The dhole Cuon alpinus was historically one of the most widespread large carnivores in Asia, but it has declined across its range as a result of habitat loss, hunting and prey depletion. There are few recent confirmed records of the species in Vietnam, and it has been reported as possibly extirpated. Here, we report a new camera-trap record of a dhole in Pu Hoat Nature Reserve, in Nghe An province, north-central Vietnam. To our knowledge, this is the first confirmed record of the dhole in Vietnam in > 20 years. We are unable to determine whether the record represents a vagrant animal or a remnant population. However, this new record should be viewed in the wider context of the species’ decline across Vietnam. During 2014–2024, in addition to our study, 3,231 camera-traps were set in 1,657 stations across 31 sites that would have been within the species’ historical range but the dhole was not recorded. We conclude that, despite this new record, the species is likely extirpated across most protected areas in Vietnam.

The triple burden of malnutrition (TBM) is a growing public health issue worldwide. This study examined the prevalence and association between undernutrition, overnutrition and micronutrient deficiencies (MNDs), and the key demographic and socioeconomic determinants, among Vietnamese children, using the nationally representative General Nutrition Survey (GNS) 2020(1).

The GNS 2020 was reviewed and approved by the Ethical Committee of the National Institute of Nutrition, Vietnam. Written informed consent was obtained from each participant and/or their parents prior to data collection. Data on anthropometric parameters, micronutrients biomarkers, demographic and socioeconomic indicators for 7,289 children aged 6 months to 9 years old were analysed(1). All analyses were weighted and accounted for complex survey design using svyset commands in STATA. Age-specific and region-specific prevalence of malnutrition were examined. Determinants of malnutrition were assessed using bivariate and multivariate logistic regressions, crude or adjusted odds ratio (OR/AOR) and respective 95% confidence intervals (CI) were reported.

Overall, the prevalence of stunting, underweight and wasting/thinness of children was 12.7%, 10.5%, and 4.7%, respectively, in 2020. This finding underscores that child stunting reduction in Vietnam is on track towards the target of 40% reduction by 2025 set by the Global Nutrition Targets(2) (<20%). Meanwhile overweight and obesity among school aged children is off track the target(2), with the prevalence in urban areas increasing from 8.5% in 2010 to 31% in 2020. Low serum zinc, anaemia and iron deficiency (ID) were the common MNDs observed, affecting 53.1%, 15.2%, and 13.9% of children. Prevalence of low serum retinol was relatively low (<7%). In the bivariate regressions, older child (2-4 years old) [OR (95% CI): 1.43 (1.20, 1.72)], ethnic minorities [5.94 (3.78, 9.36)], and living in mountainous areas [5.06 (1.18, 14.42)] had increased odds of stunting, whereas reduced odds were found in children from the richest quintile [0.13 (0.05, 0.32)]. Similar determinants were found to be associated with underweight and MNDs. Males [1.43 (1.16, 1.76)], older children (5-9 years old) [10.02 (6.71, 14.97), and children from the richest quintile [2.91 (1.20, 7.05)] had increased odds of overweight. After adjusting for covariates including age, sex, region, wealth index and inflammation, children with anaemia, low serum retinol and low serum zinc had increased odds of stunting and underweight than non-micronutrient deficient children (AOR = 1.43-1.71). Compared to children without MNDs, those with ≥3 MNDs had almost double the odds of stunting and underweight, whereas those with ≤3 MNDs had reduced odds of overweight (AOR = 0.38−0.60).

TBM is becoming a major public health concern for Vietnamese children, and significant demographic variation and socioeconomic inequalities in malnutrition were observed. These findings suggest that national policies and programmes in Vietnam should address age-specific, sex-specific, geographical and socioeconomic disparities to accelerate progress in reducing child malnutrition.

Although in recent decades progress has been made in reducing the global burden of micronutrient deficiencies (MNDs), nonetheless MNDs prevalence remains high in some populations(1). Among the micronutrients, deficiencies in iron, zinc and vitamin A are particularly prevalent, and causally associated with adverse health outcomes for children and adolescents. The aim of this study was to examine the prevalence and associations between MNDs and components of the double burden of malnutrition in female adolescents utilizing the nationally representative Vietnam General Nutrition Survey 2020.

1,471 female adolescents were included and categorised into: pre-adolescent (10-12-year-old), middle-adolescent (13-15-year-old), and late-adolescent (16-18-year-old) groups. Biomarkers of micronutrients, anthropometry, and sociodemographic data were selected for analyses. WHO growth reference values were applied to define stunting (height-for-age z-score (HAZ) < −2 SD), thinness (BMI-for-age z-score (BAZ) < −2 SD) and overweight (BAZ > 1). Iron deficiency was defined as serum ferritin<15μg/L (<70 μg/L for individuals with inflammation), vitamin A insufficiency (VAI) as serum retinol<1.05 μmol/L, zinc deficiency was based on Zinc International Consultative Group Recommendation, and inflammation as C-reactive protein >5 mg/L or α1-acid glycoprotein >1 g/L. One or multiple MNDs were defined as individuals with ≥ 1 MNDs.

Data were analysed by STATA 17 (STATA Corporation, US). Descriptive and logistic regression analyses were performed based on the sampling weight adjustments for the estimation at population level. Multivariate logistic regressions between MNDs and growth indicators were presented as crude (COR) and 95% confidence intervals or adjusted odds ratio (AOR), after adjusting for sociodemographic variables (age, ecological area, demographic, ethnicity, and wealth index) and inflammation.

Compared to the pre-adolescent group, prevalence of stunting doubled in late adolescence (12.4% to 26.8%). Meanwhile, the prevalence of overweight and thinness decreased with age (29.7% to 22.0% and 9.4% to 2.7%, respectively). Overall, the prevalence of MNDs increased with age. Zinc deficiency occurred most often in the entire cohort (39.8% in 10-18) and contributed the most to multi-MNDs. Prevalence of one or multiple MNDs increased with age, from 58.1% in pre-adolescence to 80% in late adolescence. In logistic regression analyses adjusting for inflammation and sociodemographic factors, stunting increased the risk of having ≥1 MNDs (AOR: 1.94 (1.3, 2.88), p=0.002), but not individual MND alone. Thinness increased the risk of VAI (AOR: 2.38 (1.34, 4.22), p=0.005). No association was found between any MND and overweight, although overweight was protective against zinc deficiency (COR: 0.76 (0.59, 0.99), p=0.04) in the unadjusted model.

Female late adolescents in Vietnam had a higher prevalence of stunting and MNDs, but lower prevalence of thinness and overweight in comparison to pre-adolescents. Stunting was a risk factor associated with having one or multiple MNDs. Thinness was associated with higher risk of VAI. No association was found between overweight and MNDs in this cohort.

Skin injury and dermatitis are common complications following chemotherapy and radiation administration for cancer treatment. Symptomatic relief of these complications is limited to slow-acting therapies and often results in holding or modifying cancer therapy that may impact patient outcomes. The off-label use of oral high dose vitamin D3 has demonstrated rapid clinical improvement in skin inflammation and swelling in both chemotherapy and radiation-induced injury. Furthermore, vitamin D3 has been shown to downregulate pro-inflammatory pathways and cytokines, including NFkB, and CCL2, as well as CCL20, which are not only involved in tissue injury, but may confer resistance to cancer treatment. In this paper, we discuss 2 patients with acute radiation dermatitis and acute radiation recall dermatitis following chemotherapy who received 50 000 – 100 000 IU of oral high dose vitamin D3 with improvement in their symptoms. These findings may indicate the potential use of vitamin D as a therapeutic intervention and future target for studying skin healing following chemotherapy and/ or radiation-induced cutaneous toxicity.

This study explores the relationship between executive functioning (EF) and degree of bilingualism in a sample (N = 79) of 5- to 7-year-old monolingual and bilingual children. The bilingual group included children who are fully fluent in two languages (balanced bilinguals) and children who are still learning their second language (dual-language learners (DLLs). In general, findings revealed mixed associations between bilingualism and EF. There were no language group differences for one type of simple inhibitory control (i.e., go or no-go task). However, a bilingual advantage was demonstrated for another type of simple inhibitory control (the Head–Toes–Knees–Shoulders task), for complex inhibitory control (i.e., the Simon effect), and for cognitive flexibility (Dimensional Change Card Sort). Effects were found when DLLs and balanced bilinguals were analyzed separately, and the latter two effects were found when both types of bilinguals were compared to monolinguals. The findings contribute to the growing literature examining a possible bilingual effect in early childhood.

This research examines the relation between shareholder litigation and corporate social responsibility (CSR). Exploiting exogenous changes in shareholder litigation rights following the staggered adoption of universal demand laws by U.S. states and the Ninth Circuit Court of Appeals’ ruling on securities class action lawsuits, we show that weaker shareholder litigation rights lead to lower CSR scores. Moreover, the relation is stronger for firms facing higher litigation risk, and a decreased CSR score enhances firm value. Our evidence suggests that firms engage in CSR activities partly to reduce shareholder litigation risk ex ante and mitigate its consequences ex post.

Morphological data and the first molecular data are provided for four species of the trematode family Bucephalidae Poche, 1907 from marine and freshwater teleost fish species of East Asia. A new species, Rhipidocotyle husi n. sp., was isolated from Huso dauricus from the Amur River, Russia. Adult worms of this species were distinguished from their congeners Rhipidocotyle illense and Rhipidocotyle kovalai by morphological analysis. Three other known species were identified: Bucephalus skrjabini and Prosorhynchus cf. squamatus were detected in Siniperca chuatsi from the Amur River and in Myoxocephalus spp. from the Okhotsk Sea, Russia, respectively, while Prosorynchoides karvei was extracted from Strongylura strongylura from Halong Bay, Vietnam. The 28S ribosomal DNA (rDNA)-based phylogenetic analysis showed that the new species formed a shared polytomy clade with Rhipidocotyle fennica. Phylogenetic analysis of all available molecular data showed that four genera, namely Rhipidocotyle, Bucephalus, Prosorynchoides and Prosorhynchus, are para- or polyphyletic. Molecular-based phylogenetic analysis of morphologically validated bucephalid species indicated that three genera – Rhipidocotyle, Bucephalus and Prosorynchoides – were monophyletic. The genus Prosorhynchus maintained paraphyly, and P. cf. squamatus was more closely related to Dollfustrema spp. than to other Prosorhynchus spp. These findings do not exclude the possibility that representatives of Dollfustrema and P. cf. squamatus belong to the same genus.

Pigs act as the intermediate hosts of the zoonotic tapeworms Taenia solium and Taenia asiatica, as well as of the non-zoonotic Taenia hydatigena. In Vietnam, human taeniasis and cysticercosis have been reported throughout the country; however, data on porcine cysticercosis are scarce. Our study aimed to estimate the prevalence of Taenia spp. in slaughtered pigs in two districts in Phu Tho, a mountainous province in northern Vietnam from where neurocysticercosis patients commonly originate. The carcasses of 399 pigs from 51 small-scale abattoirs were checked for cysticerci, while tongue, liver, masseter muscles, diaphragm and heart were sliced and examined. Retrieved cysticerci underwent polymerase chain reaction–restriction fragment length polymorphism and sequencing for species confirmation. Blood was also collected to detect antibodies by lentil lectin-purified glycoprotein enzyme-linked immunoelectrotransfer blot (LLGP-EITB) and recombinant T24H antigen (rT24H)-EITB and circulating antigens by B158/B60 Ag-ELISA. In two pigs, T. asiatica cysticerci were found, confirming the presence of the parasite in pigs in Vietnam at a low prevalence (0.5%; 95% exact confidence interval (CI): 0–1.19%). Cysticerci of T. solium were found in none of the pigs, although one serum sample was positive for antibodies in both LLGP-EITB and rT24H-EITB. Furthermore, a high prevalence of T. hydatigena cysticercosis was observed (18.0%; 95% Wilson score CI: 14.6–22.1%). In more than half of the T. hydatigena-positive pigs, circulating antigens were detected by Ag-ELISA, confirming that this test cannot be used to diagnose T. solium cysticercosis in this region. Finally, Spirometra erinaceieuropaei was found in one pig liver. It is the first record of this zoonotic cestode species in pigs in Vietnam. Overall, the findings confirmed the complex epidemiology of Taenia spp. in pigs in Vietnam.

Background: Pertussis continues to be an important health issue in Vietnam despite infant vaccination programs. In Vietnam, the incidence rates of pertussis per 100,000 population rose from 0.09 in 2014 to 0.33 in 2015 and to 0.58 in 2017. Macrolides, especially erythromycin, are the treatment of choice. However, erythromycin-resistant cases, caused by transition at A2047G position in 23S rRNA, have been reported in the region. Few data are available on antimicrobial resistance in Bordetella pertussis to guide treatment in Vietnam. We report antimicrobial susceptibility of the circulating strains in southern Vietnam during 2015–2017. Methods: Tracheal aspirates from 263 suspected pertussis cases were subject to multiplex real-time PCR to identify B. pertussis and Bordetella spp. Samples were cultured on Regan Lowe agar with 10% sheep blood containing cephalexin (40 µg/mL) and incubated at 37°C for 10 days. The antimicrobial susceptibilities to erythromycin, azithromycin, clarithromycin, and trimethoprim/sulfamethoxazole were determined using the disc diffusion method (CLSI-2017) on Regan Lowe and Mueller Hinton agar. Erythromycin minimum inhibitory concentrations (MICs) were determined using an E-test. The results were recorded after days 3 and 7 of incubation. Sequencing of the 23S rRNA gene was performed to detect mutations conferring macrolide resistance. Results: Of 263 cases, 119 were positive for B. pertussis (45.2%) by real-time PCR, and 15 of 263 strains (5.7%) were successfully cultured. All 15 isolates were susceptible to macrolides and no heterogeneous phenotype was recorded after 7 days; erythromycin MICs were ≤0.094 µg/mL (Fig. 1). We observed no difference in results generated on Regan Lowe and Mueller Hinton media. However, for testing trimethoprim/sulfamethoxazole, results on were superior, as those on Regan Lowe media were unclear. Sequencing of 23S rRNA identified no mutations known to confer macrolide resistance. Conclusions: None of 15 B. pertussis isolates tested were nonsusceptible to erythromycin and macrolides. Similarly, no mutation at the erythromycin-binding site in the 23S rRNA gene was identified. The low isolation rate of B. pertussis by culture means that few positive specimens were tested for antimicrobial susceptibility. To overcome this limitation, detection of resistance directly from clinical specimens needs to be investigated. Ongoing screening for B. pertussis and antimicrobial susceptibility is recommended to support efforts to control the spread of this respiratory tract infection agent.

Funding: None

Disclosures: None

Background: Whooping cough is a serious respiratory illness in infants caused by Bordetella pertussis. In spite of the vaccination program, the incidence rates of whooping cough per 100,000 population in Vietnam increased from 0.33 in 2015 to 0.58 in 2017. If this represents a pertussis resurgence, contributors may include pathogen adaptation, the spread of specific variants, vaccine failure, and failure to effectively treat cases and contacts. There has been little research in Vietnam on B. pertussis strains. Therefore, we investigated the molecular epidemiology of circulating B. pertussis strains in Southern Vietnam by applying multilocus sequence typing (MLST) for 7 housekeeping genes and 4 antigenic determinant genes as components in the acellular vaccine including prn, ptxP, ptxS1, and fim3. Methods: DNA was extracted from 15 isolates collected from 263 case patients during 2015–2017 and was subject to MLST using primers and cycling conditions from the Bordetella pubMLST website (www.Pubmlst.org/Bordetella/). The products were analyzed using BioEdit version 7.2.5 software and then were aligned and compared to reference sequences of each genotype in the database. The evolutionary relationship among sequence types (STs) from housekeeping genes was performed as a minimum spanning tree via the goeBURST algorithm, whereas the correlation of different variants from 4 antigenic determinant genes was built up and clarified with phylogenetic trees based on the UPGMA method by MEGA 7 program. Results: The 15 isolates were all classified as ST2 (100%) by MLST of housekeeping genes, and they belonged to a common global clonal group (Fig. 1). Sequencing of antigenic determinant genes prn2 – ptxP3 – ptxS1-1 – fim3-1 determined that all were identical to each another and the reference sequences (Fig. 2). Conclusions:B. pertussis isolates circulating in Southern Vietnam appeared to be the same as the common global strain. Few isolates were available for testing; therefore, continued surveillance is important to confirm these findings and to monitor population changes over time.

Funding: None

Disclosures: None

Introduction: Wide variability exists in emergency department (ED) syncope management. The Canadian Syncope Risk Score (CSRS) was derived and validated to predict the probability of 30-day serious outcomes after ED disposition. The objective was to identify barriers and facilitators among physicians for CSRS use to stratify risk and guide disposition decisions Methods: We conducted semi-structured interviews with physicians involved in ED syncope care at 8 Canadian sites. We used purposive sampling, contacting ED physicians, cardiologists, internists, and hospitalists until theme saturation was reached. Interview questions were designed to understand whether the CSRS recommendations are consistent with current practice, barriers and facilitators for application into practice, and intention for future CSRS use. Interviews were conducted via telephone or videoconference. Two independent raters coded interviews using an inductive approach to identify themes, with discrepancies resolved through consensus. Our methods were consistent with the Knowledge to Action Framework, which highlights the need to assess barriers and facilitators for knowledge use and for adapting new interventions into local contexts. Results: We interviewed 14 ED physicians, 7 cardiologists, and 10 hospitalists/internists across 8 sites. All physicians reported the use of electrocardiograms for patients with syncope, a key component in the CSRS criteria. Almost all physicians reported that the low risk recommendation (discharge without specific follow-up) was consistent with current practice, while less consistency was seen for moderate (15 days outpatient monitoring) and high risk recommendations (outpatient monitoring and/or admission). Key barriers to following the CSRS included a lack of access to outpatient monitoring and uncertainty over timely follow-up care. Other barriers included patient/family concerns, social factors, and necessary bloodwork. Facilitators included assisting with patient education, reassurance of their clinical gestalt, and optimal patient factors (e.g. reliability to return, support at home, few comorbidities). Conclusion: Physicians are receptive to using the CSRS tool for risk stratification and decision support. Implementation should address identified barriers, and adaptation to local settings may involve modifying the recommended clinical actions based on local resources and feasibility.