51 research outputs found
Clinical and treatment-related determinants of subjective quality of life in patients with first-episode psychosis
Subjective quality of life (SQoL) has been increasingly studied in first-episode psychosis (FEP). Prior research primarily examined the impact of psychiatric symptoms on SQoL. Relationship between treatment-related factors and SQoL is under-studied. In this study, 159 Chinese patients who had completed 2-year treatment from early intervention service in Hong Kong were recruited. Assessments on premorbid adjustment, clinical profiles including social anxiety measure, functioning, antipsychotic-induced extrapyramidal side-effects and attitude toward medication treatment were conducted. SQoL was evaluated by Chinese version SF36 which generated mental and physical component summary (MCS and PCS) scores for analysis. Our results showed that more severe positive symptoms, higher level of depression, greater social anxiety, more negative attitude toward antipsychotic medications and greater degree of akathisia independently predicted lower MCS score. Higher social anxiety level and poorer functioning predicted lower PCS score. Our results indicate that affective and positive symptoms, functioning, and treatment-related variables are critical determinants of SQoL in FEP patients. These identified factors thus represent potentially malleable therapeutic targets for early detection and prompt intervention to promote enhancement of SQoL in the early stage of illness.postprin
Sustainability of treatment effect of a 3-year early intervention programme for first-episode psychosis
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Low sensitivity of a urine LAM-ELISA in the diagnosis of pulmonary tuberculosis
<p>Abstract</p> <p>Background</p> <p>The development and evaluation of rapid and accurate new diagnostic tools is essential to improve tuberculosis (TB) control in developing countries. In a previous study, the first release of a urine LAM-ELISA by Chemogen (Portland, USA) has been evaluated with a promising sensitivity and specificity for the diagnosis of pulmonary TB. In the present study, the now commercially available assay has been clinically assessed regarding its diagnostic value alone and in combination with clinical co-factors.</p> <p>Methods</p> <p>The test was applied to two urine samples from 291 consecutively enrolled Tanzanian patients with suspected pulmonary tuberculosis. The participants were subsequently assigned to classification groups according to microbiological, clinical and radiological findings at recruitment and during a maximum follow up period of 56 days.</p> <p>Results</p> <p>Only 35 out of 69 pulmonary TB cases -confirmed by smear microscopy and/or solid culture and/or liquid culture- showed at least one positive LAM-ELISA result (sensitivity 50.7%). The sensitivity was noticeably higher in females (66.7%) and in HIV positive participants (62.0%). The specificity amounted to 87.8% and was determined in participants with negative results in all microbiological tests and with sustained recovery under antibiotic treatment at day 56. Correlation with urinalysis revealed that proteinuria was significantly and positively associated with LAM-positivity (<it>P </it>= 0.026).</p> <p>Conclusion</p> <p>This commercially available generation of LAM-ELISA does not appear to be useful as an independent diagnostic test for pulmonary tuberculosis. The question whether the assay is suitable as a supplemental device in the diagnosis of HIV-associated TB, requires further investigations.</p
Human Genetics in Rheumatoid Arthritis Guides a High-Throughput Drug Screen of the CD40 Signaling Pathway
Although genetic and non-genetic studies in mouse and human implicate the CD40 pathway in rheumatoid arthritis (RA), there are no approved drugs that inhibit CD40 signaling for clinical care in RA or any other disease. Here, we sought to understand the biological consequences of a CD40 risk variant in RA discovered by a previous genome-wide association study (GWAS) and to perform a high-throughput drug screen for modulators of CD40 signaling based on human genetic findings. First, we fine-map the CD40 risk locus in 7,222 seropositive RA patients and 15,870 controls, together with deep sequencing of CD40 coding exons in 500 RA cases and 650 controls, to identify a single SNP that explains the entire signal of association (rs4810485, P = 1.4×10(−9)). Second, we demonstrate that subjects homozygous for the RA risk allele have ∼33% more CD40 on the surface of primary human CD19+ B lymphocytes than subjects homozygous for the non-risk allele (P = 10(−9)), a finding corroborated by expression quantitative trait loci (eQTL) analysis in peripheral blood mononuclear cells from 1,469 healthy control individuals. Third, we use retroviral shRNA infection to perturb the amount of CD40 on the surface of a human B lymphocyte cell line (BL2) and observe a direct correlation between amount of CD40 protein and phosphorylation of RelA (p65), a subunit of the NF-κB transcription factor. Finally, we develop a high-throughput NF-κB luciferase reporter assay in BL2 cells activated with trimerized CD40 ligand (tCD40L) and conduct an HTS of 1,982 chemical compounds and FDA–approved drugs. After a series of counter-screens and testing in primary human CD19+ B cells, we identify 2 novel chemical inhibitors not previously implicated in inflammation or CD40-mediated NF-κB signaling. Our study demonstrates proof-of-concept that human genetics can be used to guide the development of phenotype-based, high-throughput small-molecule screens to identify potential novel therapies in complex traits such as RA
Recreation-amenity use and contingent valuation of urban greenspaces in Guangzhou, China
Recreational opportunities and amenities are important human-use services generated by urban greenspaces. This study explored the use of pattern and behavior of urban greenspaces in Guangzhou city, south China. The monetary value of the non-priced benefits was gauged by the contingent valuation method using willingness-to-pay and open-ended payment card approaches. A questionnaire gleaned data by face-to-face interviews of 340 respondents in the 18-70 age group, dwelling in 34 residential street blocks selected by clustered sampling. Guangzhou residents actively used urban greenspaces, accompanied mainly by family members. Parks were the most popular venues, whereas institutional greenspaces served as surrogate parks. Visitation is mainly induced by accessibility, followed by high green coverage and quality of the ambience. Small and low-quality sites near homes were shunned. Residents of the compact city harbored subdued expectation for privacy and solitude. They are accustomed to paying greenspace entrance fees. Ninety-six point six per cent of respondents were willing to pay to use urban greenspaces, notably more than other cities, and indicating the importance of salubrious outdoor recreation as a leisure pursuit. Conservative estimate of average willingness-to-pay was RMB17.40/person/month (US$1.00 = RMB8.26), higher than actual entrance-fee payment. Willingness-to-pay was significantly associated with income, and its marginal effect verified by an ordered probit model which hinted the treatment of urban greenspaces as superior goods. Aggregate monetary value of urban greenspaces attained RMB547 million per year which outstripped Guangzhou's annual expenditures on urban greenspaces by six times. This study verified the applicability of contingent valuation to urban greenspaces in China with socioeconomic, cultural and political backgrounds that are different from many countries. The results could assist cost-benefit analysis to justify more resources for development and management of urban greenspaces, with implications on incorporating public opinions in a precision planning process in the quest towards sustainable cities. © 2005 Elsevier B.V. All rights reserved.link_to_subscribed_fulltex
Bioreceptivity of buildings for spontaneous arboreal flora in compact city environment
The ruderal habitats in cities, extending from the ground level to buildings and walls, are colonized by a special flora which adds a new dimension to urban ecology and urban biodiversity. This study investigates the spontaneous arboreal flora on buildings of different configurations and ages in compact urban Hong Kong. The hanging plants' association with intrinsic building bioreceptivity traits, extrinsic environmental factors and human intervention were evaluated. Building plants in three districts with varied urban form and building type were assessed in the field. They cling on diverse microhabitats led by vertical wall faces and roof, and a group of horizontal substrates accommodating 57% of the plants. The flora is dictated by the tree growth form, contributing 10 of the 11 species. Moraceae (76.2%) and its seven Ficus species (74.4%) are dominant. The most abundant members are pan-tropical native tree Ficus microcarpa, and the exotic but naturalized para-shrub Catharanthus roseus. Species composition on buildings is mainly native and is similar to the ground-level ruderal sites. Their successful growth on buildings is attributed to the strangler habit that is pre-adapted to grip building appendages, and the initial epiphytic existence. The host trees in their natural tropical forest abode have been substituted by buildings niches in the city. The copious fig crops are consumed by frugivorous birds and bats serving as effective dispersal agent and germination mediator. Solar access, debris pockets, damp surfaces, and leakage from drain pipes foster germination and establishment. The bioreceptivity of old buildings with poor construction materials and maintenance is enhanced by weathered substrates to facilitate colonization. Erratic shoot removal by building management has suppressed crown size of most trees. The findings improve understanding of the intricate ecological-cum-cultural dynamics and nature-in-city enrichment of a marginal but notable urban habitat, and contribute to their conservation. © 2010 Elsevier GmbH.link_to_subscribed_fulltex
Assessing the ecosystem service of air pollutant removal by urban trees in Guangzhou (China)
In Chinese cities, air pollution has become a serious and aggravating environmental problem undermining the sustainability of urban ecosystems and the quality of urban life. Besides technical solutions to abate air pollution, urban vegetation is increasingly recognized as an alternative ameliorative method by removing some pollutants mainly through dry deposition process. This paper assesses the capability and monetary value of this ecosystem service in Guangzhou city in South China. The results indicated an annual removal of SO2, NO2 and total suspended particulates at about 312.03 Mg, and the benefits were valued at RMB90.19 thousand (US$1.00=RMB8.26). More removal was realized by recreational land use due to a higher tree cover. Higher concentration of pollutants in the dry winter months induced more removal. The lower cost of pollution abatement in China generated a relatively subdued monetary value of this environmental benefit in comparison with developed countries. Younger districts with more extensive urban trees stripped more pollutants from the air, and this capacity was anticipated to increase further as their trees gradually reach final dimensions and establish a greater tree cover. Tree cover and pollutant concentration constitute the main factors in pollutant removal by urban trees. The efficiency of atmospheric cleansing by trees in congested Chinese cities could be improved by planting more trees other than shrubs or grass, diversifying species composition and biomass structure, and providing sound green space management. The implications for greenery design were discussed with a view to maximizing this ecosystem service in Chinese cities and other developing metropolises. © 2007 Elsevier Ltd. All rights reserved.link_to_subscribed_fulltex
Value of scenic views: Hedonic assessment of private housing in Hong Kong
Diverse landscape elements in cities are valued differently by residents. People are willing to pay a premium for attractive views. This study assessed the amenity value of two major types of natural landscape in Hong Kong: harbor and mountain. The study was based on 1474 transactions in 2005 and 2006 in 18 private housing estates in a residential district. The high-rise and high-density blocks were typical for middle-income housing in the city. The hedonic pricing method was employed to estimate the proportional share of various views and factors on transaction prices. Only harbor view was preferred and reflected in housing value. A broad harbor view could increase the value of an apartment by 2.97%, equivalent to US 11,137. On the contrary, a broad mountain view would depress apartment price by 6.7%, whereas a confined mountain view was statistically insignificant. Increasing distance between an apartment and a preferred natural landscape would lower transaction price. The negative perception of street view induced a price reduction by 3.7%. Building views were tolerated as an inevitable feature of the compact and vertical city. Quantifying the value of nature and scenic endowments in cities could inform policies and strategies on urban planning, development, nature conservation, and property appraisal. © 2009 Elsevier B.V. All rights reserved.link_to_subscribed_fulltex
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