Evidence of individual differences in the long-term social, psychological, and cognitive consequences of child maltreatment

Background: The prevalence and consequences of child maltreatment are alarming, but evidence from studies with long follow-up intervals are limited. This study examined the long-term consequences of child maltreatment in relation to age of onset and follow-up interval. / Methods: The exposed group comprised 63 individuals (aged 13–34 years) with a first-time diagnosis of child maltreatment between 2001 and 2010, whereas the unexposed group comprised 63 individuals who were matched upon gender, age of onset, follow-up period, and poverty status at the index hospital admission but had no medical records of maltreatment in Hong Kong. The participants completed a set of questionnaires on executive functions and mental health and provided blood samples for measurement of IL-6 and IL-10 levels during a health assessment session. / Results: Compared with the unexposed group, the exposed group reported poorer maternal care during childhood (β = −4.64, p < 0.001) and had lower family support (β = −2.97, p = 0.010) and higher inflammatory responses (IL-6: β = 0.15, p = 0.001; IL-10: β = 0.11, p = 0.011) at follow-up. Additionally, the associations of childhood maltreatment exposure with family support and maternal care differed by age of onset and the length of time since exposure. / Conclusions: This matched cohort study highlights childhood maltreatment as a risk factor for systemic inflammation and an indicator of suboptimal social environment, both of which could persist over a long period of time

Modification by Influenza on Health Effects of Air Pollution in Hong Kong

Background: Both influenza viruses and air pollutants have been well documented as major hazards to human health, but few epidemiologic studies have assessed effect modification of influenza on health effects of ambient air pollutants. Objectives: We aimed to assess modifying effects of influenza on health effects of ambient air pollutants. Methods: We applied Poisson regression to daily numbers of hospitalizations and mortality to develop core models after adjustment for potential time-varying confounding variables. We assessed modification of influenza by adding variables for concentrations of single ambient air pollutants and proportions of influenza-positive specimens (influenza intensity) and their cross-product terms. Results: We found significant effect modification of influenza (p < 0.05) for effects of ozone. When influenza intensity is assumed to increase from 0% to 10%, the excess risks per 10-μg/m 3 increase in concentration of O 3 increased 0.24% and 0.40% for hospitalization of respiratory disease in the all-ages group and ≥ 65 year age group, respectively; 0.46% for hospitalization of acute respiratory disease in the all-ages group; and 0.40% for hospitalization of chronic obstructive pulmonary disease in the ≥ 65 group. The estimated increases in the excess risks for mortality of respiratory disease and chronic obstructive pulmonary disease in the all-ages group were 0.59% and 1.05%, respectively. We found no significant modification of influenza on effects of other pollutants in most disease outcomes under study. Conclusions: Influenza activity could be an effect modifier for the health effects of air pollutants particularly for O 3 and should be considered in the studies for short-term effects of air pollutants on health.published_or_final_versio

The central role of natural killer cells in mediating acute myocarditis after mRNA COVID-19 vaccination

BACKGROUND: Vaccine-related acute myocarditis is recognized as a rare and specific vaccine complication following mRNA-based COVID-19 vaccinations. The precise mechanisms remain unclear. We hypothesized that natural killer (NK) cells play a central role in its pathogenesis. METHODS: Samples from 60 adolescents with vaccine-related myocarditis were analyzed, including pro-inflammatory cytokines, cardiac troponin T, genotyping, and immunophenotyping of the corresponding activation subsets of NK cells, monocytes, and T cells. Results were compared with samples from 10 vaccinated individuals without myocarditis and 10 healthy controls. FINDINGS: Phenotypically, high levels of serum cytokines pivotal for NK cells, including interleukin-1β (IL-1β), interferon α2 (IFN-α2), IL-12, and IFN-γ, were observed in post-vaccination patients with myocarditis, who also had high percentage of CD57 NK cells in blood, which in turn correlated positively with elevated levels of cardiac troponin T. Abundance of the CD57 NK subset was particularly prominent in males and in those after the second dose of vaccination. Genotypically, killer cell immunoglobulin-like receptor (KIR) KIR2DL5B(-)/KIR2DS3(+)/KIR2DS5(-)/KIR2DS4del(+) was a risk haplotype, in addition to single-nucleotide polymorphisms related to the NK cell-specific expression quantitative trait loci DNAM-1 and FuT11, which also correlated with cardiac troponin T levels in post-vaccination patients with myocarditis. CONCLUSION: Collectively, these data suggest that NK cell activation by mRNA COVID-19 vaccine contributed to the pathogenesis of acute myocarditis in genetically and epidemiologically vulnerable subjects

Transmembrane 29 (Tmem29), a Newly Identified Molecule Showed Downregulation in Hypoxic-Ischemic Brain Damage

Transmembrane 29 (Tmem29) gene with unknown function is a gene located on the X chromosome of the mouse genome. The gene showed differential expression in the Vannucci neonatal hypoxic-ischemic mouse brain model. We found the gene expresses with different molecular forms, including a group of long non-coding RNA forming a family of transcripts. It was predominantly expressed in the testes, brain, and kidney of mouse. In vitro identification and functional characterization were carried out in Neuro2a cells. Using fluorescence microscopy, Tmem29 protein was found to be constitutively expressed in mouse cell lines of different origins. Oxygen glucose deprivation (OGD) induced apoptotic cell death in Neuro2a cells and was confirmed by activations of caspase 3. Tmem29 protein was found to be associated with cell death especially at the time points of caspase 3 activations. A similar response was obtained in glucose deprivation (GD) cultures suggesting Tmem29 response to a common mechanism induced by OGD and GD. Downregulation of Tmem29 was induced by OGD and GD, further validating its response to hypoxia-ischemia (HI) insults. Our findings contributed to further understanding of molecular events after hypoxic-ischemic insults and opens new avenues for developing protective and therapeutic strategies for hypoxic-ischemic encephalopathy or even pathological programmed cell death

In vitro studies of hypoxic ischemic down-regulated 1 (HID-1) protein encoded by a novel gene down-regulated in neonatal hypoxic-ischemicencephalopathy in different cell death paradigms

published_or_final_versionPaediatrics and Adolescent MedicineDoctoralDoctor of Philosoph

Transmembrane 29 <i>(Tmem29)</i>, a Newly Identified Molecule Showed Downregulation in Hypoxic-Ischemic Brain Damage

Transmembrane 29 (Tmem29) gene with unknown function is a gene located on the X chromosome of the mouse genome. The gene showed differential expression in the Vannucci neonatal hypoxic-ischemic mouse brain model. We found the gene expresses with different molecular forms, including a group of long non-coding RNA forming a family of transcripts. It was predominantly expressed in the testes, brain, and kidney of mouse. In vitro identification and functional characterization were carried out in Neuro2a cells. Using fluorescence microscopy, Tmem29 protein was found to be constitutively expressed in mouse cell lines of different origins. Oxygen glucose deprivation (OGD) induced apoptotic cell death in Neuro2a cells and was confirmed by activations of caspase 3. Tmem29 protein was found to be associated with cell death especially at the time points of caspase 3 activations. A similar response was obtained in glucose deprivation (GD) cultures suggesting Tmem29 response to a common mechanism induced by OGD and GD. Downregulation of Tmem29 was induced by OGD and GD, further validating its response to hypoxia-ischemia (HI) insults. Our findings contributed to further understanding of molecular events after hypoxic-ischemic insults and opens new avenues for developing protective and therapeutic strategies for hypoxic-ischemic encephalopathy or even pathological programmed cell death

Trioxane derivatives

New methods for preparing analogues of qinghaosu (QHS, or artemisinin) and synthetic trioxane derivatives are developed. These new derivatives which have attached DNA-ligating groups are capable of aligning the trioxane nucleus proximate to specified base sequences in DNA. Despite the idea of combining DNA-binding and other ligands to pharmacophorea is not new, these derivatives synthesized are of new chemical entities. They were also tested for cytotoxicity and neurotoxity and screened against tumour cell lines. Results are very positive and some of the compounds are found to be active. The invention has the potential of providing a new array of drugs based on the trioxane pharmacophore. They can be developed into antitumour agents which act by selective destruction of DNA in tumour cells. Other potential applications include candidates for development into antineoplastic drugs. Currently, there are no examples of specific compounds of this kind reported in any literature

The effect of brief counselling and NRT sampling on the recruitment of smokers to quit smoking

Introduction The smoking population has declined to 10.8% in Hong Kong in 2017 thematic household survey. The passive recruitment measures to motivated smokers to join smoking cessation service exclusively results in a significant missed opportunity to capture the remaining majority of smokers who are not yet planning quit attempts. 2012 Cochrane review suggests that proactive personal contact with potential participants and tailored intervention may help to recruit smokers into smoking cessation programme. The majority of smokers are ambivalent about quitting. Emerging evidence reveals that providing NRT samples engage both motivated and unmotivated smokers into the quitting process. Methodology In the past two years, a mobile truck was deployed to park at different smoking hotspots to reach the smoking population. We provide brief counselling using 5 A’s and 5 R’ techniques to engage the smokers. Free one week nicotine replacement therapy (NRT), either patch or gum was provided for those who were aged 18 or above, no chronic medical diseases or mental illness, not pregnant or breast feeding no recent hospital admission in the recent 6 months and no contraindications on the use of NRT. They were then recommended to join our formal smoking cessation programme. Phone follow up were arranged within one week to answer queries on any side effects. Those not eligible for NRT sample were also encouraged to join our service. Personal data were collected. Number of smokers who had received NRT sample and those who had enrolled our full treatment programme were recorded. The self-reported 7-day point prevalence abstinence rate at 8th and 26th week were ascertained by phone contact. Those who defaulted or could not be contacted were considered failure to quit by intention to treat analysis. Results 2,890 smokers were engaged with brief counseling and 1,394 (48.24%) enrolled our smoke cessation programme The mean age was 41.68 (SD 13.24) with male 2,324 (81.29%) and female 536 (18.71%) with 30 missing data on gender. The average cigarette consumption per day was 17.29 (SD 8.46). The average Fagerstrom score was 4.74 (SD2.38). 1,842(63.74%) received sample NRT of whom 810 (810/1842, 44%) enrolled our full treatment programme whereas 584 (584/1048, 55.7%) without NRT sample enrolled our service. The 7-day point prevalence abstinence rate of all the enrollees at 8th week, 26th week were 47.34%, 38.85% respectively. There was no major adverse events reported. Discussion and Conclusion Many smokers are in a state of contemplation or have no intention of quitting. Our initiative successfully induced 48.2% smokers to undergo formal smoking cessation treatment. The self-reported 7-day point prevalence abstinence rate at 8th and 26th was satisfactory

Sleep quality mediates the relationship between systemic inflammation and neurocognitive performance

Background: Systemic inflammation is a significant mechanism underpinning adverse cognitive changes. Sleep quality is a crucial factor associated with systemic inflammation and neurocognitive health. Elevated levels of pro-inflammatory cytokines in the periphery help mark inflammation. With this background, we examined the relationship between systemic inflammation, subjective sleep quality, and neurocognitive performance in adults. Method &amp; Results: In 252 healthy adults, we measured the systemic inflammation reflected by serum levels of IL-6, IL-12, IL-18, TNF-α and IFN-γ, subjective sleep quality reflected by the global scores of the Pittsburgh Sleep Quality Index, and their neurocognitive performance measured by the Hong Kong Montreal Cognitive Assessment. We observed that neurocognitive performance was negatively related to IL-18 (p = 0.046) and positively related to sleep quality (p = 0.006). We did not observe significant associations between other cytokines and neurocognitive performance. Furthermore, we found that sleep quality as a mediator explained the relationship between IL-18 and neurocognitive performance depending on the levels of IL-12 (index of moderated mediation: 95% CI = [0.0047, 0.0664]). Better subjective sleep quality buffered the negative effect of IL-18 on neurocognitive performance when IL-12 was low (bootstrapping 95% CI: [- 0.0824, - 0.0018]). On the contrary, poor subjective sleep quality mediated the association between higher IL-18 and poorer neurocognitive performance when IL-12 was elevated (bootstrapping 95% CI: [0.0004, 0.0608]). Conclusion &amp; Implications: Our findings indicate that systemic inflammation was negatively associated with neurocognitive performance. Sleep quality regulated by IL-18/IL-12 axis activation could be a potential mechanism underpinning neurocognitive changes. Our results illustrate the intricate relationships between immune functioning, sleep quality and neurocognitive performance. These insights are essential to understand the potential mechanisms underpinning neurocognitive changes, paving the way for the development of preventive interventions for the risk of cognitive impairment

Effectiveness of a culturally attuned internet-based depression prevention program for Chinese adolescents: a randomized controlled trial

Background: Depression prevention among adolescents is crucial for reducing the global disease burden. Internet‐based depression prevention approaches are found to be effective but they were mostly evaluated in a Western context. Grasping the Opportunity is a Chinese Internet intervention, which was translated and modified from CATCH‐IT developed in the West. We aimed to evaluate the effectiveness of Grasp the Opportunity in reducing depressive symptoms in Chinese adolescents. Methods: In this randomized controlled trial, Chinese adolescents aged 13 to 17 years with mild‐to‐moderate depressive symptoms were recruited from three secondary schools in Hong Kong. The participants (n = 257) were randomly assigned to receive either intervention or attention control. The primary outcome was the improvement in depressive symptoms according to the revised Center for Epidemiologic Studies Depression Scale (CESD‐R) at the 12‐month follow‐up. Analyses were performed using intention to treat (ITT). Results: The participants were randomly assigned to receive the intervention (n = 130) or attention control (n = 127). Follow‐up data were obtained from 250 (97%) participants. Only 26 (10%) participants completed the intervention. Compared to the attention control, Grasp the Opportunity led to reductions in depressive symptoms at the 12‐month follow‐up with a medium effect size using ITT analysis (mean difference 2.6, 95% CI 0.59–5.55, effect size d = 0.36). Conclusions: Grasp the Opportunity is effective in reducing depressive symptoms in Chinese adolescents over a long follow‐up period. Poor completion rate is the major challenge in the study