79 research outputs found

    Effects of Oat β‑Glucan and Inulin on Alleviation of Nonalcoholic Steatohepatitis Aggravated by Circadian Disruption in C57BL/6J Mice

    No full text
    This was the first study that examined the effects of oat β-glucan and inulin on diet-induced nonalcoholic steatohepatitis (NASH) in circadian-disrupted (CD)-male C57BL/6J mice. CD intensified NASH, significantly increasing alanine aminotransferase and upregulating hepatic tumor necrosis factor α (TNFα) and transforming growth factor β 1 (TGFβ1). However, these observations were significantly alleviated by oat β-glucan and inulin treatments. Compared to CD NASH mice, oat β-glucan significantly decreased the liver index, aspartate aminotransferase (AST), and insulin. In prebiotic-treated and CD NASH mice, significant negative correlations were found between enrichment of Muribaculaceae bacterium Isolate-036 (Harlan), Muribaculaceae bacterium Isolate-001 (NCI), and Bacteroides ovatus after oat β-glucan supplementation with TNFα and TGFβ1 levels; and enrichment of Muribaculaceae bacterium Isolate-110 (HZI) after inulin supplementation with AST level. In conclusion, oat β-glucan and inulin exhibited similar antiliver injury, anti-inflammatory, and antifibrotic activities but had no effect on cecal short-chain fatty acids and gut microbiota diversity in CD NASH mice

    An Initial Assessment of the Decline With Age for the 6-minute Walk Test (6MWT) in Chinese Older Adults With Chronic Obstructive Pulmonary Disease (COPD)

    No full text
    Objective: To establish an initial assessment of the decline with age for the 6-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD) in Chinese older adults. Design: It was an observational analytical study. Setting: The study was conducted in a local acute hospital. Participants: From January 2017 to January 2021, a total of 525 patients (431 men, 94 women; mean age 73.4±7.9; N=525) with COPD were studied. Main Outcome Measures: Information including sex, age, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, and 6-minute walk distance (6MWD) were collected. Results: The 6MWD was significantly decreased with increased age (P˂0.05). Mean 6MWD in the 61-65 years, 66-70 years, 71-75 years, 76-80 years, 81-85 years, and 86 years or above age groups were 301 m, 305 m, 274 m, 257 m, 260 m, and 215 m, respectively. The difference between the youngest and oldest age groups was 29%. The 6MWD was significantly lower in patients with more severe COPD (P˂0.05). The distance decreased from 317 m in GOLD 1, 306 m in GOLD 2, 259 m in GOLD 3 to 167 m in GOLD 4. The percentage dropped in 6MWD from GOLD 1 to GOLD 4 was 47%. Conclusion: An initial assessment of the decline with age for 6MWT in Chinese older adults with COPD has been established. 6MWD decreases as age (in groups 66-75, 81-85, and 86 or above) and COPD severity increases, primarily because of the increased severity of dyspnea, decline in exercise capacity, and muscle changes in aging. Health care professionals in Chinese community can use these values to evaluate these patients’ functional capacity, assess treatment effect, and set treatment goals

    Mitochondrial diseases in Hong Kong: prevalence, clinical characteristics and genetic landscape

    No full text
    Abstract Objective To determine the prevalence of mitochondrial diseases (MD) in Hong Kong (HK) and to evaluate the clinical characteristics and genetic landscape of MD patients in the region. Methods This study retrospectively reviewed the phenotypic and molecular characteristics of MD patients from participating public hospitals in HK between January 1985 to October 2020. Molecularly and/or enzymatically confirmed MD cases of any age were recruited via the Clinical Analysis and Reporting System (CDARS) using relevant keywords and/or International Classification of Disease (ICD) codes under the HK Hospital Authority or through the personal recollection of treating clinicians among the investigators. Results A total of 119 MD patients were recruited and analyzed in the study. The point prevalence of MD in HK was 1.02 in 100,000 people (95% confidence interval 0.81–1.28 in 100,000). 110 patients had molecularly proven MD and the other nine were diagnosed by OXPHOS enzymology analysis or mitochondrial DNA depletion analysis with unknown molecular basis. Pathogenic variants in the mitochondrial genome (72 patients) were more prevalent than those in the nuclear genome (38 patients) in our cohort. The most commonly involved organ system at disease onset was the neurological system, in which developmental delay, seizures or epilepsy, and stroke-like episodes were the most frequently reported presentations. The mortality rate in our cohort was 37%. Conclusion This study is a territory-wide overview of the clinical and genetic characteristics of MD patients in a Chinese population, providing the first available prevalence rate of MD in Hong Kong. The findings of this study aim to facilitate future in-depth evaluation of MD and lay the foundation to establish a local MD registry

    Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

    No full text
    Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ().Results:HighFiO2maybecosteffective(cheaperandeffective).InNigeria,theaveragecostforhighFiO2was). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was 216 compared with 222forlowFiO2leadingtoa 222 for low FiO2 leading to a −6 (95% confidence interval [CI]: −13to 13 to −1) difference in costs. In India, the average cost for high FiO2 was 184comparedwith184 compared with 195 for low FiO2 leading to a −11(9511 (95% CI: −15 to −6)differenceincosts.InSouthAfrica,theaveragecostforhighFiO2was6) difference in costs. In South Africa, the average cost for high FiO2 was 1164 compared with 1257forlowFiO2leadingtoa 1257 for low FiO2 leading to a −93 (95% CI: −132to 132 to −65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

    Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference

    No full text

    Geometric and dosimetric consequences of intra-fractional movement in single isocenter non-coplanar stereotactic radiosurgery

    No full text
    Abstract Purpose To investigate the geometric and dosimetric impacts of intra-fractional movement for patients with single or multiple brain metastasis treated using Varian Hyperarc™ mono-isocentric radiosurgery. Methods A total of 50 single or hypo-fractionated Hyperarc™ treatment courses (118 lesions) were included in the analysis. Intra-fractional translational and rotational movements were quantified according to the post-treatment cone-beam CT (CBCT). Geometric displacements of all targets were calculated individually based on the assessed head movement in each treatment fraction and their relationships with treatment time and target-to-isocenter distances were studied. For dosimetric analysis, only single-fraction treatments (56 lesions) were included. Re-planning was performed with 0, 1, and 2 mm planning target volume (PTV) margins. Doses were then re-calculated on rotated CT images with isocenter shifted which emulate the change in patient treatment position. Target coverage, target and normal brain doses before and after intra-fractional movement were compared. Results The mean 3D target displacements was 0.6 ± 0.3 (SD) mm. Target shifts for patients treated within 10 min were significantly smaller than those treated in longer sessions. No correlation was found between target shift and target-to-isocenter distance as the origin of head rotation was not located at the isocenter. Loss of target coverage and minimum Gross Tumor Volume (GTV) dose due to intra-fractional movement were apparent only when no margin was used, leading to an extra 23% of the targets violating the dose acceptance criteria, in contrast, the effects on normal brain V 12Gy were negligible regardless of the margin used. The use of 1 mm PTV margin can compensate clinically significant geographical miss caused by intra-fractional movements while limiting V 12Gy to within dose criteria for 88% of the cases. The plan acceptance rate (fulfillment of both target and normal brain dose criteria) after intra-fractional movement was also the highest with the 1 mm margin. Conclusion Although intra-fractional movements during Hyperarc™ treatments were small, there were substantial dosimetric effects due to the sharp dose fall-off near target boundaries. These effects could be mitigated by using a 1 mm PTV margin and maintaining the effective treatment time to within 10 min

    Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis