Prevalence and associated factors of overweight in Chinese adolescents: A cross-sectional study.

Background and Aim: Obesity has been a global public health issue due to the increasing mortality rate and prevalence among children. However, there are scarce studies on obesity prevalence in Hong Kong children. The study aims to identify the risk factors of obesity among primary and secondary school students by assessing the relationship between sociodemographic factors, health-related behaviors, and social relationships. Methods: Self-administrated surveys were collected from 30 primary schools and 25 secondary schools participating in the "Quality Education Fund Thematic Network on Health Schools" project. Descriptive analysis was conducted to examine the proportions of different characteristics and to compare the disparity between primary and secondary school students with obesity. Results: A total of 4884 responses were collected. A larger proportion of primary school students with obesity were male (adjusted odds ratio [aOR]: 2.55, 95% confidence interval [CI]: 1.77-3.67, p < 0.001) and actively gamed (aOR: 1.64, 95% CI: 1.07-2.51, p = 0.024). Secondary school students with obesity were male (aOR: 1.61, 95% CI: 1.21-2.13, p = 0.001), had poor self-perceived academic performance (aOR:1.51, 95% CI: 1.10-2.08, p = 0.011) and expressed higher life satisfaction (family) (aOR: 1.13, 95% CI: 1.01-1.26, p = 0.032). There were negative associations found between obesity and physical activity, high consumption of sugary drinks, chocolate or candies, and insufficient consumption of vegetables. Conclusion: Male sex, physical inactivity, low self-perecived academic performance, and poor dietary behaviors were the risk factors for obesity among primary and secondary school students. The findings highlighted the importance of identifying younger individuals who were at risk of becoming clinically obese. Further studies should explore the effectiveness of various interventions through longitudinal study.

Factors associated with consuming unhealthy food in school children: A population-based study from Hong Kong.

Background and Aims: Unhealthy diets were found to be the main contributor to the overweight problem among adolescents. In this study, we aim to identify the factors causing unhealthy eating habits in adolescents. Methods: School-aged children and adolescents participated in this cross-sectional observational study with additional school and parental consent. A self-administered survey was conducted by 30 primary schools and 25 secondary schools. Participants were asked about the frequency of consuming unhealthy food and the types of unhealthy food consumed. A descriptive analysis was performed to demonstrate the proportions of characteristics. The prevalence of the outcome among participants of various factors was also analyzed using separate binary regression models. Results: A total of 4884 responses were collected. Among primary school students (grade 4, mean age: 10.06), people who (1) were actively gaining weight (aOR: 1.651, 95% CI 1.006-2.708, p = 0.047), (2) went to bed after 11 p.m. (aOR: 1.652, 95% CI 1.065-2.563, p = 0.025), (3) had more than 2 h of gaming (aOR: 2.833, 95% CI 1.913-4.195, p < 0.001), (4) suffered from self-report depressive symptoms (aOR: 1.753, 95% CI 1.233-2.493, p = 0.002) was more likely to consume unhealthy food. As for secondary school students (grade 3, mean age: 15.28), (1) males (aOR: 1.266, 95% CI 1.0004-1.601, p = 0.0496), (2) average-to-high socioeconomic status (Average: aOR: 1.471, 95% CI 1.115-1.941, p = 0.006; High: aOR: 2.253, 95% CI 1.585-3.202. p < 0.001), (3) having more than 2 h of gaming (aOR: 1.342, 95% CI 1.069-1.685, p = 0.011), (4) suffering from psychological distress (aOR: 1.395, 95% CI 1.051-1.852, p = 0.021) were associated with the increased odds of consuming unhealthy food. Conclusion: Several lifestyle and health factors were significantly associated with unhealthy eating behaviors in school-aged children and adolescents in Hong Kong, sharing similarities with many other countries. In conjunction with implementing a policy that addresses factors for unhealthy eating habits, further research should investigate potential interventions targeting these factors to ultimately tackle the overweight and obesity concern for children and adolescents in Hong Kong.

Factors associated with mental health among Hong Kong children: A population-based study of 4884 individuals.

BACKGROUND: This cross-sectional study aimed to investigate the association between negative mental health conditions and demographic characteristics, socioeconomic background and health-related parameters in both Hong Kong's primary and secondary school students. METHODS: A self-administrated survey was conducted and investigated the prevalence of negative mental health conditions (psychological stress, depression and suicidality) in students from 30 primary schools and 25 secondary schools in Hong Kong in 2017. The Kessler Psychological Distress Scale (K6) was chosen as the instrument to evaluate non-specific psychological distress. Depression was evaluated using the prolonged feeling of despair as a proxy. Suicidality was measured by four questions on whether they had ever intentionally injured themselves, seriously considered attempting suicide, planned how they would attempt suicide and had attempted suicide. Multiple logistic regression models examined the explanatory factors' association with mental health conditions after adjusting for confounding, using the enter method. RESULTS: A total of 4884 responses were collected. It is found that both very high and low parent expectations were risk factors for multiple conditions, namely suicidality and psychological distress among primary school students, and psychological distress among secondary school students. As for primary school students, the experience of being bullied was a significant risk factor for all conditions. A significant association was found between having one's own bedroom and suicidality amongst primary school students; whilst having three close friends or more and higher life satisfaction levels were significantly associated with a lower risk of negative mental health conditions among secondary school students. CONCLUSIONS: It was found that having one's own bedroom was a risk factor for suicidality among primary school student. Parents should be alert to the risky behaviours of children, have more involvement in children's daily life and build a supportive and caring family environment for children. For secondary school students, as the importance of friends is greatly increased, teachers should encourage students to engage in extra-curricular activities in school.

Associations between GoSmart Channel, health literacy and health behaviours in adolescents: A population-based study.

BACKGROUND: Health literacy is essential in the promotion of healthy lifestyle habits and chronic disease prevention. OBJECTIVE: To assess the health literacy level among Hong Kong adolescents; to evaluate the association between access of an online health information platform (GoSmart Channel) and health literacy level; and to examine the association between health literacy level and various unhealthy behaviours. DESIGN: This study recruited students from 10 local secondary schools in Hong Kong to assess the health literacy level among adolescents. SETTINGS AND PARTICIPANTS: Participants were required to complete a self-administered questionnaire on health behaviours and health literacy using the Health Literacy Measure for Adolescents (HELMA). MAIN OUTCOME MEASURE: Data were analysed using descriptive statistics and multivariate regression modelling. RESULTS: A total of 777 responses were collected. Overall, most (74.4%) of the adolescents in Hong Kong have limited health literacy (HELMA score <66). The majority (63.7%) of adolescents relied on their parents for health information, while 11.4% of the respondents sought information from the GoSmart Channel. The intervention of GoSmart Channel was significantly associated with better health literacy in almost all aspects among adolescents. Desired levels of health literacy were significantly associated with better perceived health (adjusted odds ratio: 2.04, p = .001) and negatively associated with a range of unhealthy and risky behaviours including unhealthy dietary habits, poor hygienic measures and physical inactivity. DISCUSSION AND CONCLUSION: This study highlights the importance of improving health literacy among Hong Kong adolescents and the potential of technology-based interventions. The findings suggest the need for continued efforts to promote health literacy and healthy behaviours among adolescents, especially given the limited health literacy levels observed in the study. PATIENT OR PUBLIC CONTRIBUTION: Members of the GoSmart.Net Built-on Project patient and public involvement and engagement group advised about survey development.

Factors associated with physical inactivity among the pre-school children: A cohort of 1681 participants.

AIM: To investigate the risk factors associated with physical inactivity of young children in Hong Kong. METHODS: This follow-up study was part of a prospective cohort study named Studying Impact of Nutrition on Growth (SING) initiated in 2015. Subjects were recruited from randomly selected local nurseries and kindergartens in Hong Kong. Self-administrated questionnaires were distributed to parents in 2016-2017 to collect information on: (i) socio-economic background; (ii) health-related factors, including gestation at time of birth, and hospitalisation of the child since birth; (iii) types of leisure activities, including time spent on electronic games and physical activity. RESULTS: A total of 1681 responses were collected. A higher likelihood of physical inactivity on weekdays was associated with being female, not being the firstborn, having been hospitalised three or more times since birth, and having physically inactive care givers. Meanwhile, children whose mother was unemployed/retired, and who spent more than 1 h on electronic games per day were significantly less likely to be physically inactive. Similarly, being female, being the secondborn or the thirdborn, and having a care giver with low physical activity level were associated with a higher chance of physical inactivity on weekends. CONCLUSIONS: Parental support could play a pivotal role in determining a child's physical activity level. Public health policies should be implemented to promote family-based physical activities.

Factors Associated with Vaccination Uptake among Young Children: A Follow-Up Study of 1799 Toddlers.

Childhood vaccination is crucial to protect young children from harmful infectious diseases. This study aimed to investigate the recent childhood immunization rate of recommended and additional vaccinations and identify the factors affecting the vaccination uptake of young children in Hong Kong. The self-administrated questionnaires were distributed to parents of toddlers aged 2 to 5. They were asked to provide information on (1) socioeconomic demographic factors; (2) experiences during pregnancy; and (3) the medical history of the toddler. A total of 1799 responses were collected. Children were more likely to be fully vaccinated when they were at a younger age (aOR = 0.61, 95% CI: 0.48-0.78, p < 0.001), the first child in the family (aOR second-born = 0.62, 95% CI: 0.48-0.81, p < 0.001; aOR third-born = 0.33, 95% CI: 0.19-0.55, p < 0.001), had a higher household income (aOR HKD 15,000-HKD 29,999 = 1.80, 95% CI: 1.27-2.55, p = 0.001; aOR ≥ HKD 30,000 = 3.42, 95% CI: 2.39-4.90, p < 0.001; compared with

Total 25(OH)D Concentration Moderates the Association between Caffeine Consumption and the Alkaline Phosphatase Level in Pregnant Women.

The evidence as to whether caffeine consumption is beneficial or harmful to human health has been mixed. This study aimed to examine the effect of 25-hydroxyvitamin D (25(OH)D) concentration on the association between caffeine consumption and mineral metabolism in pregnant women. This is a cross-sectional study involving pregnant women at their 25th to 35th gestational week recruited at antenatal clinics in the period of July 2019 to December 2020. Peripheral blood samples were collected to determine their total 25(OH)D, albumin, alkaline phosphatase (ALP), calcium, phosphate, and ferritin level in serum. Questionnaires on demographics and dietary intake were also administered. Among 181 pregnant women recruited (Average age = 32.9 years), 50 (27.6%) of them were found to be vitamin D insufficient (25(OH)D concentration < 75 nmol/L), and 131 (72.4%) were vitamin D sufficient (25(OH)D concentration ≥ 75 nmol/L). Adjusted regression models identified an association between higher caffeine intake and lower ALP level only among vitamin D-sufficient pregnant women (ß = −0.24, p = 0.006), but not in those with insufficient vitamin D (ß = −0.02, p = 0.912). The findings provide new insights into 25(OH)D concentration as a potential modifier of the health effects of caffeine consumption during pregnancy.

Impact of COVID-19 on Life of Students: Case Study in Hong Kong.

COVID-19 has an impact on the day-to-day life of students, with school closure and detrimental effects on health and well-being that cannot be underestimated. A study collected data reflecting the health and well-being of secondary school students entering a programme entitled "Healthy Life Planning: Assist Students to Acquire and Practice Health Knowledge and Skills" (ASAP study) in September and October 2019 before the outbreak of COVID-19. Follow-up data were collected in June and July 2020, over half a year since the spread of COVID-19, which facilitated analyses of its impact on the health behaviours and well-being of young people. Comparative analyses between baseline and the follow-up period were conducted on weight status, sleep pattern and quality, pattern of sedentary lifestyle, pattern of physical activity, attitudes and perceived barriers for exercise, and hand hygiene. Attitudes toward precautionary measures and influenza vaccination, self-reported changes in hygiene practices, exercise habits and eating habits were analysed. Although hygiene habits and risk perceptions among young people have improved in many aspects, the level of physical activity has declined as well as the beliefs and attitudes on increasing time on electronic media and change in sleep hygiene. Attitudes and beliefs towards influenza vaccination have declined, which would reflect the slow increase in the uptake rate of COVID-19 vaccination. Health education should equip students with the knowledge and skills to cultivate beliefs and attitudes to face health challenges.

Delivery of Healthcare Resources Using Autonomous Ground Vehicle Convoy Systems: An Overview.

Utilizing military convoys in humanitarian missions allows for increased overall performance of healthcare logistical operations. To properly gauge performance of autonomous ground convoy systems in military humanitarian operations, a proper framework for comparative performance metrics needs to be established. Past efforts in this domain have had heavy focus on narrow and specialized areas of convoy performance such as human factors, trust metrics, or string stability analysis. This article reviews available Army doctrine for manned convoy requirements toward healthcare missions and establishes a framework to compare performance of autonomous convoys, using metrics such as spacing error, separation distance, and string stability. After developing a framework of comparison for the convoy systems, this article compares the performance of two autonomous convoys with unique convoy control strategies to demonstrate the application and utility of the framework.

Dually targeted bioinspired nanovesicle delays advanced prostate cancer tumour growth in vivo.

Prostate cancer (PC) is second-leading cancer in men, with limited treatment options available for men with advanced and metastatic PC. Prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) have been exploited as therapeutic targets in PC due to their upregulation in the advanced stages of the disease. To date, several PSA- and PSMA-activatable prodrugs have been developed to reduce the systemic toxicity of existing chemotherapeutics. Bioinspired nanovesicles have been exploited in drug delivery, offering prolonged drug blood circulation and higher tumour accumulation. For the first time, this study describes the engineering of dually targeted PSA/PSMA nanovesicles for advanced PC. PSMA-targeted bioinspired hybrids were prepared by hydrating a lipid film with anti-PSMA-U937 cell membranes and DOX-PSA prodrug, followed by extrusion. The bioinspired hybrids were characterised using dynamic light scattering, transmission electron microscopy, Dot blot, flow cytometry and Western blot. Cellular binding and toxicity studies in PC cancer cell lines were carried out using flow cytometry, confocal microscopy, and resazurin assay. Finally, tumour targeting and therapeutic efficacy studies were performed in solid and metastatic C4-2B-tumor-bearing mice. Interestingly, our PSMA-targeted hybrids demonstrated high cell uptake in PSMA-expressing cells with significant accumulation in solid and metastatic C4-2B tumour tissues following intravenous administration. More promisingly, our dually targeted PSA/PSMA hybrid significantly slowed down the C4-2B tumour growth in vivo, compared to free DOX-PSA and non-targeted PSA-hybrid. Our PSA/PSMA bioinspired hybrid could offer a highly selective treatment for advanced PC with lower side effects. STATEMENT OF SIGNIFICANCE: This study investigates a new approach to treat prostate cancer using dually targeted bioinspired nanovesicle . Our bioinspired vesicles are made mainly of a human blood cell membrane with a ligand recognising a specific marker (PSMA) on the surface of the prostate cancer cells. The present work describes the successful loading of a doxorubicin prodrug linked to a PSA- activatable peptide into these targeted bioinspired nanovesicle , where the active PSA enzyme presents in these cells converts the drug to its active form. Our dually targeted PSA/PSMA hybrid vesicles has successfully improved site-specific prodrug delivery to tackle advanced prostate cancer, offering a novel and effective prostate cancer treatment.

Mycoplasma genitalium: test positivity in syndromic presentations and clinicians' adherence with treatment guidelines at Sydney Sexual Health Centre.

Mycoplasma genitalium (M.genitalium) is associated with urethritis, cervicitis, pelvic inflammatory disease, proctitis and epididymitis. Its treatment is complicated by antimicrobial resistance. To assess clinicians' adherence to M.genitalium diagnostic testing recommendations for syndromic presentations, as well as resistance-guided management of M.genitalium at Sydney Sexual Health Centre, we reviewed patients presenting between August and December 2018. 349/372 (94%) syndromic presentations were tested for M.genitalium with 16% M.genitalium test positivity and 81% macrolide resistance. 16/27 (59%) macrolide-sensitive infections and 65/77 (84%) macrolide-resistant infections received resistance-guided treatment. Tests of cure (TOCs) were unnecessarily ordered for 82% macrolide-sensitive cases, while 88% macrolide-resistant cases were correctly ordered TOCs. Co-existing STIs at the time of macrolide-sensitive (p = 0.30) or macrolide-resistant M.genitalium (p = 0.94) diagnosis did not significantly affect adherence to treatment guidelines. This study confirms the expected prevalence of M.genitalium and macrolide resistance in syndromic presentations while our real-world data highlight the decision-making challenges involved with managing M.genitalium, offering insights for further research.

PD1 blockade potentiates the therapeutic efficacy of photothermally-activated and MRI-guided low temperature-sensitive magnetoliposomes.

This study investigates the effect of PD1 blockade on the therapeutic efficacy of novel doxorubicin-loaded temperature-sensitive liposomes. Herein, we report photothermally-activated, low temperature-sensitive magnetoliposomes (mLTSL) for efficient drug delivery and magnetic resonance imaging (MRI). The mLTSL were prepared by embedding small nitrodopamine palmitate (NDPM)-coated iron oxide nanoparticles (IO NPs) in the lipid bilayer of low temperature-sensitive liposomes (LTSL), using lipid film hydration and extrusion. Doxorubicin (DOX)-loaded mLTSL were characterized using dynamic light scattering, differential scanning calorimetry, electron microscopy, spectrofluorimetry, and atomic absorption spectroscopy. Photothermal experiments using 808 nm laser irradiation were conducted. In vitro photothermal DOX release studies and cytotoxicity was assessed using flow cytometry and resazurin viability assay, respectively. In vivo DOX release and tumor accumulation of mLTSL(DOX) were assessed using fluorescence and MR imaging, respectively. Finally, the therapeutic efficacy of PD1 blockade in combination with photothermally-activated mLTSL(DOX) in CT26-tumor model was evaluated by monitoring tumor growth, cytokine release and immune cell infiltration in the tumor tissue. Interestingly, efficient photothermal heating was obtained by varying the IO NPs content and the laser power, where on-demand burst DOX release was achievable in vitro and in vivo. Moreover, our mLTSL exhibited promising MR imaging properties with high transverse r2 relaxivity (333 mM-1 s-1), resulting in superior MR imaging in vivo. Furthermore, mLTSL(DOX) therapeutic efficacy was potentiated in combination with anti-PD1 mAb, resulting in a significant reduction in CT26 tumor growth via immune cell activation. Our study highlights the potential of combining PD1 blockade with mLTSL(DOX), where the latter could facilitate chemo/photothermal therapy and MRI-guided drug delivery.

Genetically-engineered anti-PSMA exosome mimetics targeting advanced prostate cancer in vitro and in vivo.

The present work describes the engineering of anti-PSMA peptide-decorated exosome mimetics (EMs) targeting advanced prostate cancer (PC). The targeted EMs were produced from anti-PSMA peptide, WQPDTAHHWATL, expressing U937 monoblastic cells, followed by successive extrusion cycles. The engineered EMs were nanosized, produced at a high yield, and displayed the anti-PSMA peptide, exosomal markers and monocytes proteins on their surface. As anticipated, PSMA-EMs showed increased cellular internalization in PSMA positive PC cell lines (LNCaP and C4-2B), compared to unmodified EMs. Most importantly, higher tumour targeting was observed in solid C4-2B tumours, following intravenous administration, confirming their targeting ability in vivo. Overall, our study indicates that the engineered anti-PSMA peptide-targeted EMs can be a promising drug delivery system for advanced PC.

Nanoprecipitation preparation of low temperature-sensitive magnetoliposomes.

Lysolipid-containing thermosensitive liposomes (LTSL) have gained attention for triggered release of chemotherapeutics. Superparamagnetic iron oxide nanoparticles (SPION) offers multimodal imaging and hyperthermia therapy opportunities as a promising theranostic agent. Combining LTSL with SPION may further enhance their performance and functionality of LTSL. However, a major challenge in clinical translation of nanomedicine is the poor scalability and complexity of their preparation process. Exploiting the nature of self-assembly, nanoprecipitation is a simple and scalable technique for preparing liposomes. Herein, we developed a novel SPION-incorporated lysolipid-containing thermosensitive liposome (mLTSL10) formulation using nanoprecipitation. The formulation and processing parameters were carefully designed to ensure high reproducibility and stability of mLTSL10. The effect of solvent, aqueous-to-organic volume ratio, SPION concentration on the mLTSL10 size and dispersity was investigated. mLTSL10 were successfully prepared with a small size (∼100 nm), phase transition temperature at around 42 °C, and high doxorubicin encapsulation efficiency. Indifferent from blank LTSL, we demonstrated that mLTSL10 combining the functionality of both LTSL and SPION can be successfully prepared using a scalable nanoprecipitation approach.

Magneto-Liposomes as MRI Contrast Agents: A Systematic Study of Different Liposomal Formulations.

The majority of the clinically approved iron oxide nanoparticles (IO NPs) used as contrast agents for magnetic resonance imaging (MRI) have been withdrawn from the market either due to safety concerns or lack of profits. To address this challenge, liposomes have been used to prepare IO-based T2 contrast agents. We studied the influence of different phospholipids on the relaxivity (r2) values of magneto-liposomes (MLs) containing magnetic NPs in the bilayer, where a strong correlation between the bilayer fluidity and r2 is clearly shown. Embedding 5-nm IO NPs in the lipid bilayer leads to a significant improvement in their relaxivity, where r2 values range from 153 ± 5 s-1 mM-1 for DPPC/cholesterol/DSPE-PEG (96/50/4) up to 673 ± 12 s-1 mM-1 for DOPC/DSPE-PEG (96/4), compared to "free" IO NPs with an r2 value of 16 s-1 mM-1, measured at 9.4 T MRI scanner. In vitro MRI measurements, together with the ICP-MS analysis, revealed MLs as highly selective contrast agents that were preferentially taken up by cancerous T24 cells, which led to an improvement in the contrast and an easier distinction between the healthy and the cancerous cells. A careful selection of the lipid bilayer to prepare MLs could offer efficient MRI contrast agents, even at very low IO NP concentrations.

Microfluidic Production of Lysolipid-Containing Temperature-Sensitive Liposomes.

The presented protocol enables a high-throughput continuous preparation of low temperature-sensitive liposomes (LTSLs), which are capable of loading chemotherapeutic drugs, such as doxorubicin (DOX). To achieve this, an ethanolic lipid mixture and ammonium sulfate solution are injected into a staggered herringbone micromixer (SHM) microfluidic device. The solutions are rapidly mixed by the SHM, providing a homogeneous solvent environment for liposomes self-assembly. Collected liposomes are first annealed, then dialyzed to remove residual ethanol. An ammonium sulfate pH-gradient is established through buffer exchange of the external solution by using size exclusion chromatography. DOX is then remotely loaded into the liposomes with high encapsulation efficiency (> 80%). The liposomes obtained are homogenous in size with Z-average diameter of 100 nm. They are capable of temperature-triggered burst release of encapsulated DOX in the presence of mild hyperthermia (42 °C). Indocyanine green (ICG) can also be co-loaded into the liposomes for near-infrared laser-triggered DOX release. The microfluidic approach ensures high-throughput, reproducible and scalable preparation of LTSLs.

Liposome-Templated Indocyanine Green J- Aggregates for In Vivo Near-Infrared Imaging and Stable Photothermal Heating.

Indocyanine green (ICG) is an FDA-approved near-infrared fluorescent dye that has been used in optical imaging and photothermal therapy. Its rapid in vivo clearance and photo-degradation have limited its application. ICG pharmacokinetics and biodistribution have been improved via liposomal encapsulation, while its photothermal stability has been enhanced by ICG J-aggregate (IJA) formation. In the present work, we report a simple approach to engineer a nano-sized, highly stable IJA liposomal formulation. Our results showed that lipid film hydration and extrusion method led to efficient IJA formation in rigid DSPC liposomes, as supported by molecular dynamics modeling. The engineered DSPC-IJA formulation was nano-sized, and with spectroscopic and photothermal properties comparable to free IJA. Promisingly, DSPC-IJA exhibited high fluorescence, which enabled its in vivo tracking, showing prolonged blood circulation and significantly higher tumor fluorescence signals, compared to free ICG and IJA. Furthermore, DSPC-IJA demonstrated high photo-stability in vivo after multiple cycles of 808 nm laser irradiation. Finally, doxorubicin was loaded into liposomal IJA to utilize the co-delivery capabilities of liposomes. In conclusion, with both liposomes and ICG being clinically approved, our novel liposomal IJA could offer a clinically relevant theranostic platform enabling multimodal imaging and combinatory chemo- and photothermal cancer therapy.

Changes in dietary habits and prevalence of cardiovascular risk factors among school students in Macao, China.

OBJECTIVE: Given the increasing burden of childhood obesity, it is important to examine the changes in dietary habits and prevalence of cardiovascular risk factors among Macao students. METHODS: A cross-sectional study was conducted among primary and secondary school students in Macao, China in 2014-2015 with addition to data collected from 2008 to 2009 for comparison. The dietary behaviours, prevalence of obesity and dyslipidaemia were compared by study period. SUBJECTS: In 2014-2015, dietary assessment was conducted among 3635 students, physical assessment was conducted among 1427 school students. In 2008-2009, dietary assessment was conducted among 4271 students, physical assessment was conducted among 1700 school students. RESULTS: When compared with students in 2008, higher percentage of students from present study period consumed dairy products, crispy food and chocolate, while fewer students had fruits, vegetables and fried food at least once every day. Despite lower prevalence of elevated total cholesterol and low-density-lipoprotein cholesterol, the rate of general obesity, low high-density-lipoprotein cholesterol and hyperglycaemia has increased significantly in 2014-2015. Students aged 12-14 consumed less fruits and vegetables and suffered from higher rate of general and abdominal obesity, as well as low high-density-lipoprotein cholesterol and elevated serum triglycerides in 2014-15. CONCLUSIONS: The students' diet had both favourable and unfavourable changes. The rate of obesity and dyslipidaemia rises, while the situation for students aged 12-14 is more concerning.

Sterically stabilized liposomes production using staggered herringbone micromixer: Effect of lipid composition and PEG-lipid content.

Preparation of lipid-based drug delivery systems by microfluidics has been increasingly popular, due to the reproducible, continuous and scalable nature of the microfluidic process. Despite exciting development in the field, versatility and superiority of microfluidics over conventional methods still need further evidence, since preparing clinically-relevant sterically stabilised liposomes has been lacking. The present study describes the optimisation of PEGylated liposomal formulations of various rigidity using staggered herringbone micromixer (SHM). The effect of both processing parameters (total flow rate (TFR) and aqueous-to-ethanol flow rate ratio (FRR)) and formulation parameters (lipid components and composition, initial lipid concentration and aqueous media) was investigated and discussed. Liposomal formulations consist of 1,2-dioleoyl-sn-glycero-3-phosphatidylcholine (DOPC), 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine (DPPC) or 1,2-distearoyl-sn-glycero-3-phosphatidylcholine (DSPC), with cholesterol and PEGylated lipid (DSPE-PEG2000) were successfully prepared with the desired size (∼100 nm) and dispersity (<0.2). Doxorubicin was successfully encapsulated in these liposomes at high (>80%) encapsulation efficiency using the pH-gradient remote loading method, illustrating their bilayer integrity and capability as drug delivery systems. We demonstrated that clinically-relevant PEGylated liposomal formulations could be prepared with properties comparable to conventional techniques. Limitations and recommendations on the microfluidic production of PEGylated liposomes were also discussed.