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Background: Prior research has found that children with attention-deficit hyperactivity disorder (ADHD) and reading difficulties (RD) are at an elevated risk of developing further cognitive deficits and developmental challenges [1]. ADHD and RD are characterized by a deficit in working memory, which negatively affects learning and behavior. The main aims of this study were to design a working memory training app and examine its effectiveness through a 5-week training program in Chinese children with ADHD and/or RD., Methods: There were three experimental groups, with 26 participants in the ADHD group, 38 participants in the RD group, and 24 participants in the ADHD + RD group. The typically developing (TD) control group had 32 participants. All participants completed the pretest and posttest assessments on executive function and reading performance., Results: The findings indicate that the experimental groups improved performance in verbal and visual-spatial working memory as well as Chinese word reading. There was an overall reduction in functional impairment following the training, in contrast to the TD group., Conclusion: This study showed that working memory can be improved through computerized training in children with ADHD and/or RD. The implications of future research in working memory are discussed., Trial Registration: Clinical Trials Identifier: NCT06567444 (retrospectively registered) on 20 August 2024., (© 2024. The Author(s).)

Background: Parents' high academic expectations are positively associated with young children's mathematical abilities. However, minimal attention has been devoted to whether, and how, different ways of conveying the performance targets would result in different outcomes., Aims: The current study investigated whether and how parents' perfectionistic strivings and concerns were associated with young children's mathematical abilities through home mathematical activities, children's approach motivation to learn mathematics, and children's avoidance motivation to learn mathematics., Sample: Participants included 211 kindergarteners in Hong Kong and their parents., Methods: Data were collected through individual child tests and parent questionnaires., Results: Structural equation modelling revealed that parents' perfectionistic strivings had a direct positive link with children's mathematical abilities, an indirect link via approach motivation to learn mathematics, and an indirect link via home mathematical activities, and then approach motivation. Parents' perfectionistic concerns had a direct negative link with children's mathematical abilities, an indirect link via approach motivation to learn mathematics, and an indirect link via avoidance motivation to learn mathematics., Conclusions: Early childhood practitioners are recommended to raise parents' awareness of how to communicate high-performance targets to children in a constructive manner., (© 2024 British Psychological Society.)

Introduction: The Sustainable Development Goals of the United Nations include a commitment to "leave no one behind" as a universal goal. To achieve this in geriatric oncology (GO) worldwide, it is important to understand the current state of GO at an international level. The International Society of Geriatric Oncology (SIOG) has several National Representatives (NRs) who act as SIOG's delegates in their respective countries. The NRs took part in this international survey exploring the state of GO practice, identifying barriers and solutions., Materials and Methods: The NRs answered open-ended questions by email from February 2020 to October 2022. The questionnaire domains included the demographic information of older adults for their countries, and the NRs' opinions on whether GO is developing, what the barriers are to developing GO, and proposed actions to remove these barriers. The demographic data of each country reported in the survey was adjusted using literature and database searches., Results: Twenty-one of thirty countries with NRs (70%) participated in this questionnaire study: 12 European, four Asian, two North American, two South American, and one Oceanian. The proportion of the population aged ≥75 years varied from 2.2% to 15.8%, and the average life expectancy also varied from 70 years to 86 years. All NRs reported that GO was developing in their country; four NRs (18%) reported that GO was well developed. Although all NRs agreed that geriatric assessment was useful, only three reported that it was used day-to-day in their countries' clinical practice (14%). The major barriers identified were the lack of (i) evidence to support GO use, (ii) awareness and interest in GO, and (iii) resources (time, manpower, and funding). The major proposed actions were to (i) provide new evidence through clinical trials specific for GO patients, (ii) stimulate awareness through networking, and (iii) deliver educational materials and information to healthcare providers and medical students., Discussion: This current survey has identified the barriers to GO and proposed actions that could remove them. Broader awareness seems to be essential to implementing GO. Additional actions are needed to develop GO within countries and can be supported through international partnerships., Competing Interests: Declaration of Competing Interest All the contributing authors declare no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: This network meta-analysis aimed to evaluate the association of anti-thyroid drugs (ATD), radioactive iodine (RAI), and thyroidectomy with subsequent outcomes in patients with newly-diagnosed hyperthyroidism., Methods: The Ovid Medline, Ovid Embase, and Cochrane Library databases were searched for observational studies and randomized controlled trials. Included studies were published on or before 1st May 2022 involving at least two of the treatments among ATD, RAI, and thyroidectomy for hyperthyroidism. Pairwise comparisons and Bayesian network meta-analysis were used to estimate hazard ratios (HRs) and their credible interval (CrI) of outcomes, including cardiovascular disease (CVD), cancer, overall mortality, and Graves' ophthalmopathy (GO)., Results: A total of 22 cohort studies with 131,297 hyperthyroidism patients were included. Thyroidectomy was associated with lower risks of mortality and GO than ATD (HR = 0.54, 95% CrI: 0.31, 0.96; HR = 0.31, 95% CrI: 0.12, 0.64) and RAI (HR = 0.62, 95% CrI: 0.41, 0.95; HR = 0.18, 95% CrI: 0.07, 0.35). RAI had a higher risk of GO (HR = 1.70, 95% CrI: 1.02, 2.99) than ATD treatment., Conclusions: This Bayesian network meta-analysis indicated that thyroidectomy was associated with lower risks of mortality and GO in newly-diagnosed hyperthyroid patients compared to ATD and RAI. Relative to ATD, RAI therapy increased the risk of GO., (© 2024 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)

Introduction: This prospective, single-arm, pragmatic implementation study evaluated the feasibility of a nurse-led symptom-screening program embedded in routine oncology post-treatment outpatient clinics by assessing (1) the acceptance rate for symptom distress screening (SDS), (2) the prevalence of SDS cases, (3) the acceptance rate for community-based psychosocial support services, and (4) the effect of referred psychosocial support services on reducing symptom distress., Methods: Using the modified Edmonton Symptom Assessment System (ESAS-r), we screened patients who recently completed cancer treatment. Patients screening positive for moderate-to-severe symptom distress were referred to a nurse-led community-based symptom-management program involving stepped-care symptom/psychosocial management interventions using a pre-defined triage system. Reassessments were conducted at 3-months and 9-months thereafter. The primary outcomes included SDS acceptance rate, SDS case prevalence, intervention acceptance rate, and ESAS-r score change over time., Results: Overall, 2988/3742(80%) eligible patients consented to SDS, with 970(32%) reporting ≥1 ESAS-r symptom as moderate-to-severe (caseness). All cases received psychoeducational material, 673/970(69%) accepted psychosocial support service referrals. Among 328 patients completing both reassessments, ESAS-r scores improved significantly over time (p < 0.0001); 101(30.8%) of patients remained ESAS cases throughout the study, 112(34.1%) recovered at 3-month post-baseline, an additional 72(22%) recovered at 9-month post-baseline, while 43(12.2%) had resumed ESAS caseness at 9-month post-baseline., Conclusion: Nurse-led SDS programs with well-structured referral pathways to community-based services and continued monitoring are feasible and acceptable in cancer patients and may help in reducing symptom distress. We intend next to develop optimal strategies for SDS implementation and referral within routine cancer care services., (© 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

Background: The debate on using concrete versus abstract materials in learning mathematics has been longstanding. For decades, research has focused on the physical characteristics of materials when defining them as concrete or abstract., Aims: This study extends the field by proposing a two-dimensional classification, which defines materials as concrete or abstract based on the two dimensions of representation, namely object (i.e., appearance) and language (i.e., label)., Sample: A total of 120 university students participated in the study., Methods: Participants were randomly assigned to learn the concept of modular arithmetic with one of four types of learning materials: concrete object labelled with concrete language, concrete object labelled with abstract language, abstract object labelled with concrete language and abstract object labelled with abstract language. They were also divided into high and low maths anxiety groups., Results: Results showed that the students who learnt with abstract objects, regardless of the level of maths anxiety, outperformed their peers who learnt with concrete objects. However, for students with low maths anxiety only, those who learnt with materials labelled with abstract language showed better far-transfer performance compared with those who learnt with materials labelled with concrete language., Conclusions: The findings offer a new direction in the conceptualization of concrete and abstract learning materials by specifying the dimensions of representation., (© 2023 The British Psychological Society.)

Background: The extent of thyroid surgery remains controversial for differentiated thyroid cancers (DTCs) that measure more than 1 cm but are not considered high risk. This study aimed to compare survival outcomes between hemithyroidectomy (HT) and total thyroidectomy (TT) in non-high-risk DTCs., Methods: A population-based retrospective cohort of patients with non-high-risk DTCs more than 1 cm undergoing HT or TT between 1997 and 2017 in a territory with 41 public hospitals and clinics serving a population of 7 million was analysed. Multivariable Cox proportional hazards regression models adjusted for patient demographics and clinical parameters were used to compare the overall, disease-specific, and recurrence-free survival between TT and HT. Risks of postoperative complications were compared between the two groups., Results: A total of 4771 patients (HT, 1368; TT, 3403) underwent thyroid surgery as a primary treatment. Median (range) follow-up was 117 (range: 72-179) months. Patients in the TT and HT groups had comparable risks of overall survival (HR 0.87; 95 per cent c.i. 0.73 to 1.04; P = 0.119) and disease-specific survival (HR 0.85; 95 per cent c.i. 0.52 to 1.40; P = 0.518). The TT group had better recurrence-free survival (HR 0.37; 95 per cent c.i. 0.26 to 0.52; P < 0.001) than the HT group. The temporary and permanent hypoparathyroidism rates in TT group were 14.96 per cent and 7.49 per cent respectively; none were reported in the HT group., Conclusions: Despite the comparable overall and disease-specific survivals, TT was associated with better recurrence-free survival than HT in a 10-year follow-up. This was at the expense of higher surgical morbidity rate in TT., (© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.)

Background: The relationship between good early control of thyroid hormone levels after thyroidectomy for Graves' disease (GD) and subsequent risks of mortality and morbidities is not well known. The aim of this study was to examine the association between thyroid hormone levels within a short interval after surgery and long-term mortality and morbidity risks from a population-based database., Methods: Patients with GD who underwent complete/total thyroidectomy between 2006 and 2018 were selected from the Hong Kong Hospital Authority clinical management system. All patients were classified into three groups (euthyroidism, hypothyroidism, and hyperthyroidism) according to their thyroid hormone levels at 6, 12, and 24 months after surgery. Cox proportional hazards models were performed to compare the risks of all-cause mortality, cardiovascular disease (CVD), Graves' ophthalmopathy, and cancer., Results: Over a median follow-up of 68 months with 5709 person-years, 949 patients were included for analysis (euthyroidism, n = 540; hypothyroidism, n = 282; and hyperthyroidism, n = 127). The hypothyroidism group had an increased risk of CVD (HR = 4.20, 95 per cent c.i. 2.37 to 7.44, P < 0.001) and the hyperthyroidism group had an increased risk of cancer (HR = 2.14, 95 per cent c.i. 1.55 to 2.97, P < 0.001) compared with the euthyroidism group. Compared with patients obtaining euthyroidism both at 6 months and 12 months, the risk of cancer increased in patients who achieved euthyroidism at 6 months but had an abnormal thyroid status at 12 months (HR = 2.33, 95 per cent c.i. 1.51 to 3.61, P < 0.001) and in those who had abnormal thyroid status at 6 months but achieved euthyroidism at 12 months (HR = 2.52, 95 per cent c.i. 1.60 to 3.97, P < 0.001)., Conclusions: This study showed a higher risk of CVD in postsurgical hypothyroidism and a higher risk of cancer in hyperthyroidism compared with achieving euthyroidism early after thyroidectomy. Patients who were euthyroid at 6 months and 12 months had better outcomes than those achieving euthyroidism only at 6 months or 12 months. Attaining biochemical euthyroidism early after thyroidectomy should become a priority., (© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.)

From infrared body temperature surveillance to lifeguarding, real-life visual search is usually continuous and comes with rare targets. Previous research has examined realistic search tasks involving separate slides (such as baggage screening and radiography), but search tasks that require continuous monitoring have generally received less attention. In this study, we investigated whether continuous visual search would display a target-rate effect similar to the low-prevalence effect (LPE) in regular visual search. We designed a continuous detection task for a target feature (e.g., a green color) among items of continuously and gradually changing features (e.g., other colors). In four experiments, we demonstrated target-rate effects in terms of slower hit response times (RTs) and higher miss rates when targets were rare. Similar to regular search, target-rate effects were also observed for relative frequencies across two target features. Taken together, these results suggest a target-rate effect in continuous visual search, and its behavioral characteristics are generally similar to those of the LPE in regular visual search., (© 2022. The Author(s).)

Background: The aim of this study was to compare long-term mortality, morbidity, and cumulative healthcare costs between antithyroid drugs, radioactive iodine, and surgical treatment for patients with persistent or relapsed Graves' disease., Methods: Data on patients with persistent or relapsed Graves' disease between 2006 and 2018 were retrieved from the Hong Kong Hospital Authority. Hazard ratios (HRs) estimated by Cox proportional hazards regression models were used to compare the risks of all-cause mortality, cardiovascular disease, atrial fibrillation, psychological disease, Graves' ophthalmopathy, and cancer across treatment groups. The 10-year healthcare cost and change in co-morbidity status were also estimated., Results: Over a median follow-up of 79 months (22 636 person-years), a total of 3443 patients (antithyroid drug 2294, radioactive iodine 755, surgery 394) were analysed. Compared with antithyroid drug treatment, surgery was associated with significantly lower risks of all-cause mortality (HR 0.40, 95 per cent c.i. 0.36 to 0.45), cardiovascular disease (HR 0.54, 0.48 to 0.60), atrial fibrillation (HR 0.11, 0.09 to 0.14), psychological disease (HR 0.85, 0.79 to 0.92), Graves' ophthalmopathy (HR 0.09, 0.08 to 0.10), and cancer (HR 0.56, 0.50 to 0.63). Patients who underwent surgery also had a lower risk of all outcome events than those in the radioactive iodine group. The 10-year direct cumulative healthcare cost was €14 754 for surgery compared with €17 390 for antithyroid drugs, and €17 918 for the radioactive iodine group., Conclusion: Patients who underwent surgery for persistent or relapsed Graves' disease had lower risks of all-cause mortality and analysed morbidities. The 10-year cumulative healthcare cost in the surgery group was lowest among the three treatment alternatives., (© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The efficacy of anti-angiogenic agents (AAAs) in epithelial ovarian cancer (EOC) remains unclear. Therefore, we conducted a systematic review and network meta-analysis (NMA) to synthesize evidence of their comparative effectiveness for improving overall survival (OS) among EOC patients. We searched six databases for randomized controlled trials (RCTs) from their inception to February 2021. We performed an NMA with hazard ratios (HRs) and 95%-confidence intervals (CIs) to evaluate comparative effectiveness among different AAAs in chemotherapy-naïve and recurrent EOC. P-score was used to provide an effectiveness hierarchy ranking. Sensitivity NMA was carried out by focusing on studies that reported high-risk chemotherapy-naïve, platinum-resistant, and platinum-sensitive EOC. The primary outcome was OS. We identified 23 RCTs that assessed the effectiveness of AAAs. In recurrent EOC, concurrent use of trebananib (10 mg/kg) with chemotherapy was likely to be the best option (P-score: 0.88, HR 1.67, 95% CI 0.94; 2.94). The NMA indicated that bevacizumab plus chemotherapy followed by maintenance bevacizumab (P-score: 0.99) and pazopanib combined with chemotherapy (P-score: 0.79) both had the highest probability of being the best intervention for improving OS in high-risk chemotherapy-naïve and platinum-resistant EOC, respectively. AAAs may not play a significant clinical role in non-high-risk chemotherapy-naïve and platinum-sensitive EOC., (© 2022. The Author(s).)

Patients with radioactive iodine (RAI) refractory locally advanced or metastatic differentiated thyroid cancer have a poor prognosis. This article reviews the definition of RAI-refractory thyroid cancer and the management approach. Watchful waiting should be considered for patients with asymptomatic and non-progressive disease, while oral targeted agent with tyrosine kinase inhibitors can be considered for patients who are symptomatic or whose disease would cause irreversible complications if treatment has not been initiated. Since these targeted agents only improve disease-free survival and are associated with adverse events, physicians should assess both clinical and tumor factors carefully to decide on the right timing of start of palliative treatment., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Most patients with well-differentiated thyroid cancers (WDTC) are adequately treated with surgery, radioactive iodine, and TSH suppression by thyroxine. External radiotherapy (ERT) is reserved for selected cases and for older patients. Some of the indications for ERT to neck include adjuvant treatment for gross or microscopic disease after surgery, palliation of locally advanced unresectable tumor, or as salvage for recurrent disease which is not amenable to surgery or does not uptake radioactive iodine. High radiation dose of at least 60Gy is required for locoregional control of gross or microscopic residual disease. As even patients with recurrent or metastatic disease can have long survival, it is important to minimize late radiation-induced morbidity without compromising local control. Modern ERT technique like intensity-modulated radiotherapy allows high radiation dose to be delivered to the large, complex target volume while protecting the adjacent critical normal structures like the trachea, larynx, esophagus, and cervical spinal cord., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Radioactive iodine is given after total thyroidectomy for remnant ablation or treatment of residual/metastatic disease. The decision and dose of radioactive iodine should be in a personalized and patient-specific approach, taking account the clinical-pathological features, risk stratification, patient's preference, and facilities of the institutions. We review the principles and use of radioactive iodine in differentiated thyroid cancer., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Developed as an antidiabetic drug, recent evidence suggests that several sodium-glucose co-transporter 2 inhibitors (SGLT2i), especially canagliflozin and dapagliflozin, may exhibit in vitro and in vivo anticancer activities in selected cancer types, including an inhibition of tumor growth and induction of cell death. When used in combination with chemotherapy or radiotherapy, SGLT2i may offer possible synergistic effects in enhancing their treatment efficacy while alleviating associated side effects. Potential mechanisms include a reduction of glucose uptake into cancer cells, systemic glucose restriction, modulation of multiple signaling pathways, and regulation of different gene and protein expression. Furthermore, preliminary clinical findings have reported potential anticancer properties of canagliflozin and dapagliflozin in patients with liver and colon cancers respectively, with reference to decreases in their tumor marker levels. Given its general tolerability and routine use in diabetes management, SGLT2i may be a good candidate for drug repurposing in cancer treatment and as adjunct to conventional therapies. While current evidence reveals that only certain SGLT2i appear to be effective against selected cancer types, further studies are needed to explore the antitumor abilities of each SGLT2i in various cancers. Moreover, clinical trials are called for to evaluate the safety and feasibility of introducing SGLT2i in the treatment regimen of patients with specific cancers, and to identify the preferred route of drug administration for targeted delivery to selected tumor sites., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This article synthesizes findings from an international virtual conference, funded by the National Science Foundation (NSF), focused on the home mathematics environment (HME). In light of inconsistencies and gaps in research investigating relations between the HME and children's outcomes, the purpose of the conference was to discuss actionable steps and considerations for future work. The conference was composed of international researchers with a wide range of expertise and backgrounds. Presentations and discussions during the conference centered broadly on the need to better operationalize and measure the HME as a construct - focusing on issues related to child, family, and community factors, country and cultural factors, and the cognitive and affective characteristics of caregivers and children. Results of the conference and a subsequent writing workshop include a synthesis of core questions and key considerations for the field of research on the HME. Findings highlight the need for the field at large to use multi-method measurement approaches to capture nuances in the HME, and to do so with increased international and interdisciplinary collaboration, open science practices, and communication among scholars.

Background: Schools around the world are increasingly diverse in ethnicity. Given the importance of peer acceptance in children's well-being and development, it is a pressing concern for educators to promote intergroup acceptance in schools., Aims: First, to examine the developmental trends of acceptance of outgroup members in both the ethnic minority and majority students. Second, to investigate how outgroup acceptance is subject to the interplay between perceived norm of prejudice, a risk factor in the macrosystem, and teacher support, a protective factor in the microsystem., Sample: The participants were 3,723 students (ethnic majority: 61%; boys: 51.9%; mean age: 13.7) at Grade 2, 5, 8, and 11 from 24 schools in Hong Kong., Methods: The students were asked to complete a battery of questionnaires regarding their willingness to accept outgroup members in schools, perceived societal norm of prejudice against ethnic minority group, and teacher support they received in schools., Results: It was found that ethnic minority students accepted outgroup members more than ethnic majority students accepted them. The difference was primarily driven by the low outgroup acceptance of ethnic majority students in Grades 2 and 5. The results of multi-level analysis revealed that outgroup acceptance was associated negatively with perceived norm of prejudice but positively with teacher support. The negative association between outgroup acceptance and perceived norm of prejudice was attenuated in schools with supportive culture., Conclusions: The results point to the need of early intervention and the importance of cultivating school culture with strong social emotional support., (© 2020 The British Psychological Society.)

Background: The long-term outcomes of first-line choice among ATD, RAI, and thyroidectomy for GD patients remain unclear., Objective: To compare the long-term morbidity, mortality, relapse, and costs of GD patients receiving first-line treatment., Methods: A population-based retrospective cohort of GD patients initiating first-line treatment with ATD, RAI, or thyroidectomy as a first-line primary treatment between 2006 and 2018 from Hong Kong Hospital Authority was analyzed. Risks of all-cause mortality, CVD, AF, psychological disease, diabetes, and hypertension were estimated using Cox proportional hazards regression models. The 10-year healthcare costs, change of comorbidities, and risk of relapse were compared across treatments., Results: Over a median follow-up of 90 months with 47,470 person-years, 6385 patients (ATD, 74.93%; RAI, 19.95%; thyroidectomy, 5.12%) who received first-line treatment for GD were analyzed. Compared with ATD group, patients who had undergone surgery had significantly lower risks of all-cause mortality [hazard ratio (HR) = 0.363, 95% confidence interval (CI) = 0.332-0.396], CVD (HR = 0.216, 95% CI = 0.195-0.239), AF (HR = 0.103, 95% CI = 0.085-0.124), psychological disease (HR = 0.279, 95% CI = 0.258-0.301), diabetes (HR = 0.341, 95% CI = 0.305-0.381), and hypertension (HR = 0.673, 95% CI = 0.632-0.718). Meanwhile, RAI group was also associated with decreased risks of all-cause mortality (HR = 0.931, 95% CI = 0.882-0.982), CVD (HR = 0.784, 95% CI = 0.742-0.828), AF (HR = 0.622, 95% CI = 0.578-0.67), and psychological disease (HR = 0.895, 95% CI = 0.855-0.937). The relapse rate was 2.41% in surgery, 75.60% in ATD, and 19.53% in RAI group. The surgery group was observed with a significant lower Charlson Comorbidity Index score than the other 2 groups at the tenth-year follow-up. The mean 10-year cumulative healthcare costs in ATD, RAI, and surgery group was US$23915, US$24260, and US$20202, respectively., Conclusions: GD patients who received surgery as an initial treatment appeared to have lower chances of all-cause mortality, CVD, AF, psychological disease, diabetes, and hypertension in the long-term when compared to those treated with ATD or RAI. The surgery group had the lowest relapse and direct healthcare costs among the 3 treatment modalities. This long-term cohort study suggested surgery may have a larger role to play as an initial treatment for GD patients., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: Research in recent years has shown that mindfulness-based interventions can enhance teachers' mental and physical health. However, the existing studies were predominantly conducted in Western, educated, industrialized, rich, and democratic (WEIRD) societies. As a randomized controlled trial in a non-WEIRD society, the present study examined the effectiveness and mechanisms of mindfulness training for Hong Kong teachers in difficult times., Methods: Teachers from primary and secondary schools ( n  = 186) were randomly assigned to mindfulness training (eight-week .b Foundations) or waitlist control condition. They completed online self-report surveys on measures of well-being, emotion management, and mindfulness in teaching at baseline, post-intervention, and two-month follow-up., Results: The intervention group reported significantly higher levels of life satisfaction, positive affect, general health, along with significantly lower levels of insomnia, stress, and negative affect than the control group at post-test and two-month follow-up. The effect sizes were medium to large ( η p 2  = 0.06 to 0.14). More importantly, teachers' baseline well-being had a significant moderating effect on the intervention effectiveness. Those with a lower baseline in well-being benefitted more than their counterparts with a higher baseline. In addition, teachers' emotion management was found to be the mediator through which mindfulness training enhanced teachers' well-being. Such improvement in well-being also predicted higher levels of mindfulness in teaching., Conclusions: This study provides evidence on the efficacy of mindfulness training for teachers beyond WEIRD societies. It suggests the universality and practicality of mindfulness training in enhancing teachers' well-being and reducing their distress in difficult times., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.)

Objective: This study compared the efficacy of PF-based and CROSS-based neoadjuvant chemoradiotherapy for ESCC., Background: PF-based regimen has been a standard regimen for ESCC, but it has been replaced by the CROSS regimen in the past few years, despite no prospective head-to-head comparative study has been performed., Methods: This is a single center retrospective study. Records of all ESCC patients who have received neoadjuvant PF with 40 Gy radiotherapy in 20 daily fractions (PFRT Group) or CROSS with 41.4 Gy radiotherapy in 23 daily fractions (CROSS Group) during the period 2002 to 2019 were retrieved. Propensity score matching (1:1) was performed to minimize baseline differences. The primary and secondary endpoints were overall survival and clinicopathological response. Subgroup analysis ("CROSS Eligibility") was performed based on tumor length, cT-stage, cM-stage, age, and performance status., Results: One hundred (out of 109) patients (CROSS group) and propensity score matched 100 (out of 210) patients (PFRT group) were included. Esophagectomy rates in CROSS and PFRT group were 69% and 76%, respectively (P = 0.268). R0 resection rates were 85.5% and 81.6% (P = 0.525) and the pathological complete remission rates were 24.6% and 35.5% (P = 0.154). By intention-to-treat, the median survival was 16.7 and 32.7 months (P = 0.083). For "CROSS Eligible subgroup," the median survival of the CROSS and PFRT group was 21.6 versus 44.9 months (P = 0.093)., Conclusions: There is no statistically difference in survival or clinicopathological outcome between both groups, but the trend favors PFRT. Prospective head-to-head comparison and novel strategies to improve the outcomes in resectable ESCC are warranted.

Aims/introduction: There is uncertainty about the direct medical costs of type 2 diabetes patients with cancers., Materials and Methods: A population-based retrospective cohort of 99,915 type 2 diabetes patients from the Hong Kong Hospital Authority between 2006 and 2017 was assembled. A total of 16,869 patients who had an initial cancer diagnosis after type 2 diabetes diagnosis were matched with 83,046 patients without cancer (controls) using a matching ratio of up to one-to-five propensity score-matching method. Patients were divided into four categories according to life expectancy. Healthcare service utilization and direct medical costs during the index year, subsequent years and mortality year were compared between patients with and without cancer in each category., Results: Medical costs of cancer patients in the index year ranged from $US27,533 for patients who died in <1 year to $US11,303 for those survived >3 years. Cancer patients had significantly greater expenditures than controls in the index year (all P < 0.001) and subsequent years ($US4,569 vs $US4,155, P < 0.001). Cancer patients also had greater costs in the year of death, and the difference was significant for patients who survived >3 years after the index year ($US32,558 vs $US28,260). For patients in both groups, patients who survived >3 years had significantly lower costs than those who died in <1 year. Costs incurred in the mortality year were greater than those in the index year and subsequent years. Hospitalization accounted for >90% of the medical costs for both groups in the mortality year., Conclusions: Type 2 diabetes patients with cancers incurred greater medical costs in the diagnosis, ensuing and mortality years than type 2 diabetes patients without cancers., (© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

We can make sense of how many a number represents by mapping the symbolic number word system onto the non-symbolic, approximate number system. This study adopted an intervention design to examine whether counting is essential in driving the formation of such symbolic-non-symbolic mappings. We compared kindergarteners' mapping ability after reading stories (1) without cardinal labels, or (2) with cardinal labels, or (3) with cardinal labels and verbal counting. Results showed that children who had counted when reading the stories showed better mapping between number words and their approximate representations than their peers in the other two conditions - suggesting that counting plays a role in developing early symbolic-non-symbolic mappings. Such findings provides empirical support for parents and early educators to enhance young children's mappings between numbers words and approximate representations through counting activities - such as counting the items in the story books while reading to children., (Copyright © 2020 Chan.)

Cervical esophageal carcinoma (CEC) is rare, accounting for 2-10% of esophageal cancers and is mostly squamous cell carcinoma. Because of the anatomical proximity of CEC to larynx, surgical treatment would involve pharyngo-laryngo-esophagectomy (PLE) with inherent high mortality and morbidity. Laryngeal preservation is an important consideration, and definitive chemoradiotherapy is the recommended treatment. Treatment strategy of CEC can be more akin to treatment for head and neck cancers than to thoracic esophageal cancers. Since the exact location, extent of primary and nodal metastasis varies between patients, radiotherapy treatment needs to be individualized. The optimal radiation dose for CEC is uncertain, but retrospective data suggests that higher radiation dose of at least 60 Gy is associated with better local control and survival. Advanced radiotherapy technique, like intensity modulated radiotherapy, is usually required to achieve high dose to tumor while protecting normal tissues from excessive radiation.

With more understanding of the tumor biology, esophageal squamous cell carcinoma (ESCC) and adenocarcinoma are increasingly recognized as different disease entities and are managed with different treatment approaches. Most patients with ESCC need systemic treatment at some point of their disease course, but only until recently, the progress in systemic treatment has been relatively stagnant compared with its adenocarcinoma counterpart. Platinum-based regimens remain the standard of care, while taxanes have been increasingly used upfront and in later lines of treatment. The attempts to personalize treatment for ESCC with various target therapies have been futile. Immune checkpoint inhibitors are now coming into play with promising activity and potentials to combine with different treatment modalities. The current chapter overviews the systemic treatment for ESCC and highlights the recent development.

Esophageal squamous cell carcinoma (ESCC) is an aggressive disease. Many patients have locally advanced disease or already have distant metastasis at presentation. Radiotherapy plays an important role in the treatment of esophageal squamous cell carcinoma. Neoadjuvant chemoradiotherapy improves the survival and surgical outcome compared to surgery alone. Definitive radiotherapy (RT) with or without chemotherapy is used in patients who decline surgery or are medically inoperable. Palliative radiotherapy using external beam radiotherapy or intraluminal brachytherapy is effective for dysphagia and pain control.d.