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Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

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Asian Journal of Andrology 2024年第1期26卷 20-24页

作者： John Shung-Lai Leung Wai-Kit Ma Brian Sze-Ho Ho Stacia Tsun-Tsun Chun Rong Na Yongle Zhan Chi-Yuen Ng Chi-Ho Ip Ada Tsui-Lin Ng Yiu-Chung Lam Division of Urology Department of SurgeryQueen Mary HospitalUniversity of Hong KongHong KongChina Division of Urology Department of SurgeryPrincess Margaret HospitalHongKongChina

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance *** with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers(queen Mary Hospital and Princess margaret Hospital,Hong Kong,China)between January 2017 and June 2022 were ***-magnetic resonance imaging fusion biopsies were performed after prostate health index *** who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were *** of the 747 patients,47.3%had Prostate Imaging Reporting and Data System score 3 lesions *** detection rate of clinically significant prostate cancer in this group was 15.0%.The cancer detection rates of clinically significant prostate cancer had statistically significant differences:5.3%in prostate health index<25.0,7.4%in prostate health index 25.0-34.9,17.9%in prostate health index 35.0-54.9,and 52.6%in prostate health index≥55.0(P<0.01).Among the patients,26.9%could have avoided a biopsy with a prostate health index<25.0,at the expense of a 5.3%risk of missing clinically significant prostate *** health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 *** could be avoided in patients with low prostate health index,with a small risk of missing clinically significant prostate cancer.

关键词： biopsy fusion biopsy magnetic resonance imaging prostate cancer prostate health index

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Functional enhancement of whey protein concentrate and egg by partial denaturation and co-processing

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Food Bioscience 2022年第5期49卷 473-483页

作者： J.Lonchamp P.S.Clegg S.R.Euston School of Health Sciences Queen Margaret UniversityQueen Margaret University DriveEdinburghEH216UUUnited Kingdom School of Physics&Astronomy The University of EdinburghPeter Guthrie Tait RoadEdinburghEH93FDUnited Kingdom Institute of Biological Chemistry Biophysics and BioengineeringSchool of Engineering and Physical SciencesHeriot-Watt UniversityEdinburghEH144ASUnited Kingdom

This study investigated functional enhancement strategies for whole egg(WE),egg yolk(EY)and whey protein concentrate(WPC)with a view to reducing their required concentrations in formulations and the resulting environmental *** and EY underwent a combined phospholipase PLA2 and controlled heat treatment(WE2 and EY2)while WPC was partially-denatured via controlled heating(pdWPC).WE2 and EY2 samples were mixed with pdWPC and were also control-heated(h)with ***2-WPC(h)foams proved more stable than their untreated ***2,EY2 and EY2-pdWPC showed higher emulsifying properties than their untreated ***,EY2 and EY2-WPC(h)hydrogels proved more viscoelastic than their untreated ***2 and EY2-WPC(h)displayed an additional 45 kDa protein band,which could correspond to surface-active apoproteins released from *** work highlighted the potential to enhance WE,EY and WPC functionality via combined partial denaturation treatments and via synergy between WPC and WE or EY when co-processed.

关键词： Egg WPC Denaturation Synergy Functionality

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(How)does RBF strengthen strategic purchasing of health care?Comparing the experience of Uganda,Zimbabwe and the Democratic Republic of the Congo

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Global Health Research and Policy 2019年第1期4卷 374-393页

作者： Sophie Witter Maria Paola Bertone Justine Namakula Pamela Chandiwana Yotamu Chirwa Aloysius Ssennyonjo Freddie Ssengooba queen margaret university EdinburghUK School of Public Health Makerere UniversityKampalaUganda Biomedical Research and training Institute HarareZimbabwe

Background:Results-Based Financing(RBF)has proliferated in health sectors of low and middle income countries,especially fragile and conflict-affected ones,and has been presented as a way of reforming and strengthening strategic ***,few studies have empirically examined how RBF impacts on health care purchasing in these *** article examines the effects of several RBF programmes on health care purchasing functions in three fragile and post-conflict settings:Uganda,Zimbabwe and the Democratic Republic of Congo(DRC)over the past ***:The article is based on a documentary review,including 110 documents from 2004 to 2018,and 98 key informant(KI)interviews conducted with international,national and district level stakeholders in early 2018 in the selected districts of the three *** and analysis followed an adapted framework for strategic purchasing,which was also used to compare across the case ***:Across the cases,at the government level,we find little change to the accountability of purchasers,but RBF does mobilise additional resources to support *** relation to the population,RBF appears to bring in improvements in specifying and informing about entitlements for some ***,the engagement and consultation with the population on their needs was found to be *** relation to providers,RBF did not impact in any major way on provider accreditation and selection,or on treatment ***,it did introduce a more contractual relationship for some providers and bring about(at least partial)improvements in provider payment systems,data quality,increased financial autonomy for primary providers and enforcing equitable *** generally,RBF has been a source of much-needed revenue at primary care level in under-funded health *** context-particularly the degree of stability and authority of government-,the design of the RBF programme and the potential for effective int

关键词： Results-based financing Performance-based financing Strategic purchasing Mother and child health care Uganda DRC Zimbabwe

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Delivering reproductive health services through non-state providers in Pakistan:understanding the value for money of different approaches

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Global Health Research and Policy 2018年第1期3卷 25-34页

作者： Adrian Gheorghe Rashid Uz Zaman Molly Scott Sophie Witter Oxford Policy Management Level 3 Clarendon House52 Cornmarket StOxford OX13HJUK Institute for Global Health and Development Queen Margaret UniversityEdinburghUK

Background:Delivering Reproductive Health Results(DRHR)programme used social franchising(SF)and social marketing(SM)approaches to increase the supply of high quality family planning services in underserved areas of *** assessed the costs,cost-efficiency and cost-effectiveness of DRHR to understand the value for money of these ***:Financial and economic programme costs were *** to individual users were captured in a pre-post *** cost per couple years of protection(CYP)and cost per new user were estimated as indicators of cost *** the cost-effectiveness analysis we estimated the cost per clinical outcome averted and the cost per disability-adjusted life year(DALY)***:Approximately£20 million were spent through the DRHR programme between July 2012 and September 2015 on commodities and services representing nearly four million *** on programme data,the cumulative cost-efficiency of the entire DRHR programme was£4.8 per *** activities would avert one DALY at the cost of£*** access indicators generally improved in programme areas,but the magnitude of progress varies across ***:The SF and SM approaches adopted in DRHR appear to be cost effective relative to comparable reproductive health *** paper adds to the limited evidence on the cost-effectiveness of different models of reproductive health care provision in low-and middle-income *** studies are needed to nuance the understanding of the determinants of impact and value for money of SF and SM.

关键词： Reproductive health Social franchising(SF) Social marketing(SM) Value for money Pakistan Non-state providers

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An unusual presentation of sclerosing mesenteritis as pneumoperitoneum: Case report with a review of the literature

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World Journal of Gastroenterology 2009年第1期15卷 117-120页

作者： Sumita Chawla Satheesh Yalamarthi Irshad A Shaikh Veena Tagore Paul Skaife Department of Colorectal Surgery University Hospital AintreeLiverpool L9 7AL United Kingdom Department of Colorectal Surgery Queen Margaret HospitalDunfermline KY12 0SU United Kingdom Department of Pathology University Hospital AintreeLiverpool L9 7AL United Kingdom

Sclerosing mesenteritis is a rare condition that involves the small or large bowel mesentery. An unusual presentation of this condition, which led to difficult preoperative assessment and diagnosis, is described. This... 详细信息

关键词： Mesenteritis Panniculitis Small bowelobstruction Mesentery

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Topical negative pressure in managing severe peritonitis: A positive contribution?

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World Journal of Gastroenterology 2009年第27期15卷 3394-3397页

作者： Amin Ibrahim Amin Irshad A Shaikh Consultant surgeon Queen Margaret hospitalDunfermline Scotland KY12 0SU United Kingdom Specialist Registrar Royal Infirmary of EdinburghLittle France Edinburgh Scotland EH16 4SAUnited Kingdom

AIM： To assess the use of topical negative pressure （TNP） in the management of severe peritonitis. METHODS： This is a four-year prospective analysis from January 2005 to December 2008 of 20 patients requiring TNP following laparotomy for severe peritonitis. RESULTS： There were 11 males with an average age of （59.3 ± 3.95） years. Nine had a perforated viscus, five had anastomotic leaks, three had iatrogenic bowel injury, and a further three had severe pelvic inflammatory disease. TNP and the VAC Abdominal Dressing System were initially used. These were changed every two to three days. Abdominal closure was achieved in 15/20 patients within 4.53 ± 1.64 d. One patient required relaparotomy due to residual sepsis. Two patients with severe faecal peritonitis due to perforated diverticular disease received primary anastomosis at second look laparotomy, as sepsis and their general condition improved. In the remaining 5/20 cases, the abdomen was lee open due to bowel oedema and or abdominal wall oedema. Dressing was switched to TNP and VAC GranuFoam . Three of the five patients returned a few months later for abdominal wall reconstruction and restoration of intestinal continuity. Two patients developed intestinal fistulae. All 20 patients survived.CONCLUSION： The use of TNP is safe. Further studies are needed to assess its value in managing these difficult cases.

关键词： Severe peritonitis Open abdomen Topicalnegative pressure VAC Abdominal Dressing System VAC GranuFoam

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Fatigue and Quality of Life of Women Undergoing Chemotherapy or Radiotherapy for Breast Cancer

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Clinical oncology and cancer researeh 2009年第3期6卷 179-185页

作者： Winnie K.W.So Gene Marsh W.M.Ling F.Y.Leung Joe C.K.Lo Maggie Yeung George K.H.Li Department of Nursing Studies The University of Hong Kong School of Nursing University of Colorado Health Science Center Nurse Specialist Department of Clinical OncologyPamela Youde Nethersole Eastern Hospital Infection Control Unit Princess Margaret Hospital Oncology Department Princess Margaret Hospital Clinical Oncology Department Tuen Mun Hospital Department of Surgery Queen Mary Hospital

OBJECTIVE To examine fatigue and quality of life (QOL) inbreast cancer patients undergoing chemotherapy or *** A self-report survey derived from the Chineseversion of Brief Fatigue Inventory, the Functional Assessmentof Chronic Illness Therapy for Breast Cancer, and the MedicalOutcomes Study Social Support Survey. Descriptive statisticswas used to examine the intensity of fatigue and the prevalenceof severe fatigue. Multivariate analysis of variance was used todetermine factors that affect the five domains of QOL among *** The majority of the participants (n = 261) perceiveda mild level of fatigue, but 35.6% of them suffered severe *** had a significantly negative association with all domainsof QOL except social/family wellbeing. The participants whowere receiving chemotherapy, undergoing curative treatment andhaving inadequate social support were more likely to have poorerQOL in all five domains (after adjustment for age).CONCLUSION Although the majority of the participantsexperienced a mild level of fatigue, there was a substantial groupof breast cancer patients who perceived their fatigue as severe. Thefindings of this study showed that fatigue had a detrimental effecton the various aspects of the participants' QOL. Demographic andclinical characteristics of breast cancer patients who were at riskof getting poorer QOL were identified. The results of the studydemonstrate that we should enhance healthcare professionals'awareness of the importance of symptom assessment, andprovide them with information for planning effective symptom-management strategies among this study population.

关键词： breast neoplasm fatigue quality of life drug therapy.

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The political economy of results-based financing:the experience of the health system in Zimbabwe

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Global Health Research and Policy 2019年第1期4卷 180-196页

作者： Sophie Witter Yotamu Chirwa Pamela Chandiwana Shungu Munyati Mildred Pepukai Maria Paola Bertone ReBUILD programme Queen Margaret UniversityEdinburgh EH216UUUK ReBUILD and Biomedical Research and Training Institute P O Box CY 1753HarareZimbabwe Biomedical Research and Training Institute P O Box CY 1753HarareZimbabwe

Background:Since 2000,results based financing(RBF)has proliferated in health sectors in Africa in particular,including in fragile and conflict affected settings(FCAS)and there is a growing but still contested literature about its relevance and *** examined are the political economy factors behind the adoption of the RBF policy,as well as the shifts in influence and resources which RBF may bring *** this article,we examine these two topics,focusing on Zimbabwe,which has rolled out RBF nationwide in the health system since 2011,with external ***:The study uses an adapted political economy framework,integrating data from 40 semi-structured interviews with local,national and international experts in 2018 and thematic analysis of 60 policy documents covering the decade between 2008 and ***:Our findings highlight the role of donors in initiating the RBF policy,but also how the Zimbabwe health system was able to adapt the model to suit its particular circumstances-seeking to maintain a systemic approach,and avoiding *** Zimbabwe was highly resource dependent after the political-economic crisis of the 2000s,it retained managerial and professional capacity,which distinguishes it from many other FCAS *** active adaptation has engendered national ownership over time,despite initial resistance to the RBF model and despite the complexity of RBF,which creates dependence on external technical *** was also aided by ideological retro-fitting into an earlier government performance management *** main beneficiaries of RBF were frontline providers,who gained small but critical additional resources,but subject to high degrees of control and ***:This study highlights resource-seeking motivations for adopting RBF in some low and middle income settings,especially fragile ones,but also the potential for local health system actors to shape and adapt RBF to suit their needs in some circ

关键词： Political economy analysis Results-based financing Zimbabwe Health financing reforms Fragile and crisis-affected settings

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Meso-American Nephropathy in El Salvador: Increasing Farmer Participation in MeN Prevention Efforts

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Occupational Diseases and Environmental Medicine 2019年第2期7卷 50-63页

作者： Keven Bermudez Carlos Orantes Montserrat León Marta Jiménez Nicole Vidal Pol De Vos Institute for Global Health and Development Queen Margaret University Edinburgh UK National Health Institute Ministry of Health (MINSAL) of San Salvador San Salvador El Salvador

Objectives: This paper highlights and discusses major factors affecting Salvadoran farmers’ involvement in National Health System-led efforts to prevent MeN in El Salvador and includes some recommendations to enhance their involvement. Methods: The study, conducted in El Salvador in June 2018, involved 10 life-long farmers residing in five MeN-affected communities in Chalatenango and Usulutan Departments who were either MeN-free or MeN-controlled, to understand through semi-structured, qualitative interviews their experience of participation in broader epidemic control efforts. Complementary interviews held with two nephrology teams and a senior representative of the grassroots-level National Health Forum operating in the same area, provided necessary contrast. Interview questions were informed by reference to the Adaptation and Development after Persecution and Trauma (ADAPT) model [1] as applicable in post-conflict environments like El Salvador to analyze contextual factors influencing community participation. Findings: Farmers are scarcely involved in wider MeN prevention efforts in El Salvador despite greater National Health System emphasis on encouraging community participation since the approval of the 2009 Health Reform [2]. This study found that widespread insecurity due to gang warfare, declining family and social networks due to high murder rates and international migration, and unresolved sense of injustice over unremitting poverty are among major factors with potential destructive effect on farmer participation. Conclusions: Health system-led MeN prevention responses need to encompass attention to persisting social vulnerabilities in economically and socially marginalized communities in order to enhance farmer participation in this effort. This paper concludes with some recommendations on how this can be done.

关键词： El Salvador Meso-American Nephropathy CKDu Pesticides Dehydration Heat Stress Farmer Resilience

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The Hong Kong consensus statements on unresectable hepatocellular carcinoma:narrative review and update for 2021

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Hepatobiliary Surgery and Nutrition 2023年第3期12卷 366-385页

作者： Tan-To Cheung Simon Chun-Ho Yu Stephen L.Chan Ronnie T.P.Poon Philip Kwok Ann-Shing Lee Anna Tai Derek Tam Chin-Cheung Cheung Tak-Wing Lai Nam-Hung Chia Ada Law Tracy Shum Yim-Kwan Lam Vince Lau Victor Lee Charing Chong Chung-Ngai Tang Thomas Yau Department of Surgery Queen Mary HospitalThe University of Hong KongHong KongChina Department of Imaging&Interventional Radiology Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina State Key Laboratory of Translational Oncology and Department of Clinical Oncology Sir YK Pao Centre for CancerPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Radiology and Imaging Queen Elizabeth HospitalHong KongChina Department of Clinical Oncology Tuen Mun HospitalHong KongChina Department of Clinical Oncology Queen Elizabeth HospitalHong KongChina Department of Surgery United Christian HospitalHong KongChina Department of Surgery Tuen Mun HospitalHong KongChina Department of Surgery Princess Margaret HospitalHong KongChina Department of Surgery Queen Elizabeth HospitalHong KongChina Department of Clinical Oncology Pamela Youde Nethersole Eastern HospitalHong KongChina Department of Clinical Oncology Princess Margaret HospitalHong KongChina Department of Medicine and Geriatrics United Christian HospitalHong KongChina Department of Radiology Queen Mary HospitalHong KongChina Department of Clinical Oncology Queen Mary HospitalThe University of Hong KongHong KongChina Department of Surgery Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Surgery Pamela Youde Nethersole Eastern HospitalHong KongChina Department of Medicine Queen Mary HospitalThe University of Hong KongHong KongChina

Background and Objective:Hong Kong,like many parts of Asia,faces a high burden of hepatocellular carcinoma(HCC)caused by high endemic rates of hepatitis B virus *** Kong clinicians have developed a high level of expertise in HCC treatment across surgical,transarterial,ablative,radiotherapeutic and systemic *** publication summarizes the latest evidence-based recommendations on how these modalities should be ***:In two meetings held in 2020,a multidisciplinary panel of surgeons,oncologists and interventional radiologists performed a narrative review of evidence on the management of HCC,with an emphasis on treatment of HCC not amenable to surgical *** attention was paid to new evidence published since the previous version of these statements in *** Content and Findings:The expert panel has formulated 60 consensus statements to guide the staging and treatment of unresectable *** the previous version of these statements,considerable additions have been made to the recommendations on use of targeted therapies and immunotherapies because of the large volume of new ***:Our consensus statements offer guidance on how to select HCC patients for surgical or non-surgical treatment and for choosing among non-surgical modalities for patients who are not candidates for *** particular,there is a need for more evidence to aid physicians in the selection of second-line systemic therapies,as currently most data are limited to patients with disease progression on first-line sorafenib.

关键词： Hepatocellular carcinoma(HCC) Hong Kong guidelines consensus

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