Microvinification: How small can we go?

High-throughput methodologies to screen large numbers of microorganisms necessitate the use of small-scale culture vessels. In this context, an increasing number of researchers are turning to microtiter plate (MTP) formats to conduct experiments. MTPs are now widely used as a culturing vessel for phenotypic screening of aerobic laboratory cultures, and their suitability has been assessed for a range of applications. The work presented here extends these previous studies by assessing the metabolic footprint of MTP fermentation. A comparison of Chardonnay grape juice fermentation in MTPs with fermentations performed in air-locked (self-induced anaerobic) and cotton-plugged (aerobic) flasks was made. Maximum growth rates and biomass accumulation of yeast cultures grown in MTPs were indistinguishable from self-induced anaerobic flask cultures. Metabolic profiles measured differed depending on the metabolite. While glycerol and acetate accumulation mirrored that of self-induced anaerobic cultures, ethanol accumulation in MTP ferments was limited by the increased propensity of this volatile metabolite for evaporation in microlitre-scale culture format. The data illustrates that microplate cultures can be used as a replacement for self-induced anaerobic flasks in some instances and provide a useful and economical platform for the screening of industrial strains and culture media. © 2010 Springer-Verlag

Demand and willingness to pay for different treatment and care services among patients with heart diseases in Hanoi, Vietnam

Bach Xuan Tran,1,2 Giang Thu Vu,3 Thu Hong Thi Nguyen,4 Long Hoang Nguyen,5 Dat Dinh Pham,4 Viet Quang Truong,4 Thao Phuong Thi Thai,6 Thuc Minh Thi Vu,7 Tuan Quoc Nguyen,8 Vu Nguyen,9 Trang Huyen Thi Nguyen,10 Carl A Latkin,2 Cyrus SH Ho,11 Roger CM Ho12 1Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 2Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 3Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam; 4Hanoi Heart Hospital, Hanoi, Vietnam; 5Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam; 6Department of General Planning and Department of Cardiology, Friendship Hospital, Hanoi, Vietnam; 7Tam Anh Hospital, Hanoi, Vietnam; 8Hanoi Department of Health, Hanoi, Vietnam; 9Department of Neurosurgery Spine-Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam; 10Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 11Department of Psychological Medicine, National University Hospital, Singapore, Singapore; 12Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Introduction: In Vietnam, cardiovascular diseases (CVDs) are serious health issues, especially in the context of overload central heart hospitals, insufficient primary healthcare, and lack of customer-oriented care and treatment. Attempts to measure demand and willingness-to-pay (WTP) for different CVD treatments and care services have been limited. This study explored the preferences and WTP of patients with heart diseases for different home- and hospital-based services in Hanoi, Vietnam. Methods: A cross-sectional survey was performed at the Hanoi Heart Hospital from July to December 2017. A contingent valuation was adopted to determine the preferences of patients and measure their WTP. Interval regressions were employed to determine the potential predictors of patients’ WTP. Results: Hospital-based services were most preferred by patients, with demand ranging from 45.6% to 82.3% of total participants, followed by home-based (45.4%–45.8%) and administrative services (28.9%–34%). WTP for hospital-based services were in the range of US$9.8 (US$ 8.4–11.2)–US$21.9 (US$ 20.3–23.4), while figures for home-based and administrative services were US$9.8 (US$ 8.4–11.2)–US$22 (US$ 18.7–25.3) and 1.9 (US 1.6–2.2)–US 7.5 (US$ 6.3–8.6), respectively. Patients who lived in urban areas, were employed, were having higher level of education, and were not covered by health insurance were willing to pay more for services, especially home-based ones. Conclusion: Demand and WTP for home-based services among heart disease patients were moderately low compared with hospital-based ones. There is a need for more policies supporting home-based services, better communication of services’ benefits to general public and patients, and introduction of services packages based on patients’ preferences. Keywords: willingness to pay, preference, heart disease, service, Vietna

Clinical and aetiological study of hand, foot and mouth disease in southern Vietnam, 2013–2015: Inpatients and outpatients

Background Hand, foot and mouth disease (HFMD) has been associated with large outbreaks among young children in the Asia-Pacific Region since 1997, including cases of severe illness and death. Severe illness is often associated with enterovirus A71 (EV-A71). Vietnam experienced a large sustained outbreak of 200 000 hospitalized cases and over 200 deaths in 2011–12, the large majority occurring in southern Vietnam. Methods A prospective observational study was conducted in the outpatient clinics, infectious diseases wards, and paediatric intensive care units of the three main referral centres for the treatment of HFMD in southern Vietnam. Demographic data, basic laboratory parameters, and clinical data were recorded, and molecular diagnostic tests were performed. Results Between July 2013 and July 2015, a total of 1547 children were enrolled. Four serotypes of enterovirus A (EV-A71, Coxsackievirus (CV) A6, A10, and A16) were responsible for 1005 of 1327 diagnosed cases (75.7%). An unexpected dominance of EV-A71 was found among both inpatients and outpatients, as well as a strong association with severe illness. CV-A6 and CV-A10 emerged in Vietnam during the study period and replaced CV-A16. CV-A10 was associated with different clinical and laboratory characteristics. During admission, 119 children developed a more severe illness. It was found that children with a skin rash showed less progression of severity, but when a rash was present, a macular rash was significantly associated with an increased risk of progression. Conclusions This study represents the most comprehensive descriptive HFMD study from Vietnam to date. Co-circulation and replacement of different serotypes has implications for vaccine development and implementation. These findings from a severely affected country add to our understanding of the presentation, progression, and aetiology of HFMD.</p

Clinical and aetiological study of hand, foot and mouth disease in southern Vietnam, 2013–2015: Inpatients and outpatients

Background Hand, foot and mouth disease (HFMD) has been associated with large outbreaks among young children in the Asia-Pacific Region since 1997, including cases of severe illness and death. Severe illness is often associated with enterovirus A71 (EV-A71). Vietnam experienced a large sustained outbreak of 200 000 hospitalized cases and over 200 deaths in 2011–12, the large majority occurring in southern Vietnam. Methods A prospective observational study was conducted in the outpatient clinics, infectious diseases wards, and paediatric intensive care units of the three main referral centres for the treatment of HFMD in southern Vietnam. Demographic data, basic laboratory parameters, and clinical data were recorded, and molecular diagnostic tests were performed. Results Between July 2013 and July 2015, a total of 1547 children were enrolled. Four serotypes of enterovirus A (EV-A71, Coxsackievirus (CV) A6, A10, and A16) were responsible for 1005 of 1327 diagnosed cases (75.7%). An unexpected dominance of EV-A71 was found among both inpatients and outpatients, as well as a strong association with severe illness. CV-A6 and CV-A10 emerged in Vietnam during the study period and replaced CV-A16. CV-A10 was associated with different clinical and laboratory characteristics. During admission, 119 children developed a more severe illness. It was found that children with a skin rash showed less progression of severity, but when a rash was present, a macular rash was significantly associated with an increased risk of progression. Conclusions This study represents the most comprehensive descriptive HFMD study from Vietnam to date. Co-circulation and replacement of different serotypes has implications for vaccine development and implementation. These findings from a severely affected country add to our understanding of the presentation, progression, and aetiology of HFMD.</p

Families in Southeast and South Asia

Southeast and South Asia are home to one-third of the world’s population. Their great economic and cultural diversities make generalization about family patterns and trends hazardous. We review literature on trends in fertility, marriage, divorce, and living arrangements in the past half century. Explanations focus on structural and ideological changes related to socioeconomic development, cultural factors including kinship system, religion and ethnicity, and public policies. While the impact of rapid modernization and related ideational changes are evident, there are also changes, or lack thereof, that cannot be explained by development and may be attributable to historical and cultural factors that have shaped family norms in the region. The following trends are evident: (1) declining fertility and rising age at marriage, although teenage and arranged marriages remain common in South Asia, (2) a majority of elderly continue to live with or are supported by their children, (3) divorce and out-of-wedlock childbearing remain relatively rare