Education attainment, intelligence and covid-19: A mendelian randomization study

Background: Evidence of socioeconomic inequality in COVID-19-related outcomes is emerging, with a higher risk of infection and mortality observed among individuals with lower education attainment. We aimed to evaluate the potential interventions against COVID-19 from the socioeconomic perspective, including improvement in education and intelligence. Methods: With a two-sample Mendelian randomization approach using summary statistics from the largest genome-wide association meta-analysis, univariable analysis was adopted to evaluate the total causal effects of genetically determined education attainment and intelligence on COVID-19 outcomes. Multivariable analysis was performed to dissect the potential mechanisms. Results: Genetic predisposition to higher education attainment by 1 SD (4.2 years) was independently associated with reduced risk of COVID-19 severity (OR = 0.508 [95% CI: 0.417–0.617]; p < 0.001). Genetically higher education attainment also lowered the risk of COVID-19 hospitalization (0.685 [0.593–0.791]; p < 0.001), but the association was attenuated after adjustment for beta estimates of intelligence in multivariable analysis. Genetically higher intelligence was associated with reduced risk of COVID-19 hospitalization (0.780 [0.655–0.930]; p = 0.006), with attenuation of association after adjustment for education attainment. Null association was observed for genetically determined education attainment and intelligence with SARS-CoV-2 infection. Conclusion: Education may act independently and jointly with intelligence in improving the COVID-19 outcomes. Improving education may potentially alleviate the COVID-19-related health inequality

Education attainment, intelligence and COVID-19 : a mendelian randomization study

202207 bcvcVersion of RecordSelf-fundedPublishe

Satisfaction with inpatient care in a population-based Hong Kong Chinese sample

Objective To measure self-reported inpatient experience in Hong Kong. Design Data were derived from the 2005 Thematic Household Survey. Setting and participants 24 364 non-institutional and 3390 institutionalised respondents aged at least 18 years systematically drawn to represent the Hong Kong adult population, 6.9% of whom were admitted at least once as an inpatient during the previous 12 months. Data from this group was analysed. Main outcome measure Picker Patient Experience Questionnaire-15. Results Overall, respondents scored their last inpatient episode 39.6 (range=0-100, the lower the score, the better the patient experience). Patients who sought care from private hospitals reported a lower Picker Patient Experience Questionnaire-15 score than those cared for in public facilities (31.1 vs 41.8 respectively, p<0.001). We observed substantial differences between public hospital geographic clusters that were confirmed by multivariable regression. When benchmarked against the UK, Germany and the USA, Hong Kong patients tended to report a significantly higher number of problems. Conclusions We found systematic differences between the level of satisfaction and type of problems reported by Hong Kong Chinese compared to those in Euro-American settings. The observed heterogeneities among different public hospitals, between the private and public sectors, and among subgroups of inpatients should provide an evidence based on which quality improvement initiatives can be designed and evaluated.link_to_subscribed_fulltex

Pattern of use of serum prostate-specific antigen (PSA) among different clinical specialties: retrospective study in a tertiary hospital

Abstract and Poster PresentationThis free Journal suppl. entitled: Special Issue: Abstracts of the Hong Kong Urological Association, 22nd Annual Scientific Meeting, 20 November 2016, Hong KongOBJECTIVE: The Urology Clinic at our unit receives many referrals for raised PSA. The study focused on why PSA was checked initially, whether it was clinically indicated or affected patient management. PATIENTS AND METHODS: This was a single center cross-sectional study on all whose PSA were checked from January 2014 to March 2014. Patient demographics, requesting specialty, indications of checking PSA were extracted from clinical records. PSA results and patients’ clinical outcomes were followed up. RESULTS: 2104 PSA requests of whose mean age 69.6 years old were reviewed. Mean PSA was 36.37 ng/mL (median 2.7 ng/mL). 429(20.4%, 2014) had elevated PSA (>4 ng/mL). 386(90%, 429) were subsequently managed at the Urology Clinic. 128 patients (29.8%, 429) underwent trans-rectal ultrasound guided prostate biopsy. 49 patients (38%, 128) were diagnosed with prostate cancer, of which 23 (46.9%, 49) opted for radical treatment – 10(43.5%, 23) underwent radical prostatectomy, 13(56.5%, 23) had radiotherapy. Logistic analysis showed that age and stage of disease were significantly higher in whom underwent radiotherapy. Age was the only statistically significant predictor for prostate cancer (p = 0.001). Others factors, like PSA level, requesting specialty and clinical indications were not predictors for prostate cancer detection. CONCLUSION: Inappropriate PSA testing is widespread at our institute. Patient counselling is important prior to its checking as to understand the implications of raised PSA levels.link_to_OA_fulltex

A prospective review of outcomes of metallic ureteric stents

Abstract and Oral Presentation: Oral (Free Paper) Session III: Andrology / Stone & Infection / Stents: abstract no. OP.3-

The optimal prostate-specific antigen and prostate-specific antigen density cut-off levels for Chinese men to consider transrectal ultrasound-guided prostate biopsy

Poster Presentation10th World Chinese Urological Society (WCUS) Meeting, 16 May 2015 NOMCC : 356-35

Prognostic significance of time to prostate-specific antigen (PSA) nadir and its relationship to survival beyond time to PSA nadir for prostate cancer patients with bone metastases after primary androgen deprivation therapy

BACKGROUND: This study investigated the prognostic significance of time to the prostate-specific antigen nadir (TTPN) and its relationship to survival beyond TTPN in metastatic prostate cancer after primary androgen-deprivation therapy (ADT). METHODS: All metastatic prostate cancer patients treated with primary ADT from 2000 to 2009 were reviewed. The prognostic significance of TTPN in predicting progression-free survival (PFS) beyond TTPN and overall survival (OS) beyond TTPN was analyzed using the Cox regression model. The median PFS and OS were plotted against TTPN on a monthly interval. The PFS beyond TTPN and the OS beyond TTPN with reference to TTPN were calculated and presented. RESULTS: The study enrolled 419 patients with a median follow-up period of 38 months. The findings showed that TTPN was a significant prognostic indicator for both PFS beyond TTPN (hazard ratio [HR] 0.72, 95 % confidence interval [CI] 0.52-0.99, p = 0.04) and OS beyond TTPN (HR 0.65, 95 % CI 0.47-0.90, p = 0.01) according to Cox regression analyses. The relationship between TTPN and survival beyond TTPN consisted of three phases. In the first phase (17 months for PFS and >20 months for OS), the survival beyond TTPN increased exponentially with TTPN. CONCLUSIONS: In this study, TTPN was a good prognostic indicator for PFS beyond TTPN and OS beyond TTPN in metastatic prostate cancer cases after primary ADT. Different TTPNs had different implications for predicting survival beyond TTPN