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Summary Background PD-1 and PD-L1 inhibitors are active in metastatic urothelial carcinoma, but positive randomised data supporting their use as a first-line treatment are lacking. In this study we assessed outcomes with first-line pembrolizumab alone or combined with chemotherapy versus chemotherapy for patients with previously untreated advanced urothelial carcinoma. Methods KEYNOTE-361 is a randomised, open-label, phase 3 trial of patients aged at least 18 years, with untreated, locally advanced, unresectable, or metastatic urothelial carcinoma, with an Eastern Cooperative Oncology Group performance status of up to 2. Eligible patients were enrolled from 201 medical centres in 21 countries and randomly allocated (1:1:1) via an interactive voice-web response system to intravenous pembrolizumab 200 mg every 3 weeks for a maximum of 35 cycles plus intravenous chemotherapy (gemcitabine [1000 mg/m2] on days 1 and 8 and investigator's choice of cisplatin [70 mg/m2] or carboplatin [area under the curve 5] on day 1 of every 3-week cycle) for a maximum of six cycles, pembrolizumab alone, or chemotherapy alone, stratified by choice of platinum therapy and PD-L1 combined positive score (CPS). Neither patients nor investigators were masked to the treatment assignment or CPS. At protocol-specified final analysis, sequential hypothesis testing began with superiority of pembrolizumab plus chemotherapy versus chemotherapy alone in the total population (all patients randomly allocated to a treatment) for the dual primary endpoints of progression-free survival (p value boundary 0·0019), assessed by masked, independent central review, and overall survival (p value boundary 0·0142), followed by non-inferiority and superiority of overall survival for pembrolizumab versus chemotherapy in the patient population with CPS of at least 10 and in the total population (also a primary endpoint). Safety was assessed in the as-treated population (all patients who received at least one dose of study treatment). This study is completed and is no longer enrolling patients, and is registered at ClinicalTrials.gov , number NCT02853305 . Findings Between Oct 19, 2016 and June 29, 2018, 1010 patients were enrolled and allocated to receive pembrolizumab plus chemotherapy (n=351), pembrolizumab monotherapy (n=307), or chemotherapy alone (n=352). Median follow-up was 31·7 months (IQR 27·7–36·0). Pembrolizumab plus chemotherapy versus chemotherapy did not significantly improve progression-free survival, with a median progression-free survival of 8·3 months (95% CI 7·5–8·5) in the pembrolizumab plus chemotherapy group versus 7·1 months (6·4–7·9) in the chemotherapy group (hazard ratio [HR] 0·78, 95% CI 0·65–0·93; p=0·0033), or overall survival, with a median overall survival of 17·0 months (14·5–19·5) in the pembrolizumab plus chemotherapy group versus 14·3 months (12·3–16·7) in the chemotherapy group (0·86, 0·72–1·02; p=0·0407). No further formal statistical hypothesis testing was done. In analyses of overall survival with pembrolizumab versus chemotherapy (now exploratory based on hierarchical statistical testing), overall survival was similar between these treatment groups, both in the total population (15·6 months [95% CI 12·1–17·9] with pembrolizumab vs 14·3 months [12·3–16·7] with chemotherapy; HR 0·92, 95% CI 0·77–1·11) and the population with CPS of at least 10 (16·1 months [13·6–19·9] with pembrolizumab vs 15·2 months [11·6–23·3] with chemotherapy; 1·01, 0·77–1·32). The most common grade 3 or 4 adverse event attributed to study treatment was anaemia with pembrolizumab plus chemotherapy (104 [30%] of 349 patients) or chemotherapy alone (112 [33%] of 342 patients), and diarrhoea, fatigue, and hyponatraemia (each affecting four [1%] of 302 patients) with pembrolizumab alone. Six (1%) of 1010 patients died due to an adverse event attributed to study treatment; two patients in each treatment group. One each occurred due to cardiac arrest and device-related sepsis in the pembrolizumab plus chemotherapy group, one each due to cardiac failure and malignant neoplasm progression in the pembrolizumab group, and one each due to myocardial infarction and ischaemic colitis in the chemotherapy group. Interpretation The addition of pembrolizumab to first-line platinum-based chemotherapy did not significantly improve efficacy and should not be widely adopted for treatment of advanced urothelial carcinoma. Funding Merck Sharp and Dohme, a subsidiary of Merck, Kenilworth, NJ, USA.

Purpose To investigate the prognostic significance of (18)F-FDG PET imaging in patients with bone and soft tissue sarcoma, a meta-analysis was conducted. Methods Comprehensive literature searches were performed in PubMed, Embase, Web of Science and Cochrane Library. Pooled hazard ratio (HR) values were calculated to assess the correlations of pre-chemotherapy SUV (SUV1), post-chemotherapy SUV (SUV2), SUV Ratio, total lesion glycolysis (TLG) and metabolic tumor volume (MTV) with event-free survival (EFS) and overall survival (OS). Results Twenty-three studies with 1261 patients were identified. The combined HRs for EFS were 1.84 (95% CI: 1.54–2.20) for SUV1, 2.92 (95% CI: 2.15–3.97) for SUV2, 1.90 (95% CI: 1.43–2.52) for SUV Ratio, 3.01 (95% CI: 1.36–6.67) for TLG and 2.32 (95% CI: 1.44–3.75) for MTV. The pooled HRs for OS were 1.85 (95% CI: 1.49–2.30) for SUV1, 2.00 (95% CI: 1.39–2.88) for SUV2, 2.20 (95% CI: 1.18–4.10) for SUV Ratio, 6.19 (95% CI: 2.17–17.66) for TLG and 2.67 (95% CI: 1.52–4.68) for MTV. Besides, high SUV1 was found to be significantly associated with higher rate of metastasis (RR 5.55, 95% CI: 2.75–11.18) and local recurrence (RR 1.87 95% CI: 1.28–2.72). Conclusion (18)F-FDG PET parameters of SUV1, SUV2, SUV Ratio, TLG and MTV may have effective prognostic significance for patients with bone and soft tissue sarcoma. (18)F-FDG PET imaging may be a promising tool to help predict survival outcomes of these patients.

The ASEAN–China Free Trade Area (ACFTA) is the first of the free trade agreements signed by ASEAN with its major trade partners, and is generally considered a success. However, while liberalization of trade among ASEAN countries has historically not provoked any major issues, things went differently concerning the ACFTA, and complaints have been raised that the treaty allows China too many trade benefits. The purpose of this article is to evaluate, using trade gravity equations, if there is any evidence that the ACFTA has been responsible for the growing trade imbalance between China and Indonesia. The model has not produced any conclusive results about the negative effects on the ACFTA for Indonesia. Given the relevance of this treaty for the ongoing regional integration in Asia, however, the coming years will be crucial in determining the form of it among the existing options and the outcome now seems more uncertain than ever.

Student creation of educational materials has the capacity both to enhance learning and to decrease costs. Three successive honors-style classes of undergraduate students in a cancer genetics class worked with a new software system, CuboCube, to create an e-textbook. CuboCube is an open-source learning materials creation system designed to facilitate e-textbook development, with an ultimate goal of improving the social learning experience for students. Equipped with crowdsourcing capabilities, CuboCube provides intuitive tools for nontechnical and technical authors alike to create content together in a structured manner. The process of e-textbook development revealed both strengths and challenges of the approach, which can inform future efforts. Both the CuboCube platform and the Cancer Genetics E-textbook are freely available to the community.

Background: KEYNOTE-189 is a randomized, placebo-controlled, Phase III study of pembro plus pemetrexed-platinum versus placebo plus pemetrexed-platinum among pts with metastatic nonsquamous NSCLC. At median follow-up of 10.5 months, pts in the pembro-combination arm had improved OS (HR, 0.49; 95% CI, 0.38-0.64; P Methods: Pts with untreated metastatic nonsquamous NSCLC, ECOG PS 0/1, and without EGFR/ALK alteration were randomized 2:1 to receive up to 35 Q3W cycles of pembro 200 mg or placebo plus 4 cycles of pemetrexed 500 mg/m2 and carboplatin AUC 5 mg/mL/min or cisplatin 75 mg/m2 followed by maintenance pemetrexed. Randomization was stratified by PD-L1 TPS ( Results: 616 pts were randomized (pembro-combination, n=410; placebo-combination, n=206). At data cutoff, median follow-up was 18.7 months. At baseline, 19% of pts had liver metastases and 18% had brain metastases. HRs for OS and PFS favored the pembro-combination vs placebo-combination across all groups, and were similar for pts with/without liver or brain metastases (Table). Conclusion: Pembro plus pemetrexed-platinum provided superior outcomes vs chemotherapy alone irrespective of liver or brain metastases in pts with untreated metastatic nonsquamous NSCLC. Benefit was observed in pts with brain or liver metastases, for whom prognosis is historically poor. PFSOSN*Median, mo (95% CI)HR(95% CI)Median, mo (95% CI)HR(95% CI)Pts With Liver MetastasesPembro-combination666.1 (4.7-8.5)0.52 (0.34-0.81)12.6 (8.1-19.1)0.62 (0.39-0.98)Placebo-combination493.4 (2.8-4.7)6.6 (4.6-7.6)Pts Without Liver MetastasesPembro-combination3449.2 (8.8-11.0)0.48 (0.39-0.59)23.7 (20.1-25.9)0.58 (0.45-0.74)Placebo-combination1575.4 (4.9-6.7)13.2 (10.0-16.4)Pts With Brain MetastasesPembro-combination736.9 (5.4-11.0)0.42 (0.27-0.67)19.2 (15.0-25.9)0.41 (0.24-0.67)Placebo-combination354.7 (2.2-5.5)7.5 (4.6-10.0)Pts Without Brain MetastasesPembro-combination3379.2 (8.3-10.9)0.48 (0.39-0.59)22.4 (19.7-25.4)0.59 (0.46-0.75)Placebo-combination1714.9 (4.7-5.9)12.1 (9.1-15.0)*25 patients had both brain and liver metastases. 1 of 2 Citation Format: Marina C. Garassino, Shirish Gadgeel, Emilio Esteban, Enriqueta Felip, Giovanna Speranza, Flávia De Angelis, Manuel Domine, Philip Clingan, Maximilian J. Hochmair, Steven F. Powell, Susanna Y.-S. Cheng, Helge G. Bischoff, Nir Peled, Francesco Grossi, Ross R. Jennens, Martin Reck, Rina Hui, Edward B. Garon, Michael Boyer, Belén Rubio-Viqueira, Silvia Novello, Takayasu Kurata, Jhanelle E. Gray, Anna Cardellino, Jing Yang, M. Catherine Pietanza, Delvys Rodríguez-Abreu. Outcomes among patients (pts) with metastatic nonsquamous NSCLC with liver metastases or brain metastases treated with pembrolizumab (pembro) plus pemetrexed-platinum: Results from the KEYNOTE-189 study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT043.

In developing countries, an effective civil service pay system may provide strong incentives for better public service and rein in corruption, whereas poor remuneration can fuel corruption and disc...

China has rapidly developed a sophisticated regionalism strategy in East Asia. Minimising the region’s “China threat” perception has been a significant consideration in this strategy. Unfortunately, the ongoing escalation of tension concerning territorial disputes over the Diaoyutai / Senkaku Islands and the South China Sea, initiated by a series of high-profile naval exercises in the latter half of 2010, has reinforced the “China threat” perception and bolstered the hedging strategies of countries in the region. China is aware of its relative disadvantage, and it has been keeping its options open while allowing ASEAN to maintain the initiative.

The evolution of international production chains has facilitated the flow of industrial capital from developed countries into China. Multinational corporations in China apparently make huge profits through exploiting cheap labour, but they also exert pressure on their contractors to improve workers’ rights. International non-governmental organizations enter into the relationship with their moral force and global networks. The authority of the All-China Federation of Trade Unions was challenged, and new channels were offered in fighting for workers’ rights. But within the existing Chinese political system and labour-market system, their roles all remain limited; the protection and promotion of workers’ rights in China still demand a reform of the prevalent systems.

Sino-Vietnamese relations since the mid-1980s represent an interesting case for studying how economic considerations can transform two conflicting states into peaceful accommodation in an asymmetrical bilateral relationship. The Chinese leadership's pursuit of a peaceful international environment for economic development has been followed by its Vietnamese counterpart.

Migrant workers have become a major component of China's labour force in the manufacturing sector, and therefore an important force in the country's economic modernization. Yet, for a long time, migrant workers were perceived as peasants by the Chinese authorities, and were excluded from the scope of the state's labour policy. In the new century, the government has begun to consider them as an important part of the manufacturing labour force, and attempt to protect their rights through adjustments in its labour policy. However, in many aspects, migrant workers are still considered “pseudo labourers”. This article attempts to examine the issue of migrant workers within the framework of the state's labour policy. The socio-economic problems associated with migrant workers will not be resolved until they are treated as a proper part of the labour force, and granted the same legal and policy protection as urban workers.

The issue of social networks is central to scholars' examinations of China's economic reform and its transitional society. This article presents an effort to examine the impact of the property rights reform on the evolution of entrepreneurs' social networks in the context of rural China. This study proposes three different patterns of social networks: in-group networks, official-centered networks, and market-oriented networks; and examines how the significance of different network patterns has evolved under the context of institutional change. By using data collected in Wuxi city, Jiangsu province, China, this article attempts to explore four significant questions. Do social networks still matter? How is the significance of different patterns of social networks changing? Why could this happen? In which fields do social networks still matter?

Protecting the legitimate rights and interests of migrant workers has become a pressing public policy issue in China, which calls for coordinated efforts from the government, enterprises, trade unions and nongovernmental organizations (NGOs). Through a case study of an NGO in Panyu, Guangzhou, this article finds that NGOs have a significant role to play in protecting the legitimate corporate social responsibility. Furthermore, the role of NGOs in protecting migrant workers' rights indicates a newly-emerged governance mode in China calling for the close collaboration between the government and NGOs. For this purpose, it is necessary for the government to create a favorable environment for the development of NGOs.

A proactive strategy for the aging population was first proposed by the World Health Organization in 2002. Chinese authorities and experts in gerontology welcome the strategy, and they have already emphasized the need to safeguard the dignity of the elderly population and utilize their talents. There currently exists a shortage of expertise concerning the positive utilization of older persons, and attempts to implement such utilization must be monitored closely and may require preventive intervention. China's experts in gerontology therefore advocate new socioeconomic ideals regarding the elderly community, proposing refinement of statutes and policies to protect the rights of elderly people. Furthermore, the success of this proactive strategy demands social support, the mobilization of public opinion, and allocation of resources. It appears that the Chinese leadership has already laid a good foundation for this process.

Phase functions for hexagonal ice plates randomly oriented in the horizontal plane are calculated with a facet-tracing code. The bright optical phenomena like sundog and parhelion 120 ∘ are quantified by their weight coefficients that are tabulated as functions of both incident angles and particle aspect ratios. Dependence of the scattered intensity on azimuth scattering angles is studied in details.

We examined the association between chronic hepatitis B virus (HBV) infection and clinical outcomes in a consecutive cohort of Chinese patients with type 2 diabetes.Between 1995 and 1999, 2,838 type 2 diabetes patients underwent comprehensive assessments and blood screening for hepatitis B surface antigen (HBsAg). The risk of occurrence of cardiovascular events and end-stage renal disease (defined as need for dialysis, doubling of serum creatinine or serum creatinineor =500 micromol/l) was compared between HBsAg-positive and HBsAg-negative groups.At baseline, HBV-infected patients (n=286, 10.1%) were younger (51.0+/-11.5 vs 53.7+/-12.7 years, p=0.004), had earlier onset of diabetes (51.0+/-11.5 vs 53.7+/-12.7 years, p=0.001) and a higher frequency of retinopathy (28 vs 22%, p=0.03) than non-HBV-infected patients. After a median follow-up of 3.5 years (interquartile range: 1.7-5.9 years) and adjustment of age, glycaemic control and other potential confounding factors, HBV-infected patients were more likely to develop end-stage renal disease than non-HBV infected patients (8.7 vs 6.4%) with a hazard ratio of 4.5 (95% CI 1.1-18.6). The difference in the frequency of cardiovascular endpoints was not statistically significant.In Chinese type 2 diabetes patients, chronic HBV infection was associated with increased risk of end-stage renal disease, and this was independent of other potential confounding factors. Early identification of HBV status and close surveillance of renal function are important in patients with type 2 diabetes who are living in areas where HBV is endemic or who are at risk of chronic HBV infection.

A new method for enhancing stimulated Raman scattering (SRS) Stokes waves in CS2 by using Rhodamine 6G fluorescent dye was reported firstly in this paper. The first and second-order Stokes line intensities of CS2 are measured, respectively, 1.7 and 96.6 times that of pure CS2. The mechanism of the enhancement together with its potential application is discussed.

The Asia‐Pacific region's vulnerabilities to the consequences of globalisation were vividly revealed by its financial crisis in 1997–98. ASEAN states considered the US and APEC less than helpful during the crisis, and they found the conditionalities imposed by the IMF unpalatable. But ASEAN as a regional organisation has been much weakened, and it has been working hard to revive its influence. The ‘ASEAN plus 3’ approach has been perceived as an important means to strengthen ASEAN's status and relevance. The ASEAN‐China Free Trade Area is undoubtedly an outstanding achievement of this approach; but ASEAN has been trying to keep its options open. On the other hand, China has been concerned with the danger of a deterioration in Sino‐American relations and the increasing distrust between Tokyo and Beijing. Improvement of China‐ASEAN relations therefore assumes increasing significance in China's regional policy; and enhancing mutual interests and interdependence is the best way to erode the ASEAN states' perc...

Pure rotational Raman scattering signals from atmospheric gases such as nitrogen and oxygen can be used to deduce the temperature of the atmosphere. Previously, this method has been successfully implemented as a remote temperature sensing lidar system. In this paper, theoretical studies of the method have been carried out using Monte Carlo simulations for different temperature profiles from radio sonde data. The geometry of the lidar as well as the aerosol profiles of the atmosphere can be specifically defined in this method. It is important to understand whether or not multiple scattering will have a significant effect on the accuracy of temperature retrieval from the measured lidar returns. From the exact pure rotational Raman scattering matrix, we have computed the lidar returns of individual Raman lines. We have given the ratios of multiple to single scattering return signals for atmospheres without clouds, with water clouds and with cirrus clouds. The results indicate that the effect of mult...

C hina's admission into the World Trade Organization (WTO) has important implications for the international trading system.' Before its admission, China had the largest economy outside the WTO. By many estimates, China is the world's third largest economy after the United States and Japan, and the world's tenth largest trading economy. A World Bank report estimates that China's share of world trade may triple from 3 percent in 1992 to 9.8 percent in 2020, making China the world's second largest trading nation after the United States.2 China's WTO application was controversial because China was still a developing country, yet its economy and trade were significant. China's WTO membership means China must change many laws, institutions

Three-dimensional large-eddy simulations are performed with the dynamic sub-grid scale model for an idealised urban canyon with pollution modelled as a passive scalar. In addition to concentration distributions, turbulence statistics for the canyon are presented. Higher turbulence intensities are predicted in the core of the vortex compared to the widely used k – e model. This results in a more homogeneous distribution of pollutants, in agreement with experimental studies reported in the literature. Regions of enhanced turbulence are also observed near the walls leading to a lateral dispersion of pollutants along the canyon. The centre of the vortex is observed to precess around the canyon and also meanders along the length of the canyon. Puffs of pollution are ejected from the top of canyons intermittently rather than smoothly, with a characteristic time scale of the order of 30–60 s.

Large-eddy simulations (LESs) are applied to the problem of pollution dispersion within the urban canopy layer, specifically street canyons. The objective is to study the turbulence structure and hence the physical dispersion mechanisms of pollutants. LESs are implemented by incorporating the dynamic sub-grid scale stress model into the commercial computational fluids dynamics code CFX. To gain confidence in the approach, simulations are performed for a canyon-like geometry (roof garden) for which experimental measurements were also made. The experimental campaign consisted of using sonic anemometers to measure mean flow and turbulence intensities at a high sample rate of 60 Hz. Good agreement between simulations and experimental data are obtained. Real geometric features, such as non-uniform wall heights, result in a very much three-dimensional flow distribution. Comparisons with the k–e model show that LESs are able to predict more accurately the turbulence statistics of the flow.

The EPICS framework was chosen as control system infrastructure for the new project of 3 GeV synchrotron light source (Taiwan Photon Source, TPS). Various control system prototypes of TPS with the EPICS mechanism have been gradually built and tested. One EPICS data archive system is necessary to be developed to record various machine parameters and status information for long time logging. An archive engine takes PV data from EPICS IOCs via channel access, and stores them in the data storage. The PostgreSQL RDB (Relational Database) was adopted as the data storage for the TPS archive system. Both the historic PVs (Process Variable) data and the archive engine configuration are saved into the same RDB. The archived data can be retrieved in the graphical user interface of data browser. Taking the performance and redundancy into considerations, the storage servers and RDB table structures are tuned relatively. The primary factor most common used to judge system performance is the mean response time. We propose the queueing model method to analyze the performance of a network-based archive system, and simplify the architecture as the queueing model in serial and parallel to derive the equations of mean response time. Then we apply the proposed method to estimate the approximate response time of the actual network-based system which constructed in serial and in parallel. The efforts are described at this paper.

A synchrotron light facility, Taiwan Photon Source (TPS), is being constructed at the campus of the NSRRC (National Synchrotron Radiation Research Center). In order to prevent damage to accelerator components induced by various events, design of the global machine protection system (MPS) is on-going. The MPS collects interlock signals and beam dump request from various subsystem, perform decision, transmit dump beam request to RF system. The MPS equipments are distributed on 24 CIAs (Control Instrumentation Areas) include a main PLC (Programmable Logic Controller) with remote I/Os, event receiver, transient capture module responsible for slow-interlock and fast-interlock, sequence events capture. Special input/output patch boards are designed for signal type conversion which is easily connectivity and trouble shooting. To protect the TPS accelerator equipments, the MPS should collect urgent beam dump requests to beam abort devices (most probably is RF system) within short and deterministic latency time (e.g. less than 10 msec). The PLC based system will be used as a slow MPS which can delivery less than 8 msec reaction time. The fast MPS will dependent on event based timing system to deliver response time less than 5 msec. Trigger signal for post-mortem will also be distributed by the fast MPS. To ensure alive of the system, several self-diagnostics mechanisms include heartbeat and transient capture will be implemented. The MPS architecture, plans and implementation were presented in this report.

For beam-diagnostic applications of synchrotron light facility at Taiwan Photon Source (TPS), the design and implementation of a system for image acquisition and processing is in progress. The optical system comprises a screen, lens and lighting system. A CCD camera with Gigabit Ethernet interface (GigE Vision) will be a standard device for image acquisition, to be undertaken with an EPICS (Experimental Physics and Industrial Control System) via a process variables (PVs) channel, analysis of the properties is made with a Mat lab tool to evaluate the beam profile (sigma), beam-size position and tilt angle etc. Various fitting strategies that affect the analysis results were discussed in this paper. The computer-simulated beam profiles with varied background noise and conditions are used to evaluate the duration of computing and to estimate the fitting errors.

The Insertion devices (ID) for Taiwan Photon Source are under construction. There are eight insertion devices under construction. These devices include in-vacuum undulators (IU) with or without taper, elliptically polarized undulators (EPU). Control framework for all IDs was developed. Using common hardware and software components are as possible. Motion control functionality for gap and phase adjustment supports servo motors, stepper motors, absolute encoders, and protection. The motion control system for all IDs is based on the EPICS (Experimental Physics and Industrial Control System) architecture. Trimming power supply for corrector magnets and phase shifter control functionality are also addressed. Miscellaneous controls include ion pumpers and BA gauges for vacuum system, temperature sensors for ID environmental monitoring and baking, limit switches, emergency button. User interface for ID beam line users are included to help them to do experiment, such as ID gap control and on-the fly experimental. The efforts of IDs motion control system will be summarized in the report.

In many ways, regional cooperation generates new momentum for economic growth. The final decades of the 20th century saw the combination of Hong Kong’s capital, technology, and entrepreneurship with the cheap labor and land supply in Guangdong Province give rise to abundant business opportunities and the promotion of economic development in both places. Industrialization in this southern China province was given a major boost and Hong Kong’s labor-intensive, export-oriented processing industries were able to maintain their international competitiveness. Hong Kong’s emergence as one of the top 10 trading entities in the world also provided a solid foundation supporting the development of service industries both at home and in Guangdong. From 1979 to the end of 1999, Guangdong actually utilized US$76.6 billion worth of Hong Kong investment, i.e., 69.2% of all foreign investment used (US$110.67 billion) during the period; 80% of the investment was concentrated in the Pearl River Delta (PRD) region. Most of the Hong Kong

Epidemiology studies have found associations between increases in air pollutants and increases in morbidity and mortality from cardiovascular disease. The 1995 finding by Godleski et al. at Harvard that inhalation exposures of dogs to high concentrations of residual oil fly ash (ROFA) caused changes in the ST segment and T waves in the electrocardiogram (ECG) suggested a potential mechanism, and also suggested that inhaled metals might contribute to the effect. We conducted the present study to establish a baseline correspondence to the Godleski et al. findings in preparation for studies of the cardiac effects of specific particle-borne metals. The ROFA used in this study consisted of 45% carbon and 15.5% transition metals by mass. In vitro assays using cultured A549 cells and rat alveolar macrophages demonstrated that the ROFA was biologically active but was not highly cytotoxic. Four 10.5-yr-old beagles were exposed by oral inhalation to 3 mg/m3 of aerosolized ROFA for 3 h/day on 3 consecutive days. During the exposures, ECGs were continuously recorded from leads I, II, III, and V4. ECG data were also collected during three control exposures to clean air, during one of which changes were induced using drugs as a positive control. The ROFA exposures caused no consistent changes in the amplitude of the ST segment, the form or amplitude of the T wave, or arrhythmias. The data suggested a slight slowing of heart rate during exposure. Whether the difference between the present and previous findings resulted from differences in the composition of the two batches of ROFA or differences in methodology could not be determined by the study. This study did not address the cardiac effects of ROFA in subjects having preexisting cardiac susceptibility factors, nor was it a rigorous evaluation of effects on the frequency distribution of heart rate. Our results indicate that healthy dogs can inhale high concentrations of ROFA without changes in cardiac electrophysiology, which are detectable by clinical evaluations.

The First International Intercomparison and Intercalibration Meeting for Thoron and its Progeny and Thoron/Radon Mixture was organized to compare techniques for determining concentrations and particle size distributions of 220 Rn and mixtures of 222 Rn and 220 Rn . The meeting was held at Elliot Lake, Canada, November 2–6, 1992. We have reported results of activity size distributions and measurements of unattached fractions of both thoron progeny and mixtures of thoron/radon. Four teams, including the US Bureau of Mines in cooperation with Canada Center for Mineral and Energy Technology, the US Environmental Measurement Laboratory (EML), the Lovelace Respiratory Research Institute, and the Swedish Radiation Protection Institute (SSI) participated in the intercomparison of activity size distributions. Each team had a different diffusion sampling system and counting protocol. Results for all four systems were in good agreement when thoron gas was used in the test chamber. However, in the case of thoron and radon gas mixtures, the agreement among the different sampling systems was not as good. One reason for the inconsistency of results was that the sensitivity of the systems was different. Calculation of size distribution for individual progeny ( 218 Po , 214 Pb , 214 Bi , 212 Pb , and 212 Bi ) requires sampling systems with improved sensitivity. Our results suggest those diffusion batteries with a minimum of four stages and more likely five stages are optimal. In addition, a system for continuously counting the total alpha particles, such as the EML system, or alpha spectrometry, such as the SSI system, is needed. Our results provide a relationship between the unattached fraction and condensation nucleus concentration over a wide range of particles from 300 to 16,000 cm −3 . These findings are consistent with measurements obtained in indoor environments, mines, and underground caves, indicating that it is possible to establish a more universal relationship.

This article examines the emergence and development of grassroots community organizations in Hong Kong from the late 1960s to the present. It analyzes their contribution to the democratization movement, and how they in turn have been supported by the development of representative government. The article then considers the relationship between grassroots community organizations and the pro-democracy political parties: their mutual support, tensions, etc. Difficulties and challenges facing grassroots community organizations in the 1990s are discussed. An attempt has also been made to study the impact of the community’s values on the development of grassroots groups. As published literature on the subject is limited, the author relies heavily on interviews with the leading grassroots activists.

The merging of computers and technologies is facilitating the trend toward remote work arrangements. Telemedicine is a kind of remote work arrangement that is specifically adapted for the health care industries. Telemedicine is seen to be an important potential solution in improving the effectiveness of public services in a community with a limited number of medical experts and other related resources. This article first discusses the needs of telemedicine in Hong Kong and then investigates the current development of telemedicine in Hong Kong and its ability to support collaborative work through image‐transfer and video‐conferencing between professionals across different health care organizations. A model for the development of telemedicine is proposed that includes networked hospitals, remote medical experts, and remote patients. How the proposed model can be implemented, based on existing development, and the benefits it brings are discussed.

Background Benign strictures at the cardia are troublesome for patients and often require repeated endoscopic treatments. Paclitaxel can reduce fibrosis. This study evaluated a biodegradable paclitaxel-eluting nanofibre-covered metal stent for the treatment of benign cardia stricture in vitro and in vivo. Methods Drug release was investigated in vitro at pH 7·4 and 4·0. Eighty dogs were divided randomly into four groups (each n = 20): controls (no stent), bare stent (retained for 1 week), and two drug-eluting stent (DES) groups with retention for either 1 week (DES-1w) or 4 weeks (DES-4w). Lower oesophageal sphincter pressure (LOSP) and 5-min barium height (5-mBH) were assessed before, immediately after stent deployment, at 1 week, and 1, 3 and 6 months later. Five dogs in each group were killed for histological examination at each follow-up point. Results Stent migration rates were similar (0 bare stent versus 2 DES; P = 0·548). The percentage and amount of paclitaxel released in vitro was higher at pH 4·0 than at pH 7·4. After 6 months, LOSP and 5-mBH were both improved in the DES-1w (P = 0·004 and P = 0·049) and DES-4w (both P

Hong Kong has two major economic assets: its geographical location and labour force. Shortage of educated manpower has created a bottleneck hampering economic growth. Substantial emigration flows relating to 1997 is also a problem. Development of higher education and infrastructure are means to ensure sustainable economic growth. The government plans to enable 25% of the relevant age group to attend degree and diploma courses in 1995 through rapid expansion and heavy subsidy.

This study contributes to a conceptual model that, reflecting the mediating role of customer satisfaction and the moderating role of perceived value, indicates the effect of service quality on customer loyalty in the restaurant industry. The analysis confirms that customer satisfaction is positively influenced by service quality, whereas customer loyalty is positively influenced by customer satisfaction. Furthermore, customer loyalty is indirectly influenced by service quality through customer satisfaction. Finally, other key finding is the relationship between customer satisfaction and customer loyalty, which is stronger for customers who perceive high value than for those who perceive low value. According to the findings, the implications and future research directions are provided.

Steady-state visual-evoked potential (SSVEP)-based brain-computer interfaces (BCIs) have generated significant interest due to their high information transfer rate (ITR). Due to the amplitude-frequency characteristic of the SSVEP, the flickering frequency of an SSVEP-based BCI is typically lower than 20 Hz to achieve a high SNR. However, a visual flicker with a flashing frequency below the critical flicker-fusion frequency often makes subjects feel flicker jerky and causes visual discomfort. This study presents a novel technique using high duty-cycle visual flicker to decrease user's visual discomfort. The proposed design uses LEDs flashing at 13.16 Hz, driven by flickering sequences consisting of repetitive stimulus cycles with a duration T (T = 76 ms). Each stimulus cycle included an ON state with a duration T(ON) and an OFF state with a duration T(OFF) (T = T(ON) + T(OFF)), and the duty cycle, defined as T(ON)/T, varied from 10.5% to 89.5%. This study also includes a questionnaire survey and analyzes the SSVEPs induced by different duty-cycle flickers. An 89.5% duty-cycle flicker, reported as a comfortable flicker, was adopted in a phase-tagged SSVEP system. Six subjects were asked to sequentially input a sequence of cursor commands with the 25.08-bits/min ITR.

A highly manufacturable embedded DRAM technology at 40nm node is presented. This report provides the characterization data of 128Mbit embedded DRAM test vehicle fabricated by 40nm eDRAM 200MHz low power process. The test vehicle is composed of 32 macros and each macro unit is 4Mb with configuration 32k×128 bits. The process is cost effective and compatible to our low power Logic core process with three additional critical masks to the base process. The DRAM memory cell consists of a high performance pass gate transistor and a metal-insulator-metal (MIM) storage capacitor with a cell size of 0.0583 um2 (< 1/4 of SRAM 0.242 um2) and small macro size of 0.145 mm2 per Mega bits (Mb). The stacked cell capacitor is formed using low temperature processed high-k dielectrics to achieve sufficient storage capacitance in DRAM cell. Low cell device leakage below 20 fA/cell at 105°C with silicided node process coupled with the high-k storage capacitance. The macro design for random access speed can operate from 25MHz to 200 MHz comparable to 6T SRAM. It has built-in ECC parity generation and correction circuits with memory storage space used for storing parity bits. The characterization is based on 200MHz, covering Vcc+/−15% at 125°C/ 105°C/ 25°C/ −40°C. Process corner skew includes core device corners TT/FS/SF/FF/SS and fast/slow cell device. Highly manufacturing yield of 128Mb macro is achieved to demonstrate the maturity of technology. The excellent cosmic ray (neutron) soft error rate (SER) performance of less than 4FITs/Mb is also achieved. The integration technologies can be applicable to the future embedded DRAM in 28nm, 20nm node and beyond.

By employing low molecular-weight polyvinyl alcohol (PVA) as binder, the spatial resolution of a red-sensitive PVA/acrylamide based photopolymer are improved from 1000 lines/mm to 3000 lines/mm. By increasing the ambient temperature during the holographic recording, the photosensitivity of photopolymer is also increased about 5 times. The optimized photopolymer system has high capacity such as high photosensitivity (8 mJ/cm(2)), high spatial resolution (over 3000 lines/mm) and high diffraction efficiency (over 94%). To our knowledge, its holographic recording performance is the best of ever reported PVA/acrylamide based photopolymer systems. It has good application prospects in real-time holographic interferometry, holographic storage and holographic display.

SUMMARY The present study compares the efficacy of a self-expanding metallic stent (SEMS, diameter of 30 mm) and pneumatic dilation for the long-term clinical treatment of achalasia. A total of 155 patients diagnosed with achalasia were allocated for pneumatic dilation (n= 80, group A) or a temporary, 30-mm diameter SEMS (n= 75, group B). The SEMSs were placed under fluoroscopic guidance and removed by gastroscopy 4–5 days after placement. Data on clinical symptoms, complications, and long-term clinical outcomes were collected, and follow-up observations were performed at 6 months and at 1, 3–5, 5–8, 8–10, and >10 years, postoperatively. Pneumatic dilation and stent placement were technically successful in all of the patients. There were no significant differences in technique success, 30-day mortality, or complications between the two groups. The clinical remission rate in group A was significantly lower than that in group B at 1, 1–3, 3–5, 5–8 and, >10 years (P < 0.05), while the cumulative clinical failure rate in group A (66%, 53/80) was higher than that in group B (92%, 6/75). The mean primary patency in group B was significantly longer than that in group A (4.2 vs 2.1 years, respectively; P < 0.001). A temporary, 30-mm diameter SEMS was associated with a better long-term clinical efficacy in the treatment of patients with achalasia as compared with treatment with pneumatic dilation.

Silicon carbide whiskers (SiCW) and continuous glass filaments are important components of composite materials having potentially widespread use in the automotive, aerospace, and power generation industries. We determined the in vitro activity of three well-characterized samples of silicon carbide whiskers and a continuous glass filament sample in four different cellular assays and compared this to the activities of UICC crocidolite, JM Code 100 glass microfiber, and erionite in the same assay systems. The SiCW had a diameter range of 0.32-0.75 microns and a length range of 4.5-20.1 microns. The SiCW was significantly toxic; on a mass basis, one SiCW sample was more toxic than crocidolite; however, JM Code 100 glass microfiber, which is not toxic in vivo (i.e., it does not cause fibrogenesis or carcinogenesis when inhaled), was also more toxic than crocidolite. The glass filament sample was the least cytotoxic of all the samples tested. On a fiber number basis, all three SiCW samples were more toxic than crocidolite. The results of our study showed that SiCW exhibits significant in vitro biological reactivity. Thus, despite the caution that must be exercised in extrpolating the results of in vitro studies to conclusions about in vivo health effects, SiCW should be considered toxic until further toxicological data are available.

An achromatic method of seeing through a phase-distorting medium, such as a turbulent atmosphere, utilizes a grating interferometer. Measurements are made at sample points throughout the region of fringe formation. A set of nonlinear simultaneous equations is generated and then solved by computer.

A 12-generation selection experiment involving a selected line (S) and a control line (C) has been conducted since 1992 with the aim of increasing the number of fertile eggs laid by the Brown Tsaiya duck after a single artificial insemination (AI) with pooled Muscovy semen. On average, 28.9% of the females and 17.05% of the males were selected. The selection responses and the predicted responses showed similar trends. The average predicted genetic responses per generation in genetic standard deviation units were 0.40 for the number of fertile eggs, 0.45 for the maximum duration of fertility, and 0.32 for the number of hatched mule ducklings' traits. The fertility rates for days 2–8 after AI were 89.14% in the S line and 61.46% in the C line. Embryo viability was not impaired by this selection. The largest increase in fertility rate per day after a single AI was observed from d5 to d11. In G12, the fertility rate in the selected line was 91% at d2, 94% at d3, 92% at days 3 and 4 then decreased to 81% at d8, 75% at d9, 58% at d10 and 42% at d11. In contrast, the fertility rate in the control line showed an abrupt decrease from d4 (74%). The same tendencies were observed for the evolution of hatchability according to the egg set rates. It was concluded that selection for the number of fertile eggs after a single AI with pooled Muscovy semen could effectively increase the duration of the fertile period in ducks and that research should now be focused on ways to improve the viability of the hybrid mule duck embryo.

The counting efficiency of the TSI model 3020 condensation nucleus counter (CNC) was determined as a function of aerosol flow rate and trigger level using aerosols of known size and an aerosol electrometer. When the aerosol flow rate dropped from 300 to 200 mL/min, counting efficiencies increased significantly in the single-particle counting mode for particles with diameter 20 nm increased and exceeded unity. When the aerosol flow rate was reduced to 100 mL/min, the counting efficiencies for both counting modes decreased regardless of particle size. Varying the trigger level of the CNC did not influence the photometric mode counting efficiency. However, the counting efficiency of the single-particle counting mode increased with decreasing trigger level, especially for particles < 20 nm in diameter. Characteristics for individual instruments need to be measured because...

We report a design of low-loss THz Bragg fibers with a core size on the order of wavelength that operates near the cutoff frequency of its TE01 mode. We also propose a broadband Y-type mode converter based on branched rectangular metallic waveguides to facilitate coupling between the TE01 mode of the Bragg fiber and the TEM mode in free space with 60% efficiency. Our fiber holds strong promise to facilitate beam-wave interaction in gyrotron for high-efficiency THz generation.

Summary Background Non-alcoholic fatty liver disease is prevalent in affluent countries and is strongly associated with metabolic syndrome. Aim To study the prevalence of undiagnosed diabetes and postchallenge hyperglycaemia in Chinese patients with non-alcoholic fatty liver disease. Methods 73 consecutive patients with biopsy-proven non-alcoholic fatty liver disease and no history of diabetes underwent comprehensive metabolic screening. Diagnosis of diabetes and impaired glucose regulation was based on the 2006 American Diabetes Association criteria. Results The prevalence of undiagnosed diabetes and impaired glucose tolerance in non-alcoholic fatty liver disease patients was 33% and 29%, respectively. Among patients with 2-h plasma glucose above 7.8 mm, 47% had normal fasting glucose (below 5.6 mm). Impaired glucose tolerance was more common in patients with non-alcoholic steatohepatitis than those with simple hepatic steatosis (P = 0.036), and 2-h plasma glucose correlated with fibrosis stage (Spearman coefficient: 0.25, P = 0.046). In a binary logistic regression analysis, high fasting glucose and low high-density lipoprotein cholesterol were independent factors associated with diabetes. Nevertheless, if oral glucose tolerance test was only performed in non-alcoholic fatty liver disease patients with impaired fasting glucose, 20.8% of diabetes cases would be missed. Conclusions Isolated postchallenge hyperglycaemia is common among Chinese non-alcoholic fatty liver disease patients without history of diabetes. It is associated with histological severe disease, and cannot be accurately predicted by any fasting glucose cut-off.

Airborne atmospheric measurement of nitrogen dioxide (NO 2 ) column density was performed using the solar spectroscopic method. The measurement was carried out at different altitudes, from 460 to 700 meters above sea level during a flight in Hong Kong (22.2°N, 114.1°E), the People's Republic of China (PRC). In the territory, the boundary layer height in a sunny day is about 1000 meters. Below the boundary layer, most of the NO 2 exists. The airborne solar spectroscopic measurement gives the NO 2 vertical profile below the boundary layer. In particular, the solar spectroscopic measurement requires a solar tracking system to collect the direct sunlight. However, in an acceptable small percentage of error in tracking the sun position, it is possible to collect the direct sunlight manually. In this paper, to reduce the complexity of the experimental setup, the sunlight is collected by a portable miniature CCD spectrometer. In the retrieval of NO 2 column density, the airborne solar spectrum is normalized to a reference solar spectrum, which is taken at a high altitude (11,230 meters) during another flight in Xinjiang (42.208°N, 83.949°E) province, PRC. The column density retrieval is achieved from the normalized solar spectrum using the differential optical absorption spectroscopy. A ground-based off-axis control experiment is also performed to estimate the error in the slant column density from the airborne measurement.