Improved Constraints on Primordial Gravitational Waves using Planck, WMAP, and BICEP/Keck Observations through the 2018 Observing Season

We present results from an analysis of all data taken by the BICEP2, Keck Array, and BICEP3 CMB polarization experiments up to and including the 2018 observing season. We add additional Keck Array observations at 220 GHz and BICEP3 observations at 95 GHz to the previous 95/150/220  GHz dataset. The Q/U maps now reach depths of 2.8, 2.8, and 8.8  μK_{CMB} arcmin at 95, 150, and 220 GHz, respectively, over an effective area of ≈600 square degrees at 95 GHz and ≈400 square degrees at 150 and 220 GHz. The 220 GHz maps now achieve a signal-to-noise ratio on polarized dust emission exceeding that of Planck at 353 GHz. We take auto- and cross-spectra between these maps and publicly available WMAP and Planck maps at frequencies from 23 to 353 GHz and evaluate the joint likelihood of the spectra versus a multicomponent model of lensed ΛCDM+r+dust+synchrotron+noise. The foreground model has seven parameters, and no longer requires a prior on the frequency spectral index of the dust emission taken from measurements on other regions of the sky. This model is an adequate description of the data at the current noise levels. The likelihood analysis yields the constraint r_{0.05}<0.036 at 95% confidence. Running maximum likelihood search on simulations we obtain unbiased results and find that σ(r)=0.009. These are the strongest constraints to date on primordial gravitational waves.

Social, Psychological, and Behavioral Predictors of Salivary Bacteria, Yeast in Caries-Free Children

INTRODUCTION

Early childhood caries (ECC) is a complex, multifactorial oral disease that is a major public health concern because it is prevalent, profoundly alters a child's quality of life, is difficult to treat effectively, and has a distressing tendency to recur following treatment.

OBJECTIVES

The purpose of the study was to examine social, psychological, and behavioral predictors of salivary bacteria and yeast in young children at risk for ECC.

METHODS

A sample of 189 initially caries-free preschool children was assessed for child stress physiology from salivary cortisol, child and family stress exposure, diet, oral health behaviors, and sociodemographic risks. Multiple logistic regression analysis was implemented to examine the associations between these risk factors and cariogenic microorganisms: mutans streptococci (MS), lactobacilli (LB), and Candida species.

RESULTS

Higher baseline salivary cortisol (odds ratio [OR] = 6.26; 95% confidence level [CL], 1.69-23.16) and a blunted response to an acute laboratory stressor (OR = .56; 95% CL, .37-.83) were associated with an increased likelihood of elevated salivary MS (≥10⁵ colony-forming units/mL) in caries-free children. Sociodemographic risk for cariogenic microorganisms was also found. Specifically, lower education attainment of the parent/primary caregiver was associated with children being more likely to carry salivary Candida species and elevated salivary MS; in addition, children from households with an unemployed parent/primary caregiver were more likely (OR = 3.13; 95% CL, 1.2-8.05) to carry salivary Candida species and more likely (OR = 3.03; 95% CL, 1.25-7.33) to carry elevated levels of MS and/or salivary Candida and/or LB.

CONCLUSIONS

The impact of sociodemographic risk and stress physiology on cariogenic disease processes are evident prior to ECC onset. The findings provide novel data on the early onset of cariogenic processes in children and the importance of considering sociodemographic, psychosocial, and behavioral factors when judging ECC risk.

KNOWLEDGE TRANSFER STATEMENT

The findings provide valuable and novel findings that, pre-ECC onset, the caries disease process is explicable from a detailed assessment of behavioral, sociodemographic, and psychosocial stress variables.

Recombinant turnip yellow mosaic virus coat protein as a potential nanocarrier

AIMS

To display a short peptide (GSRSHHHHHH) at the C-terminal end of turnip yellow mosaic virus coat protein (TYMVc) and to study its assembly into virus-like particles (TYMVcHis₆ VLPs).

METHODS AND RESULTS

In this study, recombinant TYMVcHis₆ expressed in Escherichia coli self-assembled into VLPs of approximately 30-32 nm. SDS-PAGE and Western blot analysis of protein fractions from the immobilized metal affinity chromatography (IMAC) showed that TYMVcHis₆ VLPs interacted strongly with nickel ligands in IMAC column, suggesting that the fusion peptide is protruding out from the surface of VLPs. These VLPs are highly stable over a wide pH range from 3·0 to 11·0 at different temperatures. At pH 11·0, specifically, the VLPs remained intact up to 75°C. Additionally, the disassembly and reassembly of TYMVcHis₆ VLPs were studied in vitro. Dynamic light scattering and transmission electron microscopy analysis revealed that TYMVcHis₆ VLPs were dissociated by 7 mol l^-1 urea and 2 mol l^-1 guanidine hydrochloride (GdnHCl) without impairing their reassembly property.

CONCLUSIONS

A 10-residue peptide was successfully displayed on the surface of TYMVcHis₆ VLPs. This chimera demonstrated high stability under extreme thermal conditions with varying pH and was able to dissociate and reassociate into VLPs by chemical denaturants.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first C-terminally modified TYMVc produced in E.  coli. The C-terminal tail which is exposed on the surface can be exploited as a useful site to display multiple copies of functional ligands. The ability of the chimeric VLPs to self-assemble after undergo chemical denaturation indicates its potential role to serve as a nanocarrier for use in targeted drug delivery.

The Scope of Family-Centred Care Practices, and the Facilitators and Barriers to Implementation of Family-Centred Care for Hospitalised Children and their Families in Developing Countries: An Integrative Review

PROBLEM

Limited knowledge exists regarding the scope practices and implementation from developing countries. This integrative review aims to report research on the scope of FCC practices, facilitators and barriers to the FCC implementation for hospitalised children and their families in developing countries.

ELIGIBILITY CRITERIA

Qualitative, quantitative, mixed-method studies, reports, systematic reviews and integrative reviews reporting implementation, barriers and facilitators of FCC, published in English between 2008 and 2018, from developing countries were evaluated. Joanna Briggs Institute Appraisal Tools were used for methodological assessment.

SAMPLE

Eleven studies from developing countries met the inclusion criteria. Four studies were randomised controlled trials, five were cross-sectional, one was a quasi-experimental while one was a qualitative study.

RESULTS

The scope of FCC research focuses on information sharing, family participation, and respect and dignity and FCC implementation focuses on practices and perceptions, measurement and impact of FCC. Both personal and health system facilitators and barriers exist but their influence on FCC implementation is limited. Research on needs of families and hospitalised children is also limited.

CONCLUSION

FCC practice and research are still in infancy stage in developing countries. There is limited understanding on scope of FCC practices, the needs of parents and children, and the influence of facilitators and barriers.

IMPLICATIONS

The limited findings reported in this review support the need for international collaboration to FCC to critique FCC research and integrate it with other philosophies such as child and family centred care and child centred care as is the case in some developed countries.

Association between Dental Anomalies and Orofacial Clefts: A Meta-analysis

OBJECTIVES

To conduct a systematic review and meta-analysis to assess whether individuals with nonsyndromic orofacial clefts (OCs) display a higher frequency of dental anomalies (DAs) when compared with individuals without OCs.

METHODS

A literature search of indexed databases (PubMed, Cochrane, Web of Science, Embase, Scopus, and LILACS) was conducted without language restriction up to and including February 1, 2020. Cross-referencing was used to further identify articles. Several cleft teams across the United States and Europe were contacted to obtain unpublished data. The eligibility criteria were observational studies with original data that statistically compared individuals with OC without syndromes and those without OC on any type of DA in primary and/or permanent dentition. Random effects meta-analysis through the Mantel-Haenszel estimator was used to evaluate the association between OC and DA based on odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS

The literature search generated 933 records, and 75 full-text articles were reviewed. Twenty-six studies encompassing 15,213 individuals met the inclusion criteria. The meta-analysis revealed statistically significant associations between OC and agenesis (OR, 14.2; 95% CI, 9.4 to 21.3), supernumerary teeth (OR, 5.7; 95% CI, 3.3 to 9.7), developmental enamel defects (OR, 5.6; 95% CI, 3.5 to 9.0), microdontia (OR, 14.8; 95% CI, 4.0 to 54.6), peg-shaped anterior teeth (OR, 12.2; 95% CI, 3.6 to 41.2), taurodontism (OR, 1.7; 95% CI, 1.0 to 2.7), tooth malposition and/or transposition (OR, 5.6; 95% CI, 2.8 to 11.5), tooth rotation (OR, 3.2; 95% CI, 1.3 to 8.2), and tooth impaction (OR, 3.6; 95% CI, 1.1 to 12.2). The OR estimates of the reviewed studies exhibited significant heterogeneity (P < 0.0001). No association was observed between OC and fusion and/or gemination.

CONCLUSION

Within the limitations of this study, the available evidence suggests that individuals with OCs are more likely to present with a range of DAs than their unaffected peers.

KNOWLEDGE TRANSFER STATEMENT

The findings of the current review suggest that individuals with orofacial clefts (OCs) are more likely to present with a range of dental anomalies than their unaffected peers. Understanding the association between OCs and dental anomalies is essential in guiding clinicians during treatment-planning procedures and is important in raising our awareness of the possible need for future dental treatment for patients with OCs.

Questionnaire survey on medical futility and termination of resuscitation in cardiac arrest patients among emergency physicians in Hong Kong

INTRODUCTION

The perceptions of medical futility and decisions about termination of resuscitation (TOR) for out-of-hospital cardiac arrest (OHCA) are highly heterogeneous and dependent on the practice of the attending emergency physicians. The objective of this study was to report and investigate the knowledge, attitudes, and practices regarding medical futility and TOR during management of OHCA in Hong Kong.

METHODS

A cross-sectional survey was conducted among emergency medicine physicians in Hong Kong. The questionnaire assessed participants' background, knowledge, attitudes, and behaviours concerning medical futility and TOR in management of OHCA. Composite scores were calculated to reflect knowledge, attitudes, and practices of OHCA treatment. Subgroup analysis and multiple regression analysis were used to explore the relationship between participants' background, knowledge, attitudes, and behaviours.

RESULTS

The response rate to this survey was 57% (140/247). Independent predictors of less aggressive resuscitation in OHCA patients included status as a Fellow of the Hong Kong College of Emergency Medicine (β= -0.314, P=0.028) and being an Advanced Cardiac Life Support instructor (β= -0.217, P=0.032). There was no difference in aggressiveness of resuscitation in terms of years of clinical experience (β=0.015, P=0.921), knowledge of TOR (β=0.057, P=0.509), or attitudes about TOR (β= -0.103, P=0.214). The correlation between knowledge and attitudes was low (Spearman's coefficient=0.02, P=0.795).

CONCLUSION

Clinical practice and behaviour of TOR was not demonstrated to have associations with knowledge or attitude. Status as a Fellow of the Hong Kong College of Emergency Medicine or Advanced Cardiac Life Support instructor were the only two parameters identified that had significant relationships with earlier TOR in medically futile patients with OHCA.

Constraints on Primordial Gravitational Waves Using Planck, WMAP, and New BICEP2/Keck Observations through the 2015 Season

We present results from an analysis of all data taken by the bicep2/Keck CMB polarization experiments up to and including the 2015 observing season. This includes the first Keck Array observations at 220 GHz and additional observations at 95 and 150 GHz. The Q and U maps reach depths of 5.2, 2.9, and 26  μK_{CMB} arcmin at 95, 150, and 220 GHz, respectively, over an effective area of ≈400 square degrees. The 220 GHz maps achieve a signal to noise on polarized dust emission approximately equal to that of Planck at 353 GHz. We take auto and cross spectra between these maps and publicly available WMAP and Planck maps at frequencies from 23 to 353 GHz. We evaluate the joint likelihood of the spectra versus a multicomponent model of lensed-ΛCDM+r+dust+synchrotron+noise. The foreground model has seven parameters, and we impose priors on some of these using external information from Planck and WMAP derived from larger regions of sky. The model is shown to be an adequate description of the data at the current noise levels. The likelihood analysis yields the constraint r_{0.05}<0.07 at 95% confidence, which tightens to r_{0.05}<0.06 in conjunction with Planck temperature measurements and other data. The lensing signal is detected at 8.8σ significance. Running a maximum likelihood search on simulations we obtain unbiased results and find that σ(r)=0.020. These are the strongest constraints to date on primordial gravitational waves.

Plasma-derived microparticles in polycythaemia vera

INTRODUCTION

Microparticles are membrane bound vesicles, measuring less than 1.0 um, which are released during cellular activation or during apoptosis. Studies have shown that these circulating microparticles play a role in coagulation, cell signaling and cellular interactions. Increased levels of circulating microparticles have been observed in a number of conditions where there is vascular dysfunction, thrombosis and inflammation. The objective of this study was to determine the various plasma-derived microparticles in patients with polycythaemia vera (PV) in Universiti Kebangsaan Malaysia Medical Centre and to compare them with normal control.

METHODS

A total of 15 patients with PV and 15 healthy volunteers were included in this cross-sectional descriptive study. Plasma samples from both patients and healthy volunteers were prepared and further processed for isolation of microparticles. Flow cytometry analyses were then carried out in all samples to determine the cellular origin of the microparticles. Full blood count parameters for both groups were also collected. Data collected were analyzed using SPSS version 12.0.

RESULTS

Patients with PV had a significantly higher percentage of platelet derived microparticles compared to healthy controls (P <0.05). The control group had a higher level of endothelial derived microparticles but the differences were not statistically significant (P > 0.05).

CONCLUSION

The median percentage of positive events for platelet derived microparticles was higher in patients with PV compared to normal healthy controls.

Primary imatinib resistance in chronic myeloid leukemia patients in a developing country: BCR-ABL kinase domain mutations or BCR-ABL independent mechanisms?

Clinical resistance to imatinib (IM) in chronic myeloid leukemia (CML) carries adverse consequences. We investigated 22 CML patients who developed IM-resistance for BCR-ABL kinase domain (KD) mutations. The median follow-up for this study was 101.9 months (range: 22.2 to 176.5 months) and the estimated mean overall survival was 150.87 months (95% CI: 130.0 to 171.0). Five out of 22 patients tested positive for BCR-ABL KD mutations: 2 had T315I, 2 had E255K and 1 had V289F mutations. Of the remaining 17 patients who did not harbor BCR-ABL KD mutations, 11 patients received nilotinib while the rest continued on IM. All 17 achieved haematological remission but only 5 patients achieved complete cytogenetic remission, 4 of whom did so after switching to nilotinib. Our study shows that most of our IM-resistant patients do not test positive for BCR-ABL KD mutations by available testing methods and the role of second generation tyrosine kinase inhibitors remains undetermined. A critical analysis of the BCR-ABL KD mutations and the underlying mechanisms/ pathways of BCR-ABL independent IM-resistance along with potential treatments in the horizon will be discussed.

Unusual presentation of severe dengue: Dengue maculopathy

Dengue infection is epidemic but ocular complications of dengue are less reported. We report a case of dengueinfected patient with disturbing ocular symptoms. He was admitted for severe dengue. Subsequently, he presented with symptoms of bilateral central scotoma with metamorphosia. Fundus examination revealed cotton wool spots and flame-shaped haemorrhages at the macula, with dull foveal light reflex. He was diagnosed with bilateral dengue maculopathy. The patient was managed conservatively with surveillance. One week later, his eye symptoms improved and were resolved six months later. Early recognition and close monitoring remains the key to successful management and interventions are rarely needed.

Dismal outcome of therapy-related myeloid neoplasm associated with complex aberrant karyotypes and monosomal karyotype: a case report

INTRODUCTION

Individuals who are exposed to cytotoxic agents are at risk of developing therapyrelated myeloid neoplasms (t-MN). Cytogenetic findings of a neoplasm play an important role in stratifying patients into different risk groups and thus predict the response to treatment and overall survival.

CASE REPORT

A 59-year-old man was diagnosed with acute promyelocytic leukaemia. Following this, he underwent all-trans retinoic acid (ATRA) based chemotherapy and achieved remission. Four years later, the disease relapsed and he was given idarubicin, mitoxantrone and ATRA followed by maintenance chemotherapy (ATRA, mercaptopurine and methotrexate). He achieved a second remission for the next 11 years. During a follow-up later, his full blood picture showed leucocytosis, anaemia and leucoerythroblastic picture. Bone marrow examination showed hypercellular marrow with trilineage dysplasia, 3% blasts but no abnormal promyelocyte. Fluorescence in-situ hybridisation (FISH) study of the PML/RARA gene was negative. Karyotyping result revealed complex abnormalities and monosomal karyotype (MK). A diagnosis of therapy-related myelodysplastic syndrome/myeloproliferative neoplasm with unfavourable karyotypes and MK was made. The disease progressed rapidly and transformed into therapy-related acute myeloid leukaemia in less than four months, complicated with severe pneumonia. Despite aggressive treatment with antibiotics and chemotherapy, the patient succumbed to the illness two weeks after the diagnosis.

DISCUSSION AND CONCLUSION

Diagnosis of t-MN should be suspected in patients with a history of receiving cytotoxic agents. Karyotyping analysis is crucial for risk stratification as MK in addition to complex aberrant karyotypes predicts unfavourable outcome. Further studies are required to address the optimal management for patients with t-MN.

Improved Constraints on Cosmology and Foregrounds from BICEP2 and Keck Array Cosmic Microwave Background Data with Inclusion of 95 GHz Band

We present results from an analysis of all data taken by the BICEP2 and Keck Array cosmic microwave background (CMB) polarization experiments up to and including the 2014 observing season. This includes the first Keck Array observations at 95 GHz. The maps reach a depth of 50 nK deg in Stokes Q and U in the 150 GHz band and 127 nK deg in the 95 GHz band. We take auto- and cross-spectra between these maps and publicly available maps from WMAP and Planck at frequencies from 23 to 353 GHz. An excess over lensed ΛCDM is detected at modest significance in the 95×150 BB spectrum, and is consistent with the dust contribution expected from our previous work. No significant evidence for synchrotron emission is found in spectra such as 23×95, or for correlation between the dust and synchrotron sky patterns in spectra such as 23×353. We take the likelihood of all the spectra for a multicomponent model including lensed ΛCDM, dust, synchrotron, and a possible contribution from inflationary gravitational waves (as parametrized by the tensor-to-scalar ratio r) using priors on the frequency spectral behaviors of dust and synchrotron emission from previous analyses of WMAP and Planck data in other regions of the sky. This analysis yields an upper limit r_{0.05}<0.09 at 95% confidence, which is robust to variations explored in analysis and priors. Combining these B-mode results with the (more model-dependent) constraints from Planck analysis of CMB temperature plus baryon acoustic oscillations and other data yields a combined limit r_{0.05}<0.07 at 95% confidence. These are the strongest constraints to date on inflationary gravitational waves.

Joint analysis of BICEP2/keck array and Planck Data

We report the results of a joint analysis of data from BICEP2/Keck Array and Planck. BICEP2 and Keck Array have observed the same approximately 400  deg^{2} patch of sky centered on RA 0 h, Dec. -57.5°. The combined maps reach a depth of 57 nK deg in Stokes Q and U in a band centered at 150 GHz. Planck has observed the full sky in polarization at seven frequencies from 30 to 353 GHz, but much less deeply in any given region (1.2  μK deg in Q and U at 143 GHz). We detect 150×353 cross-correlation in B modes at high significance. We fit the single- and cross-frequency power spectra at frequencies ≥150  GHz to a lensed-ΛCDM model that includes dust and a possible contribution from inflationary gravitational waves (as parametrized by the tensor-to-scalar ratio r), using a prior on the frequency spectral behavior of polarized dust emission from previous Planck analysis of other regions of the sky. We find strong evidence for dust and no statistically significant evidence for tensor modes. We probe various model variations and extensions, including adding a synchrotron component in combination with lower frequency data, and find that these make little difference to the r constraint. Finally, we present an alternative analysis which is similar to a map-based cleaning of the dust contribution, and show that this gives similar constraints. The final result is expressed as a likelihood curve for r, and yields an upper limit r_{0.05}<0.12 at 95% confidence. Marginalizing over dust and r, lensing B modes are detected at 7.0σ significance.

Uptake of breast screening and associated factors among Hong Kong women aged ≥50 years: a population-based survey

OBJECTIVE

To examine the uptake of breast screening and its associated factors among Hong Kong Chinese women aged ≥50 years.

STUDY DESIGN

Cross-sectional population-based survey.

METHODS

A sample of Hong Kong Chinese women was recruited through telephone random-digit dialling. The survey consisted of six sections: perceived health status, use of complementary medicine, uptake of breast screening, perceived susceptibility to cancer, family history of cancer and demographic data. The factors associated with uptake of breast screening were analysed using logistic regression analysis.

RESULTS

In total, 1002 women completed the (anonymous) telephone survey. The mean age was 63.5 (standard deviation 10.6) years. The uptake rate of breast screening among Hong Kong Chinese women aged ≥50 years was 34%. The primary reasons for undertaking breast screening were as part of a regular medical check-up (74%), prompted by local signs and symptoms (11%) and a physician's recommendation (7%). Higher educational level, married or cohabiting, family history of cancer, frequent use of complementary therapies, regular visits to a doctor or Chinese herbalist, and the recommendation of a health professional were all independently and significantly associated with increased odds of having had a mammogram.

CONCLUSIONS

This study provides community-based evidence of the need for public health policy to promote broader use of mammography services among this target population, with emphasis on the active involvement of health care professionals, through the development and implementation of appropriate evidence-based and resource-sensitive strategies.

Detection of B-mode polarization at degree angular scales by BICEP2

We report results from the BICEP2 experiment, a cosmic microwave background (CMB) polarimeter specifically designed to search for the signal of inflationary gravitational waves in the B-mode power spectrum around ℓ∼80. The telescope comprised a 26 cm aperture all-cold refracting optical system equipped with a focal plane of 512 antenna coupled transition edge sensor 150 GHz bolometers each with temperature sensitivity of ≈300  μK(CMB)√s. BICEP2 observed from the South Pole for three seasons from 2010 to 2012. A low-foreground region of sky with an effective area of 380 square deg was observed to a depth of 87 nK deg in Stokes Q and U. In this paper we describe the observations, data reduction, maps, simulations, and results. We find an excess of B-mode power over the base lensed-ΛCDM expectation in the range 30 < ℓ < 150, inconsistent with the null hypothesis at a significance of >5σ. Through jackknife tests and simulations based on detailed calibration measurements we show that systematic contamination is much smaller than the observed excess. Cross correlating against WMAP 23 GHz maps we find that Galactic synchrotron makes a negligible contribution to the observed signal. We also examine a number of available models of polarized dust emission and find that at their default parameter values they predict power ∼(5-10)× smaller than the observed excess signal (with no significant cross-correlation with our maps). However, these models are not sufficiently constrained by external public data to exclude the possibility of dust emission bright enough to explain the entire excess signal. Cross correlating BICEP2 against 100 GHz maps from the BICEP1 experiment, the excess signal is confirmed with 3σ significance and its spectral index is found to be consistent with that of the CMB, disfavoring dust at 1.7σ. The observed B-mode power spectrum is well fit by a lensed-ΛCDM+tensor theoretical model with tensor-to-scalar ratio r = 0.20_(-0.05)(+0.07), with r = 0 disfavored at 7.0σ. Accounting for the contribution of foreground, dust will shift this value downward by an amount which will be better constrained with upcoming data sets.

Dispositional study of opioids in mice pretreated with sympathomimetic agents

Brain and plasma levels of morphine and codeine were determined by an assay method involving solid-phase extraction and ion-pair reversed phase HPLC. Detection was by a variable wavelength UV-detector (for codeine) and an amperometric electrochemical detector (for morphine) coupled in series. Ephedrine or phenylpropanolamine pretreatment did not interfere with the plasma disposition of morphine, evidenced by overlapping plasma concentration-time profiles. Brain opioid levels were equally unaffected by sympathomimetic pretreatment. The relative ratios of brain to plasma concentrations at the time corresponding to the respective peak anti-nociceptive activity for morphine and codeine revealed no significant differences. It is concluded that single doses of ephedrine and phenylpropanolamine do not affect the disposition of morphine and codeine in mice.

BRCA mutation in Chinese population: results from the Hong Kong hereditary and high risk breast cancer programme (HRBCP) and the Hong Kong hereditary and high risk breast cancer family registry

Abstract #3097

Background: Little is known about the frequency and spectrum of BRCA 1/2 mutations among Chinese population. Previous research suggests possible differences in the prevalence and penetrance of inherited mutations in these genes among Asians and the earlier presentation of breast cancer in Asian population may have more relevance to genetic causes. The access to genetic counseling and testing in Asia have been limited. The HRBCP (www.HRBCP.org) was established in 2007. This is first in Hong Kong and provides genetic testing, counseling and research on the spectrum of the disease in Asia and in particular Chinese population. The data from this programme will be entered in the newly established The Hong Kong Hereditary Breast Cancer Family Registry.&#x2028; Methods: Probands who were diagnosed to have breast cancer age 50 or below, have a family history or personal history of breast and/or ovarian cancer, bilateral breast cancer, male breast cancer, triple negative breast carcinoma were recruited. Genetic counseling were given and consent for testing were obtained. Blood and tumor samples were collected. The entire coding regions of the extracted DNA/RNA and flanking introns of BRCA1 and 2 were screened for germline mutations using full gene sequencing and MLPA.&#x2028; Results: A total of 119 Chinese have been sequenced and analysed. 21 (18%) deleterious mutations were identified of which 4 were novel mutations. 8 (38%) were BRCA 1 mutations and 13 (62%) were BRCA 2 mutations. 66.6% had first degree relatives with breast cancer. 49 (41.2%) were under the age of 40 years old of which 11 (22%) were found to carry a BRCA mutation. 7 (64%) of this younger age group with mutation have family history of breast cancer. For the other 4, 1 had triple negative cancer, 1 had a family history of ovarian cancer, 1 unknown and 1 with no risk except for young age. Of the 37 family members tested, 21 (57%) have BRCA mutations and only 9 of them have breast or ovarian cancers. 1 only had stomach cancer. 6 male family members were found to carry the BRCA mutation with no history of cancer.&#x2028; Conclusions: Approximately 18% of the tested blood samples from clinically high risk Chinese women carry a deleterious mutation in BRCA1 or 2. In contrast to Caucasian data, there was a comparative higher rate of BRCA2 mutations. Further research on the spectrum of the mutations in Chinese and other Asian population will allow the tailor-making of an ethnic-based risk assessment model and also screening, prophylactic and preventative measures to be taken.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3097.

Ablation of paternal accessory sex glands imparts physical and behavioural abnormalities to the progeny: an in vivo study in the golden hamster

The functional significance of male accessory sex glands (ASG) remains unclear. This study explored their importance in reproduction. In previous investigations, embryos sired by males with ASG either totally or partially removed had a shift in the cell cycle and delayed cleavage during preimplantation development, higher incidence of apoptosis, early oviductal-uterine transit, higher proportion of embryo degeneration, lower implantation rate, and ultimately reduced fertility and fecundity. Some pups were born alive; but would they be normal? We hypothesized that the first generation offspring (F1) could also bear undesirable traits. To test our hypothesis, we raised and studied these F1 pups from birth to 8 weeks. We monitored physical growth and assessed behaviour such as nest patch odor preference, acoustic startle response (ASR) and exploratory activity. We detected deviations from the norm in physical growth, a premature cessation of nest patch odor preferences, accelerated acoustic startle habituation and more frequent rearing when exposed to a novel environment. In terms of structure, we found one incidence of diphallus with duplicated urethra. We concluded that sperm lacking contact with ASG secretions gave rise to progeny with abnormal traits.

Two-dimensional biosensor arrays based on surface plasmon resonance phase imaging

We present a biosensor design based on capturing the two-dimensional (2D) phase image of surface plasmon resonance (SPR). This 2D SPR imaging technique may enable parallel label-free detection of multiple analytes and is compatible with the microarray chip platform. This system uses our previously reported differential phase measurement approach, in which 2D phase maps obtained from the signal (P) and reference (S) polarizations are compared pixel by pixel. This technique greatly improves detection resolution as the subtraction step can eliminate measurement fluctuations caused by external disturbances as they essentially appear in both channels. Unlike conventional angular SPR systems, in which illumination from a range of angles must be used, phase measurement requires illumination from only one angle, thus making it well suited for 2D measurement. Also, phase-stepping introduced from a moving mirror provides the necessary modulation for accurate detection of the phase. In light of the rapidly increasing need for fast real-time detection, quantification, and identification of a range of proteins for various biomedical applications, our 2D SPR phase imaging technique should hold a promising future in the medical device market.

Application of two-dimensional spectral surface plasmon resonance to imaging of pressure distribution in elastohydrodynamic lubricant films

What we believe to be a novel two-dimensional spectral surface plasmon resonance imaging technique determining pressure distribution in elastohydrodynamic lubricant films is presented. This technique makes use of the spectral characteristics associated with the surface plasmon resonance (SPR) effect, and it provides more spectral information in refractive index mapping than conventional contrast SPR imaging. Two-dimensional imaging is demonstrated and applied to a highly pressurized liquid lubricant trapped inside an elastohydrodynamic lubrication (EHL) dimple. The hydrostatic pressure inside the EHL dimple causes a localized change of the refractive index of the lubrication oil. This also results in a shift in the spectral SPR absorption dip. By monitoring the color changes within the SPR image and calibrating with lubricants of known refractive index profiles, we can obtain a direct measurement of the refractive index distribution within the EHL dimple. PB 2400 lubricant dimples were studied in our experiments. The proposed SPR imaging approach is irrespective of the absolute lubricant film thickness h, therefore overcoming the major limitations of a conventional optical interference technique. With further development of the two-dimensional refractive index mapping technique, widespread applications in various fields are possible, including high-throughput sensors and the detection of bioaffinity interactions.

Hirschsprung's disease: the Australian Paediatric Surveillance Unit's experience

Hirschsprung's disease (HD) was introduced into the Australian Paediatric Surveillance Unit (APSU) system in 1996 with the objective to collect data on demographics, incidence, family history, associated anomalies, clinical features, investigation, and surgical treatment in Australia. Children under 15 years of age with HD (confirmed by biopsy) were entered into a database maintained at The Children's Hospital at Westmead in Sydney. Nationwide, 127 children with HD were reported from January 1997 to December 2000, and near-complete information was available on 126. Neonatal presentation was seen in 114 cases (90%), whereas 12 (10%) presented post-neonatally. There was a history of delayed passage of meconium (more than 24 h) in 65 of the 114 patients (57%) who presented in the neonatal period. In those presenting post-neonatally there was no history of delayed passage of meconium. Primary pull-through was performed in 42 of the 82 patients (51%) operated upon. The Soave procedure was performed in 53 of the total 82 (65%) operations and 29 of 42(69%) primary pull-through operations. Pre-operative enterocolitis was seen in 15 of 126 (12%) and postoperative enterocolitis in 17 of 82 (21%) children. The majority of children with HD are diagnosed in the neonatal period (90%). Primary pull-through is becoming more popular (51%). The Soave procedure is the most commonly performed operation (65%) in Australia. Pre- and post-operative enterocolitis is still a significant problem.

Papuloerythroderma of Ofuji associated with acute myeloid leukaemia

Papuloerythroderma of Ofuji (PEO) is an uncommon skin condition most commonly described in Japan. The aetiology of PEO is unknown and treatment may be difficult. There are several reports of an association between PEO and malignancy, most particularly with T-and B-cell lymphomas. We describe PEO complicated by acute myeloid leukaemia occurring in a 62-year-old man. This association has not been reported previously.

Environmental Noise and Community in Hong Kong

In order to find out the attitude of the community towards environmental noise, community surveys were conducted over the territory of Hong Kong through telephone sampling. Specific surveys were also carried out for areas previously affected by severe aircraft noise. Main observations on the community's response towards noise are that noise pollution was ranked the third among five selected social concerns (after "air pollution" and "security", and higher than "traffic jam" and "cleanliness"); about 60% of the respondents found the territory "noisy"; the most annoying noise source was "traffic noise"; 40% of people found the most annoying noise not tolerable and that most people affected by noise suffered from "distraction". Nonetheless, many did nothing (e.g. did not complain) against the noise and still preferred an open-window life style.

Industrial wastewater minimization using water pinch analysis: a case study on an old textile plant

Industrial wastewater minimization can be conducted using four main strategies: (i) reuse; (ii) regeneration-reuse; (iii) regeneration-recycling; and (iv) process changes. This study is concerned with (i) and (ii) to investigate the most suitable approach to wastewater minimization for an old textile industry plant. A systematic water networks design using water pinch analysis (WPA) was developed to minimize the water usage and wastewater generation for the textile plant. COD was chosen as the main parameter. An integrated design method has been applied, which brings the engineering insight using WPA that can determine the minimum flowrate of the water usage and then minimize the water consumption and wastewater generation as well. The overall result of this study shows that WPA has been effectively applied using both reuse and regeneration-reuse strategies for the old textile industry plant, and reduced the operating cost by 16% and 50% respectively.

A case series of six children with primary pulmonary hypertension

INTRODUCTION

Primary pulmonary hypertension is an uncommon but serious disease in children. Management is difficult despite recent advances in pharmacotherapy.

CLINICAL PICTURE

We reviewed patients with this condition with respect to their presenting symptoms, investigations, treatment and outcome.

TREATMENT

These children were treated with individualised combinations of oxygen, diuretics and calcium antagonists.

OUTCOME

In our follow-up of 5 children, 4 had died.

CONCLUSION

This condition is irreversible and progressive with a high mortality rate. A better understanding of, and research into, the pathogenesis would hopefully lead to the formulation of improved therapeutic strategies for this condition.

Cyclic strain induces proliferation of cultured embryonic heart cells

Embryonic heart cells undergo cyclic strain as the developing heart circulates blood to the embryo. Cyclic strain may have an important regulatory role in formation of the adult structure. This study examines the feasibility of a computerized cell-stretching device for applying strain to embryonic cardiocytes to allow measurement of the cellular response. A primary coculture of myocytes and a secondary culture of nonmyocytes from stage-31 (7 d) embryonic chick hearts were grown on collagen-coated membranes that were subsequently strained at 2 Hz to 20% maximal radial strain. After 24 h, total cell number increased by 37+/-6% in myocyte cocultures and by 26+/-6% in nonmyocyte cultures over unstrained controls. Lactate dehydrogenase and apoptosis assays showed no significant differences in cell viabilities between strained and unstrained cells. After 2 h strain, bromodeoxyuridine incorporation was 38+/-1.2% versus 19+/-0.2% (P < 0.01) in strained versus unstrained myocyte cocultures, and 35+/-2.1% versus 16+/-0.2% (P = 0.01) in nonmyocyte cultures. MF20 antibody labeling and periodic acid-Schiff (PAS) staining estimated the number of myocytes in strained wells as 50-67% larger than in control wells. Tyrosine phosphorylation may play a role in the cellular response to strain, as Western blot analysis showed an increase in tyrosine phosphorylation of two proteins with approximate molecular weights of 63 and 150 kDa within 2 min of strain. The results of this study indicate that embryonic chick cardiocytes can be cultured in an active mechanical environment without significant detachment and damage and that increased proliferation may be a primary response to strain.

Trabeculated embryonic myocardium shows rapid stress relaxation and non-quasi-linear viscoelastic behavior

Passive viscoelastic behavior is important in embryonic cardiovascular function, influencing the rate and magnitude of contraction and relaxation. We hypothesized that if viscoelastic behavior is influenced by interstitial fluid flow, then the stage-21 (312d) and stage-24 (4d) chick myocardium with large intertrabecular spaces will exhibit much different viscoelastic behavior than stage-16 (212d) and stage-18 (3d) compact myocardium and a non-quasi-linear response. Excised left ventricular sections were tested with ramp-and-hold stress relaxation tests at axial stretch ratios of 1.05:1.1:1.2:1.3. The measured stress relaxation was much more rapid than previously observed in the compact, non-trabeculated myocardium. The reduced relaxation curves depended significantly on the stretch level. A continuous-spectrum quasi-linear relaxation function described their shape well but the model-fit parameters also depended on the stretch level. Sinusoidal stretching of ventricular sections at rates from 0.2 to 25Hz showed that the steepening of stress-strain curves with increasing strain rate was half as much as predicted by a quasi-linear model. Hysteresis ranged from 25-35%, varied little with loading rate from 0.2 to 8Hz, and was twice that predicted from a quasi-linear model. Doubling the viscosity of the perfusate in stress-relaxation tests produced increased stiffness and decreased relaxation rate. These results demonstrate that the passive viscoelastic behavior of the trabeculated embryonic myocardium is markedly different from that of younger, compact myocardium and is not quasi-linear.

Population dynamics of the feral macaques in the Kowloon Hills of Hong Kong

Hong Kong's feral monkey population is controversial. Many people complain about the aggressiveness of the monkeys, while some conservationists urge the government to deal with the problem in a way that will not harm the monkeys. The population dynamics of the macaques in the Kowloon Hills were studied in 1992 and 1993. Vital statistics are provided from this study as a first step in resolving the problems of human provisioning and wildlife management. It is unlikely that these macaques are indigenous to the area. They are the descendents of macaques that were released in the early twentieth century to control the spread of a local poisonous plant, the strychnos, which contains alkaloids poisonous to livestock and humans but which is a favorite food of the macaques. The macaque population expanded dramatically during the 1980s. The census method employed in this study is direct head count and photo-identification. At the end of 1993, the estimated abundance was 690 (+/-6) in eight social groups in the Kowloon Hills. Species found were rhesus (Macaca mulatta) 65.3%, longtailed (M. fascicularis) 2.2%, Tibetan (M. thibetana) 0.2%, and hybrids 32.3%. The overall home ranges occupied 2.15 km2, resulting in a very high macaque density of 326 per km2. The birth rates were 56.9% and 69.4% in 1992 and 1993, respectively. Mean adult sex ratio (M:F) was 1:2.2 for social groups and 1:1.6 including all peripheral males. The main mortality factor was road accidents and these contributed to the "missing rate" of 9.8% and 10.6% in 1992 and 1993, respectively. Population growth was 5.6% in 1992 and 7.8% in 1993. The estimated macaque population in the year 2000 will be around 1,100 if conditions remain favorable. Management strategies are recommended.

Effects of a histamine H2 receptor agonist and antagonist on restraint-induced antinociception in female mice

Restraint for 1 h induced significant antinociceptive activity, as assessed by the hot plate test, in female mice. The antinociceptive activity was significant throughout the 1 h period of observation starting immediately after restraint. Prior administration of the histamine H2 receptor agonist dimaprit (1.5-6.0 mg/kg s.c.) 15 min before restraint further enhanced the restraint-induced antinociceptive activity. Furthermore, the induction of antinociceptive activity by restraint was antagonised by prior administration of histamine H2 receptor antagonists, cimetidine (2.5-10.0 mg/kg s.c.) or zolantidine (2.5-10.0 mg/kg s.c.). However, when these drugs were administered immediately after restraint for 1 h, the antinociceptive activity observed was similar to those restrained animals receiving saline injection. The histamine receptor agonist and antagonists, at the doses used in the present study, did not affect the response of unrestrained animals to the hot plate test. These results demonstrate that the effect of a histamine H2 receptor agonist and antagonists on restraint-induced antinociception is dependent upon their time of administration and may act by altering the intensity of stress, thus affecting the antinociceptive activity induced.

The involvement of opioid delta receptor in restraint-induced antinociception in mice

Restraint for 1 h induced significant antinociceptive activity in both male and female mice. The restraint animals all showed an increase in response time to the hot plate test at 55 degrees C. The antinociceptive activity decreased with time after restraint but was still apparent at 1 h post restraint. In the male animals, prior administration of opioid delta receptor antagonist naltrindole (0.5-2.0 mg/kg s.c.) 15 min before restraint for 1 h did not affect the degree of antinociceptive activity induced by restraint. In addition, the same doses of naltrindole administered s.c. immediately after restraint for 1 h also did not affect the degree of antinociceptive activity in male mice. However, for female mice the same doses of naltrindole administered s.c. before restraint dose-dependently suppressed the antinociceptive activity induced by restraint. When administered immediately after restraint for 1 h, naltrindole also reversed the antinociceptive activity in female mice. The response times measured 10 min after restraint were significantly reduced when compared with the saline restraint controls. It is concluded that restraint can induce antinociceptive activity in mice; however, different mechanisms may be involved in the antinociception observed. In male mice the endogenous opioid systems did not seem to play a significant role in restraint-induced antinociception, whereas for female animals blockade of opioid delta receptors greatly diminished the antinociception observed after restraint.

The involvement of histamine H2-receptors in restraint-induced antinociception in male mice

Restraint for 1 h induced significant antinociceptive activity in male mice assessed by the hot-plate test at 55 degrees C. The antinociceptive activity was significant throughout the 1-h period of observation. Prior administration of the histamine H2-receptor agonist dimaprit further enhanced the antinociceptive activity. Furthermore, the induction of antinociception by restraint was antagonized by prior administration of the histamine H2-receptor blocker cimetidine. Similar findings were obtained with another histamine H2-receptor blocker, zolantidine, which supposedly crosses the blood-brain barrier. On the other hand, prior administration of 2-pyridylethylamine, a histamine H1-receptor agonist, or mepyramine, a histamine H1-receptor antagonist, did not affect the development of antinociceptive activity induced by restraint. The doses of histamine receptor agonists and antagonists used in the present study had no effect on the hot-plate response of non-restraint control animals. These results suggest that histamine H2-receptors may be involved in the restraint-induced antinociceptive activity in mice.

Further metabolic studies of codeine and morphine in mice pretreated with sympathomimetics

The effects of ephedrine and phenylpropanolamine (PPA) on the 24 h urinary excretion of morphine, codeine and their metabolites, and on the plasma and brain disposition of morphine and codeine at steady state in mice were studied. Morphine-3-glucuronide was the major urinary metabolite in morphine treated animals, while for codeine treated animals norcodeine and morphine-3-glucuronide were the major metabolites. In all cases percentage of drug excreted unchanged was 10-15% of the administered dose. Ephedrine or PPA pretreatment had no apparent effect on these parameters. The metabolic ratios for the different pathways were comparable in all treatment groups. Steady-state plasma and brain concentration-time profiles of codeine and morphine also showed marked similarity in all treatment groups. Apparently, ephedrine or PPA pretreatment has no effect on the disposition of morphine and codeine in mice. The results are discussed from the perspective of our earlier findings of dependence on cough mixtures containing opioids and sympathomimetics.

The effect of naloxone on restraint-induced antinociception in mice

Restraint for a period from 15-60 min induced significant antinociceptive effect in both male and female mice. The restraint animals all showed an increase in response time to the hot plate test at 55 degrees C. The antinociceptive activity was still apparent one hour after restraint. In the male animals, prior administration of naloxone s.c. 15 min before restraint for 60 min did not affect the degree of antinociceptive activity induced by restraint. In addition, naloxone administered s.c. immediately after restraint for 60 min also did not affect the degree of antinociceptive activity in male mice. These findings indicate that in male animals the endogenous opioid mechanism is most likely not involved in the restraint-induced antinociception. However, for the female mice naloxone administered s.c. either before or immediately after restraint for 60 min dose-dependently suppressed the antinociceptive activity induced by restraint. It is concluded that restraint can induce antinociceptive activity in mice; however, different mechanisms may be involved in the antinociception observed. In male mice the endogenous opioid systems do not seem to play a significant role in restraint-induced antinociception, while for female animals blockade of opioid receptors would greatly diminish the antinociception observed after restraint.

Reconstituted thiopentone retains its alkalinity without bacterial contamination for up to four weeks

The manufacturers of thiopentone recommend that after reconstitution, it should be kept only for 24 hr to reduce the risk of contamination. However, there are no studies to support this practice and compliance with this recommendation has economic implications. The reasons for discarding a reconstituted bottle of thiopentone are related to concerns about chemical and physical (pH) stability, contamination with infectious agents, and contamination with cellular material. We studied the incidence of bacterial contamination and pH stability of thiopentone in clinical use, as well as the pH stability of thiopentone not in clinical use, and surveyed the eight hospitals affiliated with the University of British Columbia to determine their protocols for thiopental preparation and storage. Cost comparisons were made between our current practice of discarding thiopentone when depleted and the practice of routinely discarding it 24 hr after reconstitution. Samples of thiopentone in clinical use were cultured daily and the pH was measured. The bottles had been in clinical use from 1 to 25 days (mean 4.23 +/- 4.32 SD). Of 106 samples there were no positive bacteriological cultures and there were only minor changes in pH. The telephone survey of the eight hospitals revealed that only one had a policy to discard thiopentone after 24 hr. Cost comparisons indicate that discarding thiopentone 24 hr after reconstitution would result in increased cost. In conclusion, reconstituted thiopentone retains its alkalinity for up to four weeks, and has an acceptably low risk of bacterial contamination for periods beyond 24 hr, therefore thiopentone need not be discarded after 24 hr.

The disposition of antituberculous drugs in plasma of elderly patients. II. Isoniazid, rifampicin and pyrazinamide

The pharmacokinetics of isoniazid (INH), rifampicin (RIF) and pyrazinamide (PZA) were studied in 18 elderly patients (67-89 years of age) and 19 young adult patients (19-59 years of age) on the first day and at one month of treatment for pulmonary tuberculosis. Elderly patients exhibited more side effects but there were no age-related changes in the pharmacokinetics of any of the three drugs when used in this combination. The clearance for INH and RIF at steady-state were significantly lower than after first-dose, while that of PZA remained unchanged. At steady-state the clearances for INH and RIF were not characteristic of polymorphic metabolism and auto-enzyme induction, respectively. Elderly patients are more sensitive to antituberculous (anti-TB) drugs; therefore, a modification in the dosage for this patient group should be considered.