Prevalence and Factors Associated with Psychological Problems of Healthcare Workforce in Vietnam: Findings from COVID-19 Hotspots in the National Second Wave.

Adopting a cross-sectional study design, we aimed to examine the prevalence of psychological problems in different healthcare workers during the COVID-19 pandemic in the hospitals in these COVID-19 hotspots (Da Nang city and Quang Nam province) and to explore the socioeconomic and COVID-19 control-related factors that are associated with various psychological problems. A total of 611 healthcare workers were included in the final analysis from 1 August 2020 to 31 August 2020. The prevalence of anxiety, depression, insomnia, and overall psychological problems was 26.84%, 34.70%, 34.53%, and 46.48%, respectively. The prevalence rates of anxiety were approximately equal amongst the groups of healthcare workers, and moderate-to-severe anxiety was the most common in physicians (11.11%). The prevalence of depression was the highest in nurses (38.65%) and moderate-to-severe depression was mainly found in physicians (11.81%). The prevalence rates of insomnia were 34.03% in physicians, 36.20% in nurses, and 31.21% in technicians; in particular, the rate of moderate-to-severe insomnia was higher in physicians and nurses compared to technicians. The prevalence of overall moderate-to-severe psychological problems was the highest among physicians (14.58%), followed by nurses (12.58%) and technicians (9.22%). Statistically significant associated factors of current psychological problems were the occupations of physicians or nurses, less than 1 year of experience, university education, living with 4-5 people, reporting 1000-5000 m distance between home and workplace, participating in the COVID-19 control for less than 1 week, being under social isolation at home, being affected a lot by the community, reporting inadequate equipment in current workplace conditions, frequently working in the department directly in contact with the COVID-19 patients, and feeling anxious, stressed, or sad about current works. Present findings can provide valuable evidence for the policymakers and managers to adopt supportive, encouraging, motivational, protective, training, and educational interventions into healthcare workforce in other parts of Vietnam.

Impact of Pre-, Intra-and Post-Operative Parameters on In-Hospital Mortality in Patients Undergoing Emergency Coronary Artery Bypass Grafting: A Scarce Single-Center Experience in Resource-Scare Setting.

BACKGROUND: In-hospital mortality after emergency coronary artery bypass grafting (CABG) remains an important issue that has needed considerable attention in recent years as the mortality rate is still high and prevention factors are not yet optimal. Our study presents the first largest cohort of emergency CABG from one large institution in Vietnam with the primary aim of comparing a large variety of pre-, intra-and post-operative parameters between in-hospital mortality patients and in-hospital survival patients and investigate risk factors of in-hospital mortality in patients undergoing emergency CABG. METHODS: We conducted a retrospective evaluation of prospectively collected data in patients undergoing emergency CABG at the Hanoi Heart Hospital (Hanoi, Vietnam) from January 1, 2017, to December 31, 2019. Primary outcome variable was in-hospital mortality. RESULTS: A total of 71 patients were included in final analysis. The mean age of the cohort was 68.68 years (± 9.28, range 38-86). The mean weight, height and body mass index were 54.35 kg (± 9.17, range 37-77), 158.96 (±7.64, range 145-179) and 21.48 kg/m2 (±3.08, range 13.59-30.08), respectively. In-hospital mortality rate was 9.86%. Preoperative risk factors for in-hospital mortality included diabetes, decreased ejection fraction (EF), EF below 30%, cardiogenic shock, elevated systolic pulmonary artery pressure (PAP), elevated NT-ProBNP, and Euroscore II. Without grafting with left internal thoracic artery, and prolonged cardiopulmonary bypass (CPB) time were increased intraoperative factors for in-hospital mortality risk. In-hospital mortality's postoperative risk factors were found to be postextubation respiratory failure requiring mechanical ventilation, ventricular fibrillation, dialysis-requiring acute renal failure, pneumonia, bacterial sepsis, gastrointestinal bleeding, and prolonged mechanical ventilation time. Significant predictors determining in-hospital mortality were known as prolonged CPB time in surgery and postoperative ventricular fibrillation. CONCLUSION: Our hospital mortality rate after emergency CABG was relatively high. An optimal preventive strategy in emergency CABG management should target significant factors combined with other previously identified risk factors to reduce in-hospital mortality.

Recycling of aquaculture wastewater and sediment for sustainable corn and water spinach production.

This study develops a method to reuse aquaculture wastewater and sediment from a catfish pond in order to increase agricultural productivity and protect the environment. Material flow analysis (MFA) is a central concept of this study that involves collecting catfish pond wastewater (CPW) and reusing it to irrigate five water spinach (Ipomoea aquatic) ponds before discharging it into a river. Typically, catfish pond sediment (CPS) was collected and composted to produce organic fertilizer for cornfields. The results revealed that pollutant removal efficiency of wastewater from CPW (by using water spinach) were total organic carbon (TOC) = 38.78%, nitrogen (N) = 27.07%, phosphorous (P) = 58.42%, and potassium (K) = 28.64%. By adding 20 tons of CPS compost per hectare of the cornfield, the corn yield boosted 15% compared to the control field. In addition, the water spinach grew and developed well in the medium of wastewater from the fish pond. Altogether, the results illustrate that catfish pond wastewater and sediment can act as organic fertilizers for crops meanwhile reduce environmental pollution from its reuse.

Enhanced Production of Active Ecumicin Component with Higher Antituberculosis Activity by the Rare Actinomycete Nonomuraea sp. MJM5123 Using a Novel Promoter-Engineering Strategy.

Ecumicins are potent antituberculosis natural compounds produced by the rare actinomycete Nonomuraea sp. MJM5123. Here, we report an efficient genetic manipulation platform of this rare actinomycete. CRISPR/Cas9-based genome editing was achieved based on successful sporulation. Two genes in the ecumicin gene cluster were further investigated, ecuN and ecuE, which potentially encode a pretailoring cytochrome P450 hydroxylase and the core peptide synthase, respectively. Deletion of ecuN led to an enhanced ratio of the ecumicin compound EcuH16 relative to that of EcuH14, indicating that EcuN is indeed a P450 hydroxylase, and there is catalyzed hydroxylation at the C-3 position in unit12 phenylalanine to transform EcuH16 to the compound EcuH14. Furthermore, promoter engineering of ecuE by employing the strong promoter kasO*P was performed and optimized. We found that integrating the endogenous ribosome-binding site (RBS) of ecuE together with the RBS from kasO*P led to improved ecumicin production and resulted in a remarkably high EcuH16/EcuH14 ratio. Importantly, production of the more active component EcuH16 was considerably increased in the double RBSs engineered strain EPR1 compared to that in the wild-type strain, reaching 310 mg/L. At the same time, this production level was 2.3 times higher than that of the control strain EPA1 with only one RBS from kasO*P. To the best of our knowledge, this is the first report of genome editing and promoter engineering on the rare actinomycete Nonomuraea.

Clinical and Epidemiological Characteristics of Scrub Typhus and Murine Typhus among Hospitalized Patients with Acute Undifferentiated Fever in Northern Vietnam.

A descriptive study on rickettsiosis was conducted at the largest referral hospital in Hanoi, Vietnam, to identify epidemiological and clinical characteristics of specific rickettsiosis. Between March 2001 and February 2003, we enrolled 579 patients with acute undifferentiated fever (AUF), excluding patients with malaria, dengue fever, and typhoid fever, and serologically tested for Orientia tsutsugamushi and Rickettsia typhi. Of the patients, 237 (40.9%) and 193 (33.3%) had scrub and murine typhus, respectively, and 149 (25.7%) had neither of them (non-scrub and murine typhus [non-ST/MT]). The proportion of murine typhus was highest among patients living in Hanoi whereas that of scrub typhus was highest in national or regional border areas. The presence of an eschar, dyspnea, hypotension, and lymphadenopathy was significantly associated with a diagnosis of scrub typhus (OR = 46.56, 10.90, 9.01, and 7.92, respectively). Patients with murine typhus were less likely to have these findings but more likely to have myalgia, rash, and relative bradycardia (OR = 1.60, 1.56, and 1.45, respectively). Scrub typhus and murine typhus were shown to be common causes of AUF in northern Vietnam although the occurrence of spotted fever group rickettsiae was not determined. Clinical and epidemiological information may help local clinicians make clinical diagnosis of specific rickettsioses in a resource-limited setting.

Severe malaria not responsive to artemisinin derivatives in man returning from Angola to Vietnam.

Resistance to artemisinin derivatives, the most potent antimalarial drugs currently used, has emerged in Southeast Asia and threatens to spread to Africa. We report a case of malaria in a man who returned to Vietnam after 3 years in Angola that did not respond to intravenous artesunate and clindamycin or an oral artemisinin-based combination.

Clinical and microbiological features of melioidosis in northern Vietnam.

Sporadic cases of melioidosis have been reported from Vietnam for decades, but clinical and epidemiological data for the indigenous population are still scarce. In this study, we reviewed clinical and demographic data of patients with culture-proven melioidosis diagnosed at a single large referral hospital in Hanoi between November 1997 and December 2005. We found that the clinical manifestations of melioidosis (with fatal septicaemia as the most common presentation), a high rate of underlying diseases, and a peak of cases admitted during the wet season, were similar to studies from other endemic areas. The geographical origin of patients with melioidosis showed that melioidosis existed in at least 18 northern provinces. The characterization of clinical Burkholderia pseudomallei strains by multilocus sequence typing identified 17 different sequence types (STs), 11 of which have (as yet) not been found outside Vietnam. Several of these STs presumably were generated through recent evolutionary events in this rapidly diversifying bacterial species, and thus, restricted geographic distribution may be a consequence of limited time passed since emergence. To our knowledge, this is the first report on a series of cases describing clinical and epidemiological features of melioidosis and corresponding B. pseudomallei strains from northern Vietnam.