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Concept: Hong Kong

167

BACKGROUND: Patients with severe mental illness are at increased risk of developing metabolic disorders. The risk of metabolic syndrome in the Hong Kong general population is lower than that observed in western countries; however the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong is unknown. METHOD: This cross-sectional study aimed to estimate the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong and to identify the relationships between metabolic syndrome and socio-demographic, clinical and lifestyle factors. RESULTS: A total of 139 patients with a diagnosis of severe mental illness participated in the study. The unadjusted prevalence of metabolic syndrome was 35%. The relative risk of metabolic syndrome in comparison with the general Hong Kong population was 2.008 (95% CI 1.59-2.53, p < 0.001). In a logistic regression model sleep disruption and being prescribed first generation antipsychotics were significantly associated with the syndrome, whilst eating less than 3 portions of fruit/vegetables per day and being married were weakly associated. CONCLUSION: The results demonstrate that metabolic syndrome is highly prevalent and that physical health inequalities in patients with severe mental illness in Hong Kong are similar to those observed in western countries. The results provide sufficient evidence to support the need for intervention studies in this setting and reinforce the requirement to conduct regular physical health checks for all patients with severe mental illness.

Concepts: Health care, Regression analysis, Epidemiology, Nutrition, Medical statistics, Cross-sectional study, Mental illness, Hong Kong

164

During March 2013-February 24, 2017, annual epidemics of avian influenza A(H7N9) in China resulted in 1,258 avian influenza A(H7N9) virus infections in humans being reported to the World Health Organization (WHO) by the National Health and Family Planning Commission of China and other regional sources (1). During the first four epidemics, 88% of patients developed pneumonia, 68% were admitted to an intensive care unit, and 41% died (2). Candidate vaccine viruses (CVVs) were developed, and vaccine was manufactured based on representative viruses detected after the emergence of A(H7N9) virus in humans in 2013. During the ongoing fifth epidemic (beginning October 1, 2016),* 460 human infections with A(H7N9) virus have been reported, including 453 in mainland China, six associated with travel to mainland China from Hong Kong (four cases), Macao (one) and Taiwan (one), and one in an asymptomatic poultry worker in Macao (1). Although the clinical characteristics and risk factors for human infections do not appear to have changed (2,3), the reported human infections during the fifth epidemic represent a significant increase compared with the first four epidemics, which resulted in 135 (first epidemic), 320 (second), 226 (third), and 119 (fourth epidemic) human infections (2). Most human infections continue to result in severe respiratory illness and have been associated with poultry exposure. Although some limited human-to-human spread continues to be identified, no sustained human-to-human A(H7N9) transmission has been observed (2,3).

Concepts: Virus, Influenza, Avian influenza, People's Republic of China, Pandemic, Influenza vaccine, World Health Organization, Hong Kong

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Among all influenza viruses assessed using CDC’s Influenza Risk Assessment Tool (IRAT), the Asian lineage avian influenza A(H7N9) virus (Asian H7N9), first reported in China in March 2013,* is ranked as the influenza virus with the highest potential pandemic risk (1). During October 1, 2016-August 7, 2017, the National Health and Family Planning Commission of China; CDC, Taiwan; the Hong Kong Centre for Health Protection; and the Macao CDC reported 759 human infections with Asian H7N9 viruses, including 281 deaths, to the World Health Organization (WHO), making this the largest of the five epidemics of Asian H7N9 infections that have occurred since 2013 (Figure 1). This report summarizes new viral and epidemiologic features identified during the fifth epidemic of Asian H7N9 in China and summarizes ongoing measures to enhance pandemic preparedness. Infections in humans and poultry were reported from most areas of China, including provinces bordering other countries, indicating extensive, ongoing geographic spread. The risk to the general public is very low and most human infections were, and continue to be, associated with poultry exposure, especially at live bird markets in mainland China. Throughout the first four epidemics of Asian H7N9 infections, only low pathogenic avian influenza (LPAI) viruses were detected among human, poultry, and environmental specimens and samples. During the fifth epidemic, mutations were detected among some Asian H7N9 viruses, identifying the emergence of high pathogenic avian influenza (HPAI) viruses as well as viruses with reduced susceptibility to influenza antiviral medications recommended for treatment. Furthermore, the fifth-epidemic viruses diverged genetically into two separate lineages (Pearl River Delta lineage and Yangtze River Delta lineage), with Yangtze River Delta lineage viruses emerging as antigenically different compared with those from earlier epidemics. Because of its pandemic potential, candidate vaccine viruses (CVV) were produced in 2013 that have been used to make vaccines against Asian H7N9 viruses circulating at that time. CDC is working with partners to enhance surveillance for Asian H7N9 viruses in humans and poultry, to improve laboratory capability to detect and characterize H7N9 viruses, and to develop, test and distribute new CVV that could be used for vaccine production if a vaccine is needed.

Concepts: Infectious disease, Virus, Influenza, Avian influenza, Pandemic, Influenza vaccine, World Health Organization, Hong Kong

140

International Conference on Nanopore Technology (Shenzhen), 30 March-1 April 2017, Shenzhen, China The International Conference on Nanopore Technology (Shenzhen) was held from 30 March to 1 April 2017 in Shenzhen, China. The goal of the meeting was threefold: leverage the unique properties of nanopore technology to promote transformative advances in medicine, encourage cross-disciplinary collaborations in the research community within China and abroad; and discuss critical challenges that need to be addressed to rapidly advance the field. The meeting was chaired by Peixuan Guo, Endowed chair professor and Director of The Center for RNA Nanobiotechnology & Nanomedicine at The Ohio State University, USA and co-chaired by Xian-En Zhang, distinguished professor of the Institute of Biophysics, Chinese Academy of Sciences, China. The conference was attended by more than 300 academic researchers, hospital administrators, government leaders and scientists from many disciplines across the country from both academic institutions and industry.

Concepts: United States, Science, Management, University, Ohio, Hong Kong, Tenure, Ohio State University

45

Objective To assess the potential association between prenatal use of antidepressants and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring.Design Population based cohort study.Setting Data from the Hong Kong population based electronic medical records on the Clinical Data Analysis and Reporting System.Participants 190 618 children born in Hong Kong public hospitals between January 2001 and December 2009 and followed-up to December 2015.Main outcome measure Hazard ratio of maternal antidepressant use during pregnancy and ADHD in children aged 6 to 14 years, with an average follow-up time of 9.3 years (range 7.4-11.0 years).Results Among 190 618 children, 1252 had a mother who used prenatal antidepressants. 5659 children (3.0%) were given a diagnosis of ADHD or received treatment for ADHD. The crude hazard ratio of maternal antidepressant use during pregnancy was 2.26 (P<0.01) compared with non-use. After adjustment for potential confounding factors, including maternal psychiatric disorders and use of other psychiatric drugs, the adjusted hazard ratio was reduced to 1.39 (95% confidence interval 1.07 to 1.82, P=0.01). Likewise, similar results were observed when comparing children of mothers who had used antidepressants before pregnancy with those who were never users (1.76, 1.36 to 2.30, P<0.01). The risk of ADHD in the children of mothers with psychiatric disorders was higher compared with the children of mothers without psychiatric disorders even if the mothers had never used antidepressants (1.84, 1.54 to 2.18, P<0.01). All sensitivity analyses yielded similar results. Sibling matched analysis identified no significant difference in risk of ADHD in siblings exposed to antidepressants during gestation and those not exposed during gestation (0.54, 0.17 to 1.74, P=0.30).Conclusions The findings suggest that the association between prenatal use of antidepressants and risk of ADHD in offspring can be partially explained by confounding by indication of antidepressants. If there is a causal association, the size of the effect is probably smaller than that reported previously.

Concepts: Mental disorder, Antidepressant, Psychiatry, Mother, Psychiatric medication, Hong Kong

29

Recent taxonomic and molecular work on the eagle rays (Family Myliobatidae) revealed a cryptic species in the northwest Pacific. This species is formally described as Aetobatus narutobiei sp. nov. and compared to its congeners. Aetobatus narutobiei is found in eastern Vietnam, Hong Kong, China, Korea and southern Japan. It was previously considered to be conspecific with Aetobatus flagellum, but these species differ in size, structure of the NADH2 and CO1 genes, some morphological and meristic characters and colouration. Aetobatus narutobiei is particularly abundant in Ariake Bay in southern Japan where it is considered a pest species that predates heavily on farmed bivalve stocks and is culled annually as part of a ‘predator control’ program. The discovery of A. narutobiei highlights the paucity of detailed taxonomic research on this group of rays. This discovery impacts on current conservation assessments of A. flagellum and these need to be revised based on the findings of this study.

Concepts: Predation, China, People's Republic of China, Pacific Ocean, Hong Kong, Spotted eagle ray, Eagle ray, Myliobatidae

27

With the development of the Internet, Internet vigilantism (netilantism) has emerged as a new phenomenon in recent years. Although there are several qualitative studies explaining netilantism, there is little empirical research on public perceptions of netilantism. This article aims to outline Hong Kong university students' general perception of netilantism and investigate the differences between different roles in netilantism. By using empowerment theory as the theoretical framework, we will investigate whether Internet vigilantes (netilantes) (a) perceive the criminal justice system as effective, (b) possess high levels of self-efficacy in the cyber world, and © tend to believe netilantism can achieve social justice. Findings support the proposition that human flesh search engine is an empowerment tool for the netilante enabling him or her to achieve his goal of social justice. Different roles in netilantism (i.e., bystander, netilante, victim, and none of the above roles) have different perceptions of netilantism and the criminal justice system. The results will be explained by studying two representative cases of netilantism-the “Government Official Molestation” case and the “Cat Abuse in Shun Tin Village” case from China and Hong Kong, respectively.

Concepts: Scientific method, Understanding, Perception, Theory, Criminal justice, Chinese language, Hong Kong, Internet vigilantism

27

To estimate the prevalence of, and risk factors associated with, sexual dysfunction among Hong Kong Chinese married men aged 30-60 years.

Concepts: Sexual intercourse, Chinese language, Hong Kong, Cantonese people, Hong Kong people, Standard Mandarin, Teochew people, Bruce Lee

27

BACKGROUND:: Although the incidence rates of breast cancer have been increasing remarkably in Hong Kong over the last 2 decades, little is known on breast cancer screening practices among this group of women. OBJECTIVES:: This study aimed to report breast cancer screening practices among Hong Kong Chinese women and to examine the relationship between (1) demographic factors and (2) the modified Chinese Breast Cancer Screening Beliefs Questionnaire (CBCSB) score and women’s breast screening behaviors. METHODS:: A descriptive and cross-sectional method was used. Both English and Chinese versions of the modified CBCSB were administered. Of 946 Hong Kong Chinese women older than 18 years and invited to participate in the study, 753 (79.6%) completed and returned the questionnaire. RESULTS:: The majority of participants (70%-90%) had heard of breast self-examination (BSE), clinical breast examination (CBE), and mammograms. Only 33.3% performed a BSE monthly; 37.8% and 32.7% of women within the targeted age group had a CBE annually and had a mammogram every 2 years, respectively. Being married and part-time employment were positively associated with women who performed BSE as recommended. In terms of modified CBCSB score, women who had BSE, CBE, and mammogram as recommended had significantly higher scores on the subscale attitudes to health check-up. CONCLUSION:: Attitudes toward health check-up was influential in compliance with breast cancer screening practices among Chinese-Australian women. IMPLICATIONS FOR PRACTICE:: Effort should be focused on specific subgroups of Hong Kong Chinese women, to fully understand the barriers involved in participating in breast cancer screening practices.

Concepts: Cancer, Breast cancer, Oncology, Breast, Mammography, Hong Kong, Cantonese people, Breast self-examination

25

Skin appearance is influenced by biophysical parameters. Seasonal changes affect the condition of normal skin and may trigger cutaneous disorders.

Concepts: People's Republic of China, Skin, Guangdong, Guangzhou, Hong Kong, Beijing, Historical capitals of China, Sun Yat-sen University