The influence of attributes on community preferences regarding antibiotic treatment: evidence from a discrete choice model.

Antibiotic resistance (AR) rates in Vietnam are among the highest in Asia, and recent infections due to multi-drug resistance in the country have caused thousands of deaths each year. This study investigated a Vietnamese community's preferences for antibiotic treatment and its knowledge and attitudes regarding antibiotics. A discrete choice experiment-based survey was developed and administered to the population of interest. The respondents were given sociodemographic-, knowledge- and attitude-related items and 17 pairs of choice tasks. Two hypothetical options were included in each choice task. Latent class analysis was conducted to determine the differences among the respondents' preferences. Among 1,014 respondents, 805 (79.4%) gave valid questionnaires. A three-latent-class model with four covariates (age, healthcare-related education or career, occupation, and attitude classifications) was used in the analysis. All five attributes significantly influenced the respondents' decisions. The majority, including young employed respondents with non-healthcare-related work or education, found treatment failure more important. Older respondents who had healthcare-related education/careers and/or appropriate antibiotic use- and antibiotics resistance-related attitudes, regarded contribution to antibiotic resistance as an important attribute in selecting antibiotic treatments. Unemployed individuals with correct knowledge identified the cost of antibiotic treatment as the most essential decision-making factor. Findings suggest minimal antibiotic impact on resistance; only 7.83% view it as amajor concern. The respondents exhibited substantial preference heterogeneity, and the general Vietnamese public had poor knowledge of and attitudes toward antibiotic use and antibiotic resistance. This study emphasizes the need for individual responsibility for antibiotic resistance and appropriate antibiotic use.

Single-stage repair for coarctation with ventricular septal defect: results of 100 cases at a single centre.

OBJECTIVES: The outcomes of the single-stage surgical repair of aortic arch hypoplasia (AAH) and/or coarctation of the aorta (CoA) associated with ventricular septal defect (VSD) remain controversial, especially in a lower middle-income country. This study reports the results of a single-stage repair protocol at our institution for AAH/CoA with VSD using selective cerebral perfusion. METHODS: This retrospective study included 100 consecutive patients who underwent single-stage repair via median sternotomy using selective cerebral perfusion for AAH/CoA with VSD from July 2010 to March 2017. RESULTS: The patients consisted of 65 males and 35 females. The median age of the patients was 67 days (range 4-2266 days); the median weight was 3.8 kg (range 2.1-15 kg). The average cardiopulmonary bypass time was 132 ± 28 min, the aortic cross-clamp time was 92 ± 23 min and the selective cerebral perfusion time was 33 ± 10 min. The survival rate of all patients was 94.7 ± 2.3%, with an in-hospital mortality of 5% and no late mortality at a median follow-up of 37 months (range 4-96 months). Four patients required reoperation due to recoarctation. The overall event-free survival rate following surgery was 87.1%. The median pressure gradient across the anastomosis at the last follow-up was 8.3 ± 2.8 mmHg. Multivariate logistic regression analysis revealed proximal aortic arch obstruction as a predictor of mortality (odds ratio = 3.8). The aortic isthmus diameter was identified as a predictor for reintervention by Cox regression (hazard ratio = 6.7). CONCLUSIONS: Single-stage repair for AAH/CoA with VSD is safe and feasible in a developing country.

Hierarchical Distributed Control for Global Network Integrity Preservation in Multirobot Systems.

In this paper, we address a novel hierarchical distributed control (HDC) strategy for networked multirobot systems (MRSs). This strategy is developed on a geometric approach without requiring estimation of algebraic connectivity. It is originally based upon behavioral control, but upgraded by distributed node control with a mobility constraint for global network integrity preservation and distributed connectivity control with a local connectivity minimization strategy for network coverage expansion. Thanks to properties of HDC, a networked MRS is capable of achieving high performance with cooperative tasks. We have examined and evaluated our proposed method in both simulations with up to 100 simulated robots and real-world experiments with up to 14 real robots.

Intraoperative hypoxia secondary to pneumothorax: The role of lung ultrasound.

Intraoperative pneumothorax during general anesthesia is a dangerous event. It is a possible cause of sudden intraoperative hypoxia, which can be critical especially in high-risk patients such as those with end-stage heart failure. Early diagnosis and effective treatment are essential. We describe the case of a pneumothorax during cardiac transplantation, diagnosed by ultrasound and immediately treated. A good skill in lung ultrasound is advantageous in the management of intraoperative hypoxia, particularly for prompt diagnosis of pneumothorax.

Effect of Porous Structure and Acidity of ZSM-5/SBA-15 Catalyst on 1,3,5-Triisopropylbenzene Cracking Catalytic Activity.

ZSM-5/SBA-15 composite materials with different acidities and mesoporous system formations were successfully synthesized by three-step method. The catalysts were characterized by XRD, HR-TEM, BET, EDX and TPD-NH3 methods. It showed that the Si/Al molar ratio had effect on the formation and property of materials. Among synthesized catalysts with the different Si/Al molar ratios of 30 (HZSC-30), 50 (HZSC-50), 70 (HZSC-70), HZSC-50 catalyst had better mesoporous system formation and acidity. These properties helped this catalyst to have higher catalytic activity in 1,3,5-triisopropylbenzene cracking reaction than other studied catalysts in term of higher benzene product yield. In comparison to HZSM-5 microporous material that had the similar Si/Al molar ratio of 50, it showed that the formation of mesopore system of HZSC-50 catalyst had a major improvement on the cracking catalytic activity.

Study on the Synthesis and Characterization of Nano Silver Loaded ZSM-5 Zeolite for Bacterial Elimination.

The synthesis of nano silver coated ZSM-5 zeolite (Ag/ZSM-5) by ion exchange method combined with anaerobic thermal treatment and its bacterial elimination performance were studied. The various Ag content of different samples was analysed by atomic absorption spectroscopy method. The Ag/ZSM-5 sample with 0.251 wt% Ag (denoted as ZAg3) was characterized by using atomic absorption spectroscopy, transmission electron microscopy, X-ray photoelectron spectroscopy and pulsed CO chemisorption methods. The results showed that silver nanoparticles with a small nano-size of 2-3 nm were formed and distributed on the surface of ZSM-5 zeolite with a dispersion value of 59%. The samples denoted as ZAg1, ZAg2, ZAg3, ZAg4 correspond to a Ag content of 0.064; 0.128; 0.251; 0.253 wt% Ag. In the evaluation series, after 10 min of contact time between bacterial and Ag/ZSM-5, over 99% of E.coli (initial concentration was 10(6) cfu/ml) could be eliminated by Ag/ZSM-5 with the Ag content of at least 0.251 wt% (ZAg3). In addition, over 99% of Coliform (initial concentration was 10(5) cfu/ml) could be eliminated by Ag/ZSM-5 with Ag content of at least 0.128 wt% (ZAg2). In a further evaluation series varying the contact time, ZAg3 sample could eliminate over 99% and 100% of Ecoli after 10 min and 60 min, respectively (initial concentrations of both E.coli and Coliform were 10(5) cfu/ml). In addition, it could eliminate 100% of Coliform in only 10 min of contact time.