Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection

We aimed to explore the diagnostic accuracy of various mediastinal measurements in determining acute nontraumatic thoracic aortic dissection with respect to posteroanterior (PA) and anteroposterior (AP) chest radiographs, which had received little attention so far. We retrospectively reviewed 100 patients (50 PA and 50 AP chest radiographs) with confirmed acute thoracic aortic dissection and 120 patients (60 PA and 60 AP chest radiographs) with confirmed normal aorta. Those who had prior history of trauma or aortic disease were excluded. The maximal mediastinal width (MW) and maximal left mediastinal width (LMW) were measured by two independent radiologists and the mediastinal width ratio (MWR) was calculated. Statistical analysis was then performed with independent sample t test. PA projection was significantly more accurate than AP projection, achieving higher sensitivity and specificity. LMW and MW were the most powerful parameters on PA and AP chest radiographs, respectively. The optimal cutoff levels were LMW = 4.95 cm (sensitivity, 90 %; specificity, 90 %) and MW = 7.45 cm (sensitivity, 90 %; specificity, 88.3 %) for PA projection and LMW = 5.45 cm (sensitivity, 76 %; specificity, 65 %) and MW = 8.65 cm (sensitivity, 72 %; specificity, 80 %) for AP projection. MWR was found less useful and less reliable. The use of LMW alone in PA film would allow more accurate prediction of aortic dissection. PA chest radiograph has a higher diagnostic accuracy when compared with AP chest radiograph, with negative PA chest radiograph showing less probability for aortic dissection. Lower threshold for proceeding to computed tomography aortogram is recommended however, especially in the elderly and patients with widened mediastinum on AP chest radiograph

Whiteboard Animations for Flipped Classrooms in a Common Core Science General Education Course

[EN] Whiteboard animation, an engaging tool for teaching and learning, consists of a series of hand-drawing illustrations with voice-over narration to explain complex and abstract ideas. Our team had produced four short whiteboard animations tailor-made for a common core science general education (GE) course. This study aims at evaluating the effectiveness of using these whiteboard animations for flipped classrooms in the common core science GE course. The pre-tutorial survey showed that students who watched the animations got significantly higher average marks in the quizzes at the beginning of the tutorials (p<0.001). The post-tutorial feedback survey indicated that the whiteboard animations attracted 67% of students to watch the animations. For students who watched the animations, over 86% of them reported that the animations raised their interest in the issues discussed in the tutorial classes, and learning materials in the form of whiteboard animation were more interesting than lecture videos; more than 90% of the students agreed the whiteboard animations were helpful in (i) understanding the assigned readings, (ii) clarifying the concepts of the discussed issues, and (iii) gaining the related knowledge before the tutorial. We concluded that whiteboard animation is an effective and engaging tool for flipped classrooms in the common core science GE course.We want to thank the Centre for eLearning and Innovation Technology of The Chinese University of Hong Kong for their support. This project was funded by the Micro-module Courseware Development Grant Scheme.Li, M.; Lai, CW.; Szeto, WM. (2019). Whiteboard Animations for Flipped Classrooms in a Common Core Science General Education Course. En HEAD'19. 5th International Conference on Higher Education Advances. Editorial Universitat Politècnica de València. 929-938. https://doi.org/10.4995/HEAD19.2019.9250OCS92993

Development of teaching beliefs and the focus of change in the process of pre-service ESL teacher education

This study sets out to investigate how pre-serviceESLteachers shape their beliefs in the process of experimenting with new teaching methods introduced in the teacher education programme. A 4-year longitudinal study was conducted with four randomly selectedESLpre-service teachers. Their theoretical orientations ofESLinstruction were tracked at intervals through a protocol which consisted of i) descriptive accounts, ii) surveys, iii) lesson plan analysis, iv) lesson recording and v) interviews. Despite the fact that these 4 student teachers had shown different theoretical orientations in the protocols, they shared similar patterns of instructional practices in the Teaching Practicum. It was also found that the new teaching method practiced in the teacher education programme was re-conceptualised by these student teachers in the actual teaching context because of the strong influence of their personal agency beliefs

Education Curriculum on Extracorporeal Membrane Oxygenation: The Evolving Role of Simulation Training

Continuing education is essential for the success and safety of an extracorporeal membrane oxygenation (ECMO) programme. However, it is challenging due to the intrinsic characteristic of ECMO—a complex, high-risk, low-volume clinical activity which require teamwork, inter-professional communication, critical decision and rapid response especially in emergency. Thus, simulation is a rapidly evolving teaching methodology in ECMO education to address those training needs that cannot be entirely addressed by traditional teaching modalities. The development of a simulation programme requires commitment on resources for equipment, environment setup and training of personnel. Knowledge on ECMO management, education science and debriefing technique forms the cornerstone of successful ECMO simulation facilitators and hence the simulation programme. Currently, researches have already shown that ECMO simulation can improve individual and team performance despite that its impact on patient outcome is still unknown. In the future, the role of simulation will increase importantly in multicentre research, certifying specialists and credentialing if standardization of training curriculum can be achieved

The central policy unit in the governance of Hong Kong : a study of institutional dynamics

published_or_final_versionPolitics and Public AdministrationMasterMaster of Public Administratio

Restoring Hong Kong's landscar in the Anderson Quarry : an analysis of civic engagement strategies

published_or_final_versionPolitics and Public AdministrationMasterMaster of Public Administratio

Atherosclerotic cardiovascular disease risk profile of patients with chronic hepatitis B treated with tenofovir alafenamide or tenofovir disoproxil fumarate for 96 weeks

Atherosclerosis; Cardiovascular disease; Chronic hepatitis BAterosclerosi; Malaltia cardiovascular; Hepatitis B crònicaAterosclerosis; Enfermedad cardiovascular; Hepatitis B crónicaBackground Patients with chronic hepatitis B (CHB) who switch from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) show changes in lipid profiles. Aim To evaluate how these changes affect cardiovascular risk. Methods This pooled analysis, based on two large prospective studies, evaluated fasting lipid profiles of patients with CHB who were treated with TAF 25 mg/day or TDF 300 mg/day for 96 weeks. Patients who fulfilled the American College of Cardiology criteria (age 40–79 years, high-density lipoprotein [HDL] 20–100 mg/dL, total cholesterol [TC] 130–320 mg/dL and systolic blood pressure 90–200 mmHg) required to assess 10-year atherosclerotic cardiovascular disease (ASCVD) risk with baseline lipid data and at least one post-baseline measurement were included in the ASCVD-risk population. The 10-year ASCVD risk was calculated for patients in this population, and changes from baseline to Week 96 were assessed using intermediate- (≥7.5%) and high-risk (≥20%) cut-offs. Results Among 1632 patients, 620 (38%) met the criteria for the ASCVD-risk population. At Week 96, fasting levels of all lipids, except TC:HDL ratio, were lower with TDF than TAF. No significant increase was observed in overall ASCVD risk or in any ASCVD-risk categories during the 96-week treatment period compared with baseline. A similar proportion of patients in the TAF and TDF treatment groups (1.3% and 2.3%, respectively; p = 0.34) reported cardiovascular events. Conclusion Despite on-treatment differences in lipid profiles with TAF and TDF, predicted cardiovascular risk and clinical events were similar for both groups after 96 weeks

Neuroprotective Effect of Ginkgolide B on Bupivacaine-Induced Apoptosis in SH-SY5Y Cells

Local anesthetics are used routinely and effectively. However, many are also known to activate neurotoxic pathways. We tested the neuroprotective efficacy of ginkgolide B (GB), an active component of Ginkgo biloba, against ROS-mediated neurotoxicity caused by the local anesthetic bupivacaine. SH-SY5Y cells were treated with different concentrations of bupivacaine alone or following preincubation with GB. Pretreatment with GB increased SH-SY5Y cell viability and attenuated intracellular ROS accumulation, apoptosis, mitochondrial dysfunction, and ER stress. GB suppressed bupivacaine-induced mitochondrial depolarization and mitochondria complex I and III inhibition and increased cleaved caspase-3 and Htra2 expression, which was strongly indicative of activation of mitochondria-dependent apoptosis with concomitantly enhanced expressions of Grp78, caspase-12 mRNA, protein, and ER stress. GB also improved ultrastructural changes indicative of mitochondrial and ER damage induced by bupivacaine. These results implicate bupivacaine-induced ROS-dependent mitochondria, ER dysfunction, and apoptosis, which can be attenuated by GB through its antioxidant property