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Twenty (20) vertical electrical soundings were acquired using ABEM SAS 300 terrameter in order to determine the hydraulic characteristics of the identified aquifers within Adamu Augie College of Education Argungu near Birnin Kebbi, Northwestern Nigeria. The data were interpreted and seven sounding curves were obtained (KH, HQ, HA, HK, AA, A, and Q). The generated geoelectric sections characterized the subsurface into six lithologic units (topsoil, clayey sand, sandstone, clay, shale and sand) with sandstone and sand constituting the major aquifers in the area. The resistivity layer parameters delineated across the entire area were used to determine the hydraulic characteristics of the identified aquifers. The delineated layers above the aquifers showed transverse resistance ranging from 333.06Ωm² to 23100.61Ωm², longitudinal conductance S from 0.025047 to 1.226506 mhos, hydraulic conductivity K from 0.44 m/day to 25.57 m/day, transmissivity T from 7.144 m²/day to 465.374m²/day, and coefficient of anisotropy from 0.98 to 1.0. The protective map shows that about 75% of the area falls within poor overburden protective capacity, 20% constitute moderate protective capacity, while the remaining 5% have good protective capacity rating. Therefore, the hydraulic characteristics of the area suggest that the materials above aquifers are less protected, and by implication vulnerable to infiltration. [ABSTRACT FROM AUTHOR]

The persisting risk of long-term health consequences of SARS-CoV-2 infection and the protection against such risk conferred by COVID-19 vaccination remains unclear. Here we conducted a retrospective territory-wide cohort study on 1,175,277 patients with SARS-CoV-2 infection stratified by their vaccination status and non-infected controls to evaluate the risk of clinical sequelae, cardiovascular and all-cause mortality using a territory-wide public healthcare database with population-based vaccination records in Hong Kong. A progressive reduction in risk of all-cause mortality was observed over one year between patients with SARS-CoV-2 infection and controls. Patients with complete vaccination or have received booster dose incurred a lower risk of health consequences including major cardiovascular diseases, and all-cause mortality than unvaccinated or patients with incomplete vaccination 30-90 days after infection. Completely vaccinated and patients with booster dose of vaccines did not incur significant higher risk of health consequences from 271 and 91 days of infection onwards, respectively, whilst un-vaccinated and incompletely vaccinated patients continued to incur a greater risk of clinical sequelae for up to a year following SARS-CoV-2 infection. This study provided real-world evidence supporting the effectiveness of COVID-19 vaccines in reducing the risk of long-term health consequences of SARS-CoV-2 infection and its persistence following infection. The long-term health consequences of COVID-19 infection are not fully understood. In this retrospective cohort study from Hong Kong, the authors describe changes in the risk of various clinical outcomes including all-cause mortality for one year following COVID-19 infection and how they vary by vaccination status. [ABSTRACT FROM AUTHOR]

Previous studies indicate an increased carditis risk among adolescents following the two-dose messenger RNA COVID-19 vaccine. Several jurisdictions have extended the interdose interval between the first and second doses to reduce the risk. However, the effectiveness of such an extension policy remains inconclusive. Using the territory-wide vaccine record-linked electronic health records in Hong Kong, we conducted a nested case–control study from February 23, 2021 to August 15, 2022. Adolescents aged between 12 and 17 who received two-dose BNT162b2 were included for comparing risks between standard interdose interval (21–27 days) versus extended interdose interval (≥ 56 days). The carditis cumulative incidence within 28 days following the second dose was calculated. The adjusted odds ratio was estimated from multivariable conditional logistic regression. We identified 49 adolescents with newly diagnosed carditis within 28 days following the second dose. The crude cumulative incidence is 37.41 [95% confidence interval (CI): 27.68–49.46] per million vaccinated adolescents. Compared to the standard interdose interval group, adolescents with an extended interval had a significantly lower risk of carditis [adjusted odds ratio (aOR) 0.34 (95% CI: 0.16–0.73)]. Sensitivity analysis of carditis occurring within 14 days following the second dose yielded a similar estimate [aOR 0.30 (95% CI: 0.13–0.73)]. Extending the interdose interval of the BNT162b2 vaccine from 21 to 27 days to 56 days or longer is associated with 66% lower risk of incident carditis among adolescents. Our findings contribute towards an evidence-based vaccination strategy for a vulnerable population and potentially informs product label updates. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the long‐term associations between coronavirus disease 2019 (COVID‐19) and diabetes complications and mortality, in patients with diabetes. Materials and Methods: People with diabetes diagnosed with COVID‐19 infection (exposed group), from 16 March 2020 to 31 May 2021 from the UK Biobank (UKB cohort; n = 2456), and from 1 April 2020 to 31 May 2022 from the electronic health records in Hong Kong (HK cohort; n = 80 546), were recruited. Each patient was randomly matched with participants with diabetes but without COVID‐19 (unexposed group), based on age and sex (UKB, n = 41 801; HK, n = 391 849). Patients were followed for up to 18 months until 31 August 2021 for UKB, and up to 28 months until 15 August 2022 for HK. Characteristics between cohorts were further adjusted with Inverse Probability Treatment Weighting. Long‐term association of COVID‐19 with multi‐organ disease complications and all‐cause mortality after 21 days of diagnosis was evaluated by Cox regression. Results: Compared with uninfected participants, patients with COVID‐19 infection with diabetes were consistently associated with higher risks of cardiovascular diseases (coronary heart disease [CHD]: hazard ratio [HR] [UKB]: 1.6 [95% confidence interval {CI}: 1.0, 2.4], HR [HK]: 1.2 [95% CI: 1.0, 1.5]; and stroke: HR [UKB]: 2.0 [95% CI: 1.1, 3.6], HR [HK]: 1.5 [95% CI: 1.3, 1.8]), microvascular disease (end stage renal disease: HR [UKB]: 2.1 [95% CI: 1.1, 4.0], HR [HK]: 1.2 [95% CI: 1.1, 1.4]) and all‐cause mortality (HR [UKB]: 4.6 [95% CI: 3.8, 5.5], HR [HK]: 2.6 [95% CI: 2.5, 2.8]), in both cohorts. Conclusions: COVID‐19 infection is associated with long‐term increased risks of diabetes complications (especially cardiovascular complications, and mortality) in people with diabetes. Monitoring for signs/symptoms of developing these long‐term complications post‐COVID‐19 infection in the infected patient population of people with diabetes may be beneficial in minimizing their morbidity and mortality. [ABSTRACT FROM AUTHOR]

Geohydraulic parameters, namely hydraulic conductivity (K), transmissivity (T), effective porosity (ϕ ), permeability ( k p ), anisotropy coefficient (λ), and longitudinal conductance (S), of aquifer units in Etioro-Akoko, southwestern Nigeria, were evaluated using the Schlumberger vertical electrical sounding (VES) technique. This study aimed to understand the hydrodynamics and water–rock interaction of the near-surface crustal architecture to determine the groundwater yield and vulnerability of the aquifer units in the study area. A total of 7 model curve types were generated for fifty-two geoelectrical surveyed points, with percentage distributions in the order of HA > AA > H > KH > A > HK > AK. The VES curve models constrained the subsurface layers into topsoil, weathered units, weathered/fractured bedrock units, and fresh bedrock. The weathered and fractured aquifer zones occurred at the depths of 8 m and > 16 m (with depths exceeding 26.5 m for some sections). The K and T values for the aquifer units varied from 0.1901 to 0.6188 m/day and 0.7111 to 6.3525 m2/day, respectively. These parameters coupled with the aquifer ϕ (18.03–23.35%) and k p (0.028–0.089 µm2) classified the delineated aquifer units as low to moderate groundwater-yielding capacity aquifers, with recorded resistivity values between 85.1 Ω-m and < 613.0 Ω-m. The observed positive correlations and R2 values with > 32–100% prediction rates affirmed the dependence of K on T, ϕ , and k p for effective water–rock interactions and groundwater transmissibility. The recorded S values (0.0146–0.162 mhos) and low logarithm hydraulic resistance, Log C (0.89–1.75 years), suggested poor to weak aquifer protective capacity ratings, resulting in high aquifer vulnerability index delineated across the study area. As a result, deep-weathered/fractured aquifers should be exploited for sustainable potable groundwater supplies. However, intended wells/boreholes in the study area must be developed properly for long-term groundwater abstraction to alleviate potable groundwater deficit and optimize future operational drilling costs. [ABSTRACT FROM AUTHOR]

Background With accruing case reports on de novo or relapsing glomerular diseases (GD) following different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, we evaluated the risk of GD following BNT162b2 and CoronaVac vaccines. Methods A modified self-controlled case series analysis was conducted using anonymized, territory-wide SARS-CoV-2 vaccination records in Hong Kong. All Hong Kong residents aged 18 years or above with outcomes of interest were included. Outcomes of interest were GD, proteinuria or hematuria within 42 days following each dose of SARS-CoV-2 vaccines. Incidence per 100 000 doses of SARS-CoV-2 vaccines administered was calculated, and incidence rate ratios (IRRs) were estimated using conditional Poisson regression with seasonality adjustment. Results Between 23 February 2021 and 31 March 2022, 4062 patients had an incident diagnosis of GD, proteinuria or hematuria, with 2873 of them being vaccinated during the observation period. The incidences of the composite events 1–41 days after vaccination were 3.7 (95% CI 3.1–4.4) per 100 000 doses of BNT162b2 administered, and 6.5 (95% CI 5.7–7.5) per 100 000 doses CoronaVac administered. There was no significant increase in the risks of composite events following the first (BNT162b2: IRR = 0.76, 95% CI 0.56–1.03; CoronaVac: IRR = 0.92, 95% CI 0.72–1.19), second (BNT162b2: IRR = 0.92, 95% CI 0.72–1.17; CoronaVac: IRR = 0.88. 95% CI 0.68–1.14) or third (BNT162b2: IRR = 0.39. 95% CI 0.15–1.03; CoronaVac: IRR = 1.18. 95% CI 0.53–2.63) dose of SARS-CoV-2 vaccines. Conclusions There was no evidence of increased risks of de novo or relapsing GD with either BNT162b2 or CoronaVac vaccines. [ABSTRACT FROM AUTHOR]

Influenza virus alters glycosylation patterns on its surface exposed glycoproteins to evade host adaptive immune responses. The viral hemagglutinin (HA), in particular the H3 subtype, has increased its overall surface glycosylation since its introduction in 1968. We previously showed that modulating predicted N-linked glycosylation sites on H3 A/Hong Kong/1/1968 HA identified a conserved epitope at the HA interface. This epitope is occluded on the native HA trimer but is likely exposed during HA "breathing" on the virion surface. Antibodies directed to this site are protective via an ADCC-mediated mechanism. This glycan engineering strategy made an otherwise subdominant epitope dominant in the murine model. Here, we asked whether cysteine stabilization of the hyperglycosylated HA trimer could reverse this immunodominance by preventing access to the interface epitope and focus responses to the HA receptor binding site (RBS). While analysis of serum responses from immunized mice did not show a redirection to the RBS, cysteine stabilization did result in an overall reduction in immunogenicity of the interface epitope. Thus, glycan engineering and cysteine stabilization are two strategies that can be used together to alter immunodominance patterns to HA. These results add to rational immunogen design approaches used to manipulate immune responses for the development of next-generation influenza vaccines. [ABSTRACT FROM AUTHOR]

The hemagglutinin (HA) of A/H3N2 pandemic influenza viruses (IAVs) of 1968 differed from its inferred avian precursor by eight amino acid substitutions. To determine their phenotypic effects, we studied recombinant variants of A/Hong Kong/1/1968 virus containing either human-type or avian-type amino acids in the corresponding positions of HA. The precursor HA displayed receptor binding profile and high conformational stability typical for duck IAVs. Substitutions Q226L and G228S, in addition to their known effects on receptor specificity and replication, marginally decreased HA stability. Substitutions R62I, D63N, D81N and N193S reduced HA binding avidity. Substitutions R62I, D81N and A144G promoted viral replication in human airway epithelial cultures. Analysis of HA sequences revealed that substitutions D63N and D81N accompanied by the addition of N-glycans represent common markers of avian H3 HA adaptation to mammals. Our results advance understanding of genotypic and phenotypic changes in IAV HA required for avian-to-human adaptation and pandemic emergence. Author summary: Pandemic influenza A viruses (IAVs) originate from animal IAVs and always contain the envelope protein hemagglutinin (HA) of the animal parent. Molecular changes essential for the animal-to-human adaptation of the HA are not well defined. To address this problem, we studied phenotypic effects of eight amino acid substitutions that accompanied evolution of the HA of the 1968 pandemic IAV from its inferred avian precursor. We also analysed patterns of evolution of these HA positions of IAVs in birds and mammals. Our results predict that the 1968 pandemic IAV acquired its HA from a wild duck virus. We showed that two substitutions were primarily responsible for increased HA binding to human-type receptors and, in addition, marginally decreased stability of the HA, whereas three other substitutions reduced binding avidity of the HA. We demonstrated that substitutions accompanied by the addition of N-glycan at either position 63 or 81 represent a previously unrecognized common marker of avian-to-mammalian adaptation of IAVs. Our findings highlight the importance of the studies on previous pandemic IAVs for the influenza risk assessment and pandemic preparedness. [ABSTRACT FROM AUTHOR]

Preemptive pharmacogenetic testing has the potential to improve drug dosing by providing point-of-care patient genotype information. Nonetheless, its implementation in the Chinese population is limited by the lack of population-wide data. In this study, secondary analysis of exome sequencing data was conducted to study pharmacogenomics in 1116 Hong Kong Chinese. We aimed to identify the spectrum of actionable pharmacogenetic variants and rare, predicted deleterious variants that are potentially actionable in Hong Kong Chinese, and to estimate the proportion of dispensed drugs that may potentially benefit from genotype-guided prescription. The projected preemptive pharmacogenetic testing prescription impact was evaluated based on the patient prescription data of the public healthcare system in 2019, serving 7.5 million people. Twenty-nine actionable pharmacogenetic variants/ alleles were identified in our cohort. Nearly all (99.6%) subjects carried at least one actionable pharmacogenetic variant, whereas 93.5% of subjects harbored at least one rare deleterious pharmacogenetic variant. Based on the prescription data in 2019, 13.4% of the Hong Kong population was prescribed with drugs with pharmacogenetic clinical practice guideline recommendations. The total expenditure on actionable drugs was 33,520,000 USD, and it was estimated that 8,219,000 USD (24.5%) worth of drugs were prescribed to patients with an implicated actionable phenotype. Secondary use of exome sequencing data for pharmacogenetic analysis is feasible, and preemptive pharmacogenetic testing has the potential to support prescription decisions in the Hong Kong Chinese population. Author summary: Pharmacogenetic testing provides relevant drug phenotype information to guide personalized drug prescription, which potentially improves drug efficacy and prevent adverse drug reactions. However, its implementation in the Chinese population is limited by the lack of Chinese-specific pharmacogenetics data. In this study, we studied the spectrum of 133 actionable pharmacogenetic variants and rare deleterious variants in 108 pharmacogenes using an exome sequencing consisting of 1116 Hong Kong Chinese subjects. It was found that nearly all individuals carried at least one actionable pharmacogenetic variant and one rare, predicted deleterious pharmacogenetic variant. In addition, we projected the potential prescription impact of actionable pharmacogenetic variants using prescription data of the Hong Kong's public healthcare system. We estimated that one-seventh of the Hong Kong population received at least one of the 36 drugs with clinical pharmacogenetics guideline recommendations. The findings demonstrated the potential of pharmacogenetic testing in improving patient care and resource allocation in Chinese. The cohort dataset also supports clinical implementation of pharmacogenetics in the Chinese population. [ABSTRACT FROM AUTHOR]

Background To determine the impact of a co-payment on the cost-effectiveness of systematic screening for diabetic retinopathy in Hong Kong (HK). Methods An analysis was conducted from provider and societal perspectives. A Markov cohort model was used to determine the cost- effectiveness of screening with a co-payment of HK$60 (US$7.7) compared with free screening, with and without an assumption that the inverse care law (ICL) would operate in the presence of a fee as seen in our previous data. Results From the provider perspective, the incremental cost-effectiveness ratio (ICER) of free versus pay systematic screening was HK$166 558 (US$21 354)/extra quality adjusted life year (QALY) gained assuming an effect of the ICL and free screening was always more cost-effective than pay screening when willingness to pay for a QALY was HK$124 488 (US$15 960) or above. Without an effect of the ICL, the ICER was HK$480 479 (US$61 600)/extra QALY gained. From the societal perspective, the ICER was HK$144 046 (US$18 467)/extra QALY gained with an effect of the ICL and HK$199 741 (US$25 608)/extra QALY gained with no effect. Conclusions Free systematic screening was highly cost-effective from the societal perspective compared with screening with a small co-payment irrespective of the effects of the ICL. From the provider perspective, free screening was highly cost-effective if the ICL operates. [ABSTRACT FROM AUTHOR]

shiu a.t.y., lee d.t.f. & chau j.p.c. (2011) Exploring the scope of expanding advanced nursing practice in nurse-led clinics: a multiple-case study. Journal of Advanced Nursing 68(6), 1780-1792. Abstract Aim. This article is a report on a study to explore the development of expanding advanced nursing practice in nurse-led clinics in Hong Kong. Background. Nurse-led clinics serviced by advanced practice nurses, a common international practice, have been adopted in Hong Kong since 1990s. Evaluations consistently show that this practice has good clinical outcomes and contributes to containing healthcare cost. However, similar to the international literature, it remains unclear as to what the elements of good advanced nursing practice are, and which directions Hong Kong should adopt for further development of such practice. Methods. A multiple-case study design was adopted with six nurse-led clinics representing three specialties as six case studies, and including two clinics each from continence, diabetes and wound care. Each case had four embedded units of analysis. They included non-participant observation of nursing activities (9 days), nurse interviews ( N = 6), doctor interviews ( N = 6) and client interviews ( N = 12). The data were collected in 2009. Within- and cross-case analyses were conducted. Results. The cross-case analysis demonstrated six elements of good advanced nursing practice in nurse-led clinics, and showed a great potential to expand the practice by reshaping four categories of current boundaries, including community-hospital, wellness-illness, public-private and professional-practice boundaries. From these findings, we suggest a model to advance the scope of advanced nursing practice in nurse-led clinics. Conclusion. The six elements may be applied as audit criteria for evaluation of advanced nursing practice in nurse-led clinics, and the proposed model provides directions for expanding such practice in Hong Kong and beyond. [ABSTRACT FROM AUTHOR]

Primary hepatothiasis (HL) and recurrent pyogenic cholangitis (RPC) are two terms describing the different aspects of the same disease, with HL emphasizing the pathologic changes and RPC emphasizing the clinical presentation and suppurative inflammation. It is predominantly a disease of the Far East. In the 1960s, it was the third most common cause of emergency abdominal surgery at a university hospital in Hong Kong. Thereafter, its incidence has decreased considerably, possibly due to improved standards of living and Westernized diet. Clinically, patients may present acutely with recurrent bacterial cholangitis and its possible complications, such as liver abscess and septicemic shock, or with chronic complications, such as cholangiocarcinoma. Pathologically, it is characterized by pigmented calcium bilirubinate stones within dilated intra-hepatic bile ducts featuring chronic inflammation, mural fibrosis, and proliferation of peribiliary glands, without extrahepatic biliary obstruction. Episodes of suppurative inflammation cumulate in sclerosing cholangitis of peripheral ducts and parenchymal fibrosis resulting from collapse and scarring. Mass-forming inflammatory pseudotumor and neoplasms like intraductal papillary neoplasms and cholangiocarcinoma are increasingly recognized complications. Modern imaging techniques allow definitive diagnosis, accurate assessment for treatment planning, and detection of complications. A multidisciplinary team approach (interventional endoscopist, interventional radiologist, hepatobiliary surgeon, and intensivists) is important for optimal patient outcome. [ABSTRACT FROM AUTHOR]