O2 without using sacrificial agents, pushing the practical application of in-situ solar H2O2 toward real-world scenarios

Dengue Associated Acute Encephalitis Syndrome Cases in Son La Province, Vietnam in 2014

Acute encephalitis syndrome (AES) is associated with high morbidity and mortality, and affects both children and adults. The main etiologic agent is Japanese encephalitis virus (JEV); however, there are also reports of Dengue virus (DENV) encephalitis. The objectives of this study were to determine the proportion of patients with encephalitis due to JEV during the 2014 outbreak in Son La Province in Vietnam and to explore the association of DENV in non-JEV viral encephalitis cases. Of 90 patients, 6 (6.7%) were positive for anti-JEV immunoglobulin M (IgM), 5 (5.6%) were positive for anti-DENV IgM, 30 (33.3%) were positive for both anti-JEV and anti-DENV IgM, and 56 (62.2%) were positive for flavivirus immunoglobulin G (IgG). In 5 patients with AES, who had positive anti-DENV IgM results in at least one of the paired serum samples, DENV was confirmed by neutralization testing. The incidence of JEV infection was high. There is still a need to maintain and strengthen the national JEV immunization program. This noticeable occurrence of DENV infection was not reported in Son La Province in 2013?2014. Our data suggested that in addition to JEV, DENV was also a causative agent of AES in 2014 in Son La Province, and this finding also confirmed the local occurrence of DENV infection

Aboveground Net Primary Production at Acacia mangium Plantation in Northern Vietnam

Net primary production (NPP) is an important index for understanding carbon cycling in forest ecosystems. In this study, aboveground NPP at Acacia mangium plantation was estimated basing on allometry for aboveground biomass increment (ΔM) and litter trap technique for litterfall (Lf). The experiment was conducted in two plots of 300 m2 each (15 × 20 m), established at a 21-month old plantation. Data were collected five times of 3-month intervals in a total duration of 357 days. The results indicated that Lf and ΔM were seasonal-dependent. Litterfall was highest (4.06 g m-1 day-1) during Sep-Jan (late rainy season, early winter) and lowest (1.10 g m-1 day-1) during Mar-Jun (early rainy season, early summer). While, ΔM was highest (13.51 g m-1 day-1) during Jun-Sep (rainy season, summer) and lowest (3.10 g m-1 day-1) during Jan-Mar (dry season, winter). Total Lf in a duration of 357 days was 9.69 tons ha-1 and ΔM was 27.71 tons ha-1, leading to total aboveground NPP of the present study plantation of 37.40 tons ha-1. It is concluded that aboveground NPP of acacia plantation was much higher than other forests of different types and ages around the world. Such difference indicates the importance of acacia plantation in soil nutrient cycling through litterfall decomposition and carbon sequestration through aboveground biomass increment

Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration

Background and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. REGISTRATION: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921