Oral History and Storytelling: reflection on an alternative aproach of teaching History

In the paper, I will share and review a method I have been experimenting for teaching the history of Hong Kong. Hong Kong was a fishing village before it was ceded as a British Colony. However this part of Hong Kong’s history is missed in our textbook, and water life is not part of the city’s everyday knowledge. Oral history is the starting point of the process. The teacher and university students conducted oral history together to build up the primary pool of historical materials (audio records and transcripts), which however were not friendly to general learners. Next, another group of students studied the transcripts and picked out interesting transcript segments and slightly edited them into understandable fishermen’s stories. Then, a larger group of students studied the transcript segments and organized the fragmented stories into a storyline to give shape for the fishermen’s accounts. They visited local secondary schools and told the stories to the students in the classroom aided by visual images. The teacher, an experienced oral history researcher, facilitates the whole process by giving context, background information and basic knowledge to the student narrators. The students had many misunderstanding about the fishermen’s oral history due to a lack of knowledge and experience of lives on the water. The method of storytelling requires the students to serve as a medium of knowledge transfer. When they try this unconventional method of teaching history, they have to make sense of the unfamiliar lived experiences as told in the oral history, by comparing different lifestyles between land and water, by raising land people’s curiosity of the dangers on the rough sea, by inserting useful knowledge in order to appreciate the lifestyle of fishing on the water. To understand how this medium of storytelling (the student narrators) is important to make this method an effective means of teaching history.postprin

Double-blind randomized control trial of acupuncture for autistic spectrum disorder

Free Paper Presentations: no. FP3OBJECTIVE: To study the efficacy, safety, and compliance of short-term electro-acupuncture (EA) for children with autism spectrum disorder (ASD). METHODS: This was a randomised, double-blind, sham-controlled, clinical trial. Children with ASD were randomly assigned to EA group (n=30) or sham electro-acupuncture (SEA) group (n=25) matched by age and severity of autism. The EA group received EA for selected acupoints while SEA group received sham EA to sham acupoints. A total of 12 acupuncture sessions over 4 weeks were given. Primary outcome measures included WeeFIM, Pediatric Evaluation of Disability Inventory (PEDI), Leiter International Performance Scale–Revised (Leiter-R), Clinical Global Impression–Improvement (CGI-I) scale. Secondary outcome measures consisted of Aberrant Behavior Checklist (ABC), Ritvo-Freeman Real Life Scale (RFRLS), Reynell Developmental Language Scale (RDLS), and standardised parental report. Data were analysed by Mann-Whitney test. RESULTS: There was significant improvement in language comprehension domain of WeeFIM (P=0.02), self-care caregiver assistant domain of PEDI (P=0.028), and CGI-I (P=0.003) in the EA than SEA group. As for parental report, the EA group also showed significantly better social initiation (P=0.01), receptive language (P=0.006), motor skill (P=0.034), coordination (P=0.07), and attention span (P=0.003). More than 70% children with ASD adapted acupuncture easily, while 8% had poor acupuncture compliance. Mild side-effect with minor superficial bleeding or irritability during acupuncture was found. CONCLUSION: A short 4 weeks (12 sessions) course of EA is useful to improve the specific function in children with ASD, especially for language comprehension and self-care ability.published_or_final_versionThe 1st Hong Kong Neurological Congress cum 22nd Annual Scientific Meeting of the Hong Kong Neurological Society, Hong Kong, 6-8 November 2009. In Hong Kong Medical Journal, 2009, v. 15 n. 6, suppl. 7, p. 29, abstract FP

Studies on the Programmable Protein Assembly via Genetically Encoded Native Chemical Ligation

PhDProgrammed protein assembly has vast potential in applications as diverse as bioreactors, smart materials and drug delivery. However, to realise this potential, exact control of the assembly process is required. Thus, this thesis describes generic genetically controlled methods to engineer the self-assembly of geometrically designed protein fusions to form user-defined structures. In particular, it shows how designed fusion proteins can be reacted to form fibres and encapsulations via split-intein mediated native chemical ligation in both one-pot and stepwise syntheses. When compatible fusions are mixed, they react quickly via a split-intein mediated native chemical ligation (NCL) to produce peptide bonded products in high yields (75 % yield). The correctly formed products can be purified to high homogeny and were shown to form the intended user-defined structures

Anatomic variations of neurovascular structures of the ankle in relation to arthroscopic portals: a cadaveric study of Chinese subjects.

PURPOSE: To investigate anatomic variations of neurovascular structures in the ankle and the safety margin for arthroscopic portals. METHODS: 11 left and 12 right ankles from 8 female and 15 male fresh cadavers of Chinese ethnicity aged 53 to 88 (mean, 68) years were used. The ankle was standardised in a plantigrade position, zero-degree inversion, and neutral rotation. Four ankle portals, namely anteromedial (AM), anterolateral (AL), posteromedial (PM) and posterolateral (PL), were identified using 23-gauge needles. Skin and subcutaneous fat were dissected from the underlying fascia to visualise neurovascular structures. Distances were measured from: (1) the AM portal to the saphenous vein and nerve and its branches, (2) the AL portal to branches of the superficial peroneal nerves, of which the lateral one was labelled as the intermediate dorsal cutaneous branch and the medial one as the medial dorsal cutaneous branch, (3) the PM portal to the posterior tibial neurovascular bundles, and (4) the PL portal to the sural nerve. RESULTS: The distances from (1) the AM portal to branches of the great saphenous vein and nerve, and (2) the AL portal to the intermediate dorsal cutaneous branch of the superficial peroneal nerve were short and may be an anatomic hazard. Variations were significant among the cadavers in terms of distances of the portals to the neurovascular structures. CONCLUSION: In Chinese cadavers, variations of neurovascular structures are significant. Care must be taken to avoid inadvertent injury during ankle arthroscopy.published_or_final_versio

Hyaluronic Acid Instillation Following Arthroscopic Anterior Cruciate Ligament Reconstruction: A Double-blinded, Randomised Controlled Study.

PURPOSE: To assess the effect of hyaluronic acid instillation after arthroscopic anterior cruciate ligament (ACL) reconstruction for improving pain, range of movement, and function of the knee. METHODS: 28 men and 4 women underwent arthroscopic ACL reconstruction for isolated ACL rupture (partial or complete) and instability after recreational sports injury 2 to 120 months earlier. They were randomised to undergo arthroscopic ACL reconstruction followed by intra-articular viscoseal instillation (13 men and 3 women) or arthroscopic ACL reconstruction alone (15 men and 1 woman). The knee injury osteoarthritis outcome score (for pain, symptoms, activities of daily living, sport and recreation function, and quality of life), range of movement, knee circumference, and analgesic use were assessed on days -1, 1, and 2, and weeks 2, 6 and 12. RESULTS: Patient demographics were similar at baseline. At postoperative days 1 and 2, all subscales of the knee injury osteoarthritis outcome score (except for quality of life) were significantly higher in the viscoseal group. At weeks 2, 6, and 12, improvement in both groups equalised. Knee swelling (change in knee circumference) was significantly less in the viscoseal group at days 1 and 2 (p=0.009 and p=0.038, respectively, Mann-Whitney U test). Only one patient in the viscoseal group had a limited range of movement. No patient developed any adverse reaction. CONCLUSION: Intra-articular viscoseal instillation improved pain control and swelling 2 days after arthroscopic ACL reconstruction.published_or_final_versio

IPA-3 inhibits the growth of liver cancer cells by suppressing PAK1 and NF-kB activation

Hepatocellular carcinoma (HCC) is one of the major malignancies worldwide and is associated with poor prognosis due to the high incidences of metastasis and tumor recurrence. Our previous study showed that overexpression of p21-activated protein kinase 1 (PAK1) is frequently observed in HCC and is associated with a more aggressive tumor behavior, suggesting that PAK1 is a potential therapeutic target in HCC. In the current study, an allosteric small molecule PAK1 inhibitor, IPA-3, was evaluated for the potential in suppressing hepatocarcinogenesis. Consistent with other reports, inhibition of PAK1 activity was observed in several human HCC cell lines treated with various dosages of IPA-3. Using cell proliferation, colony formation and BrdU incorporation assays, we demonstrated that IPA-3 treatment significantly inhibited the growth of HCC cells. The mechanisms through which IPA-3 treatment suppresses HCC cell growth are enhancement of apoptosis and blockage of activation of NF-κB. Furthermore, our data suggested that IPA-3 not only inhibits the HCC cell growth, but also suppresses the metastatic potential of HCC cells. Nude mouse xenograft assay demonstrated that IPA-3 treatment significantly reduced the tumor growth rate and decreased tumor volume, indicating that IPA-3 can suppress the in vivo tumor growth of HCC cells. Taken together, our demonstration of the potential preclinical efficacy of IPA-3 in HCC provides the rationale for cancer therapy.published_or_final_versio

The clinical course of polymyalgia rheumatica in Chinese

Polymyalgia rheumatica (PMR) is diagnosed based on clinical features that may overlap with other rheumatic conditions like rheumatoid arthritis (RA). Furthermore, a proportion of PMR patients may subsequently evolve into RA. The aim of this study was to examine the clinical characteristics of PMR patients in a Chinese cohort compared to a Caucasian series. Patients diagnosed to have PMR during 1997-2008 were reviewed for clinical features and compared to a reported Caucasian series. Rheumatoid factor (RF) and anticyclic citrullinated peptide (CCP) antibodies were determined by immunonephelometry and enzyme-linked immunosorbent assay, respectively. Forty-four patients of southern Chinese origin were diagnosed to have PMR according to specialist opinion. Seventy-five percent of patients (n = 33) were >65 years of age at diagnosis (mean ± standard deviation, 75.8 ± 9.6 years). The commonest feature at disease onset was elevated erythrocyte sedimentation rate >40 mm/h (100% vs. 95.7%; p = 0.17) and bilateral shoulder pain or stiffness (95.5% vs. 90.8%; p = 0.31), comparable in frequency to the Caucasian cohort. However, Chinese patients had significantly longer duration of symptoms before diagnosis (p < 0.001) but less bilateral upper arm tenderness (p < 0.001) and generalized stiffness (p = 0.01). Twelve (27.3%) patients evolved into RA after a median duration of 2 months from onset of PMR. RF and anti-CCP antibodies were positive in 66.7% and 60% of these patients compared to 9.4% and 6.2%, respectively, among those who did not evolve into RA during the period observed. Chinese patients with PMR have modestly different clinical profile compared to the Caucasian counterpart. RF and anti-CCP antibodies were more likely to be present in those who subsequently developed into RA. © 2009 Clinical Rheumatology.postprin

Health-related quality of life and risk of colorectal cancer recurrence and All-cause death among advanced stages of colorectal cancer 1-year after diagnosis

Background: The study aimed to examine the association between health-related quality of life (HRQOL) assessed with overall survival (OS) and recurrence after diagnosis of colorectal cancer (CRC). Methods: Overall 160 patients with advanced stage CRC were recruited in an observational study and completed the generic and condition-specific HRQOL questionnaires at the colorectal specialist outpatient clinic in Hong Kong, between 10/2009 and 07/2010. Socio-demographic and clinical characteristics including duration since diagnosis, primary tumor location and treatment modality, were collected to serve as predictor variables in regression models. All-cause death or CRC recurrence was the event of interest. Association between HRQOL with OS was assessed using Cox regression. Association between HRQOL and CRC recurrence was further modeled by competing-risks regression adjusted for the competing-risks of death from any cause. Results: After a median follow-up of 23 months, there were 22 (16.1%) incidents of CRC recurrence and 15 (9.4%) deaths. Decreased physical functioning (hazard ratios, HR = 0.917, 95%CI:0.889-0.981) and general health of domains in SF-12 (HR = 0.846, 95%CI:0.746-0.958) or SF-6D scores (HR = 0.010, 95%CI:0.000-0.573) were associated with an increased risk of death, with adjustment of patients' characteristics. Increased vitality (HR = 1.151, 95%CI:1.027-1.289) and mental health (HR = 1.128, 95%CI:1.005-1.265) were associated with an increased likelihood of death. In models adjusted for competing-risk of death, those with worse HRQOL was not associated with increased risk of CRC recurrence. Conclusions: Although self-reported HRQOL was not a significant prognostic factor for CRC recurrence, the HRQOL provided independent prognostic value about mortality in patients with advanced stage of CRC.published_or_final_versio