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Domestic fuel combustion from cooking and heating, to which about 3 billion people worldwide are exposed, is associated with increased lung cancer risk. Lung cancer incidence in Xuanwei is the highest in China, and the attributable risk of lung cancer from unvented smoky coal burning is greater than 90%. To evaluate any lung cancer mortality reduction after changing from unvented stoves to portable stoves, we used lifetime smoky coal users in a retrospective cohort of all farmers born during 1917-1951 and residing in Xuanwei in 1976. Of the 42,422 enrolled farmers, 4054 lifetime smoky coal users changed to portable stoves, 4364 did not change, and 1074 died of lung cancer. Lung cancer morality associated with stove change was assessed by product-limit survival curves and multivariate Cox regression models. Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change. Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46-0.82) and female participants (HR=0.41, 95% CI=0.29-0.57). Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries. [ABSTRACT FROM AUTHOR]

The disposal of increased quantities of dewatered sewage sludge to landfills may cause geoenvironmental problems such as leachability, total and differential settlement, and slope stability of the waste during disposal. This study investigates the geotechnical properties of the dewatered sewage sludge generated from chemically enhanced primary treatment (CEPT) in Hong Kong. Compaction test results show that CEPT sludge exhibits compaction characteristics similar to those of clayey soils; however, the lowest hydraulic conductivity of CEPT sludge does not occur near the wet side of its optimum water content. The consolidation behavior of CEPT sludge does not follow the conventional Terzaghi's theory. Under an overburden pressure higher than 24 kPa, the relationship between the logarithm of the hydraulic conductivity (logk) and the void ratio (e) is linear. Results from direct shear tests reveal that, for CEPT sludge, slopes of 20° can probably be constructed during the landfill operation without causing sliding problems. Compared with the disposal of pure CEPT sludge, the co-disposal of dewatered sewage sludge with other solid wastes commonly found in Hong Kong results in lower compressibility, smaller settlement, but higher hydraulic conductivity.Key words: co-disposal, geotechnical properties, landfill disposal, sewage sludge.L'entreposage de quantités croissantes de boues d'égouts asséchées dans des sites d'enfouissement peut causer des problèmes géoenvironnementaux tels que le lessivage, un tassement différentiel ou total, l'instabilité de la pente de la boue durant l'entreposage. Cet article étudie les propriétés géotechniques de la boue d'égout asséchée générée par le traitement chimique primaire (CEPT) à Hong Kong. Les résultats d'essais de compactage indiquent que la boue CEPT montrent des caractéristiques de compactage similaires à celles des sols argileux ; cependant, la conductivité hydraulique la plus faible de la boue de CEPT n'est pas obtenue tout près du côté humide de sa teneur en eau optimale. Le comportement en consolidation de la boue CEPT ne suit pas la théorie conventionnelle de Terzaghi. Sous une pression sus-jacente supérieure à 24 kPa, la relation entre le logarithme de la conductivité hydraulique (logk) et le rapport de vide (e) est linéaire. Les résultats d'essais de cisaillement direct révèle que pour la boue CEPT, des pentes de 20[sup o] peuvent probablement être construites durant l'opération de remplissage sans causer de problèmes de glissement. En comparaison avec l'entreposage de boue pure CEPT, l'entreposage simultané de boue d'égout asséchée avec d'autres déchets solides communément trouvés à Hong Kong résultent en une plus basse compressibilité, un tassement plus faible, mais une conductivité hydraulique plus élevée.Mots clés : entreposage simultané, propriétés géotechniques, enfouissement sanitaire, boue d'égout.[Traduit par la Rédaction] [ABSTRACT FROM AUTHOR]

The reclamation for the new airport at Chek Lap Kok in Hong Kong included the placement of a substantial volume of sand fill by various hydraulic placement techniques, which resulted in a wide range of as-placed densities of the sand fill. This paper described the use of cone penetration tests (CPT) on the evaluation of the possible ranges of density achievable by various hydraulic placement methods adopted in the construction of the new airport. The results of the CPT indicated that the placement technique is one of the most important factors in controlling the as-placed density of hydraulically placed sand fill. There is a marked contrast in cone tip resistance (and the associated relative density) profiles for the sand fills formed by subaerial and subaqueous placement methods, in which the cone tip resistance of the sand fill formed by subaerial placement is substantially higher than that of the sand fill formed by subaequeous placement. The results confirm that dense sand fill cannot be formed by subaqueous placement methods. The weakest zone is generally located just beneath the water level where fill is placed by subaqueous discharge.Key words: sand, hydraulic fill, cone penetration test, calibration chamber test, in situ density.Le remblayage pour le nouvel aéroport à Chek Lap Kok de Hong Kong comprend la mise en place d'un volume substantiel de remblai de sable par différentes techniques de mise en place hydraulique, qui ont résulté en une large plage de densités en place du remblai de sable. Cet article décrit l'utilisation de l'essai de pénétration au cône (CPT) pour l'évaluation des plages possibles de densité qui peuvent être obtenues par différentes méthodes de mises an place hydrauliques adoptées pour la construction du nouvel aéroport. Les résultat de CPT indiquent que la technique de mise en place est un des facteurs les plus importants pour le contrôle de la densité en place de sable remblayé par méthode hydraulique. Il y a un contraste marqué entre les profils de résistance à la pointe (et la densité relative correspondante) pour les remblais de sable mis en place par des méthodes subaériennes ou sous l'eau, le premier étant appréciablement plus élevé. Les résultats confirment qu'un remblai de sable dense ne peut pas être obtenu par des méthode de mise en place sous l'eau. La zone la plus faible est en général localisée juste sous le niveau d'eau, là où la déposition du matériau de remblayage se fait par décharge sous-l'eau.Mots clés : sable, remblai hydraulique, essai de pénétration au cône, essai en chambre de calibrage, densité in situ.[Traduit par la Rédaction] [ABSTRACT FROM AUTHOR]

Deals with a study which investigated the geotechnical behavior of a hydraulic sand placed at a land reclamation site in Hong Kong, China. Hydraulic fill sites that were selected for the study; Extraction of marine sand; Summary and conclusions.

Background: In Xuanwei County, Yunnan Province, China, lung cancer mortality rates in both males and females are among the highest in China.Methods: We evaluated differential effects of smoking on lung cancer mortality before and after household stove improvement with chimney to reduce exposure to smoky coal emissions in the unique cohort in Xuanwei, China. Effects of independent variables on lung cancer mortality were measured as hazard ratios and 95% confidence intervals using a multivariable Cox regression model that included separate time-dependent variables for smoking duration (years) before and after stove improvement.Results and Conclusion: We found that the effect of smoking on lung cancer risk becomes considerably stronger after chimney installation and consequent reduction of indoor coal smoke exposure. [ABSTRACT FROM AUTHOR]

Adolescent idiopathic scoliosis (AIS) is a structural deformity of the spine affecting millions of children. As a complex disease, the genetic aetiology of AIS remains obscure. Here we report the results of a four-stage genome-wide association study (GWAS) conducted in a sample of 4,317 AIS patients and 6,016 controls. Overall, we identify three new susceptibility loci at 1p36.32 near AJAP1 (rs241215, Pcombined=2.95 × 10(-9)), 2q36.1 between PAX3 and EPHA4 (rs13398147, Pcombined=7.59 × 10(-13)) and 18q21.33 near BCL-2 (rs4940576, Pcombined=2.22 × 10(-12)). In addition, we refine a previously reported region associated with AIS at 10q24.32 (rs678741, Pcombined=9.68 × 10(-37)), which suggests LBX1AS1, encoding an antisense transcript of LBX1, might be a functional variant of AIS. This is the first GWAS investigating genetic variants associated with AIS in Chinese population, and the findings provide new insight into the multiple aetiological mechanisms of AIS.

Classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency is a well-known disorder of sexual development (previously known as ambiguous genitalia) in genotypic female neonates. We report on a 66-year-old Chinese, brought up as male, with a simple virilising form of congenital adrenal hyperplasia associated with Turner's syndrome (karyotype 45,X/47,XXX/46,XX). His late presentation was recognised due to his exceptionally short stature and persistent sexual ambiguity. His condition was only brought to medical attention as he developed a huge abdominal mass, which later turned out to be a benign ovarian mucinous cyst. It is therefore important to look out for co-existing congenital adrenal hyperplasia in patients with Turner's syndrome and virilisation, after the presence of Y chromosome material has been excluded.

Introduction: The expansion in gambling activities over the past decade has made gambling more accessible than ever. This could bring changes in the sociodemographic and clinical profiles of those seeking treatment for pathological gambling., Methods: This study examined the differences between two cohorts of 150 patients each, treated at the National Addictions Management Service between 2001 and 2006 (cohort-1) and between 2006 and 2008 (cohort-2), respectively., Results: Compared to cohort-1, cohort-2 was significantly younger (p-value less than 0.01), comprised fewer Chinese and were more highly educated (p-value less than 0.05), with no significant difference in gender or marital status. Regarding the type of gambling activities, cohort-2 was more likely to engage in soccer betting (p-value less than 0.01). Although the proportion presenting with any comorbidity remained unchanged, alcohol use disorders had increased more than three-fold and suicide risk was slightly elevated, although not significantly., Discussion: Clinicians should undertake routine screening and assessment of alcohol misuse and suicide risk, offering brief interventions, where necessary, for this vulnerable population.

Objective: To determine the frequency, risk factors, clinical features, and management of amiodarone-induced thyroid dysfunctions., Design: Retrospective study., Setting: A regional hospital in Hong Kong., Patients: Patients who had been prescribed amiodarone for at least 6 months from 1 October 2005 to 30 September 2007., Results: A total of 390 patients (mean age, 70 years; standard deviation, 9 years; 54% male) with a median follow-up of 43 (interquartile range, 25-69) months were studied. Hypothyroidism developed in 87 (22%) of the patients (mean age, 72 years; standard deviation, 7 years; 56% male) and thyrotoxicosis in 24 (6%) of the patients (65 years; 11 years; 54% male). Increased baseline thyrotropin (thyroid-stimulating hormone) level appeared to be predictive of amiodarone-induced hypothyroidism, in which a thyroid-stimulating hormone level of 4 mIU/L or above was associated with a 4.7-fold increase in the risk (95% confidence interval, 1.9-11.7; P<0.001). Compared with those who remained euthyroid on amiodarone, thyrotoxicosis developed in younger patients. In these patients, the classical symptoms of thyroid dysfunction were frequently absent, although worsening of underlying arrhythmias, their cardiac condition, weight loss, and over-warfarinisation were suggestive of amiodarone-induced thyrotoxicosis. In both amiodarone-induced thyrotoxicosis and hypothyroidism, the disease course was benign. Patients with the former showed a good response to anti-thyroid drugs and steroid therapy., Conclusions: Amiodarone-induced thyroid dysfunction is common among our population. As the clinical presentations are usually vague and atypical, regular biochemical monitoring of thyroid function is warranted, particularly in patients with elevated baseline thyroid-stimulating hormone level. The disease course of amiodarone-induced thyrotoxicosis is usually benign and remits with timely administration of anti-thyroid medications, with or without corticosteroids.

Schistosoma japonicum obtained from Taiwan is a zoophilic strain that only infects domestic and small animals. Recombinant fructose-1,6-bisphosphate aldolase (FBPA) derived from this strain was used as an antigen in an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of human schistosomiasis. The full-length DNA sequence of FBPA was found to be 1092 bp, encoding a protein of 363 amino acid residues, with a molecular mass of 39.6 kDa. A total of 120 participants were recruited from China and Taiwan to evaluate the diagnostic value of this recombinant protein. In these participants, 34 were found to be infected with S. japonicum, 16 with Ascaris lumbricoides, 15 with hookworm, 13 with Paragonimus westermani and 13 with Clonorchis sinensis, whereas 29 had no ova on faecal examination. Western blot analysis showed that the recombinant FBPA reacts strongly with schistosome ova-positive sera. The sensitivity and specificity of ELISA with FBPA were found to be 85.3% and 93.0%, respectively. These results indicate that FBPA derived from the Formosan strain of S. japonicum can be used for the diagnosis of human schistosomiasis.

Unlabelled: Many studies have demonstrated the role of melatonin in the etiology of AIS. Previous studies have shown that there is no evidence of mutations in the melatonin receptor 1A gene in AIS patients. In this study, we have examined the role of melatonin receptor 1B in predisposition for AIS. Using haplotype block tagging technique, a set of tagging SNPs were defined for MTNR1B from the Han Chinese data of the International HapMap project. The association between the tagging of single nucleotide polymorphisms (tSNPs) in MTNR1B region and the occurrence of AIS was studied., Method: 473 AIS girls and 311 normal controls were recruited. The age range of the patients was between 10 and 18 years old. The maximum Cobb was recorded at latest follow-up in AIS patients. Three of five tSNPs were studied; they were all located within the coding region of the MTNR1B gene., Results: There was no significant difference in the genotype or allelic frequencies (AF) of the 3 tSNPs between AIS and controls. In a case-only analysis, no difference in curve severity in AIS patients was found among patients with different genotypes (by one-way ANOVA)., Discussion: The 3 tSNPs showed no association with either the occurrence of AIS or the maximum Cobb angle within AIS girls. Further analysis of the remaining tSNPs within the regulatory region of the MTNR1B gene and other related genes in the melatonin signaling pathway may provide further information on the role of the melatonin in AIS girls.

The functional anatomy of Chinese character processing was investigated using fMRI. Right-handed Mandarin-English bilingual participants made either semantic or perceptual size judgements with characters and pictures. Areas jointly activated by character and picture semantic tasks compared to size judgement tasks included the left prefrontal region (BA 9, 44, 45), left posterior temporal, left fusiform, and left parietal regions. Character processing produced greater activation than picture processing in the left mid and posterior temporal as well as left prefrontal regions. The lateral occipital regions were more active during picture semantic processing than character semantic processing. A similar pattern of activation and contrasts was observed when English words and pictures were compared in another set of bilingual participants. However, there was less contrast between word and picture semantic processing than between character and picture processing in the left prefrontal region. When character and word semantic processing were compared directly in a third group, the loci of activation peaks was similar in both languages but Chinese character semantic processing was associated with a larger MR signal change. The semantic processing of Chinese characters, English words, and pictures activates a common semantic system within which there are modality-specific differences. The semantic processing of Chinese characters more closely resembles English words than pictures., (Copyright 2000 Academic Press.)