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The inhibition deficit hypothesis (IDH) proposed that individual differences in inhibitory control is an underlying reason for age-related language decline. This study examined whether the hypothesis holds within the domain of lexico-semantic retrieval. Sixty-six older adults aged 60-79 were tested in a semantic fluency task comprising 16 categories; each response was classified as automatic or controlled. Also, Stroop color and word test and an ERP flanker task were employed to yield both behavioral and neural measures of inhibitory control. Mixed-effects modelling revealed that the number of controlled (but not automatic) responses was negatively associated with age. This interaction could be partially accounted for by the behavioral Stroop inhibition score and two neural measures from the ERP flanker task (P2 and Pc amplitudes). These results not only provide converging evidence supporting the IDH, but also demonstrate the involvement of specific inhibitory control components, including attentional control and performance monitoring., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Clustering and switching are hypothesised to reflect the automatic and controlled components in category fluency, respectively, but how they are associated with cognitive functions has not been fully elucidated, due to several uncertainties. (1) The conventional scoring method that segregates responses by semantic categories could not optimally dissociate the automatic and controlled components. (2) The temporal structure of individual responses, as characterised by mean retrieval time (MRT) and mean switching time (MST), has seldom been analysed alongside the more well-studied variables, cluster size (CS) and number of switches (NS). (3) Most studies examined only one to a few semantic categories, raising concerns of generalisability. This study built upon a distance-based automatic clustering procedure, referred to as temporal-semantic distance procedure, to thoroughly characterise the category fluency performance. Linear mixed-effects (LME) modelling was applied to re-examine the differential associations of clustering and switching with cognitive functions with a sample of 80 university students. Our results revealed that although lexical retrieval speed (LRS) is clearly the determining factor for effective clustering and switching, matrix reasoning and processing speed also have significant roles to play, possibly in the processes of identifying and validating the semantic relationships. Interestingly, total fluency score was accurately predicted by the four clustering/switching indices alone; including the cognitive variables did not significantly improve the prediction. These findings underline the importance of the clustering and switching indices in explaining the category fluency performance and the cognitive demands in category fluency.

Since the outbreak of COVID-19 in December 2019, there had been global shortage of personal protective equipment (PPE) supply due to the breakage of supply chain and also the forbidding of PPE exported by various countries. This situation had greatly affected the healthcare services in local hospitals of Hong Kong. To maintain the availability of PPE for healthcare workers in high-risk clinical settings, the cluster management of New Territories West Cluster, Hospital Authority, had implemented a bundle of interventions in controlling and managing the PPE consumption and ensuring its proper use. A Taskforce on Management of PPE was set up in February 2020 with the aim to monitor and manage the use of PPE in five local hospitals and eight general outpatient clinics of New Territories West Cluster, which were governed in a cluster basis, under the COVID-19 epidemic. Interventions including cutting down non-essential services, implementing telecare, monitoring PPE consumption at unit level and PPE stock at the Cluster Central Distribution Centre and forming mobile infection teams were implemented. The updated PPE standards and usage guidelines to clinical staff were promulgated through forums, newsletters and unit visits. The PPE consumption rates of individual unit were reviewed. Significant decrease in PPE consumption rates was noted when comparing with the baseline data. Comparing the data between 20 February and 1 June 2020, the overall PPE consumption rates were reduced by 64% (r=-0.841; p<0.001) while the PPE consumption rates in anaesthesia and operating theatres, and isolation and surveillance wards were reduced by 47% (r=-0.506; p=0.023) and 49% (r=-0.810; p<0.001), respectively. A bundled approach, including both administrative measures and staff education, is effective in managing PPE consumption during major infection outbreaks especially when PPE supply is at risk., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To systematically compare the endometrial microbiota in infertile women with and without chronic endometritis (CE), as diagnosed by a quantitative and reference range-based method., Design: Case-control observational study., Setting: University-affiliated hospital., Patient(s): One hundred and thirty infertile women., Intervention(s): Endometrial biopsy and fluid (uterine lavage, UL) collected precisely 7 days after LH surge, with plasma cell density (PCD) determined based on Syndecan-1 (CD138)-positive cells in the entire biopsy section and culture-independent massively parallel sequencing of the 16S ribosomal RNA gene performed on both the CE and non-CE endometrial fluid samples., Main Outcome Measure(s): Relative abundance of bacterial taxa., Result(s): Chronic endometritis was diagnosed if the PCD was above the 95th percentile (>5.15 cells per 10 mm 2 ) of the reference range in fertile control subjects. With this stringent diagnostic criterion, 12 women (9%) were diagnosed with CE. Sequencing was successfully performed on all endometrial samples obtained by UL) (CE, n = 12; non-CE, n = 118). The median relative abundance of Lactobacillus was 1.89% and 80.7% in the CE and non-CE microbiotas, respectively. Lactobacillus crispatus was less abundant in the CE microbiota (fold-change, range: 2.10-2.30). Eighteen non-Lactobacillus taxa including Dialister, Bifidobacterium, Prevotella, Gardnerella, and Anaerococcus were more abundant in the CE microbiota (fold-change, 2.10-18.9). Of these, Anaerococcus and Gardnerella were negatively correlated in relative abundance with Lactobacillus (SparCC correlation magnitude, range: 0.142-0.177)., Conclusion(s): Chronic endometritis was associated with a statistically significantly higher abundance of 18 bacterial taxa in the endometrial cavity., Clinical Trials Registry Number: ChiCTR-IOC-16007882., (Copyright © 2019 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: To compare the 5-year subjective and objective outcomes of transobturator tension-free vaginal tape alone versus the same procedure with concomitant pelvic floor repair surgery for pelvic organ prolapse in women with urinary stress incontinence., Design: Prospective cohort study., Setting: Urogynaecology unit at a university hospital in Hong Kong., Patients: Of 218 women, 96 (44%) received transobturator tension-free vaginal tape alone and 122 (56%) received transobturator tension-free vaginal tape with concomitant pelvic floor repair surgery from September 2004 to December 2009. The women were followed up annually for up to 5 years after the operation., Main Outcome Measures: The 5-year subjective and objective cure rates were assessed. Subjective cure was defined as no urine loss during physical activity and objective cure was defined as no urine leakage on coughing during urodynamic study., Results: Overall, 88 women receiving transobturator tension-free vaginal tape alone and 101 women receiving transobturator tension-free vaginal tape with concomitant pelvic floor repair surgery were followed up for 5 years after operation. The subjective and objective cure rates of the two groups were 70.5% versus 94.1% (P<0.01) and 80.3% versus 85.7% (P=0.58), respectively., Conclusions: Transobturator tension-free vaginal tape is an effective treatment for urinary stress incontinence in women who received it alone or with concomitant pelvic floor repair surgery for pelvic organ prolapse, providing high subjective and objective efficacy for up to 5 years after operation. Transobturator tension-free vaginal tape with concomitant pelvic floor repair surgery achieved similar, if not better, long-term outcome compared with transobturator tension-free vaginal tape alone.

Background: Women suffering from urinary incontinence have impaired quality of life (QoL). Pelvic floor muscle training (PFMT) has been recommended to be the first-line treatment for them., Aims: This study evaluated the role of (PFMT) in women with urinary incontinence., Materials and Methods: All women suffering from urinary incontinence without pelvic organ prolapse who attended the urogynaecology unit of a university hospital from January 2009 to June 2010 were recruited. Urinary symptoms and impact on QoL were assessed using the Chinese validated Urogenital Distress Inventory short form (UDI-6) and Incontinence Impact Questionnaire short form (IIQ-7) before and after PFMT. Urodynamic studies (UDS) were used to differentiate the diagnoses of urinary incontinence., Results: Three hundred and seventy-two women, aged 52.3 ± 10.8 years and practised PFMT for 9.9 ± 7.3 months, completed the study. Over 65% recorded improvement in both UDI-6 and IIQ-7. Stratified for urodynamic diagnosis, stress incontinence group and those who had no UDS abnormality had significant improvement in their urinary symptoms and QoL after PFMT. UDI-6 and IIQ-7 also improved significantly after PFMT in groups where the clinical presentation was stress incontinence, overactive bladder symptoms or mixed urinary incontinence. Age was not associated with a significant difference in the response to PFMT., Conclusions: Pelvic floor muscle training appears to be an effective first-line intervention for improving urinary symptoms and QoL of women presenting with urinary incontinence. Future studies on long-term effectiveness and cost-effectiveness are also required., (© 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

The hydrothermal synthesis of three new vanadoborate compounds with elliptical (V10B28O74H8) clusters is described. The clusters contain pairs of bimetallic Zn2 or Mn2 units.

Preoccupied with the diagnosis of SARS (severe acute respiratory syndrome) in a SARS outbreak, doctors tend to overlook other endemic diseases, such as tuberculosis. Incorrectly labeling a patient as SARS may result in serious consequences. Single isolation being not always possible, the patient may have to be isolated with a group of SARS patients. The following article reports how a young girl suffering from pulmonary tuberculosis was erroneously diagnosed as SARS in an outbreak. Isolated with other SARS patients, she was infected with the virus. The treatment of SARS and tuberculosis resulted in liver dysfunction. Fortunately, the patient recovered uneventfully. The importance of keeping an open mind in an outbreak is highlighted.