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To sought for an easily applicable nomogram for detecting individuals at high risk of undiagnosed type 2 diabetes.The development cohort included 2542 participants recruited randomly from a rural population in 2011.The glycemic status of subjects was determined using the fasting plasma glucose test and the oral glucose tolerance test. The Bayesian Model Average approach was used to search for a parsimonious model with minimum number of predictor and maximum discriminatory power. The corresponding prediction nomograms were constructed and checked for discrimination, calibration, clinical usefulness, and generalizability in nationwide population in 2012.The non-lab nomogram including waist circumference and systolic blood pressure was the most parsimonious with the area under receiver operating characteristic curve (AUC) of 0.71 (95 %CI = 0.64-0.76). Adding low-density lipoprotein cholesterol in the non-lab nomogram generated the lab-based nomogram with significantly improved AUC of 0.83 (0.78-0.87, P 0.001). The nomograms had a positive net benefit at threshold probability between 0.01 and 0.15. Applying the non-lab nomogram to the national population yielded the AUC of 0.66 (0.63-0.70) and 0.68 (0.65-0.71) in the cohorts aged 40-64 and 30-69 years, respectively.The novel nomograms could help promote the early detection of undiagnosed diabetes in rural Vietnamese population.

Antibiotic-resistant bacteria have become a serious problem worldwide, caused in part by the excessive use and discharge of antibiotics into the environment. Ampicillin (ABPC) is a widely used antibiotic. However, this chemical rapidly decomposes in water containing divalent cations like Ca2+ and Mg2+, thus, detection of ABPC in environmental water is difficult. This study was carried out to evaluate the presence of 2-hydroxy-3-phenylpyrazine (HPP), one of the degradation products of ABPC and β-lactam antibiotics with an ABPC substructure, in environmental water. An analytical method for HPP monitoring in environmental water was developed using liquid chromatography/tandem mass spectrometry. The analyte was extracted from water samples and enriched using a solid-phase extraction cartridge. The quantification limit was 1 ng L−1. The HPP recovery rates from spiked water samples of 25 and 125 ng L−1 were 84.1 and 86.1%, respectively. The method was then used to determine HPP residue levels in 98 environmental water samples from rivers, household ponds, and aquacultural ponds in Vietnam. HPP residues were detected in 60 samples. The HPP detection rates in rivers and household ponds were 42 and 79%, respectively. HPP was not detected in aquacultural ponds. HPP residue concentrations in the samples ranged from 1.3 to 413.3 ng L−1. The residue levels in rivers flowing through city centres were higher than levels in other sampling locations. The findings of this study suggest that HPP is a promising marker for assessing the discharge of ABPC and β-lactam antibiotics with an ABPC substructure into the environment around sampling sites.

Aflatoxins, fumonisins and ochratoxin A that contaminate various agricultural commodities are considered of significant toxicity and potent human carcinogens. This study took a total dietary study approach and estimated the dietary exposure of these mycotoxins for adults living in Lao Cai province, Vietnam. A total of 42 composite food samples representing 1134 individual food samples were prepared according to normal household practices and analysed for the three mycotoxins. Results showed that the dietary exposure to aflatoxin B1 (39.4 ng/kg bw/day) and ochratoxin A (18.7 ng/kg bw/day) were much higher than recommended provisional tolerable daily intake (PTDI) values mainly due to contaminated cereals and meat. The exposure to total fumonisins (1400 ng/kg bw/day) was typically lower than the PTDI value (2000 ng/kg bw/day). The estimated risk of liver cancer associated with exposure to aflatoxin B1 was 2.7 cases/100,000 person/year. Margin of exposure (MOE) of renal cancer linked to ochratoxin A and liver cancer associated with fumonisins were 1124 and 1954, respectively indicating risk levels of public health concern. Further studies are needed to evaluate the efficiency of technical solutions which could reduce mycotoxin contamination as well as to determine the health effects of the co-exposure to different types of mycotoxins.

Mycotoxins in food are increasingly a food safety hazard concern in particular in developing countries. This study was performed to determine the occurrence and determinants of aflatoxin and fumonisin contamination in rice and maize and to assess health risks through dietary intake exposure among ethnic minority groups in northern Vietnam. A total of 111 rice and 102 maize samples, were tested for occurrence of fungi and mycotoxins, i.e. aflatoxins (AF’s) and fuminisin B (FB). Results showed that 107 (96.4%) rice and 84 (82.4%) maize samples were contaminated by fungi. Aspergillus flavus was found in 68 (61.3%) rice and 30 (29.4%) maize samples, Aspergilus parasiticus in 40 (36.0%) rice and 27 (26.7%) maize samples. AF’s - were detected in 27 rice (24.3%) and 27 maize samples (26.4%) at minimum and maximum levels in rice of 2.06 and 77.8 ng/g and 20.5 and 110 ng/g in maize, respectively. Nine (8.1%) rice and 24 (23.5%) maize samples contained FB at ranges of 2.3–624 ng/g in rice and 5.6–89.8 ng/g in maize. Data collected through interviews and observations in households showed that type of crop, storage duration and presence of fungi, particularly mycotoxigenic fungi were important risk factors for AF’s and FB contamination. Based on daily food consumption data, the estimated average exposure dose of aflatoxin B1(AFB1) from rice was 21.7 ng/kg bw/day for adults and 33.7 ng/kg bw/day for children. For FB, the rice based average exposure amounted to 536 ng/kg bw/day for adults and 1019 ng/kg bw/day for children. The calculated excess risk of liver cancer incidence by ingestion of cereals containing AFB1 was 1.5 per 100,000 adults and 2.3 per 100,000 children per year. The average intake of FB was calculated to be lower than the tolerable diet intake (TDI). Our findings highlight that rice and maize are contaminated with mycotoxins at levels representing actual health hazards for the ethnic minority groups consuming these stable cereals. Proper drying and storage conditions in households are likely to reduce the mycotoxin contamination.