Cost-effectiveness analysis of newborn screening for organic acidemias in Hong Kong

published_or_final_versio

Enhancement of Gap Junction Function During Acute Myocardial Infarction Modifies Healing and Reduces Late Ventricular Arrhythmia Susceptibility

Objectives: To investigate the effects of enhancing gap junction (GJ) coupling during acute myocardial infarction (MI) on the healed infarct scar morphology and late post-MI arrhythmia susceptibility. Background: Increased heterogeneity of myocardial scarring after MI is associated with greater arrhythmia susceptibility. We hypothesized that short-term enhancement of GJ coupling during acute MI can produce more homogeneous infarct scars, reducing late susceptibility to post-MI arrhythmias. Methods: Following arrhythmic characterisation of the rat 4-week post-MI model (n=24), a further 27 Sprague-Dawley rats were randomised to receive rotigaptide to enhance GJ coupling (n=13) or saline control (n=14) by osmotic minipump immediately prior to, and for the first 7 days following surgical MI. At 4 weeks post-MI, hearts were explanted for ex vivo programmed electrical stimulation (PES) and optical mapping. Heterogeneity of infarct border zone (IBZ) scarring was quantified by histomorphometry. Results: Despite no detectable difference in infarct size at 4 weeks post-MI, rotigaptide-treated hearts had reduced arrhythmia susceptibility during PES (Inducibility score: rotigaptide 2.40.8, control 5.00.6, p=0.02) and less heterogeneous IBZ scarring (standard deviation of IBZ Complexity Score: rotigaptide 1.10.1, control 1.40.1, p=0.04), associated with an improvement in IBZ conduction velocity (rotigaptide 43.13.4 cm/s, control 34.82.0 cm/s, p=0.04). Conclusions: Enhancement of GJ coupling for only 7 days at the time of acute MI produced more homogeneous IBZ scarring and reduced arrhythmia susceptibility at 4 weeks post-MI. Short-term GJ modulation at the time of MI may represent a novel treatment strategy to modify the healed infarct scar morphology and reduce late post-MI arrhythmic risk

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis

published_or_final_versio

Evaluating the predictive performance of empirical estimators of natural mortality rate using information on over 200 fish species

Many methods have been developed in the last 70 years to predict the natural mortality rate, M, of a stock based on empirical evidence from comparative life history studies. These indirect or empirical methods are used in most stock assessments to (i) obtain estimates of M in the absence of direct information, (ii) check on the reasonableness of a direct estimate of M, (iii) examine the range of plausible M estimates for the stock under consideration, and (iv) define prior distributions for Bayesian analyses. The two most cited empirical methods have appeared in the literature over 2500 times to date. Despite the importance of these methods, there is no consensus in the literature on how well these methods work in terms of prediction error or how their performance may be ranked. We evaluate estimators based on various combinations of maximum age (t(max)), growth parameters, and water temperature by seeing how well they reproduce \u3e200 independent, direct estimates of M. We use tenfold cross-validation to estimate the prediction error of the estimators and to rank their performance. With updated and carefully reviewed data, we conclude that a t(max)-based estimator performs the best among all estimators evaluated. The t(max)-based estimators in turn perform better than the Alverson-Carney method based on t(max) and the von Bertalanffy K coefficient, Pauly\u27s method based on growth parameters and water temperature and methods based just on K. It is possible to combine two independent methods by computing a weighted mean but the improvement over the t(max)-based methods is slight. Based on cross-validation prediction error, model residual patterns, model parsimony, and biological considerations, we recommend the use of a t(max)-based estimator (M = 4.899t(max)(-0.916), prediction error = 0.32) when possible and a growth-based method (M = 4.118K(0.73)L(infinity)(-0.33), prediction error = 0.6) otherwise

Freshwater diatom persistence on clothing II: Further analysis of species assemblage dynamics over investigative timescales

Diatoms are a useful form of environmental trace evidence, yielding a circumstantial link between persons and scenes of forensic interest. A developing empirical research base has sought to understand those factors affecting the transfer and persistence of freshwater diatoms on clothing and footwear surfaces. Although an initial study has demonstrated that diatoms can persist on clothing following weeks of wear, no previous research has explored the temporal dynamics of a persistent species assemblage over timescales pertinent to forensic investigations. This study therefore aimed to determine if: (1) valve morphology (size and shape) influences diatom persistence, (2) the relative abundance of taxa within an assemblage affects retention, and (3) a persistent diatom assemblage retrieved from clothing after one month can reliably be compared to the site of initial transfer. To build on previous research findings which highlighted the impact of substrate and environmental seasonality on diatom transfer and persistence, here, nine clothing materials were tested in spring before a seasonal comparison in the winter. Fabric swatches were immersed in a freshwater river, worn attached to clothing, and subsamples retrieved at regular intervals (hours, days, weeks) up to one month post-immersion. Diatoms were extracted using a H2O2 technique and analysed via microscopy. The results indicated that smaller diatoms (< 10 µm) are retained in significantly greater abundance, with no statistically significant difference between centric and pennate diatom loss over time. Although a persistent species assemblage was relatively stable over the one month of wear, significant differences were identified between clothing substrate in the spring and between the seasonal samples. The most abundant environmental taxa were consistently identified in the forensic samples, with greater variability attributed to the retention of relatively less common species. The findings suggest that, despite a loss in the abundance and species-richness of diatoms retrieved from clothing over time, a persistent assemblage may provide a useful circumstantial link to the site of initial transfer. The complex relationships between clothing type, environmental seasonality, and time since wear on retention, emphasise the need for diatom trace evidence to be carefully interpreted within an exclusionary framework, and the significance of any casework findings to be determined with reference to empirical evidence bases

Freshwater diatom persistence on clothing I: A quantitative assessment of trace evidence dynamics over time

Freshwater diatoms offer valuable circumstantial forensic indicators, with a growing empirical research base aiming to identify and understand some of the spatial and temporal factors affecting their validity as trace evidence. Previous studies demonstrated that recipient surface characteristics, environmental variability, and individual species traits influence the initial transfer of freshwater diatoms to clothing. However, no previous research has sought to consider the impact of these and other variables on the persistence of transferred diatoms over investigative timescales. Therefore, this study aimed to identify and explore diatom retention dynamics on clothing following wear over time (hours to weeks). A series of experiments were designed to examine the impact of clothing material, seasonality, and time since wear (persistence interval) on the total number and species-richness of diatoms recovered and their relative retention (%) over time. Nine clothing swatches were immersed in a freshwater environment and then worn for one month in the spring. Subsamples were retrieved at regular intervals (e.g. 30 mins, 1 h, 8 h, 24 h) up to one month, diatoms were extracted using a H2O2 method, and examined microscopically. Three clothing materials were subject to the same experiment in the winter to generate a seasonal comparison. The results broadly identified three stages of diatom persistence on clothing - rapid initial loss, variable intermediate decay, and sustained long-term presence. Clothing material significantly impacted the number of diatoms recovered and retention dynamics over time, with complex interactions identified with seasonality. Although fewer diatoms were recovered in the winter, overall retention trends were consistent at the different times of year. The findings demonstrate that diatoms can be recovered from clothing, even weeks or months after an initial transfer, yielding a useful environmental trace indicator for forensic reconstructions over investigative timescales. The impact of clothing material and seasonality on persistence identified cotton, acrylic, and viscose clothing as the most reliable temporal repository of diatom trace evidence, with a more abundant forensic assemblage available for forensic comparisons in the spring

Tests of scaling assumputions, construct validity and reliability of the Chinese child health questionnaire, partent form (CHQ-PF50) and child form (CHQ-CF87)

Poster SessionValidated instruments for assessment of quality of life in Chinese children are as yet unavailable. We determined the construct validity and reliability of the translated Chinese versions of the Child Health Questionnaires (Landgraf, Abetz & Ware, 1999) designed for completion by parents (CHQ-PF50) and children (CHQ-CF87). The Chinese versions were developed through iterative forward and backward translation processes by independent parties. The feasibility, as rated by degree of difficulty using a 4-point scale, and time for completion were evaluated for the Chinese CHQ-PF50 and CHQ-CF87 in 15 and 11 subjects, respectively. To assess the construct validity and reliability, 1143 parents of healthy children and 823 school children were invited to complete the Chinese CHQ-PF50 and CHQ-CF87, respectively. The results showed that both the Chinese CHQ-PF50 (mean rating 1.66) and CHQ-CF87 (mean rating 1.33) were easy to complete, with completion times of 14.23±5.23 minutes and 13.82±3.52 minutes, respectively. Psychometric analysis on item convergent validity and discriminant validity showed perfect or near perfect (>99%) rates of success for all ten scales in the CF87 and >94% for all but one scale in the PF50. The exception was the general health scale (86%). Minimal floor effects were observed for both questionnaires. However, substantial ceiling effects were observed for the five scales in both questionnaires (physical functioning, role-emotional, behavioral, role-physical, bodily pain and family activities). The median alpha coefficient of reliability for CF87 was 0.90 (range 0.85 to 0.94). The median alpha coefficient for PF50 was 0.80 (range 0.44 to 0.88), with the mental health scale falling just below the minimum criterion for group level analysis (0.68) and the general health scale being the lowest (0.44). These findings suggest that the Chinese translations of CHQ-PF50 and CHQ-CF87 are robust and sufficient. Additional work with regard to ceiling effects is required to assess the performance of the measures in condition groups

Prospective Memory Training in Older Adults: A Systematic Review and Meta-Analysis.

Prospective memory (PM), which enables one to remember to carry out delayed intentions, is crucial for everyday functioning. PM commonly deteriorates upon cognitive decline in older adults, but several studies have shown that PM in older adults can be improved by training. The current study aimed to summarise this evidence by conducting a qualitative systematic analysis and quantitative meta-analysis of the effects of PM training in older adults, for which systematic searches were conducted across seven databases (Cochrane Library, Embase, PubMed, PsycInfo, Web of Science, CINAHL and Scopus). Forty-eight studies were included in the qualitative analysis, and 43% of the assessed PM training interventions showed positive gains in enhancing PM. However, the methodological quality varied across the studies, with 41% of the non-randomised control trials (non-RCTs) rated as having either serious or critical risk of bias. Therefore, only 29 RCTs were included in the subsequent quantitative meta-analysis. We found a significant and moderate immediate efficacy (Hedges' g = 0.54) of PM training in enhancing PM performance in older adults, but no significant long-term efficacy (Hedges' g = 0.20). Two subgroup analyses also revealed a robust training efficacy across the study population (i.e., healthy and clinical population) and the number of training sessions (i.e., single session and programme-based). Overall, this study provided positive evidence to support PM training in older adults. Further studies are warranted to explore the mechanisms by which PM training exerts its effects, and better-quality RCTs are needed to provide more robust evidence supporting our findings

The logic of comparative life history studies for estimating key parameters, with a focus on natural mortality rate

There are a number of key parameters in population dynamics that are difficult to estimate, such as natural mortality rate, intrinsic rate of population growth, and stock-recruitment relationships. Often, these parameters of a stock are, or can be, estimated indirectly on the basis of comparative life history studies. That is, the relationship between a difficult to estimate parameter and life history correlates is examined over a wide variety of species in order to develop predictive equations. The form of these equations may be derived from life history theory or simply be suggested by exploratory data analysis. Similarly, population characteristics such as potential yield can be estimated by making use of a relationship between the population parameter and bio-chemico-physical characteristics of the ecosystem. Surprisingly, little work has been done to evaluate how well these indirect estimators work and, in fact, there is little guidance on how to conduct comparative life history studies and how to evaluate them. We consider five issues arising in such studies: (i) the parameters of interest may be ill-defined idealizations of the real world, (ii) true values of the parameters are not known for any species, (iii) selecting data based on the quality of the estimates can introduce a host of problems, (iv) the estimates that are available for comparison constitute a non-random sample of species from an ill-defined population of species of interest, and (v) the hierarchical nature of the data (e.g. stocks within species within genera within families, etc., with multiple observations at each level) warrants consideration. We discuss how these issues can be handled and how they shape the kinds of questions that can be asked of a database of life history studies