| 1. |
- Tran, Ngoc Hieu, et al.
(författare)
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Genetic profiling of Vietnamese population from large-scale genomic analysis of non-invasive prenatal testing data
- 2020
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- The under-representation of several ethnic groups in existing genetic databases and studies have undermined our understanding of the genetic variations and associated traits or diseases in many populations. Cost and technology limitations remain the challenges in performing large-scale genome sequencing projects in many developing countries, including Vietnam. As one of the most rapidly adopted genetic tests, non-invasive prenatal testing (NIPT) data offers an alternative untapped resource for genetic studies. Here we performed a large-scale genomic analysis of 2683 pregnant Vietnamese women using their NIPT data and identified a comprehensive set of 8,054,515 single-nucleotide polymorphisms, among which 8.2% were new to the Vietnamese population. Our study also revealed 24,487 disease-associated genetic variants and their allele frequency distribution, especially 5 pathogenic variants for prevalent genetic disorders in Vietnam. We also observed major discrepancies in the allele frequency distribution of disease-associated genetic variants between the Vietnamese and other populations, thus highlighting a need for genome-wide association studies dedicated to the Vietnamese population. The resulted database of Vietnamese genetic variants, their allele frequency distribution, and their associated diseases presents a valuable resource for future genetic studies.
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| 2. |
- Tran, Dien M., et al.
(författare)
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High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals : Risk factors and burden of disease
- 2019
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Ingår i: Journal of Infection. - : Saunders Elsevier. - 0163-4453 .- 1532-2742. ; 79:2, s. 115-122
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCarbapenem-resistant Enterobacteriaceae (CRE) is an increasing problem worldwide, but particularly problematic in low- and middle-income countries (LMIC) due to limitations of resources for surveillance of CRE and infection prevention and control (IPC).MethodsA point prevalence survey (PPS) with screening for colonisation with CRE was conducted on 2233 patients admitted to neonatal, paediatric and adult care at 12 Vietnamese hospitals located in northern, central and southern Vietnam during 2017 and 2018. CRE colonisation was determined by culturing of faecal specimens on selective agar for CRE. Risk factors for CRE colonisation were evaluated. A CRE admission and discharge screening sub-study was conducted among one of the most vulnerable patient groups; infants treated at an 80-bed Neonatal ICU from March throughout June 2017 to assess CRE acquisition, hospital-acquired infection (HAI) and treatment outcome.ResultsA total of 1165 (52%) patients were colonised with CRE, most commonly Klebsiella pneumoniae (n=805), Escherichia coli (n=682) and Enterobacter spp. (n=61). Duration of hospital stay, HAI and treatment with a carbapenem were independent risk factors for CRE colonisation. The PPS showed that the prevalence of CRE colonisation increased on average 4.2 % per day and mean CRE colonisation rates increased from 13% on the day of admission to 89% at day 15 of hospital stay. At the NICU CRE colonisation increased from 32% at admission to 87% at discharge, mortality was significantly associated (OR 5•5, P < 0•01) with CRE colonisation and HAI on admission.ConclusionThese data indicate that there is an epidemic spread of CRE in Vietnamese hospitals with rapid transmission to hospitalised patients.
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| 3. |
- Dang, Vu Phuong Linh
(författare)
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Impairment of B cell trafficking and differentiation during HIV-1 infection
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- During the course of HIV-1 infection, several B cell dysfunctions occur as result of virus replication and indirect mechanisms of immunopathology. The B cells abnormalities include hypergammaglobulinemia, a decreased number of memory B cells, increased levels of activation markers on B cell surface and plasmacytosis. The molecular bases for these impairments are not fully characterized but may have relevance for designing functional HIV vaccines and improved treatment. In paper I the expression of chemokine receptors/chemokines important for B cell function was determined on cells from HIV-1 infected patients and controls. We studied the CXC chemokine receptor 4 (CXCR4), CXCR5, and CC chemokine receptor 7 (CCR7) and their respective ligands. We found a decreased expression of CXCR5 to be present on blood B cells from patients (P<0.05), in association with low CD4+ T-cell counts. Interestingly, B cells in blood and lymph nodes from HIV-1-infected patients also displayed an increased expression of the CXC chemokine ligand 13 (CXCL13), the ligand for CXCR5. Upon B-cell activation in vitro, CXCL13 was secreted in culture. The findings suggest that altered CXCR5/CXCL13 expression may participate in B-cell dysfunctions during HIV-1 infection. Loss of memory B cells is a regular finding in the blood of HIV-1 infected patients and the possibility exists that increased apoptosis via the Fas death receptor pathway may participate in this pathological mechanism. Interleukin-7 (IL-7), present to high levels in blood of HIV-1 infected patients, was previously reported to lead to increased Fas expression and Fas mediated apoptosis on T cells. In paper II, a novel mechanism responsible for increased B cell apoptosis in presence of the high IL-7 concentration was described. T cells cultured with IL-7 induced high Fas expression on resting B cells together with an increased sensitivity to Fas mediated apoptosis. As the mediator responsible for B cell priming to Fas mediated apoptosis we identified the cytokine IFN-γ that T cells secrete in response to IL-7. These results indicate a potential link between IL-7 and the increased B cell apoptosis in HIV-1 infected individuals. During HIV-1 infection, loss of memory B-cells, together with an altered differentiation of naïve B-cells, result in production of low quality antibodies, which may be due to impaired immunoglobulin affinity maturation. In paper III, we evaluated the effect of HIV-1 infection on class switch recombination and somatic hypermutation, crucial processes for the generation of functional antibodies, by studying the expression of activation-induced cytidine deaminase (AID) in peripheral B-cells from HIV-1 infected patients and healthy controls. We also studied the phenotype of B cells and their ability to produce immunoglobulins in vitro. Cells from HIV-1 infected patients showed higher baseline levels of AID expression and increased IgA production measured ex-vivo and upon CD40 and TLR9 stimulation in vitro. Moreover, the percentage of CD27(-)IgA+ and CD27(-)IgG+ B-cells in blood was significantly increased in HIV-1 infected patients. Interestingly, our results also showed a significantly increased number of somatic hypermutations in the VH genes in CD27(-) cells from patients. Taken together, the results show that during HIV-1 infection, CD27(-) B-cells can produce class switched and somatically hypermutated antibodies. High levels of soluble CD27 (sCD27), a marker of immune activation, are found during HIV-1 infection; whether sCD27 has a biological role on B cells was previously not known. The aim of paper IV was to investigate whether sCD27, by binding to CD70, can induce IgG production from B cells. B cells from healthy and HIV-1-infected individuals were cultured with recombinant human sCD27 (rhsCD27) and IgG production was measured in culture. We demonstrated that rhsCD27 induced IgG production from antigen-primed (CD27+) B cells. This effect was mediated by rhsCD27 binding to CD70 on B cells leading to activation of Blimp-1 and XBP-1, transcription factors associated with plasma cell differentiation. We found a significant correlation between the levels of serum sCD27 and IgG in HIV-1-infected individuals and healthy controls. The sCD27 may act to enhance immunoglobulin production and differentiation of activated memory B cells, thus providing an activation signal to antigen-experienced B cells. This mechanism may operate during HIV-1 infection when continuous immune activation may lead to up-regulation of CD70 expression and increased sCD27 cleavage and account for increased levels of circulating IgG. In conclusion, in this PhD thesis different mechanisms leading to impairments of B cell function observed during HIV-1 infection, in parallel to abnormal events of immune activation, are characterized.
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| 4. |
- Dempsey, Tina, et al.
(författare)
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Endotracheal intubation performance at a large obstetric hospital delivery room, Hanoi, Vietnam
- 2022
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Ingår i: Resuscitation Plus. - : Elsevier. - 2666-5204. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Intrapartum-related events account for nearly 700,000 neonatal deaths globally yearly. Endotracheal intubation is a cornerstone in preventing many of these deaths, but it is a difficult skill to acquire. Previous studies have described intubation performances in high-income coun-tries, but data from low-and middle-income countries are lacking. We aimed to assess the performance of delivery room intubation in a lower middle -income country.Methods: This prospective observational study was conducted at the Phu San Hanoi Hospital, Vietnam, from September 2020 to January 2021. Video cameras were positioned above the resuscitation tables and data were extracted using adopted software (NeoTapAS). All neonates requiring positive pressure ventilation were included. Our main variables of interest were time to first intubation attempt, first intubation attempt duration, and successful first intubation attempt.Results: 18,107 neonates were born during the five months. Of these, 75 (0.4%) received positive pressure ventilation, and 36 (0.2%) required endotracheal intubation of whom 24 were captured on video. The median time to the first intubation attempt was 252 seconds (range 91-771 sec-onds), the median first attempt duration was 49 seconds (range 10-105 seconds), and the first attempt success rate was 75%.Conclusion: Incidences of positive pressure ventilation and endotracheal intubation were low in comparison to global estimates. Three out of four intubations were successful at the first attempt and the procedural duration was often longer than recommended. Future studies should focus on how to achieve and maintain intubation skills and could include considering alternative devices for airway management at birth.
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| 5. |
- Dempsey, Tina, et al.
(författare)
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Incidence of Intrapartum-Related Events at the Largest Obstetric Hospital in Hanoi, Vietnam : A Retrospective Study
- 2022
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Ingår i: Children. - : MDPI AG. - 2227-9067. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Every year, 2.4 million neonates die during their first month of life and even more suffer permanent injury. The main causes are intrapartum-related events, prematurity, and infection, with sub-Saharan Africa and southern Asia being the worst affected regions. With a focus on intrapartum-related events, we aimed to assess the neonatal demographic characteristics, clinical management, and outcomes among neonates born at the largest obstetric hospital in Hanoi, Vietnam. This was a retrospective cross-sectional study that included all the inborn neonates in November 2019, which was selected as a representative month. A total of 4554 neonates were born during the study period. Of these, 1.0% (n = 44) were stillbirths, 0.15% (n = 7) died in hospital, 0.61% (n = 28) received positive pressure ventilation at birth, and 0.15% (n = 7) were diagnosed with hypoxic ischemic encephalopathy. A total of 581 (13%) neonates were admitted to the neonatal unit, among which the most common diagnoses were prematurity (37%, n = 217) and infection (15%, n = 89). Except for the intrapartum-related events, our findings are consistent with the previously documented data on neonatal morbidity. The intrapartum-related events, however, were surprisingly low in number even in comparison to high-income countries. Research on the current clinical practice at Phu San Hanoi Hospital may bring further clarity to identify the success factors.
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| 6. |
- Kien, Vu Duy, et al.
(författare)
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Inequalities in Household Catastrophic Health Expenditure and Impoverishment Associated With Noncommunicable Diseases in Chi Linh, Hai Duong, Vietnam
- 2017
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Ingår i: Asia-Pacific journal of public health. - : SAGE Publications. - 1010-5395 .- 1941-2479. ; 29, s. 35S-44S
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Tidskriftsartikel (refereegranskat)abstract
- A costly modern-day double burden, the expenses of noncommunicable diseases (NCDs) are becoming a devastating epidemic. The World Health Organization estimates $7 trillion in economic losses from NCDs in 2011-2025. Although regarded as affluent diseases, the burden of NCDs is shifting into poorer groups. In this study, we assessed the socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with NCDs in Northern Vietnam. We also identified associated factors for catastrophic health expenditure and impoverishment. Households self-reporting NCD diagnoses had the highest association with both catastrophic health expenditure and impoverishment, followed by those in urban areas. Such households were likely poorer according to our calculations estimating socioeconomic inequalities. Households with at least 1 member older than 60 years were also more likely to suffer catastrophic health expenditures. These findings suggest that targeted policy to prevent or subsidize care for NCDs could prevent catastrophic health expenditure and impoverishment among those already most disadvantaged.
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| 7. |
- Li, Jing-Rebecca, et al.
(författare)
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SpinDoctor : a Matlab toolbox for diffusion MRI simulation
- 2019
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Ingår i: NeuroImage. - : Elsevier BV. - 1053-8119 .- 1095-9572. ; 202
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Tidskriftsartikel (refereegranskat)abstract
- The complex transverse water proton magnetization subject to diffusion-encoding magnetic field gradient pulses in a heterogeneous medium can be modeled by the multiple compartment Bloch-Torrey partial differential equation (BTPDE). A mathematical model for the time-dependent apparent diffusion coefficient (ADC), called the H-ADC model, was obtained recently using homogenization techniques on the BTPDE. Under the assumption of negligible water exchange between compartments, the H-ADC model produces the ADC of a diffusion medium from the solution of a diffusion equation (DE) subject to a time-dependent Neumann boundary condition. This paper describes a publicly available Matlab toolbox called SpinDoctor that can be used 1) to solve the BTPDE to obtain the dMRI signal (the toolbox provides a way of robustly fitting the dMRI signal to obtain the fitted ADC); 2) to solve the DE of the H-ADC model to obtain the ADC; 3) a short-time approximation formula for the ADC is also included in the toolbox for comparison with the simulated ADC. The PDEs are solved by P 1 finite elements combined with built-in Matlab routines for solving ordinary differential equations. The finite element mesh generation is performed using an external package called Tetgen that is included in the toolbox. SpinDoctor provides built-in options of including 1) spherical cells with a nucleus; 2) cylindrical cells with a myelin layer; 3) an extra-cellular space (ECS) enclosed either a) in a box or b) in a tight wrapping around the cells; 4) deformation of canonical cells by bending and twisting. 5) permeable membranes for the BT-PDE (the H-ADC assumes negligible permeability). Built-in diffusion-encoding pulse sequences include the Pulsed Gradient Spin Echo and the Oscillating Gradient Spin Echo.
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| 8. |
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| 9. |
- Nguyen, Tra My, et al.
(författare)
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Effects of Coumarins from Roots of Paramignya scandens (Griff.) Craib on LPS-induced IL-1β and IL-10 Cytokine Production in RAW 264.7 Macrophages
- 2024
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Ingår i: Natural Product Sciences. - 1226-3907. ; 30:1, s. 30-38
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Tidskriftsartikel (refereegranskat)abstract
- Based on our previous study, we evaluated the modulatory effects on LPS-induced IL-1β and IL-10 cytokine production in RAW 264.7 macrophages of several medicinal herbs, including P. scandens. The results showed that P. scandens extract showed significant effects on LPS-induced IL-1β and IL-10 cytokine production in RAW 264.7 macrophages. Therefore, in the current research, we focused on the P. scandens sample. Cytokine production effects bioassay-guided isolation of ethyl acetate fraction of 70% ethanol extract from roots of Paramignya scandens (XL) obtained seven coumarins (1–7). Their chemical structures were identified using spectroscopic methods (NMR and MS) and compared with those previously published data to be xanthyletin (1), luvangetin (2), clausenidin (3), nordentatin (4), dentatin (5), clausarin (6), and anisocoumarin E (7). This study represents the first report on the presence of compounds 3, 6, and 7 in the Paramignya genus and compounds 1 and 2 in XL. All isolates (1–7) exhibited significant inhibition of LPS-induced interleukin (IL)-1β production compared to the LPS 5 ng/mL control group, with IL-1β concentrations ranging from 42.77 to 69.76 pg/mL. Additionally, the IL-10 production induced by compounds 1‒7 in LPS-stimulated RAW 264.7 macrophages ranged from 175.98 to 321.56 pg/mL, demonstrating a marked increase as compared to the LPS 5 ng/mL control group. The stimulatory effect on IL-10 production and inhibitory effect on IL-1β production of compounds 1, 2, and 6 gradually increased with the test concentration in both RAW 264.7 macrophages and LPS-induced RAW 264.7 macrophages. Compounds 1, 2, and 6 inhibited IL-1β production in LPS-induced RAW 264.7 macrophages with IC50 values of 10.70 ± 1.18 µM, 8.57 ± 1.05 µM, and 17.43 ± 1.05 µM, respectively. These findings highlight the potential of all the compounds derived from P. scandens roots in inducing IL-1β and IL-10 cytokines activity in LPS-stimulated RAW 264.7 macrophages. The results contributed to expanding the knowledge of the chemistry and bioactivities of P. scandens and provided valuable data for future investigations on this species.
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| 10. |
- Persson, Lars-Åke, 1947-, et al.
(författare)
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Effect of facilitation of local maternal-and-newborn stakeholder groups on neonatal mortality : cluster-randomized controlled trial
- 2013
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Ingår i: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 10:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam.METHODS AND FINDINGS: In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]).CONCLUSIONS: A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period.TRIAL REGISTRATION: Current Controlled Trials ISRCTN44599712. Please see later in the article for the Editors' Summary.
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