Outpatient antibiotic use in acute respiratory infections in Ho Chi Minh City, Vietnam

Acute respiratory infections (ART) are among the most frequent infectious diseases in children worldwide, particularly in developing countries. Antibiotics are very often prescribed or purchased without prescription for the treatment of ARl, although viruses are recognised as the predominant pathogens [1-7]. The aim of the work presented in this thesis was to quantify antibiotic use in outpatients with ARI in Children's Hospital 1, Ho Chi Minh City, Vietnam, to identify the viral and bacterial respiratory aetiologic agents and to assess the impact of antibiotic use on the selection of resistant bacteria in the intestinal flora. Two prospective descriptive studies were conducted in the outpatient clinic: one in ARl patients and the other in healthy children. The epidemiology, presentation and treatment characteristics of children with ARI in the outpatient clinic were described. Antibiotics were prescribed in 99.6% of 563 patients while respiratory viruses were detected in 72.5% among these patients with the use of multiplex PCR in respiratory specimens. Antibiotic use was considered inappropriate in 67.7% of cases, according to evidence-based guidelines and detected pathogens. Besides antibiotics, other treatments such as oral bronchodilators, oral corticosteroids, antihistamines, and mucolytic agents were commonly used at the rates of 57.6%, 10.3%, 11 % and 11 %, respectively, and in most of the cases, were not in accordance with the current guidelines. We observed a short-term selection of resistant Enterobacteriaceae in patients' intestinal flora resistant not only to the antibiotic class the patients received but also co-selection of resistance to other rarely used antibiotics. HPLC assays were developed with high sensitivity and specificity to determine the presence of 6 beta- lactam antibiotics in the urine antibiotic use before presentation as determined by HPLC (32%) was significantly higher than that reported by parent interviews (21 %). Antibiotic use in Vietnam is largely unrestricted leading to overuse and overprescription for uncomplicated ARI

Effect of phosphate fertilizer-coated Dicarboxylic Acid Polymer on rice yield and components under greenhouse conditions

A significant amount of phosphorus (P) becomes fixed by aluminium (Al) and iron (Fe) in acidic soils, leading to decreased efficiency in P utilization and subsequently lowering crop yield. Enhanced P fertilization offers a potential solution, as the dicarboxylic acid polymer (DCAP) coating on P fertilizer promotes increased plant productivity and more effective P utilization. The improvement achieved through enhanced P fertilization can contribute to higher rice yields in acidic soils, accompanied by an increase in P solubility. The study aimed to determine the impact of DCAP-mixed phosphate fertilizer on P uptake by plants, absorption efficiency, and rice yield. The results demonstrated a significant increase in available P (about 3.5 mg P/kg) when DCAP was used in a greenhouse setting, resulting in elevated yields and total P absorption (ranging from 0.03 to 0.05 grams/pot). However, the addition of 60 kg of phosphate mixed with DCAP has not yet demonstrated a significant increase in available phosphorus in the soil compared to adding just 60 kg of phosphate. The application of phosphate at a dose of 30 kg of P2O5 mixed with DCAP for growth and phosphorus absorption yield results equivalent to using 60 kg of P2O5 without DCAP. Furthermore, the use of DCAP in conjuction with 50% P fertilizer increased P availability by the same amount as that achieved with 100% P fertilizer. Consequently, DCAP reduced chemical P fertilizer in the soil by approximately 50%. However, it is essential to evaluate the effectiveness of mixed phosphate fertilizer (DCAP) under field conditions before recommending its widespread use

Evaluation of water loss and solute uptake during osmotic treatment of white radishes (Raphanus sativus L.) in salt-sucrose solution

White radish, scientifically known as Raphanus sativus L., is a yearly vegetable. Currently, it was being grown and widely used in the world, including Vietnam. These plants have been used as food or food processing. The osmotic treatment of vegetables involves the removal of water from plants in which the solids from the osmotic solution are transported to the plant material by osmosis. By this procedure, sucrose and saline solution are usually performed. White radishes were dehydrated in different hypertonic solutions by combined sucrose and NaCl at three different concentrations, including 9 runs. Mass transfer behaviour was applied according to three common models such as Fick’s second law, Weibull and Peleg’s equations based on the change of moisture and solid content of white radish during osmotic dehydration. The obtained results showed that the mass transfer was fast at initial stage and became slowly at the later stage. The effective moisture (Dm) and solid diffusivities (Ds) were ranged from 1.0186 to 1.2826x10-8 and from 1.0692 to 2.3322x10-8 (m2/s) respectively. The Peleg’s equation was found to be the best fitting for water loss and solid uptake thanks to the high determination coefficient (>97.64%) and the low average relative error (<3.174%). Raised up solution concentration resulted in higher water loss and mass gain

Isolation and production of polyhydroxybutyrate (PHB) from Bacillus pumilus NMG5 strain for bioplastic production and treatment of wastewater from paper factories

Polyhydroxybutyrate (PHB) has the potential to replace traditional plastics and limit environmental pollution caused by plastic waste. This study combined wastewater treatment with PHB production to reduce costs. Bacteria capable of synthesizing PHB were isolated from paper mill wastewater and identified using Matrix Assisted Laser Desorption/Ionization–Time of Flight (MALDI-TOF) mass spectrometry and 16S rRNA gene analysis. Bacillus pumilus NMG5 strain was found to have a good yield in modified Nutrient Broth culture, reaching 42.28% of dry biomass. The PHB product was analyzed using FTIR spectroscopy and 1H NMR spectroscopy. The bacterial strain was also tested for its ability to treat paper mill wastewater, and it showed impressive results in terms of biochemical oxygen demand (COD), total nitrogen, and total phosphorus, with efficiencies of 95.93%, 79.36%, and 83.55%, respectively. The study found that wastewater treatment combined with PHB production was a promising solution to reduce costs and limit environmental pollution. The bacterial strain B. pumilus NMG5 had a high yield of PHB, and the PHB product was of high quality, as confirmed by FTIR and 1H NMR spectroscopy. Furthermore, the bacterial strain showed impressive results in treating paper mill wastewater with high COD, total nitrogen, and total phosphorus efficiencies. These results suggest that this harmless bacterium could be used in paper mill wastewater treatment systems to produce PHB, providing a sustainable and environmentally friendly solution

New record and dietary ecology of an endangered amphibian species, Micryletta nigromaculata Poyarkov, Nguyen, Duong, Gorin & Yang, 2018, from Vietnam

The Black-spotted Paddy Frog (Micryletta nigromaculata) was recently discovered from northern Vietnam. Due to its restricted distribution in limestone karst forests and habitat degradation, the endemic species has been listed as “Endangered” in the IUCN Red List. However, knowledge about the natural history of this species is scarce, including data on its dietary ecology. Recent field surveys revealed new populations of M. nigromaculata occurring in Son La Province, northwestern Vietnam based on morphological analysis. Using the stomach-flushing method, we analyzed stomach contents of 45 individuals (21 males and 24 females) from a total of 52 captured frogs because stomachs of six males and one female (13.5%) were empty. The food spectrum of M. nigromaculata comprises 12 types with a total of 691 prey items (687 invertebrate items and four unidentified items), belonging to six insect orders, larvae and Araneae. Similar to other species of the family Microhylidae, M. nigromaculata is also identified as an ant (Formicidae) – termite (Rhinotermitidae) eating specialist with distinctly higher percentages of occurrence frequency (F = 65 %), number of prey items (N = 80 %), and importance (Ix = 75 %) than those of remaining types. The Simpson diversity index of 0.939 shows a high abundance of food prey in the wild, and the Evenness index of 0.536 suggests biased consumption of feeding selection for M. nigromaculata

Structural assessment based on vibration measurement test combined with an artificial neural network for the steel truss bridge

Damage assessment is one of the most crucial issues for bridge engineers during the operational and maintenance phase, especially for existing steel bridges. Among several methodologies, the vibration measurement test is a typical approach, in which the natural frequency variation of the structure is monitored to detect the existence of damage. However, locating and quantifying the damage is still a big challenge for this method, due to the required human resources and logistics involved. In this regard, an artificial intelligence (AI)-based approach seems to be a potential way of overcoming such obstacles. This study deployed a comprehensive campaign to determine all the dynamic parameters of a predamaged steel truss bridge structure. Based on the results for mode shape, natural frequency, and damping ratio, a finite element model (FEM) was created and updated. The artificial intelligence network’s input data from the damage cases were then analysed and evaluated. The trained artificial neural network model was curated and evaluated to confirm the approach’s feasibility. During the actual operational stage of the steel truss bridge, this damage assessment system showed good performance, in terms of monitoring the structural behaviour of the bridge under some unexpected accidents.This research was funded by FCT/MCTES through national funds (PIDDAC) from the R&D Unit Institute for Sustainability and Innovation in Structural Engineering (ISISE), under the reference UIDB/04029/2020, and from the Associate Laboratory Advanced Production and Intelligent Systems ARISE, under the reference LA/P/0112/2020, as well as financial support of the project research “B2022-GHA-03” from the Ministry of Education and Training. And The APC was funded by ANI (“Agência Nacional de Inovação”) through the financial support given to the R&D Project “GOA Bridge Management System—Bridge Intelligence”, with reference POCI-01-0247-FEDER069642, which was cofinanced by the European Regional Development Fund (FEDER) through the Operational Competitiveness and Internationalisation Program (POCI)

Disinfection performance of an ultraviolet lamp: a CFD investigation

Ultraviolet (UV)-based devices have shown their effectiveness on various germicidal purposes. To serve their design optimisation, the disinfection effectiveness of a vertically cylindrical UV lamp, whose wattage ranges from P = 30 − 100 W, is numerically investigated in this work. The UV radiation is solved by the Finite Volume Method together with the Discrete Ordinates model. Various results for the UV intensity and its bactericidal effects against several popular virus types, i.e., Corona-SARS, Herpes (type 2), and HIV, are reported and analysed in detail. Results show that the UV irradiance is greatly dependent on the lamp power. Additionally, it is indicated that the higher the lamp wattage employed, the larger the bactericidal rate is observed, resulting in the greater effectiveness of the UV disinfection process. Nevertheless, the wattage of P ≤ 100W is determined to be insufficient for an effective disinfection performance in a whole room; higher values of power must hence be considered in case intensive sterilization is required. Furthermore, the germicidal effect gets reduced with the viruses less sensitive to UV rays, e.g, the bactericidal rate against the HIV virus is only ∼8.98% at the surrounding walls

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

Retrospective analysis assessing the spatial and temporal distribution of paediatric acute respiratory tract infections in Ho Chi Minh City, Vietnam.

BACKGROUND: Acute respiratory tract infections (ARIs) are the leading cause of morbidity and mortality in young children in low/middle-income countries. Using routine hospital data, we aimed to examine the spatial distribution, temporal trends and climatic risk factors of paediatric ARIs in Vietnam. METHODS: Data from hospitalised paediatric (<16 years) patients with ARIs residing in Ho Chi Minh City (HCMC) between 2005 and 2010 were retrieved from the two main Children's Hospitals and the Hospital for Tropical Diseases in HCMC. Spatial mapping and time series analysis were performed after disaggregating data into upper respiratory tract infections (URIs) and lower respiratory tract infections (LRIs). RESULTS: Over the study period, there were 155 999 paediatric patients admitted with ARIs (33% of all hospital admissions). There were 68 120 URIs (14%) and 87 879 LRIs (19%). The most common diagnoses were acute pharyngitis (28% of all ARI), pneumonia (21%), bronchitis (18%) and bronchiolitis (16%). A significant increasing trend over time was found for both URIs (mean weekly incidence per 1000 population, I=3.12), incidence rate ratio for 1-week increase in time (RR 1.0, 95% CI 1.02 to 1.17) for URI and (I=4.02, RR 1.08 (95% CI 1.006 to 1.16)) for LRI. The weekly URI incidence peaked in May-June and was significantly associated with lags in weekly URI incidence and the average humidity, rainfall and water level. The weekly LRI incidence exhibited significant seasonality (P<0.0001), with an annual peak in September-October and was significantly associated with lags in weekly LRI incidence and lags in weekly average temperature, rainfall and water level. CONCLUSIONS: ARIs are a leading cause of childhood hospitalisation in HCMC, Vietnam. The incidence of ARIs was higher in the wet season and in specific HCMC districts. These results may guide health authorities in where and when to effectively allocate resources for the prevention and control of ARIs

Antibiotic use and prescription and its effects on Enterobacteriaceae in the gut in children with mild respiratory infections in Ho Chi Minh City, Vietnam. A prospective observational outpatient study.

BACKGROUND AND OBJECTIVES: Treatment guidelines do not recommend antibiotic use for acute respiratory infections (ARI), except for streptococcal pharyngitis/tonsillitis and pneumonia. However, antibiotics are prescribed frequently for children with ARI, often in absence of evidence for bacterial infection. The objectives of this study were 1) to assess the appropriateness of antibiotic prescriptions for mild ARI in paediatric outpatients in relation to available guidelines and detected pathogens, 2) to assess antibiotic use on presentation using questionnaires and detection in urine 3) to assess the carriage rates and proportions of resistant intestinal Enterobacteriaceae before, during and after consultation. MATERIALS AND METHODS: Patients were prospectively enrolled in Children's Hospital 1, Ho Chi Minh City, Vietnam and diagnoses, prescribed therapy and outcome were recorded on first visit and on follow-up after 7 days. Respiratory bacterial and viral pathogens were detected using molecular assays. Antibiotic use before presentation was assessed using questionnaires and urine HPLC. The impact of antibiotic usage on intestinal Enterobacteriaceae was assessed with semi-quantitative culture on agar with and without antibiotics on presentation and after 7 and 28 days. RESULTS: A total of 563 patients were enrolled between February 2009 and February 2010. Antibiotics were prescribed for all except 2 of 563 patients. The majority were 2nd and 3rd generation oral cephalosporins and amoxicillin with or without clavulanic acid. Respiratory viruses were detected in respiratory specimens of 72.5% of patients. Antibiotic use was considered inappropriate in 90.1% and 67.5%, based on guidelines and detected pathogens, respectively. On presentation parents reported antibiotic use for 22% of patients, 41% of parents did not know and 37% denied antibiotic use. Among these three groups, six commonly used antibiotics were detected with HPLC in patients' urine in 49%, 40% and 14%, respectively. Temporary selection of 3rd generation cephalosporin resistant intestinal Enterobacteriaceae during antibiotic use was observed, with co-selection of resistance to aminoglycosides and fluoroquinolones. CONCLUSIONS: We report overuse and overprescription of antibiotics for uncomplicated ARI with selection of resistant intestinal Enterobacteriaceae, posing a risk for community transmission and persistence in a setting of a highly granular healthcare system and unrestricted access to antibiotics through private pharmacies. REGISTRATION: This study was registered at the International Standard Randomised Controlled Trials Number registry under number ISRCTN32862422: http://www.isrctn.com/ISRCTN32862422