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"Chan, Alain"
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A look back at the first wave of COVID-19 in China: A systematic review and meta-analysis of mortality and health care resource use among severe or critical patients
2022
To investigate the mortality and health care resource use among patients with severe or critical coronavirus disease of 2019 (COVID-19) in the first wave of pandemic in China.
We performed a systematic review and meta-analysis to investigate the mortality, discharge rate, length of hospital stay, and use of invasive ventilation in severe or critical COVID-19 cases in China. We searched electronic databases for studies from China with no restrictions on language or interventions patients received. We screened records, extracted data and assessed the quality of included studies in duplicate. We performed the meta-analysis using random-effect models through a Bayesian framework. Subgroup analyses were conducted to examine studies by disease severity, study location and patient enrolment start date. We also performed sensitivity analysis using various priors, and assessed between-study heterogeneity and publication bias for the primary outcomes.
Out of 6,205 titles and abstracts screened, 500 were reviewed in full text. A total of 42 studies were included in the review, of which 95% were observational studies (n = 40). The pooled 28-day and 14-day mortalities among severe or critical patients were 20.48% (7,136 patients, 95% credible interval (CrI), 13.11 to 30.70) and 10.83% (95% CrI, 6.78 to 16.75), respectively. The mortality declined over time and was higher in patients with critical disease than severe cases (1,235 patients, 45.73%, 95% CrI, 22.79 to 73.52 vs. 3,969 patients, 14.90%, 95% CrI, 4.70 to 39.57) and patients in Hubei compared to those outside Hubei (6,719 patients, 26.62%, 95% CrI, 13.11 to 30.70 vs. 244 patients, 5.88%, 95% CrI 2.03 to 14.11). The length of hospital stay was estimated at 18.48 days (6,847 patients, 95% CrI, 17.59 to 21.21), the 28-day discharge rate was 50.48% (3,645 patients, 95% CrI, 26.47 to 79.53), and the use of invasive ventilation rate was 13.46% (4,108 patients, 95% CrI, 7.61 to 22.31).
Our systematic review and meta-analysis found high mortality among severe and critical COVID-19 cases. Severe or critical COVID-19 cases consumed a large amount of hospital resources during the outbreak.
Journal Article
Hepatitis B Surface Antigen Loss with Tenofovir Disoproxil Fumarate Plus Peginterferon Alfa-2a: Week 120 Analysis
2018
Background and AimsHepatitis B surface antigen (HBsAg) loss is the ideal clinical endpoint but is achieved rarely during oral antiviral treatment. A current unmet need in CHB management is achievement of HBsAg loss with a finite course of oral antiviral therapy, thereby allowing discontinuation of treatment. Significantly higher rates of HBsAg loss at 72 weeks post-treatment have been demonstrated when tenofovir disoproxil fumarate (TDF) was combined with pegylated interferon (PEG-IFN) for 48 weeks compared with either monotherapy. This analysis provides follow-up data at week 120.MethodsIn an open-label, active-controlled study, 740 patients with chronic hepatitis B were randomly assigned to receive TDF plus PEG-IFN for 48 weeks (group A), TDF plus PEG-IFN for 16 weeks followed by TDF for 32 weeks (group B), TDF for 120 weeks (group C), or PEG-IFN for 48 weeks (group D). Efficacy and safety at week 120 were assessed.ResultsRates of HBsAg loss at week 120 were significantly higher in group A (10.4%) than in group B (3.5%), group C (0%), and group D (3.5%). Rates of HBsAg loss and HBsAg seroconversion in group A were significantly higher than rates in group C (P < 0.001 for both) or group D (HBsAg loss: P = 0.002; HBsAg seroconversion: P < 0.001).ConclusionsThe results of this analysis confirm the results from earlier time points which demonstrate the increased rate of HBsAg loss in patients treated with a finite course of PEG-IFN plus TDF compared with the rates in patients receiving either monotherapy.
Journal Article
Correction to: Hepatitis B Surface Antigen Loss with Tenofovir Disoproxil Fumarate Plus Peginterferon Alfa-2a: Week 120 Analysis
2019
The original version of this article unfortunately contained affiliation and textual errors. This has been corrected with this erratum.
Journal Article
A look back at the first wave of COVID-19 in China: A systematic review and meta-analysis of mortality and health care resource use among severe or critical patients
2022
Background To investigate the mortality and health care resource use among patients with severe or critical coronavirus disease of 2019 (COVID-19) in the first wave of pandemic in China. Methods We performed a systematic review and meta-analysis to investigate the mortality, discharge rate, length of hospital stay, and use of invasive ventilation in severe or critical COVID-19 cases in China. We searched electronic databases for studies from China with no restrictions on language or interventions patients received. We screened records, extracted data and assessed the quality of included studies in duplicate. We performed the meta-analysis using random-effect models through a Bayesian framework. Subgroup analyses were conducted to examine studies by disease severity, study location and patient enrolment start date. We also performed sensitivity analysis using various priors, and assessed between-study heterogeneity and publication bias for the primary outcomes. Results Out of 6,205 titles and abstracts screened, 500 were reviewed in full text. A total of 42 studies were included in the review, of which 95% were observational studies (n = 40). The pooled 28-day and 14-day mortalities among severe or critical patients were 20.48% (7,136 patients, 95% credible interval (CrI), 13.11 to 30.70) and 10.83% (95% CrI, 6.78 to 16.75), respectively. The mortality declined over time and was higher in patients with critical disease than severe cases (1,235 patients, 45.73%, 95% CrI, 22.79 to 73.52 vs. 3,969 patients, 14.90%, 95% CrI, 4.70 to 39.57) and patients in Hubei compared to those outside Hubei (6,719 patients, 26.62%, 95% CrI, 13.11 to 30.70 vs. 244 patients, 5.88%, 95% CrI 2.03 to 14.11). The length of hospital stay was estimated at 18.48 days (6,847 patients, 95% CrI, 17.59 to 21.21), the 28-day discharge rate was 50.48% (3,645 patients, 95% CrI, 26.47 to 79.53), and the use of invasive ventilation rate was 13.46% (4,108 patients, 95% CrI, 7.61 to 22.31). Conclusions Our systematic review and meta-analysis found high mortality among severe and critical COVID-19 cases. Severe or critical COVID-19 cases consumed a large amount of hospital resources during the outbreak.
Journal Article
Review on nanoparticles and nanostructured materials: history, sources, toxicity and regulations
by
Chan, Yen S
,
Dufresne, Alain
,
Danquah, Michael K
in
Biological properties
,
Carbon black
,
Chemical Sciences
2018
Nanomaterials (NMs) have gained prominence in technological advancements due to their tunable physical, chemical and biological properties with enhanced performance over their bulk counterparts. NMs are categorized depending on their size, composition, shape, and origin. The ability to predict the unique properties of NMs increases the value of each classification. Due to increased growth of production of NMs and their industrial applications, issues relating to toxicity are inevitable. The aim of this review is to compare synthetic (engineered) and naturally occurring nanoparticles (NPs) and nanostructured materials (NSMs) to identify their nanoscale properties and to define the specific knowledge gaps related to the risk assessment of NPs and NSMs in the environment. The review presents an overview of the history and classifications of NMs and gives an overview of the various sources of NPs and NSMs, from natural to synthetic, and their toxic effects towards mammalian cells and tissue. Additionally, the types of toxic reactions associated with NPs and NSMs and the regulations implemented by different countries to reduce the associated risks are also discussed.
Journal Article
Why people participate in the sharing economy: an empirical investigation of Uber
by
Chong, Alain Yee-Loong
,
Chan, Tommy K.H
,
Balaji, M.S
in
Business models
,
Car pools
,
Collaboration
2018
Purpose
The purpose of this paper is to examine the effects of inhibiting, motivating, and technological factors on users’ intention to participate in the sharing economy.
Design/methodology/approach
A self-reported online survey was conducted among Uber users in Hong Kong. A total of 295 valid responses were collected. The research model was empirically tested using the structural equation modeling technique.
Findings
The results suggested that perceived risks, perceived benefits, trust in the platform, and perceived platform qualities were significant predictors of users’ intention to participate in Uber.
Research limitations/implications
This study bridged the research gaps in the sharing economy literature by examining the effects of perceived risks, perceived benefits, and trust in the platform on users’ intention to participate in the sharing economy. Moreover, this study enriched the extended valence framework by incorporating perceived platform qualities into the research model, responding to the calls for the inclusion of technological variables in information systems research.
Practical implications
The findings provided practitioners with insights into enhancing users’ intention to participate in the sharing economy.
Originality/value
This study presented one of the first attempts to systematically examine the effects of inhibiting, motivating, and technological factors on users’ intention to participate in the sharing economy.
Journal Article
A convolutional neural network segments yeast microscopy images with high accuracy
by
Gligorovski, Vojislav
,
Economou, Augoustina Maria
,
Joly, Denis Alain Henri Lucien
in
13/62
,
14/63
,
631/114/1564
2020
The identification of cell borders (‘segmentation’) in microscopy images constitutes a bottleneck for large-scale experiments. For the model organism
Saccharomyces cerevisiae
, current segmentation methods face challenges when cells bud, crowd, or exhibit irregular features. We present a convolutional neural network (CNN) named YeaZ, the underlying training set of high-quality segmented yeast images (>10 000 cells) including mutants, stressed cells, and time courses, as well as a graphical user interface and a web application (
www.quantsysbio.com/data-and-software
) to efficiently employ, test, and expand the system. A key feature is a cell-cell boundary test which avoids the need for fluorescent markers. Our CNN is highly accurate, including for buds, and outperforms existing methods on benchmark images, indicating it transfers well to other conditions. To demonstrate how efficient large-scale image processing uncovers new biology, we analyze the geometries of ≈2200 wild-type and cyclin mutant cells and find that morphogenesis control occurs unexpectedly early and gradually.
Current cell segmentation methods for
Saccharomyces cerevisiae
face challenges under a variety of standard experimental and imaging conditions. Here the authors develop a convolutional neural network for accurate, label-free cell segmentation.
Journal Article
A 9-Valent HPV Vaccine against Infection and Intraepithelial Neoplasia in Women
by
Cuzick, Jack
,
Petersen, Lone Kjeld
,
Kjaer, Susanne K
in
Adolescent
,
Adult
,
Alphapapillomavirus
2015
The quadrivalent human papillomavirus vaccine is effective in preventing infection and disease related to HPV types 6, 11, 16, and 18. This phase 3 trial involving 14,000 women reports the efficacy of a 9-valent vaccine that targets additional HPV types.
The human papillomavirus (HPV) causes premalignant and malignant lesions of the cervix,
1
,
2
vagina,
3
,
4
vulva,
4
,
5
anus,
4
,
6
penis,
7
and oropharynx,
8
as well as genital warts.
9
,
10
The recent development of prophylactic vaccines directed against the most relevant disease-causing HPV types has helped to prevent diseases related to HPV.
11
In clinical trials, the bivalent HPV viruslike particle vaccine against HPV types 16 and 18 was efficacious against related infection with these types and against cervical dysplasia,
12
and the quadrivalent HPV viruslike particle vaccine against types 6, 11, 16, and 18 was efficacious against related infection and against cervical, vaginal, . . .
Journal Article
Bowel ultrasound for predicting surgical management of necrotizing enterocolitis: a systematic review and meta-analysis
2018
BackgroundNecrotizing enterocolitis (NEC) is a devastating inflammatory disease of the intestinal tract that represents a significant source of morbidity and mortality in preterm infants. Imaging of the abdomen is valuable for timely diagnosis and close monitoring of disease progression in NEC. Bowel ultrasound (US) is increasingly being recognized as an important imaging tool for evaluating NEC that provides additional detail than plain abdominal radiographs.ObjectiveTo identify bowel US findings associated with surgical management or death in infants with NEC.Materials and methodsWe searched Embase, PubMed, and the Cumulative Index to Nursing and Allied Health Literature for studies investigating the association between bowel US findings and surgical management or death in NEC. Selected articles were evaluated for quality of study methodology using the Newcastle-Ottawa Scale, and aggregate statistics for odds ratio (OR) and 95% confidence interval were calculated.ResultsOf 521 articles reviewed, 11 articles comprising 748 infants were evaluated for quality. Nine of the studies were retrospective and from single-center experiences. Pooled analysis showed that focal fluid collections (OR 17.9, 3.1–103.3), complex ascites (OR 11.3, 4.2–30.0), absent peristalsis (OR 10.7, 1.7–69.0), pneumoperitoneum (OR 9.6, 1.7–56.3), bowel wall echogenicity (OR 8.6, 3.4–21.5), bowel wall thinning (OR 7.11.6–32.3), absent perfusion (OR 7.0, 2.1–23.8), bowel wall thickening (OR 3.9, 2.4–6.1) and dilated bowel (OR 3.5, 1.8–6.8) were associated with surgery or death in NEC. In contrast, portal venous gas (OR 3.0, 0.8–10.6), pneumatosis intestinalis (OR 2.1, 0.9–5.1), increased bowel perfusion (OR 2.6, 0.6–11.1) and simple ascites (OR 0.54, 0.1–2.5) were not associated with surgery or death.ConclusionThis meta-analysis identified several bowel US findings that are associated and not associated with surgery or death in NEC. Bowel US may be useful for early identification of high-risk infants with NEC who may benefit from more aggressive treatment, including surgery. Future studies are needed to determine whether the addition of bowel US in NEC evaluation would improve outcomes.
Journal Article
Can Malaysian firms improve organizational innovation performance via SCM?
2011
Purpose - The purpose of this paper is to empirically test a framework which identifies the relationships between supply chain management (SCM) practices, operational performance and innovation performance of Malaysian manufacturing and service firms.Design methodology approach - Data for the study were collected from a sample of 163 Malaysian manufacturing and service firms. The research model was tested using structural equation modeling.Findings - The results show that SCM practices in both the upstream and downstream supply chain have a direct and significant impact on organizational and innovation performance of Malaysian firms. Innovation improvement caused by SCM also results in better organizational performance. The findings also reveal that manufacturing and service firms in Malaysia do not have a significant difference in their SCM practices.Research limitations implications - The time sequence of the association between the variables could not be concluded given that cross-sectional data were used. This study also focuse only on Malaysian firms.Practical implications - This paper shows the importance of SCM practices and how they directly influence organizational and innovation performance. This result will be encouraging to firms in other developing countries. This paper has developed and validated a multi-dimensional construct of SCM practices, and this tool can assist decision makers of Malaysian firms to evaluate the efficiency of their current SCM practices.Originality value - The paper presents one of the few studies which empirically validates the relationships between SCM practices and organizational and innovation performances. The study also focuses on a developing country which is in transition from being manufacturing focused to service focused.
Journal Article