Development and pilot-testing of patient decision aid for use among Chinese patients with primary open-angle glaucoma

Background: A patient decision aid (PDA) is a tool for shared decision making (SDM), which emphasises patient empowerment. It is useful in chronic diseases and when there are multiple, no best single treatment option. Although SDM is prevalent in Western countries, its use is limited in Chinese societies, where the adoption of a paternalistic approach is strong. Here, we report the development, acceptance and pilot test results of a PDA targeted at Chinese patients with primary open-angle glaucoma (POAG). Methods: We developed a PDA designed for use in Chinese patients with POAG. Recruited subjects were given our PDA. Baseline evaluation included decision conflict scale (DCS), validated glaucoma adherence questionnaires and glaucoma knowledge questionnaire. Subjects were briefed through the PDA and instructed to read it that day. Three to four weeks later, follow-up questionnaire as described above were conducted with the addition of acceptance questionnaires. Results: Data from 65 subjects were available. The PDA was well received among subjects. DCS improved from 48.9±20.4 at baseline to 34.3±20.3 during follow-up, with P<0.01. Validated medication adherence questionnaires and knowledge showed improvement from baseline, which was statistically significant. Conclusions: The use of PDA among Chinese subjects with POAG demonstrated positive reception and acceptance. Evaluation of its initial effects shows improvement in DCS, medication adherence and glaucoma knowledge. The implementation of SDM and PDA among Chinese subjects with POAG is encouraged. Future studies with randomised design and later evaluation time points can further reveal the impacts of PDA among Chinese subjects with POAG.published_or_final_versio

Seven-Year Treatment Outcome of Entecavir in a Real-World Cohort: Effects on Clinical Parameters, HBsAg and HBcrAg Levels

published_or_final_versio

Assessing Transboundary-Local Aerosols Interaction Over Complex Terrain Using a Doppler LiDAR Network

This is the final version. Available from Wiley via the DOI in this recordData Availability Statement: Surface metrological data sets in Hong Kong are available at Hong Kong Observatory’s website: https://www.hko.gov.hk/en/cis/climat.htm. PM2.5 concentrations data sets can be obtained from Hong Kong Environmental Protection Department: https://www.aqhi.gov.hk/en.html. Processed 3DREAMS LiDAR data set and HKIA LiDAR data sets can be obtained in the repository: https://figshare.com/s/78e928f29c57ff86b5eeTransboundary-local aerosols interaction requires to be comprehensively understood in urban air quality research. A year-long intensive observation of the atmospheric boundary layer (ABL) at multiple sites in Hong Kong was conducted using a four-Doppler Light Detection and Ranging (LiDAR) network with different scanning modes. Results show that heterogeneity of the ABL in terms of mixing layer height and wind shear was induced by orographic topography. Interaction between local and advected aerosol layers during a transboundary air pollution (TAP) episode was identified by the network. During TAP episode, downward transport of transboundary aerosol relied on small scale eddies with weak wind speed in nighttime, while the transport of surface local aerosol to upper level was the dominated process in daytime, but the heterogeneity of the ABL affected by terrain determined the capacity of the mixing, eventually resulting in the opposite transport direction of aerosols in the transboundary-local aerosols interaction.Dr. Stanley Ho Medicine Development FoundationVice-Chancellor’s Discretionary Fund of The Chinese University of Hong Kon

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

Development of theoretical fashion design process model for modern elderly women.

202311 bcvcVersion of RecordSelf-fundedPublishe

Impacts of co-design process on ex-mentally ill persons practicing expressive textile arts in Hong Kong

202311 bcvcVersion of RecordSelf-fundedPublishe

Nausea and vomiting after phacoemulsification using topical or retrobulbar anesthesia

Purpose: To determine and compare the incidence of postoperative nausea and vomiting in patients having phacoemulsification under topical or retrobulbar anesthesia. Setting: Department of Ophthalmology, United Christian Hospital, Hong Kong, China. Methods: In this prospective randomized clinical trial, patients scheduled for routine phacoemulsification with posterior chamber intraocular lens implantation under local anesthesia without sedation were randomized to receive topical anesthesia or retrobulbar anesthesia. One hundred seven eyes of 107 Chinese patients were included. There were 49 patients and 58 patients of similar age and sex distribution in the retrobulbar group and topical group, respectively. Postoperative nausea and vomiting (PONV), the need for an antiemetic, and intraocular pressure (IOP) were recorded 1 day after surgery. Also recorded were the patient's preexisting risk factors for PONV (if any), fasting time, duration of surgery, and intraoperative complications or need for supplementary anesthesia or analgesia. Results: The overall incidence of PONV in the entire study group was 3.7% (4 patients). No statistically significant differences in PONV were found between the 2 anesthesia techniques, although 6.1% (3 of 49) in the topical group had nausea compared with 1.7% (1 of 58) in the retrobulbar group. No significant differences were found in the fasting time, duration of surgery, or postoperative IOP between patients who had PONV and those who did not. Conclusions: Topical and retrobulbar anesthesia were associated with a low incidence of PONV in routine phacoemulsification. There were no statistically significant differences in PONV between the 2 anesthesia techniques. No significant correlation was found between the incidence of PONV and the duration of surgery, presence of complications, fasting time, postoperative IOP, or history of PONV or motion sickness.link_to_subscribed_fulltex

Phacotrabeculectomy in treatment of primary angle-closure glaucoma and primary open-angle glaucoma

Purpose: To evaluate the surgical outcome of combined phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy (phacotrabeculectomy) in patients with primary angleclosure glaucoma (PACG) or primary open-angle glaucoma (POAG). Methods: The records of 57 consecutive patients (65 eyes) with PACG or POAG that were treated with phacotrabeculectomy were reviewed retrospectively. There were 31 eyes with PACG and 34 with POAG. The mean follow-up period was 21.0 ± 8.3 months. The visual acuity, intraocular pressure (IOP), number of medications, and complications were evaluated. Results: The mean IOP and the number of glaucoma medications decreased significantly after phacotrabeculectomy in both groups. The mean IOP reduction was significantly greater in eyes with PACG (P < 0.05). The absolute success rates were 87.1% and 70.6% in PACG and POAG, respectively. The difference in the success rates was not significant (P = 0.297). The early postoperative complication rates were similar in both groups. Conclusions: Phacotrabeculectomy results in greater IOP reduction in eyes with PACG than in those with POAG, but the overall success rates were not significantly different. © Japanese Ophthalmological Society 2004.link_to_subscribed_fulltex

Diode laser transscleral cyclophotocoagulation as primary surgical treatment for medically uncontrolled chronic angle closure glaucoma: Long-term clinical outcomes

Purpose: To evaluate the long-term efficacy and safety of diode laser transscleral cyclophotocoagulation as primary surgical treatment of medically uncontrolled chronic angle closure glaucoma. Patients and Methods: Thirteen eyes of 13 Chinese patients with medically uncontrolled chronic angle closure glaucoma were treated with diode laser transscleral cyclophotocoagulation between February 2000 and May 2001, and followed up for over 18 months. Post-treatment anti-glaucoma medications were adjusted according to intraocular pressure. If intraocular pressure remained above 21 mm Hg despite medications for more than 4 weeks after cyclophotocoagulation, the procedure was repeated. Results: Mean follow-up ± SD was 26.5 ± 4.2 months. Two eyes required repeat cyclophotocoagulation at 6 weeks. Rate of relative success, defined as maintaining an intraocular pressure of 21 mm Hg or below with or without medications, was 92.3% (12 of 13 eyes). Rate of absolute success, defined as maintaining an intraocular pressure of 21 mm Hg or below without medications, was 0% (0 of 13 eyes). Mean ± SD intraocular pressure was reduced from 36.4 ± 12.6 mm Hg pre-operatively, to 18.7 ± 12.2 mm Hg at final follow-up (P = 0.003, paired t test). The mean ± SD number of intraocular pressure-lowering eye drops was reduced from 2.0 ± 0.8 pre-operatively, to the lowest point of 0.5 ± 0.8 at 12 months, and then gradually increased to 2.1 ± 0.9 at final follow-up. The visual acuity improved after treatment in 2 of 13 eyes (15.4%), remained unchanged in 6 of 13 eyes (46.2%) and deteriorated in 5 of 13 eyes (38.5%). No major complications were encountered. Conclusion: Diode laser cyclophotocoagulation appeared to be an effective and safe primary surgical treatment of medically uncontrolled chronic angle closure glaucoma, with intraocular pressure-lowering effect persisting for up to two years. Copyright © 2005 by Lippincott Williams & Wilkins.link_to_subscribed_fulltex