SUMMARY
Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease caused by a novel coronavirus, but its immunopathological mechanisms have not yet been fully elucidated. We ...investigated changes in plasma T helper (Th) cell cytokines, inflammatory cytokines and chemokines in 20 patients diagnosed with SARS. Cytokine profile of SARS patients showed marked elevation of Th1 cytokine interferon (IFN)‐γ, inflammatory cytokines interleukin (IL)‐1, IL‐6 and IL‐12 for at least 2 weeks after disease onset, but there was no significant elevation of inflammatory cytokine tumour necrosis factor (TNF)‐α, anti‐inflammatory cytokine IL‐10, Th1 cytokine IL‐2 and Th2 cytokine IL‐4. The chemokine profile demonstrated significant elevation of neutrophil chemokine IL‐8, monocyte chemoattractant protein‐1 (MCP‐1), and Th1 chemokine IFN‐γ‐inducible protein‐10 (IP‐10). Corticosteroid reduced significantly IL‐8, MCP‐1 and IP‐10 concentrations from 5 to 8 days after treatment (all P < 0·001). Together, the elevation of Th1 cytokine IFN‐γ, inflammatory cytokines IL‐1, IL‐6 and IL‐12 and chemokines IL‐8, MCP‐1 and IP‐10 confirmed the activation of Th1 cell‐mediated immunity and hyperinnate inflammatory response in SARS through the accumulation of monocytes/macrophages and neutrophils.
Fabry Disease (FD) is a systemic disorder that can result in cardiovascular, renal, and neurovascular disease leading to reduced life expectancy. FD should be considered in the differential of all ...patients with unexplained left ventricular hypertrophy (LVH). We therefore performed a prospective screening study in Edmonton and Hong Kong using Dried Blood Spot (DBS) testing on patients with undiagnosed LVH. Participants found to have unexplained LVH on echocardiography were invited to participate and subsequently subjected to DBS testing. DBS testing was used to measure α-galactosidase (α-GAL) enzyme activity and for mutation analysis of the α-galactosidase (GLA) gene, both of which are required to make a diagnosis of FD. DBS testing was performed as a screening tool on patients (n = 266) in Edmonton and Hong Kong, allowing for detection of five patients with FD (2% prevalence of FD) and one patient with hydroxychloroquine-induced phenocopy. Left ventricular mass index (LVMI) by GLA genotype showed a higher LVMI in patients with IVS4 + 919G > A mutations compared to those without the mutation. Two patients were initiated on ERT and hydroxychloroquine was discontinued in the patient with a phenocopy of FD. Overall, we detected FD in 2% of our screening cohort using DBS testing as an effective and easy to administer screening tool in patients with unexplained LVH. Utilizing DBS testing to screen for FD in patients with otherwise undiagnosed LVH is clinically important due to the availability of effective therapies and the value of cascade screening in extended families.
A case study of a special event of low‐level windshear and turbulence at the Hong Kong International Airport is performed. The mountainous Lantau Island to the south of the Airport may lead to ...terrain‐disrupted airflow disturbances in the Airport area in certain wind directions, resulting in low‐level windshear and turbulence to the aircraft. There are a number of novel features in the flow field in the airport region. First, over the seas to the west of the airport, there is sharp convergence between northerly flow and southerly flow within a short distance. Second, in the temperature measurements over this region, there are sharp increases and decreases in temperature. The performance of a high‐resolution numerical weather prediction model in predicting these features is studied. It is shown that, though the model is quite successful in reproducing some features, it may not be able to capture some novel features, such as a sharp rise of temperature and sharp convergence of the airflow. The case study may be a useful reference for aviation weather forecasters and mountain meteorologists.
Surface isobaric chart at 00 UTC, 24 (upper panel) and 25 (lower panel) March 2022.
Cognitive impairment is not uncommon in patients with end-stage renal disease and can make it more difficult for these patients to carry out peritoneal dialysis (PD) on their own. Their attempts to ...do so may result in adverse consequences such as peritonitis. PD exchange is a complex procedure demanding knowledge and skill which requires close supervision and guidance by a renal nurse specialist. In this study, a non-immersive virtual reality (VR) training program using a Leap motion hand tracking device was developed to facilitate patients’ understanding and learning of the PD exchange procedure before attempting real task practice. This study was a two-center single-blinded randomized controlled trial on 23 incident PD patients. Patients in the experimental group received 8 sessions of VR training, while patients in the control were provided with printed educational materials. The results showed that there were significant differences between the two groups in performance of the overall PD exchange sequence, especially on the crucial steps. VR had a patient satisfaction rate of 89%, and all patients preferred to have the VR aid incorporated in PD training. Our findings conclude VR can be a useful aid in the training and reinforcement of PD exchange procedures, with distinct merits of being free from restrictions of time, space, and manpower.
Background. Herpes zoster (HZ) adversely affects individuals aged 50—59, but vaccine efficacy has not been assessed in this population. This study was designed to determine the efficacy, safety, and ...tolerability of zoster vaccine for preventing HZ in persons aged 50—59 years. Methods. This was a randomized, double-blind, placebo-controlled study of 22 439 subjects aged 50—59 years conducted in North America and Europe. Subjects were given 1 dose of licensed zoster vaccine (ZV) (Zostavax; Merck) and followed for occurrence of HZ for ≥1 year (mean, 1.3 years) postvaccination until accrual of ≥96 confirmed HZ cases (as determined by testing lesions swabs for varicella zoster virus DNA by polymerase chain reaction). Subjects were followed for all adverse events (AEs) from day 1 to day 42 postvaccination and for serious AEs (SAEs) through day 182 postvaccination. Results. The ZV reduced the incidence of HZ (30 cases in vaccine group, 1.99/1000 person-years vs 99 cases in placebo group, 6.57/1000 person-years). Vaccine efficacy for preventing HZ was 69.8% (95% confidence interval, 54.1—80.6). AEs were reported by 72.8% of subjects in the ZV group and 41.5% in the placebo group, with the difference primarily due to higher rates of injection-site AEs and headache. The proportion of subjects reporting SAEs occurring within 42 days postvaccination (ZV, 0.6%; placebo, 0.5%) and 182 days postvaccination (ZV, 2.1%; placebo, 1.9%) was similar between groups. Conclusions. In subjects aged 50—59 years, the ZV significantly reduced the incidence of HZ and was well tolerated. Clinical Trials Registration. NCT00534248.
AbstractThis paper investigates the impact of Super Typhoon Mangkhut on Hong Kong, especially the wind effects on high-rise buildings, based on 24-h-long field measurement records collected from the ...two tallest skyscrapers (484 and 420 m in height) in the metropolis and six meteorological stations on different types of terrain on September 16, 2018. Mangkhut corresponded to a 50-year return period and was the most violent typhoon since wind records in Hong Kong began in 1946. In this large-scale monitoring study, the wind characteristics of Mangkhut over different terrains are investigated using the climate records by anemometers and a weather surveillance radar, the wind-excited structural responses of the monitored skyscrapers are analyzed according to measurements by accelerometers and a global navigation satellite system, the structural dynamic properties are estimated by the random decrement technique and the Bayesian spectral density approach, and both rigid and aeroelastic modeling techniques for wind tunnel testing are validated by in-situ measurements during the typhoon. This study aims to enhance the understanding of strong typhoon-generated wind characteristics over different terrains and provide comprehensive information for the wind-resistant design of high-rise buildings in tropical cyclone-prone regions.
Anthropogenic heat flux is the heat generated by human activities in the urban canopy layer, which is considered the main contributor to the urban heat island (UHI). The UHI can in turn increase the ...use and energy consumption of air-conditioning systems. In this study, two effective methods for water-cooling air-conditioning systems in non-domestic areas, including the direct cooling system and central piped cooling towers (CPCTs), are physically based, parameterized, and implemented in a weather research and forecasting model at the city scale of Hong Kong. An extreme high temperature event (June 23-28, 2016) in the urban areas was examined, and we assessed the effects on the surface thermal environment, the interaction of sea-land breeze circulation and urban heat island circulation, boundary layer dynamics, and a possible reduction of energy consumption. The results showed that both water-cooled air-conditioning systems could reduce the 2 m air temperature by around 0.5 °C-0.8 °C during the daytime, and around 1.5 °C around 7:00-8:00 pm when the planetary boundary layer (PBL) height was confined to a few hundred meters. The CPCT contributed around 80%-90% latent heat flux and significantly increased the water vapor mixing ratio in the atmosphere by around 0.29 g kg−1 on average. The implementation of the two alternative air-conditioning systems could modify the heat and momentum of turbulence, which inhibited the evolution of the PBL height (a reduction of 100-150 m), reduced the vertical mixing, presented lower horizontal wind speed and buoyant production of turbulent kinetic energy, and reduced the strength of sea breeze and UHI circulation, which in turn affected the removal of air pollutants. Moreover, the two alternative air-conditioning systems could significantly reduce the energy consumption by around 30% during extreme high temperature events. The results of this study suggest potential UHI mitigation strategies and can be extended to other megacities to enable them to be more resilient to UHI effects.
Vaccination is a key strategy to control the coronavirus disease 2019 (COVID-19) pandemic. Safety concerns strongly influence vaccine hesitancy. Disease transmission during pregnancy could exacerbate ...risks of preterm birth and perinatal mortality. This study examined patterns of vaccination and transmission among pregnant and postnatal women during the fifth wave of COVID-19 in Hong Kong.
The Antenatal Record System and Clinical Management System of the Hospital Authority was used to retrieve information concerning the demographic characteristics, vaccination history, COVID-19 status, and obstetric outcomes of women who were booked for delivery at Queen Mary Hospital in Hong Kong and had attended the booking antenatal visit from 1 July 2021 to 30 June 2022.
Among 2396 women in the cohort, 2006 (83.7%), 1843 (76.9%), and 831 (34.7%) had received the first, second, and third doses of COVID-19 vaccine, respectively. Among 1012 women who had received the second dose, 684 (67.6%) women were overdue for their third dose. There were 265 (11.1%) reported COVID-19 cases. Women aged 20 to 29 years had a low vaccination rate but the highest disease rate (19.1%). The disease rate was more than tenfold higher in women who had no (20.3%) or incomplete (18.8%) vaccination, compared with women who had complete vaccination (2.1%; P<0.001).
Acceptance of COVID-19 vaccination was low in pregnant women. Urgent measures are needed to promote vaccination among pregnant women before the next wave of COVID-19.
Electronic nematic materials are characterized by a lowered symmetry of the electronic system compared to the underlying lattice, in analogy to the directional alignment without translational order ...in nematic liquid crystals. Such nematic phases appear in the copper- and iron-based high-temperature superconductors, and their role in establishing superconductivity remains an open question. Nematicity may take an active part, cooperating or competing with superconductivity, or may appear accidentally in such systems. Here we present experimental evidence for a phase of fluctuating nematic character in a heavy-fermion superconductor, CeRhIn5 (ref. 5). We observe a magnetic-field-induced state in the vicinity of a field-tuned antiferromagnetic quantum critical point at Hc ≈ 50 tesla. This phase appears above an out-of-plane critical field H* ≈ 28 tesla and is characterized by a substantial in-plane resistivity anisotropy in the presence of a small in-plane field component. The in-plane symmetry breaking has little apparent connection to the underlying lattice, as evidenced by the small magnitude of the magnetostriction anomaly at H*. Furthermore, no anomalies appear in the magnetic torque, suggesting the absence of metamagnetism in this field range. The appearance of nematic behaviour in a prototypical heavy-fermion superconductor highlights the interrelation of nematicity and unconventional superconductivity, suggesting nematicity to be common among correlated materials.
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