Publisher Correction:Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

In the original version of this Article, Table 2 was formatted in such a way that made it difficult to interpret. This has now been corrected in the PDF and HTML versions of the Article.</p

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

Asymmetric Exchange Rate Exposure - Research in Southeast Asian Countries

The study aims to analyse the impact of exchange rate exposure on stock returns in six countries representative of Southeast Asia, including Indonesia, Malaysia, Philippines, Singapore, Thailand and Vietnam from 2009 to 2014. Both nominal and real exchange rates are taken into account for evaluating exchange rate fluctuations via panel data. In order to achieve this goal, a panel regressive estimation approach is proposed in which a GLS model is firstly used to treat heteroscedasticity in the panel data and, then, a GMM estimator is employed to ensure the consistency of the estimates. The results point out that the exchange rate exposure of these countries is asymmetric. At market level, for a rise in the exchange rate (or local currency depreciates), the average stock returns tend to decrease. However, due to the favourable impact of currency depreciation on the net export position, the reduction speed of stock returns is faster than the rising speed of the exchange rate

Microencapsulation of Lemongrass (Cymbopogon citratus) Essential Oil Via Spray Drying: Effects of Feed Emulsion Parameters

The purpose of this study was to attempt the encapsulation of lemongrass (Cymbopogon citratus) essential oil utilizing spray drying technique. An array of process parameters including concentration of wall (15&ndash;30%), type of wall materials (maltodextrin, maltodextrin and gum Arabic mixture), and concentration of essential oil (0.5&ndash;2.0%) were thoroughly investigated. The results show that the use of sole maltodextrin as encapsulant gave microcapsules characteristics comparable to that of powder produced using maltodextrin and gum Arabic mixture. The encapsulation process that was performed with maltodextrin at the concentration of 30% as wall material and lemongrass essential oil at the concentration of 1.5% as core material showed highest drying yield (84.49%), microencapsulation yield (89.31%) and microencapsulation efficiency (84.75%). Encapsulated essential oils retained most of their major constituents in comparison with the bare essential oils without any significant compromise in product quality

An observational study of breakthrough SARS-CoV-2 Delta variant infections among vaccinated healthcare workers in Vietnam

Background Data on breakthrough SARS-CoV-2 Delta variant infections in vaccinated individuals are limited. Methods We studied breakthrough infections among Oxford-AstraZeneca vaccinated healthcare workers in an infectious diseases hospital in Vietnam. We collected demographic and clinical data alongside serial PCR testing, measurement of SARS-CoV-2 antibodies, and viral whole-genome sequencing. Findings Between 11th–25th June 2021 (7-8 weeks after the second dose), 69 staff tested positive for SARS-CoV-2. 62 participated in the study. Most were asymptomatic or mildly symptomatic and all recovered. Twenty-two complete-genome sequences were obtained; all were Delta variant and were phylogenetically distinct from contemporary viruses obtained from the community or from hospital patients admitted prior to the outbreak. Viral loads inferred from Ct values were 251 times higher than in cases infected with the original strain in March/April 2020. Median time from diagnosis to negative PCR was 21 days (range 8–33). Neutralizing antibodies (expressed as percentage of inhibition) measured after the second vaccine dose, or at diagnosis, were lower in cases than in uninfected, fully vaccinated controls (median (IQR): 69.4 (50.7-89.1) vs. 91.3 (79.6-94.9), p=0.005 and 59.4 (32.5-73.1) vs. 91.1 (77.3-94.2), p=0.043). There was no correlation between vaccine-induced neutralizing antibody levels and peak viral loads or the development of symptoms. Interpretation Breakthrough Delta variant infections following Oxford-AstraZeneca vaccination may cause asymptomatic or mild disease, but are associated with high viral loads, prolonged PCR positivity and low levels of vaccine-induced neutralizing antibodies. Epidemiological and sequence data suggested ongoing transmission had occurred between fully vaccinated individuals

Publisher Correction:Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study (npj Primary Care Respiratory Medicine, (2020), 30, 1, (42), 10.1038/s41533-020-00201-z)

Correction to: npj Primary Care Respiratory Medicine https://doi.org/10.1038/s41533-020-00201-z, published online 6 October 2020 In the original version of this Article, Table 2 was formatted in such a way that made it difficult to interpret. This has now been corrected in the PDF and HTML versions of the Article

Determining Key Research Areas for Healthier Diets and Sustainable Food Systems in Viet Nam

Vietnamese food systems are undergoing rapid transformation, with important implications for human and environmental health and economic development. Poverty has decreased, and diet quality and under-nutrition have improved significantly since the end of the Doi Moi reform period (1986-1993) as a result of Viet Nam opening its economy and increasing its regional and global trade. Yet poor diet quality is still contributing the triple burden of malnutrition, with 25 percent stunting among children under age 5, 26 percent and 29 percent of women and children, respectively, anemic, and 21 percent of adults overweight. Agricultural production systems have shifted from predominantly diverse smallholder systems to larger more commercialized and specialized systems, especially for crops, while the ‘meatification’ of the Vietnamese diet is generating serious trade-offs between improved nutrition and sustainability of the Vietnamese food systems. The food processing industry has developed rapidly, together with food imports, resulting in new and processed food products penetrating the food retail outlets, trending towards an increase in the Westernized consumption patterns that are shifting nutrition-related problems towards overweight and obesity and, with it, an increase of non-communicable disease-related health risks. While regulatory policies exist across the food system, these are not systematically implemented, making food safety a major concern for consumers and policy makers alike. Where data exists, it is not easy to aggregate with data from across food system dimensions, making it difficult for Viet Nam to make an informed analysis of current and potential food system trade-offs. In our research, we reviewed existing literature and data, and applied a food systems framework to develop an initial food systems profile for Viet Nam and to identify a comprehensive set a of research questions to fill current data gaps identified through the review. Insights on these would provide the comprehensive evidence needed to inform policy makers on how to develop new food systems policies for Viet Nam, and further refine and improve existing policies to achieve better quality diets and more sustainable food systems in Viet Nam. Based on these, we then engaged with stakeholders to develop research priorities in the Viet Nam context and identified 25 priority research questions. This paper aims to stimulate such reflections by clearly outlining key areas for research, government policy, and development programs on priority investment to build the evidence base around inclusive food systems interventions that aim to result in healthier diets and more sustainable food systems for Viet Nam. <br/

Determining Key Research Areas for Healthier Diets and Sustainable Food Systems in Viet Nam

Vietnamese food systems are undergoing rapid transformation, with important implications for human and environmental health and economic development. Poverty has decreased, and diet quality and under-nutrition have improved significantly since the end of the Doi Moi reform period (1986-1993) as a result of Viet Nam opening its economy and increasing its regional and global trade. Yet poor diet quality is still contributing the triple burden of malnutrition, with 25 percent stunting among children under age 5, 26 percent and 29 percent of women and children, respectively, anemic, and 21 percent of adults overweight. Agricultural production systems have shifted from predominantly diverse smallholder systems to larger more commercialized and specialized systems, especially for crops, while the ‘meatification’ of the Vietnamese diet is generating serious trade-offs between improved nutrition and sustainability of the Vietnamese food systems. The food processing industry has developed rapidly, together with food imports, resulting in new and processed food products penetrating the food retail outlets, trending towards an increase in the Westernized consumption patterns that are shifting nutrition-related problems towards overweight and obesity and, with it, an increase of non-communicable disease-related health risks. While regulatory policies exist across the food system, these are not systematically implemented, making food safety a major concern for consumers and policy makers alike. Where data exists, it is not easy to aggregate with data from across food system dimensions, making it difficult for Viet Nam to make an informed analysis of current and potential food system trade-offs. In our research, we reviewed existing literature and data, and applied a food systems framework to develop an initial food systems profile for Viet Nam and to identify a comprehensive set a of research questions to fill current data gaps identified through the review. Insights on these would provide the comprehensive evidence needed to inform policy makers on how to develop new food systems policies for Viet Nam, and further refine and improve existing policies to achieve better quality diets and more sustainable food systems in Viet Nam. Based on these, we then engaged with stakeholders to develop research priorities in the Viet Nam context and identified 25 priority research questions. This paper aims to stimulate such reflections by clearly outlining key areas for research, government policy, and development programs on priority investment to build the evidence base around inclusive food systems interventions that aim to result in healthier diets and more sustainable food systems for Viet Nam

Ultra-deep massively parallel sequencing with unique molecular identifier tagging achieves comparable performance to droplet digital PCR for detection and quantification of circulating tumor DNA from lung cancer patients

The identification and quantification of actionable mutations are of critical importance for effective genotype-directed therapies, prognosis and drug response monitoring in patients with non-small-cell lung cancer (NSCLC). Although tumor tissue biopsy remains the gold standard for diagnosis of NSCLC, the analysis of circulating tumor DNA (ctDNA) in plasma, known as liquid biopsy, has recently emerged as an alternative and noninvasive approach for exploring tumor genetic constitution. In this study, we developed a protocol for liquid biopsy using ultra-deep massively parallel sequencing (MPS) with unique molecular identifier tagging and evaluated its performance for the identification and quantification of tumor-derived mutations from plasma of patients with advanced NSCLC. Paired plasma and tumor tissue samples were used to evaluate mutation profiles detected by ultra-deep MPS, which showed 87.5% concordance. Cross-platform comparison with droplet digital PCR demonstrated comparable detection performance (91.4% concordance, Cohen's kappa coefficient of 0.85 with 95% CI = 0.72-0.97) and great reliability in quantification of mutation allele frequency (Intraclass correlation coefficient of 0.96 with 95% CI = 0.90-0.98). Our results highlight the potential application of liquid biopsy using ultra-deep MPS as a routine assay in clinical practice for both detection and quantification of actionable mutation landscape in NSCLC patients