Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong

Acknowledgments We would like to thank the General Outpatient Clinics (Lek Yuen, Ma On Shan, Shatin (Tai Wai), Yuen Chau Kok) and Shatin Rhenish Neighbourhood Elderly Centre for the support and help in recruitment. We also greatly thank all the patients who joined in the cohort. Funding The staff working on this cohort received funding from the Hong Kong Jockey Club Charities Trust. Competing interests None declared. Patient consent for publication Not required. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available on reasonable request. The authors warmly welcome collaborations for future research based on this study. For those who would like to request for the data or propose new assessments into the follow-up assessments, they can email to: ([email protected]). For more information please see the website: http://cpcp.sphpc.cuhk.edu.hk/chi/.Peer reviewedPublisher PD

Pretreatment with beta-blockers and the frequency of hypokalemia in patients with acute chest pain

Plasma potassium concentration was measured at admission in 1234 patients who presented with acute chest pain. One hundred and ninety five patients were on P blockers before admission. The potassium concentrations of patients admitted early (within four hours of onsetof symptoms) were compared with those admitted later (4-18 hours after onset of symptoms). There was a transient fall in plasma potassium concentrations in patients not pre-treated with , B blockers. This was not seen in patients who had been on P blockers before admission. Nonselective, B blockers were more effective than cardioselective agents in maintaining concentrationsof plasma potassium. These findings suggest a mechanism for the beneficial effects of ,B blockers on morbidity and mortality in acute myocardial infarction

Adaptation of an internet-based depression prevention intervention for Chinese adolescents: from "CATCH-IT" to "grasp the opportunity"

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Acute tryptophan depletion Moja-De: a method to study central nervous serotonin function in children and adolescents

Serotonin (5-HT) is widely implicated as a key neurotransmitter relevant to a range of psychiatric disorders and psychological processes. The role of central nervous 5-HT function underlying these processes can be examined through serotonergic challenge methodologies. Acute tryptophan depletion (ATD) is a key challenge method whereby a diminished dietary intake of tryptophan—the amino acid precursor to brain 5-HT synthesis—results in temporary diminished central nervous 5-HT synthesis. While this particular methodology has been used in adult populations, it was only recently that modifications were made to enable the use of ATD in child and adolescent populations. Additionally, the Moja-De modification of the ATD challenge methodology has demonstrated benefits over other ATD techniques used previously. The aim of this protocol paper is to describe the ATD Moja-De methodology in detail, its benefits, as well as studies that have been conducted to validate the procedure in child and adolescent samples. The ATD Moja-De protocol provides a potential methodology for investigating the role of central nervous 5-HT via manipulation of brain tryptophan availability in human psychopathology from a developmental viewpoint

Use of the Chinese version Modified Checklist for Autism in Toddlers in a high-risk sample in Taiwan

This study examined the utility of the Chinese version Modified Checklist for Autism in Toddlers (C-M-CHAT) in a high-risk sample. This study recruited 236 children aged from 18 to 47 months old in rural area of Southern Taiwan, including 113 children with Autism Spectrum Disorder (ASD) and 123 children with Developmental Delay (DD). Using failing any four of the 23 C-M-CHAT items as cutoff, it showed a sensitivity of 77.0% and a specificity of 72.4%. The positive predictive value (PPV) was 71.9% while the negative predictive value (NPV) was 77.4%. Using failing any three of the 14 new critical items--referred to as the "Brief 14"--as cutoff, it yielded a sensitivity of 70.8% and a specificity of 82.1%. The PPV of the "Brief 14" was 78.4% while the NPV was 75.4%. The preliminary results of the C-M-CHAT and the "Brief 14" performance demonstrated an acceptable predictive validity and promising utility for use in high-risk, rural populations in Taiwan

Kinetics of antigen expression and epitope presentation during virus infection

Current knowledge about the dynamics of antigen presentation to T cells during viral infection is very poor despite being of fundamental importance to our understanding of anti-viral immunity. Here we use an advanced mass spectrometry method to simultaneously quantify the presentation of eight vaccinia virus peptide-MHC complexes (epitopes) on infected cells and the amounts of their source antigens at multiple times after infection. The results show a startling 1000-fold range in abundance as well as strikingly different kinetics across the epitopes monitored. The tight correlation between onset of protein expression and epitope display for most antigens provides the strongest support to date that antigen presentation is largely linked to translation and not later degradation of antigens. Finally, we show a complete disconnect between the epitope abundance and immunodominance hierarchy of these eight epitopes. This study highlights the complexity of viral antigen presentation by the host and demonstrates the weakness of simple models that assume total protein levels are directly linked to epitope presentation and immunogenicity.NHMRC (National Health and Medical Research Council of Australia

Observed photodetachment in parallel electric and magnetic fields

We investigate photodetachment from negative ions in a homogeneous 1.0-T magnetic field and a parallel electric field of approximately 10 V/cm. A theoretical model for detachment in combined fields is presented. Calculations show that a field of 10 V/cm or more should considerably diminish the Landau structure in the detachment cross section. The ions are produced and stored in a Penning ion trap and illuminated by a single-mode dye laser. We present preliminary results for detachment from S- showing qualitative agreement with the model. Future directions of the work are also discussed.Comment: Nine pages, five figures, minor revisions showing final publicatio

Homeward bound or bound for a home? Assessing the capacity of dementia patients to make decisions about hospital discharge: Comparing practice with legal standards

Background This article stems from a larger project which considers ways of improving assessments of capacity and judgements about best interests in connection with people with dementia admitted to acute hospitals with respect to decisions about place of residence. Aims Our aim is to comment on how assessments of residence capacity are actually performed on general hospital wards compared with legal standards for the assessment of capacity set out in the Mental Capacity Act, 2005 (MCA). Method Our findings are grounded in ethnographic ward-based observations and in-depth interviews conducted in three hospital wards, in two hospitals (acute and rehabilitation), within two NHS healthcare trusts in the North of England over a period of nine months between 2008 and 2009. Twenty-nine patient cases were recruited to the study. We also draw from broader conceptions of capacity found in domestic and international legal, medical, ethical and social science literature. Results Our findings suggest that whilst professionals profess to be familiar with broad legal standards governing the assessment of capacity under the MCA, these standards are not routinely applied in practice in general hospital settings when assessing capacity to decide place of residence on discharge from hospital. We discuss whether the criteria set out in the MCA and the guidance in its Code of Practice are sufficient when assessing residence capacity, given the particular ambiguities and complexities of this capacity. Conclusions We conclude by suggesting that more specific legal standards are required when assessing capacity in this particular context