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Antimicrobial resistance (AMR) is a significant public health threat. Understanding public knowledge and attitudes toward antibiotic usage is essential for educational campaigns combating AMR. This study evaluates public knowledge and awareness about antibiotics and AMR in Vietnam.
Methods:
A cross-sectional survey was conducted online in December 2021, featuring 20 questions on antibiotics, AMR, and participants’ habits, attitudes, and potential solutions. The survey was distributed via social media platforms such as Facebook, Zalo, Viber, and WhatsApp. The target sample included Vietnamese working adults above 18 years old. Responses were coded and analyzed using SPSS version 21 and Microsoft Excel version 16.5. Participants were categorized into high, intermediate, and low knowledge levels based on their scores (>80%, 51–79%, and <50%).
Results:
A total of 866 Vietnamese adults participated. Most participants (90%) had moderate to high knowledge of antibiotics and AMR. However, only 32.8% knew that 75% of antibiotics are used in agriculture. Knowledge levels varied significantly across demographics such as gender, age, education, profession, and antibiotic use history. Healthcare-related professionals had significantly higher knowledge of antibiotics and AMR than nonhealthcare professionals (p < 0.001). Those with health-focused educational backgrounds also had higher knowledge levels (p < 0.001). Despite being aware that it was inappropriate, many participants reported discontinuing antibiotics before completing the course prescribed by their doctors.
Conclusions:
Age, education, profession, and antibiotic use history positively influenced AMR knowledge. However, even among health-related fields, understanding was only moderate. This indicates a need for enhanced public education to improve knowledge and attitudes toward antibiotics and AMR.
The effect of reservoir construction on medically important parasites is well known worldwide but lacks information in Vietnam. With 385 active hydropower plants and numerous water reservoirs, Vietnam provides an ideal setting for studying this issue. This study investigated trematode infection in snail first intermediate hosts from three hydropower reservoirs: Hoa Binh, Son La, and Thac Ba. In total, 25,299 snails representing 16 species were examined, with 959 individuals (8 species) shedding identifiable cercariae. Infection prevalence was highest in thiarid snails (5.4%–15.4%), followed by bithynid snails (2.9%–5.8%). Other snail species showed infection prevalence ranging from 0.3% to 2.9%. Infection prevalence varied significantly across regions, with the highest prevalence in Son La, followed by Hoa Binh and Thac Ba reservoirs. However, no significant differences were observed between snails collected from reservoirs versus canals and paddy fields. Morphological identification resulted in nine cercarial morphotypes, with pleurolophocercaria, xiphidiocercariae, and echinostome being the most common types, accounting for 89.2% of all cercarial infections. Echinostome cercariae were found in seven snail species, while the other cercarial morphotypes were shed by two to five species. Gabbia fuchsiana, Parafossarulus manchouricus, and Melanoides tuberculata were the most common hosts, each harboring five cercarial morphotypes, while Radix auricularia only released echinostome type. In conclusion, our findings highlight the endemic presence of trematodes in hydropower reservoirs and emphasize the need to consider the human-environment interaction around these reservoirs for a better understanding of disease transmission risks.
The literature on green tea consumption and glucose metabolism has reported conflicting findings. This cross-sectional study examined the association of green tea consumption with abnormal glucose metabolism among 3000 rural residents aged 40–60 years in Khánh Hòa province in Vietnam. Multinomial logistic regression analysis was conducted to examine the association of green tea consumption (0, < 200, 200–< 400, 400–< 600 or ≥ 600 ml/d) with prediabetes and diabetes (based on the American Diabetes Association criteria). Linear regression analysis was performed to examine the association between green tea consumption and the log-transformed homeostatic model assessment of insulin resistance (HOMA-IR) (a marker of insulin resistance) and the log-transformed homeostatic model assessment of β-cell function (HOMA-β) (a marker of insulin secretion). The OR for prediabetes and diabetes among participants who consumed ≥ 600 ml/d v. those who did not consume green tea were 1·61 (95 % CI = 1·07, 2·42) and 2·04 (95 % CI = 1·07, 3·89), respectively. Higher green tea consumption was associated with a higher level of log-transformed HOMA-IR (Pfor trend = 0·04) but not with a lower level of log-transformed HOMA-β (Pfor trend = 0·75). Higher green tea consumption was positively associated with the prevalence of prediabetes, diabetes and insulin resistance in rural Vietnam. The findings of this study indicated prompting the need for further research considering context in understanding the link between green tea consumption and glucose metabolism, especially in rural settings in low- and middle-income countries.
Objectives: Antimicrobial resistance (AMR) has emerged as a major concern in Vietnam, mainly due to the inappropriate use of antibiotics. Appropriate antibiotic management enables us to minimize the likelihood of antibiotic resistance and the spread of resistant bacteria. We evaluated vancomycin and colistin resistance and related factors in the intensive care unit (ICU) of Hue Central Hospital, a national hospital in central Vietnam. Methods: Using a cross-sectional descriptive study, we enrolled 362 patients who were prescribed antibiotics and were admitted to the ICU in 2019. Pathogens isolated from 473 routine clinical samples were subjected to antimicrobial susceptibility testing following the recommendations in the Clinical & Laboratory Standards Institute M100, 28thEdition. Colistin testing was performed using the broth microdilution method. Statistical significance was determined using the Fisher exact test. Results: The most commonly identified microorganisms were Acinetobacter baumannii (31.5%), Klebsiella pneumoniae (31.2%), Pseudomonas aeruginosa (12%), and Staphylococcus aureus (8.9%). All isolates of A. baumannii, K. pneumoniae, and P. aeruginosa tested with colistin were nonresistant. Moreover, >65% of A. baumannii isolates were resistant to all antibiotics except colistin. S. aureus had the highest resistance rate to erythromycin (80.6%), but no vancomycin-resistant isolates were identified. Factors associated with resistance to at least 1 antibiotic tested included length of stay (OR, 5.32; 95% CI, 1.47–19.17; P = .017), duration of antibiotics therapy (OR, 5.25; 95% CI, 1.46–18.95; P = .017), and the use of tracheal intubation and ventilator (OR, 3.08; 95% CI, 1.09–8.72; P = .038). Conclusions: These data indicated that although the vancomycin and colistin resistance rate is low, patients with longer length of stay, longer time on antibiotics, and invasive ventilation were at higher risk of AMR infection. Decreasing device use and strong antibiotic stewardship program at the hospital would help to reduce AMR infections.
We extend a result of Lieb [‘On the lowest eigenvalue of the Laplacian for the intersection of two domains’, Invent. Math.74(3) (1983), 441–448] to the fractional setting. We prove that if A and B are two bounded domains in $\mathbb R^N$ and $\lambda _s(A)$, $\lambda _s(B)$ are the lowest eigenvalues of $(-\Delta )^s$, $0<s<1$, with Dirichlet boundary conditions, there exists some translation $B_x$ of B such that $\lambda _s(A\cap B_x)< \lambda _s(A)+\lambda _s(B)$. Moreover, without the boundedness assumption on A and B, we show that for any $\varepsilon>0$, there exists some translation $B_x$ of B such that $\lambda _s(A\cap B_x)< \lambda _s(A)+\lambda _s(B)+\varepsilon .$
China is the second-largest export destination for Vietnam’s exports, with total export value increasing tenfold from around US$2 billion in 2000 to nearly US$22 billion in 2016, of which agricultural products accounted for 35 per cent. Total import-export turnover between the two countries increased from US$71.9 billion in 2016 to US$93.6 billion in 2017. The total value of Vietnam’s trade with China amounted to 22 per cent of the value of its total trade with the world. More importantly, the ratio of Vietnam’s trade with China to its total trade has been steadily increasing, with agricultural exports playing a significant role in overall export growth. China’s market share of Vietnam’s exports rose from about 6 per cent to 7 per cent between 2002 and 2008 to 26 per cent in 2017. This increase in China’s share of exports reflects an increase in Vietnam’s major agricultural exports in particular and export products in general.
The total value of agricultural products exported from Vietnam to China grew significantly from US$3.8 billion in 2014 to US$4.5 billion in 2016. Rice, fresh fruit and coffee are Vietnam’s top three exports by value. The value of rice exports remained relatively stable at around US$700 million throughout 2014–16, whereas the value of fresh fruit exports fluctuated, peaking at US$811 million in 2015 from US$627 million in 2014 then declining to US$533 million in 2016 (Atlas of Economic Complexity 2018). However, the value of fresh fruit exports was still vastly higher than that of coffee exports, which in 2014 stood at US$90 million.
Of special interest to Vietnam is the growing demand from China’s expanding middle class for fresh fruit and coffee. Between 2012 and 2015, the total value of Vietnam’s fresh fruit exports to China almost doubled, from US$442 million to US$861 million. In 2017, China imported about US$2.5 billion worth of fresh tropical fruit from Vietnam, representing an increase of 179 per cent since 2011 (Kubo and Sakata 2018). This surge in fruit exports coincided with an equally remarkable surge in Vietnam’s coffee exports to China, which in 2016 reached US$330.1 million, a heady 226 per cent increase in just two years.
To examine the association between red/processed meat consumption and glycaemic conditions (i.e. prediabetes (preDM) and diabetes mellitus (DM)) among middle-aged residents in rural Khánh Hòa, Vietnam.
Design:
In this cross-sectional study, a multinomial logistic regression model was used to examine the association between daily consumption of red/processed meat (0–99 g, 100–199 g or ≥ 200 g) and preDM/DM with adjustments for socio-demographic, lifestyle-related and health-related variables.
Setting:
Khánh Hòa Province, Vietnam
Participants:
The study used data collected through a baseline survey conducted during a prospective cohort study on CVD among 3000 residents, aged 40–60 years, living in rural communes in Khánh Hòa Province.
Results:
The multinomial regression model revealed that the relative-risk ratios for DM were 1·00 (reference), 1·11 (95 % CI = 0·75, 1·62) and 1·80 (95 % CI = 1·40, 2·32) from the lowest to the highest red/processed meat consumption categories (Ptrend = 0·006). The corresponding values for preDM were 1·00 (reference), 1·25 (95 % CI = 1·01, 1·54) and 1·67 (95 % CI = 1·20, 2·33) (Ptrend = 0·004). We did not find any evidence of statistical significance in relation to poultry consumption.
Conclusion:
Increased red/processed meat consumption, but not poultry consumption, was positively associated with the prevalence of preDM/DM in rural communes in Khánh Hòa Province, Vietnam. Dietary recommendations involving a reduction in red/processed meat consumption should be considered in low- and middle-income countries.
Iodine is essential for thyroid hormone synthesis. Individuals adhering to vegan and vegetarian diets have been found to be vulnerable to iodine deficiency. Yet, iodine has not been monitored in these groups across time. This study aims to investigate iodine status, intake and knowledge in vegans, vegetarians and omnivores and determine changes between 2016–2017 and 2019. Dietary intake (µg/d) was estimated by 3-d food diaries and iodine FFQ. Urinary iodine concentration, analysed by inductively coupled plasma mass spectrometry, assessed iodine status according to WHO criteria. Iodine knowledge was scored by an adapted questionnaire. IBM SPSS was used for statistical analysis. Ninety-six adults (18–60 years) were recruited in October 2016–2017 (vegans: 12; vegetarians: 5; omnivores: 43) and June 2019 (vegans: 7; vegetarians: 10;omnivores: 19). Median dietary iodine was below the Reference Nutrient Intake for all groups. Vegans and vegetarians had the lowest iodine intake. Vegans had significantly lower iodine intake than omnivores (2016–2017, P = 0 032; 2019, P = 0 001). Omnivores had the highest iodine status (2016–2017, 79 4 µg/l; 2019, 72 4 µg/l) and vegans the lowest (2016–2017, 31 2 µg/l; 2019, 12 2 µg/l). Iodine knowledge was poor but did not differ between dietary groups (2016–2017, P = 0 219; 2019, P = 0 532). Vegans and vegetarians continue to be at risk of iodine deficiency. Further, iodine intake in the UK is poor independent of dietary choice. Iodine education is needed along with research into improving iodine nutrition at national level.
where $p>0$ and $ 0<s<1 $. We establish a Liouville-type theorem for positive solutions in the case $p>1$ and give a uniform lower bound of positive solutions when $0<p\leq 1$. In particular, when v is independent of the time variable, we obtain a similar result for the fractional elliptic Lichnerowicz equation
with $p>0$ and $0<s<1$. This extends the result of Brézis [‘Comments on two notes by L. Ma and X. Xu’, C. R. Math. Acad. Sci. Paris349(5–6) (2011), 269–271] to the fractional Laplacian.
We first establish a family of sharp Caffarelli–Kohn–Nirenberg type inequalities (shortly, sharp CKN inequalities) on the Euclidean spaces and then extend them to the setting of Cartan–Hadamard manifolds with the same best constant. The quantitative version of these inequalities also is proved by adding a non-negative remainder term in terms of the sectional curvature of manifolds. We next prove several rigidity results for complete Riemannian manifolds supporting the Caffarelli–Kohn–Nirenberg type inequalities with the same sharp constant as in the Euclidean space of the same dimension. Our results illustrate the influence of curvature to the sharp CKN inequalities on the Riemannian manifolds. They extend recent results of Kristály (J. Math. Pures Appl. 119 (2018), 326–346) to a larger class of the sharp CKN inequalities.
For a vibration system, the best designed spring is compliant to a desired vibration mode while it is robust to other undesired modes. There are several types of spring design for displacing the proofmass along the x and y axes, however, very few designs of spring compliant to the z axis are introduced. Therefore, we propose a z axis microactuator in which the suspending spring is designed so that it is only compliant to vibration along the z axis. The suspending spring consists of straight beam stages mechanically coupled with each other via frames which are symmetrically designed around a center plate. The operation characteristics of the microactuator is investigated by theoretical expresses and numerical simulation. The frequency split between the z axis mode and undesired modes can obtain more than 45%. The operation frequency can be modified in a wide range, from 68 kHz to 400 kHz, by changing the dimensional parameters of spring beams. The spring beams can be lengthened to increase displacement in the z axis while the mode cross-talk is still suppressed. Compared to the previously reported researches, the current microactuator shows robustness to undesired vibration modes, which is potential for integration in low mode cross-talk multi-axis micro-stages and low-noise mechanical sensors.
Background: Antibiotic overuse has led to increasing rates of antibiotic resistant infections and unnecessary antibiotic costs. Clinical pharmacists can play a key role in optimizing appropriate use of antimicrobials and reducing antimicrobial resistance. However, the role of clinical pharmacists in antimicrobial stewardship is new and not well established in Viet Nam. Objective: We evaluated the use of clinical pharmacists for improved antimicrobial prescribing. Methods: We assembled an antibiotic stewardship program (ASP) team consisting of a clinical pharmacist and a specialist in infection prevention and control in a 60-bed medical intensive care unit (MICU) at Hue Central Hospital in central Viet Nam. During January–September 2018, the ASP team collected baseline antibiotic prescribing days of therapy (DOT) for all antibiotics administered in the MICU. Then, from October 2018 through June 2019, the ASP team reviewed daily positive clinical bacterial cultures and susceptibility results for all patients present in the MICU. They reviewed medical charts, including antimicrobial prescriptions, during week days and only if patient was still in the ICU at the time of ASP rounds. The team recommended changes to antibiotic therapy verbally to physicians and left the decision to change antibiotic therapy to their discretion. The ASP team documented whether their recommendations were accepted or rejected. Statistical significance was determined using the Student t test. Results: The ASP team reviewed 160 medical charts and made 169 ASP recommendations: 122 (72%) to continue current treatment; 24 (14%) to monitor drug levels or obtain diagnostic tests; 10 (6%) to discontinue therapy; 6 (4%) to de-escalate therapy; 5 (3%) to adjust doses; and 2 (1%) to broaden therapy. Only 8 of the recommended changes (5%) were declined by the clinicians. The average monthly DOT for all types of antibiotics declined significantly from 2,213 to 1,681 (24% decrease; P = .04). Reductions in DOT for the most common broad-spectrum antibiotics included colistin from 303 to 276 (P = .75); imipenem-cilastatin 434 to 248 (P = .06); doripenem 150 to 144 (P = .85). Piperacillin-tazobactam increased from 122 to 142 (P = 0.75). Conclusions: We demonstrated that daily review of cultures and antibiotic use decreased overall antibiotic prescribing. Given that few recommendations included discontinuation of therapy, ASP rounds likely raised awareness for clinicians to optimize antibiotic use.
The median duration of hospital stays due to COVID-19 has been reported in several studies on China as 10−13 days. Global studies have indicated that the length of hospitalisation depends on different factors, such as the time elapsed from exposure to symptom onset, and from symptom onset to hospital admission, as well as specificities of the country under study. The goal of this paper is to identify factors associated with the median duration of hospital stays of COVID-19 patients during the second COVID-19 wave that hit Vietnam from 5 March to 8 April 2020.
Method
We used retrospective data on 133 hospitalised patients with COVID-19 recorded over at least two weeks during the study period. The Cox proportional-hazards regression model was applied to determine the potential risk factors associated with length of hospital stay.
Results
There were 65 (48.9%) females, 98 (73.7%) patients 48 years old or younger, 15 (11.3%) persons with comorbidities, 21 (16.0%) severely ill patients and 5 (3.8%) individuals with life-threatening conditions. Eighty-two (61.7%) patients were discharged after testing negative for the SARS-CoV-2 virus, 51 were still in the hospital at the end of the study period and none died. The median duration of stay in a hospital was 21 (IQR: 16–34) days. The multivariable Cox regression model showed that age, residence and sources of contamination were significantly associated with longer duration of hospitalisation.
Conclusion
A close look at how long COVID-19 patients stayed in the hospital could provide an overview of their treatment process in Vietnam, and support the country's National Steering Committee on COVID-19 Prevention and Control in the efficient allocation of resources over the next stages of the COVID-19 prevention period.
In this chapter, we have introduced existing solutions in the literature aiming to improve the performance of ambient backscattercommunication systems (ABCSs). We have first provided the reviews on several multiple access schemes that allows multiple transmitters backscatter data to the receiver. Then, solutions focusing on improving the communication range, bitrate, reliability, and robustness are presented in details. Finally, we have discussed challenges and future research directions to further improve the performance of ABCSs.
In this chapter, we have provided an overview of ambient backscatter communication systems. Firstly, we have introduced the fundamentals of modulated backscatter and its three main configurations, i.e., monostatic, bistatic, and ambient backscatter communication systems. Then, key channel-coding and modulation techniques in modulated backscatter communication systems are discussed. Two major types of backscatter communication channels and their link budgets are also introduced. Next, theoretical analyses and experimental measurements of backscatter channels are reviewed. Finally, we have discussed some research challenges of backscatter communication systems, especially ambient backscatter communication systems.
This chapter introduces some basic background and the development of ambient backscatter technology. Furthermore, objectives and organization of the book are presented in this chapter.
This chapter discussed open issues and potential research directions for future developemnt of ambient backscatter communication. Many emerging research directions are presented in this chapter such as full-duplex ambient backscatter, ultra-wideband backscatter, visible-light backscactter, and millimeter-wave backscatter.