Use of functional MRI to evaluate correlation between acupoints and brain cortex activites: comparison between conventional and electrical acupuncture

The use of acupuncture therapy in various functional disorders goes back several thousand years in China. Recendy, acupuncture becomes a 'hot' topic in the functional Magnetic Resonance (MR) imaging research studies [1-4]. A majority of these research projects is to study die correlation between the acupuncture points (acupoints) and die corresponding brain cortices, either by conventional acupuncture, electro-acupuncture or laser acupuncture. Cho et al reported mat by stimulating die vision-related acupoints (BL60, BL65, BL66, BL67) at the lateral side of die foot, neural response (i.e. high signal) was obtained at die visual cortex [1]. In this study, we verified Cho et al acupoints using conventional acupuncture and electro-acupuncture.published_or_final_versio

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

How does Covid-19 affect global equity markets?

202212 bckwVersion of RecordPublishe

Is there really any contagion among major equity and securitized real estate markets? Analysis from a new perspective

202210 bcwwAccepted ManuscriptRGCOthersThe PolyU Internal Research Grant (Project # G-YBJL and G-UA6V)Publishe

Optimal trading strategy during bull and bear markets for Hong Kong-Listed Stocks

201901 bcrcVersion of RecordPublishe

A new time-dependent trading strategy for securitized real estate and equity indices

2017-2018 > Academic research: refereed > Publication in refereed journal201802 bcrcVersion of RecordPublishe

Novel laser sampling technique for inductively coupled plasma atomic emission spectrometry

A novel laser sampling technique, back-surface ablation, has been developed for ICP-AES. Samples are coated onto a transparent substrate and a laser beam is irradiated onto the sample through the substrate instead of sampling directly from the sample surface. As part of the sample is vaporized by the laser beam, a high pressure develops at the sample-substrate interface. The sample at the laser spot is explosively and completely removed by the expanding vapour. Sampling efficiency is up to ten times higher than conventional 'front-surface' laser sampling. Also, preferential vaporization is minimized because of complete removal of the sample at the laser spot. The risk of inaccurate chemical analysis associated with non-stoichiometric thermal vaporization in front surface laser sampling is reduced. Two methods of calibration, viz., standard additions and calibration with standards in a poly (vinyl alcohol) matrix, were used for quantitative elemental analysis of household paints using front- and back-surface ablation-ICP-AES. Internal standards were used to compensate for pulse-to-pulse laser energy fluctuation and sample thickness variation across a sample. Ten elements with different thermal properties and at concentrations ranging from 10 to 1000 ppm were determined and the elemental concentrations were compared with those of microwave digestion/solution nebulization ICP-AES. Back-surface ablation appears to be more accurate than conventional front-surface ablation.link_to_subscribed_fulltex

New tests of calendar effects on equity and securitized real estate markets

201906 bcmaVersion of RecordPublishe