Search

This study aimed to investigate the occurrence of potential pathogenic bacteria from surface water samples collected at 30 stations along Ha Long Bay, Vietnam. Among 116 bacterial isolates identified, the composition analysis indicated 24 distinct bacterial genera, with Vibrio (29.3%), Pseudomonas (23.3%), Staphylococcus (8.6%), and Bacillus (6.0%) being the most dominant. The taxonomic analysis revealed 61/116 (52.6%) isolates as potential pathogens (risk group 2) belonging to 21 bacterial species. Potential pathogens were detected in 28/30 (93.3%) sampling stations, with the most common pathogens including Vibrio alginolyticus (n=25), Vibrio parahaemolyticus (n=5), Enterobacter cloacae (n=3), Pseudomonas mendocina (n=3), Aeromonas hydrophila (n=2), Enterobacter asburiae (n=2), Klebsiella oxytoca (n=2), Bacillus cereus (n=2), and Staphylococcus haemolyticus (n=2). The selected pathogens were highly resistant to Amoxicillin (100%), Piperacillin (100%), Amoxicillin + Clavulanate (85.7%), Ticarcillin (71.4%), Cefoxitin (54.4%), Kanamycin (50%), and Fosfomycin (50%), and less resistant to Trimethoprim + sulfamethoxazole, Fusidic Acid, Tetracycline, Erythromycin, Pristinamycin, Dalacin, and Rifampicin (

Introduction. Multidrug-resistant (MDR) Gram-negative bacilli including carbapenem-resistant Gram-negative Enterobacteriaceae (CRE) threaten global health. Little is known, however, about the distribution of antimicrobial resistance genes in MDR isolated from patients in Vietnamese hospitals. In this study, we collected MDR Escherichia coli, defined as E. coli resistance against all fluoroquinolones, aminoglycosides, and carbapenems. Aim. This study was designed to clarify the molecular epidemiology of Escherichia coli isolates resistant to carbapenems, fluoroquinolones, and aminoglycosides isolated from patients admitted to one of the largest hospitals in Vietnam in 2014–2019 based on both whole-genome sequencing (WGS) and phenotypic data. Methodology. Sixty-seven Vietnamese isolates screened by drug resistance by the disk test were subjected to WGS, and their sequences were analyzed to determine their multilocus sequence type (MLST), O-types, H-types, distribution of drug resistance genes, plasmid types, pathogenicity islands (PIs), virulence factor distribution, and phylogenetic evolution using the WGS data. Results. Among the STs detected, ST410 was relatively dominant. Dominant O-types and H-types were O102 and H9 and showed some links, such as those between O102 and H8. The most dominant plasmid type and carbapenemase type were 4 and NDM-5, respectively. MLST, O-types, H-types, plasmid types, and types of carbapenemases were very heterogeneous among the isolates, with no clear correlation between them. Dominant plasmid type carrying drug resistance gene was IncQ1_1. The percentage of isolates positive for drug resistance genes, such as anti-beta-lactams and aminoglycosides, was relatively high because the isolates screened were resistant to carbapenems, fluoroquinolones, and aminoglycosides. Conclusions. MDR E. coli isolates isolated at a high-volume Vietnamese hospital were very heterogeneous, suggesting that they were acquired from different sources, including nosocomial infection, animals, and water. Eradication of MDR E. coli from hospitals and other clinical environments is very challenging because a single measure may be ineffective.

Human epidermal growth factor receptor 2 (HER2) has been identified as a molecular target for breast cancer therapy, such as Trastuzumab (Herceptin®). This has been shown to improve patient survival substantially. The current study is aiming to locally produce an anti-HER2 monoclonal antibody (named Trastuzumab) which has an equivalent biological properties in comparison with the original version, Herceptin®). In silico design and construction of recombinant vectors, as well as the establishment of transfected cell lines with high expression of Trastuzumab were performed. Based on the protein sequences obtained from the Drugbank, the DNA sequences encoding for the light chain (Tras-Lc) and heavy chain (Tras-Hc) of Trastuzumab were optimized and integrated into pNanogen-Hygro and pNanogen-Puro vectors, respectively. The Neon Transfection System was used to co-transfect the pNanogen-Tras-Lc-Hygro and pNanogen-Tras-Hc-Puro constructs into CHO cells. Different co-transfected single-cell-colonies selected on media supplemented with hygromycin and puromycin were used for ELISA and SDS-PAGE assays to identify the CHO cell lines which highly express Trastuzumab. Based on the present results, 30μg of both constructs were suitable for DNA co-transfection. After 07 days of culture, the highest amount of Trastuzumab (561 µg/ml) was obtained from the H06LD68 cell line.

Abstract Background Dengue is a neglected tropical disease, for which no therapeutic agents have shown clinical efficacy to date. Clinical trials have used strikingly variable clinical endpoints, which hampers reproducibility and comparability of findings. We investigated a delta modified Sequential Organ Failure Assessment (delta mSOFA) score as a uniform composite clinical endpoint for use in clinical trials investigating therapeutics for moderate and severe dengue. Methods We developed a modified SOFA score for dengue, measured and evaluated its performance at baseline and 48 h after enrolment in a prospective observational cohort of 124 adults admitted to a tertiary referral hospital in Vietnam with dengue shock. The modified SOFA score included pulse pressure in the cardiovascular component. Binary logistic regression, cox proportional hazard and linear regression models were used to estimate association between mSOFA, delta mSOFA and clinical outcomes. Results The analysis included 124 adults with dengue shock. 29 (23.4%) patients required ICU admission for organ support or due to persistent haemodynamic instability: 9/124 (7.3%) required mechanical ventilation, 8/124 (6.5%) required vasopressors, 6/124 (4.8%) required haemofiltration and 5/124 (4.0%) patients died. In univariate analyses, higher baseline and delta (48 h) mSOFA score for dengue were associated with admission to ICU, requirement for organ support and mortality, duration of ICU and hospital admission and IV fluid use. Conclusions The baseline and delta mSOFA scores for dengue performed well to discriminate patients with dengue shock by clinical outcomes, including duration of ICU and hospital admission, requirement for organ support and death. We plan to use delta mSOFA as the primary endpoint in an upcoming host-directed therapeutic trial and investigate the performance of this score in other phenotypes of severe dengue in adults and children.

There have been few reports on the imaging characteristics of cryptococcus neoformans (C. neoformans) infection of the breast. Herein, we reported the imaging features of C. neoformans infection of the breast in a 41-year-old woman with immune thrombocytopenic purpura. Bilateral, diffuse, hyperechoic, and well-defined margin lesions were observed on breast ultrasounds. In addition, a global asymmetry in the left breast, and a focal asymmetry in the right breast were observed on mammograms. Breast fine needle aspiration and biopsy results revealed a C. neoformans infection. After 5 months of treatment with oral fluconazole and amphotericin B, the lesion on the right breast disappeared on repeated-breast ultrasounds.

BackgroundCritically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the different diseases.MethodsWe calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients.ResultsICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity.ConclusionThis study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care.

Ginsenosides are major bioactive compounds present in the Panax species. Ginsenosides exhibit various pharmaceutical properties, including anticancer, anti-inflammatory, antimetastatic, hypertension, and neurodegenerative disorder activities. Although several commercial products have been presented on the market, most of the current chemical processes have an unfriendly environment and a high cost of downstream processing. Compared to plant extraction, microbial production exhibits high efficiency, high selectivity, and saves time for the manufacturing of industrial products. To reach the full potential of the pharmaceutical resource of ginsenoside, a suitable microorganism has been developed as a novel approach. In this review, cell biological mechanisms in anticancer activities and the present state of research on the production of ginsenosides are summarized. Microbial hosts, including native endophytes and engineered microbes, have been used as novel and promising approaches. Furthermore, the present challenges and perspectives of using microbial hosts to produce ginsenosides have been discussed.

Lagoonal environments exhibit high levels of instability depending on hydrological, climatic and ecological factors, thereby influencing the distribution and structure of submerged plant communities. Conditions typically fluctuate widely due to the interaction of freshwater from rivers with saltwater from the sea, as well as from aquaculture activities that together influence submerged hydrophyte community spatial and temporal variability depending on plant survival strategies. Ruppia species feature either underwater pollination mediated by an air bubble or by the release of pollen floating at the water surface, the former promoting self-pollination. Tropical Asian Ruppia brevipedunculata Yu and den Hartog was assumed to pollinate below the water surface and identified as a separate lineage among selfed Ruppia taxa. We used nine nuclear microsatellites to estimate inbreeding levels and connectivity of R. brevipedunculata within a large SE Asian lagoon complex. Ruppia brevipedunculata meadows were strongly inbred as could be derived from the many monomorphic or totally fixed loci for unique alleles in different parts of the lagoon, which appears consistent with selfing behavior. Those from aquaculture ponds were highly inbred (FIS = 0.620), though less than open lagoon sites that showed nearly total inbreeding (FIS = 0.942). Ruppia brevipedunculata from two major lagoon parts were highly differentiated with spatially structured gene pools and a strong barrier between parts of the lagoon over a 30 km distance. Migration-n analysis indicated unidirectional though limited gene flow and following potential hydrological connectivity. Overall, private alleles under homozygote conditions explained a stronger genetic differentiation of populations situated inside aquaculture ponds than of open lagoon populations. Kinship values were only relevant up to 5 km distance in the open lagoon. Within a confined area of aquaculture ponds featuring dense vegetation in stagnant water, there would be opportunity for mixed pollination, thereby explaining the higher diversity of unique multilocus genotypes of aquaculture pond habitats. Low connectivity prevents gene pools to homogenize however promoted sites with private alleles across the lagoon. Complex hydrodynamic systems and human-made habitats enclosed by physical structures impose barriers for propagule dispersal though may create refugia and contribute to conserving regional genetic diversity.

African swine fever (ASF) is the cause of a recent pandemic that is posing a threat to much of the world swine production. The etiological agent, ASF virus (ASFV), infects domestic and wild swine, producing a variety of clinical presentations depending on the virus strain and the genetic background of the pigs infected. No commercial vaccine is currently available, although recombinant live attenuated vaccine candidates have been shown to be efficacious. In addition to determining efficacy, it is paramount to evaluate the safety profile of a live attenuated vaccine. The presence of residual virulence and the possibility of reversion to virulence are two of the concerns that must be evaluated in the development of live attenuated vaccines. Here we evaluate the safety profile of an efficacious live attenuated vaccine candidate, ASFV-G-ΔI177L. Results from safety studies showed that ASFV-G-ΔI177L remains genetically stable and phenotypically attenuated during a five-passage reversion to virulence study in domestic swine. In addition, large-scale experiments to detect virus shedding and transmission confirmed that even under varying conditions, ASFV-G-ΔI177L is a safe live attenuated vaccine.

Pyrazinamide (PZA) is a key antibiotic in current anti-tuberculosis regimens. Although the WHO has stressed the urgent need to obtain data on PZA resistance, in high tuberculosis burden countries, little is known about the level of PZA resistance, the genetic basis of such resistance or its link with Mycobacterium tuberculosis families. In this context, this study assessed PZA resistance through the molecular analysis of 260 Vietnamese M. tuberculosis isolates. First-line drug susceptibility testing, pncA gene sequencing, spoligotyping and mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) typing were performed. Overall, the pncA mutation frequency was 38.1% (99 out of 260 isolates) but was higher than 72% (89 out of 123 isolates) in multidrug and quadruple-drug resistant isolates. Many different pncA mutations (71 types) were detected, of which 55 have been previously described and 50 were linked to PZA resistance. Among the 16 novel mutations, 14 are likely to be linked to PZA resistance because of their mutation types or codon positions. Genotype analysis revealed that PZA resistance can emerge in any M. tuberculosis cluster or family, although the mutation frequency was the highest in Beijing family isolates (47.7%, 62 out of 130 isolates). These data highlight the high rate of PZA resistance-associated mutations in M. tuberculosis clinical isolates in Vietnam and bring into question the use of PZA for current and future treatment regimens of multidrug-resistant tuberculosis without PZA resistance testing.Emerging Microbes & Infections (2017) 6, e86; doi:10.1038/emi.2017.73; published online 11 October 2017

In this study, we showed that crude extract of Anisomeles indica (AI-EtE) expressed its toxicity to HeLa cells with an IC50 dose of 38.8 µg/mL and to zebrafish embryos with malformations, lethality and hatching inhibition at 72-hpf at doses higher than 75 µg/mL. More interestingly, flow cytometry revealed that AI-EtE significantly promoted the number of cells entering apoptotic. Accordingly, the transcript levels of BAX, CASPASE-8, and CASPASE-3 in the cells treated with AI-EtE at IC50 dose were 1.55-, 1.62-, and 2.45-fold higher than those in the control cells, respectively. Moreover, treatment with AI-EtE caused cell cycle arrest at the G1 phase in a p53-independent manner. Particularly, percentages of AI-EtE-treated cells in G1, S, G2/M were, respectively 85%, 6.7% and 6.4%; while percentages of control cells in G1, S, G2/M were 64%, 15% and 19%, respectively. Consistent with cell cycle arrest, the expressions of CDKN1A and CDNK2A in AI-EtE-treated cells were up-regulated 1.9- and 1.64-fold, respectively. Significantly, treatment with AI-EtE also decreased anchorage-independent growth of HeLa cells. In conclusion, we suggest that Anisomeles indica can be considered as a medicinal plant with a possible use against cervical cancer cells; however, the used dose should be carefully monitored, especially when applying to pregnant women.

The present paper is concerned with the elastic design optimisation of continuous composite beams. This optimisation is based on the analysis of the beam in the inelastic range including the concrete creep and shrinkage, the tension stiffening and temperature difference effects as well as the possible local buckling instability. The finite element program PONTMIXTE (adapted to study continuous beams at real scale with short time computation) is first presented with its different sections: Pre-design (in accordance with Eurocode specifications), Non linear finite element calculation and Post-processing. In order to validate the proposed model, the numerical calculations are compared against experimental results from tests on a two-span beam in reduced scale (7.5 m length for each span) without taking into account the local buckling phenomenon avoided in the experimental test by using web-stiffeners. Next, special attention is paid to study the influence of the local buckling instability on the internal moment redistribution coefficient between hogging and sagging zones. The application concerns different 3-span beams of bridge at real scale with medium span lengths (40–60–40 m). The post-buckling behaviour represented by moment-rotation curves (M-θ) is deduced from a 3D finite element model of the cross-section developed using Castem finite element code. The M-θ curves describing the local buckling phenomenon are approximated using hyperbolic functions and implemented in PONTMIXTE using a specific rotational spring finite element. The influence of this instability on the moment redistribution coefficients calls the Standart predictions into question.

Problem Direct application of digital health technologies from high-income settings to low- and middle-income countries may be inappropriate due to challenges around data availability, implementation and regulation. Hence different approaches are needed. Approach Within the Viet Nam ICU Translational Applications Laboratory project, since 2018 we have been developing a wearable device for individual patient monitoring and a clinical assessment tool to improve dengue disease management. Working closely with local staff at the Hospital for Tropical Diseases, Ho Chi Minh City, we developed and tested a prototype of the wearable device. We obtained perspectives on design and use of the sensor from patients. To develop the assessment tool, we used existing research data sets, mapped workflows and clinical priorities, interviewed stakeholders and held workshops with hospital staff. Local setting In Viet Nam, a lower middle-income country, the health-care system is in the nascent stage of implementing digital health technologies. Relevant changes Based on patient feedback, we are altering the design of the wearable sensor to increase comfort. We built the user interface of the assessment tool based on the core functionalities selected by workshop attendees. The interface was subsequently tested for usability in an iterative manner by the clinical staff members. Lessons learnt The development and implementation of digital health technologies need an interoperable and appropriate plan for data management including collection, sharing and integration. Engagements and implementation studies should be conceptualized and conducted alongside the digital health technology development. The priorities of end-users, and understanding context and regulatory landscape are crucial for success. [Phrase omitted] Utilisation de l'intelligence artificielle et des technologies numeriques en matiere de sante au Viet Nam Probleme Transposer directement des technologies numeriques en matiere de sante des pays a revenu eleve vers des pays a revenu faible et intermediaire peut se reveler inapproprie en raison des defis que posent la disponibilite, la mise en reuvre et la reglementation des donnees. Par consequent, differentes approches sont necessaires. Approche Dans le cadre du projet Viet Nam ICU Translational Applications Laboratory, nous developpons depuis 2018 un dispositif portable pour le suivi individuel des patients, ainsi qu'un outil d'evaluation clinique visant a ameliorer la gestion de la dengue. En etroite collaboration avec les equipes locales de l'Hopital des maladies tropicales, a Ho Chi Minh Ville, nous avons mis au point et teste un prototype de ce dispositif portable. Nous avons ainsi pu recueillir l'avis des patients quant a la conception et a l'utilisation du capteur. Pour elaborer l'outil d'evaluation, nous avons employe des ensembles de donnees de recherche existantes, cartographie les processus et les priorites cliniques, interroge les parties prenantes et organise des ateliers avec le personnel de l'hopital. Environnement local Le Viet Nam est un pays a revenu faible, ou le deploiement des technologies numeriques n'en est encore qu'a ses debuts dans le secteur des soins de sante. Changements significatifs En nous fondant sur les avis des patients, nous avons modifie le design du capteur portable en vue de le rendre plus confortable. Nous avons egalement imagine l'interface utilisateur de l'outil devaluation en nous inspirant des principales fonctionnalites selectionnees par les participants aux ateliers. Cette interface a ensuite ete testee de maniere iterative par les membres du personnel clinique afin d'en mesurer la facilite d'utilisation. Lecons tirees L'elaboration et la mise en reuvre des technologies numeriques en matiere de sante requierent un plan de gestion des donnees adequat et interoperable, notamment en termes de collecte, de partage et d'integration. Des etudes sur l'engagement et le deploiement doivent etre conceptualisees et menees parallelement au developpement de telles technologies. Tenir compte des priorites des utilisateurs finaux, mais aussi comprendre le contexte et le cadre reglementaire est essentiel a la reussite de ce projet. Aplicacion de la inteligencia artificial y las tecnologias sanitarias digitales en Vietnam Situacion La aplicacion directa de las tecnologias sanitarias digitales desde los entornos de ingresos altos a los paises de ingresos bajos y medios puede resultar inadecuada debido a los problemas relacionados con la disponibilidad de datos, la implementacion y la regulacion. Por consiguiente, se necesitan enfoques diferentes. Enfoque Dentro del proyecto Viet Nam ICU Translational Applications Laboratory, se esta desarrollando desde 2018 un dispositivo ponible para la monitorizacion individual del paciente y una herramienta de evaluacion clinica para mejorar el manejo de la enfermedad del dengue. En estrecha colaboracion con el personal local del Hospital para las Enfermedades Tropicales de Ciudad Ho Chi Minh, se desarrollo y probo un prototipo del dispositivo ponible. Se obtuvo la opinion de los pacientes sobre el diseno y el uso del sensor. Para desarrollar la herramienta de evaluacion, se utilizaron conjuntos de datos de investigacion existentes, se trazaron flujos de trabajo y prioridades clinicas, se entrevisto a las partes interesadas y se organizaron talleres con el personal del hospital. Marco regional En Vietnam, un pais de ingresos medios bajos, el sistema sanitario se encuentra en una fase incipiente de implantacion de tecnologias sanitarias digitales. Cambios importantes A partir de los comentarios de los pacientes, se ha modificado el diseno del sensor portatil para aumentar su comodidad. Se creo la interfaz de usuario de la herramienta de evaluacion segun las principales funciones que seleccionaron los asistentes al taller. Posteriormente, los miembros del personal clinico comprobaron la usabilidad de la interfaz de manera iterativa. Lecciones aprendidas El desarrollo y la implementacion de la tecnologia sanitaria digital necesitan un plan interoperable y adecuado para la gestion de datos, que incluya la recopilacion, el intercambio y la integracion. Los compromisos y los estudios de implementacion deben conceptualizarse y llevarse a cabo junto con el desarrollo de la tecnologia sanitaria digital. Las prioridades de los usuarios finales y la comprension del contexto y el panorama reglamentario son fundamentales para lograr los objetivos., Introduction Artificial intelligence and digital health technologies are improving clinical services, and are facilitating the decentralization of health care. Within low- and middle-income countries, opportunities for applying these innovations are [...]