Parents' attitudes about their children's cleft lip and palate in Hong Kong

"A dissertation submitted in partial fulfillment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, June 30, 2010."Includes bibliographical references (p. 26-28).Thesis (B.Sc)--University of Hong Kong, 2010.This study investigates the concerns, attitudes and stress of Hong Kong parents of children with cleft lip and/or palate (CLP). Twenty-three parents participated and were asked to fill in two questionnaires. The results showed that parents generally had similar concerns to other parents in Hong Kong, including health, social development and performance in school. They tended to possess positive attitudes towards CLP. However, they would not want their children to have CLP if they could choose. More than half of the parents were experiencing high parenting stress. The results gave insight regarding the need for expanded speech therapy services in public hospitals and inclusion of counseling services in the multidisciplinary craniofacial team.published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Hybrid intelligence for data mining

Today, enormous amount of data are being recorded in all kinds of activities. This sheer size provides an excellent opportunity for data scientists to retrieve valuable information using data mining techniques. Due to the complexity of data in many neoteric problems, one-size-fits-all solutions are seldom able to provide satisfactory answers. Although the studies of data mining have been active, hybrid techniques are rarely scrutinized in detail. Currently, not many techniques can handle time-varying properties while performing their core functions, neither do they retrieve and combine information from heterogeneous dimensions, e.g., textual and numerical horizons. This thesis summarizes our investigations on hybrid methods to provide data mining solutions to problems involving non-trivial datasets, such as trajectories, microblogs, and financial data. First, time-varying dynamic Bayesian networks are extended to consider both causal and dynamic regularization requirements. Combining with density-based clustering, the enhancements overcome the difficulties in modeling spatial-temporal data where heterogeneous patterns, data sparseness and distribution skewness are common. Secondly, topic-based methods are proposed for emerging outbreak and virality predictions on microblogs. Complicated models that consider structural details are popular while others might have taken overly simplified assumptions to sacrifice accuracy for efficiency. Our proposed virality prediction solution delivers the benefits of both worlds. It considers the important characteristics of a structure yet without the burden of fine details to reduce complexity. Thirdly, the proposed topic-based approach for microblog mining is extended for sentiment prediction problems in finance. Sentiment-of-topic models are learned from both commentaries and prices for better risk management. Moreover, previously proposed, supervised topic model provides an avenue to associate market volatility with financial news yet it displays poor resolutions at extreme regions. To overcome this problem, extreme topic model is proposed to predict volatility in financial markets by using supervised learning. By mapping extreme events into Poisson point processes, volatile regions are magnified to reveal their hidden volatility-topic relationships. Lastly, some of the proposed hybrid methods are applied to service computing to verify that they are sufficiently generic for wider applications

韓麗珠作品中的身體改造與主體性的辯證關係

本文分析香港新生代作家韓麗珠的三本小說，分別為《縫身》、《人皮刺繡》和《空臉》，三本小說皆有描述改造人體的情節，並藉由這些異化情節探討主體性在社會中該如何彰顯。《縫身》中，主角順應社會主流而進行縫身手術，手術後迎來諸多不便，最後選擇進行分離手術；《人皮刺繡》中，主角是一名人皮刺繡師，透過刺繡的方式同時傷害和療癒客人；《空臉》中，主角希望消除別人在她臉上留下的痕跡，故選擇換臉，最終她領悟到臉不代表主體，但換臉手術能使臉更貼近真實的自己。三部作品分別描述身體改造和主體性之間的對立、矛盾和統一，構成辯證關係。筆者將以三章分析三部作品，先以改造身體的動機、過程和結果帶出身體改造的特點，再以小說中的重要意象分析何謂主體性，繼而帶出身體改造和主體性如何構成辯證關係

Cerebral small vessel disease burden is associated with poststroke depressive symptoms: A 15-month prospective study

Objective: All types of cerebral small vessel disease (SVD) markers including lacune, white matter hyperintensities (WMH), cerebral microbleeds, and perivascular spaces were found to be associated with poststroke depressive symptoms (PDS). This study explored whether the combination of the four markers constituting an overall SVD burden was associated with PDS. Methods: A cohort of 563 patients with acute ischemic stroke were followed over a 15-month period after the index stroke. A score of _7 on the 15-item Geriatric Depression Scale was defined as clinically significant PDS. Scores of the four SVD markers ascertained on magnetic resonance imaging were summed up to represent total SVD burden. The association between SVD burden and PDS was assessed with generalized estimating equation models. Results: The study sample had a mean age of 67.0 _ 10.2 years and mild-moderate stroke [National Institutes of Health Stroke Scale score: 3, interquartile, 1–5]. PDS were found in 18.3%, 11.6%, and 12.3% of the sample at 3, 9, and 15 months after stroke, respectively. After adjusting for demographic characteristics, vascular risk factors, social support, stroke severity, physical and cognitive functions, and size and locations of stroke, the SVD burden was associated with an increased risk of PDS [odds ratio = 1.30; 95% confidence interval = 1.07–1.58; p = 0.010]. Other significant predictors of PDS were time of assessment, female sex, smoking, number of acute infarcts, functional independence, and social support. Conclusion: SVD burden was associated with PDS examined over a 15-month follow-up in patients with mild to moderate acute ischemic stroke

Validation and application of health utilities index in Chinese subjects with down syndrome

Objectives: The objectives of the study were (1) to validate the Chinese version of Health Utilities Index (HUI-Ch); (2) to examine the Health-related Quality of Life (HRQoL) of Chinese subjects with Down syndrome (DS); and (3) to study the impact of chronic health conditions on HRQoL of Chinese with DS. Methods: The multiple choice questionnaire for scoring Health Utilities Index Mark 2 (HUI2) and Health Utilities Index Mark 3 (HUI3) was translated and validated. In addition to the HRQoL scores from HUI2 and HUI3, proxy-data on socio-demographics, and 10 common chronic health conditions for people with DS were collected and analyzed. Data analysis involves multiple imputation and multiple regression analysis to predict variations in HRQoL in relation to different factors. Lastly, a gradient interval was constructed on the number of chronic health conditions in relation to HRQoL. Results: HUI-Ch was validated according to standard guidelines. People with DS were found to have a lower HRQoL as compared to the general population, with the majority categorized as moderate or severe on the scale. Behavioral and hearing problems on HUI2, and hearing problems on HUI3 were found to be statistically significant predictors of a lower HRQoL score. A significant gradient relationship existed showing when the number of health problems increased, the HRQoL scores decreased. Conclusions: HUI-Ch is a valid instrument to assess HRQoL. It can have broad application in Chinese subjects with DS including the study of the impact of different chronic health conditions on their quality of life. The quantifiable nature of HUI-Ch will facilitate longitudinal study on the well-being of subjects with DS and evaluation of effectiveness of intervention programs in the near future

Differentiation of ankle sprain motion and common sporting motion by ankle inversion velocity

This study investigated the ankle inversion and inversion velocity between various common motions in sports and simulated sprain motion, in order to provide a threshold for ankle sprain risk identification. The experiment was composed of two parts: Firstly, ten male subjects wore a pair of sport shoes and performed ten trials of running, cutting, jump-landing and stepping-down motions. Secondly, five subjects performed five trials of simulated sprain motion by a supination sprain simulator. The motions were analyzed by an eight-camera motion capture system at 120. Hz. A force plate was employed to record the vertical ground reaction force and locate the foot strike time for common sporting motions. Ankle inversion and inversion velocity were calculated by a standard lower extremity biomechanics calculation procedure. Profiles of vertical ground reaction force, ankle inversion angle and ankle inversion velocity were obtained. Results suggested that the ankle was kept in an everted position during the stance. The maximum ankle inversion velocity ranged from 22.5 to 85.1°/s and 114.0 to 202.5°/s for the four tested motions and simulated sprain motion respectively. Together with the ankle inversion velocity reported in the injury case (623°/s), a threshold of ankle inversion velocity of 300°/s was suggested for the identification of ankle sprain. The information obtained in this study can serve as a basis for the development of an active protection apparatus for reducing ankle sprain injury. © 2010 Elsevier Ltd

Association of cerebral small vessel disease burden and health-related quality of life after acute ischemic stroke

Objective: Cerebral small vessel disease (SVD) is associated with increased mortality, disability and cognitive decline, depression in stroke survivors. This study examined the association between SVD burden, defined by a combination of SVD markers, and health-related quality of life (HRQoL) in acute ischemic stroke. Methods: Patients admitted with acute ischemic stroke of any etiology were prospectively screened between January 2010 to December 2014 and enrolled in the study if they met study entry criteria. HRQoL was evaluated with the 12-item Stroke Specific Quality of Life (SSQoL) at 3 months after the onset of acute ischemic stroke. SVD was ascertained by the presence of any of the SVD markers including lacune, white matter hyperintensities (WMH), cerebral microbleeds (CMB) and enlarged perivascular spaces (EPVS) in the basal ganglia or their combinations on brain magnetic resonance imaging (MRI). The presence of each individual marker scored 1 point and was summed up to generate an ordinal “SVD score” (0–4) capturing total SVD burden. Linear regression was used to determine the associations between SVD burden and HRQoL. Results: Of the743 acute ischemic stroke patients that formed he study sample (mean age: 66.3 ± 10.6 years; 41.7% women), 49.3%, 22.5%, 16.0%, 9.2% and 3.1% had SVD scores of 0, 1, 2, 3 and 4, respectively. After adjusting for demographic, clinical and imaging variables, the SVD score was independently associated with lower overall score of SSQoL (B = − 1.39, SE = 0.56, p = 0.01), and its domains of mobility (B = − 0.41, SE = 0.10, p \u3c 0.001) and vision (B = − 0.12, SE = 0.06, p = 0.03). Acute infract volume (B = − 1.44, SE = 0.54, p = 0.01), functional independence (B = 5.69, SE = 0.34, p \u3c 0.001) and anxious (B = − 1.13, SE = 0.23, p \u3c 0.001) and depressive symptoms (B = − 3.41, SE = 0.22, p \u3c 0.001) were also the significant predictors of the overall score of SSQoL. Conclusion: The brain’s SVD burden predicts lower HRQoL, predominantly in domains of mobility and vision at 3 months after acute ischemic stroke. The evaluation of SVD burden could facilitate developing individual treatment strategies

Acute renal impairment in coronavirus-associated severe acute respiratory syndrome

Acute renal impairment in coronavirus-associated severe acute respiratory syndrome.BackgroundSevere acute respiratory syndrome (SARS) is a newly emerged infection from a novel coronavirus (SARS-CoV). Apart from fever and respiratory complications, acute renal impairment has been observed in some patients with SARS. Herein, we describe the clinical, pathologic, and laboratory features of the acute renal impairment complicating this new viral infection.MethodsWe conducted a retrospective analysis of the plasma creatinine concentration and other clinical parameters of the 536 SARS patients with normal plasma creatinine at first clinical presentation, admitted to two regional hospitals following a major outbreak in Hong Kong in March 2003. Kidney tissues from seven other patients with postmortem examinations were studied by light microscopy and electron microscopy.ResultsAmong these 536 patients with SARS, 36 (6.7%) developed acute renal impairment occurring at a median duration of 20 days (range 5–48 days) after the onset of viral infection despite a normal plasma creatinine level at first clinical presentation. The acute renal impairment reflected the different prerenal and renal factors that exerted renal insult occurring in the context of multiorgan failure. Eventually, 33 SARS patients (91.7%) with acute renal impairment died. The mortality rate was significantly higher among patients with SARS and acute renal impairment compared with those with SARS and no renal impairment (91.7% vs. 8.8%) (P < 0.0001). Renal tissues revealed predominantly acute tubular necrosis with no evidence of glomerular pathology. The adjusted relative risk of mortality associated with the development of acute renal impairment was 4.057 (P < 0.001). By multivariate analysis, acute respiratory distress syndrome and age were the most significant independent risk factors predicting the development of acute renal impairment in SARS.ConclusionAcute renal impairment is uncommon in SARS but carries a high mortality. The acute renal impairment is likely to be related to multi-organ failure rather than the kidney tropism of the virus. The development of acute renal impairment is an important negative prognostic indicator for survival with SARS

P53 and Pten control neural and glioma stem/progenitor cell renewal and differentiation

Glioblastoma (GBM) is a highly lethal brain tumor presenting as one of two subtypes with distinct clinical histories and molecular profiles. The primary GBM subtype presents acutely as high-grade disease that typically harbors EGFR, Pten and Ink4a/Arf mutations, and the secondary GBM subtype evolves from the slow progression of low-grade disease that classically possesses PDGF and p53 events1–3. Here, we show that concomitant CNS-specific deletion of p53 and Pten in the mouse CNS generates a penetrant acute-onset high-grade malignant glioma phenotype with striking clinical, pathological and molecular resemblance to primary GBM in humans. This genetic observation prompted p53 and Pten mutational analysis in human primary GBM, demonstrating unexpectedly frequent inactivating mutations of p53 as well the expected Pten mutations. Integrated transcriptomic profiling, in silico promoter analysis and functional studies of murine neural stem cells (NSCs) established that dual, but not singular, inactivation of p53 and Pten promotes an undifferentiated state with high renewal potential and drives elevated c-Myc levels and its associated signature. Functional studies validated increased c-Myc activity as a potent contributor to the impaired differentiation and enhanced renewal of p53-Pten null NSCs as well as tumor neurospheres (TNSs) derived from this model. c-Myc also serves to maintain robust tumorigenic potential of p53-Pten null TNSs. These murine modeling studies, together with confirmatory transcriptomic/promoter studies in human primary GBM, validate a pathogenetic role of a common tumor suppressor mutation profile in human primary GBM and establish c-Myc as a key target for cooperative actions of p53 and Pten in the regulation of normal and malignant stem/progenitor cell differentiation, self-renewal and tumorigenic potential