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In Hip Hing Construction Co Ltd v Hong Kong Airlines Ltd[2024] HKCFI 370, [2024] HKCLC 83, the Hong Kong Court of First Instance held that a clause purporting to create a trust of a sum of money over the defendant’s general assets was void for uncertainty of subject-matter. This note seeks to examine the significance of the Court’s reasoning. In particular, it argues that the Court’s express endorsement of the beneficial co-ownership analysis when analysing the question of certainty of subject-matter is to be welcomed. The Court correctly highlighted the importance of identifying the “mass”, of which the trust asset forms part. The “mass” or the “single asset” must be identified before the beneficiary could acquire an equitable interest as an equitable tenant-in-common.

An interview with Shirley Tse exploreing sculptural interventions that interrogate place, politics, and ecology, advocating for "world-making" as a poetics of survival, is presented. Topics include Tse's early work on plastics, her "Quantum Shirley Series" prototyping the plasticity of narratives, and her recent focus on issues related to fragile democracy and climate change.

TOMMY LEE AGE: 24 IDENTITIES AS: Gay OCCUPATION: Arts coordinator HOMETOWN: East Los Angeles RELATIONSHIP STATUS: Single How do you see yourself fitting into the gay community? Being part of [...]

Addressing the urgent global climate crisis demands a rapid and meaningful expansion of “climate mainstreaming,” which refers to the integration of climate objectives in all aspects of development programs and policies. However, progress remains slow and uneven due to bottlenecks in policy and institutional change. Considering the parallel struggle recorded over decades to mainstream gender across the same policy arenas, a key question emerges: what can climate mainstreaming learn from gender mainstreaming? To answer this question, we review 57 policy, strategy, and guidance documents of United Nations agencies, all of which integrate these themes into food security and broader development programming. Our analysis identifies gaps in climate mainstreaming efforts and derives lessons from gender mainstreaming to bridge these gaps. It underscores the importance of adapting programmatic mainstreaming strategies in response to evolving contexts, for example, by simultaneously considering both mainstreaming and targeted interventions. Additionally, it highlights the need to adopt organizational climate mainstreaming and establish mechanisms for accountability. Finally, it emphasizes the urgency of embracing a climate justice lens; in practice, this involves prioritizing populations at greater risk of climate change impacts and actively engaging diverse perspectives in decision‐making, particularly communities facing multiple forms of discrimination. This article is categorized under:Integrated Assessment of Climate Change > Assessing Climate Change in the Context of Other IssuesClimate and Development > Sustainability and Human Well‐BeingPolicy and Governance > International Policy Framework The speed at which climate considerations are being integrated into development programs and policies is not keeping up with the urgent need for climate action. Drawing insights from prolonged efforts to mainstream gender perspectives across similar policy domains, we propose strategies to propel the integration of lessons learnt from gender mainstreaming into the more recent field of climate mainstreaming, primarily in the context of global food systems development.

Objective.To test the performances of established cardiovascular (CV) risk scores in discriminating subclinical atherosclerosis (SCA) in patients with psoriatic arthritis.Methods.These scores were calculated: Framingham risk score (FRS), QRISK2, Systematic COronary Risk Evaluation (SCORE), 10-year atherosclerotic cardiovascular disease risk algorithm (ASCVD) from the American College of Cardiology and the American Heart Association, and the European League Against Rheumatism (EULAR)–recommended modified versions (by 1.5 multiplication factor, m-). Carotid intima-media thickness > 0.9 mm and/or the presence of plaque determined by ultrasound were classified as SCA+.Results.We recruited 146 patients [49.4 ± 10.2 yrs, male: 90 (61.6%)], of whom 142/137/128/118 patients were eligible to calculate FRS/QRISK2/SCORE/ASCVD. Further, 62 (42.5%) patients were SCA+ and were significantly older, with higher systolic blood pressure and higher low-density lipoprotein cholesterol (all p < 0.05). All CV risk scores were significantly higher in patients with SCA+ [FRS: 7.8 (3.9–16.5) vs 2.7 (1.1–7.8), p < 0.001; QRISK2: 5.5 (3.1–10.2) vs 2.9 (1.2–6.3), p < 0.001; SCORE: 1 (0–2) vs 0 (0–1), p < 0.001; ASCVD: 5.6 (2.6–12.4) vs 3.4 (1.4–6.1), p = 0.001]. The Hosmer-Lemeshow test revealed moderate goodness of fit for the 4 CV scores (p ranged from 0.087 to 0.686). However, of the patients with SCA+, those identified as high risk were only 44.1% (by FRS > 10%), 1.8% (QRISK2 > 20%), 10.9% (SCORE > 5%), and 43.6% (ASCVD > 7.5%). By applying the EULAR multiplication factor, 50.8%/14.3%/14.5%/54.5% of the patients with SCA+ were identified as high risk by m-FRS/m-QRISK2/m-SCORE/m-ASCVD, respectively. EULAR modification increased the sensitivity of FRS and ASCVD in discriminating SCA+ from 44% to 51%, and 44% to 55%, respectively.Conclusion.All CV risk scores underestimated the SCA+ risk. EULAR–recommended modification improved the sensitivity of FRS and ASCVD only to a moderate level.

AbstractBackgroundAgricultural intensification is having profound impacts on food security and rural livelihoods; however, concerns remain about the potential implications on public health.ObjectivesWe aim to examine and synthesize the evidence for human health risks of agricultural intensification in Southeast Asia.MethodsWe conducted a systematic review of peer-reviewed articles published between January 2000 and December 2015 from two electronic databases (PubMed, CAB Direct).ResultsA total of 73 relevant studies were included and evaluated. More than half of the studies used epidemiological methods while others applied alternative methods to quantify or estimate risks. Studies mainly focused on occupational and consumer exposure to pesticides, without often specifying the actual health risk.ConclusionOverall, the current knowledge on health risks appears to be limited. More research on long-term health implications and a wider range of contaminants are needed if sustainable benefits are to be obtained from agricultural intensification.

Pork safety is an important public health concern in Vietnam and is a shared responsibility among many actors along the pork value chain. We examined the knowledge, perceptions, and practices regarding food safety, disease, and health risk among selected pork value chain actors (slaughterhouse owners and workers, people living around slaughterhouses, pork sellers, consumers, and veterinary and public health staff) in three districts in Hung Yen Province, Vietnam. We randomly selected 52 pork value chain actors to be surveyed through questionnaires, observation checklists, key informant interviews, and focus group discussions. Most slaughterhouse workers acquired knowledge and experience of food safety through “learning by doing” rather than from training by a veterinary or public health professional. Both slaughterhouse worker and pork seller groups had some accurate perceptions about pig diseases and foodborne diseases; however, misperceptions of risk and, especially, of zoonoses were present. Furthermore, while workers and sellers often use cloths to dry the meat and clean equipment, they did not think this was a risk for meat contamination. Moreover, when sellers wear protective equipment, such as gloves, masks, or hats, consumers perceive that the sellers may have health issues they are trying to conceal and so consumers avoid buying from them. The perceived freshness of pork, along with trust in the seller and in the pork production process, were strong indicators of consumer preference. And yet, pork value chain actors tend to trust their own individual food safety practices more, rather than the practices of other actors along the chain. Veterinary and public health staff emphasized the gap between regulations and food safety practices. Education and training on food safety risks and proper handling are priorities, along with integrated and intensive efforts to improve food safety among pork value chain actors.

Background: Axial spondyloarthritis (axSpA) patients are at higher risk of cardiovascular (CV) disease (CVD) than the general population, partly due to consequences of inflammation or its treatment. But relationship between inflammation in axSpA and cardiovascular events (CVE) is unknown.Objectives: To examine whether inflammatory burden over time can predict CVE independent of baseline CV risk factors in axSpA patients.Design: A cohort analysis was performed in patients who had been recruited since January 2001. The primary outcome was a first CVE occurring between January 2001 and December 2020.Methods: Three CVD risk scores were computed at baseline. The performance of the original and modified (*1.5 multiplication factor) CV risk algorithms were assessed. Time-varying Cox proportional hazard models and Kaplan–Meier survival analysis were used to assess whether inflammatory burden (Bath ankylosing spondylitis disease activity index [BASDAI] and inflammatory markers), nonsteroidal anti-inflammatory drugs (NSAIDs) and disease modifying antirheumatic drugs (DMARDs) can predict the development of first CVE.Results: 463 patients (35 [26–45] years, male: 360 [77.8%]) were recruited. After a median follow-up of 12 (7–19) years, 61 patients (13.2%) experienced a first CVE. Traditional/modified CV risk scores underestimated CV risk. Erythrocyte sedimentation rate (ESR) ⩾ 20 mm/h was associated with a significantly higher risk of CVE during follow-up (HR: 2.07, 95%CI [1.10, 3.98], p= 0.008). Active disease as indicated by a rising BASDAI also showed positive trend towards a higher risk of developing CVE over time. After adjusting for CV risk scores in the multivariable models, high ESR level (ESR ⩾ 20 mm/h) over time remained significantly associated with a higher risk of developing CV events.Conclusion: Increased inflammatory burden as reflected by elevated ESR levels (ESR ⩾ 20) was associated with increased risk of CVE, while the use of NSAIDs and DMARDs were not.

OBJECTIVE To study the profile of incidents affecting quality outcomes after surgery by developing a usable operating room and perioperative clinical incident report database and a functional electronic classification, triage, and reporting system. Previously, incident reports after surgery were handled on an individual, episodic basis, which limited the ability to perceive actuarial patterns and meaningfully improve outcomes. DESIGN, SETTING, AND PARTICIPANTS Clinical incident reports were experientially generated in the second largest health care system in New York City. Data were entered into a functional classification system organized into 16 categories, and weekly triage meetings were held to electronically review and report summaries on 40 to 60 incident reports per week. System development and deployment reviewed 1041 reports after 19 693 operative procedures. During the next 4 years, 3819 additional reports were generated from 83 988 operative procedures and were reported electronically to the appropriate departments. MAIN OUTCOME MEASURES Number of incident reports generated annually. RESULTS A significant decrease in volume-adjusted clinical incident reports occurred (from 53 to 39 reports per 1000 procedures) from 2001 to 2005 (P &lt; .001). Reductions in incident reports were observed for ambulatory conversions (74% reduction), wasted implants (65%), skin breakdown (64%), complications in the operating room (42%), laparoscopic conversions (32%), and cancellations (23%) as a result of data-focused process and clinical interventions. Six of 16 categories of incident reports accounted for more than 88% of all incident reports. CONCLUSION These data suggest that effective review, communication, and summary feedback of clinical incident reports can produce a statistically significant decrease in adverse outcomes.Arch Surg. 2008;143(12):1192-1197--

The article presents the results of a survey about the lives and experiences of gays, lesbians, bisexuals and transgender individuals. The family background, relationships, involvement in gay activities, interests and pastimes of respondents were determined in the survey. Seventy percent of the respondents were gay. Majority of the respondents live in major urban areas. Most of the respondents believe that sexuality or gender identity is significant but not primary. Eighty-six percent of them have children.

The article discusses the views of several men and women on issues affecting the gay, lesbian, bisexual and transgender community. According to gay arts coordinator Tommy Lee, being part of the gay community is a mix of being an active gay consumer and an advocate for gay issues. Lesbian disc jockey Adien Aggenbach believes that the gay community has problems with people who are bisexual or straight and not with people of color. Gay student Will Mouradian describes the reaction of his mother when he came out.

Established in Article 14 of the Paris Agreement, countries must evaluate progress toward climate adaptation, mitigation, and financial goals via the 2023 global stocktake. Yet, the extent of climate integration into evaluation in response to the rapidly approaching stocktake mandate remains unclear. Many United Nations agencies recognize the importance of mainstreaming climate action into food security and broader development programming, which presents an opportunity to learn from experiences documented in United Nations food security evaluation reports. Our goal is to examine how United Nations food security programs are evaluating climate action. Using a systematic search and screening process, we included evaluations that described any aspect of food security, evaluated completed programs, and were published between 2014 and 2019. We examined the extent of climate change mainstreaming into food security evaluation by developing and applying an assessment rubric. We also identified, compared, and characterized evaluation challenges and opportunities using thematic analysis. Of the 136 relevant evaluations, 69% (n = 94) assessed food security programs that integrated climate action. While many evaluations reported adaptation outcomes, considerations of climate action in the evaluation approach were often insufficient. Based on our analysis, challenges to climate evaluation included inadequate resource allocation, weak monitoring and evaluation systems, dependency on food security evaluation, and limited climate focus in programs and evaluations. The assessment rubric provides a tool for understanding and encouraging climate change integration into evaluation, and through this, helps countries prepare for the upcoming global stocktake.

Aims: Psoriatic arthritis (PsA) is associated with accelerated atherosclerosis due to underlying inflammation. Whether inflammatory burden and drugs used to suppress inflammation over time are associated with cardiovascular (CV) events remained unclear. This study aims to examine the time-varying effect of C-reactive protein (CRP) levels and the use of drugs, including non-steroidal anti-inflammatory drugs (NSAIDs) and disease modifying anti-rheumatic drugs, on the risk of CV events independent of traditional CV risk factors in PsA patients.Methods: A retrospective cohort analysis was performed in patients with PsA who were recruited from 2008 to 2015 and followed until the end of 2019. The outcome was occurrence of a first CV event. Framingham risk score (FRS) was used to quantify the traditional CV risk. Cox proportional hazard models with time-varying CRP levels and drugs used were analysed to identify the risk factors for CV events in PsA patients.Results: Two hundred patients with PsA [median age: 47.5 (40.0–56.0); male: 119 (59.5%)] were recruited. After a mean follow-up of 8.8 ± 3.8 years, 30 (15%) patients developed a first CV event. The multivariable Cox regression model showed that time-varying CRP level [hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.00–1.04] and NSAIDs exposure (HR 0.38, 95% CI 0.15–0.96) were significantly associated with CV events after adjusting for baseline FRS (HR 5.06, 95% CI 1.84–13.92).Conclusion: Increased inflammatory burden as reflected by elevated CRP level was associated with increased risk of CV events, while the risk was significantly reduced with NSAIDs use in PsA patients.

Background: Although the short-term effects of tumor necrosis factor alpha (TNF-α) and interleukin-17A (IL-17A) inhibition on the structural changes in psoriatic arthritis (PsA) using high-resolution peripheral quantitative computed tomography (HR-pQCT) have been reported, no studies have investigated the long-term structural changes in PsA patients receiving routine care. We reported longitudinal changes of erosions and enthesiophytes using HR-pQCT and their relationship with treatments in PsA patients over a 5-year period. Methods: HR-pQCT examination at the second and third metacarpal heads (MCH2 and MCH3) was performed in 60 PsA patients at baseline and after 5 years. The size of each individual lesion was quantified. Erosion and enthesiophyte progression were defined as change exceeding the smallest detectable change (SDC). Results: A total of 108 bone erosions and 99 enthesiophytes were detected at baseline. Three new bone erosions but no new enthesiophytes were evident at 5 years. A significant increase in mean (±SD) erosion (0.58 ± 1.50 mm3, P&lt; 0.001) and enthesiophyte (0.47 ± 0.76 mm3, P&lt; 0.001) volume was observed. Erosion and enthesiophyte progression were found in 37/111 (33.3%) and 50/99 (50.5%) lesions, respectively. During this 5-year period, 26 (43%) out of the 60 patients achieved sustained Disease Activity index for PSoriatic Arthritis (DAPSA) low disease activity (LDA) (SDL group, defined as achieving DAPSA-LDA at both baseline and 5 years). Fourteen (23%) out of 60 patients received a TNF inhibitor throughout the 5-year period (TNFi group). Fewer erosions progressed (12/51 [23.5%] vs 25/60 [41.7%], P= 0.047) and the increased in enthesiophyte volume was significantly less (0.28 ± 0.67 vs 0.61 ± 0.80 mm3, P= 0.048) in the SDL group than in the non-SDL group. However, no significant difference between the TNFi and non-TNFi groups was detected in terms of the change in volume or progression of bone erosion and enthesiophyte. Conclusion: Damage accrual in terms of bone erosion and enthesiophyte was observed in PsA patients over a period of 5 years despite receiving routine clinical care. Nonetheless, sustained control of disease activity may be able to prevent these bony damages.

A 49-year-old man with multiple myeloma, IgA type, contracted cutaneous plasmocytomas. No deposits of immunoglobulin were found in the cutaneous tumor by direct immunofluorescence. The case is an unusual manifestation occurring in multiple myeloma.(JAMA 237:2625-2626, 1977)

The article presents the poem "A Blossom," by Steven Lam. First Line: Many gathered around your bed when; Last Line: But for an unforgiveable stubborness to keep a friend alive.