Tuberculous meningitis is often lethal. Early antituberculosis treatment and adjunctive treatment with glucocorticoids improve survival, but nearly one third of patients with the condition still die. ...We hypothesized that intensified antituberculosis treatment would enhance the killing of intracerebral Mycobacterium tuberculosis organisms and decrease the rate of death among patients.
We performed a randomized, double-blind, placebo-controlled trial involving human immunodeficiency virus (HIV)-infected adults and HIV-uninfected adults with a clinical diagnosis of tuberculous meningitis who were admitted to one of two Vietnamese hospitals. We compared a standard, 9-month antituberculosis regimen (which included 10 mg of rifampin per kilogram of body weight per day) with an intensified regimen that included higher-dose rifampin (15 mg per kilogram per day) and levofloxacin (20 mg per kilogram per day) for the first 8 weeks of treatment. The primary outcome was death by 9 months after randomization.
A total of 817 patients (349 of whom were HIV-infected) were enrolled; 409 were randomly assigned to receive the standard regimen, and 408 were assigned to receive intensified treatment. During the 9 months of follow-up, 113 patients in the intensified-treatment group and 114 patients in the standard-treatment group died (hazard ratio, 0.94; 95% confidence interval, 0.73 to 1.22; P=0.66). There was no evidence of a significant differential effect of intensified treatment in the overall population or in any of the subgroups, with the possible exception of patients infected with isoniazid-resistant M. tuberculosis. There were also no significant differences in secondary outcomes between the treatment groups. The overall number of adverse events leading to treatment interruption did not differ significantly between the treatment groups (64 events in the standard-treatment group and 95 events in the intensified-treatment group, P=0.08).
Intensified antituberculosis treatment was not associated with a higher rate of survival among patients with tuberculous meningitis than standard treatment. (Funded by the Wellcome Trust and the Li Ka Shing Foundation; Current Controlled Trials number, ISRCTN61649292.).
By adding new gauge singlets of neutral leptons, the improved versions of the 3-3-1 models with right-handed neutrinos have been recently introduced in order to explain recent experimental neutrino ...oscillation data through the inverse seesaw mechanism. We prove that these models predict promising signals of lepton-flavor-violating decays of the standard-model-like Higgs boson h10→μτ,eτ, which are suppressed in the original versions. One-loop contributions to these decay amplitudes are introduced in the unitary gauge. Based on a numerical investigation, we find that the branching ratios of the decays h10→μτ,eτ can reach values of 10−5 in the regions of parameter space satisfying the current experimental data of the decay μ→eγ. The value of 10−4 appears when the Yukawa couplings of leptons are close to the perturbative limit. Some interesting properties of these regions of parameter space are also discussed.
This study quantified the secondhand smoke (SHS) concentration in a sample of public places in Vietnam to determine changes in SHS levels 5 years after a public smoking ban was implemented.
Two ...monitoring campaigns, one in 2013 (before the tobacco control law was implemented) and another in 2018 (5 years after the implementation of the law) were conducted in around 30 restaurants, cafeterias and coffee shops in major cities of Vietnam. Concentrations of PM
, as an indicator of SHS, were measured by portable particulate matter monitors (TSI SidePak AM510 and Air Visual Pro).
The geometric mean PM
concentration of all monitored venues was 87.7 µg/m
(83.7-91.9) in the first campaign and 55.2 µg/m
(53.7-56.7) in the second campaign. Pairwise comparison showed the PM
concentrations in the smoking observed area was triple and double those in the non-smoking area and the outdoor environment. After adjusting for sampling locations and times, the SHS concentration 5 years after the implementation of the tobacco control law reduced roughly 45%.
The study results indicate an improvement in air quality in public places in Vietnam via both the reduction in PM
levels and the number of people observed smoking. However, greater enforcement of the free-smoke legislation is needed to eliminate SHS in public places in Vietnam.
Promotion of integrated aquaculture with agriculture, including crops and livestock (IAA-farming), requires consideration of both bio-physical and socio-economic contexts. The major factors ...influencing the adoption of IAA-farming by households at three sites in the Mekong delta were identified. Special attention was given to the multiple roles ponds play in IAA-farming systems. Information was collected through semi-structured interviews and discussions with focus groups and key individuals. Data were analyzed using multivariate factor analysis, analysis of variance or participatory ranking methods. Three major IAA-systems were identified: (1) low-input fish farming integrated with intensive fruit production (system 1), (2) medium-input fish farming integrated with less intensive fruit production (system 2), and (3) high-input fish farming integrated with less intensive fruit production (system 3). System 1 was commonly practised in a rural fruit-dominated area with fertile soils, while systems 2 and 3 were more evident in peri-urban rice-dominated areas with less fertile soils. In the study area, only 6% of poor farmers adopted IAA-farming, while this was 42% for intermediate and 60% for rich households. Richer farmers tended to intensify fish farming and seek a more commercial orientation. The major factors why farmers did not start aquaculture were the inappropriateness of technology, insufficient land holding or poor access to extension services, limited farm management, and through a fear of conflicts associated with pesticide use on crops. The main motivations for practising IAA-farming included increased income and food for home consumption from the available farm resources while reducing environmental impacts. Further improvements to IAA-systems can be realized by strengthening nutrient recycling between different IAA-system components while enhancing farming output and safeguarding the environment.
Combined effects of global warming and rapid urbanization replace green spaces with urban facilities. Children in urban areas are at a higher risk of heat-related adverse health effects. Our study ...aimed to examine the protective effect of urban green space on heat-related respiratory hospitalization among children under 5 years of age in Hanoi, the capital city of Vietnam. We estimated district-specific meteorological conditions from 2010 to 2014 by using a dynamic downscaling approach with a fine-resolution numerical climate model. The green space in each district was calculated using satellite data. The attributable fraction of heat-related respiratory hospitalization was estimated using a two-stage model, including a distributed lag non-linear model (DLNM) coupled with multivariate meta-analysis. The association between heat-related respiratory hospitalization and green spaces at the district level was explored using a linear regression model. The central districts were more crowded and hotter, with less green spaces than the outer districts. At temperatures > 34 °C (extreme heat threshold), the hospitalizations in the central districts increased significantly; however, in the outer districts, the hospitalization rate was insignificant. On average, extreme heat attributed 0.33% to citywide hospitalization, 0.35% in the center, and 0.32% in the outer region. Every 1% increase in the green space fraction will reduce heat-related respiratory hospitalization risk by 3.8%. Heat significantly increased the risk of respiratory hospitalization among children under 5 years in Hanoi, Vietnam. These findings are valuable for authorities to consider strategies to protect children’s health against the effects of heat, including increasing green space.
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•Synthesis of regioregular P3HT terminally mono-functionalized with thiol group.•MOF-catalyzed photopolymerization to give polymethacrylates with maleimide side groups.•First time ...grafting of P3HT to a coil backbone by thiol-maleimide coupling.•This rod-coil graft copolymer can be potential for optoelectronic materials.
While several strategies have been developed in the literature to obtain rod-coil graft copolymers composed of regioregular poly(3-hexyl thiophene) (P3HT), our contribution in this field consists of a convenient and versatile way to obtain a copolymer with a coil polymethacrylate backbone grafted with P3HT rod chains by a combination of the thiol-maleimide chemistry and MOF-catalyzed photoinitiated atom transfer radical polymerization (ATRP) method. Well-defined synthesis of the P3HT-graft copolymer was described, and its structure, morphology and properties were characterized by proton nuclear magnetic resonance, gel permeation chromatography, Fourier transform infrared, UV–vis and photoluminescence spectroscopy, differential scanning calorimetry and atomic force microscopy.
A new thermoresponsive self-healing polymer thermoset ((1.5M/F)DA-PDMS-PU) based on the Diels–Alder (DA) reaction between furan and maleimide groups was developed. The material exhibited glass ...temperature induced shape memory effect that brings crack faces into intimate contact, enabling the reformation of DA bridges located in the crack surfaces. In addition, the incorporation PDMS segments and excess maleimide functional groups besides DA bridges in the network promotes the mobility of dynamic groups and the healing reaction, therefore increasing the ability of the material to heal damages at a mild temperature. Scratch healing was possible via a one-step heating process at a moderate temperature of 60 °C for 4 h, reaching a tensile strength recovery of above 85%.
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•A thermoresponsive Diels-Alder crosslinked self-healing polymer thermoset was prepared.•PDMS segments and excess maleimide groups were incorporated to promote the healing ability.•The material exhibited glass transition induced shape memory that assists crack closure.•Scratch healing was possible via a one-step heating process at a moderate temperature of 60 °C.
Adjuvant radiotherapy for breast cancer may involve some incidental exposure of the ipsilateral internal mammary artery to ionizing radiation. However, the relevant evidence is limited and ...inconsistent. The dataset presented in this article contains the information used to assess the effects of accidental radiation exposure on the internal mammary artery in patients with unilateral total mastectomy followed radiotherapy for breast cancer. The study population consists of two groups: the irradiated group and the control group. The left and right internal mammary arteries were assessed through the second intercostal spaces using a computed sonography system (Vivid S6; GE, Tirat Carmel, Israel) equipped with a 5.5 - 11 MHz transducer. The recorded parameters were the diameter, time-averaged maximum velocity, and blood flow of the internal mammary artery.
The dataset contains two files of data: a raw and an analyzed data. The raw data file contains the individual information of each participant, including demographic characteristics and the parameters of the internal mammary artery duplex ultrasound imaging. The analyzed data file was made up of R Markdown, a markup language of R. The results of data analysis were presented in the related research article which has been accepted for publication in the Annals of Vascular Surgery. The dataset presented in this article may be reused for further studies in which the internal mammary artery is considered as potential donor or recipient vessels for a vascular bypass or free flap anastomosis.
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