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Background It is unclear how the coronavirus disease 2019 (Covid-19) pandemic has affected multimorbidity incidence among those with one pre-existing chronic condition, as well as how vaccination could modify this association. Aim To examine the association of Covid-19 infection with multimorbidity incidence among people with one pre-existing chronic condition, including those with prior vaccination. Design Nested case–control study. Methods We conducted a territory-wide nested case–control study with incidence density sampling using Hong Kong electronic health records from public healthcare facilities and mandatory Covid-19 reports. People with one listed chronic condition (based on a list of 30) who developed multimorbidity during 1 January 2020–15 November 2022 were selected as case participants and randomly matched with up to 10 people of the same age, sex and with the same first chronic condition without having developed multimorbidity at that point. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) of multimorbidity. Results In total, 127 744 case participants were matched with 1 230 636 control participants. Adjusted analysis showed that there were 28%-increased odds of multimorbidity following Covid-19 [confidence interval (CI) 22% to 36%] but only 3% (non-significant) with prior full vaccination with BNT162b2 or CoronaVac (95% CI −2% to 7%). Similar associations were observed in men, women, older people aged 65 or more, and people aged 64 or younger. Conclusions We found a significantly elevated risk of multimorbidity following a Covid-19 episode among people with one pre-existing chronic condition. Full vaccination significantly reduced this risk increase. [ABSTRACT FROM AUTHOR]

Background. Older adults in residential care homes in Hong Kong usually have multiple co-morbidities and need end-of-life (EOL) care. Repeated hospitalisations before death are common. The Hospital Admission Risk Reduction Program for the Elderly (HARRPE) score is correlated with mortality. We compared older adults identified by clinical referral with older adults identified by HARRPE score ≥0.4 in terms of EOL programme enrolment rate and mortality rates at 180 and 365 days. Methods. This retrospective cohort study included older adults aged ≥80 years residing in care homes from 1 July 2018 to 30 June 2019. We compared older adults identified by clinical referral with older adults identified by HARRPE score ≥0.4 in terms of EOL programme enrolment rate and mortality rates at 180 and 365 days. Results. Of 113 clinical referral patients and 735 patients with HARRPE score ≥0.4, 102 and 96, respectively, fulfilled EOL programme criteria. Their mean age was 92 years, with female predominance (71%). Enrolment rates were similar (57% and 51%, respectively). Survival probability was higher among enrolled patients than among nonenrolled patients (p<0.001). The two groups were comparable in terms of the 180-day mortality rate and 365-day mortality rate. In both groups, survival probabilities were higher in patients who enrolled in the EOL programme, compared with patients who did not enrol (p<0.001). The median survival was longer in the HARRPE group (191 vs 155 days). Conclusions. Older adults in residential care homes requiring EOL care according to HARRPE score ≥0.4 have similar enrolment and mortality rates, compared with clinical referral. The HARRPE score is a feasible tool to supplement clinical referral for timely EOL care. [ABSTRACT FROM AUTHOR]

While assigning given OD demand flows onto network links, travel times along different routes could be varied depending on respective traffic volumes. To achieve equilibrium, all used routes should have the minimum and identical travel times. Such route travel times are composed by link travel times and end of link delay. Upstream and downstream traffic signals are coordinated through bandwidth maximization. Path flows and path travel times are modeled to be responsive to traffic signal settings to enable attractive path choices. Approximated linear function will be established to linearize the end of link delay in TRANSYT model. The problem is formulated as a Binary-Mixed-Integer-Linear-Program and could be solved by standard branch-and-bound method.

Lane-based traffic signal design has been developed for designing signal-controlled intersections. Conventional designs take on fixed configurations as exogenous inputs to design traffic signal settings. The proposed study will be an extension to merge geometrical junction arrangement and signal controls together for network configuration designs. Design methodology would be directly extended from existing lane-based design method. New Path flows variables and new flow conservation constraints are required to ensure the users’ input OD flows could be assigned onto network paths through different signal-controlled intersections. This problem is new that involves binary variables and related linear constraints which is formulated as a BMILP. Standard technique could solve the optimum solution. A four-intersection network with two approach lane settings is optimized for demonstration purposes.

A survey of 1,001 Hong Kong adults found a discrepancy between perceived prevalence and the ability to name different child abuse types without prompting. Only about 40 percent would report abuse cases to authorities. Those who would not report abuse were less likely to classify abuse situations as abusive. (Author/CR)