An in vitro Evaluation on a Novel Root Canal Cleansing Method by Using Nylon Fibers

Despite traditional metal-based dental files, such as NiTi being demonstrated effective in root cleaning, the tooth structure is always damaged. Thus, to fulfill the need for a minimally invasive tool for contemporary endodontics and dentistry, the use of polymer fibers might provide a good option, as it is soft, fabricable, and disposable. In this study, two types of nylon fibers with respective average diameters of 206.9 µm (fiber W) and 156.4 µm (fiber B), respectively, were used as dental files, and mounted onto either a reciprocating or a low-speed rotary hand-piece. In vitro, simulated root canal models were colored red using nail varnish, and then cleaned by the fiber files mounted on the hand-pieces. Three parts of the simulated models, i.e., the apical third, the medium third, and the coronal third, were chosen to assess the cleaning the efficiency (CE) of each specimen by calculating the ratio of the cross-sectional area changes, before and after cleansing, using micro-Computer Tomography (CT). A NiTi file with a low-speed hand-piece was used as a control. SEM was used to observe the nylon fiber surfaces before and after the cleansing. Micro-CT results showed that for both the nylon fibers, W and B, an average CE of 82.11% ± 9.68% for the medium third could be achieved, which is statistically higher (p < 0.01) than the coronal third and apical third. The cleansing efficiency was not affected by, the types of fibers, nor the hand-pieces according to student’s t-test. Most of the nylon fibers could withstand deformation after the cleansing. To conclude, nylon fiber files have demonstrated a certain cleansing efficiency in simulated root canals, and micro-CT is a promising method to assess CE.published_or_final_versio

The building of a new business ecosystem: Sustaining national competitive advantage through electronic commerce

Despite the high level of interest in the role of governments in building national information infrastructure (NII) as a source of competitive advantage, it is still not clear how major information technology initiatives can help leverage national economies into the global marketplace. In light of the recent rollout of one of the world's largest electronic commerce initiatives, we examine the role of private-public partnerships in the success of such initiative in Hong Kong. Furthermore, we trace the 3 stages of the project - development, implementation, and competitive entrenchment - to identify the difficulties and challenges encountered and how these were overcome. By drawing some comparisons with the Singapore approach, we identify the kind of government involvement appropriate to spur on national competitiveness. We show that in building the NII, the dual aspects of private-sector leadership and government involvement are mutually reinforcing. Government intervention is necessary in creating the initial supply push, whereas the demand pull engendered by the market is critical for leveraging the NII as a platform for national competitiveness. The ramification of the study for other countries is discussed.published_or_final_versio

Prevalence of influenza vaccination and associated factors among Chinese nursing home health care workers

BACKGROUND: Influenza vaccination (IV) in nursing home health care workers (nHCWs) can reduce mortality of nursing home older adults. There is no study examining the prevalence of IV in Chinese nHCWs ...postprin

Characterization of a new polysiloxane-based titanium surface treatment for resin titanium bonding

PURPOSE: To characterize the polysiloxane-coated titanium surface with thermal treatment by XPS and AFM. Such a novel coating might significantly enhance resin bonding. METHODS AND MATERIALS: A layer (2mm) of silicone grease (Dow Corning Co., Michigan, USA) was applied on two titanium plates (Permascand, Ljungaverk, Sweden) followed by a thermal treatment at two temperatures, 800 and 1100 ◦C, respectively. Another titanium plate was surface treated by sandblasting. The atomic composition of titanium surfaces and change of chemical state…postprin

Herpetic shoulder paresis in a Chinese elderly patient

A patient with left shoulder girdle weakness secondary to herpetic myotomal paresis is reported. Needle electromyography revealed denervational discharge from the left supraspinatus, deltoid, and brachioradialis muscles, compatible with a radiculopathy that was relevant to his myotomes affected by zoster infection. The patient was managed with range-of-movement and strengthening exercises as well as pain relief for post-herpetic neuralgia. Further studies are required to determine whether antiviral treatment can limit the extent of motor deficit and hasten recovery. Zoster paresis should be one of the differential diagnoses of girdle muscle weakness.published_or_final_versio

Effectiveness of influenza vaccination in institutionalised older adults: a systematic review

This journal suppl. entitled: 19th Medical Research Conference; Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong KongBACKGROUND: Influenza infection is common among institutionalised older adults. Many non-randomised observational studies on influenza vaccination suggested that it could reduce influenza-related hospitalizations and mortality in institutionalised older adults. Criticism regarding the effectiveness of influenza vaccine estimated by non-randomised observational studies includes the frailty selection bias and use of non-specific outcome like all-cause mortality. A systematic review of studies of influenza vaccination in institutionalized older adults to ...postprin

A retrospective analysis of complications of treatment of nevus of Ota with the Q-switched Alexandrite (QS Alex) and Q-switched Neodymium: Yttrium-Aluminum-Garnet (QS Nd-YAG) lasers

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Advance directive and preference of old age home residents for community model of end-of-life care in Hong Kong

Key Messages: 1. Among 1600 cognitively normal elderly persons living in old age homes in Hong Kong, 88% preferred palliative treatments that could keep them comfortable and free from pain, and 88% agreed to have advance directives. Factors that favour having advance directives among Chinese elders included the practice of asking for relatives’ advice in medical decisions, wishing to be informed of their terminal illness diagnoses, absence of a stroke history, and having no problems in self-care. 2. Approximately one third of old age home residents would accept dying in place. Older age, religion (Catholic or non-believer of traditional Chinese religion), having a better mood score (Geriatric Depression Scale), having no siblings, not receiving an old age allowance, and being a resident of subvented old age homes were independent predictors of preference for community end-of-life care and dying in place. 3. End-of-life care in the hospital was expensive. The total bed-day costs for the 2084 deaths in the two clusters for the index death episode, cumulative 3, 6, and 12 months of hospitalisation were HK$65 474 591, HK$82 543 510, HK$100 170 949, and HK$108 960 348, respectively. The annual cost-savings in hospitalisation bed-days would be HK$177 million when about 30% of elders accepted dying in their old age homes. 4. Elderly residents were willing to pay an additional fee for community end-of-life care services in old age homes. Both the services of the doctor and old age home staff were important attributes. Hence, elderly people were prepared to use more community end-of-life care if better staff and doctor services were provided.published_or_final_versio

Patient Perception of Physician Attire Before and After Disclosure of the Risks of Microbial Contamination

Background: The white coat is traditionally considered to be the appropriate attire for physicians but it may also be contaminated with microbes and act as a potential source of infection. We aimed to study patients’ acceptance of physicians’ attire, their underlying reasons, and their reactions to an educational intervention with regards to the risks of contamination. Methods: We conducted a voluntary questionnaire survey at a university teaching hospital in Hong Kong from February to July 2012. 262 patient-responses from adult inpatients and outpatients across various specialties were analysed. Results: White coats were highly favoured (90.8%) when compared with scrubs (22.1%), smart casual (7.6%) and formal (7.3%) wears. ’Professional image’ and ‘ease of identification’ were the main attributes of the white coat. Most patients (92.2%) would prefer doctors washing their white coats every few days, whilst 80.9% believed that doctors were actually doing so. After patients were informed of the potential risk of microbial contamination, white coats remained as the most favoured attire (66.4%), but with scrubs doubling in popularity (45.8%). Smart casual (9.2%) and formal attire (4.6%) remain the least accepted. Conclusion: Despite cross-infections being a significant concern within the healthcare environments, patients’ predominant acceptance and perceived attributes towards the white coat were maintained after an educational intervention on the risks of microbial contamination.published_or_final_versio

Systems dynamics in the community care pathway at the end-of-life: the Hong Kong experience

BACKGROUND: Since 2009, the HKWC-CGAT in collaboration with TWGHs JC C&A Home piloted the “EOL Program for RCHE in HKWC” program. The program offered 2 EoL care pathways on top of existing care framework: 1) AED pathway: residents remain in RCHE during last stage of life and stay there until very last moment of life; 2) FYKH pathway: resident be transferred to the hospital via expedite pathway at the last moment of life to receive hospice and palliative care until he/she passed away. The program has served 32 residents, 9 have chosen the AED pathway and two passed away peacefully in 2010. Success of this program highlights the need to examine interplaying factors in EoL care pathway and reflect on practical implications for quality EoL care. OBJECTIVE: To identify system factors that contributes to EoL care decision making and dignified EoL Care Pathways. METHOD: This is a qualitative study with individual interviews and focus groups conducted. Participants was …published_or_final_versio