Search

Introduction: The issue of whether integrase inhibitors (INSTIs) may confer a higher risk of paradoxical tuberculosis‐related immune reconstitution inflammatory syndrome (TB‐IRIS) compared with other classes of antiretroviral in people with HIV with a profound level of immunosuppression remains insufficiently explored. We aimed to assess whether such a higher risk exists by examining a cohort of patients with TB‐HIV initiating antiretroviral therapy (ART) in Hong Kong. Methods: This was a retrospective review of 133 patients registered in the TB‐HIV Registry of the Department of Health during the period 2014–2021. Results: Sixteen of 70 patients (22.9%; 95% confidence interval [CI] 13.0–32.7) and 14 of 63 patients (22.2%; 95% CI 12.0–32.5) from the INSTI and non‐INSTI groups experienced TB‐IRIS (p = 0.920). The median intervals between ART initiation and IRIS among patients from the two groups were similar (3 weeks [interquartile range IQR 2.0–7.8] vs. 4 weeks [IQR 2.0–5.1], p = 0.620). The proportion of patients requiring steroid therapy were similar, as were the hospitalization rates. There was no IRIS‐related death in either group. The risk of TB‐IRIS with INSTI versus non‐INSTI was also similar in a stratified analysis in a subgroup of patients with a baseline CD4 count of <50 μL (10/33 [30.3%; 95% CI 14.6–46.0] vs. 10/22 [45.5%; 95% CI 24.7–66.3], p = 0.252) and another subgroup of patients with ART initiated within 4 weeks of anti‐TB treatment (10/26 [38.5%; 95% CI 19.8–57.2] vs. 10/23 [43.5%; 95% CI 23.2–63.7], p = 0.721). Conclusion: Our cohort study did not offer support for an increased risk of TB‐IRIS with INSTIs compared with non‐INSTIs, even in severely immunocompromised people with HIV. [ABSTRACT FROM AUTHOR]

Real‐time dynamic super‐resolution focusing technology is crucial for various imaging applications. However, the diffraction limit significantly impedes the achievement of real‐time dynamic super‐resolution imaging. Prior studies within this domain, such as super‐resolution fluorescence imaging and structured illumination microscopy, heavily rely on fluorescent labels and intricate algorithms. This article proposes a novel approach to achieving real‐time dynamic super‐resolution imaging at microwave frequency by integrating the Mikaelian lens derived from conformal transformation optics with the space‐time‐coding metasurface antenna. Real‐time dynamic super‐resolution focusing with a resolution ranging from 0.3λ to 0.4λ is demonstrated at the periphery of the Mikaelian lens with a numerical aperture (NA) of 0.54. The proposed hybrid lens exhibits the capacity to discern features separated by about one‐third of a wavelength with high precision. The work offers a universal solution for achieving dynamic real‐time super‐resolution imaging electrically, which can be extended to terahertz waves, visible light, and other wave fields, such as acoustic and flexural waves. [ABSTRACT FROM AUTHOR]

As the proliferation of video content continues, and many video archives lack suitable metadata, therefore, video retrieval, particularly through example‐based search, has become increasingly crucial. Existing metadata often fails to meet the needs of specific types of searches, especially when videos contain elements from different modalities, such as visual and audio. Consequently, developing video retrieval methods that can handle multi‐modal content is essential. An innovative Multi‐modal Video Search by Examples (MVSE) framework is introduced, employing state‐of‐the‐art techniques in its various components. In designing MVSE, the authors focused on accuracy, efficiency, interactivity, and extensibility, with key components including advanced data processing and a user‐friendly interface aimed at enhancing search effectiveness and user experience. Furthermore, the framework was comprehensively evaluated, assessing individual components, data quality issues, and overall retrieval performance using high‐quality and low‐quality BBC archive videos. The evaluation reveals that: (1) multi‐modal search yields better results than single‐modal search; (2) the quality of video, both visual and audio, has an impact on the query precision. Compared with image query results, audio quality has a greater impact on the query precision (3) a two‐stage search process (i.e. searching by Hamming distance based on hashing, followed by searching by Cosine similarity based on embedding); is effective but increases time overhead; (4) large‐scale video retrieval is not only feasible but also expected to emerge shortly. [ABSTRACT FROM AUTHOR]

Peripheral arterial occlusive disease (PAOD) is a clinical manifestation of systemic atherosclerosis and is always associated with cerebrovascular disease and various complications. The aim of our study is to evaluate the relationship between the coronavirus disease 2019 (COVID‐19) infection and the subsequent PAOD development. A retrospective cohort study was conducted and individuals with COVID‐19 infection were identified from the TriNetX analytics platform. A total of 2 206 065 patients with COVID‐19 infection and 2 206 065 patients without COVID‐19 infection were recruited after exclusion and matching. The primary outcome was the development of PAOD after the COVID‐19 infection. The Cox proportional hazard regression was adopted to yield the hazard ratio (HR) and 95% confidence interval (CI) of PAOD between groups. After the whole follow‐up period, the incidence of PAOD was significantly higher in the COVID‐19 group at both the 3‐month follow‐up (HR: 1.27, 95% CI: 1.24–1.30) and the 12‐month follow‐up (HR: 1.33, 95% CI: 1.31–1.35) The Kaplan‐Meier analysis with the log‐rank test demonstrated a higher cumulative probability of PAOD in the COVID‐19 group compared to the non‐COVID‐19 group (p < 0.001). In stratified analysis using 65 years as the threshold, both age groups in the COVID‐19 group exhibited a higher risk of PAOD. Similarly, in the sex and race stratified analysis, the COVID‐19 group performed a higher risk of PAOD in both subgroups. In conclusion, the COVID‐19 infections are strongly associated with an increment of PAOD incidence. [ABSTRACT FROM AUTHOR]

The case reported here is a large non‐ossifying fibroma (NOF) of the mandible presenting in a 24‐year‐old male patient. The lesion was diagnosed through radiological and histopathological assessment. It remains under observation without surgical intervention, despite its large size, as the extensive surgery to remove it is not currently justifiable. Whilst common at the metaphysis of the long bones in paediatric patients, NOFs are rarely observed in the jaw bones. These benign fibrous lesions are often asymptomatic and may be an incidental radiological finding. Most NOFs of the limbs presenting in children will not require any treatment, and spontaneously resolve when growth ceases. However, regarding mandibular lesions, the majority of historical cases have been successfully treated with curettage and do not recur. Due to their scarcity, the outcomes for untreated NOFs of the gnathic bones are not reliably known. We discuss the clinical, radiological and histopathological findings for this case. A thorough literature review of previous reports of this rare entity reveals the typical characteristics and behaviour of this lesion. [ABSTRACT FROM AUTHOR]

The terahertz frequency range is gaining popularity in security, stealth technology, and the future 6G network communication. For the control of severe terahertz electromagnetic interference (EMI) pollution, frequency‐selective stealth‐capable shielding materials are being explored to mask terahertz signals. For the realization of masking terahertz signals, the robustness, lightweight, and shape‐conformable materials with excellent terahertz EMI shielding/absorption are crucial. Here, the study reports the fabrication of 3D symmetric pyramidal architectural MXene composite films with frequency‐selective stealth performance characteristics via the facile drop casting method. With the high absorption capability of 2D MXene layers, the MXene composite films exhibit substantial terahertz stealth performance. 3D pyramidal microstructure design leads to frequency selective surface‐assisted reflection resonance in the frequency range of 0.6–1.1 THz. The MXene composite film demonstrates an outstanding maximum terahertz shielding effectiveness (SE) of up to 70.4 dB and a specific SE of 0.55 dB µm−1. These terahertz SE values exceed all of those for MX‐based shielding material designs reported in the literature. The investigation will open a new direction toward developing terahertz EMI shielding thin films with easy integration into any surface for stealth capabilities. [ABSTRACT FROM AUTHOR]

Introduction: Recreational use of methamphetamine is increasing worldwide, but epidemiology studies from Asia are lacking. We aimed to characterise the trends, drug use pattern, clinical presentations and health services utilisation of acute methamphetamine toxicity presenting to emergency departments and the current practice of emergency department psychosocial interventions in Hong Kong. Methods: This was a secondary analysis of a retrospective study on emergency department patients reported to the Hong Kong Poison Information Centre between 2010 and 2019 for acute toxicity related to recreational methamphetamine use. We studied the trend using a negative binominal regression model. Results: During the study period, 1225 episodes (involved 979 patients; 68.9% men; with a median age of 33.0 years) were reported. Acute methamphetamine toxicity did not increase significantly (odds ratio = 1.10, 95% confidence interval = 0.86–1.40, p = 0.46). Polysubstance abuse predominated. Many patients developed hypokalaemia (24.0%), rhabdomyolysis (17.2%), acute kidney injury (9.4%) and myocardial injury (4.7%); psychotic symptoms including auditory hallucination (23.8%) and paranoid delusion (21.1%); various acute behavioural disturbances and injuries. Overall, 66 patients required intensive care and 14 patients died. Only a minority of the patients were referred to social workers and voluntary drug treatment and rehabilitation services. Conclusion: Methamphetamine has a significant impact on physical and mental health in Hong Kong. Our findings highlight the need for screening for hypokalaemia, rhabdomyolysis, acute kidney injury, myocardial injury and psychosis in methamphetamine users and support policies that address polysubstance abuse, prevent drug use through continued public education and strengthen the referral system by integrating substance abuse services at the emergency department. [ABSTRACT FROM AUTHOR]

Under the impetus of wireless communications, metamaterials have attracted considerable attention due to their superior merits of free manipulation of electromagnetic waves and easy integration. However, most efforts to date are mainly focused on the modulation of wave information or recognition of wave intensity, while the frequency detection is rarely explored. Here, a spoof localized surface plasmon (SLSP) structure is proposed to realize reconfigurable frequency detections. By switching the bias voltage applied to the varactor, the resonance frequency of SLSP can be controlled dynamically from 1.95 to 2.35 GHz. The SLSP‐based waveguide has a relatively high quality factor due to the strongly localized field confinement. Reconfigurable frequency detection is demonstrated experimentally by monitoring the output voltage of the introduced detector. The measured and simulated results are in good agreement. This work will hold promising applications in wireless communication and sensing systems. [ABSTRACT FROM AUTHOR]

Manipulations of free‐space light are usually achieved through various metasurfaces and spatial light modulators. However, an external light source is required to excite these devices, making complete on‐chip integrations difficult. Integrated photonics enables the miniaturization and multi‐functionalization of optical systems by densely packing numerous optical components on a single chip. Particularly, plasmons have recently attracted extensive attention due to their unique abilities to enable the routing and manipulation of light at the nanoscale. Here optical wavefront shaping achieved by holographic metal‐insulator‐metal plasmonic gap waveguides is reported. An arbitrary free‐space wave's amplitude and phase information can be recorded in the waveguide by the amplitude variation of the guided wave. By elaborately designing the plasmonic gap waveguide, the guided waves can be molded into any desired free‐space light field, thus enabling complex free‐space functions including highly directional beams, dual beams with arbitrarily tailorable power ratio and radiation angles, focusing beams, and Airy beam generation. This study opens a new route for optical wavefront shaping via modulating guided waves. It paves the way for optical interconnects across multifunctional photonic integrated devices and free space, holding potential in optical communications, light detection and ranging, imaging, and displays. [ABSTRACT FROM AUTHOR]

Background and Aims: The evolving mutants of SARS‐CoV‐2 have made the COVID‐19 pandemic sustained for over 3 years. In 2022, BA.4 and BA.5 were the Omicron variants dominating the spread globally. Although COVID‐19 was no longer a Public Health Emergency of International Concern (PHEIC) as announced by WHO, the SARS‐CoV‐2 variants remain a challenge to global healthcare under the circumstances of withdrawal and loosening of personal protective behavior in the post‐quarantine era. This study aims to acknowledge the clinical characteristics caused by Omicron BA.4/BA.5 in COVID‐19 naive people and analyze possible factors affecting disease severities. Methods: In this retrospective study, we report and analyze the clinical features of 1820 COVID‐19 patients infected with the BA.4/BA.5 Omicron variants of SARS‐CoV‐2 during a local outbreak that occurred in Macao SAR, China, from June to July 2022. Results: A total of 83.5% of patients were symptomatic eventually. The most common symptoms were fever, cough, and sore throat. Hypertension, dyslipidemia, and diabetes mellitus were the leading comorbidities. There were significantly more elderly patients (p < 0.001), more patients with comorbidity (p < 0.001) and more patients without vaccination or not completing the series (p < 0.001) in the "Severe to Critical" group. All deceased patients were elderly with at least three comorbidities and were partial to totally dependent in their daily lives. Conclusion: Our data are consistent with a milder disease caused by BA.4/5 Omicron variants in the general population, while patients with old age and comorbidities have developed severe to critical diseases. Complete vaccination series and booster doses are effective strategies to reinforce protection against severe diseases and avoid mortality. [ABSTRACT FROM AUTHOR]

The next‐generation wireless communications and intrachip and interchip communications require high‐speed terahertz (THz) interconnects. The interconnects based on spoof surface plasmon polaritons (SSPPs) provide a possible route to achieve this goal. Recently, some THz plasmonic devices are explored, but they suffer from bulk sizes and/or single function. Herein, planar multifunctional THz plasmonic devices based on the interaction between SSPPs and spoof localized surface plasmon (SLSPs) including the functions of pass‐through transmission, multifrequency resonances, and phase shift are proposed and experimentally demonstrated. The pass‐through transmission can be realized on the SSPP waveguide by increasing the loss of the coupled SLSP resonator; the multifrequency resonances are obtained by placing the SU‐8 films with different thicknesses on the SLSP resonator due to its high sensitivity; and the phase shift can be achieved by integrating the SU‐8 film on the SSPP waveguide due to the flexible dispersion behaviors of SSPPs. The proposed multifunctional THz plasmonic devices hold great promise for the THz on‐chip integrations, wireless communications, and sensing systems. [ABSTRACT FROM AUTHOR]

Driven by increasing demands for the ultra‐compact interconnects of integrated electronics and the ultrafast information transfer of communication systems, research on spoof plasmonic metamaterials has attracted considerable attention. However, most efforts to date have been only achieved in individual modulation of amplitude or phase at a single frequency because of the limitation of structural design. Herein, an ultra‐thin reprogrammable modulator consisting of a spoof surface plasmonic polariton (SSPP) waveguide and spoof localized surface plasmon (SLSP) resonators is proposed and experimentally demonstrated. It allows controlling the amplitudes and phases of surface waves independently. By simultaneously manipulating the SSPP waveguide and SLSP resonators in real time, different modulations are realized in a programmable way, such as amplitude‐shift keying, phase‐shift keying, quadrature amplitude modulation, and frequency‐shift keying. Measured results confirm that the reprogrammable plasmonic metamaterial can modulate the surface electromagnetic waves, holding promising applications in integrated circuits and communication systems. [ABSTRACT FROM AUTHOR]

Background: Periodontal disease may drive a systemic inflammatory response that triggers migraine; however, the association between periodontal disease and migraine has rarely been investigated in a community‐based setting. Methods: This cross‐sectional study included 66,109 participants aged 30 to 70 years from Taiwan Biobank (TWB). A structured questionnaire was administered to participants, who were also subjected to whole‐genome single nucleotide polymorphism genotyping using the customized Axiom–TWB array. To identify subjects with periodontal disease and migraine, the computerized linkage of data obtained from TWB and the National Health Insurance Research Database was performed. Participants were evaluated for their genetic predisposition to migraine using a polygenic risk score. We examined and estimated the magnitude of associations between periodontal disease and migraine. Results: In this study, 4618 (4618/66,109; 7%) participants with migraine and 61,491 (61,491/66,109; 83%) participants without migraine were included. Participants with migraine exhibited a higher prevalence of periodontal disease than participants without migraine (4324/4618; 94% vs. 56,036/61,491; 91%). A significant positive association was observed between periodontal disease and migraine, with an adjusted odds ratio (ORadj) of 1.40 (95% confidence interval [CI] = 1.24–1.59; p < 0.001). The association remained consistent even after excluding participants with other comorbidities (ORadj = 1.34; 95% CI = 1.16–1.55; p < 0.001). Moreover, the positive association between periodontal disease and migraine remained significant across the subgroups of age, sex, other comorbidities, and classified polygenic risk scores of migraine, with the ORadj ranging from 1.26 to 1.78. Conclusions: A significant positive association was observed between periodontal disease and migraine. Future studies need to explore the biological mechanisms of how periodontal disease might affect migraine. [ABSTRACT FROM AUTHOR]

Background: The Hong Kong Poison Information Centre has provided consultation service to healthcare professionals and collected epidemiological data on poisoning in Hong Kong since 2005. Objective: To analyse and report the poisoning data of Hong Kong Poison Information Centre in 2020 during the COVID-19 pandemic. Methods: A retrospective review of all poisoning cases recorded in the Poison Information and Clinical Management System of Hong Kong Poison Information Centre in 2020. Results: A total of 3633 poisoning cases were analysed. Compared to 2019 (pre-COVID era), there was a reduction of ~10% of total poisoning cases recorded (383 cases), with a majority (> 90%) of reduction from poisoning cases with no clinical effect (353 cases). A greater proportion of reduction was observed among the children (0–12 years), patients with general unintentional poisoning, poisoning due to therapeutic error and food poisoning. An increased number of cases was noted from abusive use, adverse herb/proprietary Chinese medicine reaction and poisoning related to household bleaches. Teenage (13–19 years) poisoning seemed to be unaffected by the COVID-19 pandemic and the previously observed increasing trend continued (up to 11.8% of total poisoning cases this year). Despite a total reduction in poisoning cases recorded, the number of deaths increased by 37% from 35 in 2019 to 48 in 2020 (mortality rate 1.5%). A total of seven interesting cases were discussed. Conclusion: This 15th annual report provides updated epidemiological information on poisoning patterns in Hong Kong during the COVID-19 pandemic. It also highlighted important changes and possible effects of the COVID-19 pandemic on poisoning in Hong Kong in comparison with our previous reports. [ABSTRACT FROM AUTHOR]

Introduction: Tetrodotoxin poisoning is typically caused by puffer fish consumption. This study is to review its demographics, clinical presentations and management in Hong Kong. Method: Reported cases of tetrodotoxin poisoning to Hong Kong Poison Information Centre from October 2008 to March 2021 were included in the study. Information from electronic database was analysed. Results: Forty-two cases were included in this case series. The number of incidents of tetrodotoxin poisoning ranged from 0 to 5 per year, mostly in the winter months. Median ingestion-to-symptom and ingestion-to-door time was 2 and 6.5 h, respectively. 48% of puffer fish meal sharer was symptomatic and attended emergency department. 100% and 48% of all cases had neurological and cardiovascular/gastrointestinal symptoms, respectively. Fukuda and Tani clinical Grade 1 and 2 were the most common presentation. 17% required intensive care while most patients were managed safely in emergency department and/or emergency medicine ward. Conclusion: There are recurrent incidents of tetrodotoxin poisoning in Hong Kong. Public education is the key to prevent future outbreaks. Targeted history and enhanced availability of tetrodotoxin test would assist in its diagnoses. [ABSTRACT FROM AUTHOR]

Objective: To compare local poisoning patterns of preadolescents and adolescents. Methods: Retrospective cross-sectional study. Data collected through the Hong Kong Poison Information Centre (HKPIC) Poisoning Information and Clinical Management System (PICMS). Patients aged 10 to 17 years old from January 2016 to December 2018 were included and divided into preadolescent (10–12 years old) and adolescent (13–17 years old) groups. Statistical analysis for categorical variables was performed using chi-square test of independence, p < 0.05. Strength of association examined with Cramer's V. Rate ratios with 95% confidence interval were used to determine nature of association, using preadolescents as comparison group. Results: A total of 703 cases were analyzed. There were 107 cases in the preadolescent group and 596 cases in the adolescent group. Three variables showed moderate association: intentional exposure (rate ratio: 2.91, 2.13–3.98), exposure in school (rate ratio: 0.30, 0.21–0.44), and the use of pharmaceuticals (rate ratio: 1.95, 1.57–2.44). The most common substance of exposure were analgesics (n = 213, 24.94%) and fumes, gases, and vapors (n = 19, 15.08%) in adolescents and preadolescents, respectively. Conclusion: Epidemiological difference still exists between preadolescents and adolescents. The association of adolescents with intentional poisoning, and the use of pharmaceuticals was highlighted. The study acts as a recent update of pediatric poisoning patterns and hopes to act as a reference for future studies. [ABSTRACT FROM AUTHOR]

Introduction: Development of coagulopathy after anticoagulant rodenticide ingestion varies among patients. This study aimed to identify factors that were associated with coagulopathy after anticoagulant rodenticide ingestion. Methods: This was a retrospective cohort study, conducted in the Hong Kong Poison Information Centre. All patients who reported rodenticide exposure and presented to the Accident and Emergency Department from 1 January 2010 to 31 December 2019 were recruited. Coagulopathy was defined as International Normalized Ratio of 1.3 or above. Results: One hundred sixty-nine patients were included in the final analysis. The median age was 44 years old. Forty-nine patients developed coagulopathy (International Normalized Ratio ⩾1.3). Univariate analysis (at p < 0.05) showed that age (p = 0.003), ingestion of first-generation anticoagulant rodenticide (p = 0.017), ingestion of more than one pack (p < 0.001), intentional ingestion (p = 0.002), hypoalbuminemia (p < 0.001), elevated alanine aminotransferase level (p = 0.041) and abnormal estimated glomerular filtration rate (p = 0.005) on presentation, and co-ingestion with paracetamol (p = 0.018) were associated with coagulopathy after anticoagulant rodenticide ingestion. Among these, ingestion of more than one pack (p < 0.001; odds ratio = 19.8; 95% confidence interval = 6.78–65.7), ingestion of first-generation anticoagulant rodenticide (p = 0.006; odds ratio = 5.2; 95% confidence interval = 1.96–15.2), hypoalbuminemia (p < 0.001; odds ratio = 22.4; 95% confidence interval = 6.17–99.0) and elevated alanine aminotransferase level on presentation (p = 0.039; odds ratio = 7.11; 95% confidence interval = 1.58–33.1) were statistically significant in the multivariate analysis. Conclusion: Ingestion of more than one pack and ingestion of first-generation anticoagulant rodenticides were significantly associated with the development of coagulopathy after anticoagulant rodenticide ingestion. Patients who developed hypoalbuminemia or elevated alanine aminotransferase level as a result of anticoagulant rodenticide ingestion were also significantly associated with the development of coagulopathy. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal toxin removal is used for enhanced elimination in severe lithium poisoning. The Extracorporeal TReatments In Poisoning workgroup provides recommendations on the use of extracorporeal toxin removal in poisoning. Objectives: Our aim was to identify the pattern for using extracorporeal toxin removal in managing lithium poisoning in Hong Kong and compare the outcomes in extracorporeal toxin removal-treated patients and non-extracorporeal toxin removal-treated patients if indicated for treatment as defined by The Extracorporeal TReatments In Poisoning criteria. Methods: Lithium poisoning presented between year 2009 and 2019 in Hong Kong Poison Information Centre (HKPIC) database was categorized into extracorporeal toxin removal-treated group and non-extracorporeal toxin removal-treated group. Comparative analyses were performed. Results: Among 112 lithium-poisoned patients, 21% were treated with extracorporeal toxin removal. Larger proportion of patients had fulfilled at least one Extracorporeal TReatments In Poisoning criteria for extracorporeal toxin removal in the extracorporeal toxin removal-treated group (87% vs 18%, p < 0.005). The extracorporeal toxin removal-treat group patients were more commonly presented with impaired consciousness, seizure and dysrhythmia (p < 0.05). They also got higher admission (3.62 mmol/L vs 2.18 mmol/L, p < 0.05) and peak (4.15 mmol/L vs 2.28 mmol/L, p < 0.05) serum lithium concentrations, as well as a significantly higher serum creatinine concentration upon presentation (263.74 µmol/L vs 98.66 µmol/L, p < 0.05). Extracorporeal toxin removal-treat group patients more frequently had a severe poisoning outcome (91.3% vs 9%, p < 0.05) and developed complications (69.6% vs 13.5%, p < 0.05). Logistic regression identified seizure, peak serum lithium concentration, and serum creatinine concentration upon presentation as risk factors for severe poisoning outcome. In subgroup analysis on patients with at least one indication for extracorporeal toxin removal as defined by Extracorporeal TReatments In Poisoning criteria, the proportion of severe poisoning remained higher in the extracorporeal toxin removal-treated group (90% vs 43.7%, p < 0.05). Complication rate was not significantly different between the two groups. Conclusion: Clinically severe lithium poisoning patients were treated with extracorporeal toxin removal in Hong Kong. Extracorporeal TReatments In Poisoning criteria can serve as a reference in considering extracorporeal toxin removal treatment for lithium poisoning patients. Nevertheless, Extracorporeal TReatments In Poisoning criteria recommend more extracorporeal toxin removal treatment than it was actually done. Lithium poisoning patients with positive Extracorporeal TReatments In Poisoning criteria have been managed without extracorporeal toxin removal. No statistically significant adverse outcome was observed in these cases. [ABSTRACT FROM AUTHOR]

Spoof surface plasmon polariton (SSPP) interconnects have great potential for the next‐generation wireless communications and terahertz (THz) integrated circuits. SSPP logic gates are reported to meet the above development requirements. However, the reported SSPP logic gates consist of 3D domino waveguide structure and conversion structure with a funnel‐shaped metasurface; and hence, suffer from the size limit of the compact on‐chip integrations. To explore a more compact and flexible design, a series of logic gates in the planar THz SSPP platform, including OR, AND, XOR, NOT, and NAND gates, is experimentally demonstrated. Owing to the flexible dispersion behaviors, different phase differences between inputs can be controlled by manipulating the SSPP waveguide structure, such as the SSPP Mach–Zehnder interferometer, thereby realizing various THz SSPP logic gates, which will enable powerful potential in large‐scale on‐chip systems, future wireless communications, and intelligent computing. [ABSTRACT FROM AUTHOR]

During extracellular electron transfer, Geobacter sulfurreducens constitutively expresses the bc‐cytochrome CbcL, yet cells containing only this menaquinone oxidase fail to respire above −0.1 V vs. SHE. By identifying mutations within cbcL that permit growth at higher potentials, we provide evidence that this cytochrome is regulated by redox potential. Strains expressing only CbcLV205A, CbcLV205G, and CbcLF525Y were capable of growth with high potential electron acceptors including Fe(III) citrate, Mn(IV) oxides, and electrodes poised at +0.1 V vs. SHE. Electrochemical characterization of wild type CbcL revealed oxidative inactivation of electron transfer above −0.1 V, while CbcLV205A, CbcLV205G, and CbcLF525Y remained active. Growth yields of CbcLV205A, CbcLV205G, and CbcLF525Y were only 50 % of WT, consistent with CbcL‐dependent electron transfer conserving less energy. These data support the hypothesis that CbcL has evolved to rapidly shut off in response to redox potential, in order to divert electrons to higher yield oxidases that coexist in the Geobacter membrane. [ABSTRACT FROM AUTHOR]

Single‐cycle infectious virus can elicit close‐to‐natural immune response and memory. One approach to generate single‐cycle severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is through deletion of structural genes such as spike (S) and nucleocapsid (N). Transcomplementation of the resulting ΔS or ΔN virus through enforced expression of S or N protein in the cells gives rise to a live but unproductive virus. In this study, ΔS and ΔN BAC clones were constructed and their live virions were rescued by transient expression of S and N proteins from the ancestral and the Omicron strains. ΔS and ΔN virions were visualized by transmission electron microscopy. Virion production of ΔS was more efficient than that of ΔN. The coated S protein from ΔS was delivered to infected cells in which the expression of N protein was also robust. In contrast, expression of neither S nor N was detected in ΔN‐infected cells. ΔS underwent viral RNA replication, induced type I interferon (IFN) response, but did not form plaques. Despite RNA replication in cells, ΔS infection did not produce viral progeny in culture supernatant. Interestingly, viral RNA replication was not further enhanced upon overexpression of S protein. Taken together, our work provides a versatile platform for development of single‐cycle vaccines for SARS‐CoV‐2. [ABSTRACT FROM AUTHOR]

The shoot‐through (ST) states are essential for the operation of sinusoidal pulse‐width‐modulation (SPWM) based Z‐source inverters. However, the insertion of shoot‐through state unavoidably leads to output harmonics which is greatly affected by its distribution, especially for bipolar modulation schemes. With quantitative analysis, this paper investigates the mathematical relationship between the output harmonics and shoot‐through states for single‐phase Z‐source inverters. A modified double‐Fourier‐transformation‐based calculation scheme is proposed to estimate the output harmonics with different shoot‐through states insertion methods. Simulations and hardware experiments with a 200 W single‐phase Z‐source converter under two bipolar modulation control methods verified the accuracy of the proposed theory. The quantitative analysis would be helpful for the design of Z‐source converter's control strategy and modulation scheme. [ABSTRACT FROM AUTHOR]

Background: The Hong Kong Poison Information Centre (HKPIC) provides consultation service to health care professionals and collect epidemiological data on poisoning in Hong Kong since 2005. Objective: To report and analyse the data of Hong Kong Poison Information Centre on poisoning in 2019. Methods: This was a retrospective review of all poisoning cases recorded in the Poison Information and Clinical Management System of Hong Kong Poison Information Centre in 2019. Results: A total of 4016 poisoned cases were analysed, which involved 1698 men (42.3%), 2312 women (57.6%) and 6 sex-unspecified patients (0.1%). Majority of cases (77.3%) were between 13 and 69 years of age, and 10.5% were teenagers 13–19 years of age. Self-harm/suicidal attempt (42.1%), unintentional exposure (18.1%) and abusive substance use (11.1%) were common reasons of poisoning. Excluding ethanol, which was the common co-ingestant, the five most common types of poison were benzodiazepines, paracetamol, household products, zopiclone and Chinese herbal medicine. While most patients were managed with supportive treatment, 16.5% and 16.8% of the consultation cases were treated with decontamination and antidotes, respectively. Majority of cases recovered uneventfully, but 1.0% died and 4.7% had a major outcome. A total of six interesting cases and two outbreaks were discussed in this report. Conclusion: This 14th annual report provided updated epidemiological information on the pattern of poisoning in Hong Kong and highlighted a number of important changes compared with our previous reports. [ABSTRACT FROM AUTHOR]

In recent years, frequency selective surface (FSS)‐based two‐dimensional (2D) and three‐dimensional (3D) carbon materials such as carbon nanofibers, carbon nanotubes, and carbon‐filled filaments are essential tools to design millimeter‐wave radomes, absorbers, electromagnetic interference (EMI) shielding, and antenna reflectors in gigahertz (GHz) regimes. Terahertz (THz) technologies are gaining attentions from medical imaging to security surveillance. In this work, a 3D microstructured FSS using carbon‐based polyimide as a precursor to enhance the resonant frequency at the THz range. Furthermore, gold nanoparticles (AuNPs) are embedded on 3D microsturctured carbonized polyimide (3D‐CPI) film to improve their FSS property through plasmonic effects. From the time domain spectroscopy measurements, 3D‐CPI FSS film shows band‐stop filter properties in the frequency range of 0.5–1.5 THz and with a maximum return loss (RL) of 40.5 dB (at the resonant frequency of 1 THz). The 3D‐CPI/AuNPs film demonstrates the highest RL of 43.7 dB at the higher excitation resonance frequency ≈1.06 THz due to the interaction of plasmonic electrons with scattered delocalized electrons in carbon, which induces the mechanisms for EMI shielding. The results will open insight into 3D plasmonic carbon microstructures as an EMI shielding material at THz frequency. [ABSTRACT FROM AUTHOR]

Despite modern terahertz (THz) systems benefit from the developments in metasurfaces with flexible wavefront manipulation capabilities, the large propagation space between the THz source/detector and metasurface component, as well as the inherent insertion loss of metasurfaces, are the two main bottlenecks that hinder metasurface‐based THz devices from becoming a practical technology. This article addresses these two problems by demonstrating a compact, high‐efficiency folded metasurface system in the THz band. The device comprises two parallel dielectric metasurfaces, between which the THz waves are confined to reduce the system volume. The bottom reflective metasurface consists of an array of anisotropic dielectric resonators, which can simultaneously manipulate THz waves' phase and polarization properties. The upper metasurface is a dielectric Bragg polarizer that selects the desired linear polarization of THz waves to pass through. Low‐loss and nondispersive high‐resistivity silicon is used as the material for both metasurfaces in this design, which is essential to achieving high efficiency. The compact and high‐efficiency folded THz metasystem is further experimentally verified. The introduced folded device can be used in diverse applications such as high‐speed THz communications, non‐destructive detection, and imaging systems, significantly reducing their volume and increasing their radiation efficiency. [ABSTRACT FROM AUTHOR]

We aim to leverage the transformational science enabled by the Event Horizon Telescope (EHT) to study the physics of, and near, the black holes in a sample of galaxies covering a large parameter space in supermassive black hole mass, accretion rate, and jet power. To this end, we work on a sample of nearby galaxies whose directly measured black hole masses and distances imply that 40 micro‐arcsec EHT observations will resolve the central engine at <100 Schwarzschild radius resolution. To complement the near‐future EHT observations, we attempt to constrain the accretion properties of nearby active galactic nuclei by modeling the broadband spectral energy distribution using a general relativistic Monte Carlo radiative transfer code. These results will provide apriori information that is vital for an accurate ray‐tracing of EHT millimeter maps of accretion flows in the future. [ABSTRACT FROM AUTHOR]

Geobacter sulfurreducens utilizes extracellular electron acceptors such as Mn(IV), Fe(III), syntrophic partners, and electrodes that vary from +0.4 to −0.3 V versus standard hydrogen electrode (SHE), representing a potential energy span that should require a highly branched electron transfer chain. Here we describe CbcBA, a bc‐type cytochrome essential near the thermodynamic limit of respiration when acetate is the electron donor. Mutants‐lacking cbcBA ceased Fe(III) reduction at −0.21 V versus SHE, could not transfer electrons to electrodes between −0.21 and −0.28 V, and could not reduce the final 10%–35% of Fe(III) minerals. As redox potential decreased during Fe(III) reduction, cbcBA was induced with the aid of the regulator BccR to become one of the most highly expressed genes in G. sulfurreducens. Growth yield (CFU/mM Fe(II)) was 112% of WT in ∆cbcBA, and deletion of cbcL (an unrelated bc‐cytochrome essential near −0.15 V) in ΔcbcBA increased yield to 220%. Together with ImcH, which is required at high redox potentials, CbcBA represents a third cytoplasmic membrane oxidoreductase in G. sulfurreducens. This expanding list shows how metal‐reducing bacteria may constantly sense redox potential to adjust growth efficiency in changing environments. [ABSTRACT FROM AUTHOR]

Information on genetic variants associated with elevated serum alanine aminotransferase (ALT) levels remains limited. A genome‐wide association study was performed to identify single‐nucleotide polymorphisms (SNPs) associated with ALT levels. The ALT‐associated SNP was further evaluated for hepatocellular carcinoma (HCC) risk. A cohort of 892 anti‐HCV seropositive patients was used for genome‐wide SNP array to examine the associations with baseline ALT levels. SNPs <10−5 were further tested for associations with serial ALT levels then validated in 486 anti‐HCV seropositives. Multinomial logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals of SNPs associated with ALT. The SNP was evaluated for HCC risk by using Cox's proportional hazards models. After quality control, 803 participants with 564,464 SNPs were included in the analysis. Of these, 12 SNPs were associated with ALT (p < 10−5). Among the participants, 158 (19.7%) had ALT persistently ≤15 U/L, 327 (40.7%) ever >15 U/L but never >45 U/L, and 318 (39.6%) ever >45 U/L during follow‐up. The rs568800 was associated with serial ALT levels, and this was replicated in the external population significantly (p <.05). The A allele (vs C) of rs568800 was associated with ALT >15 U/L but ≤45 U/L and ALT >45 U/L, with the adjusted ORs of 1.41 (1.11–1.78) and 1.86 (1.34–2.60), respectively. The adjusted HRs for HCC were 2.09 (0.90–4.89) for AC and 2.64 (1.13–6.17) for AA (CC as a reference). In conclusion, the rs568800 was associated with serum ALT levels and HCC risk. Clinical utility should be evaluated among patients who have received antivirals. [ABSTRACT FROM AUTHOR]

Houttuynia cordata (H. cordata) is a popular vegetable in Asian countries and is also used extensively as herbal medicine in treating various diseases. H. cordata contains aristolactams, which have a similar Chinese name as aristolochic acids (AAs); hence, an emerging concern in the greater China region has arisen about the potential linkage between H. cordata and aristolochic acid nephropathy (AAN). However, only a single study has tested for the presence of AAs in H. cordata samples, and the analysis was limited by the analytical sensitivity of the method. Thus, further analysis of AAs in H. cordata using analytical method of higher sensitivity is needed to alleviate public anxiety over the use of this popular vegetable. In this study, a liquid chromatography–tandem mass spectrometry (LC–MS/MS) method was used to analyze H. cordata samples for the natural existence of aristolochic acid I (AA‐I) and aristolochic acid II (AA‐II), which are the most carcinogenic and nephrotoxic compounds in the AA family. After evaluating the method performance by fortifying blank samples with three concentrations of AAs, the validated method was applied to identify AA‐I and AA‐II in both fresh and sun‐dried H. cordata samples (n = 20) collected from different cities in China. The LC–MS/MS method achieved method detection limits (MDLs) as low as 2 ng/g of AAs in H. cordata. Analysis of the collected fresh and sun‐dried H. cordata samples revealed that AA‐I and AA‐II either do not exist naturally in H. cordata or exist at concentrations below the MDLs. Therefore, it is not very likely that consumption of H. cordata will result in AAN because AA‐I and AA‐II, the nephrotoxic and carcinogenic culprits of AAN, are not produced naturally in the plant or are produced at levels that do not pose a risk of AAN. [ABSTRACT FROM AUTHOR]

Background: To update the Hong Kong Urological Association–Hong Kong Society of Uro‐Oncology consensus statements on the management of advanced prostate cancer, the same panelists as in the previous consensus panel held a series of meetings to discuss updated clinical evidence and experiences. Methods: The previous consensus statements were retained, deleted, or revised, and new statements were added. At the final meeting, all statements were reviewed and amended as appropriate, followed by panel voting. Results: There were significant changes and additions to the previous consensus statements, primarily driven by the advances in androgen receptor signaling inhibitors, treatment sequencing in metastatic castration‐resistant prostate cancer, and increasing recognition of oligometastatic prostate cancer since the introduction of prostate‐specific membrane antigen positron emission tomography. In this update, a total of 59 consensus statements were accepted and established. Conclusions: The consensus panel updated consensus statements on the management of advanced prostate cancer, aiming to allow physicians in the region to keep abreast of the recent evidence on optimal clinical practices. [ABSTRACT FROM AUTHOR]

Aim: In response to the fast‐developing coronavirus disease 2019 (COVID‐19) pandemic, special arrangement and coordination are urgently required in the interdisciplinary care of patients across different medical specialties. This article provides recommendations on the management of different stages of localized or metastatic prostate cancer (PC) amid this pandemic. Methods: The Hong Kong Urological Association and Hong Kong Society of Uro‐oncology formed a joint discussion panel, which consisted of six urologists and six clinical oncologists with extensive experience in the public and private sectors. Following an evidence‐based approach, the latest relevant publications were searched and reviewed, before proceeding to a structured discussion of relevant clinical issues. Results: The joint panel provided recommendations for PC management during the pandemic, in terms of general considerations, diagnostic procedures, different disease stages, treatment modules, patient support, and interdisciplinary collaboration. The overall goal was to minimize the risk of infection while avoiding unnecessary delays and compromises in management outcomes. Practical issues during the pandemic were addressed such as the use of invasive diagnostic procedures, robotic‐assisted laparoscopic prostatectomy, hypofractionated radiotherapy, and prolonged androgen deprivation therapy. The recommendations were explicated in the context of Hong Kong, a highly populated international city, in relation to the latest international guidelines and evidence. Conclusion: A range of recommendations on the management of PC patients during the COVID‐19 pandemic was developed. Urologists, oncologists, and physicians treating PC patients may refer to them as practical guidance. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: To investigate the lingual artery (LA) position in the tongue base through intraoperative ultrasound (IOU) imaging during transoral robotic surgery (TORS) and evaluate bleeding complications with or without the assistance of IOU. Study Design: Cohort study with historical control. Methods: Patients with obstructive sleep apnea (OSA) who underwent TORS for tongue base resection were recruited since 2016. During surgery, ultrasound imaging was employed to identify anatomic parameters of the LA in the tongue base, including distance to the midline and arterial depth and diameter. Results: Ninety‐three OSA patients (82 men, 88.2%) were analyzed. Mean age was 42.2 ± 10.0 years and body mass index was 29.2 ± 4.5 kg/m2. Average apnea–hypopnea index (AHI) was 58.1 ± 21.4 events/hour. Overall, 70 patients who underwent TORS with IOU had a shorter operation time (191.7 ± 3.8 vs. 220.1 ± 6.6 minutes), lower total blood loss (11.3 ± 10.8 vs. 19.6 ± 26.7 mL), and higher tongue base reduction volume (7.1 ± 2.5 vs. 3.9 ± 1.6 mL) than 23 patients who underwent TORS without IOU. Significant predictors of arterial depth included higher AHI level during the rapid eye movement sleep (P =.038), larger tonsil size (P =.034), and more elevated Friedman tongue position (P =.012). Postoperative complications associated with LA injury were not found in patients subjected to IOU. Conclusions: With the assistance of IOU, surgeons can confidently determine LA position. The use of IOU can maximize efficiency and minimize catastrophic bleeding complications when OSA patients undergo TORS for tongue base resection. Level of Evidence: 4 Laryngoscope, 131:E1383–E1390, 2021 [ABSTRACT FROM AUTHOR]

SUMMARY: The Internet of Everything (IoE), clearly a 21st century's technology, brilliantly plays with digital data obtained from analog sources, bringing together two different realities, the analog (physical/real), and the digital (cyber/virtual) worlds. Then, with the boundaries of IoE still analog in nature, the required functions at the interface involve sensing, measuring, filtering, converting, processing, and connecting, which imply that the analog layer governs the entire system in terms of accuracy and precision. Furthermore, such interface integrates several analog and mixed‐signal subsystems that comprise mainly signal transmission and reception, frequency generation, energy harvesting, data, and power conversion. This paper sets forth a state‐of‐the‐art design perspective of some of the most critical building blocks used in the analog/digital interface, covering wireless cellular transceivers, millimeter‐wave frequency generators, energy harvesting interfaces, plus, data and power converters, that exhibit high quality performance achieved through low‐power consumption, high energy‐efficiency, and high speed. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to report and analyse the poisoning data of Hong Kong Poison Information Centre in 2018. Methods: In 2018, all poisoning cases received by Hong Kong Poison Information Centre were retrieved from its database, Poison Information and Clinical Management System, for analysis. Results: A total of 3960 poisoned cases were analysed. There were 1770 male patients (44.7%), 2188 female patients (55.3%) and 2 sex-unspecified patients (<0.1%). The majority of cases (68.3%) were between 20 and 69 years old, and 9.9% involved children of 0–5 years old. The common causes of poisoning were suspected self-harm/suicidal attempt (36.6%), unintentional exposure (18.4%) and abusive substance use (11.1%). Excluding the common co-ingestant ethanol, the five commonest types of poison were benzodiazepines, paracetamol, Chinese herbal medicine, household products and zopiclone. Most patients were managed with supportive measures, while 13.5% and 13.7% of consultation cases were treated by decontamination and antidotes, respectively. The majority of cases had uneventful recovery; 0.8% resulted in death and 4.9% had major outcomes. A total of eight interesting cases were discussed. Conclusion: This 13th annual report provided the updated epidemiological information on poisoning pattern in Hong Kong and highlighted important changes in comparison with our previous reports. [ABSTRACT FROM AUTHOR]

Many studies have reported a positive association between lower socioeconomic status (SES) and higher head and neck cancer (HNC) risk. Fewer studies have examined the impact of SES on the association between alcohol or cigarette use and HNC risk. The current case‐control study (1104 HNC cases and 1363 controls) investigated the influence of education, a SES indicator, on the association between HNC and the use of alcohol, cigarettes, or betel quids in Taiwan, a country with universal health care. Our results showed a larger increase in HNC risk associated with alcohol among those with lower educational level (odds ratio [OR] = 2.07; 95% confidence interval [CI], 1.53‐2.80) than those with higher educational level (OR = 1.38; 95% CI, 1.04‐1.85) (heterogeneity‐P =.03). Educational level had an influence on the association between alcohol use and HNC risk among those with genetic susceptibility (ALDH2‐deficient) to the carcinogenic effect of alcohol. The association between cigarette or betel quid use and HNC risk was similar between the high and low educational groups. National policies and social interventions have led to the decline in the prevalence of cigarette and betel quid users in Taiwan. In contrast, due to the lack of adequate alcohol control policies, alcohol consumption in Taiwan has continued to rise. A higher impact of alcohol on HNC risk among lower SES individuals even with universal health care could be the result of insufficient alcohol control policies in Taiwan. [ABSTRACT FROM AUTHOR]

Clofarabine is active in refractory/relapsed acute myeloid leukemia (AML). In this phase 2 study, we treated 18‐ to 65‐year‐old AML patients refractory to first‐line 3 + 7 daunorubicin/cytarabine induction or relapsing after 3 + 7 induction and high‐dose cytarabine consolidation, with clofarabine (30 mg/m2/d, Days 1‐5), cytarabine (750 mg/m2/d, Days 1‐5), and mitoxantrone (12 mg/m2/d, Days 3‐5) (CLAM). Patients achieving remission received up to two consolidation cycles of 50% CLAM, with eligible cases bridged to allogeneic hematopoietic stem cell transplantation (allo‐HSCT). The mutational profile of a 69‐gene panel was evaluated. Twenty‐six men and 26 women at a median age of 46 (22‐65) years were treated. The overall response rate after the first cycle of CLAM was 90.4% (complete remission, CR: 69.2%; CR with incomplete hematologic recovery, CRi: 21.2%). Twenty‐two CR/CRi patients underwent allo‐HSCT. The 2‐year overall survival (OS), relapse‐free survival (RFS), and event‐free survival (EFS) were 65.8%, 45.7%, and 40.2%, respectively. Multivariate analyses showed that superior OS was associated with CR after CLAM (P =.005) and allo‐HSCT (P =.005), and superior RFS and EFS were associated with allo‐HSCT (P <.001). Remarkably, CR after CLAM and allo‐HSCT resulted in 2‐year OS of 84.3% and 90%, respectively. Karyotypic aberrations and genetic mutations did not influence responses or survivals. Grade 3/4 neutropenia/thrombocytopenia and grade 3 febrile neutropenia occurred in all cases. Other nonhematologic toxicities were mild and uncommon. There was no treatment‐related mortality and the performance of allo‐HSCT was not compromised. Clofarabine, cytarabine, and mitoxantrone was highly effective and safe in refractory/relapsed AML. This study was registered at ClinicalTrials.gov (NCT02686593). [ABSTRACT FROM AUTHOR]

Size‐fractionated aerosol particles were collected with a MOUDI 10‐stage cascade impactor from an urban roadside place in a downtown area of Hong Kong. Fine aerosol particulate samples from stage 6 (aerodynamic particle diameter between 0.56 and 1 μm) and stage 9 (aerodynamic particle diameter between 0.10 and 0.18 μm) were pretreated at a chosen temperature, including −100°C, −50°C, 25°C, and 60°C, in a load lock chamber and then analyzed using time‐of‐flight secondary ion mass spectrometry (ToF‐SIMS) at the same temperature (−100°C). Principal component analysis (PCA) was applied to further analyze ToF‐SIMS spectra of aerosol particles with different pretreatment temperatures from two selected stages. ToF‐SIMS results showed that the intensities of aliphatic hydrocarbon ions such as C4H7+ and C4H9+ and amine ions such as C2H8N+ and C4H12N+ decreased with an increase of the pretreatment temperature under ultrahigh vacuum conditions. We have shown that analyses of this type of aerosol particles using ToF‐SIMS should not be conducted at ambient temperature but at low temperature (eg, −50°C). In addition, we also developed a procedure that can be used to analyze aerosol particle samples under ultrahigh vacuum environment. [ABSTRACT FROM AUTHOR]

Rationale: Over the past six decades, residents of farming villages in multiple countries of the Balkan peninsula have been suffering from a unique type of chronic renal disease, Balkan endemic nephropathy (BEN). It was speculated that environmental pollution by aristolochic acids (AAs) produced naturally by Aristolochia clematitis L., a weed that grows in the area, was causing the disease. However, the human exposure pathway to this class of phytotoxin remains obscure. Knowledge of the sink and stability of AAs in the environment would assist in the formulation of policy reducing exposure risk. Methods: Using our newly developed liquid chromatography/tandem mass spectrometry method of high sensitivity and selectivity, we analysed over 130 soil samples collected from cultivation fields in southern Serbia for the presence of AAs. The environmental stability of AAs was also investigated by incubating soil samples spiked with AAs at various temperatures. Results: The analysis detected AA‐I in over two‐fifths of the tested samples at sub‐μg/kg to μg/kg levels, with higher concentrations observed in more acidic farmland soil. Furthermore, analysis of soil samples incubated at various temperatures revealed half‐lives of over 2 months, indicating that AAs are relatively resistant to degradation. Conclusions: Cultivation soil in southern Serbia is being extensively contaminated with AAs released from the decomposition of A. clematitis weeds. Since AAs are resistant to degradation, it is possible that AAs could have been taken up by root absorption and transported to the edible part of food crops. Prolonged exposure to AA‐contaminated food grown from polluted soil could be one of the main aetiological mechanisms of BEN observed in the area. [ABSTRACT FROM AUTHOR]

Background: The conventional chest pain protocol using thrombolysis in myocardial infarction score as the risk stratifying tool may not perform well in the emergency department in which a mix of low- and high-risk patients are encountered. Newer chest pain scores such as HEART pathway and Emergency Department Assessment of Chest Pain Score–Accelerated Diagnostic Protocol (EDACS-ADP) are found to have high sensitivity with good specificity. Objectives: This study aims to validate and compare two chest pain scores: HEART pathway and EDACS-ADP in the Accident and Emergency Department of a local hospital in Hong Kong. Methods: A prospective cohort study was carried out at the Accident and Emergency Department of Kwong Wah Hospital in Hong Kong from 1 June 2016 to 31 May 2017. Patients ⩾18 years old with chest pain lasting 5 min or more who were observed with chest pain protocol on observation ward were recruited. Results: A total of 238 patients were recruited; 231 eligible patients completed follow-up. There were five patients with major adverse cardiac events in 30 days of follow-up. The sensitivity, specificity, and negative predictive values of HEART pathway and EDACS-ADP were 100%, 74.3%, 100% and 100%, 73.5.0% and 100%, respectively. Both scores had almost the same performance in terms of major adverse cardiac events at 30 days (area under the curve = 0.87). Conclusion: Our study showed both EDACS-ADP (modified) and HEART pathway achieved high sensitivity (~100%) for detecting major adverse cardiac events in 30 days while being able to discharge more than 70% of patients as low risk for early discharge. [ABSTRACT FROM AUTHOR]

In this present study, Oreochromis mossambicus tilapia were transferred to cold water at 12°C for various time intervals (1, 4, 8, 24, and 48 hr) and its innate immune response was analyzed by studying cellular and humoral parameters. In vivo, alternative complement pathway activity in blood plasma was rapidly increased at 1 hr of cold water (12°C) exposure. Lysozyme activity and cortisol levels of plasma were increased at 4 and 1 hr, respectively. Surprisingly, only plasma cortisol levels remained unchanged through 24 hr of cold water transfer. Phagocytic ability, phagocytic capacity, and respiratory burst (RB) activity of head kidney (HK) leukocytes and splenocytes showed no any significant changes. In peripheral blood leukocytes, phagocytic capacity, and RB activity were increased at 24 hr of cold water exposure. The expressions of genes involved innate immunity in splenocytes and HK leukocytes of tilapia cold water exposure were analyzed, messenger RNA (mRNA) expressions of HSP70, HSP90, and immunoglobulin M failed to change upon exposure to cold stress. Major histocompatibility complex‐I and II mRNAs were significantly increased in tilapia splenocytes at 1 hr of cold water transferred. Whereas myxovirus (Mx) expression was increased in splenocytes and HK leukocytes of tilapia after 1 hr of cold water exposed. Our result reveals that the exposure of tilapia to acute cold stress condition significantly enhances plasma acid phosphatase activity and both phagocytic capacity and RB activity. Furthermore, cold stress significantly stimulates Mx gene expression in splenocytes and HK leukocytes. [ABSTRACT FROM AUTHOR]

Background: Strategies using oral arsenic trioxide (As2O3) are efficacious in relapsed acute promyelocytic leukemia (APL), but they have not been examined in newly diagnosed cases. Methods: Sixty‐two consecutive patients (24 men and 38 women) with a median age of 52 years (range, 22‐85 years), 36% of whom had high‐risk features, underwent induction with all‐trans retinoic acid at 45 mg/m2/d, oral As2O3 at 10 mg/d, and ascorbic acid at 1 g/d (the all‐trans retinoic acid–arsenic trioxide–ascorbic acid [AAA] regimen) for 6 weeks (with patients younger than 70 years additionally receiving daunorubicin at 50 mg/m2/d × 3); they then underwent consolidation with 2 monthly cycles of daunorubicin (50 mg/m2/d × 2) and cytarabine (100 mg/m2/d × 5) and received AAA maintenance (2 weeks every 8 weeks) for 2 years. A contemporaneous cohort of 37 newly diagnosed patients (15 men and 22 women) with a median age of 51 years (range, 23‐78 years), not consenting to oral As2O3 induction but receiving similar induction, consolidation, and AAA maintenance, served as a comparator group; 46% of these patients had high‐risk features. Results: The oral As2O3 induction cohort showed a complete remission (CR) rate of 100%. After a median of 37 months (range, 13‐82 months), there were no relapses, so conventional risks (age, leukocyte and platelet counts, and Fms‐like tyrosine kinase 3 [FLT3] mutations) were not relevant. The leukemia‐free survival (LFS) and overall survival (OS) rates were 100% at 3 years and 94.1% at 5 years. The non–As2O3 induction cohort showed a CR rate of 100%. After a median of 52 months (range, 14‐77 months), there were 3 relapses (8%). Comparable patients in the oral As2O3 induction and non–As2O3 induction cohorts showed similar OS, but LFS was significantly superior in the oral As2O3 induction cohort. Conclusions: The incorporation of oral As2O3 into induction for newly diagnosed APL was safe and decreased relapses. In the current study, 62 patients with newly diagnosed acute promyelocytic leukemia are treated with oral arsenic trioxide, all‐trans retinoic acid, and ascorbic acid as part of their induction regimen, with all achieving complete remission, and this is followed by consolidation with daunorubicin and cytarabine and maintenance with oral arsenic trioxide, all‐trans retinoic acid, and ascorbic acid. In comparison with a contemporaneous cohort of 37 patients with newly diagnosed acute promyelocytic leukemia who are treated similarly but without oral arsenic trioxide during induction, the oral arsenic trioxide cohort appears to have significantly superior leukemia‐free survival. [ABSTRACT FROM AUTHOR]

Summary: In this paper, we use optimal parameter selection technique to develop two models involving single‐vendor–multiple‐buyer supply chain, which are called the dynamic independent optimization (DIO) model and the dynamic synchronized cycles (DSC) model, respectively. These models are, respectively, similar to the traditional static independent policy model and the traditional static synchronized cycle model, except that the deterministic demands of the buyers in the above two static models are now being replaced by the stochastic demands satisfying a Wiener process, which have more real‐life applications. Similar to the above static synchronized cycles model, the synchronization of the supply chain in our DSC model is also achieved by scheduling the delivery days of the buyers and coordinating them with the vendor's production cycle. Finding the optimal expected system costs of the DIO model and the DSC model involves solving optimal parameter selection problems governed by ordinary differential equations, whose final times are continuous decision variables and discrete decision variables, respectively. Computational methods have been developed for solving these problems. Numerical results show that the coordinated policy is better than the independent optimization policy, in terms of minimizing the expected system cost of the entire supply chain. Sensitivity analysis is performed to test the effect of changing the cost coefficients and the D¯/P value on the performances of these models, where D¯/P is the ratio of the total mean demand rate of all the buyers over the vendor's production rate. [ABSTRACT FROM AUTHOR]

Objective: To investigate the safety and feasibility of robot‐assisted single‐port radical prostatectomy using the da Vinci single‐port surgical system. Methods: This was a prospective phase 1 clinical study of prostate cancer patients undergoing robot‐assisted single‐port radical prostatectomy using the da Vinci single‐port surgical system. Primary outcome measures included the conversion rate and 30‐day complications after surgery. Secondary outcome measures included operative time, blood loss, hospital stay, duration of catheterization, final pathological outcomes and number of lymph nodes yielded at pelvic lymphadenectomy. Results: From February to August 2017, 20 patients were included in the present study. The mean age was 67.7 ± 6.0 years. The mean preoperative prostate‐specific antigen level was 15.3 ± 11.3 ng/mL, and the mean prostate size was 36.6 ± 15.5 mL. Preoperatively, 12 (60%) patients had a Gleason score of 6, four (20%) had a Gleason score of 7 and four (20%) had a Gleason score of 8–10. The mean operative time was 208.9 ± 35.2 min, and the mean blood loss was 296.3 ± 220.7 mL. None of the patients required conversion. The mean hospital stay was 5.0 ± 1.7 days. Among the patients, six (15%) had T2a disease, one (5%) had T2b disease, seven (35%) had T2c disease and nine (45%) had T3a disease on final pathology. A mean number of 8.3 ± 7.1 lymph nodes were yielded at pelvic lymphadenectomy. There were no intraoperative complications. The observed postoperative complications were Clavien grade I–II, and all resolved with conservative management. Conclusion: Robot‐assisted single‐port radical prostatectomy using the da Vinci surgical system is safe and technically feasible. [ABSTRACT FROM AUTHOR]

Objective: To formulate consensus statements to facilitate physician management strategies for patients with clinically localized prostate cancer (PCa) in Hong Kong by jointly convening a panel of 12 experts from the two local professional organizations representing PCa specialists, who had previously established consensus statements on the management of metastatic PCa for the locality. Methods: Through a series of meetings, the panellists discussed their clinical experience and the published evidence regarding various areas of the management of localized PCa, then drafted consensus statements. At the final meeting, each drafted statement was voted on by every panellist based on its practicability of recommendation in the locality. Results: A total of 76 consensus statements were ultimately accepted and established by panel voting. Conclusion: Derived from the recent evidence and major overseas guidelines, along with local clinical experience and practicability, the consensus statements were aimed to serve as a practical reference for physicians in Hong Kong for the management of localized PCa. [ABSTRACT FROM AUTHOR]

Background: Frey syndrome is a common complication after parotidectomy. This study aimed to investigate the potential predictors for developing severe Frey syndrome after parotidectomy and to identify patients who may benefit from additional preventive maneuvers. Methods: A total of 485 patients received parotidectomy because of parotid tumors at the Otolaryngology Department of the National Cheng Kung University Hospital, from July 2009 to November 2015. Only 115 of 485 patients were included in this study and to fill in a questionnaire to determine the occurrence and severity of Frey syndrome. Results: A total of 115 parotidectomies were identified. 84 (73%, 84/115) patients were aware of the discomfort and were thus considered symptomatic. 39 (34%, 39/115) patients considered the symptoms apparently affected their quality of life. MSI tests showed that 56 (49%, 56/115) patients had a positive MSI test. By combining the results from symptom questionnaire and MSI test, 23 patients (20%, 23/115) had a severe form of Frey syndrome. Among all clinicopathological variables, the resected specimen size was the only significant predictor of the severe Frey syndrome group (P = 0.04). Disease pathology, tumor size, and adjuvant radiotherapy did not correlate with the severe Frey syndrome. Using receiver operating curve analysis, the best cutoff value of the resected specimen size (in largest dimension) for predicting severe Frey syndrome was 40 mm(sensitivity: 71.7%, specificity: 42.0%; area under the curve = 0.6483). The odds ratio of severe Frey syndrome with every 10 mm increase in the largest diameter of resected specimen was 1.30 (95% confidence interval, 1.01‐1.68; P = 0.04). Conclusions: Resected specimen size is the only significant predictor of developing severe Frey syndrome after parotidectomy. Preventive interventions may have to be considered in high‐risk patients whose resected specimen size (in largest dimension) is greater than 40 mm. [ABSTRACT FROM AUTHOR]