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Assessing the efficacy and safety of magnesium sulfate for management of autonomic nervous system dysregulation in Vietnamese children with severe hand foot and mouth disease.
BACKGROUND: Brainstem encephalitis is a serious complication of hand foot and mouth disease (HFMD) in children. Autonomic nervous system (ANS) dysregulation and hypertension may occur, sometimes progressing to cardiopulmonary failure and death. Vietnamese national guidelines recommend use of milrinone if ANS dysregulation with Stage 2 hypertension develops. We wished to investigate whether magnesium sulfate (MgSO4) improved outcomes in children with HFMD if used earlier in the evolution of the ANS dysregulation (Stage 1 hypertension). METHODS: During a regional epidemic we conducted a randomized, double-blind, placebo-controlled trial of MgSO4 in children with HFMD, ANS dysregulation and Stage 1 hypertension, at the Hospital for Tropical Diseases in Ho Chi Minh city. Study participants received an infusion of MgSO4 or matched placebo for 72 h. We also reviewed data from non-trial HFMD patients in whom milrinone failed to control hypertension, some of whom received MgSO4 as second line therapy. The primary outcome for both analyses was a composite of disease progression within 72 h - addition of milrinone (trial participants only), need for ventilation, shock, or death. RESULTS: Between June 2014 and September 2016, 14 and 12 participants received MgSO4 or placebo respectively, before the trial was stopped due to futility. Among 45 non-trial cases with poorly controlled hypertension despite high-dose milrinone, 33 received MgSO4 while 12 did not. There were no statistically significant differences in the composite outcome between the MgSO4 and the placebo/control groups in either study (adjusted relative risk (95%CI) of [6/14 (43%) vs. 6/12 (50%)], 0.84 (0.37, 1.92), p = 0.682 in the trial and [1/33 (3%) vs. 2/12 (17%)], 0.16 (0.01, 1.79), p = 0.132 in the observational cohort). The incidence of adverse events was similar between the groups. Potentially toxic magnesium levels occurred very rarely with the infusion regime used. CONCLUSION: Although we could not demonstrate efficacy in these studies, there were no safety signals associated with use of 30-50 mg/kg/hr. MgSO4 in severe HFMD. Intermittent outbreaks of HFMD are likely to continue across the region, and an adequately powered trial is still needed to evaluate use of MgSO4 in controlling hypertension in severe HFMD, potentially involving a higher dose regimen. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01940250 (Registered 22 AUG 2013). Trial sponsor: University of Oxford
DETERMINANTS OF THE INTENTION TO USE INTERNET BANKING IN HUE
This study aims to identify the factors that influence customers’ intention to adopt Internet banking services in Viet Nam generally and in Hue specifically. The research model was developed based on the original Technology Acceptance Model (TAM), adding Internet Experience, Social Norms and Perceived Risk. Using systematic sampling, a survey was conducted among students of Hue College of Economics yielding 540 respondents. Confirmative Factor Analysis and Structural Equation Modelling were then employed to test the validity and reliability of both constructs and research model. Results show that Perceived Ease of Use, Perceived Usefulness and Attitude all positively affect consumers’ intention to use the Internet Banking. Besides, Perceived Risk, Social Norms and Internet Experience also have some power of prediction though limited. Finally, this study contributes to providing useful implications for bank management in developing Internet Banking services in Hue, especially on student segments. Keywords: Internet banking, Technology Acceptance Model, SEM, Hue
DETERMINANTS OF THE INTENTION TO USE INTERNET BANKING IN HUE
This study aims to identify the factors that influence customers’ intention to adopt Internet banking services in Viet Nam generally and in Hue specifically. The research model was developed based on the original Technology Acceptance Model (TAM), adding Internet Experience, Social Norms and Perceived Risk. Using systematic sampling, a survey was conducted among students of Hue College of Economics yielding 540 respondents. Confirmative Factor Analysis and Structural Equation Modelling were then employed to test the validity and reliability of both constructs and research model. Results show that Perceived Ease of Use, Perceived Usefulness and Attitude all positively affect consumers’ intention to use the Internet Banking. Besides, Perceived Risk, Social Norms and Internet Experience also have some power of prediction though limited. Finally, this study contributes to providing useful implications for bank management in developing Internet Banking services in Hue, especially on student segments. Keywords: Internet banking, Technology Acceptance Model, SEM, Hue