A Prospective Study of Venous Thromboembolic Prophylaxis Using Foot Pumps Following Total Knee Replacement in a Chinese Population

AbstractPurposeThe purpose of this study was to evaluate foot pumps as mechanical prophylaxis for deep vein thrombosis (DVT) following total knee replacement (TKR) in a Chinese population.MethodsAll consecutive patients following TKR during 2002–2006 received routine duplex ultrasound surveillance for DVT 9 days postoperatively. The demographic data and risk factors were recorded. No medication was given for DVT prophylaxis in all patients.ResultsWe evaluated 91 consecutive TKRs in 85 patients. Although 44 knee replacements (Group 1) done before December 2004 were not given foot pumps, 47 knee replacements (Group 2) done afterwards were given foot pumps. All patients were followed up for more than 6 months. DVT was detected in three cases (6.8%) in Group 1 compared with four knees (8.5%) in Group 2. Proximal thrombosis was observed in two knees (4.5%) in Group 1 compared with two knees (4.3%) in Group 2. No patient had pulmonary embolism. Six out of 59 (10.2%) patients who underwent the operations under general anaesthesia suffered from DVT, whereas one in 28 (3.6%) patients operated under spinal anaesthesia had DVT. All had no statistical significance.ConclusionThe rate of proximal DVT after TKR was low (4.5%) without pharmacological prophylaxis. We advise against the use of pharmacological prophylaxis in Chinese population for TKRs because of the low risk of proximal DVT and its possible bleeding complications. Foot pump did not lower the rate of DVTfurther, and its use for DVT prophylaxis in TKR is not necessary

Genie: A Generator of Natural Language Semantic Parsers for Virtual Assistant Commands

To understand diverse natural language commands, virtual assistants today are trained with numerous labor-intensive, manually annotated sentences. This paper presents a methodology and the Genie toolkit that can handle new compound commands with significantly less manual effort. We advocate formalizing the capability of virtual assistants with a Virtual Assistant Programming Language (VAPL) and using a neural semantic parser to translate natural language into VAPL code. Genie needs only a small realistic set of input sentences for validating the neural model. Developers write templates to synthesize data; Genie uses crowdsourced paraphrases and data augmentation, along with the synthesized data, to train a semantic parser. We also propose design principles that make VAPL languages amenable to natural language translation. We apply these principles to revise ThingTalk, the language used by the Almond virtual assistant. We use Genie to build the first semantic parser that can support compound virtual assistants commands with unquoted free-form parameters. Genie achieves a 62% accuracy on realistic user inputs. We demonstrate Genie's generality by showing a 19% and 31% improvement over the previous state of the art on a music skill, aggregate functions, and access control.Comment: To appear in PLDI 201

Adverse events of special interest following the use of BNT162b2 in adolescents: a population-based retrospective cohort study

Accruing evidence suggests an increased risk of myocarditis in adolescents from messenger RNA COVID-19 vaccines. However, other potential adverse events remain under-researched. We conducted a retrospective cohort study of adolescents aged 12–18 with a territory-wide electronic healthcare database of the Hong Kong population linked with population-based vaccination records and supplemented with age- and sex-specific population numbers. Two age- and sex-matched retrospective cohorts were formed to observe 28 days following the first and second doses of BNT162b2 and estimate the age- and sex-adjusted incidence rate ratios between the vaccinated and unvaccinated. Thirty AESIs adapted from the World Health Organization’s Global Advisory Committee on Vaccine Safety were examined. Eventually, the first-dose cohort comprised 274,881 adolescents (50.25% received the first dose) and the second-dose cohort 237,964 (50.29% received the second dose). Ninety-four (34.2 per 100,000 persons) adolescents in the first-dose cohort and 130 (54.6 per 100,000 persons) in the second-dose cohort experienced ≥1 AESIs. There were no statistically significant differences in the risk of any AESI associated with BNT162b2 except myocarditis [first-dose cohort: incidence rate ratio (IRR) = 9.15, 95% confidence interval (CI) 1.14–73.16; second-dose cohort: IRR = 29.61, 95% CI 4.04–217.07] and sleeping disturbances/disorders after the second dose (IRR = 2.06, 95% CI 1.01–4.24). Sensitivity analysis showed that, with myocarditis excluded as AESIs, no significantly elevated risk of AESIs as a composite outcome associated with vaccination was observed (P = 0.195). To conclude, the overall absolute risk of AESIs was low with no evidence of an increased risk of AESIs except myocarditis and sleeping disturbances/disorders

Effectiveness of a denture hygiene intervention programme among institutionalized elders

Objectives: To evaluate the effectiveness of a denture hygiene intervention programme in terms of improving denture cleanliness and denture stomatitis. Methods: Residents at seven elderly care homes were invited to participate in a denture hygiene programme. Clinical assessment of denture stomatitis was undertaken and denture cleanliness assessed: (i) qualitatively by the Denture Cleanliness Index ratings and (ii) quantitatively by planimetric assessments of plaque coverage from digital images using Adobe Photoshop®. Individual denture hygiene instruction was provided and denture cleanser (Polident®) supplied. Six weeks later assessments of denture stomatitis and denture cleanliness were undertaken. Results: Fifty-six participants were recruited; most had evidence of denture stomatitis (82.1%, 46) and 62.5% (35) of dentures were classified as ‘very poorly cleaned’. The mean percentage of plaque coverage was 28.11 (SD 19.64) and 37.5% (21) had evidence of plaque covering more than a third of the denture surface. Denture cleanliness was associated with denture stomatitis (P0.05).Conclusion: A 6-week denture hygiene intervention programme was effective at improving denture stomatitis and denture cleanliness among residents of elderly care homes. However, persistence of problems in denture cleanliness and denture stomatitis existed and this warrants further consideration.published_or_final_versio

Effectiveness of a denture hygiene intervention programme among institutionalized elders

Objectives: To evaluate the effectiveness of a denture hygiene intervention programme in terms of improving denture cleanliness and denture stomatitis. Methods: Residents at seven elderly care homes were invited to participate in a denture hygiene programme. Clinical assessment of denture stomatitis was undertaken and denture cleanliness assessed: (i) qualitatively by the Denture Cleanliness Index ratings and (ii) quantitatively by planimetric assessments of plaque coverage from digital images using Adobe Photoshop®. Individual denture hygiene instruction was provided and denture cleanser (Polident®) supplied. Six weeks later assessments of denture stomatitis and denture cleanliness were undertaken. Results: Fifty-six participants were recruited; most had evidence of denture stomatitis (82.1%, 46) and 62.5% (35) of dentures were classified as ‘very poorly cleaned’. The mean percentage of plaque coverage was 28.11 (SD 19.64) and 37.5% (21) had evidence of plaque covering more than a third of the denture surface. Denture cleanliness was associated with denture stomatitis (P0.05).Conclusion: A 6-week denture hygiene intervention programme was effective at improving denture stomatitis and denture cleanliness among residents of elderly care homes. However, persistence of problems in denture cleanliness and denture stomatitis existed and this warrants further consideration.published_or_final_versio

Genome-Wide Association Study in Asian Populations Identifies Variants in ETS1 and WDFY4 Associated with Systemic Lupus Erythematosus

Systemic lupus erythematosus is a complex and potentially fatal autoimmune disease, characterized by autoantibody production and multi-organ damage. By a genome-wide association study (320 patients and 1,500 controls) and subsequent replication altogether involving a total of 3,300 Asian SLE patients from Hong Kong, Mainland China, and Thailand, as well as 4,200 ethnically and geographically matched controls, genetic variants in ETS1 and WDFY4 were found to be associated with SLE (ETS1: rs1128334, P = 2.33×10−11, OR = 1.29; WDFY4: rs7097397, P = 8.15×10−12, OR = 1.30). ETS1 encodes for a transcription factor known to be involved in a wide range of immune functions, including Th17 cell development and terminal differentiation of B lymphocytes. SNP rs1128334 is located in the 3′-UTR of ETS1, and allelic expression analysis from peripheral blood mononuclear cells showed significantly lower expression level from the risk allele. WDFY4 is a conserved protein with unknown function, but is predominantly expressed in primary and secondary immune tissues, and rs7097397 in WDFY4 changes an arginine residue to glutamine (R1816Q) in this protein. Our study also confirmed association of the HLA locus, STAT4, TNFSF4, BLK, BANK1, IRF5, and TNFAIP3 with SLE in Asians. These new genetic findings may help us to gain a better understanding of the disease and the functions of the genes involved

Towards a global partnership model in interprofessional education for cross-sector problem-solving

Objectives A partnership model in interprofessional education (IPE) is important in promoting a sense of global citizenship while preparing students for cross-sector problem-solving. However, the literature remains scant in providing useful guidance for the development of an IPE programme co-implemented by external partners. In this pioneering study, we describe the processes of forging global partnerships in co-implementing IPE and evaluate the programme in light of the preliminary data available. Methods This study is generally quantitative. We collected data from a total of 747 health and social care students from four higher education institutions. We utilized a descriptive narrative format and a quantitative design to present our experiences of running IPE with external partners and performed independent t-tests and analysis of variance to examine pretest and posttest mean differences in students’ data. Results We identified factors in establishing a cross-institutional IPE programme. These factors include complementarity of expertise, mutual benefits, internet connectivity, interactivity of design, and time difference. We found significant pretest–posttest differences in students’ readiness for interprofessional learning (teamwork and collaboration, positive professional identity, roles, and responsibilities). We also found a significant decrease in students’ social interaction anxiety after the IPE simulation. Conclusions The narrative of our experiences described in this manuscript could be considered by higher education institutions seeking to forge meaningful external partnerships in their effort to establish interprofessional global health education

Targeted gene sanger sequencing should remain the first-tier genetic test for children suspected to have the five common X-linked inborn errors of immunity

DATA AVAILABILITY STATEMENT : The original contributions presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.To address inborn errors of immunity (IEI) which were underdiagnosed in resource-limited regions, our centre developed and offered free genetic testing for the most common IEI by Sanger sequencing (SS) since 2001. With the establishment of The Asian Primary Immunodeficiency (APID) Network in 2009, the awareness and definitive diagnosis of IEI were further improved with collaboration among centres caring for IEI patients from East and Southeast Asia. We also started to use whole exome sequencing (WES) for undiagnosed cases and further extended our collaboration with centres from South Asia and Africa. With the increased use of Next Generation Sequencing (NGS), we have shifted our diagnostic practice from SS to WES. However, SS was still one of the key diagnostic tools for IEI for the past two decades. Our centre has performed 2,024 IEI SS genetic tests, with in-house protocol designed specifically for 84 genes, in 1,376 patients with 744 identified to have disease-causing mutations (54.1%). The high diagnostic rate after just one round of targeted gene SS for each of the 5 common IEI (X-linked agammaglobulinemia (XLA) 77.4%, Wiskott–Aldrich syndrome (WAS) 69.2%, X-linked chronic granulomatous disease (XCGD) 59.5%, X-linked severe combined immunodeficiency (XSCID) 51.1%, and X-linked hyper-IgM syndrome (HIGM1) 58.1%) demonstrated targeted gene SS should remain the first-tier genetic test for the 5 common X-linked IEI.The Hong Kong Society for Relief of Disabled Children and Jeffrey Modell Foundation.http://www.frontiersin.org/Immunologyam2023Paediatrics and Child Healt

Learning for semantic parsing and natural language generation using statistical machine translation techniques

One of the main goals of natural language processing (NLP) is to build au- tomated systems that can understand and generate human lanugages. This goal has so far remained elusive. Existing hand-crafted systems can provide in-depth anal- ysis of domain sub-languages, but are often notoriously fragile and costly to build. Existing machine-learned systems are considerably more robust, but are limited to relatively shallow NLP tasks. In this thesis, we present novel statistical methods for robust natural lan- guage understanding and generation. We focus on two important sub-tasks, seman- tic parsing and tactical generation. The key idea is that both tasks can be treated as the translation between natural languages and formal meaning representation lan- guages, and therefore, can be performed using state-of-the-art statistical machine translation techniques. Specifically, we use a technique called synchronous pars- ing, which has been extensively used in syntax-based machine translation, as the unifying framework for semantic parsing and tactical generation. The parsing and generation algorithms learn all of their linguistic knowledge from annotated cor- pora, and can handle natural-language sentences that are conceptually complex. A nice feature of our algorithms is that the semantic parsers and tactical gen- erators share the same learned synchronous grammars. Moreover, charts are used as the unifying language-processing architecture for efficient parsing and generation. Therefore, the generators are said to be the inverse of the parsers, an elegant prop- erty that has been widely advocated. Furthermore, we show that our parsers and generators can handle formal meaning representation languages containing logical variables, including predicate logic. Our basic semantic parsing algorithm is called WASP. Most of the other parsing and generation algorithms presented in this thesis are extensions of WASP or its inverse. We demonstrate the effectiveness of our parsing and generation al- gorithms by performing experiments in two real-world, restricted domains. Ex- perimental results show that our algorithms are more robust and accurate than the currently best systems that require similar supervision. Our work is also the first attempt to use the same automatically-learned grammar for both parsing and gen- eration. Unlike previous systems that require manually-constructed grammars and lexicons, our systems require much less knowledge engineering and can be easily ported to other languages and domains.Computer Science