Ad hoc influenza vaccination during years of significant antigenic drift in a tropical city with 2 seasonal peaks

We evaluated the acceptability of an additional ad hoc influenza vaccination among the health care professionals following seasons with significant antigenic drift. Self-administered, anonymous surveys were performed by hard copy questionnaires in public hospitals, and by an on-line platform available to all healthcare professionals, from April 1st to May 31st, 2015. A total of 1290 healthcare professionals completed the questionnaires, including doctors, nurses, and allied health professionals working in both the public and private systems. Only 31.8% of participating respondents expressed an intention to receive the additional vaccine, despite that the majority of them agreed or strongly agreed that it would bring benefit to the community (88.9%), save lives (86.7%), reduce medical expenses (76.3%), satisfy public expectation (82.8%), and increase awareness of vaccination (86.1%). However, a significant proportion expressed concern that the vaccine could disturb the normal immunization schedule (45.5%); felt uncertain what to do in the next vaccination round (66.0%); perceived that the summer peak might not occur (48.2%); and believed that the summer peak might not be of the same virus (83.5%). Furthermore, 27.8% of all respondents expected that the additional vaccination could weaken the efficacy of previous vaccinations; 51.3% was concerned about side effects; and 61.3% estimated that there would be a low uptake rate. If the supply of vaccine was limited, higher priority groups were considered to include the elderly aged ≥65 years with chronic medical conditions (89.2%), the elderly living in residential care homes (87.4%), and long-stay residents of institutions for the disabled (80.7%). The strongest factors associated with accepting the additional vaccine included immunization with influenza vaccines in the past 3 years, higher perceived risk of contracting influenza, and higher perceived severity of the disease impact. The acceptability to an additional ad hoc influenza vaccination was low among healthcare professionals. This could have a negative impact on such additional vaccination campaigns since healthcare professionals are a key driver for vaccine acceptance. The discordance in perceived risk and acceptance of vaccination regarding self versus public deserves further evaluation

Implication of Genetic Variants Near TCF7L2, SLC30A8, HHEX, CDKAL1, CDKN2A/B, IGF2BP2, and FTO in Type 2 Diabetes and Obesity in 6,719 Asians

OBJECTIVE— Recent genome-wide association studies have identified six novel genes for type 2 diabetes and obesity and confirmed TCF7L2 as the major type 2 diabetes gene to date in Europeans. However, the implications of these genes in Asians are unclear

The genetic architecture of type 2 diabetes

The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate, these explain only a fraction of heritability. To test the hypothesis that lower-frequency variants explain much of the remainder, the GoT2D and T2D-GENES consortia performed whole genome sequencing in 2,657 Europeans with and without diabetes, and exome sequencing in a total of 12,940 subjects from five ancestral groups. To increase statistical power, we expanded sample size via genotyping and imputation in a further 111,548 subjects. Variants associated with type 2 diabetes after sequencing were overwhelmingly common and most fell within regions previously identified by genome-wide association studies. Comprehensive enumeration of sequence variation is necessary to identify functional alleles that provide important clues to disease pathophysiology, but large-scale sequencing does not support a major role for lower-frequency variants in predisposition to type 2 diabetes

Meta-analysis of genome-wide association studies identifies eight new loci for type 2 diabetes in east Asians

We conducted a three-stage genetic study to identify susceptibility loci for type 2 diabetes (T2D) in east Asian populations. We followed our stage 1 meta-analysis of eight T2D genome-wide association studies (6,952 cases with T2D and 11,865 controls) with a stage 2 in silico replication analysis (5,843 cases and 4,574 controls) and a stage 3 de novo replication analysis (12,284 cases and 13,172 controls). The combined analysis identified eight new T2D loci reaching genome-wide significance, which mapped in or near GLIS3, PEPD, FITM2-R3HDML-HNF4A, KCNK16, MAEA, GCC1-PAX4, PSMD6 and ZFAND3. GLIS3, which is involved in pancreatic beta cell development and insulin gene expression1,2, is known for its association with fasting glucose levels3,4. The evidence of an association with T2D for PEPD5 and HNF4A6,7 has been shown in previous studies. KCNK16 may regulate glucose-dependent insulin secretion in the pancreas. These findings, derived from an east Asian population, provide new perspectives on the etiology of T2D

A survey of the health and safety conditions of apartment buildings in Hong Kong

A high-density built environment poses challenges to the idea of sustainable development in respect of health (e.g. SARS outbreak) and safety (e.g. fire and structural problems). To examine the seriousness of the high-density problem, this study aims to survey the health and safety performance of apartment buildings in a densely populated city, Hong Kong, using a simplified assessment scheme. An assessment scheme based on a hierarchy of building performance indicators concerning the quality of: (a) architectural design, (b) building services design, (c) the surrounding environment, (d) operations and maintenance, and (e) management approaches was developed. One hundred forty (140) apartment buildings were surveyed and assessed through site inspections, desk searches, and interviews. A performance analysis was conducted to examine and compare the overall health and safety performance of the buildings. We found that there were considerable variations in health and safety conditions across buildings, even though they are located within a single district. Most of the variations in building health and safety conditions were attributed to differences in building management systems rather than building design. Enhancing strategic management approaches (e.g. a better delineation of owners’ rights and duties) appears to be the most critical factor that underperformers should consider in order to improve their buildings

A Hong Kong model of sustainable development

Purpose: The purpose of this paper is to discuss a Coasian interpretation of a model of sustainable development for Hong Kong that incorporates three segments, namely economy, society, and environment. Design/Methodology/Approach: The approach is analytical, using concepts of property rights informed by Coasian neo‐institutional economics and Yu\u27s ideas on the Schumpeterian process in innovation. Findings: First, the sustainable development criteria must be non‐dictatorial, decentralized, and compatible with market economics. The emphasis is contractarian rather than legislative or administrative. Second, the essence of segment cooperation is to create a win‐win situation rather than an “integrated” rent seeking game, which will likely result in more values being created. Third, the requirement that it be progressive over time implies that programs and policies that are duplicative need to be avoided, and innovations are to be encouraged. Fourth, the requirement of satisfying only two aspects of the three segments of cooperation implies a less stringent standard of making stepwise improvements, and thus makes entrepreneurial efforts more likely. Last, the three segments of cooperation, if practiced simultaneously and improved over time, can achieve most, if not all, the principles in the Rio Declaration without aiming at a specific principle in the Declaration. Research Limitations/Implications: This paper should focus on a “win‐win” rather than a mutually exploitative approach to public participation in sustainable development promotion. Practical Implications: This paper should assist policymakers and politicians in understanding how sustainable development may be conceptually modelled. Originality/Value: The paper is the first paper that defines for Hong Kong a model of sustainable development on the basis of Coasian economics, and contrasts it with other proposed models

Metal-(phenylthio)alkanoic acid interactions-X. The crystal structures of thallium(I) (phenylthio)acetate(phenylthio)acetic acid adduct, caesium (2,4-dichloro-5-methylphenylthio)acetate(2,4-dichloro-5-methylphenylthio)acetic acid adduct, caesium (phenylthio)acetate(phenylthio)acetic acid adduct and caesium 2-(phenylthio)propionate monohydrate

Crystal structures of four univalent metal complexes with (phenylthio)acetic acid (PTAH), (2,4-dichloro-5-methylphenylthio)acetic acid (DCMPTAH), and 2-(phenylthio) propionic acid (PTPAH) have been determined using X-ray diffraction. The thallium complex, [Tl(PTA)(PTAH)], (1) is orthorhombic, space group Pccn, Z = 4, a = 10.466(6), b = 26.75(1), c = 6.013(2) Å. [Cs(DCMPTA)(DCMPTAH)], (2) is triclinic, space group Pl, Z = 1, a = 5.159(3), b = 6.898(3), c = 16.500(8) Å, a = 90.04(4), β = 94.22(4) and γ = 103.27(4)°. PTAH forms an adduct [Cs(PTA)(PTAH)], (3) which is monoclinic, space group Cc with Z = 4, a = 35.88(1), b = 7.201(2), c = 6.907(1) Å, β = 91.19(2)°. PTPAH forms a conventional hydrated complex, [Cs(PTPA)(HO)], (4), which is orthorhombic, Pbca, with Z = 8, a = 8.849(4), b = 9.500(3), c = 29.78(1) Å. The structures (1-4) were refined to residuals of 0.078, 0.087, 0.030 and 0.036 for 1353, 1571, 2225, 1807 "observed" reflections, respectively. Both 1 and 2 are examples of acid salts of the type, MHX, where X and HX are crystallographically equivalent. The molecules are polymeric and have bonded ligands as well as adducted acid species. 3 is an example of a type B (MX·HX) salt with X and HX crystallographically different. 4 is an example of a normal Cs salt. The Tl compound (1 is disordered with only half the general position sites occupied by the metal atom. Each site is at the centre of a distorted MOS octahedron with very short bonds to both asymmetric bidentate and bridging carboxylate groups [TlO, 2.22, 2.44(1) Å] and to the thioether S [TlS,2.517(4)Å]. In 2, the Cs atom is at the centre of symmetry of a distorted MO octahedron. It has a polymer structure with acetate bridges linking consecutive Cs atoms and carboxylate oxygen also bifurcated between two Cs atoms. The CsO distances are 3.123(10), 3.152(8) and 3.237(8)Å. Complex 3 has an irregular MO polyhedron about Cs with bonds from both PTA and PTAH ligands [CsO range, 3.03-3.45(1) Å; mean, 3.23(1) Å], and extends into a 2-D polymer structure. Compound 4 is also polymeric but with distorted octahedral MO coordination, bridging through both carboxylate and water oxygens [CsO range, 3.02-3.33(1) Å; mean, 3.20(1) Å]