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Dedicated studies evaluating the impact of COVID-19 on outcomes of pancreatobiliary IgG4 related disease (IgG4-RD) patients are scarce. Whether COVID-19 infection or vaccination would trigger IgG4-RD exacerbation remains unknown.Pancreatobiliary IgG4-RD patients ≥ 18 years old with active follow-up since January 2020 from nine referral centers in Asia, Europe, and North America were included in this multicenter retrospective study. Outcome measures include incidence and severity of COVID-19 infection, IgG4-RD disease activity and treatment status, interruption of indicated IgG4-RD treatment. Prospective data on COVID-19 vaccination status and new COVID-19 infection during the Omicron outbreak were also retrieved in the Hong Kong cohort.Of the 124 pancreatobiliary IgG4-RD patients, 25.0% had active IgG4-RD, 71.0% were on immunosuppressive therapies and 80.6% had ≥ 1 risk factor for severe COVID. In 2020 (pre-vaccination period), two patients (1.6%) had COVID-19 infection (one requiring ICU admission), and 7.2% of patients had interruptions in indicated immunosuppressive treatment for IgG4-RD. Despite a high vaccination rate (85.0%), COVID-19 infection rate has increased to 20.0% during Omicron outbreak in the Hong Kong cohort. A trend towards higher COVID-19 infection rate was noted in the non-fully vaccinated/unvaccinated group (17.6% vs 33.3%, P = 0.376). No IgG4-RD exacerbation following COVID-19 vaccination or infection was observed.While a low COVID-19 infection rate with no mortality was observed in pancreatobiliary IgG4-RD patients in the pre-vaccination period of COVID-19, infection rate has increased during the Omicron outbreak despite a high vaccination rate. No IgG4-RD exacerbation after COVID-19 infection or vaccination was observed.

Bile duct stenosis continues to present a diagnostic dilemma for clinicians. It is important to establish the benign or malignant nature of the stricture early in order to avoid any unnecessary delay in medical treatment or surgery. Tissue acquisition for histological diagnosis is particularly crucial when the initial diagnostic work up is inconclusive. The diagnostic yield from the conventional endoscopic retrograde cholangiopancreatography (ERCP) with brushing and biopsy is suboptimal. Patients with indeterminate biliary strictures (IDBSs) often require a multi-disciplinary diagnostic approach and additional endoscopic evaluation, including cholangioscopy and endoscopic ultrasound, before a final diagnosis can be reached. In this article, we discuss the recent endoscopic advancements in the diagnosis of biliary stricture with a focus on the roles of cholangioscopy and endoscopic ultrasound (EUS).

Despite experienced hands and availability of various well-designed catheters and wires, selective bile duct cannulation may still fail in 10–20% of cases during endoscopic retrograde cholangiopancreatography (ERCP). In case standard ERCP cannulation technique fails, salvage options include advanced ERCP cannulation techniques such as double-guidewire technique (DGW) with or without pancreatic stenting and precut papillotomy, percutaneous biliary drainage (PBD), and endoscopic ultrasound-guided Rendezvous (EUS-RV) ERCP. If the pancreatic duct is inadvertently entered during cannulation attempts, DGW technique is a reasonable next step, which can be followed by pancreatic stenting to reduce risks of post-ERCP pancreatitis (PEP). Studies suggest that early precut papillotomy is not associated with a higher risk of PEP, while needle-knife fistulotomy is the preferred method. For patients with critical clinical condition who may not be fit for endoscopy, surgically altered anatomy in which endoscopic biliary drainage is not feasible, and non-communicating multisegmental biliary obstruction, PBD has a unique role to provide successful biliary drainage efficiently in this particular population. As endoscopic ultrasound (EUS)-guided biliary drainage techniques advance, EUS-RV ERCP has been increasingly employed to guide bile duct access and cannulation with satisfactory clinical outcomes and is especially valuable for benign pathology at centres where expertise is available. Endoscopists should become familiar with each technique’s advantages and limitations before deciding the most appropriate treatment that is tailored to patient’s anatomy and clinical needs.

The study aims to develop and pilot a telehealth social emotional program, MindChip™ delivered with a computer based interventions (CBI) (Mind Reading©) for autistic adults. MindChip™ combined four theoretical perspectives and community feedback underpinning the essential mechanisms for targeting the social emotional understanding of autistic adults. A randomised pragmatic pilot trial (N = 25) was conducted to explore the feasibility of MindChip™ (n = 11) and to understand the preliminary efficacy of combining it with CBI compared to CBI only (n = 14). The use of MindChip™ and CBI combined demonstrated partial feasibility, with preliminary efficacy findings revealing increased emotion recognition generalisation outcomes compared to CBI only. Further research is required to improve the engagement and personalisation of the intervention for autistic adults.

Anti-thrombotics use is a significant risk factor of post-polypectomy bleeding (PPB). Evidence of prophylactic clipping is only available for proximal and large colonic lesions in general population. Dedicated studies to examine the benefit of prophylactic clipping in patients on aspirin remain scarce.A propensity-score weighted retrospective cohort study was performed in a tertiary referral center from January 2018 to September 2021. Patients who received aspirin and underwent colonoscopic polypectomy, endoscopic mucosal resection or endoscopic submucosal dissection were included. Data on baseline demographics, medications and endoscopic factors (polyp number, size, location, morphology, resection method and prophylactic clipping) were captured. Propensity-score weighting models were developed between prophylactic clipping and no clipping groups. The primary outcome was delayed PPB within 30 days, with a composite endpoint consisting of repeated colonoscopy for hemostasis, requirement of blood transfusion or hemoglobin drop of greater than 2g/dL.Total 1,373 patients with 3,952 polyps were included. Baseline characteristics were balanced between two groups. In the multivariate analysis, the largest polyp size was a significant risk factor for PPB (odds ratio (OR) 1.07, 95%CI 1.02-1.11, p=0.002). Prophylactic clipping was not associated with a reduced risk of PPB (OR 1.34, 95%CI 0.83-2.18, p=0.240) and did not show any risk reduction in subgroups with different polyp sizes, locations and endoscopic resection techniques.Prophylactic clipping was not associated with a lower risk of PPB in aspirin users after endoscopic resection of colorectal polyps. Aspirin use should not be regarded as the only factor for the routine use of prophylactic clips.

Purpose of Review This paper reviews the latest literature regarding the impact of COVID on endoscopy service provision. Recent Findings Endoscopy has been shown to be largely safe when appropriate infection prevention and control measures are in place. Endoscopy training and education has been profoundly affected though novel training models to overcome this have been developed. Proper handling of delayed or cancelled procedures is of utmost importance to minimize delays in diagnosis and treatment of diseases such as cancer. Adoption of new technologies such as non-endoscopy alternatives and telehealth may be a viable alternative to minimize infection risks. Summary This pandemic has led to tangible differences in how we provide endoscopy service in the future. Future research focusing on better risk stratification of patients who need endoscopy, validating novel endoscopy training models, and adopting new technologies are urgently needed to support these changes in the post-pandemic world.

Adequate bowel preparation is an important colonoscopy quality indicator. Reinforced education is effective in improving bowel preparation quality of colonoscopy with mixed indications. However, it remains unclear whether such improvement can be consistently observed in pre- and post-irrigation during colonoscopy in screening population.We aimed to study the effectiveness of nurse-led reinforced education delivered via mobile messenger (WhatsApp Messenger) on pre- and post-irrigation bowel preparation adequacy in colonoscopies for positive fecal immunochemical test in a population-based colorectal cancer screening program.Randomized controlled trial.A hospital-based endoscopy centre in Hong Kong, China.Patients undergoing colonoscopy for positive fecal immunochemical test in a population-based colorectal cancer screening program.The recruited patients were randomized to receive either WhatsApp Reinforced Education (WRE) or No Reinforced Education (NRE) (1:1). Patients in WRE group received one-off reinforced education of bowel preparation in text and video formats via WhatsApp Messenger four days prior to colonoscopy sent by investigator while NRE group received standard-of-care only. Primary outcome was the bowel preparation adequacy rate as evaluated by Aronchick Scale. Secondary outcomes included bowel preparation adequacy rate as evaluated by Boston Bowel Preparation Scale, adenoma detection rate and risk factors of bowel preparation inadequacy. Continuous variables were described as means with standard deviation (SD) and analyzed with Student's t-test. The Pearson Chi Square Test or Fisher Exact Test was used to assess categorical variables when appropriate. Risk factors were determined by logistic regression.From July 2017 to April 2019, 685 eligible patients were randomized to WRE (n = 343) and NRE (n = 342) groups. Patients in WRE group had higher bowel preparation adequacy rate as evaluated by Aronchik Scale (83.4% vs 75.4%, p = 0.010) and Boston Bowel Preparation Scale (94.2% vs 88.9%, p = 0.013). Adenoma detection rate was higher in WRE group but without statistical significance (71.4% vs 67.5%, p = 0.27). In logistic regression, WhatsApp Reinforced Education reduced the inadequate bowel preparation risk (Adjusted odds ratio: 0.564; 95% confidence interval: 0.371-0.856, p = 0.007). Male gender (Adjusted odds ratio [AOR]: 1.638; 95% confidence interval [CI]: 1.054-2.546, p = 0.028) and diabetes (AOR: 2.062; 95% CI: 1.215-3.497, p = 0.007) were risk factors of bowel preparation inadequacy.Nurse-led mobile messenger-initiated reinforced education improves both pre- and post-irrigation bowel preparation quality of screening colonoscopy following positive fecal immunochemical test. It is readily incorporable in clinical practice because of its low setup cost.Registered on 4 July 2017 on https://clinicaltrials.gov/ (NCT03209739).

Classical CD8 T cells are implicated for protective and pathogenic roles in chronic hepatitis B (CHB) infection. Recently, a subset of CD8 T cells expressing C-X-C chemokine receptor type 5 (CXCR5) and exhibiting features of TWe characterized circulating CD8In conclusion, CD8

Understanding the underlying visual scanning patterns of individuals with autism spectrum disorder (ASD) during the processing of complex emotional scenes remains limited. This study compared the complex emotion recognition performance of adults with ASD (n = 23) and matched neurotypical participants (n = 25) using the Reading the Mind in Films Task. Behaviourally, both groups exhibited similar emotion recognition accuracy. Visual fixation time towards key social regions of each stimuli was examined via eye tracking. Individuals with ASD demonstrated significantly longer fixation time towards the non-social areas. No group differences were evident for the facial and body regions of all characters in the social scenes. The findings provide evidence of the heterogeneity associated with complex emotion processing in individuals with ASD.

The present study aimed to investigate the effect of diltiazem on cardiovascular risk and exercise tolerance in patients with stable coronary artery disease and hypertension. From 2016 to 2018, 80 patients with stable coronary artery disease (5Gensini score20) and hypertension were enrolled into the present study. These patients were randomly divided into two groups: diltiazem group (Dil, 90 mg, bid), and control group (angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB) for reducing blood pressure and β-receptor blockers for controlling heart rate). Liver and kidney function, heart rate variability (HRV), blood pressure variability (BPV) and bicycle exercise were measured at baseline and after six months. The incidence of cardiovascular events (re-hospitalization due to angina pectoris, acute myocardial infarction, and cardiogenic death) was also assessed. The differences in all indexes at baseline between these two groups were not statistically significant (P0.05, respectively). After six months of treatment, both groups of patients had significant improvements in HRV, BPV and exercise tolerance compared that before treatment (p0.05). The difference in the decrease in systolic blood pressure, improvement of HRV and BPV, and cardiovascular events between these two groups was not statistically significant (P = 0.588, 0.431, 0.152, 1.000, respectively). But the Dil group was significantly better than the control group in degree of heart rate decline, diastolic blood pressure decline, and improvement of ST segment depression (P0.001), and the improvement in exercise tolerance was also better than that of the control group. We found that diltiazem compared with ACEI/ARB and β-receptor blockers can further improve the exercise tolerance of patients with stable coronary artery disease and hypertension.

The study aims to develop and pilot a telehealth social emotional program, MindChip™ delivered with a computer based interventions (CBI) (Mind Reading

Naringenin is a flavonoid compound with antioxidant effects. It is used to treat oxidative stress-related diseases, but its mechanism is unclear. In this experiment, we explored whether naringenin can increase the expression of superoxide dismutase 1(SOD1), reduce the oxidative stress of PC12 cells induced by homocysteine (Hcy), and decrease the apoptosis of PC12 cells induced by Hcy by inhibiting the expression of mir-224-3p. Different concentrations of Hcy (1, 3, 5, 8, and 10 mmol/L) was used to analyze effect of homocysteine on PC12 cells. A total of 5 mmol/L Hcy was used to induce the excitatory and neurotoxicity model of PC12 cells in vitro. The cells were divided into normal control, Hcy induction, Hcy + Naringenin (25 μM), Hcy + Naringenin (50 μM), Hcy + Naringenin (75 μM), Hcy + Naringenin (100 μM), and Hcy + Naringenin (150 μM) groups. The relative survival rate and activities of the PC12 cells were determined by the MTT method, and the apoptosis rate of the PC12 cells was determined by using flow cytometry. The Western blot method was used to determine the expressions of SOD1, Bax, Caspase-3, Caspase-8, and Bcl-2 in the PC12 cells induced by Hcy. The expressions of SOD1 mRNA and miR-224-3p in the Hcy-induced PC12 cells were determined by RT-PCR. Results found that Hcy increased the expression of miR-224-3p in a dose-dependent manner but decreased that of SOD1 mRNA and protein. Hcy also increased oxidative stress in the PC12 cells and the proapoptotic proteins Bax, Caspase-3, and Caspase-9. Furthermore, it decreased the expression of anti-apoptotic protein Bcl-2 and the activity and survival rate of the HT22 cells, but it increased the apoptosis of the PC12 cells. The treatment of Hcy-induced PC12 cells with different concentrations of naringenin for 24 h decreased the expression of miR-224-3p in a dose-dependent manner and increased the expressions of SOD1 mRNA and protein. The treatment also decreased the oxidative stress in the PC12 cells and the expressions of pro-apoptotic proteins Bax, Caspase-3, and Caspase-9; increased the expression of anti-apoptotic protein Bcl- 2; decreased the apoptosis of the PC12 cells; and increased the PC12 cells.The results suggest that Naringenin can decrease the apoptosis and oxidative stress of PC12 cells induced by Hcy and increase the activities and survival rates of PC12 cells. The mechanism may be related to naringenin decreasing the expression of miR-224-3p in PC12 cells induced by Hcy and increasing the expressions of SOD1 mRNA and protein.

Since December 2019, the outbreak of COVID-19 in Wuhan has spread rapidly due to population movement during the Spring Festival holidays. Since January 23rd, 2020, the strategies of containment and contact tracing followed by quarantine and isolation has been implemented extensively in mainland China, and the rates of detection and confirmation have been continuously increased, which have effectively suppressed the rapid spread of the epidemic. In the early stage of the outbreak of COVID-19, it is of great practical significance to analyze the transmission risk of the epidemic and evaluate the effectiveness and timeliness of prevention and control strategies by using mathematical models and combining with a small amount of real-time updated multi-source data. On the basis of our previous research, we systematically introduce how to establish the transmission dynamic models in line with current Chinese prevention and control strategies step by step, according to the different epidemic stages and the improvement of the data. By summarized our modelling and assessing ideas, the model formulations vary from autonomous to non-autonomous dynamic systems, the risk assessment index changes from the basic regeneration number to the effective regeneration number, and the epidemic development and assessment evolve from the early SEIHR transmission model-based dynamics to the recent dynamics which are mainly associated with the variation of the isolated and suspected population sizes.自2019年12月以来，武汉暴发的COVID-19疫情由于春节人口流动快速蔓延，自2020年1月23日起全国大范围实施围堵缓疫策略，并不断提高检测和检出率，有效地抑制了疫情快速蔓延的趋势。在COVID-19爆发的早期，如何利用数学模型并结合少量和实时更新的多源数据，对疫情进行风险分析，评估防控策略的有效性和时效性等具有非常重要的现实意义。本研究将结合前期研究基础，系统介绍如何依据疫情发展的不同阶段和数据的完善，逐步建立符合我国防控策略的COVID-19传播动力学模型，给出模型由自治到非自治，风险评估指标由基本再生数到有效再生数，疫情发展与评估由早期的SEIHR传播动力学决定到最终取决于隔离人群和疑似人群规模的演变等的重要研究思路。.

Recent years have seen an emergence of social emotional computer games for individuals with Autism Spectrum Disorder (ASD). These games are heterogeneous in design with few underpinned by theoretically informed approaches to computer-based interventions. Guided by the serious game framework outlined by Whyte et al. (Journal of Autism and Developmental Disorders 45(12):1-12, 2014), this study aimed to identify the key motivating and learning features for serious games targeting emotion recognition skills from the perspectives of 11 youth with ASD and 11 experienced professionals. Results demonstrated that youth emphasised the motivating aspects of game design, while the professionals stressed embedding elements facilitating the generalisation of acquired skills. Both complementary and differing views provide suggestions for the application of serious game principles in a potential serious game.

Dune slacks are biodiverse seasonal wetlands which experience considerable fluctuations in water table depths. They are subject to multiple threats such as eutrophication and climate change, and the interactions of both of these pressures are poorly understood. In this study we measured the impact of groundwater nitrogen contamination, as ammonium nitrate (0, 0.2, 10 mg/L of DIN, dissolved inorganic nitrogen), lowered water table depth (lowered by 10 cm) and the interactions of these factors, in a mesocosm study. We measured gross nutrient budgets, evapotranspiration rates, the growth of individual species and plant tissue chemistry. This study found that nitrogen uptake within dune slack habitats is substantial. Atmospheric inputs of 23 kg N ha−1 yr.−1 were retained by the mesocosms, with no increase of nutrient levels in the groundwater, i.e. there was no leaching of excess N. When N was added to the groundwater (in addition to atmospheric N), total uptake was equivalent to 116 kg N ha−1 yr.−1, at a groundwater DIN concentration of 10 mg/L. This resulted in increased plant tissue N concentrations showing uptake by the vegetation. The effect of lowering water tables did not influence N uptake, but did alter vegetation composition. This suggests that groundwater can be a substantial input of N to these habitats and should be considered in combination with atmospheric inputs, when assessing potential ecosystem damage.

In this paper, we investigate the structure of out-of-plane magnetic field in the reconnection event observed by Magnetospheric Multiscale Mission at the magnetopause of the Earth magnetosphere on 2015 October 21. We find that the perturbation of out-of-plane magnetic field in this event is different from previous observations of the quadrupolar Hall magnetic field. The distinct out-of-plane magnetic field is interpreted as a part of the hexapolar Hall magnetic field obtained in a recent simulation of asymmetric reconnection with the guide field. This is significant evidence of the hexapolar Hall magnetic field in collisionless magnetic reconnection from the observations in the magnetosphere. High-resolution measurements of particle and field are used to provide a comprehensive description of the features of the hexapolar Hall magnetic field. The results from this study offer an insight into the Hall effect in collisionless magnetic reconnection.

Sub-micro α-Al2O3 polishing liquid is often used as the slurry in chemical mechanical polishing (CMP). At present, water is usually used as dispersion medium to disperse sub-micro α-Al2O3 powders, but the sub-micro α-Al2O3 powders easily subside in aqueous solution. In previous studies, researchers usually used single method to disperse superfine powders, however, the dispersion effect was non-ideal. In order to solve the difficult problem of sub-micro α-Al2O3 powders dispersed in water suspension, firstly, using physical method, the effects of milling time, ultrasonic time on the dispersion property of sub-micro α-Al2O3 powders in water suspension was studied by single factorial test. Then, using chemical method, the effects of dispersant type, dispersant concentration and pH value on the dispersion property of sub-micro α-Al2O3 powders in water suspension was studied by orthogonal test. Absorbance was used to evaluate the dispersion property of sub-micro α-Al2O3 powders. The results show that th...

Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones > 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy. Stone clearance rate and incidence of adverse events were determined. Results Seventeen patients (10 men, 7 women; median age 76 years) with a median biliary stone size of 2 cm underwent predominantly holmium:yttrium aluminum garnet laser lithotripsy, achieving a 94 % stone clearance rate over 1 median procedure. Lithotripsy was performed in 8 of 17 patients due to an impacted biliary stone. The remaining patients underwent lithotripsy due to prior failure of the basket mechanical lithotripter to capture or crush their stones. Post lithotripsy, 2 patients developed cholangitis and 1 patient with underlying COPD developed respiratory distress, all resolved with conservative management. There were no hemobilia, perforations, pancreatitis nor any deaths. Conclusion SpyGlass DS peroral cholangioscopy-guided laser lithotripsy is an efficient and safe modality for management of complicated biliary stones.

A series of lanthanum/beta-zeolite catalysts was prepared via hydrothermal ion exchange, and characterized by inductively coupled plasma–atomic emission spectroscopy, X-ray diffraction, Fourier-transform infrared spectroscopy, and ammonia temperature-programmed desorption. The lanthanum-doping effect on beta-zeolite catalysts was investigated through catalytic cracking of supercritical methylcyclohexane under the system pressure of 4.0 MPa and the mass flow rate of 1.0 g/s. For lanthanum/beta catalyst of the Cat-2 type, the gas yield of 28.3% and heat sink of 3.35 MJ·kg−1 could be achieved at the temperature of 700°C, much higher than those for the pure beta zeolite without lanthanum modification and for the thermal pyrolysis. Correspondingly, Cat-2 has a better performance on coking inhibition with the reduction of 56.2 and 29.5% at 700°C compared to beta zeolite and thermal cracking. Therefore, it was indicated that beta zeolite with the suitable lanthanum content, still maintaining its high activity ...

University educators anticipate better engagement with students through the adoption of the three-dimensional visualization made possible by immersive virtual reality (IVR). Materials can be captured in 360° video for viewing through smartphones bracketed in head-mounted displays (HMDs) with motion sensors. Alternatively, materials can be viewed on notebook computers and tablets to offer some degree of VR experience. The paper reports on the first two undergraduate courses that have adopted both VR and IVR modes for classroom learning: ‘Pharmacology and Therapeutics’ and ‘Understanding Ecotourism’. The 360° videos have undergone a complete cycle of design, development, implementation and evaluation. These video captures can transcend physical boundaries in both clinical cases simulating a hospital ward and natural countryside landmarks. With VR and IVR embedded in the classroom, students expressed greater learning satisfaction while experiencing more opportunities to rehearse professional skills and explore historical artefacts with deeper cultural understanding.

Predicting stock price is a challenging problem as the market involve multi-agent activities with constantly changing environment. We propose a method of constrained evolutionary (CE) scheme that based on Genetic Algorithm (GA) and Artificial Neural Network (ANN) for stock price prediction. Stock market continuously subject to influences from government policy, investor activity, cooperation activity and many other hidden factors. Due to dynamic and non-linear nature of the market, individual stock price movement are usually hard to predict. Investment strategies used by regular investor usually require constant modification, remain secrecy and sometimes abandoned. One reason for such behavior is due to dynamic structure of the efficient market, where all revealed information will reflect upon the stock price, leads to dynamic behavior of the market and unprofitability of the static strategies. The CE scheme contains mechanisms which are temporal and environmental sensitive that triggers evolutionary changes of the model to create a dynamic response towards external factors.

Objective: While local bias in visual processing in children with autism spectrum disorders (ASD) has been reported to result in difficulties in recognizing faces and facially expressed emotions, but superior ability in disembedding figures, associations between these abilities within a group of children with and without ASD have not been explored. Methods: Possible associations in performance on the Visual Perception Skills Figure–Ground test, a face recognition test and an emotion recognition test were investigated within 25 8–12-years-old children with high-functioning autism/Asperger syndrome, and in comparison to 33 typically developing children. Results: Analyses indicated a weak positive correlation between accuracy in Figure–Ground recognition and emotion recognition. No other correlation estimates were significant. Conclusion: These findings challenge both the enhanced perceptual function hypothesis and the weak central coherence hypothesis, and accentuate the importance of further scrutinizing the existance and nature of local visual bias in ASD.

Background and aim Adopting the elements of the Serious Game framework has been hypothesised as a strategy to promote the efficacy of social emotional computer-based interventions (CBI) for autistic individuals. This systematic review aimed to review the application of Serious Game principles in current social emotional CBI targeting autistic individuals and evaluate the effect of these principles in remediating social emotional outcomes via meta-analysis. Methods Database searches identified 34 studies evaluating social emotional CBI with 17 controlled efficacy studies included in meta-regressions analyses. Narrative synthesis summarised the attributes of each CBI based on the five Serious Game principles; motivating storyline, goal directed learning, rewards and feedback, increasing levels of difficulty and individualisation. Results Based on the scores of the Serious Game assessment tool we developed, findings revealed on average a limited (45%) integration of Serious Game design principles in social emotional CBI for autistic individuals. Main findings from the meta-regressions of 17 controlled efficacy studies revealed a moderating effect of Serious Game design principles on the distant generalisation of social emotional skills and transferability of outcomes among autistic individuals. No significant moderating effects of Serious Game was found for close generalisation and maintenance outcomes. Conclusion Overall, findings suggest that the Serious Game design framework has utility in guiding the development of social emotional CBI which improve the social emotional skills of autistic individuals.

Background: Atypical visual perception in individuals with Autism Spectrum Disorders (ASD) may contribute to superiority in disembedding tasks. Gaze behavior has provided some insights in to mechan ...

Целью работы стало изучение взаимодействия белка E2 вируса папилломы человека (HPV16) и белка, ассоциированного с доменом смерти (Daxx). Локализацию и колокализацию белка промиелоцитарного лейкоза (PML) и E2 с Daxx в клетках Caski наблюдали с помощью метода непрямой иммунофлуоресценции. Взаимодействие E2 с Daxx анализировали методами коиммунопреципитации и вестерн-блотинга, а также в дрожжевой двугибридной системе. Флуоресцентные сигналы от Daxx и PML главным образом оказались соответственно в цитоплазме и в ядре клеток Caski. На совмещенном снимке по-прежнему были видны оба типа сигнала. В то же время при совмещении красного сигнала от E2 и зеленого сигнала от Daxx они отображаются как желтый в цитоплазме клеток Caski. Дрожжи, трансформированные одновременно плазмидами pGBKT7/Daxx и pGADT7/E2 либо pGADT7/E2 TAD, могут расти на средах SD/-Trp-Leu-His и SD/-Trp-Leu-His-Ade. Таким образом, в клетках Caski белок Daxx не локализуется совместно с PML, но колокализуется с E2 HPV16 – в основном в цитоплазме. Также показано, что E2 HPV16 и его домен активации транскрипции (TAD) могут взаимодействовать с Daxx.

Aims To estimate recent secular changes in the incidence and prevalence of diabetes and pre-diabetes among Hong Kong Chinese adults, and thus show possible future trends for developing mainland China. Methods Based on a complete census of the public sector health records of 6.4 million people from 2006 to 2014, diabetes cases were ascertained using different methods including the World Health Organization (WHO) 2011 guidelines (HbA1c, fasting plasma glucose and glucose tolerance test), American Diabetes Association (ADA) 2015 guidelines (plus random plasma glucose), and additionally recorded diagnosis codes and medication dispensation. Pre-diabetes was defined using ADA 2015 guidelines. Results We identified 697 201 people with diabetes (54.2% were incident cases); and 1 229 731 people with diabetes or pre-diabetes. In 2014, the overall incidence of diabetes was 9.46 per 1000 person-years [95% confidence interval (CI): 9.38 to 9.54], and overall prevalence was 10.29% (95% CI: 10.27% to 10.32%). Incidence decreased significantly from 2007 to 2014 (quadratic trend, P

Accuracy of a novel fluoroscopy-based method of assessing patellar tracking was determined by comparing the pattern of patellar motion with respect to orientation (flexion, internal rotation, and lateral tilt) and translation (lateral, proximal, and anterior) with the pattern of patellar motion measured using Roentgen Stereophotogrammetric Analysis (RSA) in one cadaver knee specimen. Each pose in the patellar motion could be obtained from a single as well as multiple calibrated fluoroscopic images. The mean error (SD) varies from 0.73 (0.44) to 1.60 (0.48) degrees for patellar orientation and from 0.48 (0.37) to 1.20 (0.57) mm for patellar translation. These errors appear to be sufficiently low to identify clinically significant differences in patellar kinematics. © Springer-Verlag Berlin Heidelberg 2003.

Colorectal cancer (CRC) incidence is rising among50-year olds. The objective of this study was to determine screening colonoscopy outcomes among 40- to 49-year olds, which are currently limited.Asymptomatic 40- to 49-year olds underwent one time CRC screening colonoscopy at The Chinese University of Hong Kong between 2007 and 2011. Screening outcomes, including prevalence, distribution, and predictive factors for overall and specifically proximal colorectal neoplasia were determined.Among 1133 ethnic Chinese, colorectal neoplasia prevalence was 20.5%. In men, distal adenomas were associated with proximal colorectal neoplasia. Men, advancing age, a first degree relative (FDR) with CRC, and diabetes mellitus were independently associated with colorectal neoplasia. A colorectal neoplasia was three times more likely to be found in a 45- to 49-year-old man with FDR of CRC compared with a 40- to 44-year-old woman without a FDR of CRC. The numbers needed to screen one colorectal neoplasia, and one advanced neoplasm in the highest risk group of 45- to 49-year-old men with FDR with CRC were 2.8 (95% CI: 2.2-4.4) and 18.5 (95% CI: 8.9-39.2), respectively.Colorectal neoplasia prevalence in this 40- to 49-year-old Chinese cohort was higher than previous studies. Men, advancing age, FDR with CRC, and diabetes mellitus, can be used to risk stratify for neoplasia development. Men 45-49 years old with FDR with CRC represented the highest risk subgroup, with the lowest number needed to screen.

A validated ultra-high-performance liquid chromatographic (UHPLC) method was used to determine the phenazepam dosage in clandestinely produced Erimin 5 tablets. Tablets from five different seizures submitted to the laboratory in 2013 were found to have a dosage of about 2.4 milligrams. The measurement uncertainty of the assay was estimated to be 3.2 % (relative) at a coverage factor of k=2. As an adjunct study the dyes in the tablets from several seizures were determined by thin-layer chromatography (TLC) for future comparative studies.

The aims to investigate the different protective effects of valsartan and benazepril when combined with atorvastatin in the cardio-renal functions of cardio-renal syndrome (CRS) patients.A total of 200 early CRS patients were enrolled in the present study, including 104 males and 96 females, with an average age of 62.2 ± 7.7 years. The same group of patients were set as the control group prior to treatment, and then randomly divided into two groups; the A group was treated with valsartan (80 mg/d) and atorvastatin (20 mg/d); the B group was treated with benazepril (10 mg/d) and atorvastatin (20 mg/d). The treatment period was 24 months.The clinical efficacy and clinical events were observed and the following parameters of each patient were measured before and after treatment: 24h urine protein; creatinine clearance; serum brain natriuretic peptide (BNP); high sensitivity C-reactive protein (hsCRP); blood lipid level; liver function and ejection fraction (EF) value. Compared with the control group, the clinical symptoms of the treatment groups were improved with decreased blood lipid levels, significantly decreased serum BNP and hsCRP levels and significantly increased EF values and creatinine clearance rates (p0.01). The differences between the two treatment groups were not statistically significant. The number of patients that stopped treatment due to the development of a cough was significantly higher in the B group than the A group (p0.01).When combined with atorvastatin, both valsartan and benazepril effectively improved the cardio-renal functions of early CRS patients. There was no significant difference between the two treatments however, valsartan appeared to be better tolerated by patients.

The aim of the study was to explore the interactions of human papilloma virus 16 (HPV16) E2 protein and Daxx. The location or co-localization of PML and E2 with Daxx in Caski cells was observed by indirect immunofluorescence test. The interaction of E2 and Daxx was analyzed by co-immunoprecipitation, Western-blot and yeast-two hybrid assay. In Caski cells the fluorescence of Daxx or PML was mainly distributed in the cytoplasm or nucleus, respectively, and in the align image their signals did not overlapped. However, when the red signal of HPV16 E2 and the green signal of Daxx in cyto- plasm of Caski cells were merged, the yellow signals appeared. The yeast co-transformed with pGBKT7/Daxx and pGADT7/E2 or pGADT7/E2 TAD can grow onto SD/-Trp-Leu-His and SD/-Trp-Leu-His-Ade plates. So Daxx wasn't co-located with PML but with HPV16 E2 mainly in the cytoplasm of Caski cells. On the base of the results one can propose that HPV16 E2, in particularly its transcription-activity domain (TAD), interacts with Daxx.

With increasing urbanization, urban‐fragmented landscapes are becoming more and more prevalent worldwide. Such fragmentation may lead to small, isolated populations that face great threats from genetic factors that affect even avian species with high dispersal propensities. Yet few studies have investigated the population genetics of species living within urban‐fragmented landscapes in the Old World tropics, in spite of the high levels of deforestation and fragmentation within this region. We investigated the evolutionary history and population genetics of the olive‐winged bulbul (Pycnonotus plumosus) in Singapore, a highly urbanized island which retains

To study the protective effects of valsartan (Val) and benazepril, (Ben) combined with atorvastatin (Ato), on cardiorenal syndrome (CRS) in rats.After establishing cardiorenal syndrome model, the rats were randomly divided into control, Ato, Ben+Ato and Val+Ato groups, which were treated with corresponding drugs. Before and 4 weeks after treatment, the serum creatinine (Scr), blood urea nitrogen (BUN), type-B natriuretic peptide (BNP), aldosterone (ALD), angiotensin (Ang) II, C-reactive protein (CRP), blood lipid and urine protein were determined. The left ventricular systolic pressure (LVSP), left ventricular diastolic pressure (LVDP), left ventricular end-diastolic pressure (LVEDP) as well as maximum rising and falling rates of left ventricular pressure (±dp/dtmax) were detected. The heart weight index was also determined.6, 3, 1 and 2 rats control, Ato, Ben+Ato and Val+Ato groups died, respectively. Compared with control group, the serum Cr, BUN, BNP, ALD, CRP and urinary protein levels in treatment groups significantly decreased, and the blood lipid level, LVDP, LVEDP and heart weight index significantly decreased, with increased LVSP. No statistically significant difference was observed among treatment groups.Valsartan and benazepril, combined with atorvastatin, can have significant protective effects on cardiorenal functions of rats with CRS, with no significant difference between these two drugs.

Background : The ability to distinguish between infarct and haemorrhage is essential to the management of acute cerebrovascular disease. In hospitals where emergency neuroimaging is not available, the use of stroke scores has been proposed to distinguish ischaemic from haemorrhagic stroke. Aims : To determine the accuracy of the Siriraj Stroke Score in distinguishing ischaemic from haemorrhagic stroke in a cohort of Chinese patients. Methods: We prospectively assessed and calculated the Siriraj stroke Score from 253 patients with acute stroke. The sensitivity, specificity, positive and negative predictive values of this score were determined. Results : For cerebral haemorrhage, the sensitivity and specificity were both 90% or above, but the positive predictive value was not greater than 70%. For cerebral infarct, the sensitivity and specificity were around 80%, while the positive predictive value exceeded 90%. Analysis by plotting receiver operating characteristic curves failed to find other cut-off points that would improve the performance of the Siriraj Stroke Score. Conclusions: Considering the inconsistent results from this study and previous studies of the Siriraj Stroke Score, we suggest that scoring systems that only require a small number of variables are unlikely to achieve the level of accuracy needed for clinical decision-making. (Intern Med J 2002; 32: 311−314)

This study examined sexual practices among the female population in Hong Kong. A total of 2,076 women between 18 and 50 years were interviewed by using a computerized telephone survey method. Sexually active women (59.3%) were classified into the "Husband Only Group" (HOG, n = 1,005), the "Steady Boyfriend Only Group" (SBG, n = 192), and the "Higher Risk Group" (HRG, n = 35). Over 60% of the HRG members did not perceive condom use as an efficacious means for HIV/AIDS prevention. Within the HOG and SBG, 30.0% and 41.1% reported that they always used condoms (25.7% in the HRG). Condom use was often suggested by both men and women of the SBG, but was often initiated by the women only in the HRG. "Trust" and "lack of necessity" were common reasons for not using condoms. About 85% of the respondents would ask their partners to use condoms if they suspected their partners having engaged in commercial sex; however, only 75% would have the final control. The HRG members seemed to be less able to insist on using condoms (55.6%, OR = 0.41, p < .05) and were more likely than the HOG to perceive some chance of contracting HIV (OR = 10.88, p < .01). The prevalence of high risk behaviors among women in Hong Kong was not high; however, those at risk were often inconsistent condom users and they had weak control over condom use. Women in Hong Kong had low awareness of HIV-related risk.

In the coordinate measuring machine (CMM) measurement environment, uncertainty can arise from various sources. Previous literature has focused on how to measure uncertainty in a CMM system using segregated approaches. We developed a framework to verify bias and variance tendencies deriving from form errors. Two types of form tolerances, namely flatness and circularity, are addressed here. By studying the nature of the CMM measurement uncertainty impact, this paper targets three objectives: (1) developing a design of experiments (DOE)-based measurement performance approach to integrate critical measurement strategy factors; (2) optimizing identified controllable measurement factors; and (3) synthesizing the impact of CMM uncertainty issues. Consequently, the paper fully explores the influence and interplay of these contributing factors, resulting in robust and optimal guidelines for the CMM flatness and circularity measurement strategy. Extensions of the framework for other form tolerances are discussed.

The objectives of this study were to use Artificial Neural Network (ANN) to predict colour change, shrinkage and texture of osmotically dehydrated pumpkin slices. The effects of process variables such as concentration of osmotic solution, immersion temperature and immersion time on the above mentioned physical properties were studied. The colour of the samples was measured using a colorimeter and the net colour difference changes, ΔE were determined. The texture was measured in terms of hardness by using a Texture Analyzer. As for the shrinkage, displacement of volume method was applied and percentage of shrinkage was obtained in terms of volume changes. A feed-forward backpropagation network with sigmoidal function was developed and best network configuration was chosen based on the highest correlation coefficients between the experimental values versus predicted values. As a comparison, Response Surface Methodology (RSM) statistical analysis was also employed. The performances of both RSM and ANN modelling were evaluated based on absolute average deviation (AAD), correlation of determination (R2) and root mean square error (RMSE). The results showed that ANN has higher prediction capability as compared to RSM. The relative importance of the variables on the physical properties were also determined by using connection weight approach in ANN. It was found that solution concentration showed the highest influence on all three physical properties.

Management of patients on antithrombotic therapy undergoing endoscopic procedures can be challenging. Although guidelines from major gastrointestinal endoscopy societies provide useful recommendations in this regard, data are limited concerning the bleeding risk of new complex endoscopic procedures and the management of novel anticoagulants in patients needing invasive procedures. The approach to the management of antithrombotic therapy often needs to be formulated on an individual basis, especially in patients with high thrombotic risk undergoing a high-risk endoscopic procedure. In addition to the procedure-related bleeding risk, endoscopists also need to consider the urgency of the endoscopic procedure, the thromboembolic risk of the patient if antithrombotic therapy is temporarily withheld, and the timing of discontinuation/resumption of antithrombotic therapy in the decision-making process. Diagnostic endoscopic procedures with or without biopsy can often be done without interruption of antithrombotic therapy. If possible, elective procedures with high bleeding risk should be delayed in patients on antithrombotic therapy for conditions with high thrombotic risk. If high-risk procedures cannot be delayed in these patients, thienopyridines, traditional and novel anticoagulants are usually withheld, whereas aspirin withdrawal is decided on a case by case basis. In patients with high thrombotic risk, communication with the prescribing clinician before proceeding to procedures with high bleeding risk is particularly important in optimizing the peri-procedural management plan of antithrombotic therapy.