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Multi-cohort analysis identifying core ocular surface microbiome and bacterial alterations in eye diseases
No full textPurpose: Inconsistency exists among reported studies on the composition of human ocular surface microbiome (OSM). The roles of OSM in ocular diseases remain uncertain. In this study, we aimed to determine the composition of OSM and to evaluate its potential roles and functions from multiple cohorts. Methods: Raw 16 s sequencing data were obtainable from publicly available repositories, sourced from 17 published studies. Employing a standardized method, we processed the data and conducted a cross-cohort analysis. Through bioinformatics pipelines QIIME2 and PICRUSt2, we processed a total of 1875 ocular surface samples. Core microbiome analyses, genera comparisons, and MetaCyc pathway analyses were performed within each cohort independently. The results were then combined to identify shared patterns across different datasets. Results: The core OSM comprised seven genera: Corynebacterium, Staphylococcus, Acinetobacter, Streptococcus, Pseudomonas, Cutibacterium and Bacillus. Corynebacterium and Staphylococcus are the most abundant genera on ocular surface. Most ocular diseases showed OSM alterations and eight genera demonstrated a non-specific, shared response among two or more ocular diseases. Moreover, changes in various metabolic pathways were predicted following OSM alteration, indicating potential roles of OSM in biological processes. Conclusion: We refined the core OSM candidates combining multiple cohorts. The common pattern shared by different cohorts is worth further investigation. Changes in metabolic pathways based on bioinformatic analysis indicated a role of OSM on ocular diseases. Our results help extend the knowledge and encourage further investigations on the associations between OSM and ocular diseases
Clinical Implications of Pseudomonas Aeruginosa Colonization in Chronic Obstructive Pulmonary Disease Patients
No full textConsensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma
No full textBackground: Muscle-invasive and advanced urothelial carcinoma (UC) are notorious for their high propensity for recurrence and metastasis. Recent advances in novel medications, surgical procedures, and radiotherapy techniques have substantially transformed the treatment landscape of muscle-invasive and advanced UC. It is crucial to navigate the optimal management approaches for muscle-invasive and advanced UC through the increasingly complex matrix of variables.Methods: Two professional organisations convened a consensus panel of six urologists and six clinical oncologists with extensive experience in treating urological malignancies. They reviewed the literature on the management of i) non-metastatic, muscle-invasive, and locally advanced UC of the bladder; ii) locally advanced upper tract UC (UTUC); and iii) unresectable locally advanced or metastatic UC (mUC). The panel held multiple meetings to discuss and draft consensus statements using the modified Delphi method. Each drafted statement was anonymously voted on by every panellist. A consensus statement was accepted if ≥ 80% of the panellists chose ‘accept completely’ or ‘accept with some reservation’ from the five options, which also included ‘accept with major reservation’, ‘reject with reservation’, and ‘reject completely’.Results: The panel reached a consensus on 63 statements based on current evidence and expert insights. These statements addressed the considerations for different treatment modalities, including surgical approaches, radiotherapy, radiosensitisers, platinum-based chemotherapy, immune checkpoint inhibitors, and antibody–drug conjugates, in the management of different disease entities, including muscle-invasive UC of the bladder, cN1 disease, locally advanced UTUC, unresectable locally advanced/mUC, and oligometastatic bladder cancer.Conclusion: These consensus statements are anticipated to serve as a practical recommendation for clinicians in Hong Kong, and possibly the Asia-Pacific region, regarding the management of muscle-invasive and advanced UC.</p
Language rights and publication practices and in aphasia research: lessons learned from developing aphasia assessments in multiple languages
Get PDFBackgroundAlthough people with aphasia should receive rehabilitation services on an equal basis to others, irrespective of their cultural and linguistic backgrounds, the current research on aphasia does not adequately reflect the diversity of cultures and languages worldwide.AimsThis paper aims to discuss language rights and the impact of giving preference to publishing aphasia research and clinical resources in English. We present an example of researchers adapting an aphasia assessment, the Comprehensive Aphasia Test (CAT), to diverse languages and cultures as a lens for language rights.Methods & ProceduresThe paper discusses the language rights of people with aphasia regarding language of assessment and intervention. To provide a concrete lens on the fulfilment of language rights in publishing aphasia assessments, a survey was designed to examine the experiences of researchers adapting the CAT to diverse languages and cultures. The survey comprised ten questions about their adaptation experiences from the initial language selection to the time of publication. The survey results are discussed in terms of linguistic justice.Outcomes & ResultsWe obtained responses from eight languages to which the CAT has been adapted (Norwegian, Catalan, Spanish, Mandarin, Swedish, Turkish, Cantonese Chinese, and Croatian). Most CAT adaptations were driven by the pressing need to develop assessments in a primary or widely spoken language. The timeline of the adaptation process shows the complexity and time-consuming task of adapting aphasia assessments. Major challenges to the adaptation process include funding, lack of publisher guidelines, and the existence of databases with specific linguistic features.ConclusionsThere is a pressing need to address barriers to equal access to aphasia evidence. International collaborations are attempting to address the lack of a worldwide clinical and research workforce in aphasia, however structural barriers to research dissemination and publishing in diverse languages must be urgently addressed to realise language rights in aphasiology.published_or_final_versio
Measuring digital literacy across ages and over time: Development and validation of a performance-based assessment
Get PDFMeasuring digital literacy (DL) across ages and tracking its growth over time have remained challenging in the area of digital literacy assessment. The current analysis reports on the psychometric properties of a performance-based Digital Literacy Assessment (DLA) instrument grounded in the DigComp 2.1 framework. Utilising a longitudinal cohort study design, the DLA was administered to Hong Kong students across three age cohorts, from lower primary to upper secondary, over a two-year period. Data were collected in 2019, before the COVID-19 pandemic, and in 2021, during the pandemic. The analysis provides validity and reliability evidence for using the DLA in longitudinal studies to assess DL from late childhood through late adolescence. The results further suggest that students’ DL improved with grade level, with secondary students outperforming primary students but also displaying greater variability in scores. Over the two years, students generally demonstrated improvement in DL while inter-individual differences in DL growth rates widened. These findings indicate the widening of digital divides and highlight the need to investigate factors that contribute to diversity in DL development. In conclusion, our study provides evidence for the robustness of the DLA as an instrument to assess DL growth across ages and over time. Further, the DLA allowed us to uncover the substantial overlap in DL ability across different age groups and the widening second-level digital divide as children move into higher grades, and that the digital divide aggravated during the COVID-19 pandemic. Implications and challenges to the learning and assessment of DL are discussed.published_or_final_versio
Nanoscale bismuth infused bioadhesive gelatin methacryloyl electrospun mats demonstrate excellent antibiofilm activity and biocompatibility
No full textPeriodontal diseases affect a large portion of the global population, imposing significant health and economic burdens. Traditional treatments, including antibiotics, face challenges like antibiotic resistance and rapid clearance from target sites. The study addresses these issues using nanoscale antimicrobial bismuth nanoparticles (BiNPs) delivered through electrospun gelatin methacryloyl (GelMA) nanofibrous mats. BiNPs were synthesized via a rapid chemical reduction process, yielding particles with an average size of 30 nm and a stable surface charge of −18 mV. These nanoparticles were incorporated into GelMA fibers through electrospinning and characterized using techniques such as scanning electron microscopy and Fourier transform infrared spectroscopy. The GelMA fibers exhibited a uniform morphology with a diameter of 414 nm, controlled degradation, and sustained BiNPs release. Adhesion to soft tissue was measured at ∼3 N, and the fibers maintained their mechanical strength after BiNPs incorporation. The BiNPs-loaded mats demonstrated potent antimicrobial activity, killing 100 % of Porphyromonas gingivalis, a key periodontal pathogen. Biocompatibility tests with periodontal ligament stem cells confirmed no significant cytotoxicity. This study highlights BiNPs-infused GelMA nanofibrous mats as a promising localized treatment for periodontal diseases, offering sustained antimicrobial activity, and biocompatibility.</p
Integrating brain imaging features and genomic profiles for the subtyping of major depression
No full textBackground Precise stratification of patients into homogeneous disease subgroups could address the heterogeneity of phenotypes and enhance understanding of the pathophysiology underlying specific subtypes. Existing literature on subtyping patients with major depressive disorder (MDD) mainly utilized clinical features only. Genomic and imaging data may improve subtyping, but advanced methods are required due to the high dimensionality of features. Methods We propose a novel disease subtyping framework for MDD by integrating brain structural features, genotype-predicted expression levels in brain tissues, and clinical features. Using a multi-view biclustering approach, we classify patients into clinically and biologically homogeneous subgroups. Additionally, we propose approaches to identify causally relevant genes for clustering. Results We verified the reliability of the subtyping model by internal and external validation. High prediction strengths (PS) (average PS: 0.896, minimum: 0.854), a measure of generalizability of the derived clusters in independent datasets, support the validity of our approach. External validation using patient outcome variables (treatment response and hospitalization risks) confirmed the clinical relevance of the identified subgroups. Furthermore, subtype-defining genes overlapped with known susceptibility genes for MDD and were involved in relevant biological pathways. In addition, drug repositioning analysis based on these genes prioritized promising candidates for subtype-specific treatments. Conclusions Our approach successfully stratified MDD patients into subgroups with distinct clinical prognoses. The identification of biologically and clinically meaningful subtypes may enable more personalized treatment strategies. This study also provides a framework for disease subtyping that can be extended to other complex disorders
The Myositis Clinical Trials Consortium: an international collaborative initiative to promote clinical trials in adult and juvenile myositis
No full textIdiopathic inflammatory myopathies (IIM), or myositis, are a heterogeneous group of systemic autoimmune disorders that are associated with significant morbidity and mortality. Conducting high-quality clinical trials in IIM is challenging due to the rare and variable presentations of disease. To address this challenge, the Myositis Clinical Trials Consortium (MCTC) was formed. MCTC is a collaborative international alliance dedicated to facilitating, promoting, coordinating and conducting clinical trials and related research in IIM. This partnership works to advance the discovery of effective evidence-based treatments for IIM by integrating a diverse group of clinical investigators, research professionals, medical centres, patient groups, and industry partners. The Steering Committee, Core Group, and Paediatric Subcommittee of MCTC are comprised of myositis experts and junior investigators from around the world, representing a diversity of genders, geographies, and subspecialties. MCTC works alongside other current myositis organisations to complement existing work by concentrating on the operationalisation of clinical trials. Our pilot Myositis Investigators’ Information Survey gathered responses from 173 myositis investigators globally and found considerable variability in proficiency with outcome measures, geographic disparities in patient recruitment, and a significant disconnect between investigators’ routine myositis patient load and clinical trial enrolment. MCTC will meet the need to support and diversify myositis clinical trials by facilitating trial planning, feasibility assessments, site selection, and the training and mentoring of junior investigators/centres to establish their readiness for clinical trial participation. Through experienced leadership, strategic collaborations, and interdisciplinary discussions, MCTC will establish standards for IIM clinical trial design, protocols, and outcome measures in myositis.</p
Detection and characterisation of high pathogenicity avian influenza virus (H5N1/H5N8) clade 2.3.4.4b, Hong Kong SAR, China, 2021 to 2024
No full textWe isolated three genotypes of highly pathogenic avian influenza virus (HPAIV) clade 2.3.4.4b from wild birds infected with H5N1 (n=12) and H5N8 (n=1) in Hong Kong SAR, 2021–2024. Viruses from two spoonbills from late 2022 were genetically related to a virus from a human in China. Four tested viruses exhibited variable virulence in mice but were susceptible to approved antivirals. No neutralising antibody was detected in 63 age-stratified human sera, suggesting potential risk should the virus adapt to humans
Using positive imagination to reduce negativity in information processing and hesitant attitudes towards childhood COVID‐19 vaccinations in parents: A randomized controlled trial
No full textObjectives: We aim to investigate the impact of negative information processing on parental vaccine hesitancy in Hong Kong and design an intervention to reduce negativity in pandemic and vaccine-related information processing.Design: Six hundred and forty-seven parents were recruited for baseline assessment. One week later, participants were randomly assigned to either the positive imagination simulation (PIS) intervention group or the neutral recall simulation (NRS) control group. Participants completed outcome assessments immediately and 2 weeks after the intervention.Methods: We first examined whether affective response to pandemic and vaccine-related news mediated the association between parents' distress and acceptance of childhood COVID-19 vaccination using baseline data. The PIS intervention leveraged positive psychology and personalized imagery techniques to enhance positive affect. To test intervention effectiveness, ANCOVAs were conducted to examine whether PIS versus NRS could reduce negative affective response to pandemic and vaccine-related news (immediate effect) and COVID-19 vaccine-hesitant attitudes (effect at the 2-week post-intervention point).Results: The baseline assessment showed that greater distress was linked to a more negative affective response to pandemic and vaccine-related news, which was associated with lower acceptance for childhood COVID-19 vaccination. The intervention positively impacted valence rating (F(1, 627) = 8.46, p = .004) and affective state rating (F(1, 627) = 4.88, p = .028) on pandemic and vaccine-related news. This improved positivity spilled over to significantly enhance parents' trust in COVID-19 vaccine-related information and alleviate their vaccine safety concerns 2 weeks post-intervention.Conclusions: Our study highlights the promising impact of positive affect priming in increasing positivity in information processing and, consequently, reducing vaccine-hesitant attitudes that are modifiable through positive information processing.</p