Publications by authors named "N B Hu"

2,055 Publications

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Inequities in quality and safety outcomes for hospitalized children with intellectual disability.

Dev Med Child Neurol 2021 Sep 25. Epub 2021 Sep 25.

Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.

Aim: To investigate if there are inequities in quality and safety outcomes for children with intellectual disability admitted to two tertiary paediatric hospitals.

Method: A cross-sectional study of 1367 admissions for 1018 randomly selected patients admitted for more than 23 hours to one of two tertiary children's hospitals in Sydney, Australia (1st January-31st December 2017). Electronic medical records were manually interrogated to identify children with intellectual disability (including developmental delay). Data extracted included patient demographics, length of stay, number of admissions, and reported clinical incidents.

Results: In total, 12.3% (n=125) of children admitted during the study period had intellectual disability, which represented 13.9% (n=190) of admissions. Sex and age at admission in children with and without intellectual disability were similar: 83 (43.7%) vs 507 (43.1%) females and 107 (56.3%) vs 670 (56.9%) males, p=0.875; median age 3 years (0-18y) vs 4 years (0-18y), p=0.122. Children with intellectual disability had significantly greater median length of stay (100.5h vs 79h, p<0.001) and cost of admission (A$11 596.38 vs A$8497.96) than their peers (p=0.001). Children with intellectual disability had more admissions with at least one incident compared to children without intellectual disability (14.7% vs 9.7%); this was not statistically significant (p=0.06).

Interpretation: Children with intellectual disability experience inequitable quality and safety outcomes in hospital. Engaging children and families in clinical incident reporting may enhance understanding of safety risks for children with intellectual disability in hospital.
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http://dx.doi.org/10.1111/dmcn.15066DOI Listing
September 2021

Inhibition of Notch activity promotes pancreatic cytokeratin 5-positive cell differentiation to beta cells and improves glucose homeostasis following acute pancreatitis.

Cell Death Dis 2021 Sep 23;12(10):867. Epub 2021 Sep 23.

Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China.

Some individuals develop prediabetes and/or diabetes following acute pancreatitis (AP). AP-induced beta-cell injury and the limited regenerative capacity of beta cells might account for pancreatic endocrine insufficiency. Previously, we found that only a few pancreatic cytokeratin 5 positive (Krt5) cells differentiated into beta cells in the murine AP model, which was insufficient to maintain glucose homeostasis. Notch signaling determines pancreatic progenitor differentiation in pancreas development. This study aimed to examine whether Notch signaling inhibition could promote pancreatic Krt5 cell differentiation into beta cells and improve glucose homeostasis following AP. Pancreatic tissues from patients with acute necrotizing pancreatitis (ANP) were used to evaluate beta-cell injury, Krt5 cell activation and differentiation, and Notch activity. The murine AP model was induced by cerulein, and the effect of Notch inhibition on Krt5 cell differentiation was evaluated both in vivo and in vitro. The results demonstrated beta-cell loss in ANP patients and AP mice. Krt5 cells were activated in ANP pancreases along with persistently elevated Notch activity, which resulted in the formation of massive duct-like structures. AP mice that received Notch inhibitor showed that impaired glucose tolerance was reversed 7 and 15 days following AP, and increased numbers of newborn small islets due to increased differentiation of Krt5 cells to beta cells to some extent. In addition, Krt5 cells isolated from AP mice showed increased differentiation to beta cells by Notch inhibition. Collectively, these findings suggest that beta-cell loss contributes to pancreatic endocrine insufficiency following AP, and inhibition of Notch activity promotes pancreatic Krt5 cell differentiation to beta cells and improves glucose homeostasis. The findings from this study may shed light on the potential treatment of prediabetes/diabetes following AP.
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http://dx.doi.org/10.1038/s41419-021-04160-2DOI Listing
September 2021

Serum and synovial biomarkers for distinguishing between chronic periprosthetic joint infections and rheumatoid arthritis: a prospective cohort study.

J Arthroplasty 2021 Sep 20. Epub 2021 Sep 20.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. Electronic address:

Background: Inflammatory responses in patients with active rheumatoid arthritis (RA) may lead to the current serum and synovial fluid biomarkers that misidentify chronic periprosthetic joint infection (PJI). We sought to investigate the expression of serum and synovial biomarkers in patients with active RA and to calculate thresholds for valuable biomarkers that distinguish between chronic PJI and active RA.

Methods: This prospective study was initiated to enroll 70 patients undergoing revision arthroplasty from January 2019 to January 2021, and 30 patients with active RA cumulative knee from August 2020 to March 2021. The Musculoskeletal Infection Society (MSIS) definition of PJI was utilized for the classification of cases as aseptic or infected. Serum D-dimer, ESR, CRP and IL-6, as well as synovial IL-6, PMN% and CD64 index level were measured preoperatively.

Results: An increase in biomarkers concentrations were observed in group C (active RA). Synovial fluid CD64 index exhibited good discriminatory power between group B (chronic PJI) and group C with an area under curve of 0.930. For the diagnosis of chronic PJI in the presence of active RA, the optimal threshold value of synovial CD64 index was 0.87, with a sensitivity of 82.86%, and a specificity of 93.33%.

Conclusions: Current serum biomarkers (ESR, CRP, IL-6 and D-Dimer) did not apply to the diagnosis of suspected PJI with active RA. Fortunately, satisfactory results can be achieved by adjusting the threshold of synovial fluid biomarkers.
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http://dx.doi.org/10.1016/j.arth.2021.09.009DOI Listing
September 2021

Digitally predesigned positioning tray and custom restoration shell for immediate implantation prothesis: a digital workflow.

Int J Comput Dent 2021 Sep;24(3):293-302

The present article introduces a new digital workflow for the fabrication of an immediate implantation prothesis. With this technique, based on the surgical planning, the positioning tray and the restoration shell are predesigned and premanufactured together with the implant guide before the physical surgery. After implantation, the restoration shell is placed and bonded with a temporary abutment guided by the positioning tray, which acts as a type of tooth-borne device to guide the placement and bonding of the immediate restoration. The restoration shell acts as a type of hollowed out restoration in the tissue surface to improve the implantation error tolerance.
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September 2021

Cognition effectiveness of continuous positive airway pressure treatment in obstructive sleep apnea syndrome patients with cognitive impairment: a meta-analysis.

Exp Brain Res 2021 Sep 21. Epub 2021 Sep 21.

Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, 8 Sanjiaohu Road, Wuhan, 430056, Hubei, China.

Obstructive sleep apnea (OSA) is a common respiratory disorder characterized by recurrent pharyngeal collapses during sleep leading to intermittent hypoxia and sleep disruption. Cognitive challenges and high risks of cognitive impairment, including Alzheimer's disease (AD), are closely associated with OSA. Currently, continuous positive airway pressure (CPAP) is widely used in the treatment of OSA. However, whether CPAP benefits cognitive functions in patients with OSA remains elusive. Here, we identified published studies through a systematic review of PubMed, Cochrane Library, Embase, Wanfang Data, CBM, and CNKI from January 1, 1970, to July 1, 2020. 288 patients from 7 articles (one was excluded in the meta-analysis for it was a follow-up study) were included in the present study. It revealed that cognitive functions of OSA patients with mild cognitive impairment (MCI) or AD were mildly but significantly improved after CPAP treatment (SMD 0.49, 95% CI 0.11-0.86), especially long-term CPAP treatment (SMD 0.56, 95% CI 0.10-1.02, p = 0.02), as measured by Mini-Mental State Examination (MMSE) (SMD 0.49, 95%CI 0.11-0.86). However, no significant cognition benefits were detected by the Montreal Cognitive Assessment (SMD 0.43, 95% CI 0.85-1.72). In terms of heterogeneity, cognitive improvements by CPAP were detectable on OSA patients either at a younger age or over longer periods of CPAP treatment. Therefore, our findings highlight the partial efficiency of CPAP treatment in cognition improvement of OSA patients with MCI or AD.
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http://dx.doi.org/10.1007/s00221-021-06225-2DOI Listing
September 2021
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