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By vaccinating SARS-CoV-2 naïve individuals who have already received two doses of COVID-19 vaccines, we aimed to investigate whether a heterologous prime-boost strategy, using vaccines of different platforms as the booster dose, can enhance the immune response against SARS-CoV-2 virus variants. Participants were assigned into four groups, each receiving different combination of vaccinations: two doses of BNT162b2 followed by one dose of BNT162b2 booster (B-B-B); Combination of BNT162b2 (first dose) and CoronaVac (second dose) followed by one dose of BNT162b2 booster (B-C-B); two doses of CoronaVac followed by one dose of CoronaVac booster (C-C-C); two doses of CoronaVac followed by one dose of BNT162b2 booster (C-C-B). The neutralizing antibody in sera against the virus was determined with live virus microneutralization assay (vMN). The B-B-B group and C-C-B group demonstrated significantly higher immunogenicity against SARS-CoV-2 Wild type (WT), Beta variant (BV) and Delta variant (DV). In addition, the B-B-B group and C-C-B group showed reduced but existing protection against Omicron variant (OV). Moreover, A persistent rise in vMN titre against OV was observed 3 days after booster dose. Regarding safety, a heterologous prime-boost vaccine strategy is well tolerated. In this study, it was demonstrated that using vaccines of different platforms as booster dose can enhance protection against SARS-CoV-2 variants, offering potent neutralizing activity against wild-type virus (WT), Beta variant (BV), Delta variant (DV) and some protection against the Omicron variant (OV). In addition, a booster mRNA vaccine results in a more potent immune response than inactivated vaccine regardless of which platform was used for prime doses.

Aviation is part of Hong Kong's constitutional identity. Article 128 of the Basic Law states that ＂the Hong Kong Government shall provide conditions and take measures to maintain the status of Hong Kong as a centre of international and regional aviation.＂ The key phrase ＂a centre of international and regional aviation＂ is commonly interpreted as meaning an ＂international aviation hub.＂ Hong Kong has indeed been a successful international aviation hub thanks to the city's overall laissez-faire economic policy and advanced infrastructure, although multiple factors have affected that status over the years. However, the Outline Development Plan for the Guangdong-Hong Kong-Macao Greater Bay Area (GBA) provides new opportunities for Hong Kong. The GBA initiative defines the role that Hong Kong will play in the overall development of the GBA and reinforces its importance as a leading international aviation hub. This article suggests that although Hong Kong's status as a connecting airport has weakened, the GBA initiative can strengthen its role as a center of international and regional aviation.

IntroductionMyopia and its complications can lead to irreversible visual impairment and even blindness, making this a worldwide public health concern for the 21st century. While treatments to slow myopia progression exist, their average efficacy is moderate. Bright light exposure, either in controlled animal models or naturally under sunlight for children, has demonstrated a protective effect against myopia development. This study hypothesises that bright light therapy (BLT), delivered via a home-based device mimicking sunlight, could slow myopia progression in schoolchildren.Methods and analysisWe propose a 2-year, double-masked, randomised controlled trial to investigate the effectiveness of BLT and its combination with myopia control treatment in schoolchildren. Chinese schoolchildren aged 7–12 years will be recruited and randomly assigned to one of three arms in phase 1. Subjects will be instructed to perform a minimum of 45 mins of near tasks daily under either BLT (10 000 lux white Light Emitting Diode (LED) light) or placebo light therapy (500 lux white LED light). The control subjects will receive single-vision spectacles and placebo light therapy; the single treatment subjects will receive single-vision spectacles and BLT; and the combination treatment subjects will receive defocus-incorporated multiple segments spectacles and BLT. The primary and secondary outcome measures are changes in cycloplegic objective refraction and axial length over a 2-year period.Treatment dosage is indirectly measured using a monitoring sensor attached beneath the BLT lamp rather than a wearable light metre. Variations in dosage monitoring may influence the observed treatment efficacy.Ethics and disseminationThe study has been approved by the Institutional Review Boards of The Hong Kong Polytechnic University (HSEARS 20180829002–05) and The University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW 20–362). The study results will be disseminated in scientific conferences and peer-reviewed indexed journals.Trial registration numberClinicalTrials.gov identifier: NCT04923841

The effects of the COVID-19 pandemic continue to constrain health-care staff and resources worldwide, despite the availability of effective vaccines. Aerosol-generating procedures such as endoscopy, a common investigation tool for nasopharyngeal carcinoma, are recognised as a likely cause of SARS-CoV-2 spread in hospitals. Plasma Epstein-Barr virus (EBV) DNA is considered the most accurate biomarker for the routine management of nasopharyngeal carcinoma. A consensus statement on whether plasma EBV DNA can minimise the need for or replace aerosol-generating procedures, imaging methods, and face-to-face consultations in managing nasopharyngeal carcinoma is urgently needed amid the current pandemic and potentially for future highly contagious airborne diseases or natural disasters. We completed a modified Delphi consensus process of three rounds with 33 international experts in otorhinolaryngology or head and neck surgery, radiation oncology, medical oncology, and clinical oncology with vast experience in managing nasopharyngeal carcinoma, representing 51 international professional societies and national clinical trial groups. These consensus recommendations aim to enhance consistency in clinical practice, reduce ambiguity in delivering care, and offer advice for clinicians worldwide who work in endemic and non-endemic regions of nasopharyngeal carcinoma, in the context of COVID-19 and other airborne pandemics, and in future unexpected settings of severe resource constraints and insufficiency of personal protective equipment.

Purpose Data on mental disorder prevalence and health service utilization required to inform healthcare management and planning are lacking in Hong Kong. The current study determined the prevalence of common mental disorders (CMD), and examined the patterns of mental health service utilization and associated factors. Methods We analyzed data from the Hong Kong Mental Morbidity Survey (HKMMS) of 5,719 Chinese adults aged 16–75 years in the general Hong Kong population, using the Chinese Revised Clinical Interview Schedule (CIS-R). Results The weighted prevalence estimate for any past-week CMD was 13.3 %, with mixed anxiety and depressive disorder being the most frequent diagnoses. CMD was positively associated with female gender, being divorced or separated, alcohol misuse, substance dependence, lack of regular physical exercise, and a family history of mental disorder. Among individuals with CMD, only 26 % had consulted mental health services in the past year; less than 10 % consulted general practitioners or family physicians. Lack of mental health service usage was significantly more likely in men and those with lower educational attainment. Conclusions Apart from attention to psychosocial risks, health and lifestyle factors are important considerations for mental health promotion. Service utilization for individuals with CMD in Hong Kong remains suboptimal, and would be enhanced by strengthening community primary care.

Background. DespiteWorld Health Organization recommendations, the rate of 23-valent pneumococcal (PPV) and influenza (TIV) vaccination among elderly persons in Hong Kong, China, is exceptionally low because of doubts about effectiveness of vaccination. The efficacy of dual vaccination remains unknown. Methods. From 3 December 2007 to 30 June 2008, we conducted a prospective cohort study by recruiting outpatients aged ⩾65 years with chronic illness to participate in a PPV and TIV vaccination program. All were observed until 31 March 2009. The outcome of subjects, including the rates of death, hospitalization, pneumonia, ischemic stroke, acute myocardial infarction, and coronary and intensive care admissions, were determined. Results. Of the 36,636 subjects recruited, 7292 received both PPV and TIV, 2076 received TIV vaccine alone, 1875 received PPV alone, and 25,393 were unvaccinated, with a duration of follow-up of 45,834 person-years. Baseline characteristics were well matched between the groups, except that there were fewer male patients in the PPV and TIV group and fewer cases of comorbid chronic obstructive pulmonary disease among unvaccinated persons. At week 64 from commencement of the study, dual-vaccinees experienced fewer deaths (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.55–0.77]; P <.001) and fewer cases of pneumonia (HR, 0.57; 95% CI, 0.51–0.64; P<.001), ischemic stroke (HR, 0.67; 95% CI, 0.54–0.83; P<.001), and acute myocardial infarction (HR, 0.52; 95% CI, 0.38–0.71; P<.001), compared with unvaccinated subjects. Dual vaccination resulted in fewer coronary (HR, 0.59; 95% CI, 0.44–0.79; P<.001) and intensive care admissions (HR, 0.45; 95% CI, 0.22–0.94; P = .03), compared with among unvaccinated subjects. Conclusions. Dual vaccination with PPV and TIV is effective in protecting elderly persons with chronic illness from developing complications from respiratory, cardiovascular, and cerebrovascular diseases, thereby reducing hospitalization, coronary or intensive care admissions, and death.

Background. In previous literature, the stability and temporal evolution of psychobehavioral responses to an outbreak remained undefined, because of the exclusively cross-sectional nature of such study designs. Methods. Using random-digit dialing, we sampled 4481 Hong Kong residents in 6 population-based surveys that were conducted at different times during and after the 2003 outbreak of severe acute respiratory syndrome (SARS). Results. Respondents' State-Trait Anxiety Inventory score (range, 10–40) showed a decreasing temporal trend, from a high mean value of 24.8 during the peak of the Amoy Gardens outbreak to a postepidemic mean baseline value of 14.5. Those who perceived a higher likelihood of contracting or dying of SARS had significantly higher anxiety scores. Female respondents, individuals aged 30–49 years, and individuals with only a primary education or less were predisposed to greater anxiety. There was a positive dose-response gradient between anxiety level and uptake of personal protective measures. Males respondents, individuals at the extremes of age, and individuals with lower educational levels were less likely to engage in self-protective behavior. The presence of symptoms was the only consistent predictor for greater use of health services. There was remarkable stability in the magnitude and the direction of associations between predictors and outcomes over time. Conclusions. Our findings can assist in modifying public service announcements in the future, which should be tailored to psychobehavioral surveillance intelligence to achieve the desired behavioral outcomes. Future research should explore the use of more-sophisticated techniques, including structural equation modeling and game-theoretical frameworks, to analyze population psychology and behavior, and it should integrate such findings with transmission dynamics modeling.

The rhizosphere is a dynamic ecosystem that hosts diverse microbial communities, essential for nutrient cycling, and promoting plant health and resistance to environmental stresses and pathogens. Understanding the communication strategies between plant roots and these microbial communities is vital for sustainable agriculture, as these interactions can enhance crop resilience and productivity while reducing the need for chemical fertilizers. Extensive research has focused on how soybean plants shape the rhizosphere microbiota and the signaling processes that promote these interactions; however, many influencing factors, particularly environmental stresses, remain unexplored. Key elements, including soybean genetics, growth development stages, soil properties, agricultural practices, and environmental conditions, all play crucial roles in shaping microbial symbioses. This review examines the intricate interactions between soybean and their rhizospheric microbiota, emphasizing how various stresses affect these relationships. It also discusses the role of secondary metabolites from both microbes and soybean in facilitating communication, alongside other factors that significantly influence these microbial interactions and soybean productivity.

Hepatocellular carcinoma (HCC) is an aggressive tumor, with a high mortality rate due to late symptom presentation and frequent tumor recurrences and metastasis. It is also a rapidly growing tumor supported by different metabolic mechanisms; nevertheless, the biological and molecular mechanisms involved in the metabolic reprogramming in HCC are unclear. In this study, we found that pyruvate kinase M2 (PKM2) was frequently over-expressed in human HCCs and its over-expression was associated with aggressive clinicopathological features and poor prognosis of HCC patients. Furthermore, knockdown of PKM2 suppressed aerobic glycolysis and cell proliferation in HCC cell lines in vitro. Importantly, knockdown of PKM2 hampered HCC growth in both subcutaneous injection and orthotopic liver implantation models, and reduced lung metastasis in vivo. Of significance, PKM2 over-expression in human HCCs was associated with a down-regulation of a liver-specific microRNA, miR-122. We further showed that miR-122 interacted with the 3UTR of the PKM2 gene. Re-expression of miR-122 in HCC cell lines reduced PKM2 expression, decreased glucose uptake in vitro, and suppressed HCC tumor growth in vivo. Our clinical data and functional studies have revealed a novel biological mechanism involved in HCC metabolic reprogramming.

Neurofibromatosis type 1 (OMIM 613,113, NF1) is a neurocutaneous disorder caused by pathogenic genetic alteration in NF1 gene, which exhibits nearly full penetrance and affects multiple systems. Previously two association studies of optic pathway glioma and NF1 protein domains, derived from 215 and 381 patients, respectively, obtained contradicting results, reflecting different datasets can lead to different conclusions and there is a need for a larger dataset to reach a solid conclusion. There is another association study based on 832 patients considering protein domains, clinical features, and types of variants. But it only investigated the GTPase-activating protein domain and non-truncating variants. In this study, an extended association analysis involving eight protein domains, two types of variants, namely truncating and non-truncating variants, and 32 clinical features, was performed based on a combined dataset of 1663 NF1 patients consisting of 738 cases recruited in Hong Kong and 925 reported cases from 25 studies. In summary, this study has identified 121 statistically significant associations between clinical features, types of variants, and protein domains, with 120 of them being novel findings. These new insights about the genotype–phenotype association promote better clinical management.