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Children are known to be more vulnerable to exposure to endocrine-disrupting chemicals (EDCs) compared to adults, but evaluating the exposure pathways can be challenging. This research employed target and non-target analysis (NTA) to examine the exposure characteristics of EDCs in spot urine samples collected from 46 children's (aged 3-12 years) and their parents in Hong Kong (Chinese/Western lifestyle) and Guangzhou (mainly Chinese lifestyle). The results revealed that the geometric mean concentrations of phthalate esters metabolites (mPAEs) and bisphenols (BPs) in children's urine were 127.3 μg/g crea and 2.5 μg/g crea in Guangzhou, and 93.7 μg/g crea and 2.9 μg/g crea in Hong Kong, respectively, which were consistent with global levels. NTA identified a total of 1069 compounds, including 106 EDCs, commonly detected in food, cosmetics, and drugs. Notable regional differences were observed between Guangzhou and Hong Kong with potential sources of EDCs including dietary and cosmetic additives, toys, flooring and dust, as well as differences in lifestyles, diet, and living environment. However, age was found to significantly impact EDC exposure. The quantified EDCs (mPAEs and BPs) posed possible health risks to 60% of the children. Moreover, the presence of caffeine in children's urine, which exhibited higher detection rates in children from Hong Kong (95.6%) and Guangzhou (44.4%), warrants further attention. The sources of EDCs exposure in these regions need to be fully confirmed., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Peritoneal dialysis (PD) first policy has been established in Hong Kong since 1985. After 35 years of practice, the PD first policy in Hong Kong has influenced many countries around the world including governments, health ministries, nephrologists and renal nurses on the overall health policy structure and clinical practice in treating kidney failure patients using PD as an important dialysis modality. In 2021, the International Association of Chinese Nephrologists and the Hong Kong Society of Nephrology jointly held a symposium celebrating the 35 years of PD first policy in Hong Kong. In that symposium, experts and opinion leaders from around the world have shared their perspectives on how the PD first policy has grown and how it has affected PD and home dialysis practice globally. The advantages of PD during COVID-19 pandemic were highlighted and the use of telemedicine as an important adjunct was discussed in treating kidney failure patients to improve the overall quality of care. Barriers to PD and the need for sustainability of PD first policy were also emphasized. Overall, the knowledge awareness of PD as a home dialysis for patients, families, care providers and learners is a prerequisite for the success of PD first. A critical mass of PD regional hubs is needed for training and mentorship. Importantly, the alignment of policy and clinical goals are enablers of PD first program., (© 2022 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.)

Collaborative innovation can promote scientific productivity and the development of clean technology and thus has a great potential in constraining the ecological footprint. However, current studies on the impact of collaborative innovation on ecological footprint are insufficient, and results remain controversial. To better understand these impacts, this paper took Guangdong-Hong Kong-Macao Greater Bay Area of China as a case, estimated the ecological footprint at the municipal level from 2008 to 2018, measured collaborative innovation both from four dimensions and from a composite approach, then applied threshold regression models to compare the impact of collaborative innovation on the ecological footprint across different economic intervals. The findings showed that: the ecological footprint of the Greater Bay Area displayed an overall upward trend with prominent spatial heterogeneity. The impact of collaborative innovation on the ecological footprint presented a double-threshold effect when examined with different indicators. Among which, the flow of scientific personnel and capital boosted the ecological footprint, which intensified with economic development, while collaboration in technology exerted significant inhibitory effects on ecological footprint, and the influence of inter-city knowledge collaboration was limited. Overall, collaborative innovation inhibited ecological footprint when measured by a composite index. This might inspire policymakers to adopt sustainable strategies depending on the type of collaborative innovation and the economic status of the city to constrain growth of the ecological footprint, thus minimizing the pressures of human activities on the environment and moving towards a more carbon neutral society., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Nearly 4 billion doses of the BNT162b2-mRNA and CoronaVac-inactivated vaccines have been administrated globally, yet different vaccine-induced immunity against SARS-CoV-2 variants of concern (VOCs) remain incompletely investigated., Methods: We compare the immunogenicity and durability of these two vaccines among fully vaccinated Hong Kong people., Findings: Standard BNT162b2 and CoronaVac vaccinations were tolerated and induced neutralizing antibody (NAb) (100% and 85.7%) and spike-specific CD4 T cell responses (96.7% and 82.1%), respectively. The geometric mean NAb IC 50 and median frequencies of reactive CD4 subsets were consistently lower among CoronaVac-vaccinees than BNT162b2-vaccinees. CoronaVac did not induce measurable levels of nucleocapsid protein-specific IFN-γ + CD4 + T or IFN-γ + CD8 + T cells compared with unvaccinated. Against VOCs, NAb response rates and geometric mean IC 50 titers against B.1.617.2 (Delta) and B.1.1.529 (Omicron) were significantly lower for CoronaVac (50%, 23.2 and 7.1%, <20) than BNT162b2 (94.1%, 131 and 58.8%, 35.0), respectively. Three months after vaccinations, NAbs to VOCs dropped near to detection limit, along with waning memory T cell responses, mainly among CoronaVac-vaccinees., Interpretation: Our results indicate that vaccinees especially CoronaVac-vaccinees with significantly reduced NAbs may probably face higher risk to pandemic VOCs breakthrough infection., Funding: This study was supported by the Hong Kong Research Grants Council Collaborative Research Fund (C7156-20GF and C1134-20GF); the Wellcome Trust (P86433); the National Program on Key Research Project of China (Grant 2020YFC0860600, 2020YFA0707500 and 2020YFA0707504); Shenzhen Science and Technology Program (JSGG20200225151410198 and JCYJ20210324131610027); HKU Development Fund and LKS Faculty of Medicine Matching Fund to AIDS Institute; Hong Kong Innovation and Technology Fund, Innovation and Technology Commission and generous donation from the Friends of Hope Education Fund. Z.C.'s team was also partly supported by the Theme-Based Research Scheme (T11-706/18-N)., Competing Interests: Declaration of interest The authors declare no competing interests., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Common plasticizers and their alternatives are environmentally ubiquitous and have become a global problem. In this study, common plasticizers (phthalates and metabolites) and new alternatives [bisphenol analogs, t-butylphenyl diphenyl phosphate (BPDP), and bisphenol A bis(diphenyl phosphate) (BDP)] were quantified in urine and hair samples from children in Hong Kong, drinking water (tap water/bottled water) samples, and airborne particle samples from 17 kindergartens in Hong Kong. The results suggested that locally, children were exposed to various plasticizers and their alternatives. High concentrations of BPDP and BDP were present in urine, hair, tap water, bottled water, and air particulate samples. The geometric mean (GM) concentrations of phthalate metabolites in urine samples (126-2140 ng/L, detection frequencies < 81%) were lower than those detected in Japanese and German children in previous studies. However, a comparison of the estimated daily intake values for phthalates in tap water [median: 10.7-115 ng/kg body weight bw/day] and air particles (median: 1.23-7.39 ng/kg bw/day) with the corresponding reference doses indicated no risk. Bisphenol analogs were detected in 15-64% of urine samples at GM concentrations of 5.26-98.1 ng/L, in 7-74% of hair samples at GM concentrations of 57.5-2390 pg/g, in 59-100% of kindergarten air samples at GM concentrations of 43.1-222 pg/m 3 , and in 33-100% of tap water samples at GM concentrations of 0.90-3.70 ng/L. A significant correlation was detected between the concentrations of bisphenol F in hair and urine samples (r = 0.489, p < .05). The estimated daily urinary excretion values of bisphenol analogs suggest that exposure among children via tap water intake and airborne particle inhalation in kindergartens cannot be ignored in Hong Kong., Competing Interests: Declaration of competing interest The authors declared that we have no conflict of interest to this work., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Seven perfluorinated and polyfluorinated substances (PFASs), namely perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluoroheptanoic acid (PFHpA), perfluorohexanoic acid (PFHxA), and perfluoro-1,10-decanedicarboxylic acid (PFDDA), were evaluated in urine and hair samples from children (age: 4-6 years, N = 53), airborne particles sampled at 17 kindergartens, and tap water and bottled water samples. All samples were collected in Hong Kong. The analytical results suggested widespread PFAS contamination. All target PFASs were detected in at least 32% of urine samples, with geometric mean (GM) concentrations ranging from 0.18 to 2.97 ng/L, and in 100% of drinking water samples at GM concentrations of 0.18-21.1 ng/L. Although PFOS and PFDDA were not detected in hair or air samples, the other target PFASs were detected in 48-70% of hair samples (GM concentrations: 2.40-233 pg/g) and 100% of air samples (GM concentrations: 14.8-536.7 pg/m 3 ). In summary, the highest PFAS concentrations were detected in airborne particles measured in kindergartens. PFOA was the major PFAS detected in hair, urine, and drinking water samples, while PFOA, PFDA, and PFHpA were dominant in airborne particles. Although a significant difference in PFAS concentrations in hair samples was observed between boys and girls (p < .05), no significant sex-related difference in urinary PFAS or paired PFAS (hair/urine) concentrations was observed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Antibiotic resistance genes (ARGs) and antibiotic resistant bacteria (ARB) have become a critical global public health issue in this century. There is increasing evidence for the presence and transmission of ARGs by air transmission. In this research, ARGs and ARB in air conditioner filter dust (AC dust) and urine samples from 55 kindergarten children in 17 kindergartens and nearby 10 soil samples in Hong Kong were analyzed. The results showed the presence of 16 ARG subtypes and the mobile genetic element (MGE) intI1 in AC dust, and 12 ARG subtypes in the soil samples. ARGs presenting resistance to sulfonamide (6.9 × 10 -3 -0.17) (expressed as relative abundance of the 16 S rRNA genes) were most abundant followed by macrolides (1.8 × 10 -3 -3.3 × 10 -2 ), sul1, sul2 (sulfonamide), ermF (macrolides) and intI1 genes in AC dust in 17 kindergartens. For soil samples, 12 ARG subtypes and the intI1 were detected, and the genes providing resistance to sulfonamide (1.6 × 10 -3 -2.7 × 10 -1 ) were the most abundant ARGs in the 10 soil samples, followed by tetracycline (ND-1.4 × 10 -2 ). Multi-resistant bacteria with sul1, sul2, intI1, or tetQ were detected in all AC dust samples and some urine samples. Based on bacterial genera and ARG co-occurrence network analysis and Hong Kong's special geographical location and cultural environment, there might be two origins for the ARGs detected in the kindergartens: β-lactam/macrolide ARGs mainly derived from human medicine use and tetracycline/sulfonamide ARGs mainly from other areas, as well as IntI1 may play a role in the spread of ARGs in Hong Kong. The widely detection of ARGs in AC dust in kindergartens in Hong Kong highlights the need for the improvement of management measures., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Benzophenones (BPs) and other ultra violet (UV) filters (UV-filters) are widely used in sunblock and other personal care products, raising concerns about their adverse health risks to human, especially for children. In the present study, BP-type UV-filters and other four widely used UV-filters were evaluated in the child urinary samples (4-6 years, n = 53), tap water and commercial distilled water in Hong Kong. The results suggested that the target chemicals are ubiquitous in the subject. BP1, BP2, BP3 and BP4 in children urine samples contributed closely to the overall children exposure of UV filters, with detection rates above 58% and geometric means ranging from 44.2 to 76.7 ng/mL. As a contrast, BP3 was the major substance found in the tap water and distilled bottle water, with detection rates of 100% and geometric means of 9.64 and 14.5 ng/L, respectively. There were some significant relationships between urinary UV filters and personal characteristics (BMI values, sex, income level, hand washing frequency, and body location usage), but the health risks associated with UV-filters in Hong Kong children might not be concerning. Only two children applied sun creams in this research, indicating that there were other sources to exposure these chemicals., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The urine levels of organophosphate flame retardants (PFRs) and bisphenol A (BPA) in kindergarten children (n = 31, 4-6 years old, sampling performed in 2016) in Hong Kong were measured. The detection frequency of the target PFRs, tri(2-chloroethyl)phosphate (TCEP), tris(1,3-dichloro-2-propyl) phosphate (TDCIPP), tris(chloroisopropyl)phosphate (TCIPP), triphenyl phosphate (TPHP) and 2-ethylhexyl diphenyl phosphate (EHDPP) ranged from 52% to 84%. The 95th percentile urinary concentrations of TPHP, TDCIPP, TCIPP, EHDPP and TCEP were 1.70, 0.24, 0.03, 0.05, 0.68 and 0.03 ng/mL, respectively. The median urine level of BPA was 1.69 ng/mL, with a detection frequency of 77%. Due to the lack of metabolism information, two scenarios were used to calculate the estimated daily intake (EDI) of these compounds. Back-calculated EDIs of PFRs using the urinary excretion rates from in vivo animal data (scenario 2) were up to 2.97 μg/kg/d (TDCIPP), which was only a little less than that observed in a sample of American infants, and the reference dose (RfD), meaning that the potential health risk of TDCIPP cannot be ignored. Dust ingestion was suggested to be the major pathway of exposure to PFRs, but when the levels in dust and air particles in kindergartens in Hong Kong were used to predict EDIs, these values were nearly half as much as those predicted from urinary TDCIPP in this study. This suggested that children's PFRs burden may be underestimated when considering only PFR levels in dust or air. There is thus a need for further studies with large-scale surveys and investigation of exposure routes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Aims: To examine the effects of a group-based physical activity intervention on improvement in physical activity and mitigation of symptom distress among pediatric patients with cancer., Methods: Based on convenience sampling, 57 pediatric patients with cancer admitted to the cancer center were included in the intervention group. The control group included 57 pediatric patients with cancer from two other hospitals matched to the patients in the intervention group by age, sex, and diagnosis. A group-based physical activity program was implemented among the children in the intervention group, whereas the children in the control group received standard care. Physical activity and symptoms were measured using the Children's Leisure Time Activities Study Survey-Chinese and using the Memorial Symptom Assessment Scale 10-18 at baseline and after the 12 th exercise session in both the intervention and control groups., Results: The repeated-measures analysis of variance showed that the main intervention effects on the decrease in light-intensity physical activity and increase in moderate-to-vigorous physical activity were significant between the two groups (P < .001). The group-based physical activity intervention could decrease the scores of psychological symptoms (P < .001), Global Distress Index (P < .001), and physical symptoms (P = .01) when comparing the difference between the two groups before and after the intervention. There was no significant difference in the number of symptoms or the total symptom experience score between the two groups., Conclusion: These findings suggest that a group-based physical activity intervention can promote physical activity and relieve psychological and physical symptom distress among pediatric patients with cancer., (© 2019 Wiley Periodicals, Inc.)

Objective: To determine the frequency of Hong Kong αα (HK αα) gene in α3.7 positive samples among carriers from Fujian area., Methods: Routine genetic testing for thalassemia was carried out for 10145 patients with positive screening results. Single PCR and two-round nested PCR were utilized to detect HK αα among 507 patients with α3.7/αα and 2 patients for whom electrophoresis showed α3.7, -αSEA and normal α2 alleles. Reverse dot blot test was used for detecting non-deletional α-thalassemia and β-thalassemia variants., Results: Among the 507 patients with α3.7/αα, HK αα was identified in 35 cases, which included 25 HK αα/αα, 5 HK αα/α3.7, 4 HK αα/αα with heterozygous CD41/42 (HBB: c.126&#95;129delCTTT) variant, 1 HK αα/αα with IVS-II-654 (HBB: c.316&#95;197C>T) heterozygous variant. One patient was confirmed to have α3.7/anti4.2 genotype. The two cases with α3.7, -αSEA and normal α2 alleles were confirmed to be HK αα/--SEA. The frequency of HK αα genotype in Fujian area was therefore 7.27% among patients with α3.7 and 0.36% in the general population., Conclusion: A certain proportion of HK αα has been detected in Fujian area, which will enable more accurate diagnosis and genetic counseling.

Background: Leventhal's commonsense model implies illness perceptions influence illness outcomes. This study examined illness perceptions among head and neck cancer survivors, and whether these predicted subsequent psychological distress., Methods: A total of 124 survivors of head and neck cancer (87% nasopharyngeal carcinoma; NPC) completed measures of psychological distress (Hospital Anxiety and Depression Scale; HADS), illness perceptions (Brief Illness Perception Questionnaire; B-IPQ), dispositional optimism (revised Chinese version of the Life Orientation Test; C-LOT-R), and clinical and demographic data approximately12.9 months after diagnosis (T1). Six months later (T2) psychological distress (HADS) was again measured. Adjusted multivariate analyses tested whether illness perceptions predicted T2 HADS scores., Results: Illness perception dimensions were significantly intercorrelated (0.01-0.68), explaining 8.0% of anxiety and 4.8% of depression symptom variability at T2. After adjustment for T1 distress, illness identity (β = 0.270, P < .01) and sex identification as a woman (β = 0.275, P < .01) predicted T2 anxiety symptoms while illness identity (β = 0.195, P < .05), unemployment (β = 0.195, P < .05), and pessimism (β = -0.227, P < .01) predicted T2 depression symptoms., Conclusion: Perceived illness identity predicted psychological distress, accounting for modest levels of distress variance. Unresolved symptoms may exacerbate distress., (© 2018 Wiley Periodicals, Inc.)

For the past fewer years, environment antibiotic residues have got more and more attention. The occurrence and distribution of eight common antibiotics, belonging to five classes, were determined in both water and sediment of eleven rivers of Hong Kong. The target antibiotics were found to be widely distributed. Sulfamethoxazole (n.d.-79.9 ng/L), sulfadimidine (n.d.-29.9 ng/L), and ofloxacin (n.d.-75.5 ng/L) were the dominant antibiotics in river water, with detection rates of 84.6, 76.9, and 69.2%, respectively. Tetracycline (n.d.-9.8 ng/g) was the dominant antibiotic in sediment, with a detection rate of 60%. The concentrations of all antibiotics in river water of Hong Kong were lower than which in various rivers of Europe, North America and Australia, as well as the Pearl River Basin of China. All sediment sites exhibited significant bacterial diversity. Gammaproteobacteria (0.08-12.7%) and Flavobacteria (0.14-14.1%) were the dominant bacterial classes in all sediments. The bacterial compositions varied between sites; areas polluted with high levels of antibiotics had rich and highly diverse bacterial communities. The environmental risk assessment determined that the antibiotics in 73.1% of the samples posed ecological risks to algae, and two samples posed low risks to invertebrates. Ofloxacin was the main contributor of risk to aquatic organisms, while the antibiotics in 11.5% of the samples posed resistance selection risks. The occurrence and distribution of eight common antibiotics, belonging to five classes, were widely distributed in Hong Kong. Sulfamethoxazole, sulfadimidine, and ofloxacin were the dominant antibiotics in river waters, Tetracycline was the dominant antibiotic in sediment. Areas polluted with high levels of antibiotics had rich and highly diverse bacterial communities. Antibiotics in 73.1% of the samples posed ecological risks, while the antibiotics in 11.5% of the samples posed resistance selection risks.

Introduction: The aim of this study was to compare the effect of two educational interventions on the psychosocial well-being of Hong Kong Chinese women who have a positive high-risk human papillomavirus (HPV) test and normal cervical cytology., Methods: Participants were randomised into either leaflet group, in which a written HPV factsheet was provided; or counselling group, in which a didactic HPV presentation in person in addition to the factsheet was provided. Women's psychological conditions were assessed by self-administered questionnaires at pre, post (within one week) and 6 months after the educational interventions. Main outcome measures were psychosocial well-being (cervical cancer worry, anxiety and depression, screening-related anxieties, HPV-related shame) and knowledge of cervical screening and HPV., Results: Data from 121 women (52 in leaflet group; 69 in counselling group) were analysed. There was no significant difference in the psychosocial well-being between the two groups at alltime points. Irrespective of the two educational interventions, cervical cancer worry and anxiety decreased over time. The counselling group had a significantly higher score in knowledge of cervical screening and HPV compared with leaflet group (mean score 4.65 ± 0.19 versus 3.71 ± 0.23, p = 0.002) at post-educational intervention, but there was no significant difference (mean score 4.14 ± 0.22 versus 3.58 ± 0.24, p = 0.084) at 6 months., Discussion: Both educational interventions were comparable in relieving adverse HPV-related psychosocial effects. Combination of counselling and leaflet were more effective than leaflet only in improving women's knowledge on cervical screening and HPV soon after educational interventions but the benefit was not apparent after 6 months.

Objective: The eight-item Brief Illness Perception Questionnaire (B-IPQ) supposedly evaluates cognitive and emotional representations of illness. This study examined the validity and reliability of a traditional Chinese version of the B-IPQ in Hong Kong Chinese breast cancer survivors., Methods: 358 Chinese breast cancer survivors who had recently ended their primary treatment completed this B-IPQ Chinese version. Confirmatory factor analysis (CFA) tested the factor structure. The internal consistency, construct, predictive and convergent validities of the scale were assessed., Results: CFA revealed that the original three-factor (cognitive-emotional representations and illness comprehensibility) structure of the B-IPQ poorly fitted our sample. After deleting one item measuring illness coherence, seven-item gave an optimal two-factor (cognitive-emotional representations) structure for the B-IPQ (B-IPQ-7). Cronbach's alpha for the two subscales were 0.653 and 0.821, and for the overall seven-item scale of B-IPQ was 0.783. Correlations of illness perception and physical symptom distress, anxiety, depression and known-group comparison between different treatment status suggested acceptable construct validity. The association between baseline illness perception and psychological distress at 3-month follow up supported predictive validity., Conclusions: B-IPQ-7 appears to be a moderately valid measure of illness perception in cancer population, potentially useful for assessing illness representations in Chinese women with breast cancer.