To assess the role of in-flight transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we investigated a cluster of cases among passengers on a 10-hour commercial flight. ...Affected persons were passengers, crew, and their close contacts. We traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them. Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2-46.2). We found no strong evidence supporting alternative transmission scenarios. In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight. Guidelines for preventing SARS-CoV-2 infection among air passengers should consider individual passengers' risk for infection, the number of passengers traveling, and flight duration.
Objectives
In March 2020, a COVID‐19 outbreak in a major referral hospital in Hanoi, Vietnam led to 7664 patients and staff being sent into lockdown for 2 weeks, and more than 52,200 persons across ...49 provinces being quarantined. We assessed SARS‐CoV‐2 transmission patterns during this to‐date largest hospital outbreak in Vietnam using social network analysis (SNA).
Methods
We constructed a directed relational network and calculated network metrics for ‘degree’, ‘betweenness’, ‘closeness’ and ‘eigenvector’ centrality to understand individual‐level transmission patterns. We analysed network components and modularity to identify sub‐network structures with disproportionately big effects.
Results
We detected 68 connections between 46 confirmed cases, of whom 27 (58.7%) were ancillary support staff, 7 (15.2%) caregivers, 6 (13%) patients and 2 (4.4%) nurses. Among the 10 most important cases selected by each SNA network metric, transmission dynamics clustered in 17 cases, of whom 12 (70.6%) cases were ancillary support staff. Ancillary support staff also constituted 71.1% of cases in the dominant sub‐network and 68.8% of cases in the three largest sub‐communities.
Conclusions
We identified non‐clinical ancillary support staff, who are responsible for room service and food distribution in hospital wards in Vietnam, as a group with disproportionally big impacts on transmission dynamics during this outbreak. Our findings call for a holistic approach to nosocomial outbreak prevention and response that includes both clinical and non‐clinical hospital staff. Our work also shows the potential of SNA as a complementary outbreak investigation method to better understand infection patterns in hospitals and similar settings.
•Slowing the spread of COVID-19 was initially achieved in Vietnam.•Vietnam’s healthcare system put the precaution of COVID-19 to priority.•Intensive and expansive contact, overall isolation, and ...sterilization should be implemented as soon as possible.•Further measures are expected in light of different progressive scenarios of the disease.
Vietnam was slowing the spread of COVID-19 to 200 cases by the end of March. From perspective of a relatively vulnerable healthcare systems, timely interventions were implemented to different stage of pandemic progress to limit the spread.
The authors compiled literature on different public health measures in Vietnam in compared to the progression of COVID-19 from January to March 2020.
Three stages of pandemic progression of COVID-19 were recorded in Vietnam. At 213 confirmed cases under treatment and isolation, a range of interventions were enforced including intensive and expansive contact, mass testing, isolation, and sterilization. Many were in place before any case were reported.
Preparation were key for Vietnam's healthcare system in the ever-changing landscape of COVID-19 pandemic.
In this technical note, a consistent finite element formulation of the Hyperstatic Reaction Method (HRM) for tunnel linings design is proposed by introducing a variational consistently linearized ...formulation. It permits to consider a nonlinear interaction between a lining structure and the surrounding ground. Recent advances of the HRM in regard to the consideration of the nonlinear response of the segmented tunnel lining exposed to design loads use an iterative algorithm for solving the nonlinear system of equations. In the proposed Variationally consistent Hyperstatic Reaction Method (VHRM), a distributed nonlinear spring model representing the interaction between the lining and the ground soils is considered in a variationally consistent format. Computing the tangential spring stiffness via consistent linearization, and using Newton‐Raphson iteration, requires significantly smaller number of iterations as compared to the original HRM model based on nodal springs. Furthermore, the method is applicable for simulations using solid finite elements (2D and 3D), as well as beam or finite shell elements, respectively.
BackgroundSexual functional deficiency occurs at some point in life and becomes a problematic issue in middle-aged adulthood. Regenerative medicine, especially mesenchymal stem cell (MSC) ...transplantation, has developed extensively, with preclinical and clinical trials emphasizing the benefits of stem cell therapy for restoration of sexual deficiency. This study was designed to develop a new therapeutic stem cell treatment for people with sexual functional deficiency.MethodsThirty-one patients, including 15 males and 16 females with a medical history of reduced sexual activity, met the inclusion criteria and were enrolled in the study, phase I/IIa clinical trial with a 12-month follow-up. Adipose tissue-derived mesenchymal stem/stromal cells (ADSC) were isolated by type I collagenase digestion and cultured at the Stem Cell Core Facility under ISO 14644-1. Each participant received 1 million cells/kg of body weight via the intravenous route. Safety was evaluated by assessing the occurrence of adverse events or severe adverse events. Efficacy was assessed in males by monitoring testosterone levels and administering the International Index of Erectile Function (IIEF) questionnaire and in females by monitoring anti-Mullerian hormone (AMH), estradiol (E2), and follicle-stimulating hormone (FSH) levels and administering the Female Sexual Functioning Index (FSFI) questionnaire at baseline and 3-, 6-, and 12-months post-transplantation.ResultsThere was no occurrence of severe adverse events after ADSC administration in our study. Post-transplantation sexual satisfaction was observed in all patients enrolled in this study. Testosterone levels in males increased soon after transplantation and were maintained at high levels for up to 6 months before decreasing again at the 12-month follow-up. No significant changes in AMH, FSH or E2 levels were recorded in female patients.ConclusionsAutologous ADSC infusion is a potential therapeutic option for patients with reduced sexual activity, especially for male patients.Trial RegistrationClinicalTrials.gov. NCT03346967, Registered November 20, 2017.
A single-layered slot antenna system working at 5.8 GHz Industrial, Scientific and Medical (ISM) band is proposed for in-band full duplex (IBFD) operation applications without the use of a coupler. ...First, high isolation is achieved by strong separation of even- and odd-mode feeds. The microstrip-coupled coplanar waveguide (CPW) is used at Port 1 (TX port) to excite a stepped-slot antenna in the CPW odd mode. On the opposite side, a microstrip T-junction power divider is employed at Port 2 (RX port) to feed two offset-fed stepped-slot antennas in even mode. Second, isolation is further improved by 30 dB by using a lumped capacitor at the termination of the CPW. The measured isolation between the two ports is about 50 dB across the bandwidth. The measured −10 dB bandwidth of Port 1 is 0.49 GHz (8.5%), while that of Port 2 is 1.06 GHz (18.3%). The gains of TX and RX antennas are 5.4 and 5.8 dBi at 5.8 GHz. The proposed antenna can also be deployed as a dual-polarized antenna. Mathematical analysis and equivalent transmission line circuit models are provided to give physical insight into the working principals of the antenna with validation from ANSYS HFSS simulation.
This paper examines the influence of tax administration corruption on different types of innovation inputs and outputs in Vietnam. It utilizes firm-level panel data derived from biennial surveys of ...small and medium sized enterprises (SMEs) in Vietnam from 2005 to 2015. In terms of estimation method, the study applies the control function method for a dynamic binary response panel data model with endogenous explanatory variables, state dependence, and initial condition problems simultaneously. The key estimation results confirm the grease-the-wheels hypothesis that petty tax corruption positively affects all types of firm innovative activities. It is further found that innovation outputs and machinery innovation input of an SME are positively determined by its innovation 2 years earlier and innovation in the initial period. The key finding of the study implies that it is a challenge for governments in transition economies to fight against tax corruption, especially for Vietnam, which is known to be a high tax collection, high tax effort country.
•Scrub typhus, caused by O. tsutsugamushi, is a common fever in Southeast Asia.•Delayed diagnosis of scrub typhus leads to high mortality rates, of up to 70%.•Primers and probe are designed to be ...specific to Southeast Asia's O. tsutsugamushi.•Developed RPA assay showed high sensitivity and high specificity.•Developed RPA assay is promising for field testing.
Scrub typhus, caused by Orientia tsutsugamushi, is a common fever in parts of Southern and Southeast Asia. As delayed diagnosis of scrub typhus leads to inappropriate treatment and high mortality rates, of up to 70%, sensitive and rapid detection of O. tsutsugamushi is required for timely and appropriate treatment. Molecular assays, such as PCR and real-time PCR, have been shown to be more sensitive than conventional immunoassay, however, they are only available in centralized laboratories. In contrast to PCR assays, Recombinase Polymerase Amplification (RPA) is conducted under a constant temperature ranging from 24°C to 45°C. Therefore, this technology is very promising for nucleic acid testing in the field, and in resource-limited areas. An RPA assay for the detection of O. tsutsugamushi based on the target gene encoding for the 47 kDa outer membrane protein has been reported, but the primer and probe sequences of this assay are suboptimal for detection of the majority of recently published sequences of O. tsutsugamushi isolates from Southeast Asia. We have established a real-time RPA assay with primer and probe sequences that are optimized for most Southeast Asia's isolates of O. tsutsugamushi. As a result, the new RPA assay showed better performance than the previous assay in detecting O. tsutsugamushi in clinical samples of scrub typhus cases found in Vietnam. The specificity of RPA assay was also evaluated using genomic DNA from microorganisms commonly encountered in the differential diagnosis of scrub typhus, and blood samples from healthy controls and O. tsutsugamushi negative confirmed cases.
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Plastic pollution in freshwater ecosystems, including microplastics (MPs) smaller than 5 mm, has become an emerging global concern. Asia is considered a “hot spot” for plastic pollution due to rapid ...economic and demographic growth, together with rapid urbanization. Here, we provide an overview of the current knowledge on MP abundance, sources, fate, and transfer in Asian freshwater ecosystems based on publications from January 2014 to May 2021. MP contamination in freshwater compartments, including water, sediment, and biota, was found to vary strongly. In water, it ranged from 0.004 items m−3 in a moderately urbanized region to more than 500,000 items m−3 in a dumping river in a highly populated watershed. In the sediment, MP abundance ranged from 1 to more than 30,000 items kg−1 dry weight. Polyethylene (PE) and polypropylene (PP) were predominant in both water and sediment compartments. MP was detected in biota samples from all the studied species, but their abundance depended on the locations and species studied. Overall, MP characteristics (form, size, color, and polymer type) depended on sources and natural constraints (mainly hydrodynamics). This study also revealed that MP in Asian freshwater ecosystems mainly originated from domestic wastewater/runoff, followed by industrial emissions, fisheries and aquaculture wastewater. Plastic waste is not efficiently recycled or incinerated in Asia, leading to MP transfer and accumulation in the aquatic environment, and, more importantly, to ingestion by low to high trophic level organisms. This work highlights several knowledge gaps to guides future research to improve MP pollution management for the sustainable development of highly populated regions such as Asia.
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•Overview of microplastics (MPs) in Asian freshwater ecosystems•High variability in MP abundances in water and sediment samples between studies•Various sources and factors influencing MP contamination and transfers in Asia•Perspectives for better MP management for sustainable development in Asia
Despite being a simple and inexpensive pretreatment technology, the cost-effectiveness of riverbank filtration (RBF) depends on complex hydrogeological and hydrogeochemical variables. One of the most ...important issues for decision makers regarding RBF is optimal site selection. Therefore, a methodology for multicriteria site evaluation for large-scale RBF schemes is offered. The methodology is primarily designed as a prescreening method, applied over a wide area, but can also serve as a guide for evaluating individual RBF sites. To facilitate further discussion about improvements on the methodology, the reasoning behind each relevant factor and its weight in the evaluation is presented. The methodology is divided into three sequential steps through which a site can be assessed. The first step is to establish the existence of connectivity between the river and aquifer. This is termed the essential criterion, and is a binary determination of site suitability. If the site is determined to be suitable, it is then assessed via a set of quantity criteria, which measure the aquifer capacity and amount of bank filtrate that can be effectively abstracted. Lastly, water quality criteria are assessed by means of surface-water and groundwater quality. The quantity and quality criteria form a result expressed as the site suitability index (SSI), which ranges from 0 to 1, where higher scores represent increased suitability. Finally, the methodology is applied to evaluate existing sites of large-scale RBF application as a demonstration of its applicability. The success of these existing sites is compared to the calculated SSI value and discussed.
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