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<b>1. Professor Chan Kay Sheung, Paul (13 April 2017)</b> | <b>1. Professor Chan Kay Sheung, Paul (13 April 2017)</b> | ||
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− | Before starting our project, we interviewed Professor Paul Chan at the Department of Microbiology, Prince of Wales Hospital. Professor Paul Chan is an Honorary Consultant in Microbiology of the Hong Kong Hospital Authority. He is also a member of the Global Outbreak Alert and Response Network of World Health Organization. We believe that his advice will be very useful because he is an expert in molecular methods for rapid diagnosis and strain characterization.</u>. | + | Before starting our project, we interviewed <b>Professor Paul Chan</b> at the <b>Department of Microbiology, Prince of Wales Hospital</b>. Professor Paul Chan is an <b>Honorary Consultant in Microbiology of the Hong Kong Hospital Authority</b>. He is also a <b>member of the Global Outbreak Alert and Response Network of World Health Organization</b>. We believe that his advice will be very useful because he is an expert in molecular methods for rapid diagnosis and strain characterization.</u>. |
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− | Professor Chan had explained the whole process of influenza detection, from sample collection to standard diagnosis procedures in detail. Initially, we believe that we can just collect the patient saliva for testing. However, he pointed out that actually there is a verity of sources of sample can be collected from patient: Nasopharyngeal aspirate is the most sensitive source to be examined, however, assistance of nurse is required, while throat swab is the common method adopted in clinic due to its easier manipulation and collection, but lower amount of virus can be found here, leading to lower accuracy. Thus, he emphasized if the sensitivity of the product we designed is similar to that of PCR reaction, the source limitation and profession are no longer an obstacle. | + | Professor Chan had explained the whole process of influenza detection, from sample collection to standard diagnosis procedures in detail. Initially, we believe that we can just collect the patient saliva for testing. However, he pointed out that actually there is a verity of sources of sample can be collected from patient: <b>Nasopharyngeal aspirate</b> is the most sensitive source to be examined, however, assistance of nurse is required, while <b>throat swab</b> is the common method adopted in clinic due to its easier manipulation and collection, but lower amount of virus can be found here, leading to lower accuracy. Thus, he emphasized if the sensitivity of the product we designed is similar to that of PCR reaction, the source limitation and profession are no longer an obstacle. |
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<b>2. Professor Joseph J.Y. Sung (23 June 2017) </b> | <b>2. Professor Joseph J.Y. Sung (23 June 2017) </b> | ||
<p style="font-family: roboto;font-size:115%;"> | <p style="font-family: roboto;font-size:115%;"> | ||
− | We have also met Professor Sung, Vice-Chancellor and Mok Hing Yiu Professor of Medicine of the Chinese University of Hong Kong (CUHK). Professor Sung has long been dedicated his life to public health affairs. In 2003, Professor Sung led his medical team to fight against the Severe Acute Respiratory Syndrome (SARS). He also won the name of “Asian Hero” in the Time magazine and was awarded the Distinguished Award for Scientist and Medical Professional in the Fighting Against SARS (Medical Technology Personnel Category), in praise of his great contributions. | + | We have also met <b>Professor Sung</b>, Vice-Chancellor and Mok Hing Yiu Professor of Medicine of the Chinese University of Hong Kong (CUHK). Professor Sung has long been dedicated his life to public health affairs. In 2003, Professor Sung led his medical team to <b>fight against the Severe Acute Respiratory Syndrome (SARS)</b>. He also won the name of <b>“Asian Hero” in the Time magazine</b> and was awarded <b>the Distinguished Award for Scientist and Medical Professional in the Fighting Against SARS (Medical Technology Personnel Category)<b>, in praise of his great contributions. |
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<b>1. The new territories chicken breeders association (10 July 2017)</b> | <b>1. The new territories chicken breeders association (10 July 2017)</b> | ||
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− | We interviewed a representative from the association. Before the interview, we guessed they may be interested a little bit as they suffer the loss of money during central slaughtering. Surprisingly, they were almost acceptable to the arrangements from the government because they thought that Avian influenza detection should be conducted by position with no conflict of interest, which is the government in their opinions. <br> | + | We interviewed a representative from the association. Before the interview, we guessed they may be interested a little bit as they suffer the loss of money during central slaughtering. Surprisingly, they were almost acceptable to the arrangements from the government because they thought that Avian influenza detection should be conducted by position with <b>no conflict of interest</b>, which is the government in their opinions. <br> |
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<center><img src="https://static.igem.org/mediawiki/2017/3/34/Chicken_association.png" width="300px" height="auto"></center> | <center><img src="https://static.igem.org/mediawiki/2017/3/34/Chicken_association.png" width="300px" height="auto"></center> | ||
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<b>2. Fork Eat, a local chicken farm (29 July 2017)</b> | <b>2. Fork Eat, a local chicken farm (29 July 2017)</b> | ||
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− | We also interviewed two local chicken farmers Mr. Joe Lit and Mr. Charles Lam. They are the founder of one of the local chicken farms and restaurant “Fork Eat”. Similar to the attitudes of chicken breeders association, they agreed that their role in Avian flu detection is very passive, as the government has the absolute right of slaughter. Moreover, they indicated that chicken farms in Hong Kong are undergone regular inspection frequently (approximately 2-3 times per month), which is more than enough in their opinions, so they can’t find any incentive to detect by themselves. <br> | + | We also interviewed two local chicken farmers <b>Mr. Joe Lit</b> and Mr. <b>Charles Lam</b>. They are the founder of one of the local chicken farms and restaurant “Fork Eat”. Similar to the attitudes of chicken breeders association, they agreed that their role in Avian flu detection is very passive, as the government has the absolute right of slaughter. Moreover, they indicated that chicken farms in Hong Kong are undergone regular inspection frequently (approximately 2-3 times per month), which is more than enough in their opinions, so they can’t find any incentive to detect by themselves. <br> |
<center><img src="https://static.igem.org/mediawiki/2017/6/6d/Forkeat.png" width="250px" height="auto"></center> | <center><img src="https://static.igem.org/mediawiki/2017/6/6d/Forkeat.png" width="250px" height="auto"></center> | ||
<br><p style="font-family: roboto;font-size:115%;"> | <br><p style="font-family: roboto;font-size:115%;"> | ||
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<b>1. Department of health (20 June 2017) </b> | <b>1. Department of health (20 June 2017) </b> | ||
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− | We consulted Dr. Au Ka-wing, Director of Health. He admitted early treatment for patients infected with avian influenza viruses may reduce the mortality rate and higher speed of laboratory confirmation may help fasten the initiation of medical treatment, although the time lag between onset of illness and initiation of medical treatment for avian influenza infection is affected by many factors, which is also consistent with what Prof Chan said. Nonetheless, targeted treatment for avian influenza may already be initiated for suspected cases before any laboratory confirmation. <br> | + | We consulted <b>Dr. Au Ka-wing, Director of Health<b>. He admitted early treatment for patients infected with avian influenza viruses may reduce the mortality rate and higher speed of laboratory confirmation may help fasten the initiation of medical treatment, although the time lag between onset of illness and initiation of medical treatment for avian influenza infection is affected by many factors, which is also consistent with what Prof Chan said. Nonetheless, targeted treatment for avian influenza may already be initiated for suspected cases before any laboratory confirmation. <br> |
The influenza viruses test for human specimens mainly provided by the Public Health Laboratory Services Branch under the Centre for Health Protection of the Department of Health. Thus, we further contacted the Centre for Health Protection for more details. <br> | The influenza viruses test for human specimens mainly provided by the Public Health Laboratory Services Branch under the Centre for Health Protection of the Department of Health. Thus, we further contacted the Centre for Health Protection for more details. <br> | ||
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<b>2. Centre for Health Protection (21 June 2017) </b> | <b>2. Centre for Health Protection (21 June 2017) </b> | ||
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− | Offering laboratory diagnostic services for disease surveillance and control is one of the duties of Public Health Laboratory Services Branch under the Centre for Health Protection. They provide not merely diagnostic services to confirm whether the samples are positive on influenza, but also laboratory support on outbreak investigation, in this case, subtyping the unknown samples. During peak season or outbreak, rapid kit with subtyping function may help alleviate the pressure of outbreak investigation. <br> | + | Offering laboratory diagnostic services for disease surveillance and control is one of the duties of <b>the Public Health Laboratory Services Branch</b> under <b>the Centre for Health Protection of the Department of Health</b>. They provide not merely diagnostic services to confirm whether the samples are positive on influenza, but also laboratory support on outbreak investigation, in this case, subtyping the unknown samples. During peak season or outbreak, rapid kit with subtyping function may help alleviate the pressure of outbreak investigation. <br> |
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<center><img src="https://static.igem.org/mediawiki/2017/9/98/Chp.jpeg" width="180px" height="auto"></center> | <center><img src="https://static.igem.org/mediawiki/2017/9/98/Chp.jpeg" width="180px" height="auto"></center> | ||
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<b>3. Agriculture, Fisheries and Conservation Department (AFAD) (21 June 2017)</b> | <b>3. Agriculture, Fisheries and Conservation Department (AFAD) (21 June 2017)</b> | ||
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− | Unlike Centre for Health Protection, Agriculture, Fisheries and Conservation Department (AFAD) is responsible for Avian specimen inspection. They described some methods of detection and their procedures, for instance, haemagglutination inhibition test and direct RNA detection by PCR. In Hong Kong, there is only one veterinary laboratory (Tai Lung Veterinary Laboratory) | + | Unlike Centre for Health Protection, <b>Agriculture, Fisheries and Conservation Department (AFAD)</b> is responsible for Avian specimen inspection. They described some methods of detection and their procedures, for instance, haemagglutination inhibition test and direct RNA detection by PCR. In Hong Kong, there is only one <b>veterinary laboratory (Tai Lung Veterinary Laboratory)</b>, while the detections approximately take at least 4 hours and the size of sanitary testing and inspecting team is not big enough, 46 people in total. The workloads of the veterinary laboratory will be very large when handling a lot of avian specimens during flu peak season. <br> |
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<center><img src="https://static.igem.org/mediawiki/2017/4/4a/AFCD.png" width="150px" height="auto"></center> | <center><img src="https://static.igem.org/mediawiki/2017/4/4a/AFCD.png" width="150px" height="auto"></center> | ||
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− | In the first part, 86.7% respondents have no idea what H and N represent in influenza and only very few people can correctly distinguish Avian Influenza from common flu. Noted that most people can point out H5N1 and H7N9 are avian influenza, it may be due to great media exposure during the outbreaks in 1997 and 2013 respectively, highlighting the importance of media communication. These two viruses, H5N1 and H7N9 will also be the first target in our blueprint --- we have designed corresponding toehold switches to detect them. | + | In the first part, 86.7% respondents have <b>no idea what H and N represent in influenza</b> and <b>only very few people can correctly distinguish Avian Influenza from common flu</b>. Noted that most people can point out H5N1 and H7N9 are avian influenza, it may be due to great media exposure during the outbreaks in 1997 and 2013 respectively, highlighting the importance of media communication. These two viruses, H5N1 and H7N9 will also be the first target in our blueprint --- we have designed corresponding toehold switches to detect them. |
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− | Secondly, in terms of detection and countermeasures, 70% and 71.7% respondents think it is insufficient and the performances are unsatisfactory respectively, indicating there is a potential market of new detection methods except for current traditional approaches, not only increase the choices of customers but also alleviate the burdens in public healthcare system, even if the effect may be limited. | + | Secondly, in terms of detection and countermeasures, <b>70% and 71.7% respondents think it is insufficient and the performances are unsatisfactory respectively</b>, indicating there is a <b>potential market</b> of new detection methods except for current traditional approaches, not only increase the choices of customers but also alleviate the burdens in public healthcare system, even if the effect may be limited. |
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− | In the third part, we focus more on the opinions of our design (please visit our <a href="https://2017.igem.org/Team:Hong_Kong-CUHK/Prototype">prototype page</a>), out of our expectation, more than 70% respondents are interested in and willing to purchase our products for detection, and feeling more secure and short detection time are the major motivations. On another hand, 52.4% respondents among those are not interested in the rapid test by ranking from 1 to 3 think that there is no actual need to undergo detection by themselves proactively. When we kept asking the reasons behind, almost all of them think influenza is not a big problem. However, by recalling what Prof Chan and Prof Sung had mentioned, early detection may help alleviate/reduce the damages brought by rare type of influenza under the fact that vaccine protection may be insufficient because of fast mutation rate and presence of various subtypes of virus, reflecting the significance of promotion and education (please visit our <a href="https://2017.igem.org/Team:Hong_Kong-CUHK/HP/Silver">public engagement page</a>), which is highly related to our design: only people with high awareness, our design can function in maximum through quick recognition and quick treatment afterwards. | + | In the third part, we focus more on the opinions of our design (please visit our <a href="https://2017.igem.org/Team:Hong_Kong-CUHK/Prototype">prototype page</a>), out of our expectation, more than <b>70% respondents are interested in and willing to purchase our products for detection</b>, and feeling more secure and short detection time are the major motivations. On another hand, 52.4% respondents among those are not interested in the rapid test by ranking from 1 to 3 think that there is no actual need to undergo detection by themselves proactively. When we kept asking the reasons behind, almost all of them think influenza is not a big problem. However, by recalling what Prof Chan and Prof Sung had mentioned, early detection may help alleviate/reduce the damages brought by rare type of influenza under the fact that vaccine protection may be insufficient because of fast mutation rate and presence of various subtypes of virus, reflecting the significance of promotion and education (please visit our <a href="https://2017.igem.org/Team:Hong_Kong-CUHK/HP/Silver">public engagement page</a>), which is highly related to our design: only people with high awareness, our design can function in maximum through quick recognition and quick treatment afterwards. |
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− | As reminded by Prof Chan, if we want to develop the market of the private clinic, the price will be the determining factor because the extra detection cost most likely will be carried by the private clinic customers themselves, unlike in public hospitals, the extra detection cost is shared, or even fully borne by government. The result obtained is quite evenly distributed but more people (28.3%) think that 41-60 HKD (~5-8 USD) is preferable. We could obtain a more accurate range of price if we enlarge the sample size in future. | + | As reminded by Prof Chan, if we want to develop the market of the private clinic, the price will be the determining factor because the extra detection cost most likely will be carried by the private clinic customers themselves, unlike in public hospitals, the extra detection cost is shared, or even fully borne by government. The result obtained is quite evenly distributed but more people (28.3%) think that <b>41-60 HKD (~5-8 USD)</b> is preferable. We could obtain a more accurate range of price if we enlarge the sample size in future. |
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− | Considering negative perspectives against the use of E.coli may be held by the general public (E.coli is employed in the manufacture of cell free system and biobricks), we want to evaluate their degree of acceptance, and try to explain the principles behind more. Similar to our prediction, most people feel disturbed when mentioning the involvement of E.coli, however, almost all respondents gain their composure after the explanation (emphasize that E.coli is the platform to produce biobrick—the detection tool and the users will not directly contact E.coli) and around 75% people accept such application in our design eventually. | + | Considering negative perspectives <b>against the use of E.coli</b> may be held by the general public (E.coli is employed in the manufacture of cell free system and biobricks), we want to evaluate their degree of acceptance, and try to explain the principles behind more. Similar to our prediction, most people feel disturbed when mentioning the involvement of E.coli, however, almost all respondents gain their composure after the explanation (emphasize that E.coli is the platform to produce biobrick—the detection tool and the users will not directly contact E.coli) and around 75% people accept such application in our design eventually. |
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− | Although avian influenza doesn’t affect Hong Kong recently, it is still considered as endemic in poultry in six countries (Bangladesh, China, Egypt, India, Indonesia, and Vietnam) according to WHO. If we would like to promote our product to them, we should know about their opinions. Therefore, we conducted the same questionnaires in some of the countries (but with the third part of questionnaire only), including Bangladesh (16), India (26), Vietnam (33) (the number inside the bracket indicates the number of respondents respectively). Similar to the trends in Hong Kong, more than half people are interested in using our design for detection, however, half of the respondents in Bangladesh are indifferent to our design. When investigating deeply the reasons behind, they thought the detection kit is unnecessary and be afraid of the high price, meanwhile, they also concern the accuracy. Such attitudes also can be shown in the last question, no matter in Bangladesh (100%), India (75%), Vietnam (40%, but still accounts for the highest proportion among all parameters), they all regard accuracy, ie. sensitivity and specificity as their first choice, which is correspondent with the results in Hong Kong (75%), high accuracy will be our ultimate goal in future work.<br> | + | Although avian influenza doesn’t affect Hong Kong recently, it is still considered as endemic in poultry in six countries (Bangladesh, China, Egypt, India, Indonesia, and Vietnam) according to WHO. If we would like to promote our product to them, we should know about their opinions. Therefore, we conducted the same questionnaires in some of the countries (but with the third part of questionnaire only), including Bangladesh (16), India (26), Vietnam (33) (the number inside the bracket indicates the number of respondents respectively). Similar to the trends in Hong Kong, <b>more than half people are interested in using our design for detection</b>, however, half of the respondents in Bangladesh are indifferent to our design. When investigating deeply the reasons behind, they thought the detection kit is unnecessary and be afraid of the high price, meanwhile, they also concern the accuracy. Such attitudes also can be shown in the last question, no matter in Bangladesh (100%), India (75%), Vietnam (40%, but still accounts for the highest proportion among all parameters), they all regard accuracy, ie. sensitivity and specificity as their first choice, which is correspondent with the results in Hong Kong (75%), high accuracy will be our ultimate goal in future work.<br> |
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<center><img src="https://static.igem.org/mediawiki/2017/9/9e/Bangladesh.png" width="200px" height="auto"> | <center><img src="https://static.igem.org/mediawiki/2017/9/9e/Bangladesh.png" width="200px" height="auto"> |
Revision as of 11:56, 31 October 2017