Impact of Education and Network for Avian Influenza H5N1 in Human: Knowledge, Clinical Practice, and Motivation on Medical Providers in Vietnam

BACKGROUND: Knowledge, clinical practice, and professional motivation of medical providers relating to H5N1 infection have an important influence on care for H5N1 patients who require early diagnosis and early medical intervention. METHODS/PRINCIPAL FINDINGS: Novel educational programs including training and workshops for medical providers relating to H5N1 infection in Vietnam were originally created and implemented in 18 provincial hospitals in northern Vietnam between 2008 and 2010. A self-administered, structured questionnaire survey was conducted in 8 provincial hospitals where both educational training and workshops were previously provided. A total of 326 medical providers, including physicians, nurses, and laboratory technicians who attended or did not attend original programs were enrolled in the survey. Knowledge, clinical attitudes and practice (KAP), including motivation surrounding caring for H5N1 patients, were evaluated. The study indicated a high level of knowledge and motivation in all professional groups, with especially high levels in laboratory technicians. Conferences and educational programs were evaluated to be the main scientific information resources for physicians, along with information from colleagues. The chest radiographs and the initiation of antiviral treatment in the absence of RT-PCR result were identified as gaps in education. Factors possibly influencing professional motivation for caring for H5N1 patients included healthcare profession, the hospital where the respondents worked, age group, attendance at original educational programs and at educational programs which were conducted by international health-related organizations. CONCLUSIONS: Educational programs provide high knowledge and motivation for medical providers in Vietnam caring for H5N1 patients. Additional educational programs related to chest radiographs and an initiation of treatment in the absence of RT-PCR are needed. Networking is also necessary for sharing updated scientific information and practical experiences. These enhanced KAPs by educational programs and integrated systems among hospitals should result in appropriate care for H5N1 patients and may reduce morbidity and mortality

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

BRAZILIAN ARCHIVES OF BIOLOGY AND TECHNOLOGY A N I N T E R N A T I O N A L J O U R N A L Cloning and Overexpression of GmDREB2 Gene from a Vietnamese Drought-resistant Soybean Variety

ABSTRACT This work studied the amplification, cloning and determination of the GmDREB2 gene from the soybean cultivar DT2008 and five Vietnamese local soybean cultivars (DT26, DT51, DVN5, CB, CBD) and designed the vector carrying the structure containing GmDREB2 gene from cultivar DT2008 (best drought tolerant). The coding region of GmDREB2 gene isolated from six soybean cultivars was 480 nucleotides in length, encoding 159 amino acids. The recombinant structure was designed as 35S-GmDREB2-c-myc and its expression was analysed in transgenic tobacco plants. Recombinant DREB2 protein was expressed in five transgenic tobacco lines with molecular weights close to 20 kDa. During the drought conditions, the proline accumulation of the transgenic tobacco lines was higher than on wild-type (WT) plant

Cloning and Overexpression of GmDREB2 Gene from a Vietnamese Drought-resistant Soybean Variety

ABSTRACTThis work studied the amplification, cloning and determination of the GmDREB2 gene from the soybean cultivar DT2008 and five Vietnamese local soybean cultivars (DT26, DT51, DVN5, CB, CBD) and designed the vector carrying the structure containing GmDREB2 gene from cultivar DT2008 (best drought tolerant). The coding region of GmDREB2 gene isolated from six soybean cultivars was 480 nucleotides in length, encoding 159 amino acids. The recombinant structure was designed as 35S- GmDREB2- c-myc and its expression was analysed in transgenic tobacco plants. Recombinant DREB2 protein was expressed in five transgenic tobacco lines with molecular weights close to 20 kDa. During the drought conditions, the proline accumulation of the transgenic tobacco lines was higher than on wild-type (WT) plants, with the rate from 211.17 to 332.44% after five days of drought stress, and from 262.79 to 466.04% after nine days of drought stress. The two lines, TG2 and TG12 had the highest increase rate. These results provided the basis to generate drought-tolerant soybean plants by GmDREB2 overexpression

A Study on Design and Control of the Multi-Station Multi-Container Transportation System

In considering the problem of saving spaces during the transportation of items from one station to another, for example, in warehouses, factories, hospitals, etc., an automatic transportation system (ATS) that could take advantage of the above ceiling spaces for the transportation of products is considered. Such a system guarantees that the activities occurring in the floor area will be maintained as usual. To achieve this requirement, the ceiling spaces of a building are used to construct an automatic multi-station multi-container (MSMC) transportation system. This system can transport items from one place to another in the whole system. This system is designed to utilize the spaces above the ceiling, and it has the advantage of saving floor space for transportation operations. This will increase the operational capability of the industries and also improve the productivity of the industry in which this system is implemented. The entire transportation system includes (1) the essential conveying system (which is a functional conveyor module with a specified number of containers); (2) the control block that can monitor and operate the system; and (3) the sensor block for detecting and identifying the containers. The content of this article focuses on the introduction of the mechanical system (1); the control system (2); and the operating principle of the whole system (3)

A Study on Design and Control of the Multi-Station Multi-Container Transportation System

In considering the problem of saving spaces during the transportation of items from one station to another, for example, in warehouses, factories, hospitals, etc., an automatic transportation system (ATS) that could take advantage of the above ceiling spaces for the transportation of products is considered. Such a system guarantees that the activities occurring in the floor area will be maintained as usual. To achieve this requirement, the ceiling spaces of a building are used to construct an automatic multi-station multi-container (MSMC) transportation system. This system can transport items from one place to another in the whole system. This system is designed to utilize the spaces above the ceiling, and it has the advantage of saving floor space for transportation operations. This will increase the operational capability of the industries and also improve the productivity of the industry in which this system is implemented. The entire transportation system includes (1) the essential conveying system (which is a functional conveyor module with a specified number of containers); (2) the control block that can monitor and operate the system; and (3) the sensor block for detecting and identifying the containers. The content of this article focuses on the introduction of the mechanical system (1); the control system (2); and the operating principle of the whole system (3)

Synthesis and Selective Cytotoxic Activities on Rhabdomyosarcoma and Noncancerous Cells of Some Heterocyclic Chalcones

Chemically diverse heterocyclic chalcones were prepared and evaluated for cytotoxicity, aiming to push forward potency and selectivity. They were tested against rhabdomyosarcoma (RMS) and noncancerous cell line (LLC-PK1). The influence of heteroaryl patterns on rings A and B was studied. Heterocycle functionalities on both rings, such as phenothiazine, thiophene, furan and pyridine were evaluated. Notably, the introduction of three methoxy groups at positions 3, 4, 5 on ring B appears to be critical for cytotoxicity. The best compound, with potent and selective cytotoxicity (IC50 = 12.51 μM in comparison with the value 10.84 μM of paclitaxel), contains a phenothiazine moiety on ring A and a thiophene heterocycle on ring B. Most of the potential compounds only show weak cytoxicity on the noncancerous cell line LLC-PK1

Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam

Background: Neonatal tetanus continues to occur in many resource-limited settings but there are few data regarding long-term neurological outcome from the disease, especially in settings with critical care facilities. Methods: We assessed long-term outcome following neonatal tetanus in infants treated in a pediatric intensive care unit in southern Vietnam. Neurological and neurodevelopmental testing was performed in 17 survivors of neonatal tetanus and 18 control children from the same communities using tools previously validated in Vietnamese children. Results: The median age of children assessed was 36 months. Eight neonatal tetanus survivors and 9 community control cases aged p = 0.05) with a significantly lower cognitive domain score (3 (IQR 2–6) severe disease vs 7 (IQR 7–8) mild disease, p = 0.02). Conclusions: Neonatal tetanus is associated with long-term sequelae in those with severe disease. In view of these findings, prevention of neonatal tetanus should remain a priority.</p

Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam

Abstract Background Neonatal tetanus continues to occur in many resource-limited settings but there are few data regarding long-term neurological outcome from the disease, especially in settings with critical care facilities. Methods We assessed long-term outcome following neonatal tetanus in infants treated in a pediatric intensive care unit in southern Vietnam. Neurological and neurodevelopmental testing was performed in 17 survivors of neonatal tetanus and 18 control children from the same communities using tools previously validated in Vietnamese children. Results The median age of children assessed was 36 months. Eight neonatal tetanus survivors and 9 community control cases aged < 42 months were tested using the Bayley III Scales of Infant and Toddler Development (Bayley III-VN) and 8 neonatal tetanus survivors and 9 community controls aged ≥42 months were tested using the Movement Assessment Battery for Children. No significant reductions in growth indices or neurodevelopmental scores were shown in survivors of neonatal tetanus compared to controls although there was a trend towards lower scores in neonatal tetanus survivors. Neurological examination was normal in all children except for two neonatal tetanus survivors with perceptive deafness and one child with mild gross motor abnormality. Neonatal tetanus survivors who had expienced severe disease (Ablett grade ≥ 3) had lower total Bayley III-VN scores than those with mild disease (15 (IQR 14–18) vs 24 (IQR 19–27), p = 0.05) with a significantly lower cognitive domain score (3 (IQR 2–6) severe disease vs 7 (IQR 7–8) mild disease, p = 0.02). Conclusions Neonatal tetanus is associated with long-term sequelae in those with severe disease. In view of these findings, prevention of neonatal tetanus should remain a priority