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Objective: In our wireless-centric world, evaluating the health effects of radio frequency electromagnetic radiation (RF-EMR) is crucial. An existing research gap pertains to the replication of real-world specific absorption rates (SAR) for RF-EMR, especially within aquatic environments. We aimed to bridge this gap using an innovative TEM cell platform to replicate realistic SAR conditions in water and assess RF-EMR's impact on neuroanatomical and behavioral changes. Results: We examined RF-EMR effects on zebrafish embryos exposed to RF-EMR during the 4-58 hours post-fertilization phase. Temporary neuroanatomical enlargements and minor behavioral shifts were observed, diminishing by day 8 post-fertilization. Conclusion: Short-term RF-EMR exposure at tested levels did not yield significant long-term effects. Nevertheless, investigating prolonged exposure remains imperative. Our study serves as a pioneering model for future investigations into the biological consequences of RF-EMR exposure, highlighting the importance of assessing its health implications in our wireless-centric world

Introduction COVID-19 infection is associated with post-acute adverse outcomes affecting multiple organ systems. Although preliminary studies have suggested that COVID-19 re-infection may have a cumulative effect on long-term outcome, differential effects of COVID-19 re-infection severe enough to be hospitalised on post-acute sequelae compared with hospitalised first-time infection have not been explored.Methods Retrospective cohort study using territory-wide electronic medical records databases in Hong Kong. Adults hospitalised with COVID-19 between 1 January and 30 November 2022, who survived the first 28 days after infection and was discharged, were categorised into re-infection and first-time infection groups. Individuals with reinfection were compared with those with first-time infection for all-cause mortality, all-cause hospital readmission, attendance to the emergency department and complications during the post-acute period using propensity-score-weighted Cox regression. Subgroup analyses were conducted by age (

Abstract Background Limited research exists on the risks and spectrum of complications in post‐acute phase of COVID‐19 in cancer patients. This study aimed to evaluate the post‐acute effects of COVID‐19 on different types of morbidities among cancer patients across two regions with different healthcare systems and dominant variants of COVID‐19. Materials and Methods Cancer patients with COVID‐19 from the UK Biobank (UKB, n = 2230; March 16, 2020 to May 31, 2021; pre‐Omicron‐variants dominant) and electronic medical records in Hong Kong (HK cohort, n = 22,335; April 1, 2020 to October 31, 2022; Omicron‐variant dominant) were included. Each COVID‐19 case was randomly matched with up to 10 non‐COVID‐19 cancer patients based on age and sex. Follow‐up lasted until 31 August 2021 for UKB and 23 January 2023 for HK. Inverse probability treatment weighting balanced cohort characteristics. Cox regression evaluated the association of COVID‐19 with morbidities occurred 30 days post‐infection. Results Cancer patients with COVID‐19 consistently showed significantly higher risk of major cardiovascular diseases (CVDs) [UKB: hazard ratio [HR] 1.8 (95% CI 1.3, 2.5); HK: HR 1.4 (95% CI 1.1, 1.8)], CVD death [UKB: HR 4.3 (95% CI 2.9, 6.2); HK: HR 1.7 (95% CI 1.3, 2.4)], and all‐cause mortality [UKB: HR 4.7 (95% CI 4.0, 5.5); HK: HR 1.6 (95% CI 1.5, 1.7)] in both cohorts despite the difference in dominant variants. Cancer patients at advanced ages or severely infected had higher all‐cause mortality risk. However, associations between COVID‐19 and CVDs became insignificant for fully vaccinated patients. Conclusion COVID‐19 infection is associated with increased risks of CVDs and mortality in cancer patients. Fully vaccination may reduce the post‐acute effects of COVID‐19 on CVDs. This information may guide effective pre‐emptive measures to reduce COVID‐19‐related morbidities and mortality in cancer patients.

Boiling water (BW) is a common global practice, especially in Asia, for ensuring safe drinking water, though it does not remove chemical contaminants. The World Health Organisation recommends BW as an emergency measure against microbial contamination. In Hong Kong, the Water Supplies Department ensures water quality through strict regulations and extensive monitoring. Comparisons with Norway and Canada reveal effective practices such as water safety planning and risk-based advisories. Norway mandates water safety planning and uses messaging notifications for water advisories, ensuring high compliance, while Canada issues site-specific BW advisories based on risk assessments. Hong Kong faces unique challenges, such as a warm climate and complex building infrastructure, which impact water quality. Many buildings lack proper maintenance, leading to potential health risks and necessitating regular maintenance. Health management, public health education and expert guidance are essential for promoting efficient practices and ensuring safe drinking water.

Background: Approximately two-thirds of diabetes patients develop multimorbidity, which is associated with increased mortality. We aimed to examine whether, and to what extent, the time interval between pre-existing diabetes and a second chronic disease may be associated with the risk of mortality. Methods: We carried out a territory-wide nested case-control study using incidence density sampling, utilizing electronic health records from Hong Kong’s public healthcare facilities. Among 158 732 patients first diagnosed with diabetes from January 1, 2010 to December 31, 2012 and subsequently developed multimorbidity as of December 31, 2019, we extracted those who died before December 31, 2019 as case participants. For each participant, we randomly matched with up to 4 people of the same sex, multimorbidity age, and second chronic condition who had not died after going through the same survival period of the case participant. Multimorbidity interval was included as a continuous variable. We used conditional logistic regression to estimate adjusted odds ratios (aOR) for mortality. Results: In total, 3508 case participants were matched with 14 032 control participants. Conditional logistic regression showed there were 19%-reduced odds of mortality following the extension of multimorbidity interval by 1 year. Similar associations were observed in men, women, people aged 64 years or younger, and older people aged 65 years or more. Conclusions: Delayed multimorbidity among patients living with diabetes may be related to a lower risk of mortality. This study suggests that we should focus on mitigating and lowering the risk of multimorbidity in clinical management of diabetes to reduce further complication and mortality.

Objectives: To evaluate the difference between BNT162b2 and CoronaVac in vaccine effectiveness and safety. Methods: This target trial emulation study included individuals aged ≥12 during 2022. Propensity score matching was applied to ensure group balance. The Cox proportional hazard model was used to compare the effectiveness outcomes including COVID-19 infection, severity, 28-day hospitalization, and 28-day mortality after infection. Poisson regression was used for safety outcomes including 32 adverse events of special interests between groups. Results: A total of 639,818 and 1804,388 individuals were identified for the 2-dose and 3-dose comparison, respectively. In 2-dose and 3-dose comparison, the hazard ratios (95% confidence intervals [CI]) were 0.844 [0.833-0.856] and 0.749 [0.743-0.755] for COVID-19 infection, 0.692 [0.656-0.731] and 0.582 [0.559-0.605] for hospitalization, 0.566 [0.417-0.769] and 0.590 [0.458-0.76] for severe COVID-19, and 0.563 [0.456-0.697] and 0.457 [0.372-0.561] for mortality for BNT162b2 recipients versus CoronaVac recipients, respectively. Regarding safety, 2-dose BNT162b2 recipients had a significantly higher incidence of myocarditis (incidence rate ratio [IRR] [95% CI]: 8.999 [1.14-71.017]) versus CoronaVac recipients, but the difference was insignificant in 3-dose comparison (IRR [95% CI]: 2.000 [0.500-7.996]). Conclusion: BNT162b2 has higher effectiveness among individuals aged ≥12 against COVID-19-related outcomes for SARS-CoV-2 omicron compared to CoronaVac, with almost 50% lower mortality risk.

Introduction: Tenecteplase is a thrombolytic with higher fibrin affinity, and is potentially better in clot lysis. A higher spontaneous recanalization rate for large vessel occlusions strokes (LVO) had been shown in comparison studies with Alteplase. Results of the LVO studies reflect the composite effect of the thrombolytic and thrombectomy, as patients would be treated by thrombectomy had they not been recanalized by intravenous thrombolysis alone. Thrombectomy is not readily available in many parts of the world. Our study aimed to compare the outcomes of suspected LVO patients treated with Tenecteplase versus Alteplase only, without the confounding effect of thrombectomy. Methods: This is a retrospective review. Data of patients given Tenecteplase from May 2020 to August 2023, and those given Alteplase 0.9 mg/kg from January 2019 to August 2023 were retrieved. (Due to fluctuation in supply of Tenecteplase during the COVID pandemic, some large vessel occlusion patients were given Alteplase.) Patients with anterior circulation, clinically suspected large vessel occlusion strokes (defined as National Institutes Health Stroke Scale (NIHSS) score >= 6, plus cortical signs or hyperdense vessel sign), with thrombolysis given within 4.5 hours of stroke onset were analyzed. Patients with thrombectomy done were excluded. Safety and efficacy outcomes were compared. Results: There were 245 Tenecteplase treated patients treated between 1st May 2020 and 31st August 2023, and 732 patients were treated with Alteplase between 1st January 2019 to 31st August 2023. Out of these, 148 Tenecteplase patients and 138 Alteplase 0.9 mg/kg patients fulfilled the study criteria. The symptomatic intracerebral haemorrhage rate was non-significantly lower in the Tenecteplase group (2.1% versus 5.8%, p=0.13). There were no significant differences in the rate of >=8 points NIHSS improvement (23.6% versus 23.7%, p=1) or the >= 4 points improvement (40.5% versus 40.7%, p=1) at 24 hours. At 3 months, 21.6% of Tenecteplase patients had good functional outcome (modified Rankin scale (mRS) 0-2), compared to 26.3% in the Alteplase group (p=0.40). Conclusion: In this pragmatic study of clinically suspected anterior circulation LVO patients without thrombectomy, outcome solely reflects the effects of Tenecteplase. Tenecteplase showed comparable safety and efficacy to Alteplase. But the result should be interpreted with caution in view of its small sample size and non-randomized study design.

Abstract: Herein, we report the first total synthesis of (±)-marilines B and C, as well as a failed approach to (±)-mariline A, by using our recently developed multicomponent reaction method, which involves the interception of ortho-quinone methides with various nitrogen nucleophiles to allow easy assembly of various benzylic amine cores with diverse substituents.

Sacral sore is a common problem in patients with spinal cord injury. It leads to prolonged hospitalization and recurrent infections which might require repeated surgery to treat. Flap reconstruction allows soft tissue coverage of sacral sore under the premise of infection-free wound base. Maggot debridement therapy (MDT) has been described as an alternative non-surgical management as opposed to the traditional surgical debridement in case of infected sore, reducing number of surgeries under anaesthesia. However, MDT and surgery are not mutually exclusive. In this article we describe a hybrid approach combining MDT and flap reconstruction with multi-disciplinary effort in management of sacral sore, which accelerates wound healing and prevents morbidities, while lowering the risks associated with repeated surgical debridement at the same time.

Objectives Older individuals with multimorbidity are at an elevated risk of infection and complications from COVID-19. Effectiveness of post-COVID-19 interventions or care models in reducing subsequent adverse outcomes in these individuals have rarely been examined. This study aims to examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged 85 years or above with multimorbidity.Design Retrospective cohort study emulating a randomised target trial using electronic health records.Setting We used data from the Hospital Authority and the Department of Health in Hong Kong, which provided comprehensive electronic health records, COVID-19 confirmed case data, population-based vaccination records and other individual characteristics for the study.Participants Adults aged 85 years or above with multimorbidity who were discharged after hospitalisation for COVID-19 between January 2020 and August 2022.Interventions Attending a general outpatient within 30 days of last COVID-19 discharge defined the exposure, compared to no outpatient visit.Main outcome measures Primary outcome was all-cause mortality within one year. Secondary outcomes included mortality from respiratory, cardiovascular and cancer causes.Results A total of 6183 eligible COVID-19 survivors were included in the analysis. The all-cause mortality rate following COVID-19 hospitalisation was lower in the general outpatient visit group (17.1 deaths per 100 person-year) compared with non-visit group (42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI 8.1% to 14.4%). We also observed significantly better survival from respiratory diseases in the general outpatient visit group (difference in 1-year survival: 6.3%, 95% CI 3.5% to 8.9%). In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a general outpatient visit after COVID-19 discharge, the better the survival.Conclusions Timely primary care consultations after COVID-19 hospitalisation may improve survival following COVID-19 hospitalisation among older adults aged 85 or above with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population’s recovery and well-being.