Autumn rainfall increasing trend in south central Vietnam and its association with changes in Vietnam’s East Sea surface temperature

Certain parts of Southeast Asia, such as central Vietnam, experience heavy rainfall in the boreal autumn from September to December (SOND). The 52-year SOND rainfall over Vietnam from 1961 to 2012 shows increasing trends over the south central region (SR). Along the central coastal regions and SR, SOND rainfall as well as heavy rainfall indices, such as the number of heavy rainfall days, have increased significantly since the late 1980s and early 1990s. In contrast, a decreasing trend is observed in stations located north of 17°N. Tropical cyclone-induced rainfall exhibits an increasing trend over the SR. The increasing trend of SOND rainfall is associated with the recent sea surface temperature (SST) warming after the late 1980s over the South Vietnam East Sea (SVES). Owing to the recent SST warming and grand La Niña-like pattern after the 1990s, the SVES surface temperature has increased by 0.8–1.2 °C over the period 1961–2012, leading to enhanced moisture flux convergence over the SR. Moreover, the SVES warming strengthens the anomalous northeasterly winds that affect the SR. Consequently, SR has become more prone to deep convection and heavy rainfall events

Seasonal Prediction of Surface Air Temperature across Vietnam Using the Regional Climate Model Version 4.2 (RegCM4.2)

To investigate the ability of dynamical seasonal climate predictions for Vietnam, the RegCM4.2 is employed to perform seasonal prediction of 2 m mean (T2m), maximum (Tx), and minimum (Tn) air temperature for the period from January 2012 to November 2013 by downscaling the NCEP Climate Forecast System (CFS) data. For model bias correction, the model and observed climatology is constructed using the CFS reanalysis and observed temperatures over Vietnam for the period 1980–2010, respectively. The RegCM4.2 forecast is run four times per month from the current month up to the next six months. A model ensemble prediction initialized from the current month is computed from the mean of the four runs within the month. The results showed that, without any bias correction (CTL), the RegCM4.2 forecast has very little or no skill in both tercile and value predictions. With bias correction (BAS), model predictions show improved skill. The experiment in which the results from the BAS experiment are further successively adjusted (SUC) with model bias at one-month lead time of the previous run showed further improvement compared to CTL and BAS. Skill scores of the tercile probability forecasts were found to exceed 0.3 for most of the target months

Analysis of virulence factors of Helicobacter pylori isolated from a Vietnamese population

BACKGROUND: The incidence of gastric cancer differs among countries in Asia, and it has been suggested that virulence factors associated with Helicobacter pylori are partly responsible. The aim of this study was to investigate several genetic factors regarded as virulence or molecular epidemiologic markers in H. pylori isolates from Vietnamese subjects. RESULTS: The cagA, vacA and cag right-end junction genotypes of 103 H. pylori strains from Vietnam (54 from Hanoi and 49 from Ho Chi Minh) were determined by PCR and sequencing. Three types of deletion in the region located upstream of the cagA Glu-Pro-Ile-Tyr-Ala (EPIYA) repeat region were identified: the 39-bp deletion type, the 18-bp deletion type, and the no-deletion type. The majority of strains studied (77%; 80/103) had the 18-bp deletion irrespective of geographical location in the country or clinical outcome. All of the 39-bp and 18-bp deletion-type strains possessed the East Asian type cagA repeat region. The type II cag right-end junction genotype was predominant (84%). The vacA m1 genotype was significantly more common in strains isolated in Hanoi, where the incidence of gastric cancer is higher, than in strains from Ho Chi Minh. CONCLUSION: Pre-EPIYA-region typing of the cagA gene could provide a new genetic marker of H. pylori genomic diversity. Our data support the hypothesis that vacA m1 is closely associated with gastric carcinogenesis

Outpatient antibiotic prescribing for acute respiratory infections in Vietnamese primary care settings by the WHO AWaRe (Access, Watch and Reserve) classification: An analysis using routinely collected electronic prescription data

Background: This study aims to investigate patterns of antibiotic prescribing and to determine patient-specific factors associated with the choice of antibiotics by the World Health Organization's Access-Watch-Reserve (WHO AWaRe) class for acute respiratory infections (ARIs) in rural primary care settings in northern Vietnam. Methods: We retrospectively reviewed health records for outpatients who were registered with the Vietnamese Health Insurance Scheme, visited one of 112 commune health centres in 6 rural districts of Nam Dinh province, Vietnam during 2019, and were diagnosed with ARIs. Patient-level prescription data were collected from the electronic patient databases. We used descriptive statistics to investigate patterns of antibiotic prescribing, with the primary outcomes including total antibiotic prescriptions and prescriptions by WHO AWaRe group. We identified patient-specific factors associated with watch-group antibiotic prescribing through multivariable logistic regression analysis. Findings: Among 193,010 outpatient visits for ARIs observed in this study, 187,144 (97.0%) resulted in an antibiotic prescription, of which 172,976 (92.5%) were access-antibiotics, 10,765 (5.6%) were watch-antibiotics, 3366 (1.8%) were not-recommended antibiotics. No patients were treated with reserve-antibiotics. The proportion of watch-antibiotic prescription was highest amongst children under 5-years old (18.1%, compared to 9.5% for 5–17-years, 4.9% for 18–49-years, 4.3% for 50–64-years, and 3.7% for 65-and-above-years). In multivariable logistic regression, children, district, ARI-type, comobid chronic respiratory illness, and follow-up visit were associated with higher likelihood of prescribing watch-group antibiotics. Interpretation: The alarmingly high proportion of antibiotic prescriptions for ARIs in primary care, and the frequent use of watch-antibiotics for children, heighten concerns around antibiotic overuse at the community level. Antimicrobial stewardship interventions and policy attention are needed in primary care settings to tackle the growing threat of antibiotic resistance

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

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Impact of climate change on sea surface wind in Southeast Asia, from climatological average to extreme events: results from a dynamical downscaling

International audienceSoutheast Asia (SEA) climate shows a large range of variability scales, from extreme events to interannual variability. Understanding its answer to climate change is of primary scientific and socio-economic importance. IPCC 5th assessment report however pointed the lack of knowledge in regional climate change and its impact in SEA. In particular little is known about the answer of wind to climate change. The impact of climate change on sea surface wind speed is investigated here, examining changes in daily and extreme event scales, interannual variability and climatological average between the twentieth and twenty-first centuries. For that the RegCM4 regional model was used to perform a dynamical downscaling of CMIP5 simulations done with CNRM-CM5 global climate model under RCP4.5 and RCP8.5 hypothesis. Comparisons with QuikSCAT satellite data show that the downscaled simulations perform overall better than the global simulations. Both models produce regionally and seasonally contrasted results in terms of daily wind speed answer to climate change. Global simulations produce mostly weak and non-significant changes, only suggesting an intensification of northeast winter monsoon in the northern SEA. Conversely regional downscaled simulations suggest from March to November in the northern South China Sea and Pacific regions a significant weakening of wind speed from climatological to daily scales (summer monsoon to extreme values), for regions and periods of initially strong values, associated with a 40-50% decrease of tropical cyclones frequency. These changes result from the increase of mean meridional south to north sea level pressure gradient and decrease its daily variability

A 10-km CMIP6 downscaled dataset of temperature and precipitation for historical and future Vietnam climate

Abstract High-resolution climate projections are mandatory for many applications and impact assessments in environmental and management studies. In response to the needs in Vietnam, this study constructs a new precipitation and temperature daily dataset for Vietnam, at a high spatial resolution of 0.1° × 0.1°, based on the outputs of 35 global climate models (GCMs) from the Coupled Model Intercomparison Project Phase 6 (CMIP6). The Bias Correction and Spatial Disaggregation (BCSD) method is adopted to bias-correct monthly GCM simulations using observation data, then subsequently temporally disaggregate them into daily data. The new dataset is called CMIP6-VN, covering the present-time period 1980–2014 and future projections for 2015–2099 from both CMIP6 tier-1 (Shared Socioeconomic Pathways (SSPs) 1–1.26, 2–4.5, 3–7.0, and 5–8.5) and tier-2 (SSPs 1–1.9, 4–3.4, 4–6.0) experiments. Results indicated the good performance of CMIP6-VN for the historical period, suggesting that the dataset could be used for studies on climate change assessment and impacts in Vietnam