Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study.

BACKGROUND: A range of public health measures have been implemented to suppress local transmission of coronavirus disease 2019 (COVID-19) in Hong Kong. We examined the effect of these interventions and behavioural changes of the public on the incidence of COVID-19, as well as on influenza virus infections, which might share some aspects of transmission dynamics with COVID-19. METHODS: We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (Rt) for COVID-19 and influenza A H1N1 to estimate changes in transmissibility over time. Attitudes towards COVID-19 and changes in population behaviours were reviewed through three telephone surveys done on Jan 20-23, Feb 11-14, and March 10-13, 2020. FINDINGS: COVID-19 transmissibility measured by Rt has remained at approximately 1 for 8 weeks in Hong Kong. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% CI 34-53%) reduction in transmissibility in the community, from an estimated Rt of 1·28 (95% CI 1·26-1·30) before the start of the school closures to 0·72 (0·70-0·74) during the closure weeks. Similarly, a 33% (24-43%) reduction in transmissibility was seen based on paediatric hospitalisation rates, from an Rt of 1·10 (1·06-1·12) before the start of the school closures to 0·73 (0·68-0·77) after school closures. Among respondents to the surveys, 74·5%, 97·5%, and 98·8% reported wearing masks when going out, and 61·3%, 90·2%, and 85·1% reported avoiding crowded places in surveys 1 (n=1008), 2 (n=1000), and 3 (n=1005), respectively. INTERPRETATION: Our study shows that non-pharmaceutical interventions (including border restrictions, quarantine and isolation, distancing, and changes in population behaviour) were associated with reduced transmission of COVID-19 in Hong Kong, and are also likely to have substantially reduced influenza transmission in early February, 2020. FUNDING: Health and Medical Research Fund, Hong Kong.

Outcomes of Short Fusion versus Long Fusion for Adult Degenerative Scoliosis: A Systematic Review and Meta-analysis.

The objective of this study was to evaluate differences in clinical and radiographic outcomes between short (<3 levels) and long (≥3 levels) fusions in the setting of degenerative lumbar scoliosis. A literature search was performed from six electronic databases. The key terms of "degenerative scoliosis" OR "lumbar scoliosis" AND "fusion" were combined and used as MeSH subheadings. From relevant studies identified, demographic data, complication rates, Oswestry Disability Index (ODI), and radiographic parameters were extracted and the data was pooled and analyzed. Long fusion was associated with comparable overall complication rates to short fusion (17% vs 14%, P = 0.20). There was a significant difference in the incidence of pulmonary complications when comparing short versus long fusion (0.42% vs 2.70%; P = 0.02). No significant difference was found in terms of motor, sensory complications, infections, construct-related or cardiac complications, pseudoarthrosis, dural tears, cerebrospinal fluid (CSF) leak, or urinary retention. A longer fusion was associated with a greater reduction in coronal Cobb angle and increases in lumbar lordosis, but both findings failed to achieve statistical significance. The ODI was comparable across both cohorts. If shorter fusion lengths are clinically indicated, they should be used instead of longer fusion lengths to reduce perioperative time, costs, and some other complications. However, there are no statistically significant differences in terms of radiographically measurable restoration associated with a short or long fusion.

A novel technique for placement of sacro-alar-iliac (S2AI) screws by K-wire insertion using intraoperative navigation.

Sacral-iliac fixation techniques may be indicated in the management of various lumbosacral pathologies including spinal degeneration, infection, tumour resection, fracture, pseudarthrosis, correction of spinal deformities involving long fusion constructs to the sacrum and cases with poor sacral fixation. There are a number of options for lumbosacral fixation each with their own advantages and disadvantages. Though S2-alar-iliac (S2AI) have demonstrated promising advantages over alternatives, the complex anatomy of the spinopelvic region demands precise insertion of the screws to create a biomechanically robust construct safely. As such, we present a novel technique of using intra-operative CT navigation and K-wires to establish and secure a planned trajectory, thereby ensuring solid spinopelvic fixation with S2AI screws. This was performed as part of a long fusion construct for correction of kyphosis deformity in a male patient.

Synthesis and anti-breast cancer activity of new indolylquinone derivatives.

A series of novel indolylquinones have been synthesized by treating halogeno-quinone with 2-substituated indole derivatives in the presence of kalium carbonate and TEBA in acetonitrile at room temperature. These compounds were evaluated for their antiproliferative activity against human MDA-MB-231 and MCF-7 breast cancer cell lines. All the tested compounds showed potent mircomolar cytotoxicity activity in both breast cancer cell lines. 3d (IC(50) value=2.29 µg/mL for MCF-7 cells) and 3g (IC(50) value=3.99 µg/mL for MDA-MB-231 cells) displayed the most potent antiproliferative activity of the series. Also, in vitro anticancer activity of the compounds further showed that bis-indolylquinones were more active than mono-indolylquinones. Fluorescence microscopy analysis indicated that compound 3d and 3g inhibited breast cancer cells proliferation by triggering apoptotic cell death.

Study of apoptosis induced by 188Re-DTPA-DG in MCF-7 breast carcinoma and A549 pulmonary carcinoma cells.

OBJECTIVE: To evaluate apoptosis induced by rehenium-188-labeled diethylenetriamine pentaacetic acid-glucosamine (188Re-DTPA-DG) in MCF-7 breast carcinoma cells and A549 pulmonary carcinoma cells. METHODS: Through the use of flow cytometry (FCM) with CBA software to detect apoptosis, cells of both the MCF-7 and A549 cell lines were divided into groups exposed to 188Re-DTPA-DG, 188Re-perrhenate (188ReO4-), and saline, respectively. The first two groups were further divided into subgroups on the basis of their exposure to radioactivity at 37, 55.5, or 74 kBq/mL, with the saline-exposed group divided into three corresponding subgroups. Each subgroup was introduced into 5 replicate wells of a culture plate, and the morphology of the cells in each well was determined by flow cytometry at 6-hour intervals for 18 hours. In order to determine the affinity of 188Re-DTPA-DG for tumor tissue, the biodistribution of the radiolabeled agent was assessed in breast tumor-bearing nude mice. RESULTS: Change in morphology of the cell nucleus was more evident in the 188Re-DTPA-DG-treated than in the 188ReO4--treated group, and no change in nuclear morphology was seen in the saline-exposed group. The study data suggested that there was a greater ratio of apoptotic to nonapoptotic cells among the 188Re-DTPA-DG-treated than among the 188ReO4--treated or saline-exposed cells (p<0.01), and a greater change in cell-nuclear morphology in the 188Re-DTPA-DG-treated than in the 188ReO4--treated cells. Furthermore, 188Re-DTPA-DG had a more significant apoptosis-inducing effect on both MCF-7 and A549 cells than did 188ReO4-. The biodistribution study in tumor-bearing nude mice showed that the concentration of 188Re-DTPA-DG in tumor tissue was much higher than in normal tissue, that 188Re-DTPA-DG was rapidly cleared from the blood, and that the main route of its clearance was via the kidneys. CONCLUSIONS: 188Re-DTPA-DG has a significant apoptotic effect on carcinoma cells. 188Re-DTPA-DG is an effective radiopharmaceutical for intratumoral radiation therapy.

Antitumor effects of radioiodinated antisense oligonuclide mediated by VIP receptor.

A 15-mer phosphorothioate antisense oligonuclide (ASON) complementary to the translation start region of the C-myc oncogene mRNA was radioiodinated to enhance its antitumor activity, and vasoactive intestinal peptide bound covalently polylysine (VIP-polylysine) was used as a carrier to deliver the oligonucleotide into VIP receptor-positive tumor cells. The antitumor activity of radioiodinated ASON conjugated to VIP-polylysine(VIP-131I-ASON) was investigated in athymic mice bearing HT29 tumor xenografts in comparison with unconjugated radioiodinated ASON(131I-ASON), unlabelled ASON (VIP-ASON) and scrambled oligonucleotide (VIP-131I-MON) conjugated to VIP-polylysine. Conjugation 125I-ASON to VIP-polylysine resulted in a 5.6-fold decrease in the plasma clearance and a 3.4-fold increase in tumor uptake of the radiopharmaceutical. Athymic mice bearing HT29 tumor xenografts were treated with 4 weekly doses of VIP-131I-ASON and the antitumor effects were assessed by use of the slope of the tumor growth curve. VIP-131I-ASON exhibited strong antitumor effects against HT29 xenografts, decreasing tumor growth rate 9.67-, 7.90-fold more effectively than 131I-ASON and VIP-ASON at equivalent doses of ASON. Conversely, 131I-ASON, VIP-ASON or VIP-131I-MON caused no significant effect compared with the normal saline. These data indicated that use of a VIP-polylysine carrier greatly increased HT29 tumor uptake of ASON and treatment with the VIP-131I-ASON complexes resulted in tumor growth delay in human colon cancer xenograft.