Dexamethasone and long-term outcome of tuberculous meningitis in Vietnamese adults and adolescents.

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654

Mergers & Acquisitions Market in Vietnam’s Transition Economy

This paper is the first major and a thorough study on the Merger & Acquisition (M&A) activities in Vietnam’s emerging market economy, covering almost entirely the M&A history after the launch of Doi Moi. The surge in these activities since mid-2000s by no means incidentally coincides with the jump in FDI and FPI inflows into the nation. M&A industry in Vietnam has its socio-cultural traits that could help explain economic happenings, with anomalies and transitional characteristics, far better than even the most complete set of empirical data. Proceeds from the sales of existing assets and firms have mainly flowed into the highly speculative industries of securities, banking, non-bank financials, portfolio investments and real estates. The impact of M&A on Vietnam’s long-term prosperity is thus highly questionable. An observable high degree of volatility in the M&A processes would likely blow out the high ex ante expectations by many speculators, when ex post realizations finally arrive. The effect of the past M&A evolution in Vietnam has been indecisively positive or negative, with significant presence of rent-seeking and likelihood of causing destructive entrepreneurship. From a socio-economic and cultural view, the degree of positive impacts may result in domestic entrepreneurship which will perhaps be the single most important indicator

Temporal fluctuation of multidrug resistant salmonella typhi haplotypes in the mekong river delta region of Vietnam.

BACKGROUND: typhoid fever remains a public health problem in Vietnam, with a significant burden in the Mekong River delta region. Typhoid fever is caused by the bacterial pathogen Salmonella enterica serovar Typhi (S. Typhi), which is frequently multidrug resistant with reduced susceptibility to fluoroquinolone-based drugs, the first choice for the treatment of typhoid fever. We used a GoldenGate (Illumina) assay to type 1,500 single nucleotide polymorphisms (SNPs) and analyse the genetic variation of S. Typhi isolated from 267 typhoid fever patients in the Mekong delta region participating in a randomized trial conducted between 2004 and 2005. PRINCIPAL FINDINGS: the population of S. Typhi circulating during the study was highly clonal, with 91% of isolates belonging to a single clonal complex of the S. Typhi H58 haplogroup. The patterns of disease were consistent with the presence of an endemic haplotype H58-C and a localised outbreak of S. Typhi haplotype H58-E2 in 2004. H58-E2-associated typhoid fever cases exhibited evidence of significant geo-spatial clustering along the Sông H u branch of the Mekong River. Multidrug resistance was common in the established clone H58-C but not in the outbreak clone H58-E2, however all H58 S. Typhi were nalidixic acid resistant and carried a Ser83Phe amino acid substitution in the gyrA gene. SIGNIFICANCE: the H58 haplogroup dominates S. Typhi populations in other endemic areas, but the population described here was more homogeneous than previously examined populations, and the dominant clonal complex (H58-C, -E1, -E2) observed in this study has not been detected outside Vietnam. IncHI1 plasmid-bearing S. Typhi H58-C was endemic during the study period whilst H58-E2, which rarely carried the plasmid, was only transient, suggesting a selective advantage for the plasmid. These data add insight into the outbreak dynamics and local molecular epidemiology of S. Typhi in southern Vietnam

CONTAMINATION BY PERSISTENT ORGANIC POLLUTANTS AND ENDOCRINE DISRUPTING CHEMICALS IN VIETNAM : PATTERNS, BEHAVIOR, TRENDS AND TOXIC POTENTIAL

Joint Research on Environmental Science and Technology for the Eart

Assessment of Antioxidant and Antibacterial Activities of Lactobacillus farciminis HN11 as a Probiotic Candidate

Background and Objective: Lactobacillus farciminis is an obligate homofermentative bacterial species in fermented foods. Although other species such as Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus casei and Lactobacillus rhamnosus in Lactobacillus genus have been well characterized, probiotic characteristics of Lactobacillus farciminis still need to investigate. Thus, the objective of this study was to investigate probiotic characteristics and antibacterial activity of Lactobacillus farciminis HN11 isolated from Solanum macrocarpon sauces in Hue city, Vietnam. Material and Methods: Lactobacillus farciminis HN11 was cultured in Rogosa and Sharpe media and antibacterial activity of the free-cell suspension was assessed against Escherichia coli, Vibrio parahaemolyticus K5, Vibrio parahaemolyticus KS-02, Vibrio owensii KS-05, Vibrio alginolyticus KS-08, Vibrio alginolyticus A1-1 and Staphylococcus aureus using agar well diffusion method. Various probiotic characteristics of the isolate including antibacterial and antioxidant activities, autoaggregation and coaggregation were assessed. Furthermore, hemolytic and amino-acid dercarboxylase activities were assessed for biosafety assessment. The strain abilities to resist sodium chloride and bile salts were assessed as well. Results and Conclusion: Lactobacillus farciminis HN11 exhibited significant resistance to NaCl and bile salts. The strain expressed high coaggregation abilities for Escherichia coli, significant autoaggregation abilities and antibacterial activities against Vibrio spp. and Escherichia coli. Antioxidant assessment showed that Lactobacillus farciminis HN11 contained high antioxidant activities. This strain was negative for hemolytic and amino-acid dercarboxylase activities. Moreover, ampicillin and chloramphenicol inhibited growth of Lactobacillus farciminis HN11. This study assessed characteristics of Lactobacillus farciminis HN11 and showed its great potentials as a probiotic in fermented foods, enhancing antioxidant and decreasing harmful foodborne bacteria. Although, encapsulation of the strain within acid resistance materials is suggested to better protect it against high-acid contents of the stomach. Conflict of interest: The authors declare no conflict of interest

Dexamethasone and Long-Term Outcome of Tuberculous Meningitis in Vietnamese Adults and Adolescents

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654

The transfer and decay of maternal antibody against Shigella sonnei in a longitudinal cohort of Vietnamese infants.

BACKGROUND: Shigella sonnei is an emergent and major diarrheal pathogen for which there is currently no vaccine. We aimed to quantify duration of maternal antibody against S. sonnei and investigate transplacental IgG transfer in a birth cohort in southern Vietnam. METHODS AND RESULTS: Over 500-paired maternal/infant plasma samples were evaluated for presence of anti-S. sonnei-O IgG and IgM. Longitudinal plasma samples allowed for the estimation of the median half-life of maternal anti-S. sonnei-O IgG, which was 43 days (95% confidence interval: 41-45 days). Additionally, half of infants lacked a detectable titer by 19 weeks of age. Lower cord titers were associated with greater increases in S. sonnei IgG over the first year of life, and the incidence of S. sonnei seroconversion was estimated to be 4/100 infant years. Maternal IgG titer, the ratio of antibody transfer, the season of birth and gestational age were significantly associated with cord titer. CONCLUSIONS: Maternal anti-S. sonnei-O IgG is efficiently transferred across the placenta and anti-S. sonnei-O maternal IgG declines rapidly after birth and is undetectable after 5 months in the majority of children. Preterm neonates and children born to mothers with low IgG titers have lower cord titers and therefore may be at greater risk of seroconversion in infancy

Replacement of freshwater small-size fish by formulated feed in snakehead (Channa striata) aquaculture: Experimental and commercial-scale pond trials, with economic analysis

Traditional snakehead culture in Southeast Asia relies on use of small-size (trash) fish as food, an unsustainable practice. Following development of weaning methods and testing of formulated feed (FF) in laboratory experiments, we conducted feeding trials of FF vs. trash fish (TF) in experimental ponds at Can Tho University (CTU), followed by similar trials on commercial farms in two provinces in Vietnam. CTU pond trials consisted of five treatments (in triplicate), in which TF was replaced by FF in increasing percentages: 0 (control), 25, 50, 75, and 100% replacement of TF by FF (i.e., three treatments had mixed TF/FF diets). Although survival was significantly reduced in the 100% replacement treatment, and growth was significantly reduced in the 75% and 100% replacement treatments, the cost per kg of fish produced was 28–35% less in those high-replacement treatments compared to the 0% replacement treatment. On-farm trials were then conducted at two farms in An Giang and Dong Thap provinces for 6 months with snakehead fed TF only or FF only. At both farms, survival (73–80%) was not significantly different, but growth was significantly better on FF diet at both; however, FF-fed fish at the An Giang farm showed significantly higher levels of abnormal development. Overall production was about twice as high at the An Giang farm as at Dong Thap, but significantly greater production by FF-fed fish vs. TF-fed fish was only seen at Dong Thap. Sensory evaluation by a tasting panel found no difference in product quality between FF-fed fish, TF-fed fish, and a commercial sample bought in the market. Economic analysis indicated that profits were higher for FF-fed fish from both farms, although production costs and sales varied greatly, reflecting market differences in the two provinces

Genomic serotyping, clinical manifestations, and antimicrobial resistance of non-typhoidal Salmonella gastroenteritis in hospitalized children in Ho Chi Minh City, Vietnam

Nontyphoidal Salmonella (NTS) are among the most common etiological agents of diarrheal diseases worldwide and have become the most commonly detected bacterial pathogen in children hospitalized with diarrhea in Vietnam. Aiming to better understand the epidemiology, serovar distribution, antimicrobial resistance (AMR), and clinical manifestation of NTS gastroenteritis in Vietnam, we conducted a clinical genomics investigation of NTS isolated from diarrheal children admitted to one of three tertiary hospitals in Ho Chi Minh City. Between May 2014 and April 2016, 3,166 children hospitalized with dysentery were recruited into the study; 478 (∼15%) children were found to be infected with NTS by stool culture. Molecular serotyping of the 450 generated genomes identified a diverse collection of serogroups (B, C1, C2 to C3, D1, E1, G, I, K, N, O, and Q); however, Salmonella enterica serovar Typhimurium was the most predominant serovar, accounting for 41.8% (188/450) of NTS isolates. We observed a high prevalence of AMR to first-line treatments recommended by WHO, and more than half (53.8%; 242/450) of NTS isolates were multidrug resistant (MDR; resistant to ≥3 antimicrobial classes). AMR gene detection positively correlated with phenotypic AMR testing, and resistance to empirical antimicrobials was associated with a significantly longer hospitalization (0.91 days; P = 0.04). Our work shows that genome sequencing is a powerful epidemiological tool to characterize the serovar diversity and AMR profiles in NTS. We propose a revaluation of empirical antimicrobials for dysenteric diarrhea and endorse the use of whole-genome sequencing for sustained surveillance of NTS internationally

FPGA-Based Multiple DDoS Countermeasure Mechanisms System Using Partial Dynamic Reconfiguration

In this paper, we propose a novel FPGA-based high-speed DDoS countermeasure system that can flexibly adapt to DDoS attacks while still maintaining system performance. The system includes a packet decoder module and multiple DDoS countermeasure mechanisms. We apply dynamic partial reconfiguration technique in this system so that the countermeasure mechanisms can be flexibly changed or updated on-the-fly. The proposed system architecture separates DDoS protection modules (which implement DDoS countermeasure techniques) from the packet decoder module. By using this approach, one DDoS protection module can be reconfigured without interfering with other modules. The proposed system is implemented on a NetFPGA 10G board. The synthesis results show that the system can work at up to 116.782 MHz while utilizing up to 39.9% Registers and 49.85% BlockRAM of the Xilinx Virtex xcv5tx240t FPGA device on the NetFPGA 10G board. The system achieves the detection rate of 100% with the false negative rate at 0% and false positive rate closed to 0.16%. The prototype system achieves packet decoding throughput at 9.869 Gbps in half-duplex mode and 19.738 Gbps in full-duplex mode