Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Data Analytic Framework on Student Participation in Generic Competence Development Activities

202210 bcchAuthor’s OriginalOthersUGC/FDS24/E09/20Publishe

The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles

2017-2018 > Academic research: refereed > Publication in refereed journal201805 bcrcVersion of RecordSelf-fundedPublishe

Glaucoma rehabilitation using electricai transcranial stimulation (GREAT)–optimizing stimulation protocol for vision enhancement using an RCT

202503 bcrcVersion of RecordRGCOthersResearch Impact Fund, Research Grants Council, and the Innovation and Technology Fund, HKSAR.; InnoHK and the Hong Kong Government, Natural Sciences and Engineering Research Council of Canada, and Canadian Institutes of Health ResearchPublishedC

A recursive operations strategy model for managing sustainable chemical product development and production

Sustainable consumption and production is a critical issue in the chemical industry due to increasing public concerns on environmental and safety issues. Organizations are urged to improve the quality of chemical products while minimizing the environmental impacts during production. In current practice, chemists and formulators have to determine both the ingredients to be used and the machine parameter settings during product development and production. Without appropriate operations strategies for managing sustainable consumption and production, a significant portion of the ingredients, toxic materials and pollutants are wasted or emitted during the trial-and-error processes when developing chemical products. In addition, inappropriate machine parameter settings, such as blending speed and blending temperature, result in inefficient energy use. Motivated by these issues, this paper describes a recursive operations strategy (ROS) model for achieving sustainable consumption and production in the chemical industry. The ROS model first identifies the business strategy, and then defines operations strategies by assessing the competitive priorities and policies with the use of artificial intelligence, including case-based reasoning and fuzzy logic, so as to manage the operations functions. The effectiveness of the model is verified by means of a case study. The results indicate that the model can provide direct guidelines for the users to develop products based on previously developed products. By so doing, the number of trials for testing various ingredient formulae can be reduced, minimizing the ingredient waste. The proposed model is also capable of achieving continuous improvement and determining the optimal production process conditions for avoiding unnecessary energy consumption.Department of Industrial and Systems Engineerin

Single-cell transcriptomics reveal that PD-1 mediates immune tolerance by regulating proliferation of regulatory T cells

We have previously reported an antigen-specific protocol to induce transplant tolerance and linked suppression to human embryonic stem cell (hESC)-derived tissues in immunocompetent mice through coreceptor and costimulation blockade. However, the exact mechanisms of acquired immune tolerance in this model have remained unclear.We utilize the NOD.Foxp3hCD2 reporter mouse line and an ablative anti-hCD2 antibody to ask if CD4+FOXP3+ regulatory T cells (Treg) are required for coreceptor and costimulation blockade-induced immune tolerance. We also perform genome-wide single-cell RNA-sequencing to interrogate Treg during immune rejection and tolerance and to indicate possible mechanisms involved in sustaining Treg function.We show that Treg are indispensable for tolerance induced by coreceptor and costimulation blockade as depletion of which with an anti-hCD2 antibody resulted in rejection of hESC-derived pancreatic islets in NOD.Foxp3hCD2 mice. Single-cell transcriptomic profiling of 12,964 intragraft CD4+ T cells derived from rejecting and tolerated grafts reveals that Treg are heterogeneous and functionally distinct in the two outcomes of transplant rejection and tolerance. Treg appear to mainly promote chemotactic and ubiquitin-dependent protein catabolism during transplant rejection while seeming to harness proliferative and immunosuppressive function during tolerance. We also demonstrate that this form of acquired transplant tolerance is associated with increased proliferation and PD-1 expression by Treg. Blocking PD-1 signaling with a neutralizing anti-PD-1 antibody leads to reduced Treg proliferation and graft rejection.Our results suggest that short-term coreceptor and costimulation blockade mediates immune tolerance to hESC-derived pancreatic islets by promoting Treg proliferation through engagement of PD-1. Our findings could give new insights into clinical development of hESC-derived pancreatic tissues, combined with immunotherapies that expand intragraft Treg, as a potentially sustainable alternative treatment for T1D

A recursive operations strategy model for managing sustainable chemical product development and production

202402 bcchAccepted ManuscriptRGCPublishedGreen (AAM

Fractionating the executive function in schizophrenia: does it still hold true for medication-naive sample?

This journal suppl. entitled: XIIIth Biennial Winter Workshop on Schizophrenia ResearchPoster PresentationBACKGROUND: Preliminary studies suggest that the phenomenon of fractionation of executive functions takes places in patients with chronic schizophrenia. However, we do not get much evidence to support this claim in first-onset medication-naı¨ve sample. In this study, we attempted to examine whether this phenomenon still holds true in medication-naı¨ve schizophrenia. METHODS: A sample of 78 medicatio- naı¨ve patients with schizophrenia and another sample of 60 healthy controls were recruited for the present study. All subjects completed a comprehensive set of executive function tests assessing initiation, sustained attention, online updating, switching, attention allocation, inhibition, and background cognition. RESULTS: The executive function of patients with first-episode schizophrenia was found to be compromised relative to healthy controls. However, unlike patients with established schizophrenia, first episode patients exhibited only a limited deficit in sustained attention component. Moreover, the majority of executive function components did not correlate with intellectual functioning and memory impairment in a sub-group of patients without intellectual impairment. CONCLUSIONS: These findings suggest that the phenomenon of fractionation of executive functions still holds true in the medication-nay¨ve sample. In particular, these patients show a specific pattern of executive dysfunction compared to healthy controls and patients with an established illness. This differential breakdown in executive function components is unlikely to be an artifact of general intellectual decline or memory impairment in schizophrenia