Breast cancer incidence and mortality in a transitioning Chinese population: current and future trends

Parallel Session 1 - Population Health & Policy: no. S3Conference Theme: Translating Health Research into Policy and Practice for Health of the PopulationBACKGROUND: Projections of future trends in cancer incidence and mortality are important for public health planning. Moreover, as the most economically developed city in China, Hong Kong may provide a sentinel for a substantial proportion of the global population. OBJECTIVES: To model and evaluate recent trends in breast cancer incidence and mortality in Hong Kong, and to project the trends on short to medium terms, which have significant implications on future burdens on our health care …published_or_final_versio

Cost-effectiveness of Helicobacter pylori screening and treatment for gastric cancer in Hong Kong: a decision analytic approach

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Disease burden of breast cancer in Hong Kong: an exploration of trends for screening policy and resource allocation

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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

A study of resiliency among Chinese health care workers: Capacity to cope with workplace stress

This paper reports a study of resiliency to cope with workplace stress among Chinese health care workers. We adopted a qualitative-quantitative-biomarker approach to conduct interviews, focus group discussions, and a two-wave longitudinal survey. Wave 1 survey was conducted among health care workers in Hong Kong and Mainland China (N = 773). Amongst them, 287 took part in Wave 2 survey. A confirmatory factor analysis consistently supported a 9-item scale. A sub-sample's (N = 33) resiliency was positively related to salivary IgA levels (an immune marker). Results from hierarchical regressions demonstrated that resiliency measured in Wave 1 was positively related to job satisfaction, work-life balance, and quality of life; and negatively related to physical/psychological symptoms and injuries at work in Wave 2. © 2009 Elsevier Inc. All rights reserved.postprin

Using health-seeking pattern to estimate disease burden from sentinel surveillance

Lightning Talk - oral presentationBy characterizing the health-seeking behavior of the general population, surveillance data of consultation rates could be further utilized to obtain the population and age-specific burden of diseasepublished_or_final_versio

Assembly of the outer retina in the absence of GABA synthesis in horizontal cells

<p>Abstract</p> <p>Background</p> <p>The inhibitory neurotransmitter gamma-amino-butyric acid (GABA) not only modulates excitability in the mature nervous system but also regulates neuronal differentiation and circuit development. Horizontal cells, a subset of interneurons in the outer retina, are transiently GABAergic during the period of cone photoreceptor synaptogenesis. In rodents, both horizontal cells and cone axonal terminals express GABA_Areceptors. To explore the possibility that transient GABA expression in mouse neonatal horizontal cells influences the structural development of synaptic connectivity in the outer retina, we examined a mutant in which expression of GAD67, the major synthesizing enzyme for GABA, is selectively knocked out in the retina.</p> <p>Results</p> <p>Immunocytochemistry and electron microscopy revealed that the assembly of triad synapses involving cone axonal pedicles and the dendrites of horizontal and bipolar cells is unaffected in the mutant retina. Moreover, loss of GABA synthesis in the outer retina did not perturb the spatial distributions and cell densities of cones and horizontal cells. However, there were some structural alterations at the cellular level: the average size of horizontal cell dendritic clusters was larger in the mutant, and there was also a small but significant increase in cone photoreceptor pedicle area. Moreover, metabotropic glutamate receptor 6 (mGluR6) receptors on the dendrites of ON bipolar cells occupied a slightly larger proportion of the cone pedicle in the mutant.</p> <p>Conclusions</p> <p>Together, our analysis shows that transient GABA synthesis in horizontal cells is not critical for synapse assembly and axonal and dendritic lamination in the outer retina. However, pre- and postsynaptic structures are somewhat enlarged in the absence of GABA in the developing outer retina, providing for a modest increase in potential contact area between cone photoreceptors and their targets. These findings differ from previous results in which pharmacological blockade of GABA_Areceptors in the neonatal rabbit retina caused a reduction in cone numbers and led to a grossly disorganized outer retina.</p

In vivo development of dendritic orientation in wild-type and mislocalized retinal ganglion cells

<p>Abstract</p> <p>Background</p> <p>Many neurons in the central nervous system, including retinal ganglion cells (RGCs), possess asymmetric dendritic arbors oriented toward their presynaptic partners. How such dendritic arbors become biased during development <it>in vivo </it>is not well understood. Dendritic arbors may become oriented by directed outgrowth or by reorganization of an initially unbiased arbor. To distinguish between these possibilities, we imaged the dynamic behavior of zebrafish RGC dendrites during development <it>in vivo</it>. We then addressed how cell positioning within the retina, altered in <it>heart-and-soul </it>(<it>has</it>) mutants, affects RGC dendritic orientation.</p> <p>Results</p> <p><it>In vivo </it>multiphoton time-lapse analysis revealed that RGC dendrites initially exhibit exploratory behavior in multiple directions but progressively become apically oriented. The lifetimes of basal and apical dendrites were generally comparable before and during the period when arbors became biased. However, with maturation, the addition and extension rates of basal dendrites were slower than those of the apical dendrites. Oriented dendritic arbors were also found in misplaced RGCs of the <it>has </it>retina but there was no preferred orientation amongst the population. However, <it>has </it>RGCs always projected dendrites toward nearby neuropil where amacrine and bipolar cell neurites also terminated. Chimera analysis showed that the abnormal dendritic organization of RGCs in the mutant was non-cell autonomous.</p> <p>Conclusions</p> <p>Our observations show that RGC dendritic arbors acquire an apical orientation by selective and gradual restriction of dendrite addition to the apical side of the cell body, rather than by preferential dendrite stabilization or elimination. A biased arbor emerges at a stage when many of the dendritic processes still appear exploratory. The generation of an oriented RGC dendritic arbor is likely to be determined by cell-extrinsic cues. Such cues are unlikely to be localized to the basal lamina of the inner retina, but rather may be provided by cells presynaptic to the RGCs.</p

Association between antibiotic consumption and colon and rectal cancer development in older individuals: A territory‐wide study

Background: Antibiotics may alter colorectal cancer (CRC) risk due to gut dysbiosis. We aimed to study the specific and temporal effects of various antibiotics on CRC development in older individuals. Methods: This was a territory-wide retrospective cohort study. Subjects aged 60 years and older who did not have CRC diagnosed on screening/diagnostic colonoscopy diagnosed between 2005 and 2013 were recruited. Exclusion criteria were history of CRC, colectomy, inflammatory bowel disease, and CRC diagnosed within 6 months of index colonoscopy. Exposure was use of any antibiotics up to 5 years before colonoscopy. The primary outcomes were CRC diagnosed >6 m after colonoscopy. Covariates were patient demographics, history of colonic polyps/polypectomy, concomitant medication use (NSAIDs, COX-2 inhibitors, aspirin, and statins), and performance of endoscopy centers (colonoscopy volume and polypectomy rate). Stratified analysis was conducted according to nature of antibiotics and location of cancer. Results: Ninety seven thousand one hundred and sixty-two eligible subjects (with 1026 [1.0%] cases of CRC) were identified, 58,704 (60.4%) of whom were exposed to antibiotics before index colonoscopy. Use of antibiotics was associated with a lower risk of cancer in rectum (adjusted hazard ratio [aHR]: 0.64, 95% CI: 0.54–0.76), but a higher risk of cancer in proximal colon (aHR: 1.63, 95%CI: 1.15–2.32). These effects differed as regards the anti-anaerobic/anti-aerobic activity, narrow-/broad-spectrum, and administration route of antibiotics. Conclusions: Antibiotics had divergent effects on CRC development in older subjects, which varied according to the location of cancer, antibiotic class, and administration route

Understanding the Spatial Clustering of Severe Acute Respiratory Syndrome (SARS) in Hong Kong

We applied cartographic and geostatistical methods in analyzing the patterns of disease spread during the 2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong using geographic information system (GIS) technology. We analyzed an integrated database that contained clinical and personal details on all 1,755 patients confirmed to have SARS from 15 February to 22 June 2003. Elementary mapping of disease occurrences in space and time simultaneously revealed the geographic extent of spread throughout the territory. Statistical surfaces created by the kernel method confirmed that SARS cases were highly clustered and identified distinct disease “hot spots.” Contextual analysis of mean and standard deviation of different density classes indicated that the period from day 1 (18 February) through day 16 (6 March) was the prodrome of the epidemic, whereas days 86 (15 May) to 106 (4 June) marked the declining phase of the outbreak. Origin-and-destination plots showed the directional bias and radius of spread of superspreading events. Integration of GIS technology into routine field epidemiologic surveillance can offer a real-time quantitative method for identifying and tracking the geospatial spread of infectious diseases, as our experience with SARS has demonstrated