Publications by authors named "Eric Lee"

362 Publications

Diffusiophoresis of a highly charged soft particle normal to a conducting plane.

Authors:
Yvonne Wu Eric Lee

Electrophoresis 2021 Apr 8. Epub 2021 Apr 8.

Department of Chemical Engineering, National Taiwan University, Taipei, 10617, Taiwan.

Diffusiophoresis of a soft particle in electrolyte solutions normal to a conducting solid plane is investigated theoretically in this study, focusing on the highly charged particle in particular. A pseudo-spectral method based on Chebyshev polynomial is adopted to solve the resultant governing electrokinetic equations. It was found, among other things, that the closer the soft particle is to the plane, the faster it moves in general, provided only the chemiphoresis component of the diffusiophoresis is involved, i.e., no diffusion potential is present. The presence of the conducting plane is found to have three effects upon the particle motion nearby: the geometric boundary confinement effect, the electrostatic mirror-image force analog effect, and the hydrodynamic retarding effect. The enhancement of the double layer polarization by the first two effects leads to the seeming intriguing observation mentioned above. The particle always moves away from the plane in chemiphoresis. If a diffusion potential is present, however, then it is possible to drive the particle toward the plane. The results have potential applications in drug delivery. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1002/elps.202100052DOI Listing
April 2021

Outcomes of thermal ablation of the mucosal defect margin after endoscopic mucosal resection: A prospective, international, multi-centre trial of 1000 large non-pedunculated colorectal polyps.

Gastroenterology 2021 Mar 30. Epub 2021 Mar 30.

Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia; Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia. Electronic address:

Background And Aims: Thermal ablation of the defect margin after endoscopic mucosal resection (EMR-T) for treating large (≥ 20mm) non-pedunculated colorectal polyps (LNPCPs) has shown efficacy in a randomized trial, with a four-fold reduction, in residual or recurrent adenoma (RRA) at first surveillance colonoscopy (SC1). The clinical effectiveness of this treatment, in the real world, remains unknown.

Methods: We sought to evaluate the effectiveness of EMR-T in an international multi-center prospective trial (NCT02957058). The primary endpoint was the frequency of RRA at SC1. Detailed demographic, procedural and outcome data were recorded. Exclusion criteria were LNPCPs involving the ileo-caecal valve, the appendiceal orifice and circumferential LNPCPs.

Results: Over 51 months (May 2016-August 2020) 1049 LNPCPs in 1049 patients (median size 35mm, IQR 25-45mm; right colon location 53.5%) were enrolled. Uniform completeness of EMR-T was achieved in 989 LNPCPs (95.4%). 755/803 (94.0%) eligible LNPCPs underwent SC1 (median time to SC1 6 months; IQR 5-7 months). For LNPCPs that underwent complete EMR-T the frequency of RRA at SC1 was 1.4% (10/707).

Conclusion: In clinical practice, EMR-T is a simple, inexpensive and highly effective auxiliary technique that is likely to significantly reduce RRA at first surveillance. It should be universally employed for the management of LNPCPs after EMR.
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http://dx.doi.org/10.1053/j.gastro.2021.03.044DOI Listing
March 2021

Anticipatory human subthalamic area beta-band power responses to dissociable tastes correlate with weight gain.

Neurobiol Dis 2021 Mar 26;154:105348. Epub 2021 Mar 26.

Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, USA. Electronic address:

The availability of enticing sweet, fatty tastes is prevalent in the modern diet and contribute to overeating and obesity. In animal models, the subthalamic area plays a role in mediating appetitive and consummatory feeding behaviors, however, its role in human feeding is unknown. We used intraoperative, subthalamic field potential recordings while participants (n = 5) engaged in a task designed to provoke responses of taste anticipation and receipt. Decreased subthalamic beta-band (15-30 Hz) power responses were observed for both sweet-fat and neutral tastes. Anticipatory responses to taste-neutral cues started with an immediate decrease in beta-band power from baseline followed by an early beta-band rebound above baseline. On the contrary, anticipatory responses to sweet-fat were characterized by a greater and sustained decrease in beta-band power. These activity patterns were topographically specific to the subthalamic nucleus and substantia nigra. Further, a neural network trained on this beta-band power signal accurately predicted (AUC ≥ 74%) single trials corresponding to either taste. Finally, the magnitude of the beta-band rebound for a neutral taste was associated with increased body mass index after starting deep brain stimulation therapy. We provide preliminary evidence of discriminatory taste encoding within the subthalamic area associated with control mechanisms that mediate appetitive and consummatory behaviors.
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http://dx.doi.org/10.1016/j.nbd.2021.105348DOI Listing
March 2021

Prevalence of negative emotional eating and its associated psychosocial factors among urban Chinese undergraduates in Hong Kong: a cross-sectional study.

BMC Public Health 2021 Mar 24;21(1):583. Epub 2021 Mar 24.

Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR.

Background: Emotional eating (EE), defined as eating in response to a range of emotions, has been previously associated with poor diet and obesity. Since there are limited data from non-Western populations, this study aims to examine the prevalence and factors associated with EE among urban Chinese university students.

Methods: A cross-sectional study was conducted on 424 university students (aged 18-24 years) from two large universities in Hong Kong in 2019. Respondents completed an anonymous online questionnaire that contained background questions, an emotional eating subscale of the Dutch Eating Behaviour Questionnaire (DEBQ), and Depression Anxiety and Stress Scales (DASS-21). Two-sample independent t-test and multiple regression analyses were conducted to test the association of study variables with negative emotional eating.

Results: There was over a three-fold higher likelihood of negative EE among females (14.8%) when compared with their male counterparts (4.5%) (OR = 3.7, p < 0.05). Having at least mild depressive symptoms was the only independent factor associated with negative EE among males (OR = 10.1) while for females, negative EE was independently associated with not having a romantic partner (OR = 3.45), having depressive symptoms (OR = 44.5), and having at least mild stress (OR = 5.65). Anxiety levels were not independently associated with negative EE for either gender. Both male and female students with negative EE had significantly lower self-perceived health scores, higher body mass index, and lower life satisfaction scores.

Conclusions: This study revealed that negative EE is prevalent among female Chinese university students and not uncommon among male students. Management of negative EE should be included as a component of university mental health promotion programmes in the region.
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http://dx.doi.org/10.1186/s12889-021-10531-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988990PMC
March 2021

Quantitative Measurements of Protein Volume and Concentration using Hydrogel-Backed Nanopores.

ACS Sens 2021 03 11;6(3):722-726. Epub 2021 Mar 11.

Department of Bioengineering, UCLA, 420 Westwood Plaza, Los Angeles, California 90095, United States.

Accurate identification and quantification of proteins in solution using nanopores is technically challenging in part because of the large fraction of missed translocation events due to short event times and limitations of conventional current amplifiers. Previously, we have shown that a nanopore interfaced with a poly(ethylene glycol)-dimethacrylate hydrogel with an average mesh size of 3.1 nm significantly enhances the protein residence time within the pore, reducing the number of missed events. We used hydrogel-backed nanopores to sense unlabeled proteins as small as 5.5 kDa in size and 10 fM in concentration. We show that the frequency of protein translocation events linearly scales with bulk concentration over a wide range of concentrations and that unknown protein concentrations can be determined from an interpolation of the frequency-concentration curve with less than 10% error. Further, we show an iterative method to determine a protein volume accurately from measurement data for proteins with a diameter comparable to a nanopore diameter. Our measurements and analysis also suggest several competing mechanisms for the detection enhancement enabled by the presence of the hydrogel.
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http://dx.doi.org/10.1021/acssensors.1c00284DOI Listing
March 2021

Previously Attempted Large Nonpedunculated Colorectal Polyps Are Effectively Managed by Endoscopic Mucosal Resection.

Am J Gastroenterol 2021 Feb 9. Epub 2021 Feb 9.

Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia; Westmead Clinical School, University of Sydney, Sydney, Australia; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; University Hospital of Ghent, Ghent, Belgium.

Introduction: Endoscopic mucosal resection (EMR) is an effective therapy for naive large nonpedunculated colorectal polyps (N-LNPCPs). The best approach for the treatment of previously attempted LNPCPs (PA-LNPCPs) is undetermined.

Methods: EMR performance for PA-LNPCPs was evaluated in a prospective observational cohort of LNPCPs ≥20 mm. Efficacy was measured by technical success (removal of all visible polypoid tissue during index EMR) and recurrence at first surveillance colonoscopy (SC1). Safety was assessed by clinically significant intraprocedural bleeding, deep mural injury types III-V, clinically significant post-EMR bleeding, and delayed perforation.

Results: From January 2012 to October 2019, 158 PA-LNPCPs and 1,134 N-LNPCPs underwent EMR. Median PA-LNPCP size was 30 mm (interquartile range 25-46 mm). Technical success was 93.0% and increased to 95.6% after adjusting for 2-stage EMR. Cold-forceps avulsion with adjuvant snare-tip soft coagulation (CAST) was required for nonlifting polypoid tissue in 73 (46.2%). Median time to SC1 was 6 months (interquartile range 5-7 months). Recurrence occurred in 9 (7.8%). No recurrence was identified among 65 PA-LNPCPs which underwent margin thermal ablation at SC1 vs 9 (18.0%; P < 0.001) which did not. There were significant differences in resection duration (35 vs 25 minutes; P < 0.001), technical success (93.0% vs 96.6%; P = 0.026), and use of CAST (46.2% vs 7.6%; P < 0.001), between PA-LNPCPs and N-LNPCPs. When adjusting for 2-stage EMR, no difference in technical success was identified (95.6% vs 97.8%; P = 0.100). No differences in adverse events or recurrence were identified.

Discussion: EMR, using auxillary techniques where necessary, can achieve high technical success and low recurrence frequencies for PA-LNPCPs.
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http://dx.doi.org/10.14309/ajg.0000000000001096DOI Listing
February 2021

Xylem network connectivity and embolism spread in grapevine (Vitis vinifera L.).

Plant Physiol 2021 Feb 12. Epub 2021 Feb 12.

School of the Environment, Yale University, New Haven, CT, USA.

Xylem networks are vulnerable to the formation and spread of gas embolisms that reduce water transport. Embolisms spread through interconduit pits, but the three-dimensional complexity and scale of xylem networks means that the functional implications of intervessel connections are not well understood. Here, xylem networks of grapevine (Vitis vinifera L.) were reconstructed from three-dimensional high-resolution X-ray micro-computed tomography (microCT) images. Xylem network performance was then modeled to simulate loss of hydraulic conductivity under increasingly negative xylem sap pressure simulating drought stress conditions. We also considered the sensitivity of xylem network performance to changes in key network parameters. We found that the mean pit area per intervessel connection was constant across 10 networks from three, 1.5-meter stem segments, but short (0.5 cm) segments fail to capture complete network connectivity. Simulations showed that network organization imparted additional resistance to embolism spread beyond the air-seeding threshold of pit membranes. Xylem network vulnerability to embolism spread was most sensitive to variation in the number and location of vessels that were initially embolized and pit membrane vulnerability. Our results show that xylem network organization can increase stem resistance to embolism spread by 40% (0.66 MPa) and challenge the notion that a single embolism can spread rapidly throughout an entire xylem network.
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http://dx.doi.org/10.1093/plphys/kiab045DOI Listing
February 2021

Anthracycline-induced cardiotoxicity: A case report and review of literature.

World J Cardiol 2021 Jan;13(1):28-37

Division of Medical Oncology and Hematology, Department of Medicine, Loma Linda University, Loma Linda, CA 92350, United States.

Background: Doxorubicin and other anthracycline derivatives inhibit topoisomerase II and is an important class of cytotoxic chemotherapy in cancer treatment. The use of anthracycline is limited by dose-dependent cardiotoxicity, which may manifest initially as asymptomatic cardiac dysfunction with subsequent progression to congestive heart failure. Despite baseline assessment and periodic monitoring of cardiac function for patients receiving anthracycline agents, there are unmet needs in prediction and prevention of anthracycline-induced cardiotoxicity (AIC).

Case Summary: A 35-year-old African American female was found to have a 9-cm high-grade osteosarcoma of right femur and normal baseline cardiac function with left ventricular ejection fraction of approximately 60%-70% determined by transthoracic and dobutamine stress echocardiogram. She underwent perioperative doxorubicin and cisplatin chemotherapy with 3 cycles before surgery and 3 cycles after surgery, and received a total of 450 mg/m doxorubicin at the end of her treatment course. She was evaluated regularly during chemotherapy without any cardiac or respiratory symptoms. Approximately two months after her last chemotherapy, the patient presented to the emergency department with dyspnea for one week and was intubated for acute hypoxic respiratory failure. Echocardiogram showed an ejection fraction of 5%-10% with severe biventricular failure. Despite attempts to optimize cardiac function, the patient's hemodynamic status continued to decline, and resuscitation was not successful on the seventh day of hospitalization. The autopsy showed no evidence of osteosarcoma, and the likely cause of death was cardiac failure with the evidence of pulmonary congestion, liver congestion, and multiple body cavity effusions.

Conclusion: We present a case of 35-year-old African American female developing cardiogenic shock shortly after receiving a cumulative dose of 450 mg/m doxorubicin over 9 mo. Cardiac monitoring and management of patients receiving anthracycline chemotherapy have been an area of intense research since introduction of these agents in clinical practice. We have reviewed literature and recent advances in the prediction and prevention of AIC. Although risk factors currently identified can help stratify patients who need closer monitoring, there are limitations to our current understanding and further research is needed in this field.
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http://dx.doi.org/10.4330/wjc.v13.i1.28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821007PMC
January 2021

Treatment of Immune Dysregulation Due to a PTEN Variant with Sirolimus.

J Clin Immunol 2021 Feb 2. Epub 2021 Feb 2.

Department of Immunopathology, Westmead Hospital, Sydney, New South Wales, Australia.

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http://dx.doi.org/10.1007/s10875-021-00982-zDOI Listing
February 2021

Physical and mental health outcomes including behavior and attitudes in people having social contacts with COVID-19 patients.

PLoS One 2021 2;16(2):e0245945. Epub 2021 Feb 2.

JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.

The novel coronavirus (COVID-19) infection has spread worldwide since late 2019. People who have social contacts with COVID-19 patients might be at higher risk of physical or mental health problems. This study investigated whether people who had social contacts with COVID-19 patients would have poorer physical or mental outcomes, and different attitudes and behaviors. Chinese adults were recruited to fill in an online survey using snowball sampling during 21st-26nd February 2020. Physical symptoms, psychological outcomes, quality of life, COVID-19 related attitudes, and behaviors were measured. The differences in the outcomes between participants who had COVID-19 social contacts and those who had not were analyzed. The survey included 1,447 non-infected eligible participants. Among those, 173 (12.0%) reported at least one confirmed/suspected case in their social contacts. In the multiple regression adjusted for demographic data, the presence of confirmed/suspected infection cases in one's social contacts was significantly associated with poorer physical and mental outcomes, lower health-related quality of life, and different COVID-19 related attitudes and behaviors (p<0.05). In conclusion, people who had social contacts with COVID-19 patients were at risk of adverse health outcomes. Future studies are needed to understand the long-term impacts. Similarly, strategies to improve health outcomes for these people are needed.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245945PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853483PMC
February 2021

Family accommodation in Chinese individuals with obsessive-compulsive disorder.

Psych J 2021 Feb 1. Epub 2021 Feb 1.

Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.

Family accommodation is a common, treatment-relevant construct related to obsessive-compulsive disorder (OCD) severity and treatment outcome. This initial study examined the nature, incidence, and clinical correlates of family accommodation in Chinese adults with OCD and their relative or person in a close relationship. One hundred four outpatients diagnosed with OCD completed self-report measures of obsessive-compulsive, anxiety, and depression symptoms. Additionally, the individuals with OCD and a relative completed a measure of family accommodation and impairment. Patient-reports of family accommodation were significantly correlated with OCD symptomology and severity. A multiple linear regression indicated that OCD symptomology was a significant predictor of family accommodation, but anxiety, stress, and depression were not. In addition, the current Chinese sample demonstrated greater levels of family accommodation than previous English-speaking samples. Potential explanations and implications of the high levels of reported family accommodation are discussed. Family accommodation could play a significant role in OCD development and/or maintenance in China. Future research considerations are discussed.
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http://dx.doi.org/10.1002/pchj.425DOI Listing
February 2021

In vivo selection of highly metastatic human ovarian cancer sublines reveals role for AMIGO2 in intra-peritoneal metastatic regulation.

Cancer Lett 2021 Apr 30;503:163-173. Epub 2021 Jan 30.

Department of Chemistry & Biochemistry, University of Notre Dame, Notre Dame, IN, USA; Harper Cancer Research Institute, University of Notre Dame, South Bend, IN, USA. Electronic address:

The majority of women with ovarian cancer are diagnosed with metastatic disease, therefore elucidating molecular events that contribute to successful metastatic dissemination may identify additional targets for therapeutic intervention and thereby positively impact survival. Using two human high grade serous ovarian cancer cell lines with inactive TP53 and multiple rounds of serial in vivo passaging, we generated sublines with significantly accelerated intra-peritoneal (IP) growth. Comparative analysis of the parental and IP sublines identified a common panel of differentially expressed genes. The most highly differentially expressed gene, upregulated by 60-65-fold in IP-selected sublines, was the type I transmembrane protein AMIGO2. As the role of AMIGO2 in ovarian cancer metastasis remains unexplored, CRISPR/Cas9 was used to reduce AMIGO2 expression, followed by in vitro and in vivo functional analyses. Knockdown of AMIGO2 modified the sphere-forming potential of ovarian cancer cells, reduced adhesion and invasion in vitro, and significantly attenuated IP metastasis. These data highlight AMIGO2 as a new target for a novel anti-metastatic therapeutic approach aimed at blocking cohesion, survival, and adhesion of metastatic tumorspheres.
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http://dx.doi.org/10.1016/j.canlet.2021.01.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981259PMC
April 2021

Brief Report: Mindfulness Training for Chinese Adolescents with Autism Spectrum Disorder and Their Parents in Hong Kong.

J Autism Dev Disord 2021 Jan 23. Epub 2021 Jan 23.

JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.

This study investigated the feasibility and preliminary effectiveness of a concurrent mindfulness program (MYmind) on Chinese adolescents with autism spectrum disorder and their parents in Hong Kong, China using a randomized controlled trial with a waitlist control group. Results showed the study had 80% compliance rate, 0% dropout rate, and 89% response rate. Between-group comparisons showed mindfulness had trend effects on parent's rumination (g = 1.16), mindful parenting (d = 0.6), parenting style (d = 0.59), and parenting stress (d = 0.5). The study demonstrated the feasibility of the MYmind program in the Chinese context. A larger trial with longer follow-up period is suggested to better examine the effect of mindfulness on adolescents with ASD and their parents.
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http://dx.doi.org/10.1007/s10803-020-04729-4DOI Listing
January 2021

Patient and Physician Perspectives of Deprescribing Potentially Inappropriate Medications in Older Adults with a History of Falls: a Qualitative Study.

J Gen Intern Med 2021 Jan 19. Epub 2021 Jan 19.

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.

Background: High-risk medications pose serious safety risks to older adults, including increasing the risk of falls. Deprescribing potentially inappropriate medications (PIMs) in older adults who have experienced a fall is a key element of fall reduction strategies. However, continued use of PIMs in older adults is common, and clinicians may face substantial deprescribing barriers.

Objective: Explore patient and clinician experiences with and perceptions of deprescribing PIMs in patients with a history of falls.

Design: We led guided patient feedback sessions to explore deprescribing scenarios with patient stakeholders and conducted semi-structured interviews with primary care physicians (PCPs) to explore knowledge and awareness of fall risk guidelines, deprescribing experiences, and barriers and facilitators to deprescribing.

Participants: PCPs from Kaiser Permanente Southern California (KPSC) and patient members of the KPSC Regional Patient Advisory Committee.

Approach: We used maximum variation sampling to identify PCPs with patients who had a fall, then categorized the resulting PIM dispense distribution for those patients into high and low frequency. We analyzed the data using a hybrid deductive-inductive approach. Coders applied initial deductively derived codes to the data, simultaneously using an open-code inductive approach to capture emergent themes.

Key Results: Physicians perceived deprescribing discussions as potentially contentious, even among patients with falls. Physicians reported varying comfort levels with deprescribing strategies: some felt that the conversations might be better suited to others (e.g., pharmacists), while others had well-planned negotiation strategies. Patients reported lack of clarity as to the reasons and goals of deprescribing and poor understanding of the seriousness of falls.

Conclusions: Our study suggests that key barriers to deprescribing include PCP trepidation about raising a contentious topic and insufficient patient awareness of the potential seriousness of falls. Findings suggest the need for multifaceted, multilevel deprescribing approaches with clinician training strategies, patient educational resources, and a focus on building trusting patient-clinician relationships.
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http://dx.doi.org/10.1007/s11606-020-06493-8DOI Listing
January 2021

Comparison Between Automated Office Blood Pressure Measurements and Manual Office Blood Pressure Measurements-Implications in Individual Patients: a Systematic Review and Meta-analysis.

Curr Hypertens Rep 2021 Jan 15;23(1). Epub 2021 Jan 15.

Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.

Purpose Of Review: Automated office blood pressure (AOBP) measurements may provide more accurate estimation of blood pressure (BP) than manual office blood pressure (MOBP) measurements. This systematic review investigated the diagnostic performance of AOBP and MOBP using ambulatory blood pressure measurement (ABPM) as reference. Several databases including MEDLINE, Embase, Scopus, and China Academic Journals were searched. Data were extracted, double-checked by two investigators, and were analysed using a random effects model.

Recent Findings: A total of 26 observational studies were included. The mean systolic/diastolic BP obtained by AOBP was not significantly different from that obtained by ABPM. The sensitivity and specificity of AOBP to detect elevated BP were approximately 70%. Fewer participants had white-coat hypertension on AOBP measurement than on MOBP measurement (7% versus 14%); however, about 13% had masked hypertension on AOBP measurement. The width of the limit of agreement comparing (i) AOBP and ABPM and (ii) MOBP and ABPM was comparable. AOBP may reduce the rate of the observed white-coat effect but undermine masked hypertension. The current recommendation, however, is limited by the absence of high-quality studies and the high heterogeneity of our results. More high-quality studies using different AOBP machines and in different population are therefore needed.
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http://dx.doi.org/10.1007/s11906-020-01118-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810619PMC
January 2021

Diffusiophoresis of a Highly Charged Soft Particle in Electrolyte Solutions.

Langmuir 2021 Feb 15;37(4):1480-1492. Epub 2021 Jan 15.

Department of Chemical Engineering, National Taiwan University, Taipei 10617, Taiwan.

Diffusiophoresis of a soft particle suspended in an infinite medium of symmetric binary electrolyte solution is investigated theoretically in this study, focusing on the chemiphoresis component when there is no global diffusion potential in the bulk solution. The general governing electrokinetic equations are solved with a pseudo-spectral method based on Chebyshev polynomials, and particle mobility, defined as the particle velocity per unit concentration gradient, is calculated. Parameters of electrokinetic interest are examined, in general, to explore their respective impact upon particle motion, such as the fixed charge density and permeability in the outer porous layer, the surface charge density and size of the inner rigid core, and the electrolyte strength in the solution. Nonlinear phenomena such as the motion-deterring double-layer polarization and the counterion condensation effects are scrutinized, in particular, for highly charged soft particles. Mobility reversal is observed in some range of electrolyte strength for highly charged particles. The generation of an axisymmetric counterclockwise vortex flow across the porous layer is found to be responsible for it. The onset of the mobility reversal is synchronized with the appearance or disappearance of this vortex flow. Mobility reversal may happen more than once, with particle moving toward or away from the region of higher solute concentration. The latter is undesirable in the application of drug delivery and thus should be avoided by delicate control of the electrokinetic environment. A local micro diffusion potential is discovered, which always speeds up the migration of coions and slows down that of counterions to guarantee that there is no net electric current across the double layer. Moreover, multilayer structure of the double-layer polarization is discovered when the electrolyte strength is high. The study presented here provides insight and crucial information for practical applications of soft particles, such as drug delivery.
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http://dx.doi.org/10.1021/acs.langmuir.0c03002DOI Listing
February 2021

Outcomes of Deep Mural Injury After Endoscopic Resection: An International Cohort of 3717 Large Non-Pedunculated Colorectal Polyps.

Clin Gastroenterol Hepatol 2021 Jan 8. Epub 2021 Jan 8.

Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, Australia; Westmead Clinical School, University of Sydney, Sydney, Australia. Electronic address:

Background & Aims: Although perforation is the most feared adverse event associated with endoscopic mucosal resection (EMR), limited data exists concerning its management. Therefore, we sought to evaluate the short- and long-term outcomes of intra-procedural deep mural injury (DMI) in an international multi-center observational cohort of large (≥20 mm) non-pedunculated colorectal polyps (LNPCPs).

Methods: Consecutive patients who underwent EMR for a LNPCP ≥20 mm were evaluated. Significant DMI (S-DMI) was defined as Sydney DMI Classification type III (muscularis propria injury, target sign) or type IV/V (perforation without or with contamination, respectively). The primary outcome was successful S-DMI defect closure. Secondary outcomes included technical success (removal of all visible polypoid tissue during index EMR), surgical referral and recurrence at first surveillance colonscopy (SC1).

Results: Between July 2008 to May 2020, 3717 LNPCPs underwent EMR. Median lesion size was 35mm (interquartile range (IQR) 25 to 45mm). Significant DMI was identified in 101 cases (2.7%), with successful defect closure in 98 (97.0%) using a median of 4 through-the-scope clips (TTSCs; IQR 3 to 6 TTSCs). Three (3.0%) patients underwent S-DMI-related urgent surgery. Technical success was achieved in 94 (93.1%) patients, with 46 (45.5%) admitted to hospital (median duration 1 day; IQR 1 to 2 days). Comparing LNPCPs with and without S-DMI, no differences in technical success (94 (93.1%) vs 3316 (91.7%); P = .62) or SC1 recurrence (12 (20.0%) vs 363 (13.6%); P = .15) were identified.

Conclusions: Significant DMI is readily managed endoscopically and does not appear to affect technical success or recurrence.
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http://dx.doi.org/10.1016/j.cgh.2021.01.007DOI Listing
January 2021

An exploration of factors associated with food protein-induced enterocolitis syndrome: Birth, infant feeding and food triggers.

Pediatr Allergy Immunol 2021 Jan 7. Epub 2021 Jan 7.

Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergic disorder with a well-characterized phenotype, but limited understanding of factors associated with food cross-reactivity, severity and tolerance.

Methods: A retrospective cohort study spanning 20 years on children with acute FPIES from a single paediatric tertiary centre in New South Wales, Australia, focusing on identifying food trigger co-associations and factors associated with reaction severity, multiple trigger FPIES and/or tolerance was performed.

Results: A total of 168 individuals with 329 recorded FPIES episodes between 1997 and 2017 were included. 49% were male. The median age at first reaction was 5 months, and median age at diagnosis was 9 months. 73% experienced at least one severe FPIES reaction. Rice (45%), cow's milk (30%) and soya (13%) were the most common triggers. Rice or cow's milk FPIES was strongly associated with increased odds of having multiple trigger FPIES. The odds of having multiple food FPIES and severe reactions were slightly decreased with vaginal delivery. No factors were associated with increased risk of severe reactions. Infants with rice and grains FPIES outgrew their reactions at an earlier age, compared to those with fish FPIES.

Conclusions: Rice remains the most common trigger in Australia with co-associations between rice/oats and cow's milk/soya observed. This suggests that taxonomically related foods may share similar protein structure and trigger similar mechanisms of antigen recognition. Vaginal delivery may have a mild protective effect on the development of multiple FPIES and severe reactions. No other features from birth or infant-feeding history influenced outcomes in FPIES.
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http://dx.doi.org/10.1111/pai.13448DOI Listing
January 2021

Spontaneous synchronization of motion in pedestrian crowds of different densities.

Nat Hum Behav 2021 Jan 4. Epub 2021 Jan 4.

Department of Architecture and Civil Engineering, City University of Hong Kong, Kowloon, Hong Kong.

Interacting pedestrians in a crowd spontaneously adjust their footsteps and align their respective stepping phases. This self-organization phenomenon is known as synchronization. However, it is unclear why and how synchronization forms spontaneously under different density conditions, or what functional benefit synchronization offers for the collective motion of humans. Here, we conducted a single-file crowd motion experiment that directly tracked the alternating movement of both legs of interacting pedestrians. We show that synchronization is most likely to be triggered at the same density at which the flow rate of pedestrians reaches a maximum value. We demonstrate that synchronization is established in response to an insufficient safety distance between pedestrians, and that it enables pedestrians to realize efficient collective stepping motion without the occurrence of inter-person collisions. These findings provide insights into the collective motion behaviour of humans and may have implications for understanding pedestrian synchronization-induced wobbling, for example, of bridges.
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http://dx.doi.org/10.1038/s41562-020-00997-3DOI Listing
January 2021

Eruptions and related clinical course among 296 hospitalized adults with confirmed COVID-19.

J Am Acad Dermatol 2021 04 25;84(4):946-952. Epub 2020 Dec 25.

Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York. Electronic address:

Background: Limited information exists on mucocutaneous disease and its relation to course of COVID-19.

Objective: To estimate prevalence of mucocutaneous findings, characterize morphologic patterns, and describe relationship to course in hospitalized adults with COVID-19.

Methods: Prospective cohort study at 2 tertiary hospitals (Northwell Health) between May 11, 2020 and June 15, 2020.

Results: Among 296 hospitalized adults with COVID-19, 35 (11.8%) had at least 1 disease-related eruption. Patterns included ulcer (13/35, 37.1%), purpura (9/35, 25.7%), necrosis (5/35, 14.3%), nonspecific erythema (4/35, 11.4%), morbilliform eruption (4/35, 11.4%), pernio-like lesions (4/35, 11.4%), and vesicles (1/35, 2.9%). Patterns also showed anatomic site specificity. A greater proportion of patients with mucocutaneous findings used mechanical ventilation (61% vs 30%), used vasopressors (77% vs 33%), initiated dialysis (31% vs 9%), had thrombosis (17% vs 11%), and had in-hospital mortality (34% vs 12%) compared with those without mucocutaneous findings. Patients with mucocutaneous disease were more likely to use mechanical ventilation (adjusted prevalence ratio, 1.98; 95% confidence interval, 1.37-2.86); P < .001). Differences for other outcomes were attenuated after covariate adjustment and did not reach statistical significance.

Limitations: Skin biopsies were not performed.

Conclusions: Distinct mucocutaneous patterns were identified in hospitalized adults with COVID-19. Mucocutaneous disease may be linked to more severe clinical course.
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http://dx.doi.org/10.1016/j.jaad.2020.12.046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837130PMC
April 2021

Failing Forward: Stability of Transparent Electrodes Based on Metal Nanowire Networks.

Adv Mater 2021 Feb 21;33(5):e2004356. Epub 2020 Dec 21.

Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.

Metal nanowire (MNW)-based transparent electrode technologies have significantly matured over the last decade to become a prominent low-cost alternative to indium tin oxide (ITO). Beyond reaching the same level of performance as ITO, MNW networks offer additional advantages including flexibility and low materials cost. To facilitate adoption of MNW networks as a replacement to ITO, they must overcome their inherent stability issues while maintaining their properties and cost-effectiveness. Herein, the fundamental failure mechanisms of MNW networks are discussed in detail. Recent strategies to computationally model MNWs from the nano- to macroscale and suggest future work to capture dynamic failure to unravel mechanisms that account for convolution of the failure modes are highlighted. Strategies to characterize MNW network failure in situ and postmortem are also discussed. In addition, recent work about improving the stability of MNW networks via encapsulation is discussed. Lastly, a perspective is given on how to frame the requirements of MNW-encapsulant hybrids with reference to their target applications, namely: solar cells, transparent film heaters, sensors, and displays. A cost analysis to comment on the feasibility of implementing MNW hybrids is provided, and critical areas to focus on for future work on MNW networks are suggested.
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http://dx.doi.org/10.1002/adma.202004356DOI Listing
February 2021

Analysis of motorcycle accidents using association rule mining-based framework with parameter optimization and GIS technology.

J Safety Res 2020 12 26;75:292-309. Epub 2020 Sep 26.

Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong, China.

Introduction: Analyzing key factors of motorcycle accidents is an effective method to reduce fatalities and improve road safety. Association Rule Mining (ARM) is an efficient data mining method to identify critical factors associated with injury severity. However, the existing studies have some limitations in applying ARM: (a) Most studies determined parameter thresholds of ARM subjectively, which lacks objectiveness and efficiency; (b) Most studies only listed rules with high parameter thresholds, while lacking in-depth analysis of multiple-item rules. Besides, the existing studies seldom conducted a spatial analysis of motorcycle accidents, which can provide intuitive suggestions for policymakers.

Method: To address these limitations, this study proposes an ARM-based framework to identify critical factors related to motorcycle injury severity. A method for parameter optimization is proposed to objectively determine parameter thresholds in ARM. A method of factor extraction is proposed to identify individual key factors from 2-item rules and boosting factors from multiple-item rules. Geographic information system (GIS) is adopted to explore the spatial relationship between key factors and motorcycle injury severity.

Results And Conclusions: The framework is applied to a case study of motorcycle accidents in Victoria, Australia. Fifteen attributes are selected after data preprocessing. 0.03 and 0.7 are determined as the best thresholds of support and confidence in ARM. Five individual key factors and four boosting factors are identified to be related to fatal injury. Spatial analysis is conducted by GIS to present hot spots of motorcycle accidents. The proposed framework has been validated to have better performance on parameter optimization and rule analysis in ARM. Practical applications: The hot spots of motorcycle accidents related to fatal factors are presented in GIS maps. Policymakers can refer to those maps straightforwardly when decision making. This framework can be applied to various kinds of traffic accidents to improve the performance of severity analysis.
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http://dx.doi.org/10.1016/j.jsr.2020.09.004DOI Listing
December 2020

Engineering Microbiomes-Looking Ahead.

ACS Synth Biol 2020 12;9(12):3181-3183

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http://dx.doi.org/10.1021/acssynbio.0c00558DOI Listing
December 2020

Opioid Use in Robotic-Arm Assisted Total Knee Arthroplasty: A Comparison to Conventional Manual Total Knee Arthroplasty.

Surg Technol Int 2020 Nov;37:280-289

Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Introduction: Opioids are frequently prescribed in the postoperative management of total knee arthroplasty (TKA) with multiple factors influencing postoperative opioid use. Robotic-arm-assisted TKA (raTKA) was developed with the goal of improving alignment and outcomes while decreasing soft tissue injury. The purpose of this study was to compare postoperative opioid consumption in raTKA and conventional manual TKA (mTKA) cohorts.

Materials And Methods: A consecutive series of unilateral primary TKAs performed 1/1/16 to 12/31/17 were included. Patients with major procedures requiring opioids occurring within one year of TKA were excluded. A single-surgeon raTKA cohort of 127 patients (Group 1) was compared to a same-surgeon cohort of 119 mTKAs (Group 2) using the same cemented implant design and a two-surgeon cohort of 410 mTKA (Group 3). Groups were subdivided into opioid naïve (ON) and opioid exposed (OE). Length of hospitalization and postoperative opioid utilization up to one year were compared between groups and collectively without separating raTKA and mTKA. Statistical analysis included Chi-square, Student's t-test, and Wilcoxon rank sum tests.

Results: For both ON and OE patients, Group 1 demonstrated reduced inpatient mean daily oral morphine milligram equivalent (MME) compared to Group 3 (ON p=0.007; OE p=0.034), a shorter hospitalization compared to Group 2 (ON p=0.02; OE p=0.012), and fewer opioids prescribed at discharge compared to Group 2 (ON p=0.005; OE p=0.081) and Group 3 (ON p<0.001; OE p=0.036). No differences in opioid prescriptions were seen at three months or after. Regardless of surgical technique OE patients had higher inpatient opioid utilization (p<0.001) as well as cumulative outpatient prescription quantity (MME 1050 ON, 2660 OE) and duration (ON 0.5%; OE 28.3%) at one year (p<0.001).

Conclusion: Less opioids were prescribed at discharge and used during hospitalization in raTKA compared to mTKA though no differences in opioid use were seen at further time points. Preoperative opioid use remains a dominant factor in postoperative opioid utilization regardless of TKA surgical technique.
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November 2020

A pilot feasibility randomized controlled trial on combining mind-body physical exercise, cognitive training, and nurse-led risk factor modification to reduce cognitive decline among older adults with mild cognitive impairment in primary care.

PeerJ 2020 7;8:e9845. Epub 2020 Sep 7.

Division of Family Medicine and Primary Health Care, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.

Objectives: To examine the feasibility and preliminary effectiveness of (1) combining cognitive training, mind-body physical exercise, and nurse-led risk factor modification (CPR), (2) nurse-led risk factor modification (RFM), and (3) health advice (HA) on reducing cognitive decline among older adults with mild cognitive impairment (MCI).

Methods: It was a 3-arm open-labeled pilot randomized controlled trial in the primary care setting in Hong Kong. Nineteen older adults with MCI were randomized to either CPR ( = 6), RFM ( = 7), or HA ( = 6) for 6 months. The primary outcome was the feasibility of the study. Secondary outcomes included the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), the Montreal Cognitive Assessment Hong Kong version (HK-MoCA), the Clinical Dementia Rating (CDR), the Disability Assessment for Dementia (DAD), quality of life, depression, anxiety, physical activity, health service utilization, and diet.

Results: Nineteen out the 98 potential patients were recruited, with a recruitment rate of 19% (95% CI [12-29]%,  = 0.243). The adherence rate of risk factor modification was 89% (95% CI [65-98]%,  = 0.139) for CPR group and 86% (95% CI [63-96]%,  = 0.182) for RFM group. In the CPR group, 53% (95% CI [36-70]%,  = 0.038) of the Tai Chi exercise sessions and 54% (95% CI [37-71]%,  = 0.051) of cognitive sessions were completed. The overall dropout rate was 11% (95% CI [2-34]%,  = 0.456). Significant within group changes were observed in HK-MoCA in RFM (4.50 ± 2.59,  = 0.008), cost of health service utilization in CPR (-4000, quartiles: -6800 to -200,  = 0.043), fish and seafood in HA (-1.10 ± 1.02,  = 0.047), and sugar in HA (2.69 ± 1.80,  = 0.015). Group × time interactions were noted on HK-MoCA favoring the RFM group ( = 0.000), DAD score favoring CPR group ( = 0.027), GAS-20 favoring CPR group ( = 0.026), number of servings of fish and seafood ( = 0.004), and sugar ( < 0.001) ate per day.

Conclusions: In this pilot study, RFM and the multi-domain approach CPR were feasible and had preliminary beneficial effects in older adults with MCI in primary care setting in Hong Kong.

Trial Registration: Chinese Clinical Trial Registry (ChiCTR1800015324).
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http://dx.doi.org/10.7717/peerj.9845DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482623PMC
September 2020

Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong.

BMC Geriatr 2020 11 3;20(1):442. Epub 2020 Nov 3.

JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong.

Background: The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care.

Methods: This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective.

Results: A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51-4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47-8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22-3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01-0.73).

Conclusions: While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.
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http://dx.doi.org/10.1186/s12877-020-01851-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640666PMC
November 2020

Effect and Acceptability of Mindfulness-Based Stress Reduction Program on Patients With Elevated Blood Pressure or Hypertension: A Meta-Analysis of Randomized Controlled Trials.

Hypertension 2020 12 2;76(6):1992-2001. Epub 2020 Nov 2.

From the Jockey Club School of Public Health and Primary Care, Faculty of Medicine (E.K.P.L., N.C.Y.Y., Z.X., D.Z., S.Y.S.W.), The Chinese University of Hong Kong.

The mindfulness-based stress reduction program (MBSR) may reduce blood pressure (BP) in patients with hypertension or elevated BP. However, some important parameters (such as asleep BP) have not been investigated in previous reviews, and a well-conducted meta-analysis is lacking. This meta-analysis investigates the effect and acceptability of MBSR on patients with elevated BP or hypertension. Relevant articles were searched in multiple databases, including MEDLINE, EMBASE, and APA PsycInfo. Included studies were randomized controlled trials that involved patients with an elevated BP, had a control group, and investigated the effect of MBSR. The mean office and out-of-office (including 24-hour, daytime, and asleep) systolic BP and diastolic BP, psychological outcomes (depression/anxiety/stress), and dropout rate were compared between the MBSR arm and the control arm using a random-effects model. Quality assessment was conducted based on the Cochrane risk-of-bias tool. Twelve studies were included, and only one was considered having low risk of bias. MBSR decreased the office systolic BP and diastolic BP by 6.64 and 2.47 mm Hg at postintervention, respectively; the reduction in diastolic BP was sustained until 3 to 6 months after the recruitment. Our meta-analyses did not find a significant reduction in out-of-office BP after MBSR. MBSR reduced depressive, anxiety, and stress symptoms. The dropout rate from MBSR arm was 15% and was similar to that of control arm. The current evidence is limited by lack of high-quality and adequately powered trials with long-term follow-up. Furthermore, out-of-office BP was only reported by few trials.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.16160DOI Listing
December 2020

VIP interneurons in mouse primary visual cortex selectively enhance responses to weak but specific stimuli.

Elife 2020 10 27;9. Epub 2020 Oct 27.

Allen Institute for Brain Science, Seattle, United States.

Vasoactive intestinal peptide-expressing (VIP) interneurons in the cortex regulate feedback inhibition of pyramidal neurons through suppression of somatostatin-expressing (SST) interneurons and, reciprocally, SST neurons inhibit VIP neurons. Although VIP neuron activity in the primary visual cortex (V1) of mouse is highly correlated with locomotion, the relevance of locomotion-related VIP neuron activity to visual coding is not known. Here we show that VIP neurons in mouse V1 respond strongly to low contrast front-to-back motion that is congruent with self-motion during locomotion but are suppressed by other directions and contrasts. VIP and SST neurons have complementary contrast tuning. Layer 2/3 contains a substantially larger population of low contrast preferring pyramidal neurons than deeper layers, and layer 2/3 (but not deeper layer) pyramidal neurons show bias for front-to-back motion specifically at low contrast. Network modeling indicates that VIP-SST mutual antagonism regulates the gain of the cortex to achieve sensitivity to specific weak stimuli without compromising network stability.
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http://dx.doi.org/10.7554/eLife.55130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591255PMC
October 2020

The Obsessive-Compulsive Inventory-Revised: Replication of the psychometric properties in China.

Bull Menninger Clin 2020 Oct;84(Supplement A):34-47

Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

The aim of this study is to replicate the findings from previous research about the psychometric properties of the Mandarin Chinese version of the Obsessive-Compulsive Inventory-Revised (OCI-R), which assesses the presence of symptoms obsessive-compulsive disorder and the distress associated with those symptoms. The final clinical sample included 80 participants from multiple psychiatric outpatient clinics in China. Participants completed the following questionnaires: the OCI-R, the Depression, Anxiety, and Stress Scale (DASS-21), the Yale-Brown Obsessive-Compulsive Scale-II (Y-BOCS-II), and the Clinical Global Impressions Scale, Severity (CGI-S). The Mandarin Chinese version of the OCI-R demonstrated good internal consistency for the total scale and each subscale. Good convergent and divergent validity was established. The Mandarin Chinese version of the OCI-R demonstrated good psychometric properties. Further research is needed to examine the factor structure of the Chinese version of the OCI-R and the extent to which it aligns with the original version.
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http://dx.doi.org/10.1521/bumc.2020.84.suppA.34DOI Listing
October 2020