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  1. Article ; Online: Relationship between Serial Serum Neutrophil-Lymphocyte Ratio, Cardiovascular Mortality, and All-Cause Mortality in Chinese Peritoneal Dialysis Patients.

    Lau, Lik Fung Sam / Ng, Jack K C / Fung, Winston W S / Chan, Gordon C K / Cheng, Phyllis Mei-Shan / Chow, Kai Ming / Leung, Chi Bon / Li, Philip Kam-To / Szeto, Cheuk Chun

    Kidney & blood pressure research

    2023  Volume 48, Issue 1, Page(s) 414–423

    Abstract: Introduction: It is believed that the excessive cardiovascular (CV) burden of patients on peritoneal dialysis (PD) is closely associated with chronic inflammation. Neutrophil-lymphocyte ratio (NLR) is an inflammatory marker that was shown to correlate ... ...

    Abstract Introduction: It is believed that the excessive cardiovascular (CV) burden of patients on peritoneal dialysis (PD) is closely associated with chronic inflammation. Neutrophil-lymphocyte ratio (NLR) is an inflammatory marker that was shown to correlate with CV outcomes. However, little is known about the significance of serial monitoring of serum NLR. We aimed to determine the prognostic value of serial NLR on all-cause mortality and CV mortality in PD patients.
    Methods: Serial measurement of NLR was obtained from 225 incident PD patients in a single center, with each measurement 1 year apart. Patients were divided into two groups ("high" vs. "low") by the median value of NLR. The primary and secondary outcome measure was all-cause and CV mortality, respectively.
    Results: After a median of follow-up for 43.9 months, patients with lower baseline NLR demonstrated a higher survival rate (p = 0.01). Patients with persistently high NLR values on serial measurement had the lowest survival rate (p = 0.03). Multivariate Cox regression showed that this group of patients had significantly higher all-cause mortality (HR: 1.74, 95% CI: 1.09-2.79, p = 0.02). However, the NLR failed to demonstrate a statistically significant relationship with CV mortality.
    Conclusions: While baseline NLR was an independent predictor of all-cause mortality in PD patients, persistent elevation in NLR appeared to further amplify the risk. Regular monitoring of serial serum NLR may enable early identification of patients who are at risk of adverse outcome.
    MeSH term(s) Humans ; Neutrophils ; Lymphocyte Count ; Biomarkers ; Lymphocytes ; Peritoneal Dialysis ; Prognosis ; Cardiovascular Diseases ; China ; Retrospective Studies
    Chemical Substances Biomarkers
    Language English
    Publishing date 2023-04-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1326018-2
    ISSN 1423-0143 ; 1420-4096
    ISSN (online) 1423-0143
    ISSN 1420-4096
    DOI 10.1159/000530554
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Expression of Concern: Mechanisms underlying p53 regulation of

    Astanehe, Arezoo / Arenillas, David / Wasserman, Wyeth W / Leung, Peter C K / Dunn, Sandra E / Davies, Barry R / Mills, Gordon B / Auersperg, Nelly

    Journal of cell science

    2020  Volume 133, Issue 17

    Language English
    Publishing date 2020-09-11
    Publishing country England
    Document type Journal Article ; Expression of Concern
    ZDB-ID 2993-2
    ISSN 1477-9137 ; 0021-9533
    ISSN (online) 1477-9137
    ISSN 0021-9533
    DOI 10.1242/jcs.253260
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Machine learning-based dispatch of drone-delivered defibrillators for out-of-hospital cardiac arrest.

    Chu, Jamal / Leung, K H Benjamin / Snobelen, Paul / Nevils, Gordon / Drennan, Ian R / Cheskes, Sheldon / Chan, Timothy C Y

    Resuscitation

    2021  Volume 162, Page(s) 120–127

    Abstract: Background: Drone-delivered defibrillators have the potential to significantly reduce response time for out-of-hospital cardiac arrest (OHCA). However, optimal policies for the dispatch of such drones are not yet known. We sought to develop dispatch ... ...

    Abstract Background: Drone-delivered defibrillators have the potential to significantly reduce response time for out-of-hospital cardiac arrest (OHCA). However, optimal policies for the dispatch of such drones are not yet known. We sought to develop dispatch rules for a network of defibrillator-carrying drones.
    Methods: We identified all suspected OHCAs in Peel Region, Ontario, Canada from Jan. 2015 to Dec. 2019. We developed drone dispatch rules based on the difference between a predicted ambulance response time to a calculated drone response time for each OHCA. Ambulance response times were predicted using linear regression and neural network models, while drone response times were calculated using drone specifications from recent pilot studies and the literature. We evaluated the dispatch rules based on response time performance and dispatch decisions, comparing them to two baseline policies of never dispatching and always dispatching drones.
    Results: A total of 3573 suspected OHCAs were included in the study with median and mean historical ambulance response times of 5.8 and 6.2 min. All machine learning-based dispatch rules significantly reduced the median response time to 3.9 min and mean response time to 4.1-4.2 min (all P < 0.001) and were non-inferior to universally dispatching drones (all P < 0.001) while reducing the number of drone flights by up to 30%. Dispatch rules with more drone flights achieved higher sensitivity but lower specificity and accuracy.
    Conclusion: Machine learning-based dispatch rules for drone-delivered defibrillators can achieve similar response time reductions as universal drone dispatch while substantially reducing the number of trips.
    MeSH term(s) Cardiopulmonary Resuscitation ; Defibrillators ; Emergency Medical Services ; Humans ; Machine Learning ; Ontario ; Out-of-Hospital Cardiac Arrest/therapy
    Language English
    Publishing date 2021-02-22
    Publishing country Ireland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2021.02.028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Sex Differences in Association Between Gut Microbiome and Essential Hypertension Based on Ambulatory Blood Pressure Monitoring.

    Virwani, Preeti Dinesh / Qian, Gordon / Hsu, Matthew S S / Pijarnvanit, Tommy K K T S / Cheung, Carman Nga-Man / Chow, Yick Hin / Tang, Lok Kan / Tse, Yiu-Hei / Xian, Jia-Wen / Lam, Shirley Sau-Wing / Lee, Crystal P I / Lo, Chelsea C W / Liu, Roxanna K C / Ho, Tsi Lok / Chow, Bak Yue / Leung, Kin Sum / Tsang, Hing Wai / Lo, Emily K K / Tung, Keith T S /
    Chung, Sookja Kim / Yuen, Man-Fung / Leung, Suet Yi / Ip, Patrick / Hung, Ivan Fan-Ngai / Louie, Jimmy Chun Yu / El-Nezami, Hani / Ho, Joshua Wing Kei / Lau, Kui Kai

    Hypertension (Dallas, Tex. : 1979)

    2023  Volume 80, Issue 6, Page(s) 1331–1342

    Abstract: Background: Sex differences in the pathogenesis of hypertension exist. While gut microbiota (GM) has been associated with hypertension, it is unclear whether there are sex-linked differences in the association between GM and hypertension.: Methods: ... ...

    Abstract Background: Sex differences in the pathogenesis of hypertension exist. While gut microbiota (GM) has been associated with hypertension, it is unclear whether there are sex-linked differences in the association between GM and hypertension.
    Methods: We conducted a cross-sectional study to investigate the sex differences in associations between GM characterized by shotgun sequencing, GM-derived short-chain fatty acids, and 24-hour ambulatory blood pressure in 241 Hong Kong Chinese (113 men and 128 women; mean age, 54±6 years).
    Results: The hypertensive group was associated with GM alterations; however, significant differences in β-diversity and GM composition in hypertensive versus normotensive groups were only observed in women and not in men under various statistical models adjusting for the following covariates: age, sex, body mass index, sodium intake estimated by spot urine analysis, blood glucose, triglycerides, low- and high-density lipoprotein cholesterol, smoking, menopause, and fatty liver status. Specifically,
    Conclusions: GM dysregulation was strongly associated with 24-hour ambulatory blood pressure in women but not men, which may be mediated through propionic acid. Our work suggests that sex differences may be an important consideration while assessing the role of GM in the development and treatment of hypertension.
    MeSH term(s) Humans ; Male ; Female ; Middle Aged ; Blood Pressure Monitoring, Ambulatory ; Propionates ; Gastrointestinal Microbiome ; Sex Characteristics ; Cross-Sectional Studies ; Hypertension/diagnosis ; Hypertension/epidemiology ; Blood Pressure/physiology ; Essential Hypertension
    Chemical Substances Propionates
    Language English
    Publishing date 2023-04-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 423736-5
    ISSN 1524-4563 ; 0194-911X ; 0362-4323
    ISSN (online) 1524-4563
    ISSN 0194-911X ; 0362-4323
    DOI 10.1161/HYPERTENSIONAHA.122.20752
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Multiple genetic paths including massive gene amplification allow

    Wang, Lin / Asare, Emmanuel / Shetty, Amol C / Sanchez-Tumbaco, Freddy / Edwards, Megan R / Saranathan, Rajagopalan / Weinrick, Brian / Xu, Jiayong / Chen, Bing / Bénard, Angèle / Dougan, Gordon / Leung, Daisy W / Amarasinghe, Gaya K / Chan, John / Basler, Christopher F / Jacobs, William R / Tufariello, JoAnn M

    Proceedings of the National Academy of Sciences of the United States of America

    2022  Volume 119, Issue 8

    Abstract: Mycobacterium ... ...

    Abstract Mycobacterium tuberculosis
    MeSH term(s) Animals ; Bacterial Secretion Systems/genetics ; Biological Evolution ; Evolution, Molecular ; Gene Amplification/genetics ; Mice ; Mycobacterium tuberculosis/genetics ; Mycobacterium tuberculosis/metabolism ; Type VII Secretion Systems/genetics ; Type VII Secretion Systems/physiology ; Virulence ; Virulence Factors/genetics
    Chemical Substances Bacterial Secretion Systems ; Type VII Secretion Systems ; Virulence Factors
    Language English
    Publishing date 2022-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 209104-5
    ISSN 1091-6490 ; 0027-8424
    ISSN (online) 1091-6490
    ISSN 0027-8424
    DOI 10.1073/pnas.2112608119
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Impact of postoperative haemoglobin on length of stay post fractured hip repair in patients with standardised perioperative management.

    Choi, Siu-Wai / Leung, Frankie K L / Lau, Tak-Wing / Wong, Gordon T C

    Hip international : the journal of clinical and experimental research on hip pathology and therapy

    2018  Volume 29, Issue 2, Page(s) 172–176

    Abstract: Introduction:: Perioperative blood transfusion is not without risk and effort should be made to limit patients' exposure to allogeneic blood. However, there is conflicting data regarding the impact of anaemia on postoperative recovery in patients with ... ...

    Abstract Introduction:: Perioperative blood transfusion is not without risk and effort should be made to limit patients' exposure to allogeneic blood. However, there is conflicting data regarding the impact of anaemia on postoperative recovery in patients with repaired hip fractures. It is hypothesised that for a given baseline functional status and fracture type, lower postoperative haemoglobin will increase rehabilitation time and prolong total length of hospital stay.
    Methods:: This is a retrospective study on data collected prospectively on patients entered into the Clinical Pathway aged >65 years admitted to Queen Mary Hospital (QMH) with a fractured neck of femur during 2011-2013. Potential predictor variables were analysed with linear regression with respect to total length of stay and those that reached a significance level of 0.05 were included in further analysis.
    Results:: 1092 patients were admitted to QMH with a suspected fractured neck of femur; data from 747 patients were analysed. The fracture sites were neck of femur (50%), intertrochanteric (48%) and subtrochanteric fracture (2%). Approximately 30% of patients received blood transfusions. Of these only the development of postoperative medical complications statistically prolonged hospital stay. No relationship was seen with haemoglobin levels cut-off above and below 10 g/dl with the result remaining non-significant down to a cut-off of above and below 8 g/dl.
    Discussion:: This study revealed that post-surgical haemoglobin level of between 8 g/dl and 10 g/dL did not have an impact on the total length of hospital stay. The development of postoperative medical complications was the only factor that prolonged the total length of stay.
    MeSH term(s) Aged ; Aged, 80 and over ; Anemia/complications ; Anemia/diagnosis ; Blood Transfusion ; Female ; Hemoglobins/metabolism ; Hip Fractures/blood ; Hip Fractures/surgery ; Humans ; Length of Stay ; Male ; Postoperative Complications/blood ; Postoperative Complications/etiology ; Retrospective Studies
    Chemical Substances Hemoglobins
    Language English
    Publishing date 2018-05-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1162513-2
    ISSN 1724-6067 ; 1120-7000
    ISSN (online) 1724-6067
    ISSN 1120-7000
    DOI 10.1177/1120700018773428
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  7. Article ; Online: Patient appropriateness for total knee arthroplasty and predicted probability of a good outcome

    Gillian A Hawker / Eric Bohm / James Stewart / Deborah A Marshall / Raj Sharma / Jason Werle / Peter Faris / Linda J Woodhouse / Bheeshma Ravi / Paul Duffy / Shannon Puloski / Kelly Johnston / Greg Abelseth / Raul Kuchinad / Tom Noseworthy / John Donaghy / C Allyson Jones / James Powell / Ian Stanaitis /
    Michael J Dunbar / Gillian A. Hawker / Deborah A. Marshall / Michael J. Dunbar / C. Allyson Jones / Linda J. Woodhouse / Gordon Arnett / Robert Balyk / Jeffery Bury / John Cinats / Donald Dick / D'Arcy Durand / Lee Ekert / Robert Glasgow / Don Glasgow / Gordon Goplen / Catherine Hui / Ben Herman / Larry Hunka / Hongxing Jiang / William C. Johnson / Frank Kortbeek / Guy Lavoie / Mitch Lavoie / Paul K. Leung / James Mahood / Edward Masson / Richard McLeod / James McMillan / Greg O’Connor / David Otto / Carlo Panaro / Paulose Paul / Gordon Russell / Colleen Weeks / Don Weber / Andrea Woo / Jane Squire Howden / Anne-Marie Adachi / Jessica Beatty / Shakib Rahman / Kelley De Souza / Robert Korley / Michael Monument / Maureen O'Brien / Ed Rendall / Alex Rezansoff / Scott Timmerman / Tanya Reczek / Jeffrey Depew / Bukky Dada

    RMD Open, Vol 9, Iss

    2023  Volume 2

    Abstract: Objectives One-fifth of total knee arthroplasty (TKA) recipients experience a suboptimal outcome. Incorporation of patients’ preferences in TKA assessment may improve outcomes. We determined the discriminant ability of preoperative measures of TKA need, ... ...

    Abstract Objectives One-fifth of total knee arthroplasty (TKA) recipients experience a suboptimal outcome. Incorporation of patients’ preferences in TKA assessment may improve outcomes. We determined the discriminant ability of preoperative measures of TKA need, readiness/willingness and expectations for a good TKA outcome.Methods In patients with knee osteoarthritis (OA) undergoing primary TKA, we preoperatively assessed TKA need (Western Ontario-McMaster Universities OA Index (WOMAC) Pain Score and Knee injury and Osteoarthritis Outcome Score (KOOS) function, arthritis coping), health status, readiness (Patient Acceptable Symptom State, depressive symptoms), willingness (definitely yes—yes/no) and expectations (outcomes deemed ‘very important’). A good outcome was defined as symptom improvement (met Outcome Measures in Rheumatology and Osteoarthritis Research Society International (OMERACT–OARSI) responder criteria) and satisfaction with results 1 year post TKA. Using logistic regression, we assessed independent outcome predictors, model discrimination (area under the receiver operating characteristic curve, AUC) and the predicted probability of a good outcome for different need, readiness/willingness and expectations scenarios.Results Of 1,053 TKA recipients (mean age 66.9 years (SD 8.8); 58.6% women), 78.1% achieved a good outcome. With TKA need alone (WOMAC pain subscale, KOOS physical function short-form), model discrimination was good (AUC 0.67, 95% CI 0.63 to 0.71). Inclusion of readiness/willingness, depressive symptoms and expectations regarding kneeling, stair climbing, well-being and performing recreational activities improved discrimination (p=0.01; optimism corrected AUC 0.70, 0.66–0.74). The predicted probability of a good outcome ranged from 44.4% (33.9–55.5) to 92.4% (88.4–95.1) depending on level of TKA need, readiness/willingness, depressive symptoms and surgical expectations.Conclusions Although external validation is required, our findings suggest that incorporation of patients’ TKA readiness, ...
    Keywords Medicine ; R
    Subject code 170
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas.

    Loong, Herbert Ho-Fung / Wong, Carlos King Ho / Wei, Yihui / Kwan, Sampson Sui Chun / Zhang, Yingjun / Tse, Teresa / Lau, Yat-Ming / Leung, Linda K S / Tang, Gordon C H

    ESMO open

    2020  Volume 5, Issue 6, Page(s) e001035

    Abstract: Background: The prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas.: Methods: A ... ...

    Abstract Background: The prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas.
    Methods: A population-based database was assembled to extract patients with sarcoma in Hong Kong between January 2004 and March 2018. Charlson's Comorbidity Index (CCI) score and prevalence of comorbidities, neutrophil, lymphocyte and platelet counts at diagnosis were assessed. The prognostic values of CCI, neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) were estimated using Cox proportional hazard models. Restricted cubic spline plots were used to explore the association of baseline NLR and PLR with all-cause and cancer-specific mortality.
    Results: Among 3358 eligible patients with sarcomas, 52.2% died after a median 26 months of follow-up. The most common comorbidities were diabetes mellitus (9.8%) and cerebrovascular disease (4.8%). Patients with higher CCI had higher mortality (CCI=3 vs CCI=2; HR 1.49; 95% CI 1.19 to 1.87; p<0.01; CCI ≥7 vs CCI =2; HR 3.20; 95% CI 2.62 to 3.92; p<0.001). Abnormal NLR and PLR levels were associated with higher all-cause mortality (NLR: HR 1.698, p<0.001, 95% CI 1.424 to 2.025; PLR: HR 1.346, p<0.001, 95% CI 1.164 to 1.555) and cancer-related mortality (NLR: HR 1.648, p<0.001, 95% CI 1.341 to 2.024; PLR: HR 1.430, p<0.001, 95% CI 1.205 to 1.697).
    Conclusions: This is the largest population-based soft-tissue or bone sarcoma cohort worldwide. Comorbidities have significant negative prognostic impact on the survival of patients with sarcomas. Moreover, NLR and PLR are robust prognostic factors, and abnormal NLR and PLR have negative effects yet non-linear effects on survival.
    MeSH term(s) Comorbidity ; Humans ; Lymphocytes ; Prevalence ; Prognosis ; Sarcoma/diagnosis ; Sarcoma/epidemiology
    Language English
    Publishing date 2020-11-19
    Publishing country England
    Document type Journal Article
    ISSN 2059-7029
    ISSN (online) 2059-7029
    DOI 10.1136/esmoopen-2020-001035
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  9. Article ; Online: A significant inflation in TGM6 genetic risk casts doubt in its causation in spinocerebellar ataxia type 35.

    Fung, Jasmine L F / Tsang, Mandy H Y / Leung, Gordon K C / Yeung, Kit San / Mak, Christopher C Y / Fung, Cheuk Wing / Chan, Sophelia H S / Yu, Mullin H C / Chung, Brian H Y

    Parkinsonism & related disorders

    2019  Volume 63, Page(s) 42–45

    Abstract: Spinocerebellar ataxia 35 (SCA35) has been associated with pathogenic mutations in the gene TGM6. In a Chinese exome sequencing cohort, we identified 8 families with reported TGM6 variants sharing no features of SCA35. Considering this finding, we ... ...

    Abstract Spinocerebellar ataxia 35 (SCA35) has been associated with pathogenic mutations in the gene TGM6. In a Chinese exome sequencing cohort, we identified 8 families with reported TGM6 variants sharing no features of SCA35. Considering this finding, we reviewed the public database gnomAD and found these variants to be significantly more common in the East Asians than in other ethnic groups (P < 0.0001). Gene constraint metrics showed that both missense and loss-of-function variants in TGM6 are likely to be tolerated and there is no regional constraint. By performing inflation analysis, it demonstrated that the cumulative frequency of TGM6 reported pathogenic variants is at least 111-fold inflated over disease prevalence of all autosomal dominant SCAs, indicating a high chance of misdiagnosis or low penetrance. Misclassification of benign or low penetrant variants as pathogenic is a significant problem that often results in genetic misdiagnosis. This highlights the necessity of evaluating variant pathogenicity with sequencing of genomes from diverse populations, both from asymptomatic controls and phenotypically different patients, in order to ensure accurate classification of variants.
    MeSH term(s) Adolescent ; Adult ; Asian Continental Ancestry Group/genetics ; Child ; Child, Preschool ; Female ; Genetic Predisposition to Disease/genetics ; Humans ; Infant ; Infant, Newborn ; Male ; Mutation ; Pedigree ; Spinocerebellar Ataxias/genetics ; Transglutaminases/genetics ; Young Adult
    Chemical Substances Transglutaminases (EC 2.3.2.13)
    Language English
    Publishing date 2019-01-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2019.01.013
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  10. Article ; Online: Uncovering the Devaluation of Nursing Home Staff During COVID-19

    McGilton, K / Escrig-Pinol, A / Gordon, A / Chu, CH / Zúñiga, F / Sanchez, MG / Boscart, V / Meyer, J / Corazzini, KN / Jacinto, AF / Spilsbury, K / Backman, A / Scales, K / Fagertun, A / Wu, B / Edvardsson, D / Lepore, MJ / Leung, AYM / Siegel, EO /
    Noguchi-Watanabe, M / Wang, J / Bowers, B

    Are We Fuelling the Next Health Care Crisis?

    2020  

    Keywords covid19
    Publishing date 2020-06-11
    Publisher Elsevier
    Publishing country uk
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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