The relation between complement understanding and computational skills: A random intercept cross-lagged panel model.

Understanding of the complement principle has been proposed as closely related to computational skills, but few studies have investigated their interrelations. The present longitudinal study attempted to clarify the picture by examining their potential cross-lagged relation. Fourth graders (n = 221) in Hong Kong received 3 cognitive assessments at intervals of 6 months, consisting of multiple measures of complement understanding, a nonverbal intelligence test, and a computational skills measure. A random intercept cross-lagged panel model revealed that complement understanding significantly predicted future computational skills, but the reciprocal prediction was nonsignificant. The findings provide empirical evidence supporting the close relation between complement understanding and computational skills and call for future endeavors to examine the interrelations between computational skills and understanding of other arithmetic principles. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Comorbidity between persistent reading and mathematics disabilities: The nature of comorbidity.

The current study aimed at investigating the comorbidity between reading disability (RD) and mathematical disability (MD) in a non-alphabetic language context. Over 1,900 Chinese first graders were screened on their reading and mathematics achievement twice. Children who scored consistently below the 10th percentile in reading and/or mathematics were identified as RD and/or MD respectively. A subsample of these children, together with a group of typically-achieving children, were further assessed on their cognitive capacities. Results suggested that while there were cognitive deficits that were specifically found in RD (shifting) versus MD (spatial working memory, inhibition, processing speed, visual attention) groups, deficits in naming speed was found in both RD and MD groups. The cognitive profile of the comorbid group was an additive combination of those of the two single LD groups. The findings suggest that RD and MD are two dissociable learning disabilities with distinct cognitive profiles. Effective screening and intervention can be developed based on the cognitive profiles of different disability groups.

Disease Burden, Characteristics, and Outcomes of Methicillin-Resistant Staphylococcus aureus Bloodstream Infection in Hong Kong.

We aimed to describe disease burden, characteristics, and outcomes of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) in Hong Kong. A retrospective, observational study was conducted in 26 Hong Kong public hospitals between January 2010 and December 2012. The primary outcome measures were 30-day mortality rate and infection-related hospital cost. Of 1133 patients reviewed, 727 (64.17%) were male, 1075 (94.88%) had health care-associated community-onset and 44 (3.88%) had hospital-onset MRSA infection. The mean age of patients was 76 (SD = 15) years, including 172 (15.18%) aged 20 to 59 years and 961 (84.8%) aged ≥60 years. The annual incidence rates in age groups of 20 to 59 years and ≥60 years were 0.96 to 1.148 per 100 000 and 22.7 to 24.8 per 100 000, respectively. The 30-day mortality was 367 (32.39%). Older patients (>79 years), chronic lung disease, and prior hospitalization were associated with increased mortality. The mean cost was US$10 565 (SD = 11 649; US$1 = HK$7.8). MRSA BSI was a significant burden in Hong Kong.

Determinants of an effective antibiotic campaign: Lessons from Hong Kong.

Hong Kong launched a publicity campaign on the use of antibiotics and antibiotic resistance in March/April 2011. Two population surveys were conducted in November 2010 (N=1569; response rate 69.2%) and June 2011 (N=1527; response rate 66.6%) before and after the campaign, respectively, to evaluate its impact. Adults aged ≥18 years were asked about their knowledge and attitude related to antibiotic use and antibiotic resistance. Information obtained from health professionals had the highest mean impact score. There was a significant increase in the proportion of respondents knowing that antibiotics could not cure influenza (from 58.0 to 65.0%; P<0.001) or viral infections (from 24.9 to 29.0%; P=0.002). Over one-quarter (27.7%) of respondents could recall the campaign, mostly through announcement of public interest (API) on television/radio. After regression analysis, age, personal hygiene practices in daily life, and the attitude that everyone had a role to play in alleviating the problem of antimicrobial resistance were found to be associated with campaign awareness.

Effectiveness of multifaceted hand hygiene interventions in long-term care facilities in Hong Kong: a cluster-randomized controlled trial.

OBJECTIVE: To determine the effectiveness of World Health Organization (WHO) multimodal strategy in promoting hand hygiene (HH) among healthcare workers (HCWs) in long-term care facilities (LTCFs). DESIGN: Cluster-randomized controlled trial. SETTING: Eighteen homes for the elderly in Hong Kong were randomly allocated to 2 intervention arms and a control arm. Direct observation of HH practice was conducted by trained nurses. Either handrubbing with alcohol-based handrub (ABHR) or handwashing with liquid soap and water was counted as a compliant action. Disease notification data during 2007-2010 were used to calculate incidence rate ratio (IRR). PARTICIPANTS: Managers and HCWs of the participating homes. INTERVENTIONS: The WHO multimodal strategy was employed. All intervention homes were supplied with ABHR (WHO formulation I), ABHR racks, pull reels, HH posters and reminders, a health talk, video clips, training materials, and performance feedback. The only difference was that intervention arms 1 and 2 were provided with slightly powdered and powderless gloves, respectively. RESULTS: A total of 11,669 HH opportunities were observed. HH compliance increased from 27.0% to 60.6% and from 22.2% to 48.6% in intervention arms 1 and 2, respectively. Both intervention arms showed increased HH compliance after intervention compared to controls, at 21.6% compliance (both [Formula: see text]). Provision of slightly powdered versus powderless gloves did not have any significant impact on ABHR usage. Respiratory outbreaks (IRR, 0.12; 95% confidence interval [CI], 0.01-0.93; [Formula: see text]) and methicillin-resistant Staphylococcus aureus infections requiring hospital admission (IRR, 0.61; 95% CI, 0.38-0.97; [Formula: see text]) were reduced after intervention. CONCLUSIONS: A promotion program applying the WHO multimodal strategy was effective in improving HH among HCWs in LTCFs.

Amino terminus of the SARS coronavirus protein 3a elicits strong, potentially protective humoral responses in infected patients.

The 3a protein of severe acute respiratory syndrome (SARS)-associated coronavirus is expressed and transported to the plasma membrane in tissue cells of infected patients. Its short N-terminal ectodomain was found to elicit strong humoral responses in half of the patients who had recovered from SARS. The ectodomain-specific antibodies from the convalescent-phase plasma readily recognized and induced destruction of 3a-expressing cells in the presence of the human complement system, demonstrating their potential ability to provide immune protection by recognizing and eliminating SARS coronavirus-infected cells that express the target protein. In addition, when coupled to a carrier protein, the ectodomain peptide elicited 3a-specific antibodies in mice and rabbit at high titres. These results showed that the N terminus of the 3a protein is highly immunogenic and elicits potentially protective humoral responses in infected patients. Therefore, the short extracellular domain may be a valuable immunogen in the development of a vaccine for infectious SARS.

B-cell responses in patients who have recovered from severe acute respiratory syndrome target a dominant site in the S2 domain of the surface spike glycoprotein.

Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease caused by a novel strain of coronavirus. Examination of the immune responses of patients who have recovered from SARS should provide important information for design of a safe and effective vaccine. We determined the continuous viral epitopes targeted by antibodies in plasma samples from convalescent SARS patients through biopanning with a vast M13 phage display dodecapeptide library. These epitopes converged to very short peptide fragments, one on each of the structural proteins spike and nucleocapsid and the nonstructural proteins 3a, 9b, and nsp 3. Immunoassays found that most of the patients who had recovered from SARS developed complementary antibodies to the epitope-rich region on the spike S2 protein, indicating that this is an immunodominant site on the viral envelope comprising the spike, matrix, and small envelope glycoproteins. These S2-targeting antibodies were shown to effectively neutralize the coronavirus, indicating that they provided protective immunity to help the patients recover from the viral infection. These results suggest that the SARS coronavirus might have an antigenic profile distinct from those of other human or animal coronaviruses. Due to the tested safety and protective effects of the convalescent-phase serological antibodies, identification of their complementary antigens may enable the design of an epitope-based vaccine to prevent potential antibody-mediated immunopathology.

A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome.

OBJECTIVE: To compare the clinical courses and outcomes of pregnant severe acute respiratory syndrome (SARS) patients and non-pregnant SARS patients. DESIGN: A case-control study. SETTING: Tertiary Hospital for Infectious Disease. Sample Ten pregnant and 40 non-pregnant female patients infected with SARS. METHODS: Clinical course and outcomes of pregnant SARS patients were compared with a group of non-pregnant SARS patient. Cases and controls were matched with respect to sex, age, timing of contracting SARS, health care workers status and underlying illness. MAIN OUTCOME MEASURES: The incidence of intensive care unit admission, intubation, medical complications and death rate. RESULTS: Pregnancy had no discernible impact on clinical symptoms and presentation delay. Four out of the 10 pregnant patients, nevertheless, required endotracheal intubation and six were admitted to the intensive care unit (ICU), as compared with 12.5% intubation rate (P= 0.065) and 17.5% ICU admission rate (P= 0.012) in the non-pregnant group. More pregnant SARS patients developed renal failure (P= 0.006) and disseminated intravascular coagulopathy (P= 0.006), as compared with non-pregnant SARS group. There were three deaths in the pregnant group, whereas there was no death in the non-pregnant control group (P= 0.006). CONCLUSION: Pregnant women with SARS experience a worse clinical course and poorer outcomes compared with non-pregnant women.

T-cell epitopes in severe acute respiratory syndrome (SARS) coronavirus spike protein elicit a specific T-cell immune response in patients who recover from SARS.

The immunogenicity of HLA-A2-restricted T-cell epitopes in the S protein of the Severe acute respiratory syndrome coronavirus (SARS-CoV) and of human coronavirus strain 229e (HCoV-229e) was analyzed for the elicitation of a T-cell immune response in donors who had fully recovered from SARS-CoV infection. We employed online database analysis to compare the differences in the amino acid sequences of the homologous T epitopes of HCoV-229e and SARS-CoV. The identified T-cell epitope peptides were synthesized, and their binding affinities for HLA-A2 were validated and compared in the T2 cell system. The immunogenicity of all these peptides was assessed by using T cells obtained from donors who had fully recovered from SARS-CoV infection and from healthy donors with no history of SARS-CoV infection. HLA-A2 typing by indirect immunofluorescent antibody staining showed that 51.6% of SARS-CoV-infected patients were HLA-A2 positive. Online database analysis and the T2 cell binding test disclosed that the number of HLA-A2-restricted immunogenic epitopes of the S protein of SARS-CoV was decreased or even lost in comparison with the homologous sequences of the S protein of HCoV-229e. Among the peptides used in the study, the affinity of peptides from HCoV-229e (H77 and H881) and peptides from SARS-CoV (S978 and S1203) for binding to HLA-A2 was higher than that of other sequences. The gamma interferon (IFN-gamma) release Elispot assay revealed that only SARS-CoV-specific peptides S1203 and S978 induced a high frequency of IFN-gamma-secreting T-cell response in HLA-A2(+) donors who had fully recovered from SARS-CoV infection; such a T-cell epitope-specific response was not observed in HLA-A2(+) healthy donors or in HLA-A2(-) donors who had been infected with SARS-CoV after full recovery. Thus, T-cell epitopes S1203 and S978 are immunogenic and elicit an overt specific T-cell response in HLA-A2(+) SARS-CoV-infected patients.