A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN): pilot implementation in three countries in Southeast Asia, 2019-2020

Background: Case-based surveillance of antimicrobial resistance (AMR) provides more actionable data than isolate- or sample-based surveillance. We developed A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN) as a lightweight but comprehensive platform, in which we combine clinical data collection with diagnostic stewardship, microbiological data collection and visualisation of the linked clinical-microbiology dataset. Data are compatible with WHO GLASS surveillance and can be stratified by syndrome and other metadata. Summary metrics can be visualised and fed back directly for clinical decision-making and to inform local treatment guidelines and national policy. Methods: An ACORN pilot was implemented in three hospitals in Southeast Asia (1 paediatric, 2 general) to collect clinical and microbiological data from patients with community- or hospital-acquired pneumonia, sepsis, or meningitis. The implementation package included tools to capture site and laboratory capacity information, guidelines on diagnostic stewardship, and a web-based data visualisation and analysis platform. Results: Between December 2019 and October 2020, 2294 patients were enrolled with 2464 discrete infection episodes (1786 community-acquired, 518 healthcare-associated and 160 hospital-acquired). Overall, 28-day mortality was 8.7%. Third generation cephalosporin resistance was identified in 54.2% (39/72) of E. coli and 38.7% (12/31) of K. pneumoniae isolates. Almost a quarter of S. aureus isolates were methicillin resistant (23.0%, 14/61). 290/2464 episodes could be linked to a pathogen, highlighting the level of enrolment required to achieve an acceptable volume of isolate data. However, the combination with clinical metadata allowed for more nuanced interpretation and immediate feedback of results. Conclusions: ACORN was technically feasible to implement and acceptable at site level. With minor changes from lessons learned during the pilot ACORN is now being scaled up and implemented in 15 hospitals in 9 low- and middle-income countries to generate sufficient case-based data to determine incidence, outcomes, and susceptibility of target pathogens among patients with infectious syndromes

Spatiotemporal evolution of SARS-CoV-2 Alpha and Delta variants during large nationwide outbreak of COVID-19, Vietnam, 2021

We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions

COVID-19 Social Science and Public Engagement Action Research in Vietnam, Indonesia and Nepal (SPEAR): Protocol for a mixed methods study exploring the experiences and impacts of COVID-19 for healthcare workers and vulnerable communities

Background: When the novel coronavirus – SARS-CoV-2 – started to spread globally, there was a call for social and behavioral scientists to conduct research to explore the wider socio-cultural contexts of coronavirus disease 2019 (COVID-19), to understand vulnerabilities, as well as to increase engagement within communities to facilitate adoption of public health measures. In this manuscript, we describe the protocol for a study conducted in Indonesia, Nepal, and Vietnam. In the study, we explore how the COVID-19 pandemic is affecting individuals and their communities. We focus on the wider health and economic impacts of COVID-19, in particular emerging and increased burden on mental health, as well as new or deepened vulnerabilities in the communities. The introduction of vaccines has added another layer of complexity and highlights differences in acceptance and inequalities around access.  Methods: We use mixed methods, combining survey methods and social media surveillance to gain a picture of the general situation within each country, with in-depth qualitative methods to gain a deeper understanding of issues, coupled with a synergistic engagement component. We also include an exploration of the role of social media in revealing or driving perceptions of the pandemic more broadly. Participants include health workers and members of communities from 13 sites across the three countries. Data collection is spread across two phases. Phase 1 is concerned with exploring lived experiences, impacts on working lives and livelihoods, mental health and coping strategies. Phase 2 is concerned with acceptance of COVID-19 vaccines, factors that increase and reduce acceptance, and factors that influence access. Conclusions: We will disseminate findings in multiple ways including short reports and policy briefs, articles in peer-reviewed journals, and digital diaries will be edited into short films and uploaded onto social media sites.</ns3:p

Micronutrient Deficits Are Still Public Health Issues among Women and Young Children in Vietnam

Background: The 2000 Vietnamese National Nutrition Survey showed that the population’s dietary intake had improved since 1987. However, inequalities were found in food consumption between socioeconomic groups. As no national data exist on the prevalence of micronutrient deficiencies, a survey was conducted in 2010 to assess the micronutrient status of randomly selected 1526 women of reproductive age and 586 children aged 6–75 mo. Principal Findings: In women, according to international thresholds, prevalence of zinc deficiency (ZnD, 67.262.6%) and vitamin B12 deficiency (11.761.7%) represented public health problems, whereas prevalence of anemia (11.661.0%) and iron deficiency (ID, 13.761.1%) were considered low, and folate (,3%) and vitamin A (VAD,,2%) deficiencies were considered negligible. However, many women had marginal folate (25.1%) and vitamin A status (13.6%). Moreover, overweight (BMI$23 kg/m 2 for Asian population) or underweight occurred in 20 % of women respectively highlighting the double burden of malnutrition. In children, a similar pattern was observed for ZnD (51.963.5%), anemia (9.161.4%) and ID (12.961.5%) whereas prevalence of marginal vitamin A status was also high (47.362.2%). There was a significant effect of age on anemia and ID prevalence, with the youngest age group (6–17 mo) having the highest risk for anemia, ID, ZnD and marginal vitamin A status as compared to other groups. Moreover, the poorest groups of population had a higher risk for zinc, anemia and ID

Combined Effects of Bottom Ash and Expanded Polystyrene on Light-weight Concrete Properties

The benefits of using waste materials as a partial replacement for cement in high performance concrete are also discussed. This paper presents the combined effects of bottom ash TPP “Vung Ang” and expanded polystyrene aggregate on different the properties of light-weight concrete. Twenty different concrete mixtures with a water to cement ratio of 0.4 and superplasticizer to cement ratio of 0.015 were used. On the one hand, the EPS was partially replaced with (0 ÷ 40)% by volume of concrete mixture. On the other hand, the fine aggregate was replaced with (0 ÷ 30)% by mass of BA TPP “Vung Ang”. The engineering properties, including workability, density and compressive strength of light-weight concrete were investigated at different curing times. The level of decrease in the strength depends upon the replacement level of EPS and BA. Specifically, the concrete containing 40% EPS and 30% BA at 28 days of age decrease in average density and strength were 43.2% and 26.4%, respectively, in comparison with the control concrete

Combined Effects of Bottom Ash and Expanded Polystyrene on Light-weight Concrete Properties

The benefits of using waste materials as a partial replacement for cement in high performance concrete are also discussed. This paper presents the combined effects of bottom ash TPP “Vung Ang” and expanded polystyrene aggregate on different the properties of light-weight concrete. Twenty different concrete mixtures with a water to cement ratio of 0.4 and superplasticizer to cement ratio of 0.015 were used. On the one hand, the EPS was partially replaced with (0 ÷ 40)% by volume of concrete mixture. On the other hand, the fine aggregate was replaced with (0 ÷ 30)% by mass of BA TPP “Vung Ang”. The engineering properties, including workability, density and compressive strength of light-weight concrete were investigated at different curing times. The level of decrease in the strength depends upon the replacement level of EPS and BA. Specifically, the concrete containing 40% EPS and 30% BA at 28 days of age decrease in average density and strength were 43.2% and 26.4%, respectively, in comparison with the control concrete

Effect of Aluminium Powder on Light-weight Aerated Concrete Properties

Light-weight aerated concrete (LAC) is produced by making LAC involves the addition of a gas-forming admixture like aluminium powder (AP) to a wet mortar mixture. In concrete during curing, AP will react with the calcium hydroxide in the mixture to form hydrogen. The amount of gas-forming is dependent on the mechanical properties requirements. The aim of the current work was to investigate the properties of aerated concrete (AC) containing 30% fly ash and various AP content, including dry density, porosity and modulus of elasticity, as well as strengths of test specimens. The results of this study showed that when AP content increased, the density of AC decreased, but its porosity increased. Whereas an increase in the amount of AP caused a decrease in both the compressive strength, tensile strength and the modulus of elasticity of ACspecimens. The investigation of newly modified AC through combination of local by-product in Vietnam would decrease the content of Portland cement was used and as well as reduce the amounts of ash and slag TPP as well as industrial waste thrown at a landfill. Therefore, assisting the thermoelectric power plants to be more environmentally friendly in the future

Influence of blast-furnace slag on some properties of foam concrete

Foam concrete is lightweight concrete. It has been proven to be more environmentally beneficial than conventional concrete because it uses less natural resources. Besides, saving natural resources and making effective use of industrial waste as aggregate in concrete is a pressing issue. Currently, the effective use of industrial waste is of interest to many researchers. As a result, the current study seeks to investigate alternative fines sources by examining the impact of granular blast furnace slag as a substitute for sand aggregate on the properties of foam concrete. This paper builds on the author’s earlier research into the impact of blast furnace slag on the properties of foam concrete. In total, four foam concrete mixtures with densities of 1700 kg/m3 and 900 kg/m3 and sand replacement amounts of 100% blast furnace slag were created. GOST has been used to measure the compressive strength, elastic modulus, and porosity of foam concrete. According to the findings, using blast furnace slag instead of sand makes foam concrete thicker and less porous. These findings result in higher foam concrete compressive strength and elastic modulus. Furthermore, the author used Hoff’s equation and Zheng’s equation to calculate theoretical porosity and compare it to observed porosity. The measured results indicate that the theoretical and measured porosity have a reasonably close relationship

Influence of complex additives based on sulfoaluminate cement on the properties of composite binder

One urgent issue today is reducing CO2 emissions worldwide. In particular, the study of using sulfoaluminate cement to create less CO2 is a suitable solution. The paper presents compound additives' influence on the composite binder's standard consistency. Binders such as sulfoaluminate cement, natural gypsum, and tripoli are used as additives. The resulting binder's standard consistency was determined per GOST 310.3-76. Box-Wilson central composite design method was used to simulate the test results. The results obtained are presented as the surface of the second-level regression equation, which describes the dependence of the mixed binder's standard consistency on the additives' content. Research results have been obtained from compositions of composite binders with maximum and minimum standard consistency. Based on the analysis of experimental data, conclusions were drawn about the possible mechanism of the effect of the introduced additives on the consistency of the cement paste

Effect of Complex Organo-Mineral Modifier on the Properties of Corrosion-Resistant Concrete

This paper reports the results of a research study aimed at identifying the compositional features of fly ash (FA) TPP “Pha Lai” (Vietnam), silica fume SF-90 (SF90) and superplasticizer SilkRoad SR 5000F (SR5000) contents that influence the sulfate resistance of corrosion-resistant concrete. The effect of FA, SF90 and SR5000 on the strength of corrosion-resistant concrete is obtained quickly, high early-strength concrete. In details, the compressive strength at the age of 1 and 3 days are respectively 29.6% and 61.13% in comparison to 28 days period. The deformation of corrosion-resistant concrete prisms in 5% sodium sulfate solution after 28 days of testing were determined by Russian standard GOST P 56687-2015. Using the mathematical planning method for four factors and the Matlab computer programs was obtained the mathematical model, which was adequately described the influence ofthe water-binding ratio, FA, SF90 and SR5000 contents on the concrete deformation. It was also noted that the effect of FA content is more pronounced than the water-binding ratio and content SF90. In addition, the effect of SR5000 content on the deformation of concrete is negligible, so it was discarded