Central Policy Unit

BackgroundSunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample.MethodsData for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001.ResultsThe 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger.ConclusionUVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.

Abstract. Coarse particulate matter (i.e. PM with an aerodynamic diameter between 2.5 and 10 µm – PM2.5 and PM10 – or PMcoarse) has been increasingly recognized for its importance in PM10 regulation because of its growing proportion in PM10 and the accumulative evidence for its adverse health impact. In this work, we present comprehensive PMcoarse speciation results obtained through a 1-year-long (January 2020–February 2021) joint PM10 and PM2.5 chemical speciation study in Hong Kong, a coastal and highly urbanized city in southern China. The annual average concentration of PMcoarse is 14.9 ± 8.6 µg m−3 (± standard deviation), accounting for 45 % of PM10 (32.9 ± 18.5 µg m−3). The measured chemical components explain ∼75 % of the PMcoarse mass. The unexplained part is contributed by unmeasured geological components and residue liquid water content, supported through analyses by positive matrix factorization (PMF) and the thermodynamic equilibrium model ISORROPIA II. The PMcoarse mass is apportioned to four sources resolved by PMF, namely soil dust/industrial and coal combustion, construction dust/copper-rich emissions, fresh sea salt, and an aged sea salt factor containing secondary inorganic aerosols (mostly nitrate). The PMcoarse concentration and source composition exhibit a distinct seasonal variation, a result mainly driven by the source areas the air masses have travelled through as revealed by back-trajectory analysis. In summer when the site is dominated by marine air mass, PMcoarse is the lowest (average = 8.1 µg m−3) and sea salt the largest contributor (47 %), followed by the two dust factors (36 % in total). In winter when the site receives air mass mainly from the northern continental region, PMcoarse concentration triples (24.8 µg m−3), with the two dust factors contributing three quarters of the aerosol mass. The potential dust source areas are mapped using the concentration-weighted trajectory technique, showing either the Greater Bay Area or the greater part of southern China as the origin of fugitive dust emissions leading to elevated ambient PMcoarse loadings in Hong Kong. This study, the first of this kind in our region, provides highly relevant guidance for other locations with similar monitoring needs. Additionally, the study findings point to the need for further research on the sources, transport, aerosol processes, and health effects of PMcoarse.

This manuscript reported a fast and rapid qualitative screening method for abuse drugs in urine by liquid chromatography-tandem mass spectrometry (LC-MS-MS). The scope of the abuse drugs under investigation included methamphetamine (MA), amphetamine (AMP), methylenedioxymethamphetamine (MDMA), methylenedioxyamphetamine (MDA), paramethoxymethamphetamine (PMMA), ephedrine, pseudoephedrine, ketamine (KET), deschloroketamine (DCK), 2-fluorodeschloroketamine (2 F-DCK) and deschloro-N-ethylketamine (2-oxo-PCE). The method employed a dual mode extraction (DME) column as a novel clean-up method for the urine matrix. To an aliquot of 0.2 mL urine, internal standards (ISTDs) and 0.4 mL of acidified methanol were added. After vortex and centrifugation, the supernatant was passed through a DME column before LC-MS-MS analysis. Chromatographic separation was achieved with a C18 column by gradient elution. The limits of detection (LODs) for MA, AMP, MDMA, MDA and PMMA were 3 ng/mL, whereas those for ephedrine and pseudoephedrine were 10 ng/mL and those for KET, DCK, 2 F-DCK and 2-oxo-PCE were 1 ng/mL. The matrix effects ranged from -12% to 7% (%CV from 4% to 19%). This method is fit for the intended purpose for forensic toxicology, as well as for forensic analysis of drugs facilitating sexual assault and other criminal acts.

The long-term safety of xenografts and their potential association with disease are valid concerns. Bovine bone substitutes which are by far the most commonly used xenografts in dentistry are not biodegradable. The aim of the present report was to raise awareness on the long-term risks of the bovine-derived xenografts. Patients who experienced clinical complications after xenografting are reported. Patients’ demographic, significant medical, and dental findings are reported. Complications included migration/encapsulation/displacement of the graft material, chronic inflammation, and soft-tissue disturbances/fenestrations. Albeit some xenograft complications are not significant enough to compromise the initial outcomes achieved, the xenografted particles seemed to be left intact favoring conditions for migration. The authors observed the inability of the human host to biodegrade the xenograft particles. The intact/migrated bovine bone particles present a risk to patients and may contribute to long-term clinical complications in implant dentistry.

To establish a set of consensus statements for the management of metastatic renal cell carcinoma, a total of 12 urologists and clinical oncologists from two professional associations in Hong Kong formed an expert consensus panel. Through a series of meetings and using the modified Delphi method, the panelists presented recent evidence, discussed clinical experiences, and drafted consensus statements on several areas of focus regarding the management of metastatic renal cell carcinoma. Each statement was eventually voted upon by every panelist based on the practicability of recommendation. A total of 46 consensus statements were ultimately accepted and established by panel voting. Derived from recent evidence and expert insights, these consensus statements were aimed at providing practical guidance to optimize metastatic renal cell carcinoma management and promote a higher standard of clinical care.

Medium is the Masseuse, The (with Linda Connor) 178 methodological innovations 179 Releasing the Spirits (with Linda Connor) 178-9, 183, 284 Spear and the Sword, The (with James Fox) 195n.2 Stories from the Life of a Balinese Healer (with Linda Connor) 178 Water of Words, The (with James Fox) 176-7 influence of Manchester School's 'case study method' 139 interest in pedagogical potential of ethnographic film 139 limitations of cinematography skills 143-4, 151n.23, 179 participation in MACOS project 139 Sons of Haji Omar 129n.9 Yanomam films with Napoleon Chagnon 142-9, 176, 375 Ax Fight, The 143, 146-9 Feast, The 144-6, 375 Man Called Bee, A 143 Yanomam video production 208 Ashanti people, West Africa 80 Attenborough, David 322,

This study evaluates the effects of macroprudential policy on Hong Kong’s housing market using a multivariate ordered probit-augmented vector autoregressive model (MOP-VAR). The proposed MOP-VAR extends the conventional dummy policy variable approach by allowing explicit measurement of time-varying policy intensities that underlie policy rules, and thus facilitates analyses of bilateral relationship between house prices and multiple policy instruments when endogeneity exits among the instruments’ intensities and prices. An impulse response analysis suggests that the dampening effect of macroprudential tightening is stronger and more instantaneous on transactions than on prices. The eventual outcome as indicated by conditional forecasts is dominated by a strong and prolonged own price response to house price shocks and other external developments that undermine the policy’s effectiveness. Moreover, over the long haul, a combination of a stamp duty and stress test tends to be more effective than restricting the loan-to-value ratio in triggering a trend reversal in house prices, despite the government’s preference for the latter. The out-of-sample probabilistic forecasts of policy changes are mostly consistent with the observable outcomes.

External medial maxillectomy is a common surgical approach for the management of para-nasal sinusoidal tumor, however tumor extension to nasopharynx is an extreme challenge to maxillofacial surgeon in planning surgical resection with adequate oncological control of the disease. This article will report a case of extensive adenocystic carcinoma of nasal cavity involving maxilla sinus with extension to ethmoid sinus superiorly and nasopharynx posteriorly. Patient had seen by few ENT surgeons for the management of severe nasal obstruction for more than 6 months without the consideration of neoplasm. The clinical diagnosis including histology, imaging workup in conjunction with 3D skull model printing to formulate the surgical resection & reconstruction plan will be well discussed. The operative technique of this extended external medial maxillectomy for enbloc resection of this tumor with ethmoidectomy superiorly and nasopharyngectomy posteriorly will be described in detail.