The hand hygiene (HH) behaviour of the general public and its effect on illnesses are issues of growing importance. Gender is associated with HH behaviour. HH efficiency is a combination of washing ...efficiency and hand drying, but information about the knowledge level and HH behaviour of the general public is relatively limited. The findings of this cross-sectional study can substantially contribute to the understanding on the knowledge gap and public behaviour towards HH, thereby providing information on gender-specific health promotion activities and campaigns to improve HH compliance.
An epidemiological investigation by using a cross-sectional study design on the general public was conducted either via an online platform (SurveyMonkey) or paper-and-pen methods. The hand-washing and -drying questionnaire was used for data collection.
A total of 815 valid questionnaires were collected. Majority of the respondents can differentiate the diseases that can or cannot be transmitted with poor HH, but the HH knowledge of the respondents was relatively inadequate. The female respondents had a significantly better HH knowledge than male respondents. The multiple regression analysis results also indicated that females had a significantly higher knowledge score by 0.288 towards HH than males after adjusting for age and education level. Although the majority of the respondents indicated that they performed hand cleaning under different specific situations, they admitted only using water instead of washing their hands with soap. More males than females dried their hands on their own clothing, whereas more females dried their hands through air evaporation. The average time of using warm hand dryers was generally inadequate amongst the respondents.
Being a female, middle-aged and having tertiary education level are protective factors to improve HH knowledge. Misconceptions related to the concepts associated with HH were noted amongst the public. Self-reported practice on hand drying methods indicated that additional education was needed. The findings of this study can provide information on gender-specific health promotion activities and creative campaigns to achieve sustained improvement in HH practices.
Objectives
To study the change in brown and white adipose tissue (BAT and WAT), as well as fat content in the liver and pancreas, in patients with morbid obesity before and after bariatric surgery.
...Methods
Twelve patients with morbid obesity (F=8, M=4, age: 45.4 years (38.4–51.2), BMI: 35.2 kg/m
2
(32.5–38.6)) underwent pre-op MRI at baseline and two post-op scans at 6-month and 12-month intervals after bariatric surgery. Co-registered water, fat, fat-fraction and T2* image series were acquired. Supraclavicular BAT and abdominal WAT were measured using in-house algorithms. Intrahepatic triglyceride (IHTG) was measured using MR spectroscopy and pancreatic fat was measured using a region-of-interest approach. Fat contents were compared between baseline and the first and second 6-month intervals using non-parametric analysis of Friedman’s test and Wilcoxon’s signed-rank test. Level of significance was selected at
p
=0.017 (0.05/3). Threshold of non-alcoholic fatty liver disease was set at 5.56%.
Results
Results indicated that BMI (
p
=0.005), IHTG (
p
=0.005), and subcutaneous (
p
=0.005) and visceral adipose tissues (
p
=0.005) were significantly reduced 6 months after surgery. Pancreatic fat (
p
=0.009) was significantly reduced at 12 months. Most reduction became stable between the 6-month and 12-month interval. No significant difference was observed in BAT volume, fat-fraction and T2* values.
Conclusion
The results of this study suggest that bariatric surgery effectively reduced weight, mainly as a result of the reduction of abdominal WAT. Liver and pancreatic fat were deceased below the threshold possibly due to the reduction of free fatty acid. BAT volume, fat-fraction and T2* showed no significant changes, probably because surgery itself might not have altered the metabolic profile of the patients.
Key Points
• No significant changes were observed in fat-fraction, T2* and volume of brown adipose tissue after bariatric surgery.
• Non-alcoholic fatty liver disease was resolved after surgery.
• Abdominal white fat and liver fat were significantly reduced 6 months after surgery and become stable between 6 and 12 months while pancreatic fat was significantly reduced between 0 and 12 months.
Over the past two decades, functional neuroimaging has not only grown into a large field of research, but also substantially evolved. Here we provide a quantitative assessment of these presumed in ...sample composition and data analysis, using fMRI studies on food/taste research published between 1998 and 2019 as an exemplary case in which the scientific objectives themselves have remained largely stable. A systematic search for papers written in English was done using multiple databases and identified 426 original articles that were subsequently analyzed. The median sample size significantly increased from 11.5 to 35.5 while the ratio of male to female subjects remained stable. There were, however, more papers involving female subjects only, rather than male subjects only, since 2003. There was a decline in uncorrected results and statistical correction by false‐discovery rate. Reflecting a trend toward more conservative thresholding, the number of foci reported per paper did not change significantly and sample size (power) did not correlate with the number of reported foci. The median journal impact factor and the normalized number of citations (citations per year) of the papers, in turn, showed a significantly decreasing trend. Number of citations negatively correlated to sample size, publication year but positively correlated to journal impact factor, and was also influenced by statistical correction method. There was a decreasing trend in studies recruiting both left‐handed and right‐handed subjects. In summary, the present paper quantifies several large‐scale trends that have often been anecdotally discussed and reveals the changing nature of neuroimaging studies that may be considered when pursuing meta‐analytic approaches.
The negative impact of lower urinary tract symptoms (LUTS) on affected males is substantial. This study aims to assess whether a combined auriculotherapy (AT) using laser AT (LAT) and magneto-AT ...(MAT) is more effective than using MAT alone or placebo for managing LUTS of aging males.Methods: A randomized controlled, double-blinded trial was conducted. Sixty-two aging males with moderate or severe LUTS symptoms were randomly allocated into groups: Group 1, placebo LAT plus placebo MAT (n = 20); Group 2, combined AT approach using LAT plus MAT (n = 20); and Group 3, placebo LAT followed by MAT (n = 22). Six ear acupoints assumed to be suitable for alleviating LUTS were used. The total treatment period was 4 weeks, with follow-up visits till 3 months. Generalized estimating equations model was used for the examination of the interactions among the groups over time.Results: A combined AT approach exhibited a stronger treatment effect in relieving voiding problems, improving the peak urinary flow rate, and reducing the post-void residual urine than the placebo group or MAT alone.Conclusions: This study demonstrates that the AT protocol used in this study for aging males with LUTS is feasible and can be adopted in future study of increased scale.
Many people use handwashing and hand-drying facilities in public washrooms under the impression that these amenities are hygienic. However, such facilities may be potential sites for the transmission ...of pathogenic bacteria. This study aimed to examine the hygiene facilities provided including handwashing and hand-drying facilities in public washrooms. Total bacterial counts and species identification were determined for hand-drying facilities. Antimicrobial susceptibilities were performed.
The bacterial contamination levels of 55 public washrooms ranging in category from low class communities to high end establishments, were examined. The hygienic environment and facilities of the washrooms were analysed using an electronic checklist to facilitate immediate data entry. Pre-moistened sterile swabs were used to collect samples from areas around the outlet of paper towel dispensers, air outlet of air dryers, exit door handles and paper towels in the washrooms. Total bacterial counts were performed and isolates identified using matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. Antimicrobial susceptibility was determined by disk diffusion.
The high and middle-income categories washrooms generally had cleaner facilities and environment followed by those in low categories. Fifty-two bacterial species were identified from the 55 investigated washrooms. Over 97% of the pathogenic
tested were resistant to at least one first-line antimicrobial therapeutic agent, including penicillin, cefoxitin, erythromycin, co-trimoxazole, clindamycin and gentamicin, and 22.6% demonstrated co-resistance to at least three antimicrobial agents, with co-resistance to penicillin, erythromycin and clindamycin being the most common.
Our findings suggest that hand-drying facilities in public washrooms can act as reservoirs of drug-resistant bacteria. The importance of frequent cleaning and maintenance of public washrooms to promote safe hand hygiene practices for the public are emphasised.
Research studies demonstrated pathologic lesions were unevenly distributed in patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis. As hepatic steatosis occurs ...prior to steatohepatitis and other late stage liver conditions, the distribution pattern of hepatic fat and iron concentration should be investigated to prevent sampling variability. The first purpose of this study was to perform comparison and validation of in-house hepatic fat measurements using water-fat MRI and MRS. The second objective was to quantify hepatic fat-fraction and T2* values in left and right liver lobes using water-fat MRI.
Fifty-four non-alcoholic adults (27 NAFLD, age: 42.8 ± 11.8), 27 non-NAFLD, age: 45.5 ± 11.2) and 46 non-alcoholic teenagers (23 NAFLD (age: 15.4 ± 2.6), 23 non-NAFLD (age: 13.9 ± 2.3) were recruited. All participants underwent chemical shift water-fat MRI and 1H MRS at 3 T. Hepatic steatosis was defined by intrahepatic triglyceride more than the threshold of 5.56% using MRS (clinical reference) and non-alcoholic was defined by alcohol ingestion of no more than 30 g and 20 g per day for male and female respectively. Hepatic fat-fractions in left and right liver lobes were measured using regions-of-interest (ROIs) approach. Three ROIs were drawn on the fat-fraction images and duplicated on to the co-registered T2* images at the inferior right, superior right and superior left liver lobes. Comparison and validation of water-fat MRI and MRS were performed using intraclass correlation coefficient (ICC) and Bland-Altman plot. Hepatic fat-fraction and T2* measured from the ROIs were compared using repeated measures ANOVA. Independent t-test was used for between groups analysis.
Statistical analysis indicated good correlation (R = 0.987) and agreement (ICC = 0.982) between MRS and water-fat MRI in hepatic fat measurements. Results indicated that hepatic fat was significantly higher in the right lobe compared to the left in NAFLD adults (p < 0.001) and NAFLD teenagers (p < 0.001). For T2*, significant difference between left and right lobes was observed in NAFLD adults (p < 0.001) and non-NAFLD adults (p < 0.001) but not in teenagers.
Hepatic fat measurements using MRS and water-fat MRI are statistically equivalent. In subjects with NAFLD regardless of their age, hepatic fat is stored preferentially in the right live lobe probably due to the streamline of blood flow to the right liver. T2* value is significantly higher in the right liver lobe in adults but not in the teenagers regardless of their hepatic fat contents probably due to the longer time span of hepatic iron accumulation.
To review the clinical outcome of locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by definitive surgery with or without adjuvant chemotherapy and to elucidate the ...prognostic factors for treatment outcome.
This historical cohort study was conducted at a tertiary public hospital in Hong Kong. All patients who had undergone neoadjuvant chemoradiation for locally advanced rectal cancer in our department from November 2005 to October 2014 were recruited. Local recurrence-free survival, distant metastasis-free survival, disease-free survival, and overall survival of patients were documented.
A total of 135 patients who had received neoadjuvant chemoradiation during the study period were reviewed. There were 130 patients who had completed neoadjuvant chemoradiation and surgery. The median follow-up time was 35.1 months. The 3- and 5-year local recurrence-free survival, distant metastasis-free survival, disease-free survival, as well as overall survival rates were 91.8% and 86.7%, 73.9% and 72.1%, 70.1% and 64.6%, as well as 86.5% and 68.4%, respectively. The rate of pathological complete response was 13.8%. The T and N downstaging rate was 49.2% and 63.1%, respectively. The rate of conversion from threatened circumferential resection margin to clearance of margin was 90.6%. Of the 42 cases that were initially deemed to require abdominal perineal resection, 15 (35.7%) were converted to sphincter-sparing surgery.
The treatment outcome of neoadjuvant chemoradiation for locally advanced rectal cancer was comparable with overseas data in terms of local control rate and overall survival. This strategy may increase the chance of achieving a clear surgical margin by downstaging the tumour, especially in patients who presented with threatened circumferential margin.
Background
We evaluated the role of chemoradiotherapy (CRT) for patients with inoperable squamous esophageal cancer.
Methods
Patients with locally advanced or metastatic squamous esophageal carcinoma ...who received CRT were recruited. The CRT consists of continuous infusion of 5-fluorouracil at 200 mg/m
2
/day, and cisplatin at 60 mg/m
2
on days 1 and 22, with concurrent radiotherapy for a total of 50 to 60 Gy in 25 to 30 fractions over 6 weeks. Efficacy was assessed by endoscopy and computed tomographic scan before and 8 weeks after completion of the treatment program. Median survival and the need for palliative esophageal stenting were compared with another group of patients who received endoscopic stenting.
Results
From 1996 to 2003, a total of 36 consecutive patients (33 male, mean ± SD age 63.2 ± 9.5 years) with T4 disease (81%) with or without cervical nodal metastasis (50%) received CRT, while 36 patients treated with endoscopic stenting alone were recruited as controls. Both groups were comparable in demographics, pretreatment dysphagia score, comorbidities, and tumor characteristics. CRT was completed in 32 patients (89%). There was no treatment-related mortality. Tumor volume was greatly reduced after CRT in 19 patients. Four patients (11%) received salvage esophagectomy 9 to 42 months after CRT. Compared with the stenting group, CRT statistically significantly improved 5-year survival (15% vs. 0%,
P
= .01), median survival (10.8 months vs. 4.0 months,
P
< .005), and need for stenting (22% vs. 100%,
P
= .005).
Conclusions
Palliative CRT can effectively improve the symptoms of dysphagia in patients with inoperable squamous esophageal carcinoma. It results in better survival compared with endoscopic stenting in these patients.
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