Schooling and pastoral care in Hong Kong

The theme of this thesis is to pin-point the problems that most Hong Kong school teachers have had to face since September, 1978 following the legislation to enforce 9 years of free and compulsory education, raising the school leaving age to 15. The essential problems that most Hong Kong teachers have had to face recently are those resulting from the non selective recruitment of pupils, both socially and academically. These are viewed in the context of "social class", which can be studied from two aspects primary social class, according to the occupation of the pupil's father (i.e. middle and working classes) and, secondary social class defined by the pupil's academic performance in schools. (i.e. grammar and technical schools, upper and lower streams). As children of different social classes respond differently in the same situation, the social interaction in school can be explained by either the sub-culture or the adaptation model. This forms the theoretical foundation of this thesis. The study of this thesis was based on two Hong Kong secondary schools of similar backgrounds. It was a research on the attitudes of the third year boys, their parents and teachers towards the existing pastoral care system in Hong Kong schools. The findings revealed that the pupils' views were more affected by their secondary social class backgrounds while their parents, their primary social class. However, teachers' viewpoints differed mainly because of their qualifications and work load. The message that the findings carry is that the teachers' conditions of service should be improved and more parental involvement in the school process should be encouraged before innovations in the pastoral system can be implemented. Summing up, the essence of this thesis is to highlight the importance of the teachers' role and their partnership with parents in the caring for school children

Continuous intraoperative vagus nerve stimulation for monitoring of recurrent laryngeal nerve during minimally invasive esophagectomy

Review Article on Esophageal Surgerypublished_or_final_versio

The Nucleosome Assembly Protein TSPYL2 Regulates the Expression of NMDA Receptor Subunits GluN2A and GluN2B

published_or_final_versio

Impact of COVID-19 pandemic on serum vitamin D level among infants and toddlers: An interrupted time series analysis and before-and-after comparison

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the implementation of social distancing and home confinement measures may elevate the risk of vitamin D deficiency particularly for infants. This study aimed to quantify changes in vitamin D level among infants and toddlers in Hong Kong after the COVID-19 outbreak. Methods: We recruited 303 infants and toddlers aged 2–24 months by stratified random sampling from 1 June 2019 to November 30, 2020. Regression models were used to estimate the effect of time on infants’ serum 25-hydroxyvitamin D (25(OH)D) level overall and by age groups before and after the outbreak. Interrupted time series (ITS) analysis was performed to examine the sustained effect of COVID-19 on their serum 25(OH)D level. Results: The ITS results showed no immediate reduction in serum 25(OH)D level among infants, but a decreasing trend was observed in the subsequent months post-outbreak at a monthly decline rate of −6.32 nmol/L. When analyzed by age group, the magnitude of post-outbreak reduction in 25(OH)D was stronger among younger infants (aged 2–6 months). Conclusion: Guidelines and recommendations should be given to pregnant women and mothers to ensure sufficient vitamin D level in their infants during the COVID-19 period

Hospital Authority audit of the outcome of endoscopic resection of superficial upper gastro-intestinal lesions in Hong Kong

published_or_final_versio

Development of a Health Empowerment Programme to improve the health of working poor families: protocol for a prospective cohort study in Hong Kong

Introduction: People from working poor families are at high risk of poor health partly due to limited healthcare access. Health empowerment, a process by which people can gain greater control over the decisions affecting their lives and health through education and motivation, can be an effective way to enhance health, health-related quality of life (HRQOL), health awareness and health-seeking behaviours of these people. A new cohort study will be launched to explore the potential for a Health Empowerment Programme to enable these families by enhancing their health status and modifying their attitudes towards health-related issues. If proven effective, similar empowerment programme models could be tested and further disseminated in collaborations with healthcare providers and policymakers. Method and analysis: A prospective cohort study with 200 intervention families will be launched and followed up for 5 years. The following inclusion criteria will be used at the time of recruitment: (1) Having at least one working family member; (2) Having at least one child studying in grades 1–3; and (3) Having a monthly household income that is less than 75% of the median monthly household income of Hong Kong families. The Health Empowerment Programme that will be offered to intervention families will comprise four components: health assessment, health literacy, self-care enablement and health ambassador. Their health status, HRQOL, lifestyle and health service utilisation will be assessed and compared with 200 control families with matching characteristics but will not receive the health empowerment intervention. Ethics and dissemination: This project was approved by the University of Hong Kong—the Hospital Authority Hong Kong West Cluster IRB, Reference number: UW 12-517. The study findings will be disseminated through a series of peer-reviewed publications and conference presentations, as well as a yearly report to the philanthropic funding body–Kerry Group Kuok Foundation (Hong Kong) Limited.published_or_final_versio

Overexpression of eIF-5A2 in mice causes accelerated organismal aging by increasing chromosome instability

<p>Abstract</p> <p>Background</p> <p>Amplification of 3q26 is one of the most frequent genetic alterations in many human malignancies. Recently, we isolated a novel oncogene <it>eIF-5A2 </it>within the 3q26 region. Functional study has demonstrated the oncogenic role of <it>eIF-5A2 </it>in the initiation and progression of human cancers. In the present study, we aim to investigate the physiological and pathological effect of <it>eIF-5A2 </it>in an <it>eIF-5A2 </it>transgenic mouse model.</p> <p>Methods</p> <p>An <it>eIF-5A2 </it>transgenic mouse model was generated using human <it>eIF-5A2 </it>cDNA. The <it>eIF-5A2 </it>transgenic mice were characterized by histological and immunohistochemistry analyses. The aging phenotypes were further characterized by wound healing, bone X-ray imaging and calcification analysis. Mouse embryo fibroblasts (MEF) were isolated to further investigate molecular mechanism of <it>eIF-5A2 </it>in aging.</p> <p>Results</p> <p>Instead of resulting in spontaneous tumor formation, overexpression of eIF-5A2 accelerated the aging process in adult transgenic mice. This included decreased growth rate and body weight, shortened life span, kyphosis, osteoporosis, delay of wound healing and ossification. Investigation of the correlation between cellular senescence and aging showed that cellular senescence is not required for the aging phenotypes in <it>eIF-5A2 </it>mice. Interestingly, we found that activation of <it>eIF-5A2 </it>repressed p19 level and therefore destabilized p53 in transgenic mouse embryo fibroblast (MEF) cells. This subsequently allowed for the accumulation of chromosomal instability, such as errors in cell dividing during metaphase and anaphase. Additionally, a significantly increase in number of aneuploidy cells (<it>p </it>< 0.05) resulted from an increase in the incidences of misaligned and lagging chromosomal materials, anaphase bridges, and micronuclei in the transgenic mice.</p> <p>Conclusion</p> <p>These observations suggest that <it>eIF-5A2 </it>mouse models could accelerate organismal aging by increasing chromosome instability.</p

Clinical spectrum of Exophiala infections and a novel Exophiala species, Exophiala hongkongensis

Poster PresentationBackground: Exophiala species are saprophytic fungi which have been isolated from environments rich in hydrocarbons or from hot, humid, and oligotrophic environments. These fungi are considered as dematiaceous moulds; and due to their phenotypic characteristics at the beginning of colony formation, they are also often referred to as ‘black yeasts’, a misnomer which sometimes may mislead the choice of antifungal agents. When the cultures mature, brown hyphae are formed bearing conidiogenous cells referred to as annellides, a typical characteristic of this fungal genus. Although Exophiala species are environmental fungi, they should not be disregarded as contaminants when they are isolated from clinical specimens. These fungi are causative agents of skin and subcutaneous tissue infections and of systemic infections, such as prosthetic valve endocarditis, dialysis-associated peritonitis, and disseminated infections, especially in immunocompromised patients. Unfortunately, Exophiala species can often only be identified to the genus level by phenotypic characterisation. Objectives: The aims of this study were to study the clinical spectrum of Exophiala infections in Queen Mary Hospital, Hong Kong by a polyphasic approach, and to characterise a potentially novel Exophiala species, Exophiala hongkongensis (ex-type strain HKU32T). Methods: All Exophiala strains characterised in this study were isolated from patients during a 15-year period (1998-2012) and were retrieved from the collection in the clinical microbiology laboratory at Queen Mary Hospital, Hong Kong. The strains were characterised phenotypically by microscopic examination of fungal structure using the agar block smear preparation method and phylogenetically using the internal transcribed spacer (ITS) region and Rpb1 gene. In addition, a unique strain, HKU32T, was further characterised phenotypically by scanning electron microscopy, enzyme activity test using the API-ZYM system, and growth tests on different temperatures and culture media. HKU32T was also further phylogenetically characterised using β-tubulin and β-actin genes. All the phylogenetic analyses were performed by the maximum likelihood method using MEGA 5.0.5. Results: Microscopic examination of the young cultures of all the 12 strains showed subspherical, budding, yeast-like cells. Sequencing of the ITS region and partial Rpb1 gene showed 11 of the 12 strains were known Exophiala species, including E. oligosperma [n = 3], E. jeanselmei [n = 2], E. lecanii-corni [n = 2], E. bergeri [n = 1], E. cancerae [n = 1], E. dermatitidis [n = 1], and E. xenobiotica [n = 1]). As for HKU32T, it displayed unique morphological features and was positive for eight enzymes in the API-ZYM test. Optimal growth was observed at 30°C on potato dextrose agar or at 24°C on cornmeal agar. HKU32T also occupied unique phylogenetic positions in all the phylogenetic analyses, with Exophiala nishimurae being the most closely related species. Clinical spectrum of Exophiala infections in Hong Kong included chronic skin infection, colonisation of gastrointestinal tract, continuous ambulatory peritoneal dialysis (CAPD) peritonitis, onychomycosis, pneumonia, tinea pedis, and wrist or finger nodule. Conclusion: Exophiala species could cause a wide range of infections and the most frequent species isolated from patients in Hong Kong was Exophiala oligosperma. Exophiala hongkongensis sp. nov. is proposed to describe the unique strain HKU32T

Omicron variant susceptibility to neutralizing antibodies induced in children by natural SARS-CoV-2 infection or COVID-19 vaccine

The novel SARS-CoV-2 Omicron variant may increase the risk of re-infection and vaccine breakthrough infections as it possesses key mutations in the spike protein that affect neutralizing antibody response. Most studies on neutralization susceptibility were conducted using specimens from adult COVID-19 patients or vaccine recipients. However, since the paediatric population has an antibody response to SARS-CoV-2 infection that is distinct from the adult population, it is critical to assess the neutralization susceptibility of pediatric serum specimens. This study compared the neutralization susceptibility of serum specimens collected from 49 individuals of <18 years old, including 34 adolescent BNT162b2 (Pfizer-BioNTech) vaccine recipients, and 15 recovered COVID-19 patients aged between 2 and 17. We demonstrated that only 38.2% of BNT162b2 vaccine recipients and 26.7% of recovered COVID-19 patients had their serum neutralization titre at or above the detection threshold in our live virus microneutralization assay. Furthermore, the neutralizing antibody titer against the Omicron variant was substantially lower than those against the ancestral virus or the Beta variant. Our results suggest that vaccine recipients and COVID-19 patients in the pediatric age group will likely be more susceptible to vaccine breakthrough infections or reinfections due to the Omicron variant than previous variants