Generalised cost-effectiveness analysis for breast cancer prevention and care in Hong Kong Chinese

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Optimizing resource allocation for breast cancer prevention and care among Hong Kong Chinese women: a generalized cost-effectiveness analysis

Conference Theme: Translating Health Research into Policy and Practice for Health of the PopulationPoster Presentations: Delivery of Health Services: no. P42-Ab0048BACKGROUND AND OBJECTIVES: Recommendations about funding of interventions through the full spectrum of the disease have often been made in isolation or been derived in separate single intervention analyses. We primarily evaluated and optimized budgetary allocations by comparing cost-effectiveness data for the selected preventive and management strategies throughout the disease course for breast cancer in HK Chinese women …published_or_final_versio

Interpreting Seroepidemiologic Studies of Influenza in a Context of Nonbracketing Sera

Background: In influenza epidemiology, analysis of paired sera collected from people before and after influenza seasons has been used for decades to study the cumulative incidence of influenza virus infections in populations. However, interpretation becomes challenging when sera are collected after the start or before the end of an epidemic, and do not neatly bracket the epidemic. Methods: Serum samples were collected longitudinally in a community-based study. Most participants provided their first serum after the start of circulation of influenza A(H1N1)pdm09 virus in 2009. We developed a Bayesian hierarchical model to correct for nonbracketing sera and estimate the cumulative incidence of infection from the serological data and surveillance data in Hong Kong. Results: We analyzed 4,843 sera from 2,097 unvaccinated participants in the study, collected from April 2009 to December 2010. After accounting for nonbracketing, we estimated that the cumulative incidence of H1N1pdm09 virus infection was 45% (95% credible interval [CI] = 40%, 49%), 17% (95% CI = 13%, 20%), and 11% (95% CI = 6%, 18%) for children ages 0–18 years, adults 19–50 years, and older adults >50 years, respectively. Including all available data substantially increased precision compared with a simpler analysis based only on sera collected at 6-month intervals in a subset of participants. Conclusions: We developed a framework for the analysis of antibody titers that accounted for the timing of sera collection with respect to influenza activity and permitted robust estimation of the cumulative incidence of infection during an epidemic.postprin

Hong Kong's domestic health spending—financial years 1989/90 through 2004/05

This report presents the latest estimates of Hong Kong’s domestic health spending between fiscal years 1989/90 and 2004/05, cross-stratified and categorised by financing source, provider and function on an annual basis. Total expenditure on health was HK$67 807 million in fiscal year 2004/05. In real erms, total expenditure on health showed positive growth averaging 7This increase was largely driven by the rise in public spending, which rose 9Of the$67 807 million total health expenditure in 2004/05, current xpenditure comprised $65 429 million (96$2378 million (4%) were apital expenses (ie investment in medical facilities). Services of curative care ccounted for the largest share of total health spending (67%) which were made p of ambulatory services (35%), in-patient curative care (28%), day patient ospital services (3%), and home care (1%). The next largest share of total health xpenditure was spent on medical goods outside the patient care setting (10%). Analysed by health care provider, hospitals accounted for the largest share (46%) and providers of ambulatory health care the second largest share (30%) f total health spending in 2004/05. We observed a system-wide trend towards ervice consolidation at institutions (as opposed to free-standing ambulatory linics, most of which are staffed by solo practitioner). In 2004/05, public expenditure on health amounted to $35 247 million (53.9$30 182 million) was mostly incurred at providers of mbulatory health care (54.6%). This reflects the mixed health care economy of ong Kong where public hospitals generally account for about 90% of total beddays nd private doctors (including Western and Chinese medicine practitioners) rovide 75% to 80% of out-patient care. While both public and private spending were mostly expended on personal ealth care services and goods (92.9%), the distributional patterns among functional ategories differed. Public expenditure was targeted at in-patient care (54.2%) and ubstantially less on out-patient care (24.5%), especially low-intensity first-contact are. In comparison, private spending was mostly concentrated on out-patient care (49.6%), whereas medical goods outside the patient care setting (22 .6%) and inpatient are (18.8%) comprised the majority of the remaining share. Compared to OECD countries, Hong Kong has devoted a relatively low percentage of gross domestic product to health in he last decade. As a share of total spending, public funding (either general government revenue or social security funds) was lso lower than in most comparably developed economies, although commensurate with its public revenue collection base.published_or_final_versio

Association of EP2 receptor and SLC19A3 in regulating breast cancer metastasis

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Withaferin A activates TRIM16 for its anti-cancer activity in melanoma.

Although selective BRAF inhibitors and novel immunotherapies have improved short-term treatment responses in metastatic melanoma patients, acquired resistance to these therapeutics still represent a major challenge in clinical practice. In this study, we evaluated the efficacy of Withaferin A (WFA), derived from the medicinal plant Withania Somnifera, as a novel therapeutic agent for the treatment of melanoma. WFA showed selective toxicity to melanoma cells compared to non-malignant cells. WFA induced apoptosis, significantly reduced cell proliferation and inhibited migration of melanoma cells. We identified that repression of the tumour suppressor TRIM16 diminished WFA cytotoxicity, suggesting that TRIM16 was in part responsible for the cytotoxic effects of WFA in melanoma cells. Together our data indicates that WFA has potent cytopathic effects on melanoma cells through TRIM16, suggesting a potential therapeutic application of WFA in the disease

The Nucleosome Assembly Protein TSPYL2 Regulates the Expression of NMDA Receptor Subunits GluN2A and GluN2B

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A detailed longitudinal study of infection attack rates among healthy adults in Hong Kong during the epidemic of the human swine influenza A/H1N1 virus in 2009

Conference Theme: Translating Health Research into Policy and Practice for Health of the PopulationPoster Presentations: Emerging / Infectious Diseases: abstract no. P109-Ab0091published_or_final_versio

A clinical prediction rule for diagnosing human infections with avian influenza A(H7N9) in a hospital emergency department setting

BACKGROUND: Human infections with avian influenza A(H7N9) virus are associated with severe illness and high mortality. To better inform triage decisions of hospitalization and management, we developed a clinical prediction rule for diagnosing patients with A(H7N9) and determined its predictive performance. METHODS: Clinical details on presentation of adult patients hospitalized with either A(H7N9)(n = 121) in China from March to May 2013 or other causes of acute respiratory infections (n = 2,603) in Jingzhou City, China from January 2010 through September 2012 were analyzed. A clinical prediction rule was developed using a two-step coefficient-based multivariable logistic regression scoring method and evaluated with internal validation by bootstrapping. RESULTS: In step 1, predictors for A(H7N9) included male sex, poultry exposure history, and fever, haemoptysis, or shortness of breath on history and physical examination. In step 2, haziness or pneumonic consolidation on chest radiographs and leukopenia were also associated with a higher probability of A(H7N9). The observed risk of A(H7N9) was 0.3% for those assigned to the low-risk group and 2.5%, 4.3%, and 44.0% for tertiles 1 through 3, respectively, in the high-risk group. This prediction rule achieved good model performance, with an optimism-corrected sensitivity of 0.93, a specificity of 0.80, and an area under the receiver-operating characteristic curve of 0.96. CONCLUSIONS: A simple decision rule based on data readily obtainable in the setting of patients' first clinical presentations from the first wave of the A/H7N9 epidemic in China has been developed. This prediction rule has achieved good model performance in predicting their risk of A(H7N9) infection and should be useful in guiding important clinical and public health decisions in a timely and objective manner. Data to be gathered with its use in the current evolving second wave of the A/H7N9 epidemic in China will help to inform its performance in the field and contribute to its further refinement.published_or_final_versio

Quantum-Dense Metrology

Quantum metrology utilizes entanglement for improving the sensitivity of measurements. Up to now the focus has been on the measurement of just one out of two non-commuting observables. Here we demonstrate a laser interferometer that provides information about two non-commuting observables, with uncertainties below that of the meter's quantum ground state. Our experiment is a proof-of-principle of quantum dense metrology, and uses the additional information to distinguish between the actual phase signal and a parasitic signal due to scattered and frequency shifted photons. Our approach can be readily applied to improve squeezed-light enhanced gravitational-wave detectors at non-quantum noise limited detection frequencies in terms of a sub shot-noise veto-channel.Comment: 5 pages, 3 figures; includes supplementary material