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Chen SS, Lam TP, Lam KF, Lo TL, Chao DVK, Mak KY, Lam EWW, Tang WS, Chan HY, Yip PSF. The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study. J Med Internet Res 2022; 24:e37695. [PMID: 36223182 PMCID: PMC9607886 DOI: 10.2196/37695] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/20/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Social networking sites (SNSs) have gained popularity in recent years for help seeking and self-distress expression among adolescents. Although online suicidal expression is believed to have major benefits, various concerns have also been raised, particularly around privacy issues. Understanding youths’ help-seeking behavior on SNSs is critical for effective suicide prevention; however, most research neglects the impacts of the private SNS context. Objective This study aims to examine youths’ private SNS use via the new Instagram feature, Close Friends, and its association with both online and offline help-seeking willingness as well as youths’ suicidality. Methods This study employed an exploratory sequential mixed methods approach with a combination of explorative qualitative interviews and a systematic quantitative survey, targeting youth aged 15-19 years in Hong Kong. The motivations for utilizing Close Friends and concerns regarding online expression were addressed in the focus group and individual interviews (n=40). A cross-sectional survey (n=1676) was conducted subsequently with eligible secondary school students to examine the prevalence of Close Friends usage, their online and offline help-seeking willingness, and suicide-related experiences. Results A total of 3 primary motives for using Close Friends were identified during interviews, including (1) interaction and help seeking, (2) release of negative emotions, and (3) ventilation and self-expression. Most participants also highlighted the privacy concerns associated with public online communication and the importance of contacting close friends for emotional support. Survey results showed that use of Close Friends was quite prevalent among adolescents (1163/1646, 70.66%), with around 46% (754/1646, 45.81%) of respondents being frequent users. Differences by gender and school academic banding were also revealed. Regarding help-seeking intentions, youths were generally positive about seeking help from peers and friends offline (1010/1266, 79.78%) yet negative about seeking assistance from online friends or professionals with whom they had not yet developed a real-world connection (173/1266, 13.67%). Most notably, frequencies of Close Friends usage were differentially associated with online and offline help-seeking willingness and youths’ suicidality. Compared with nonusers, those who had ever used the feature were more likely to seek offline support (adjusted odds ratios [AORs] 1.82-2.36), whereas heavy use of Close Friends was associated with increased odds of online help-seeking willingness (AOR 1.76, 95% CI 1.06-2.93) and a higher risk of suicidality (AOR 1.53, 95% CI 1.01-2.31). Conclusions The popularity of Close Friends reflects the increasing need for private online expression among youth. This study demonstrates the importance of Close Friends for self-expression and private conversation and inadequacy of peer support for suicidal adolescents. Further research is needed to identify the causal relationship between Close Friends usage and help-seeking willingness to guide the advancement of suicide prevention strategies. Researchers and social media platforms may cooperate to co-design a risk monitoring system tailored to the private SNS context, assisting professionals in identifying youth at risk of suicide.
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Affiliation(s)
- Sikky Shiqi Chen
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Tak Lam Lo
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon East Cluster, Hong Kong, China
| | - Ki Yan Mak
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Wai Sin Tang
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Chen SS, Lam TP, Lam KF, Lo TL, Chao DVK, Mak KY, Lam EWW, Tang WS, Chan HY, Yip PSF. Youths' attitudes toward open discussion of suicide, preferred contexts, and the impact of Internet use: An exploratory sequential mixed-methods study in Hong Kong. Int J Soc Psychiatry 2022; 69:575-586. [PMID: 36120996 DOI: 10.1177/00207640221123394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although the necessity and benefits of having the open and public discussion about suicide have been recognized, youths' opinions regarding such discussion remain unknown. AIMS To explore youths' attitudes toward open suicide discussion, particularly concerning their preference of discussion contexts and impacts of Internet use. METHOD This exploratory sequential mixed-methods study targeted Hong Kong youths aged 15 to 19. A total of six focus groups and 12 individual interviews were held (N = 40). Topics included adolescents' views of open suicide discussion, concerns, perceived benefits, and preferred contexts. The questionnaire survey (N = 1,676) was conducted subsequently to investigate the prevalence of youths' perspectives on public discussion of suicide and relationships with discussion contexts, use of social media platforms, and motivations of online expression. RESULTS Qualitative findings revealed three types of attitudes toward open suicide discussion: reluctance, support, and indifference. Major barriers included cultural norms, topic sensitivity, privacy concerns, contagion effect, fear of embarrassment, and unpleasant experiences in school programs. Results of quantitative analyses showed that reluctance was the dominant attitude among adolescents, and taboo was the top concern. Variations in youths' attitudes were related to gender, school academic banding, and suicide-related experiences. Notably, adolescents who had been exposed to suicide messages in contexts of peer networks and online platforms were more likely to endorse open suicide discussion. In addition, an increased likelihood of engaging in public suicide discussion was associated with the use of Instagram, WhatsApp, and Snapchat, and the motive of 'expressing emotions and opinions' online. CONCLUSIONS Our results indicated a prevalent rejection among adolescents toward open suicide discussion, suggesting the issue of stigma, the need for tailored programs, the value of appropriate contexts, and the impact of Internet use. These findings may facilitate the development of school-based suicide prevention initiatives and the efficacy of online services for suicide-related communication.
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Affiliation(s)
- Sikky Shiqi Chen
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science, the University of Hong Kong, Hong Kong, China.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Tak Lam Lo
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon East Cluster, Hong Kong, China
| | - Ki Yan Mak
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Wai Sin Tang
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, the University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
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Chen SS, Lam TP, Lam KF, Lo TL, Chao DVK, Mak KY, Lam EWW, Tang WS, Chan HY, Yip PSF. Motivations for Online Expression, Willingness of Online Help-Seeking, and the Risk of Suicide Among Hong Kong Youths: A Mixed-Methods Study. Cyberpsychol Behav Soc Netw 2022; 25:384-391. [PMID: 35594242 DOI: 10.1089/cyber.2022.0007] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Despite widespread interest in social media use, little is known about the heterogeneity of underlying motivations for online engagement among at-risk adolescents. This study adopted a mixed-methods approach to evaluate the motives of online expression among Hong Kong youths aged 15-19, as well as their relationships to online help-seeking willingness and suicide risks. In total, 6 focus groups and 12 individual interviews were conducted (N = 40) to elicit information regarding online expression purposes and to construct questionnaire items. The cross-sectional survey (N = 1,676) was undertaken subsequently to determine the prevalence of motives, and their correlations with online help-seeking willingness and suicide risks. Qualitative interviews revealed two key themes: major motivations for online expression, and features of online expression and help-seeking among suicidal youths. Quantitative analyses demonstrated the prevalence of each online expression purpose, with most reporting on "emotional expression" and "life sharing and documentation," but variations identified by gender, school academic banding, and suicide-related experience. Notably, an ordinal logistic regression model revealed that motives of "emotional expression" and "image building" were associated with increased suicide risks, while the purpose of "life sharing" was associated with decreased suicide risks. Those who expressed online for "self-expression" and "friend making" showed a stronger willingness for online help-seeking. These findings provide a more holistic overview of the purposes of online expression, which suggested the likelihood of mental health issues and the need for support. Such insight may facilitate the development of more effective suicide prevention strategies and online intervention services.
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Affiliation(s)
- Sikky Shiqi Chen
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science and The University of Hong Kong, Hong Kong, China.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Tak Lam Lo
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon East Cluster, Hong Kong, China
| | - Ki Yan Mak
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Wai Sin Tang
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Sun KS, Lam TP, Piterman L, Lam KF, Tang WS, Kwok KW, Chan HY, Wu D, Tiwari A. Management of Domestic Violence by Primary Care Physicians in Hong Kong: Association With Barriers, Attitudes, Training, and Practice Background. J Interpers Violence 2021; 36:9623-9647. [PMID: 31423927 DOI: 10.1177/0886260519869067] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
While primary care physicians (PCPs) have opportunities to recognize patients who encounter domestic violence (DV) by intimate partners, warning symptoms such as unexplained physical injury, bruising, anxiety, and depression are often missed during clinic visits. This study investigated the barriers of Hong Kong PCPs toward managing DV, including recognition, management, and referrals of these patients. Four focus group interviews were conducted to explore the in-depth opinions of PCPs on managing DV in Hong Kong. The themes identified were investigated in a questionnaire survey with data from 504 PCPs working in public and private sectors. Factor analysis of the survey data suggested four major barrier factors: (a) worries about the potential harms of intervening in patients' domestic affairs and DV issues, (b) lack of guidelines and support services, (c) limited skills and time in managing DV, and (d) patients' reluctance in disclosing DV issues. PCPs with more years of practice had more worries about intervening in domestic issues (Factor 1), while the younger PCPs tended to perceive limited skills and time in managing DV cases as barriers (Factor 3). PCPs working in the public setting were more likely to ask patients about DV (M = 5.4 vs. 2.9), suspected DV (M = 3.8 vs. 2.3), and managed DV (M = 1.7 vs. 1.0) in the past 5 years compared with the private PCPs. Some PCPs in the focus groups expressed the view that DV cases should be handled by social workers instead of doctors. Survey respondents who held such views about doctors' limited role in DV management also scored higher in all of the barrier factors. The findings suggest that there are boundaries between domestic and medical realms, especially in a Chinese context. Resolving PCPs' worries by training, provision of DV management guidelines, and referral pathway to social workers may be good starting points to bridge the gaps.
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Affiliation(s)
| | | | | | | | | | | | | | - Dan Wu
- The University of Hong Kong, China
- London School of Hygiene & Tropical Medicine, UK
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5
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Sun KS, Lam TP, Tang WS, Chan HY, Lam KF, Chow ECY, Wu D, Zhou XD, Xu JY, Ho PL. Improving Public Toilet Environment and Hygiene Practices in an Asian City: Voices From Hong Kong Residents. Asia Pac J Public Health 2021; 33:378-387. [PMID: 33593075 DOI: 10.1177/1010539521993685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Toilet hygiene is an important preventive measure for infectious diseases, including severe acute respiratory syndrome (SARS) and COVID-19. This study explored public's opinions on improving toilet environment and hygiene practices in Hong Kong. A mixed-method approach was applied. We conducted 4 focus groups plus 3 individual interviews among the Hong Kong Chinese, followed by a questionnaire survey with 300 respondents recruited from various districts. Difference in response distributions between groups with different demographics was tested by Pearson χ2 test. Instead of advocating for advanced toilet facilities, respondents were mostly concerned about basic hygiene issues. Malfunctioning facilities resulting from poor toilet management, such as clogged toilets, stained facilities, and problematic flushing systems, were most cited as barriers to toilet hygiene practices. Three quarters of the survey respondents expressed concerns over worn and poorly maintained toilets, shortage of janitors, and cleansing supplies. However, respondents who were older (P < .001), less educated (P < .001), and had lower income (P = .001) were significantly more likely to find hygiene conditions in public toilets satisfactory. The findings reflected the substandard of the current provisions as a developed city in Asia. Enhanced efforts by the government to maintain basic toilet supplies and facilities is the key to improving public compliance to toilet hygiene practices.
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Affiliation(s)
| | | | | | | | - Kwok Fai Lam
- The University of Hong Kong, Hong Kong, China.,Duke-NUS Medical School, Singapore
| | | | - Dan Wu
- The University of Hong Kong, Hong Kong, China.,London School of Hygiene and Tropical Medicine, London, UK
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Leow SN, Tang WS, Pararajasingam RP, Ee WS. Patient perception of pre-pregnancy care and family planning among reproductive-age female diabetes mellitus patients in a primary care clinic in Penang, Malaysia. Malays Fam Physician 2020; 15:35-42. [PMID: 33329861 PMCID: PMC7735880] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Pre-pregnancy care (PPC) is an important part of diabetic care among females in the reproductive age group, as it improves feto-maternal outcomes. OBJECTIVE We aimed to assess female diabetic patients' perception of PPC and family planning prior to PPC care. METHODS This was an observational, cross-sectional survey performed from June 2019 to September 2019, using universal sampling of registered female diabetic patients who fit the inclusion criteria prior to integrated PPC care. A self-administered questionnaire was used to assess patients' perception of PPC. RESULTS A total of 67 patients were recruited for the study. Only 39.4% (n=26) of the patients had heard of PPC. In our study, Code 1 contraception included those methods with a Pearl index of ≤9. Code 2 & 3 contraception included those methods with a Pearl index of >9. Only one-third of patients, 29.9% (n=20), were using Code 1 contraception, although the majority, 79.1% (n=53), felt that they had completed their family. 45 patients (68.2%) felt that they were at risk of developing complications if they were to become pregnant, and 46 patients (69.7%) felt that their health condition was not suitable for another pregnancy. However, only 31.1% (n=14) and 34.8% (n=16) of these patients were using Code 1 contraception, respectively. There were 30 patients (65.2%) who perceived that their health was not suitable for another pregnancy but were only using Code 2 or 3 contraception. CONCLUSION The patients' perception of PPC was poor. Patients had an inadequate knowledge of the effectiveness of their current contraceptive practice in relation to their intentions for further pregnancy and their self-perceived risk in case of future conception. We suggest that integration of PPC into routine follow-ups for other high-risk medical diseases, such as hypertension, heart disease, and epilepsy, be considered in future practice.
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Affiliation(s)
- S N Leow
- MD (MMA), Doctor of Family Medicine (UKM), Jalan Perak Health Clinic, Ministry of Health Malaysia, Jelutong, Pulau Pinang, Malaysia,
| | - W S Tang
- MBBS (UM), M.Med (Fam. Med) (UM), Jalan Perak Health Clinic, Ministry of Health Malaysia, Jelutong, Pulau Pinang, Malaysia
| | - R P Pararajasingam
- M. Med. (Fam. Med.), MD Jalan Perak Health Clinic, Ministry of Health Malaysia, Jelutong, Pulau Pinang, Malaysia
| | - W S Ee
- MD (UKM), Jalan Perak Health Clinic, Ministry of Health Malaysia, Jelutong, Pulau Pinang, Malaysia
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7
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Leow SN, Tang WS. Angina after anaphylaxis treatment. Malays Fam Physician 2019; 14:65-67. [PMID: 32175043 PMCID: PMC7067500] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Anaphylaxis is a life-threatening emergency, and adrenaline is the mainstay treatment for this condition. However, there have been a few reported cases of patients experiencing cardiovascular complications, such as myocardial infarction and coronary vasospasm, after its use. We highlight such a case in a young, healthy patient and the important differentials to consider.
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Affiliation(s)
- S N Leow
- MD (I.M Sechenov MMA), Doctor of Family Medicine (UKM) Jalan Perak Health Clinic, Jalan Perak, 11600 Penang Malaysia
| | - W S Tang
- MBBS (UM), MMed (Family Medicine) UM Jalan Perak Health Clinic, Jalan Perak, 11600 Penang Malaysia
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Tao R, Qu Z, Sun DF, Deng YM, Mo Y, Chen J, Zhang Y, Xie X, Tang WS, Liu WD. [Interpretation of clinical practice guideline for anorectal day surgery 2019 edition]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:1118-1123. [PMID: 31874526 DOI: 10.3760/cma.j.issn.1671-0274.2019.12.005] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
As the rapid development of minimally invasive techniques, anesthesia, and enhanced recovery after surgery (ERAS), anorectal day surgery receiving more and more attention by improving efficiency of medical care while reducing cost and hospitalized infection. However, day surgery also faces the challenge of completing the whole process from patient admission to discharge within 24 hours. Therefore, establishing a reasonable and detailed day surgery process is the cornerstone to guarantee safe medical practice and patients satisfaction. National Clinical Research Center for Geriatric Disorders (Xiangya), together with China Ambulatory Surgery Alliance formulates the clinical practice guideline for anorectal day surgery 2019 edition. Here we make some interpretations of the guidelines on the detailed process of anorectal day surgery, including indication, preoperative examination, preoperative risk evaluation, health education, assessment of day surgery anesthesia and before leaving postanesthesia care unit (PACU), postoperative management, assessment of discharge and follow-up, for the convenience of various medical centers.
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Affiliation(s)
- R Tao
- Day Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Changsha 410008, China
| | - Z Qu
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Changsha 410008, China
| | - D F Sun
- Department of Anesthesia, The First Affiliated Hospital, Dalian Medical University, Dalian 116011, China
| | - Y M Deng
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Changsha 410008, China
| | - Y Mo
- Day Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, China
| | - J Chen
- Day Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Changsha 410008, China
| | - Y Zhang
- Day Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Changsha 410008, China
| | - X Xie
- Day Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Changsha 410008, China
| | - W S Tang
- Day Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, China
| | - W D Liu
- Day Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, China; Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Changsha 410008, China
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9
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Liu Q, Cao J, Wang ZQ, Bai YS, Lü YM, Huang QL, Zhao WZ, Li J, Jiang LP, Tang WS, Fu BH, Fan FY. Dose estimation by chromosome aberration analysis and micronucleus assays in victims accidentally exposed to (60)Co radiation. Br J Radiol 2009; 82:1027-32. [PMID: 19366736 PMCID: PMC3473381 DOI: 10.1259/bjr/62484075] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Revised: 11/10/2008] [Accepted: 12/03/2008] [Indexed: 11/10/2022] Open
Abstract
The objective of this study was to assess the radiation exposure levels in victims of a (60)Co radiation accident using chromosome aberration analysis and the micronucleus assay. Peripheral blood samples were collected from three victims exposed to (60)Co 10 days after the accident and were used for the chromosome aberration and micronucleus assays. After in vitro culture of the lymphocytes, the frequencies of dicentric chromosomes and rings (dic+r) and the numbers of cytokinesis blocking micronuclei (CBMN) in the first mitotic division were determined and used to estimate radiation dosimetry. The Poisson distribution of the frequency of dic+r in lymphocytes was used to assess the uniformity of the exposure to (60)Co radiation. Based on the frequency of dic+r in lymphocytes, estimates of radiation exposure of the three victims were 5.61 Gy (A), 2.48 Gy (B) and 2.68 Gy (C). The values were estimated based on the frequencies of CBMN, which were 5.45 Gy (A), 2.78 Gy (B) and 2.84 Gy (C). The estimated radiation dosimetry demonstrated a critical role in estimating the radiation dose and facilitating an accurate clinical diagnosis. Furthermore, the frequencies of dir+r in victims A and B deviated significantly from a normal Poisson distribution. Chromosome aberration analysis offers a reliable means for estimating biological exposure to radiation. In the present study, the micronucleus assay demonstrated a high correlation with the chromosome aberration analysis in determining the radiation dosimetry 10 days after radiation exposure.
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Affiliation(s)
- Q Liu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, First Clinical Department of Medical Emergency Response Centre for Nuclear Accident, Ministry of Health, Tianjin, China
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10
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Abstract
This paper presents two neural network approaches to real-time joint torque optimization for kinematically redundant manipulators. Two recurrent neural networks are proposed for determining the minimum driving joint torques of redundant manipulators for the eases without and with taking the joint torque limits into consideration, respectively. The first neural network is called the Lagrangian network and the second one is called the primal-dual network. In both neural-network-based computation schemes, while the desired accelerations of the end-effector for a specific task are given to the neural networks as their inputs, the signals of the minimum driving joint torques are generated as their outputs to drive the manipulator arm. Both proposed recurrent neural networks are shown to be capable of generating minimum stable driving joint torques. In addition, the driving joint torques computed by the primal-dual network are shown never exceeding the joint torque limits.
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Affiliation(s)
- W S Tang
- Dept. of Mech. & Autom. Eng., Chinese Univ. of Hong Kong, Shatin
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Abstract
Many physicians are unaware of the power of the internet. In an era of an empowered public and patients, the internet may be a more powerful determinant of health-seeking behaviour than medical opinion. In the same way, it may provide more information for self-harm than was ever available to the public domain in the past. The internet is effective across cultural and geographical boundaries. In addition to reporting and romanticising suicide, it has a significant impact in assisting and promoting suicide. It provides services and information ranging from general information to online orders of prescription drugs or other poisons that bypass government regulations and custom controls. This bridges the gaps of locality and accessibility, which previously formed a natural divide in selecting the means of suicide. In addition to these negative effects, there is a vast potential to harness these properties to a beneficial effect. The wide acceptance of the internet makes it a powerful tool for recognition of the at-risk individual, for preventing suicide and supporting survivors, with chat rooms taking the place of telephone help lines. In an information age, it is vital for physicians to use all available means of informing and empowering the public and patients. The internet also has a role in training, providing accessible self-help sites for suicidal persons and web-based prevention services, all of which remain sadly under-utilised. The challenge to physicians of the 21st century is to harvest the internet in a beneficial manner.
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Affiliation(s)
- J Tam
- Sherwood Forest Hospitals NHS Trust, Sutton in Ashfield, Nottinghamshire, NG17 4JL, UK
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Abstract
A discrete-time recurrent neural network which is called the discrete-time Lagrangian network is proposed in this letter for solving convex quadratic programs. It is developed based on the classical Lagrange optimization method and solves quadratic programs without using any penalty parameter. The condition for the neural network to globally converge to the optimal solution of the quadratic program is given. Simulation results are presented to illustrate its performance.
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Tang WS. Urbanisation in China: a review of its causal mechanisms and spatial relations. Prog Plann 1997; 48:1-65. [PMID: 12321411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This article reviews "the forces underpinning Chinese urbanization.... This paper is divided into two main parts. The first addresses the (non-spatial) causal mechanisms between 1949 and 1977. Neither the ideological, the class, nor the economic formulation has touched on the more systemic mechanisms related to the socialist state and the shortage economy. This paper attempts to redress the imbalance by examining the advantages of combining Kornai's shortage model with Foucault's concept of governmentality. By drawing on concepts of spatial contingency, spatial boundary and locality effects, the second part of the paper argues that spatial relations do play significant roles in revealing Chinese urbanisation policies and patterns."
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Chen MJ, Chen DC, Ma S, Tang WS, Chen YF, Xie XL. [Antibiotic-associated colitis and Clostridium difficile]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 1985; 7:316-8. [PMID: 2939996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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