A correlation study between in-brace correction, compliance to spinal orthosis and health-related quality of life of patients with Adolescent Idiopathic Scoliosis

BACKGROUND: It has been proposed that in-brace correction is the best guideline for prediction of the results of brace treatment for patients with Adolescent Idiopathic Scoliosis (AIS). However, bracing may be a stressful experience for patients and bracing non-compliance could be psychologically related. The purpose of this study was to assess the correlation between brace compliance, in-brace correction and QoL of patients with AIS. METHODS: Fifty-five patients with a diagnosis of AIS were recruited. All were female and aged 10 years or above when a brace was prescribed, none had undergone prior treatment, and all had a Risser sign of 0–2 and a Cobb angle of 25-40°. The patients were examined in three consecutive visits with 4 to 6 months between each visit. The Chinese translated Trunk Appearance Perception Scale (TAPS), the Chinese translated Brace Questionnaires (BrQ) and the Chinese translated SRS-22 Questionnaires were used in the study. The in-brace Cobb angle, vertebral rotation and trunk listing were also measured. Patients’ compliance, in-brace correction and patients’ QoL were assessed. To identify the relationship among these three areas, logistic regression model and generalized linear model were used. RESULT: For the compliance measure, a significant difference (p = 0.008) was detected on TAPS mean score difference between Visit 1 and Visit 2 in the least compliant group (0–8 hours) and the most compliant group (17–23 hours). In addition, a significant difference (p = 0.000) was detected on BrQ mean score difference between Visit 2 and Visit 3 in the least compliant group (0–8 hours) and the most compliant group (17–23 hours). For the orthosis effectiveness measure, no significant difference was detected between the three groups of bracing hours (0–8 hours, 9–16 hours, 17–23 hours) on in-brace correction (below 40% and 40% or above). For the QoL measure, no significant difference was detected between the two different in-brace correction groups (below 40% and 40% or above) on QoL as reflected by the TAPS, BrQ and SRS-22r mean scores. CONCLUSION: The results showed a positive relationship between patients’ brace wear compliance and patients’ QoL. Poor compliance would cause a lower QoL

Associations between childhood maltreatment and psychiatric disorders: analysis from electronic health records in Hong Kong

There has been a lack of high-quality evidence concerning the association between childhood maltreatment and psychiatric diagnoses particularly for Axis II disorders. This study aimed to examine the association between childhood maltreatment exposure and Axis I and Axis II psychiatry disorders using electronic health records. In this study, the exposed group (n = 7473) comprised patients aged 0 to 19 years with a first-time record of maltreatment episode between January 1, 2001 and December 31, 2010, whereas the unexposed group (n = 26,834) comprised individuals of the same gender and age who were admitted into the same hospital in the same calendar year and month but had no records of maltreatment in the Hong Kong Clinical Data Analysis and Reporting System (CDARS). Data on their psychiatric diagnoses recorded from the date of admission to January 31, 2019 were extracted. A Cox proportional hazard regression model was fitted to estimate the hazard ratio (HR, plus 95% CIs) between childhood maltreatment exposure and psychiatric diagnoses, adjusting for age at index visit, sex, and government welfare recipient status. Results showed that childhood maltreatment exposure was significantly associated with subsequent diagnosis of conduct disorder/ oppositional defiant disorder (adjusted HR, 10.99 [95% CI 6.36, 19.01]), attention deficit hyperactivity disorder (ADHD) (7.28 [5.49, 9.65]), and personality disorders (5.36 [3.78, 7.59]). The risk of psychiatric disorders following childhood maltreatment did not vary by history of childhood sexual abuse, age at maltreatment exposure, and gender. Individuals with a history of childhood maltreatment are vulnerable to psychiatric disorders. Findings support the provision of integrated care within the primary health care setting to address the long-term medical and psychosocial needs of individuals with a history of childhood maltreatment

Sulfonylurea is associated with higher risks of ventricular arrhythmia or sudden cardiac death compared with metformin: A population-based cohort study

Background Commonly prescribed diabetic medications such as metformin and sulfonylurea may be associated with different arrhythmogenic risks. This study compared the risk of ventricular arrhythmia or sudden cardiac death between metformin and sulfonylurea users in patients with type 2 diabetes. Methods and Results Patients aged ≥40 years who were diagnosed with type 2 diabetes or prescribed antidiabetic agents in Hong Kong between January 1, 2009, and December 31, 2009, were included and followed up until December 31, 2019. Patients prescribed with both metformin and sulfonylurea or had prior myocardial infarction were excluded. The study outcome was a composite of ventricular arrhythmia or sudden cardiac death. Metformin users and sulfonylurea users were matched at a 1:1 ratio by propensity score matching. The matched cohort consisted of 16 596 metformin users (47.70% men; age, 68±11 years; mean follow‐up, 4.92±2.55 years) and 16 596 sulfonylurea users (49.80% men; age, 70±11 years; mean follow‐up, 4.93±2.55 years). Sulfonylurea was associated with higher risk of ventricular arrhythmia or sudden cardiac death than metformin hazard ratio (HR, 1.90 [95% CI, 1.73–2.08]). Such difference was consistently observed in subgroup analyses stratifying for insulin usage or known coronary heart disease. Conclusions Sulfonylurea use is associated with higher risk of ventricular arrhythmia or sudden cardiac death than metformin in patients with type 2 diabetes

Presence of tumour capsule on contrast-enhanced CT is associated with improved outcomes of stereotactic body radiation therapy in hepatocellular carcinoma patients

Purpose Stereotactic body radiation therapy (SBRT) is a novel local therapy for the treatment of hepatocellular carcinoma (HCC). While effective, there is currently noreliable radiological marker to guide patient selection. In this study, we investigated the prognostic value of capsule appearanceon contrast-enhanced computed tomography (CT) for patients undergoing SBRT. Materials and Methods Between 2006 and 2017, 156 consecutive patients with Child-Pugh score class A/B and HCC ≥5cm that underwent SBRT were retrospectively analysed. Baseline triple-phase CTs of the abdomen were reviewed for the presence of capsule appearances and correlated with objective response rate (ORR), overall survival (OS), and pattern of treatment failure. Results Capsule appearance on CT was present in 83 (53.2%) patients.It was associated with improved ORR by Response Evaluation Criteria in Solid Tumours (RECIST) (60.2% vs 24.7%; p<0.001) andModified Response Evaluation Criteria in Solid Tumours(mRECIST) (ORR 78.3% vs 34.2%; p<0.001). The presence of a capsule was also associated with superior 2-year local control (89.1% vs. 51.4%; p<0.001) and 2-year OS (34.1% vs. 14.8%, p<0.01). Hepatic out-field failure was the dominant mode of progression, which was less common in patients with intact capsule (54.2% vs. 60.3%, p=0.01). Conclusion Capsule appearance on CT could potentially be a non-invasive prognostic marker for selecting HCC patients undergoing SBRT. Larger cohort is warranted to validate our findings

A novel oxygen carrier 'YQ23' suppresses the liver tumor metastasis by decreasing circulating endothelial progenitor cells and regulatory T cells

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Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.Objetivos: explorar o conhecimento dos enfermeiros sobre a cobertura universal de saúde (CUS) para o desenvolvimento inclusivo e sustentável de serviços de saúde a idosos. Método: estudo transversal. Foi recrutada uma amostra de conveniência de 326 enrolled nurses (EN) ou registered nurses (RN). Os entrevistados responderam a um questionário com base nas estratégias de implementação preconizadas pelo Fórum Global da OMS para Governmental Chief Nursing Officers and Midwives (GCNOMs). As perguntas abordavam iniciativas do governo, políticas de financiamento da saúde, políticas de recursos humanos e percepção dos entrevistados sobre a importância e contribuição do enfermeiro no alcance da CUS em serviços de cuidados a idosos. Resultado: o conhecimento de enfermeiros sobre a CUS em serviço de atenção ao idoso foi razoavelmente satisfatório. Enfermeiros tanto da prática clínica como da gestão perceberam-se contribuindo mais e tendo mais importância do que aqueles que trabalham na educação. Eles eram relativamente indiferentes à política de saúde e à política. Conclusão: a pesquisa revelou uma lacuna de conhecimento considerável no conhecimento da CUS pelos enfermeiros nos serviços de cuidados a idosos e evidenciou a necessidade de enfermeiros terem mais sintonia com a política de saúde. O currículo de formação para preparar os enfermeiros deve ser reforçado para incluir estudos em política pública e advocacia. Os enfermeiros podem fazer a diferença por meio de sua participação no desenvolvimento e implementação da CUS nos serviços de saúde.Objetivos: explorar los conocimientos que tienen las enfermeras sobre la cobertura universal de salud (CUS) para el desarrollo inclusivo y sostenible de servicios para el cuidado de adultos mayores. Método: se utilizó una encuesta transversal. Se formó una muestra de conveniencia de 326 enrolled nurses (EN) o registered nurses (RN) que actualmente estuvieran ejerciendo. Los encuestados respondieron a un cuestionario basado en las estrategias de implementación apoyadas por el WHO Global Forum for Government Chief Nursing and Midwifery Officers (WGFGCNO). Las preguntas abarcaban la iniciativa del gobierno, políticas de financiamiento de la salud, las políticas de recursos humanos y la percepción de los encuestados sobre la importancia y la contribución de las enfermeras en el logro de la CUS en los servicios de cuidado para adultos mayores. Resultados: el conocimiento de las enfermeras sobre CUS en el servicio de cuidado para los adultos mayores fue bastante satisfactorio. Tanto las enfermeras de práctica clínica y como las de gestión perciben tener un mayor aporte e importancia que las de que están en educación. Tenían un punto de vista relativamente indiferente a la política sanitaria y la política. Conclusión: la encuesta descubrió una considerable brecha en el conocimiento de las enfermeras sobre CUS en los servicios de cuidado para adultos mayores y puso de manifiesto la necesidad de que las enfermeras estén más en sintonía con la política sanitaria. El plan de estudios para la preparación de las enfermeras debe fortalecerse para incluir estudios en las políticas públicas y promoción. Las enfermeras pueden hacer una diferencia a través de su participación en el desarrollo e implementación de CUS en los servicios de salud

Gametogenesis, Embryogenesis, and Fertilization Ecology of Platygyra acuta

Understanding the reproductive biology of dominant coral species in subtropical nonreefal coral communities is critical in providing important information on the processes underlying the distribution limits of coral species and communities. This is the first study that investigates the reproduction cycle, gametogenesis, and fertilization ecology of Platygyra acuta. Results indicated that P. acuta is hermaphroditic and exhibits a single annual gametogenic cycle. Oogenic and spermatogenic cycle occurs for 6-7 months and for 2 months, respectively, prior to annual mass spawning event in May to June in Hong Kong. It took 18 hours for P. acuta to complete embryonic development, develop cilia, and start to rotate. High (>70%) fertilization success can be achieved under a broad range of sperm concentrations from 104 to 107 sperms mL−1. Fertilization success remained consistently high 6 h after spawning, indicating a prolonged viability of its gametes that is much longer than that recorded for other coral species. Significantly higher percentage of fertilization success was recorded in the first of the two consecutive nights of spawning, suggesting differences in the quality of the eggs and/or sperms between days of spawning. These results serve as important baseline information for better understanding of corals in marginal communities

Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: randomised controlled trial

Background: Research suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD). Aims: To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive–behavioural therapy-based psychoeducation and usual care. Method: In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels. Results: Linear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only. Conclusions: These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms