An Investigation of Barriers to Adopt Green Innovation Among Manufacturing Organizations in Vietnam

This research aims to identify the main barriers to green innovation in Vietnam manufacturing organizations. This study began by reviewing the relevant literature and providing a solid theoretical framework to understand the determinants of green innovation for manufacturing firms in the global context. It also helps internal and external stakeholders figure out what influence and how to implement green innovation more efficiently by removing all impediments. Additionally, this article is considered a valuable and rational evidence for prioritizing and directing innovation policies in the manufacturing industry. Based on numerical data from 143 employees at middleand upper-level managers among manufacturing companies around Vietnam, the study found that deficiency of financial resources primarily significantly impacts green innovation adoption, followed by the uncertainty of market demand and lack of government support. However, with limited observations, the investigation did not observe the dynamic effect of green innovation over periods and only focused on the manufacturing sector instead of different industries for generalizing the research results. Moreover, the circumstances of green innovation would be diverse in other nations. Keywords: green innovation, manufacturing organizations, government supports, financial barriers, market barrier

Functional outcome and muscle wasting in adults with tetanus.

BACKGROUND: In many countries, in-hospital survival from tetanus is increasing, but long-term outcome is unknown. In high-income settings, critical illness is associated with muscle wasting and poor functional outcome, but there are few data from resource-limited settings. In this study we aimed to assess muscle wasting and long-term functional outcome in adults with tetanus. METHODS: In a prospective observational study involving 80 adults with tetanus, sequential rectus femoris ultrasound measurements were made at admission, 7 days, 14 days and hospital discharge. Functional outcome was assessed at hospital discharge using the Timed Up and Go test, Clinical Frailty Score, Barthel Index and RAND 36-item Short Form Health Survey (SF-36) and 3 and 6 months after discharge using the SF-36 and Barthel Index. RESULTS: Significant muscle wasting occurred between hospital admission and discharge (p70 y of age, functional recovery at 6 months was reduced compared with younger patients. Hospital-acquired infection and age were risk factors for muscle wasting. CONCLUSIONS: Significant muscle wasting during hospitalization occurred in patients with tetanus, the extent of which correlates with functional outcome

Combination Antifungal Therapy for Cryptococcal Meningitis

Background Combination antifungal therapy (amphotericin B deoxycholate and flucytosine) is the recommended treatment for cryptococcal meningitis but has not been shown to reduce mortality, as compared with amphotericin B alone. We performed a randomized, controlled trial to determine whether combining flucytosine or high-dose fluconazole with high-dose amphotericin B improved survival at 14 and 70 days. Methods We conducted a randomized, three-group, open-label trial of induction therapy for cryptococcal meningitis in patients with human immunodeficiency virus infection. All patients received amphotericin B at a dose of 1 mg per kilogram of body weight per day; patients in group 1 were treated for 4 weeks, and those in groups 2 and 3 for 2 weeks. Patients in group 2 concurrently received flucytosine at a dose of 100 mg per kilogram per day for 2 weeks, and those in group 3 concurrently received fluconazole at a dose of 400 mg twice daily for 2 weeks. Results A total of 299 patients were enrolled. Fewer deaths occurred by days 14 and 70 among patients receiving amphotericin B and flucytosine than among those receiving amphotericin B alone (15 vs. 25 deaths by day 14; hazard ratio, 0.57; 95% confidence interval [CI], 0.30 to 1.08; unadjusted P=0.08; and 30 vs. 44 deaths by day 70; hazard ratio, 0.61; 95% CI, 0.39 to 0.97; unadjusted P=0.04). Combination therapy with fluconazole had no significant effect on survival, as compared with monotherapy (hazard ratio for death by 14 days, 0.78; 95% CI, 0.44 to 1.41; P=0.42; hazard ratio for death by 70 days, 0.71; 95% CI, 0.45 to 1.11; P=0.13). Amphotericin B plus flucytosine was associated with significantly increased rates of yeast clearance from cerebrospinal fluid (−0.42 log10 colony-forming units [CFU] per milliliter per day vs. −0.31 and −0.32 log10 CFU per milliliter per day in groups 1 and 3, respectively; P<0.001 for both comparisons). Rates of adverse events were similar in all groups, although neutropenia was more frequent in patients receiving a combination therapy. Conclusions Amphotericin B plus flucytosine, as compared with amphotericin B alone, is associated with improved survival among patients with cryptococcal meningitis. A survival benefit of amphotericin B plus fluconazole was not found

Efficient and stable wide bandgap perovskite solar cells through surface passivation with long alkyl chain organic cations

Defects on perovskite surfaces acting as charge-carrier-traps are a key factor limiting the performance of perovskite solar cells (PSCs). Here we studied the defect passivation effect of three bromide-containing alkylammonium organic cations with increasing alkyl-chain-length: n-butylammonium bromide, n-octylammonium bromide and n-dodecylammonium bromide on a perovskite composition with 1.72 eV bandgap. Long-alkyl-chain organic cations were found to have a greater passivation effect compared to their shorter counterparts due to greater reduction in surface defects and substantial changes in the electronic structure of the passivated perovskite films. The efficiency of 1.72 eV PSCs was improved to 19.1% with an excellent open-circuit-voltage of over 1280 mV. The long-alkyl-chain passivation significantly improved the moisture and light stability of PSCs as the unencapsulated devices retained >90% of the initial performance after 144 h at 70–85% relative-humidity and >93% of the initial performance after operating under light for 80 h. The study has paved the way for efficient and stable wide bandgap perovskite top cells used in perovskite-silicon tandem solar cells.This work has been supported by the Australian Government through the Australian Renewable Energy Agency (ARENA). T. D. and J. Z. acknowledges the financial support of Postdoc Fellowships from the Australian Centre for Advanced Photovoltaics (ACAP). T. W. is the recipient of an Australian Research Council Future Fellowship (project number FT180100302) funded by the Australian Government

A prospective descriptive study of cryptococcal meningitis in HIV uninfected patients in Vietnam - high prevalence of Cryptococcus neoformans var grubii in the absence of underlying disease

<p>Abstract</p> <p>Background</p> <p>Most cases of cryptococcal meningitis occur in patients with HIV infection: the course and outcome of disease in the apparently immunocompetent is much more poorly understood. We describe a cohort of HIV uninfected Vietnamese patients with cryptococcal meningitis in whom underlying disease is uncommon, and relate presenting features of patients and the characteristics of the infecting species to outcome.</p> <p>Methods</p> <p>A prospective descriptive study of HIV negative patients with cryptococcal meningitis based at the Hospital for Tropical Diseases, Ho Chi Minh City. All patients had comprehensive clinical assessment at baseline, were cared for by a dedicated study team, and were followed up for 2 years. Clinical presentation was compared by infecting isolate and outcome.</p> <p>Results</p> <p>57 patients were studied. <it>Cryptococcus neoformans var grubii </it>molecular type VN1 caused 70% of infections; <it>C. gattii </it>accounted for the rest. Most patients did not have underlying disease (81%), and the rate of underlying disease did not differ by infecting species. 11 patients died while in-patients (19.3%). Independent predictors of death were age ≥ 60 years and a history of convulsions (odds ratios and 95% confidence intervals 8.7 (1 - 76), and 16.1 (1.6 - 161) respectively). Residual visual impairment was common, affecting 25 of 46 survivors (54.3%). Infecting species did not influence clinical phenotype or outcome. The minimum inhibitory concentrations of flucytosine and amphotericin B were significantly higher for <it>C. neoformans var grubii </it>compared with <it>C. gattii </it>(p < 0.001 and p = 0.01 respectively).</p> <p>Conclusion</p> <p>In HIV uninfected individuals in Vietnam, cryptococcal meningitis occurs predominantly in people with no clear predisposing factor and is most commonly due to <it>C. neoformans var grubii</it>. The rates of mortality and visual loss are high and independent of infecting species. There are detectable differences in susceptibility to commonly used antifungal drugs between species, but the clinical significance of this is not clear.</p