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Li Y, Tam WW, Yu Y, Zhuo Z, Xue Z, Tsang C, Qiao X, Wang X, Wang W, Li Y, Tu Y, Gao Y. The application of Aptamer in biomarker discovery. Biomark Res 2023; 11:70. [PMID: 37468977 DOI: 10.1186/s40364-023-00510-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023] Open
Abstract
Biomarkers are detectable molecules that can reflect specific physiological states of cells, organs, and organisms and therefore be regarded as indicators for specific diseases. And the discovery of biomarkers plays an essential role in cancer management from the initial diagnosis to the final treatment regime. Practically, reliable clinical biomarkers are still limited, restricted by the suboptimal methods in biomarker discovery. Nucleic acid aptamers nowadays could be used as a powerful tool in the discovery of protein biomarkers. Nucleic acid aptamers are single-strand oligonucleotides that can specifically bind to various targets with high affinity. As artificial ssDNA or RNA, aptamers possess unique advantages compared to conventional antibodies. They can be flexible in design, low immunogenicity, relative chemical/thermos stability, as well as modifying convenience. Several SELEX (Systematic Evolution of Ligands by Exponential Enrichment) based methods have been generated recently to construct aptamers for discovering new biomarkers in different cell locations. Secretome SELEX-based aptamers selection can facilitate the identification of secreted protein biomarkers. The aptamers developed by cell-SELEX can be used to unveil those biomarkers presented on the cell surface. The aptamers from tissue-SELEX could target intracellular biomarkers. And as a multiplexed protein biomarker detection technology, aptamer-based SOMAScan can analyze thousands of proteins in a single run. In this review, we will introduce the principle and workflow of variations of SELEX-based methods, including secretome SELEX, ADAPT, Cell-SELEX and tissue SELEX. Another powerful proteome analyzing tool, SOMAScan, will also be covered. In the second half of this review, how these methods accelerate biomarker discovery in various diseases, including cardiovascular diseases, cancer and neurodegenerative diseases, will be discussed.
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Affiliation(s)
- Yongshu Li
- Center for Advanced Measurement Science, National Institute of Metrology, Beijing, China.
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China.
| | - Winnie Wailing Tam
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Yuanyuan Yu
- Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Zhenjian Zhuo
- State Key Laboratory of Chemical Oncogenomic, Peking University Shenzhen Graduate School, Shenzhen, China
- Laboratory Animal Center, School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, 518055, China
| | - Zhichao Xue
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China
| | - Chiman Tsang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaoting Qiao
- Center for Advanced Measurement Science, National Institute of Metrology, Beijing, China
| | - Xiaokang Wang
- Department of Pharmacy, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Weijing Wang
- Shantou University Medical College, Shantou, China
| | - Yongyi Li
- Laboratory Animal Center, School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, 518055, China
| | - Yanyang Tu
- Research Center, Huizhou Central People's Hospital, Guangdong Medical University, Huizhou City, China.
| | - Yunhua Gao
- Center for Advanced Measurement Science, National Institute of Metrology, Beijing, China.
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China.
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Teoh Y, Chan T, Tsang C, Li K, Cheng KC, Cho C, Chan HC, Chiu Y, Ho B, Li T, Law M, Lee Y, Cheng C, Lo K, Lam K, Chan K, So HS, Leung C, Chan C, Yiu M, Ng C, Poon V, Leung C, Chi-Fai N. Transurethral en bloc resection versus standard resection of bladder tumour: A multi-center randomized trial (EB-StaR Study). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00751-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Auyeung TW, Leung JCS, Lu ZH, Tsang C, Lee JSW, Kwok TCY, Woo J. Comparison of the Physical Function Trajectories in Three Birth Cohorts of Chinese Older Adults: A 14-Year Longitudinal Study. J Nutr Health Aging 2023; 27:1056-1062. [PMID: 37997728 DOI: 10.1007/s12603-023-2026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/12/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES It remains uncertain whether the favorable trend of reduction in physical disabilities has become reversed in the recent-born cohorts of older adults. This study aimed to compare the rate of decline with time in self-reported Instrumental Activity of Daily Living (IADL) difficulties, objective measurement of gait speed and grip strength, in three birth cohorts of Chinese older adults. DESIGN A prospective cohort study. SETTING AND PARTICIPANTS Four thousand Chinese older adults aged 65 years or above in three birth cohorts (1934-1938, 1929-1933, 1905-1928) were recruited from the community in Hong Kong. MEASUREMENTS Grip strength, gait speed and IADL difficulties were measured between 2001 to 2017. Joint models were used to examine the trajectories of grip strength, gait speed and IADL difficulties over time, and the interaction effect of age-by-cohort (or also age2-by-cohort) was also examined. RESULTS The recently born cohort (1934 - 1938) had worse grip strength and more IADL difficulties at the same age than the earlier two cohorts (1929 - 1933; 1905 - 1928). Furthermore, the most recently born cohort also followed a more rapid decline longitudinally with a greater decline observed in gait speed, grip strength and IADL difficulties for women whereas a greater decline in grip strength and IADL difficulties for men. CONCLUSIONS The continuous improvement of physical limitations in old age may have halted and there appears to be a reversal of this favourable trend in the recent born cohort of older adults living in Hong Kong.
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Affiliation(s)
- T W Auyeung
- Zhi-Hui Lu, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China, Tel: (852) 2252 8895
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Li Y, Zhao J, Xue Z, Tsang C, Qiao X, Dong L, Li H, Yang Y, Yu B, Gao Y. Aptamer nucleotide analog drug conjugates in the targeting therapy of cancers. Front Cell Dev Biol 2022; 10:1053984. [PMID: 36544906 PMCID: PMC9760908 DOI: 10.3389/fcell.2022.1053984] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Aptamers are short single-strand oligonucleotides that can form secondary and tertiary structures, fitting targets with high affinity and specificity. They are so-called "chemical antibodies" and can target specific biomarkers in both diagnostic and therapeutic applications. Systematic evolution of ligands by exponential enrichment (SELEX) is usually used for the enrichment and selection of aptamers, and the targets could be metal ions, small molecules, nucleotides, proteins, cells, or even tissues or organs. Due to the high specificity and distinctive binding affinity of aptamers, aptamer-drug conjugates (ApDCs) have demonstrated their potential role in drug delivery for cancer-targeting therapies. Compared with antibodies which are produced by a cell-based bioreactor, aptamers are chemically synthesized molecules that can be easily conjugated to drugs and modified; however, the conventional ApDCs conjugate the aptamer with an active drug using a linker which may add more concerns to the stability of the ApDC, the drug-releasing efficiency, and the drug-loading capacity. The function of aptamer in conventional ApDC is just as a targeting moiety which could not fully perform the advantages of aptamers. To address these drawbacks, scientists have started using active nucleotide analogs as the cargoes of ApDCs, such as clofarabine, ara-guanosine, gemcitabine, and floxuridine, to replace all or part of the natural nucleotides in aptamer sequences. In turn, these new types of ApDCs, aptamer nucleotide analog drug conjugates, show the strength for targeting efficacy but avoid the complex drug linker designation and improve the synthetic efficiency. More importantly, these classic nucleotide analog drugs have been used for many years, and aptamer nucleotide analog drug conjugates would not increase any unknown druggability risk but improve the target tumor accumulation. In this review, we mainly summarized aptamer-conjugated nucleotide analog drugs in cancer-targeting therapies.
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Affiliation(s)
- Yongshu Li
- College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen, China,Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China,Center for Advanced Measurement Science, National Institute of Metrology, Beijing, China,*Correspondence: Yongshu Li, ; Yunhua Gao,
| | - Jing Zhao
- Scientific Research Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Zhichao Xue
- Center for Advanced Measurement Science, National Institute of Metrology, Beijing, China
| | - Chiman Tsang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaoting Qiao
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China
| | - Lianhua Dong
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China,Center for Advanced Measurement Science, National Institute of Metrology, Beijing, China
| | - Huijie Li
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China
| | - Yi Yang
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China
| | - Bin Yu
- College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen, China
| | - Yunhua Gao
- Shenzhen Institute for Technology Innovation, National Institute of Metrology, Shenzhen, China,Center for Advanced Measurement Science, National Institute of Metrology, Beijing, China,*Correspondence: Yongshu Li, ; Yunhua Gao,
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Waddell T, Fife K, Griffiths R, Sharma A, Dhokia P, Groves L, Hurst M, Tsang C, Sugrue D, McKenna S, Houghton J, Carroll R. Real-world treatment sequencing and survival in previously treated advanced renal cell carcinoma patients receiving nivolumab monotherapy: a UK retrospective cohort study. BMC Cancer 2022; 22:617. [PMID: 35668384 PMCID: PMC9169585 DOI: 10.1186/s12885-022-09694-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background The CheckMate 025 trial established nivolumab monotherapy as one of the standards of care in previously treated advanced or metastatic renal cell carcinoma (aRCC). However, supporting real-world data is lacking. This study investigated characteristics, treatment sequences and clinical outcomes of patients who received nivolumab monotherapy for previously treated aRCC in the UK. Methods This was a retrospective cohort study of aRCC patients treated with nivolumab at second line or later (2L +) at 4 UK oncology centres. Eligible patients commenced nivolumab (index date) between 01 March 2016 and 30 June 2018 (index period). Study data were extracted from medical records using an electronic case report form. Data cut-off (end of follow-up) was 31 May 2019. Results In total, 151 patients were included with median follow-up of 15.2 months. Mean age was 66.9 years, male preponderance (72.2%), and mostly Eastern Cooperative Oncology Group performance status grade 0–1 (71.5%). Amongst 112 patients with a known International Metastatic RCC Database Consortium score, distribution between favourable, intermediate, and poor risk categories was 20.5%, 53.6%, and 25.9% respectively. The majority of patients (n = 109; 72.2%) received nivolumab at 2L, and these patients had a median overall survival (OS) of 23.0 months [95% confidence interval: 17.2, not reached]. All patients who received nivolumab at 2L had received TKIs at 1L. Amongst the 42 patients (27.8%) who received nivolumab in third line or later (3L +) the median OS was 12.4 months [95% CI: 8.8, 23.2]. The most common reasons for nivolumab discontinuation were disease progression (2L: 61.2%; 3L: 68.8%) and adverse events (2L: 34.7%; 3L: 28.1%). Conclusion This study provides real-world evidence on the characteristics, treatment sequences, and outcomes of aRCC patients who received 2L + nivolumab monotherapy in the UK. Nivolumab-specific survival outcomes were similar to those achieved in the CheckMate 025 trial.
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Affiliation(s)
- T Waddell
- Gastro-Oesophageal and Renal Unit, The Christie NHS Foundation Trust, Manchester, UK.
| | - K Fife
- Cambridge University NHS Foundation Trust, Cambridge, UK
| | - R Griffiths
- The Clatterbridge Cancer Centre, Birkenhead, UK
| | - A Sharma
- Mount Vernon Cancer Centre, Northwood, UK
| | - P Dhokia
- Bristol Myers Squibb, Uxbridge, UK
| | - L Groves
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - M Hurst
- Bristol Myers Squibb, Uxbridge, UK.,Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - C Tsang
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - D Sugrue
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - S McKenna
- Health Economics & Outcomes Research Ltd, Cardiff, UK
| | - J Houghton
- Health Economics & Outcomes Research Ltd, Cardiff, UK
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Tsang C, Lee KS, Richards H, Blazeby J, Avery K. 127 Electronic Collection of Patient-Reported Outcomes Following Discharge After Surgery: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Little is known about the electronic collection and clinical feedback of patient reported outcomes (ePROs) post-surgical discharge. This review summarised the evidence on the collection and uses of electronic systems to collect PROs after discharge from hospital following surgery.
Method
Systematic searches of Medline, Embase, PsycINFO, CINAHL and Cochrane Central were undertaken from database inception to July 2019 using terms for “patient reported outcomes”, “electronic”, “surgery” and “at home”. Primary research of all study designs was included if they used electronic systems to collect PRO data away from formal health care settings. Only studies in adult patients admitted for surgery then discharged from hospital were eligible.
Results
From 9,474 records identified, 15 studies were reviewed including three randomised controlled trials. Seven studies were in orthopaedic surgery. Most studies used commercial ePRO systems (n = 9/12). Six studies reported types of electronic devices used to collect data: tablets or other portable devices (n = 3), smartphones (n = 2), combination of smartphones, tablets/portable devices and computers (n = 1). Systems had limited features or functions such as real-time feedback to clinicians (n = 6) and messaging service for patients to communicate with care teams (n = 3). No studies described integration of the ePRO system with electronic health records to support clinical feedback.
Conclusions
There is limited reporting of ePRO systems in the surgical literature. ePRO systems lack integration with hospital clinical systems. Future research should describe the ePRO system and ePRO questionnaires used, and challenges encountered during the study, to support efficient upscaling of ePRO systems using tried and tested approaches.
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Affiliation(s)
- C Tsang
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - K S Lee
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - H Richards
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - J Blazeby
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Division of Surgery, Head & Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - K Avery
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
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Tsang C, Lee KS, Richards H, Blazeby JM, Avery KNL. Electronic collection of patient-reported outcomes following discharge after surgery: systematic review. BJS Open 2021; 5:6199902. [PMID: 33782708 PMCID: PMC8007587 DOI: 10.1093/bjsopen/zraa072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/09/2020] [Indexed: 12/16/2022] Open
Abstract
Background Little is known about the electronic collection and clinical feedback of patient-reported outcomes (ePROs) following surgical discharge. This systematic review summarized the evidence on the collection and uses of electronic systems to collect PROs after discharge from hospital after surgery. Method Systematic searches of MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central were undertaken from database inception to July 2019 using terms for ‘patient reported outcomes’, ‘electronic’, ‘surgery’ and ‘at home’. Primary research of all study designs was included if they used electronic systems to collect PRO data in adults after hospital discharge following surgery. Data were collected on the settings, patient groups and specialties, ePRO systems (including features and functions), PRO data collected, and integration with health records. Results Fourteen studies were included from 9474 records, including two RCTs and six orthopaedic surgery studies. Most studies (9 of 14) used commercial ePRO systems. Six reported types of electronic device were used: tablets or other portable devices (3 studies), smartphones (2), combination of smartphones, tablets, portable devices and computers (1). Systems had limited features and functions such as real-time clinical feedback (6 studies) and messaging service for patients with care teams (3). No study described ePRO system integration with electronic health records to support clinical feedback. Conclusion There is limited reporting of ePRO systems in the surgical literature, and ePRO systems lack integration with hospital clinical systems. Future research should describe the ePRO system and ePRO questionnaires used, and challenges encountered during the study, to support efficient upscaling of ePRO systems using tried and tested approaches.
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Affiliation(s)
- C Tsang
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - K S Lee
- Bristol Medical School, University of Bristol, Bristol, UK
| | - H Richards
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - J M Blazeby
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.,Division of Surgery, Head and Neck, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - K N L Avery
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
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Hung W, Chun S, Wong T, Tsang C, Ho B, Ng A, Tsu H, Lam W. Transrectal vs. transperineal prostate biopsy under local anaesthesia: Prospective comparative analysis of cancer detection, safety and tolerability using patient-reported outcome measures at a single centre. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34175-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Cousins S, Blencowe NS, Tsang C, Chalmers K, Mardanpour A, Carr AJ, Campbell MK, Cook JA, Beard DJ, Blazeby JM. Optimizing the design of invasive placebo interventions in randomized controlled trials. Br J Surg 2020; 107:1114-1122. [PMID: 32187680 PMCID: PMC7496319 DOI: 10.1002/bjs.11509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/11/2019] [Accepted: 12/13/2019] [Indexed: 01/09/2023]
Abstract
Background Placebo‐controlled trials play an important role in the evaluation of healthcare interventions. However, they can be challenging to design and deliver for invasive interventions, including surgery. In‐depth understanding of the component parts of the treatment intervention is needed to ascertain what should, and should not, be delivered as part of the placebo. Assessment of risk to patients and strategies to ensure that the placebo effectively mimics the treatment are also required. To date, no guidance exists for the design of invasive placebo interventions. This study aimed to develop a framework to optimize the design and delivery of invasive placebo interventions in
RCTs. Methods A preliminary framework was developed using published literature to: expand the scope of an existing typology, which facilitates the deconstruction of invasive interventions; and identify placebo optimization strategies. The framework was refined after consultation with key stakeholders in surgical trials, consensus methodology and medical ethics. Results The resulting DITTO framework consists of five stages: deconstruct treatment intervention into constituent components and co‐interventions; identify critical surgical element(s); take out the critical element(s); think risk, feasibility and role of placebo in the trial when considering remaining components; and optimize placebo to ensure effective blinding of patients and trial personnel. Conclusion DITTO considers invasive placebo composition systematically, accounting for risk, feasibility and placebo optimization. Use of the framework can support the design of high‐quality RCTs, which are needed to underpin delivery of healthcare interventions.
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Affiliation(s)
- S Cousins
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and University of Bristol, Surgical Innovation Theme.,Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School
| | - N S Blencowe
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and University of Bristol, Surgical Innovation Theme.,Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School.,Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol
| | - C Tsang
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and University of Bristol, Surgical Innovation Theme.,Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School
| | - K Chalmers
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and University of Bristol, Surgical Innovation Theme.,Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School
| | - A Mardanpour
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and University of Bristol, Surgical Innovation Theme.,Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School
| | - A J Carr
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Biomedical Research Centre, University of Oxford
| | - M K Campbell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - J A Cook
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Biomedical Research Centre, University of Oxford.,Royal College of Surgeons (England) Surgical Interventional Trials Unit, University of Oxford, Headington, Oxford
| | - D J Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Biomedical Research Centre, University of Oxford.,Royal College of Surgeons (England) Surgical Interventional Trials Unit, University of Oxford, Headington, Oxford
| | - J M Blazeby
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and University of Bristol, Surgical Innovation Theme.,Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School.,Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol
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Abstract
Arterial stiffness is an emerging risk factor for cardiovascular disease and dietary anthocyanins may be important in mediating vascular tone. The present study investigated the effect of consumption of an anthocyanin-rich potato, Purple Majesty on arterial stiffness measured as pulse wave velocity in 14 healthy male and female adults. Participants consumed 200 g/day of cooked purple potato containing 288 mg anthocyanins, or a white potato containing negligible anthocyanins for 14 days, separated by a 7-day washout period. Non-invasive assessment of vascular tone by pulse wave velocity was determined in addition to systolic and diastolic blood pressure, high-density lipoproteins, low-density lipoproteins, triglycerides, glucose, insulin and C-reactive protein. Pulse wave velocity was significantly reduced (p = 0.001) following Purple Majesty consumption for 14-days. There were no significant changes with any other clinical parameter measured, and no changes following white potato consumption. The findings from this short-term study indicate a potential effect of Purple Majesty consumption on arterial stiffness.
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Affiliation(s)
- C Tsang
- Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, Lancashire, UK.
| | - N F Smail
- Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Edinburgh, UK
| | - S Almoosawi
- Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Edinburgh, UK
- Brain, Performance & Nutrition Research Centre, Northumbria University, Newcastle-upon-Tyne, UK
| | - G J M McDougall
- Environmental and Biochemical Sciences, The James Hutton Institute, Invergowrie, Dundee, UK
| | - E A S Al-Dujaili
- Centre for Cardiovascular Research, Queens Medical Research Institute, The University of Edinburgh, Edinburgh, UK
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Tsang C, Boulton C, Burgon V, Johansen A, Wakeman R, Cromwell DA. Predicting 30-day mortality after hip fracture surgery: Evaluation of the National Hip Fracture Database case-mix adjustment model. Bone Joint Res 2017; 6:550-556. [PMID: 28947603 PMCID: PMC5630992 DOI: 10.1302/2046-3758.69.bjr-2017-0020.r1] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 05/28/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The National Hip Fracture Database (NHFD) publishes hospital-level risk-adjusted mortality rates following hip fracture surgery in England, Wales and Northern Ireland. The performance of the risk model used by the NHFD was compared with the widely-used Nottingham Hip Fracture Score. METHODS Data from 94 hospitals on patients aged 60 to 110 who had hip fracture surgery between May 2013 and July 2013 were analysed. Data were linked to the Office for National Statistics (ONS) death register to calculate the 30-day mortality rate. Risk of death was predicted for each patient using the NHFD and Nottingham models in a development dataset using logistic regression to define the models' coefficients. This was followed by testing the performance of these refined models in a second validation dataset. RESULTS The 30-day mortality rate was 5.36% in the validation dataset (n = 3861), slightly lower than the 6.40% in the development dataset (n = 4044). The NHFD and Nottingham models showed a slightly lower discrimination in the validation dataset compared with the development dataset, but both still displayed moderate discriminative power (c-statistic for NHFD = 0.71, 95% confidence interval (CI) 0.67 to 0.74; Nottingham model = 0.70, 95% CI 0.68 to 0.75). Both models defined similar ranges of predicted mortality risk (1% to 18%) in assessment of calibration. CONCLUSIONS Both models have limitations in predicting mortality for individual patients after hip fracture surgery, but the NHFD risk adjustment model performed as well as the widely-used Nottingham prognostic tool and is therefore a reasonable alternative for risk adjustment in the United Kingdom hip fracture population.Cite this article: Bone Joint Res 2017;6:550-556.
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Affiliation(s)
- C Tsang
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK and Honorary Lecturer, The Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London WC2A 3PE, UK
| | - C Boulton
- Clinical Effectiveness and Evaluation Unit, Royal College of Physicians, 11 St Andrews Place, London NW1 4LE, UK
| | - V Burgon
- Clinical Effectiveness and Evaluation Unit, Royal College of Physicians, 11 St Andrews Place, London NW1 4LE, UK
| | - A Johansen
- Trauma Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK
| | - R Wakeman
- Clinical Effectiveness and Evaluation Unit, Royal College of Physicians, 11 St Andrews Place, London NW1 4LE, UK
| | - D A Cromwell
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK and Director of Clinical Effectiveness Unit, The Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London WC2A 3PE, UK
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Tsao GS, Zhang J, Xia L, Tsang C, Lin W, Yip Y, Deng W, Lo K, Lung M. Abstract 4417: The role of EBV infection in aerobic glycolysis in nasopharyngeal carcinoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Accumulating evidence indicates that oncogenic viral protein exerts a crucial role in activating aerobic glycolysis during tumorigenesis, but the underlying mechanisms are largely undefined. The Epstein-Barr virus (EBV)-encoded latent membrane protein 1 (LMP1) is a trans-membrane protein with potent cell signaling properties and has tumorigenic transformation property. Activation of NF-κB is a major signaling pathway mediating many downstream transformation properties of LMP1. Here we report that activation of mTORC1 by LMP1 is a key modulator for activation of NF-κB signaling to mediate aerobic glycolysis. NF-κB activation is involved for LMP1-induced upregulation of glucose transptor-1 (Glut-1) transcription and growth of nasopharyngeal carcinoma (NPC) cells. Collectively, blocking the activity of mTORC1 signaling effectively suppressed LMP1-induced NF-κB activation and Glut-1 transcription. Interfering NF-κB signaling has no effect on mTORC1 activity but effectively altered Glut-1 transcription. Luciferase promoter assay of Glut-1 also confirmed that Glut-1 is a direct target gene of NF-κB signaling. Furthermore, we demonstrated that the LMP1 C-terminal activating region (CTAR) 2 is the key domain involved in mTORC1 activation, mainly through IKKβ-mediated phosphorylation of TSC2 at Ser939. Depletion of Glut-1 effectively led to suppression of aerobic glycolysis, inhibition of cell proliferation, colony formation, and attenuation of tumorigenic growth property of LMP1-expressing nasopharyngeal epithelial (NPE) cells. These findings suggest that targeting the signaling axis of mTORC1/NF-κB/Glut-1 represents a novel therapeutic target against NPC.
Acknowledgement: 96 800x600 This project was supported by the General Research Fund (HKU 779810M, 17120814 and 17161116), CRF equipment grant (1061402980, Health and Medical Research Fund of Hong Kong (12110782), AoE grant (AoE/M-06/08) and TBRS grant (T12-401/13-R). We thank Prof. Dongyan Jin (Department of Biochemistry, The University of Hong Kong) for the kind gifts of IKK related plasmids and Prof. Zhenguo Wu (Division of Life Science, The Hong Kong University of Science and Technology) for the discussion and interpretation of the data. We also thank Mr. Tony Chan for his technical support.
Note: This abstract was not presented at the meeting.
Citation Format: George S. Tsao, Jun Zhang, Lin Xia, C Tsang, Weitao Lin, Y Yip, W Deng, K Lo, M Lung. The role of EBV infection in aerobic glycolysis in nasopharyngeal carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4417. doi:10.1158/1538-7445.AM2017-4417
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Affiliation(s)
| | - Jun Zhang
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - Lin Xia
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - C Tsang
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - Weitao Lin
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - Y Yip
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - W Deng
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - K Lo
- 2Chinese University of Hong Kong, Shatin, Hong Kong
| | - M Lung
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
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Johansen A, Tsang C, Boulton C, Wakeman R, Moppett I. Understanding mortality rates after hip fracture repair using ASA physical status in the National Hip Fracture Database. Anaesthesia 2017; 72:961-966. [DOI: 10.1111/anae.13908] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2017] [Indexed: 01/05/2023]
Affiliation(s)
- A. Johansen
- University Hospital of Wales; Cardiff UK
- National Hip Fracture Database; Royal College of Physicians; London UK
| | - C. Tsang
- Clinical Effectiveness Unit; Royal College of Surgeons of England; London UK
| | - C. Boulton
- Falls and Fragility Fracture Audit Programme; Royal College of Physicians; London UK
| | - R. Wakeman
- National Hip Fracture Database; Royal College of Physicians; London UK
| | - I. Moppett
- Anaesthesia and Critical Care Section; Division of Clinical Neuroscience; Queen's Medical Centre; University of Nottingham; UK
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Johansen A, Tsang C, Cromwell D, Boulton C, Wakeman R, Burgon V. P-434: Predicting 30 day mortality after hip fracture: validating the use of National Hip Fracture Database (NHFD) data. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ledina M, Liang X, Kim YG, Jung J, Perdue B, Tsang C, Soriaga M, Stickney JL. (Invited) Investigations into the Formation of Germanene Using Electrochemical Atomic Layer Deposition (E-ALD). ACTA ACUST UNITED AC 2015. [DOI: 10.1149/06606.0129ecst] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tsang C, Sokal-Gutierrez K, Barkan H, Ronsin K, Baral A. A deeper look at oral health and malnutrition in Nepal. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bottle A, Tsang C, Parsons C, Majeed A, Soljak M, Aylin P. Association between patient and general practice characteristics and unplanned first-time admissions for cancer: observational study. Br J Cancer 2012; 107:1213-9. [PMID: 22828606 PMCID: PMC3494442 DOI: 10.1038/bjc.2012.320] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: To identify patient and general practice (GP) characteristics associated with emergency (unplanned) first admissions for cancer in secondary care. Methods: Patients who had a first-time admission with a primary diagnosis of cancer during 2007/08 to 2009/10 were identified from administrative hospital data. We modelled the associations between the odds of these admissions being unplanned and various patient and GP practice characteristics using national data sets, including the Quality and Outcomes Framework (QOF). Results: There were 639 064 patients with a first-time admission for cancer, with 139 351 unplanned, from 7957 GP practices. The unplanned proportion ranged from 13.9% (patients aged 15–44 years) to 44.9% (patients aged 85 years and older, P<0.0001), with large variation by ethnicity (highest in Asians), deprivation, rurality and cancer type. In unadjusted analyses, all included patient and practice-level variables were statistically significant predictors of the admissions being unplanned. After adjustment, patient area-level deprivation was a key factor (most deprived compared with least deprived quintile OR 1.36, 95% CI 1.32–1.40). Higher total QOF performance protected against unplanned admission (OR 0.94 per 100 points; 95% CI 0.91–0.97); having no GPs with a UK primary medical qualification (OR 1.08, 95% CI 1.04–1.11) and being less able to offer appointments within 48 h were associated with higher odds. Conclusion: We have identified some patient and practice characteristics associated with a first-time admission for cancer being unplanned. The former could be used to help identify patients at high risk, while the latter raise questions about the role of practice organisation and staff training.
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Affiliation(s)
- A Bottle
- Faculty of Medicine, Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK.
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Gilleard O, Tsang C, Dheansa B. Closure of skin lacerations under tension: comment 1. Ann R Coll Surg Engl 2012; 94:68-9. [PMID: 22524945 DOI: 10.1308/003588412x13171221500583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Almoosawi S, Tsang C, Ostertag LM, Fyfe L, Al-Dujaili EAS. Differential effect of polyphenol-rich dark chocolate on biomarkers of glucose metabolism and cardiovascular risk factors in healthy, overweight and obese subjects: a randomized clinical trial. Food Funct 2012; 3:1035-43. [DOI: 10.1039/c2fo30060e] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Murray MM, Chick J, Gill J, Tsang C, Black H, Hillemacher T, Grassel E, Karagulle D, Baier D, Bleich S, Donath C, Barroso T, Barbosa A, Mendes A, Riegler AJ, Erfurth A, Kapusta N, Kogoj D, Schmid R, Walter H, Lesch OM, Jakovljevic MB, Jovanovic M, Nikic K, Radovanovic A, Pirkovic I, Dejanovic SD, Yamada T. FREE ORAL COMMUNICATIONS 1: ALCOHOL AND HEALTH * O1.1 * THE ROLE OF THE NIH IN RESPONSE TO THE GLOBAL BURDEN OF ALCOHOL AND HEALTH: OPPORTUNITIES FOR USA-EUROPEAN COLLABORATION. Alcohol Alcohol 2011. [DOI: 10.1093/alcalc/agr093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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He W, Chang S, Chen W, Baikadi M, Tsang C, Peters C, Brereton H. WE-C-BRB-02: Independent Two-Dimensional Dose Validation for TomoTherapy. Med Phys 2011. [DOI: 10.1118/1.3613321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wang N, Feng Y, Lau EPW, Tsang C, Ching Y, Man K, Tong Y, Nagamatsu T, Su W, Tsao S. F-actin reorganization and inactivation of rho signaling pathway involved in the inhibitory effect of Coptidis Rhizoma on hepatoma cell migration. Integr Cancer Ther 2011; 9:354-64. [PMID: 21106616 DOI: 10.1177/1534735410379121] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
HYPOTHESIS Hepatocellular carcinoma (HCC) is one of the most malignant human tumors and one of the risk factors is its highly metastatic property. Coptidis Rhizoma aqueous extract (CRAE) is able to suppress the migration and invasion of HCC cells, MHCC97-L, and F-actin reorganization and Rho signaling inhibition is involved. MAIN METHODS CRAE was prepared and analyzed by high-performance liquid chromatography combined with mass spectrometry. The cytotoxicity and antimigration action of CRAE on MHCC97-L cells were evaluated; Immunofluorescence and immunoblotting were used to investigate the proposed mechanism of CRAE action. KEY FINDINGS Chemical analysis reveals that the active components in CRAE are berberine and berberine-like alkaloids. CRAE exhibits a significant inhibitory effect on MHCC97-L cell migration as indicated by wound-healing and invasion-chamber assays. No significant alteration of matrix metalloproteinases and urokinase-type plasminogen activator (uPA) expression were observed in MHCC97-L cells exposed to CRAE. Reduction of F-actin polymerization and damage to cytoskeleton network in MHCC97-L cells were observed after CRAE treatment. Furthermore, it was found that CRAE significantly downregulated the Rho/ROCK signaling pathway. SIGNIFICANCE These results indicate that CRAE may act as a Rho/ROCK signaling inhibitor to suppress MHCC97-L cell migration in vitro and suggested that total alkaloids in Coptidis Rhizoma may be a potential agent for suppressing liver cancer invasion.
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Affiliation(s)
- Ning Wang
- The University of Hong Kong, Pokfulam, Hong Kong
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Abstract
ABSTRACTOxo ions (MO4)n- (M = V, Cr, Mn and Mo) have been reduced in aqueous solutions with potassium borohydride to obtain the binary oxides MO2+δ. While the vanadium and manganese oxides are nanocrystalline, the chromium and molybdenum oxides are amorphous. The nanocrystalline VO2 having a metastable structure and the amorphous CrO2 and MoO2.3 transform to the thermodynamically more stable phases upon heating above 300–400 °C. These metastable oxides after heating in vacuum at 200–300 °C to remove water show good electrode performance in lithium cells. VO2, CrO2 and MoO2.3 show a reversible capacity of, respectively, 290 mAh/g in the range 4–1.5 V, 180 mAh/g in the range 3.3–2.3 V, and 220 mAh/g in the range 3–1 V. MnO2 obtained by this process does not show good electrode properties.
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Yuan J, Chang S, Tsang C, Chen W, Jette D. SU-GG-I-173: GPU-Accelerated Digitally Reconstructed Radiograph Generation for Radiation Therapy. Med Phys 2010. [DOI: 10.1118/1.3468209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gill J, Tsang C, Black H, Chick J. Can Part of the Health Damage Linked to Alcohol Misuse in Scotland be Attributable to the Type of Drink and its Low Price (by Permitting a Rapid Rate of Consumption)? A Point of View. Alcohol Alcohol 2010; 45:398-400. [DOI: 10.1093/alcalc/agq023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lee A, Siu S, Lam A, Tsang C, Kung K, Li PKT. The concepts of family doctor and factors affecting choice of family doctors among Hong Kong people. Hong Kong Med J 2010; 16:106-115. [PMID: 20354244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVES To identify concepts including misconceptions among the community members regarding family doctors, and determine factors affecting decisions on which doctor to consult in different clinical scenarios. DESIGN Household telephone survey conducted between 4 and 13 September 2006. SETTING Hong Kong community. PARTICIPANTS Cantonese-speaking Hong Kong residents aged 18 years or more were targeted. Randomly selected participants were asked to complete a questionnaire, which was designed based on a literature search and subsequent focus group discussions. RESULTS Among the 1811 households with eligible subjects to survey, 1204 completed the questionnaire (response rate, 67%). More than 85% considered a family doctor to be the first doctor they wanted to see even if it was inconvenient. "Clearly knowing my physical conditions", "fast-acting and effective treatment", and "doctor with friendly and sincere attitude" were the three most important factors influencing the choice of a family doctor. When affected by flu-like symptoms, 65% would go to a private clinic, 20% to a general out-patient clinic, 6% to a designated clinic with staff approved by their respective medical insurance/medical benefit scheme, and 5% to a private hospital outpatient clinic. Among the latter two groups, 65% consulted the same doctor every time when they felt sick. More than 50% of those willing to have regular follow-up by a family doctor for hypertension and diabetes paid more than HK$300 per month. Approximately 64% might consider having regular follow-up at a general out-patient clinic by a nurse specialist. CONCLUSION Hong Kong inhabitants already have their own ideas regarding how to care for their own health, and what kind of family doctors they prefer. This survey should help both doctors and health care policy makers to realign their current thinking, and thus provide a platform for the development of a primary care model unique to Hong Kong.
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Affiliation(s)
- A Lee
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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Peters C, Baikadi M, Gallagher M, Tsang C, Gilbert J, Brereton H. Rapid Changes in PSA Are Apparent Midway Through Salvage Radiotherapy after Prostatectomy and May Correlate with Long-term Outcome. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- D. K. Biegelsen
- a Xerox Palo Alto Research Centre , Palo Alto , California , 94304 , U.S.A
| | - J. C. Knights
- a Xerox Palo Alto Research Centre , Palo Alto , California , 94304 , U.S.A
| | - R. A. Street
- a Xerox Palo Alto Research Centre , Palo Alto , California , 94304 , U.S.A
| | - C. Tsang
- a Xerox Palo Alto Research Centre , Palo Alto , California , 94304 , U.S.A
| | - R. M. White
- a Xerox Palo Alto Research Centre , Palo Alto , California , 94304 , U.S.A
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Affiliation(s)
- C. Tsang
- a Xerox Palo Alto Research Center , Palo Alto , California , 94304 , U.S.A
| | - R. A. Street
- a Xerox Palo Alto Research Center , Palo Alto , California , 94304 , U.S.A
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Satish RL, Thwin MM, Ratha M, Lu Y, Prithija P, Gopalakrishnakone P, Tsang C. PERITONEAL TRAUMA ALTERS sPLA2 ACTIVITY IN PERITONEAL CAVITY FOLLOWING SURGERY: AN INCISIONAL HERNIA MODEL IN RATS. Shock 2004. [DOI: 10.1097/00024382-200403001-00562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lee A, Tsang C, Lee SH, To CY. A comprehensive "Healthy Schools Programme" to promote school health: the Hong Kong experience in joining the efforts of health and education sectors. J Epidemiol Community Health 2003; 57:174-7. [PMID: 12594193 PMCID: PMC1732409 DOI: 10.1136/jech.57.3.174] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Both health and education are linked to economic performance. The success of education depends on good health, and vice versa. Modern education should help young people to determine values, and accept responsibility for their health and social behaviour. The success of health promotion in schools requires the joint efforts of both the health and education sectors. A comprehensive programme is needed to include teachers' training, curriculum development, community participation, changing policies and practices, and research. All these components are needed to build up a successful model of a health promoting school. The "Healthy Schools Programme" in Hong Kong gives a good example of close partnership between the health and education sectors, and moves towards a multidisciplinary approach and active learning towards health promotion.
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Affiliation(s)
- A Lee
- Department of Community and Family Medicine, The Chinese University of Hong Kong, School of Public Health, Prince of Wales Hospital, Shatin, NT.
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Mutwiri G, Pontarollo R, Babiuk S, Griebel P, van Drunen Littel-van den Hurk S, Mena A, Tsang C, Alcon V, Nichani A, Ioannou X, Gomis S, Townsend H, Hecker R, Potter A, Babiuk LA. Biological activity of immunostimulatory CpG DNA motifs in domestic animals. Vet Immunol Immunopathol 2003; 91:89-103. [PMID: 12543546 DOI: 10.1016/s0165-2427(02)00246-5] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Bacterial DNA contains a much higher frequency of CpG dinucleotides than are present in mammalian DNA. Furthermore, bacterial CpG dinucleotides are often not methylated. It is thought that these two features in combination with specific flanking bases constitute a CpG motif that is recognized as a "danger" signal by the innate immune system of mammals and therefore an immune response is induced when these motifs are encountered. These immunostimulatory activities of bacterial CpG DNA can also be achieved with synthetic CpG oligodeoxynucleotides (ODN). Recognition of CpG motifs by the innate immune system requires engagement of Toll-like receptor 9 (TLR-9), which induces cell signaling and subsequently triggers a pro-inflammatory cytokine response and a predominantly Th1-type immune response. CpG ODN-induced innate and adaptive immune responses can result in protection in various mouse models of disease. Based on these observations, clinical trials are currently underway in humans to evaluate CpG ODN therapies for cancer, allergy and infectious disease. However, potential applications for immunostimulatory CpG ODN in species of veterinary importance are just being explored. In this review, we will highlight what is presently known about the immunostimulatory effects of CpG ODN in domestic animals.
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Affiliation(s)
- G Mutwiri
- Veterinary Infectious Disease Organization, University of Saskatchewan, 120 Veterinary Road, Saskatoon, SK, Canada S7N 5E3.
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Ho KS, Tsang C, Seow-Choen F, Ho YH, Tang CL, Heah SM, Eu KW. Prospective randomised trial comparing ayurvedic cutting seton and fistulotomy for low fistula-in-ano. Tech Coloproctol 2001; 5:137-41. [PMID: 11875680 DOI: 10.1007/s101510100015] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2001] [Accepted: 06/28/2001] [Indexed: 02/07/2023]
Abstract
The aim of this study was to evaluate the role of ayurvedic setons in the treatment of low fistula-in-ano. One hundred and eight patients were randomised into either conventional fistulotomy (F) or ayurvedic cutting seton insertion (C). Endpoints investigated included time to wound healing and complications of surgery. Post-operative pain scores were measured daily using a visual analog scale. Anal function was compared using a continence score. Pre- and postoperative manometry and ultrasound were also performed. After exclusions, there were 54 patients in group F and 46 in group C. There were no differences in age, sex or follow-up duration between the two groups. Healing time was similar between the groups. Group C reported more pain following operation and on the first 2-4 postoperative days, but both groups experienced the same amount of pain subsequently. In conclusion, chemical seton was more painful than conventional fistulotomy in the first few days following surgery. However, there was no difference in time to wound healing, complications or functional outcome.
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Affiliation(s)
- K S Ho
- Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore
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Abstract
BACKGROUND Conventional stapled haemorrhoidectomy involves the use of a large circular anal dilator (DL technique), which may cause anal sphincter injuries. This study compared whether the procedure can be effectively performed without this dilator (ND technique), with better sphincter preservation. METHODS Fifty-eight patients with symptomatic prolapsed irreducible haemorrhoids were randomized to DL (n = 29) and ND (n = 29) groups. Preoperative continence scoring, anorectal manometry and endoanal ultrasonography were performed. These were repeated at up to 14 weeks after operation, with additional pain scores, analgesic requirements and quality of life assessments. RESULTS DL haemorrhoidectomy took significantly longer to perform (P = 0.02). However, there were fewer residual skin tags (P = 0.044) and less perianal pruritus (P = 0.007) at 2 weeks, although such symptoms subsided to an equivalent level in both groups afterwards. Internal anal sphincter fragmentation persisting to at least 14 weeks was found in four patients after DL, but not after ND haemorrhoidectomy (P = 0.038). However, these were asymptomatic and no differences were found in continence scores and anal pressures. The pain scores, satisfaction scores, quality of life assessments and time off work were similar. CONCLUSION The large circular anal dilator used for stapled haemorrhoidectomy increased the risk of anal sphincter injuries, which may become problematic with ageing.
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Affiliation(s)
- Y H Ho
- Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
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Ho YH, Cheong WK, Tsang C, Ho J, Eu KW, Tang CL, Seow-Choen F. Stapled hemorrhoidectomy--cost and effectiveness. Randomized, controlled trial including incontinence scoring, anorectal manometry, and endoanal ultrasound assessments at up to three months. Dis Colon Rectum 2000; 43:1666-75. [PMID: 11156449 DOI: 10.1007/bf02236847] [Citation(s) in RCA: 171] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Stapled hemorrhoidectomy is performed without leaving painful perianal wounds. The aim of this study was to assess any benefits, compared with a conventional open diathermy technique. METHODS A total of 119 consecutive patients with prolapsed irreducible hemorrhoids were randomly assigned (conventional open diathermy technique = 62; stapled hemorrhoidectomy = 57). Preoperative fecal incontinence scoring, anorectal manometry, and endoanal ultrasound were performed. Postoperatively, these were repeated at up to three months with pain scores, analgesic requirements, quality of life assessment, and total related medical costs. RESULTS Conventional open diathermy technique was quicker to perform (mean, 11.4 (standard error of the mean, 0.9) vs. 17.6 (3.1) minutes). Hospitalization was similar, but conventional open diathermy technique patients felt more pain during defecation (5.1 (0.4) vs. 2.6 (0.4); P < 0.005) at two weeks, and analgesic requirements were more for up to six weeks (P < 0.05). Up to the latter, 85.5 percent conventional open diathermy technique wounds remained unhealed, with more bleeding (33 (53.2 percent) vs. 19 (33.3 percent); P < 0.05) and pruritus (27 (43.5 percent) vs. 9 (15.8 percent); P < 0.05). Total complication rates were similar (conventional open diathermy technique 16 (25.8 percent) vs. stapled hemorrhoidectomy 10 (17.5 percent)), including mild strictures and bleeding in both groups. Minor incontinence occurred postoperatively in two conventional open diathermy technique and two stapled hemorrhoidectomy patients at six weeks. Endoanal ultrasound internal anal sphincter defects were found in the incontinent conventional open diathermy technique patients, but were asymptomatic in another one conventional open diathermy technique and one stapled hemorrhoidectomy. Only one patient (conventional open diathermy technique with internal sphincter defect) remained incontinent at three months. Changes between preoperative and postoperative anorectal manometry were similar in the two groups. Patients' satisfaction scores and quality of life assessments were also similar. Conventional open diathermy technique patients resumed work later (mean 22.9 (1.8) vs. 17.1 (1.9) days; P < 0.05), but the total costs incurred were less ($921.17 (16.85) vs. $1,283.09 (31.59); P < 0.005). CONCLUSIONS Stapled hemorrhoidectomy is a safe and effective option in treating irreducible prolapsed piles. It is more expensive but less painful, with less time needed off work. Nonetheless, long-term results are still awaited.
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Affiliation(s)
- Y H Ho
- Department of Colorectal Surgery, Singapore General Hospital, Singapore
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Ho YH, Tsang C, Tang CL, Nyam D, Eu KW, Seow-Choen F. Anal sphincter injuries from stapling instruments introduced transanally: randomized, controlled study with endoanal ultrasound and anorectal manometry. Dis Colon Rectum 2000; 43:169-73. [PMID: 10696889 DOI: 10.1007/bf02236976] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Injury sustained from the transanally introduced stapling technique was assessed by comparison with biofragmentable anastomotic ring anastomosis, which excluded anal manipulation. METHODS A randomized, controlled trial was conducted on consecutive patients undergoing sigmoid colectomy (where pelvic nerve injury was avoided). A bowel function questionnaire was administered six months after surgery. Anorectal manometry and endoanal ultrasonography were performed preoperatively and at six months postoperatively. The observers were blinded to the randomization. RESULTS There were 18 patients in the transanally introduced stapling technique group and 17 patients in the biofragmentable anastomotic ring group, with no differences in age, gender, Dukes staging, and follow-up. Three of the transanally introduced stapling technique patients had occasional liquid soiling, which was absent in biofragmentable anastomotic ring patients. Mean change in resting anal pressures was also significantly impaired when compared with patients with biofragmentable anastomotic ring (P = 0.007). Endosonographic internal sphincter fragmentation was found in five transanally introduced stapling technique patients but none after biofragmentable anastomotic ring anastomosis (P = 0.046). Internal sphincter fragmentation was associated with the impaired resting pressures (P = 0.007). External sphincter deficiencies were found after transanally introduced stapling technique in two patients (biofragmentable anastomotic ring = 0), and these were associated with the soiling (P = 0.005). CONCLUSIONS The transanally introduced stapling technique may result in anal sphincter defects and impaired anal pressures when assessed at six months of follow-up.
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Affiliation(s)
- Y H Ho
- Department of Colorectal Surgery, Singapore General Hospital
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Abstract
OBJECTIVES To evaluate the salivary lysozyme concentration, flow rate and pH of a predominantly Chinese, HIV-infected group in Hong Kong, and to compare with an equal number of age and gender-matched HIV-free individuals. STUDY DESIGN A prospective longitudinal study over a 12-month period of 32 predominantly Chinese, male, HIV-infected group in a hospital setting in Hong Kong. Whole saliva collection by expectoration, lysozyme evaluation by 'lysoplate method'; pH and flow rate evaluation using standard methods and correlation with other clinical parameters using regression analysis. RESULTS The flow rate and the pH of saliva were lower compared with HIV-free, healthy individuals (both P < 0.0001) and salivary lysozyme concentration of the HIV-infected group was 23% higher compared with the HIV-free group (P < 0.001), though there was no significant difference between the lysozyme output (P > 0.05) expressed as microg min-1. On multiple regression analysis, intravenous drug users had a higher salivary lysozyme concentration compared with the homosexual group (P = 0.0015) though other variables investigated were not significantly related to the salivary lysozyme concentrations. CONCLUSIONS The significant changes in the flow rate, pH value and lysozyme concentration of whole saliva of the HIV-infected individuals as compared with the HIV-free, healthy individuals, may be due to the disease itself or a combination of factors including the medications used in the disease management.
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Affiliation(s)
- C Tsang
- Faculty of Dentistry, University of Hong Kong, Hong Kong
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Ang BK, Cheong D, Teh E, Teoh TA, Tsang C. Skin stapled bowel anastomosis in a canine model. Singapore Med J 1999; 40:81-3. [PMID: 10414163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
AIM OF STUDY The aim of this study is to compare the safety and cost effectiveness of the use of staples designed for skin closure in the construction of colonic anastomoses. METHOD Twenty healthy dogs were prospectively randomised to either skin stapled or sutured anastomosis. The ascending colon was transected and reanastomosed. This segment was excised and used to test early bursting strength. There was no significant difference between the two groups. The ends of the colon were reanastomosed. RESULTS The time taken to perform the anastomosis and the cost of the suture or staples were noted. The time taken for the stapled anastomosis was significantly faster (p < 0.001) with a mean of 7.95 minutes versus a mean of 23.5 minutes for the handsewn anastomosis. The cost was also significantly less (p = 0.18) with a mean of SGD17.85 compared to a mean of SGD21.15 for the handsewn anastomosis. Two weeks later, the dogs were sacrificed and the late bursting pressures were tested and no significant difference was found between the two groups. The anastomotic site was then sent for histological examination. The four animals, one in the handsewn group and 3 in the skin stapled group, dying prior to sacrifice, were subjected to post-mortem. CONCLUSION The results show that skin stapled anastomoses are easy to learn and perform and may constitute a viable alternative to hand suture techniques.
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Affiliation(s)
- B K Ang
- Department of Surgery, Tan Tock Seng Hospital, Singapore
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Ibrahim S, Tsang C, Lee YL, Eu KW, Seow-Choen F. Prospective, randomized trial comparing pain and complications between diathermy and scissors for closed hemorrhoidectomy. Dis Colon Rectum 1998; 41:1418-20. [PMID: 9823809 DOI: 10.1007/bf02237059] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE The aim of this study was to assess pain and complication rates after closed hemorrhoidectomy with the use of either scissors or diathermy excision. METHODS Ninety-one consecutive patients were prospectively randomly assigned by use of sealed envelopes to Group A (diathermy dissection; n = 44) or Group B (scissors dissection; n = 47). The resulting hemorrhoidal pedicle after hemorrhoidal dissection was transfixed and buried under the mucosa, which was closed with 3-0 chromic catgut. RESULTS The median time taken for surgery was ten minutes in both groups. The range for Group A was 5 to 25 minutes, and the range for Group B was 5 to 20 minutes. There were no statistically significant differences in the pain scores between the two groups for any of the seven postoperative days studied. The median number of pethidine injections in Group A was 1 and in Group B was 0 (P < 0.009). The number of oral analgesic tablets used was 8 (range, 4-10) and 14 (range, 0-10) for Groups A and B, respectively (P < 0.001). The number of tubes of topical lignocaine jelly used was 14 (range, 0-22) and 14 (range, 7-88) in Groups A and B, respectively. Two patients in each group developed secondary hemorrhage, but no patient had anal stricturing. CONCLUSION No excessive complications are seen with closed hemorrhoidectomy, and diathermy seems to require less postoperative analgesic medicine than scissors for closed hemorrhoidectomy except in the first 24 hours.
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Affiliation(s)
- S Ibrahim
- Department of Colorectal Surgery, Singapore General Hospital, Singapore
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Payne AP, Sutcliffe RG, Campbell JM, Favor G, Russell D, Bennett NK, Clarke DJ, Branton R, Davies RW, Simpson E, Tsang C, Baxendale RH. Disordered locomotion in the AS/AGU mutant rat and the effects of L-dopa or fetal midbrain grafts. Mov Disord 1998; 13:832-4. [PMID: 9756155 DOI: 10.1002/mds.870130514] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- A P Payne
- The Institute of Biomedical and Life Sciences, Glasgow University, Scotland
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Tsang C, Lai SY, Manthiram A. Reduction of Aqueous Na(2)WO(4) by NaBH(4) at Ambient Temperatures To Obtain Lower Valent Tungsten Oxides. Inorg Chem 1997; 36:2206-2210. [PMID: 11669846 DOI: 10.1021/ic9610039] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A systematic investigation of the reduction of aqueous Na(2)WO(4) with aqueous NaBH(4) at ambient temperatures reveals the formation of several lower valent tungsten oxides such as the tetragonal (x < 0.38) and cubic (x > 0.43) tungsten bronzes Na(x)()WO(3) and the binary oxides WO(2) and W(24)O(68). The nature of the product formed is influenced both by the (i) reducing power of NaBH(4), which is controlled by the volume and concentration of the borohydride and the reaction pH, and (ii) the degree of condensation of the tungstate ions, which is controlled by the reaction pH. Although the reducing power of NaBH(4) increases with decreasing pH, an increasing degree of condensation of the tungstate tends to lower the degree of reduction in many instances. The as-prepared samples are amorphous as revealed by X-ray diffraction and crystallize around 450 degrees C as revealed by differential scanning calorimerty. The tungsten bronzes undergo interesting crystal-chemical changes with the temperature of heating.
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Affiliation(s)
- C. Tsang
- Center for Materials Science & Engineering, ETC 9.104, The University of Texas at Austin, Austin, Texas 78712
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Abstract
The nutrition support team at Lucile Salter Packard Children's Hospital at Stanford developed a clinical pathway for infants and children receiving parenteral nutrition (PN). Use of clinical pathways for health care delivery is one way in which clinicians and institutions are responding to pressure from managed care organizations to reduce costs and maintain or improve quality. This pathway was developed to standardize the process for ordering, implementing, and monitoring PN. Specific goals for the pathway are as follows: to decrease the number of patients receiving PN inappropriately, to decrease the duration of PN for those patients who require it, to determine complication rates, and to monitor outcomes of therapy. Such comprehensive monitoring will help identify areas for improvement. By developing and implementing action plans to address these issues, we expect to improve continuously the processes and outcomes associated with PN therapy.
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Affiliation(s)
- A A Fisher
- Department of Pharmacy, Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, California 94304, USA
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Tsang C, Dananjay A, Kim J, Manthiram A. Synthesis of Lower Valent Molybdenum Oxides by an Ambient Temperature Reduction of Aqueous K(2)MoO(4) by KBH(4). Inorg Chem 1996; 35:504-509. [PMID: 11666237 DOI: 10.1021/ic950955w] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Reduction of aqueous K(2)MoO(4) with aqueous KBH(4) at ambient temperatures has been investigated systematically to obtain lower valent molybdenum oxides. Several lower valent oxides such as MoO(2), Mo(4)O(11), K(0.26)MoO(3) (red bronze), K(0.30)MoO(3) (blue bronze), and K(0.85)Mo(6)O(17) are formed during the reduction process; however, only MoO(2) has been obtained as single-phase product. The nature of the product formed is strongly influenced by the reducing power of KBH(4). The reducing power increases with decreasing pH or increasing concentration and volume of KBH(4). The as-prepared samples are amorphous as revealed by X-ray diffraction and transmission electron microscopy. They crystallize sharply at around 350-500 degrees C as revealed by differential scanning calorimetry. Since the products formed are amorphous in nature, they may become particularly attractive for battery electrodes and catalysis.
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Affiliation(s)
- C. Tsang
- Center for Materials Science & Engineering, ETC 9.104, The University of Texas at Austin, Austin, Texas 78712
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Seow-Choen F, Leong AF, Tsang C. Selective sedation for colonoscopy. Gastrointest Endosc 1994; 40:661-4. [PMID: 7859960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
A study of selective sedation for colonoscopy was conducted in two parts. All procedures were performed by one experienced colonoscopist. In the first phase, 41 patients received intravenous sedation before colonoscopy and were then prospectively randomized to either a "not-reversed" group, which did not receive flumazenil before withdrawal of the colonoscope, or to a "reversed" group, which received flumazenil before colonoscope withdrawal. None of the 20 patients reversed and 1 of the 21 patients not reversed experienced pain during the withdrawal phase of colonoscopy. Sixty percent of patients in the reversed group and 10% in the not-reversed group remembered the colonoscopic findings being explained during the procedure. Ninety percent and 81% of patients in the reversed and not-reversed groups, respectively, expressed a preference to be awake to watch the withdrawal of the colonoscope. In the second phase of this study, 40 patients underwent colonoscopy without prior intravenous sedation. Sedation was given only if pain was experienced during the procedure. Thirty percent had no pain at all, 55% minimal pain, 8% moderate pain, and 3% severe pain. Twenty-three percent required intravenous sedation, whereas 78% did not receive any sedation. Ninety-three percent were willing to undergo another colonoscopy without prior sedation. Only 8% preferred prior intravenous sedation before any future colonoscopy.
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Affiliation(s)
- F Seow-Choen
- Department of Colorectal Surgery, Singapore General Hospital
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Abstract
A study of selective sedation for colonoscopy was conducted in two parts. All procedures were performed by one experienced colonoscopist. In the first phase, 41 patients received intravenous sedation before colonoscopy and were then prospectively randomized to either a "not-reversed" group, which did not receive flumazenil before withdrawal of the colonoscope, or to a "reversed" group, which received flumazenil before colonoscope withdrawal. None of the 20 patients reversed and 1 of the 21 patients not reversed experienced pain during the withdrawal phase of colonoscopy. Sixty percent of patients in the reversed group and 10% in the not-reversed group remembered the colonoscopic findings being explained during the procedure. Ninety percent and 81% of patients in the reversed and not-reversed groups, respectively, expressed a preference to be awake to watch the withdrawal of the colonoscope. In the second phase of this study, 40 patients underwent colonoscopy without prior intravenous sedation. Sedation was given only if pain was experienced during the procedure. Thirty percent had no pain at all, 55% minimal pain, 8% moderate pain, and 3% severe pain. Twenty-three percent required intravenous sedation, whereas 78% did not receive any sedation. Ninety-three percent were willing to undergo another colonoscopy without prior sedation. Only 8% preferred prior intravenous sedation before any future colonoscopy.
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Affiliation(s)
- F Seow-Choen
- Department of Colorectal Surgery, Singapore General Hospital
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Toppari J, Tsutsumi I, Bishop PC, Parker JW, Ahmad N, Tsang C, Campeau JD, diZerega GS. Flow cytometric quantification of rat spermatogenic cells after hypophysectomy and gonadotropin treatment. Biol Reprod 1989; 40:623-34. [PMID: 2758092 DOI: 10.1095/biolreprod40.3.623] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
DNA flow cytometry was evaluated as a tool to analyze stage-specific changes that occur in absolute cell numbers in the testes. Hypophysectomy was selected as a model system for perturbing testicular cell types, since the cytological sequelae of this treatment post-hypophysectomy in the rat are well documented in the literature. Rat spermatogenic cells in stages II-V, VII, and IX-XIII of the seminiferous epithelial cycle (as defined by Leblond and Clermont, 1952) were quantified in numbers per standard length of seminiferous tubule by DNA flow cytometry after hypophysectomy and subsequent gonadotropin treatment. In agreement with previous histological studies, we found that acrosome- and maturation-phase spermatids disappeared from the seminiferous epithelium after 17 days post-hypophysectomy, whereas meiosis and early spermiogenesis continued at least 164 days. The number of meiotic cells and round spermatids gradually decreased after hypophysectomy. Changes were observed as early as Day 6 post-hypophysectomy. Treatment with human chorionic gonadotropin (hCG) alone maintained most cell numbers within normal limits, and follicle-stimulating hormone (FSH) was needed in addition to hCG to maintain the normal number of cells with the amount of DNA contained in primary spermatocytes and spermatogonia in G2/M-phase (4C) in stages IX-XIII and elongated spermatids (1C') in stages II-V of the epithelial cycle. The absolute numbers of spermatogenic cells at different phases of maturation provide a useful reference for quantitative studies of spermatogenesis. Pathological changes in the seminiferous epithelium can be detected and quantified by DNA flow cytometry.
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Affiliation(s)
- J Toppari
- Livingston Reproductive Biology Laboratory, University of Southern California School of Medicine, Los Angeles 90033
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