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This article explores the relationship between cognitive impairment and functional limitations in individuals with haemophilia in Hong Kong. The study reveals that patients who experience difficulties with memory, attention, and executive functioning tend to have poorer performance at work or school. These cognitive functions are crucial for setting and achieving goals, as well as adapting to one's surroundings, so deficiencies in these areas can impact occupational or educational performance. The findings suggest that regular monitoring of cognitive function should be integrated into the standard care for haemophilia patients, particularly those facing occupational or vocational challenges. Further research is necessary to develop a cost-effective and clinically feasible method for monitoring cognitive function in these individuals. The study investigates how cognitive impairment affects functional limitations in haemophilia patients. The researchers discover that impairments in attention, motor processing speed, and cognitive flexibility are linked to a decline in functional status. The study proposes that regular screening for cognitive deficits and cognitive rehabilitation may be necessary for this population. However, the study has limitations, such as potential selection bias and the absence of a control group. Further research is needed to validate the findings and assess the long-term consequences of functional limitations in haemophilia patients. [Extracted from the article]

Background: Triage is pivotal in intensive care for patient safety and resource allocation. The admission algorithm has been shown to correlate with the appropriateness of ICU admission and offer decision aid when facing challenges in times of scarce critical care resources. This study aimed to explore the development of a reference tool to support triage decisions for admission to the ICU. Methods: In this retrospective observational study, the Intensive Care Triage Score (ICTS) was generated as a reference to correlate with the triage decision made by clinical judgment. ICU admission would be advised for ICTS below 6. The primary outcome was ICU admission. The secondary outcomes included ICU, hospital, 90- day, and 1-year mortality. The receiver operating characteristic curve was used to assess the performance of ICTS. Results: A total of 1664 patients were included in the analysis. There were 1204 patients (72.4%) admitted to the ICU; 680 of 738 (92%) with ICTS below 6 were admitted to the ICU. The hospital mortality of the whole cohort was 25.1%; there was a positive correlation between ICTS and hospital mortality. The area under the receiver operating characteristic curve (AUC) of ICTS in predicting hospital mortality for all patients was 0.754 (95% CI 0.728-0.780). The correlation between ICTS and hospital mortality was observed in patients admitted and not admitted to the ICU. Conclusion: Developing a scoring system as a reference tool would be useful for ICU triage. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are among the most common mental health problems in childhood. Early detection and treatment are essential. We aimed to determine the psychometric properties of the Spence Children's Anxiety Scale - parent version (SCAS-P) in children with various psychiatric disorders in Hong Kong. Methods: Children aged 6 to 12 years and their parents or guardians were recruited by convenience sampling from the child and adolescent psychiatry specialist out-patient clinic at Queen Mary Hospital. The parents or guardians were asked to complete the SCAS-P, the Diagnostic Interview Schedule for Children version IV (DISC-IV) anxiety module, the Screen for Child Anxiety Related Emotional Disorders parent version (SCARED-P), and the Child Behavior Checklist (CBCL). Results: In total, 135 child-parent pairs were included. The median age of the children (78 male and 57 female) was 10 (interquartile range, 8-11) years. The children had various psychiatric diagnoses; 43.7% had attention deficit hyperactivity disorder and 41.4% had autism spectrum disorder. In addition, 57 (42.2%) children were diagnosed by a psychiatrist with at least one anxiety disorder (based on the DISC-IV anxiety module). The median SCAS-P score was 36.0; it was higher in children with anxiety disorder (n = 57) than in children without anxiety disorder (n = 78) [46.0 vs 28.5, p < 0.001]. The internal consistency of the SCAS-P was high (Cronbach's alpha = 0.938). Convergent validity of the SCAS-P was confirmed with the SCARED-P and CBCL subscales of internalising and anxiety, whereas divergent validity of the SCAS-P was confirmed with the CBCL subscales of externalising, aggression, and delinquency. Test-retest reliability of the SCAS-P was good (intraclass correlation coefficient = 0.90). The SCAS-P had satisfactory criterion validity for any anxiety disorder (area under the curve [AUC] = 0.77), obsessive compulsive disorder (AUC = 0.76), social anxiety disorder (AUC = 0.70), separation anxiety disorder (AUC = 0.81), generalised anxiety disorder (AUC = 0.82), and physical injury fears (AUC = 0.86). Conclusion: The SCAS-P has satisfactory validity and reliability in screening anxiety disorders among children with various psychiatric disorders. In a busy clinic setting, we recommend using the total SCAS-P score to screen anxiety among children with psychiatric disorders. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Parent–child and teacher–child relationship closeness have been shown to be crucial for children's development of socioemotional competencies from preschool to school-age stages. However, less is known about the importance of developing close relationships with young infants and toddlers attending childcare group settings for their early socioemotional development. The current study aimed to address this gap and to explore how child gender may influence the associations. Participants included 378 Hong Kong Chinese children (196 girls; Mage = 22.05 months, SD = 9.81 months) enrolled in childcare centres, along with their parents and teachers. Parents reported on children's socioemotional competencies as well as their relationship closeness with children; teachers reported on their relationship closeness with children. Multiple group structural equation modelling was used to analyse the results. The findings showed that both parent–child and teacher–child closeness were positively associated with children's social competence, while teacher–child closeness was negatively associated with children's anxiety behaviour. Parents of girls reported greater parent–child closeness, higher levels of social competence, and higher levels of anxiety behaviours compared to parents of boys. Furthermore, teacher–child closeness was significantly associated with social competence exclusively among girls, while parent–child closeness was significantly associated with anxiety behaviours solely among boys. Findings are discussed in terms of the role of child gender in influencing the associations between parent–child closeness, teacher–child closeness, and children's socioemotional competencies in the earliest years. [ABSTRACT FROM AUTHOR]

Hong Kong, in contrast to its previous image as a glamourous global city, has recently been associated with negative keywords such as oppression, fear, violence and even human rights emergency, following the 2019 Anti‐Extradition Law Movement and later the implementation of National Security Law (NSL) in 2020. Meanwhile, the Hong Kong Special Area Administration presented a post‐NSL policy direction as promising a 'Beautiful New Hong Kong'. This paper is aimed at understanding how Hongkongers have continuously lived with/against the imposed (re)writing of Hong Kong. We examined how Hongkongers have been taking initiatives to raise awareness about the 'slow emergencies' in Hong Kong and to counter it in various forms of 'evacuation', whether they are on the move or staying put in place, in order to pursue future‐making. We carried out a multi‐sited study on the two kinds of Hongkongers between January 2020 and August 2023. We talked to those who already left Hong Kong for Taiwan, the UK, Canada, and so forth, and with those who were debating about relocation and at the same time preparing for departure if necessary. We strategically read 'evacuation' in two senses: First, evacuation responds to emergencies and therefore by adopting 'evacuation' is itself a disagreement with the Beautiful New Hong Kong policy as curated by the state. Second, evacuation responds to geography of future and politics of simultaneity. We conceptualised 'normalisation of evacuation' to understand the future‐making behind the move in Hong Kong. The particular kind of evacuation discussed took shape in two forms, relocation elsewhere and reorganisation in situ, both of which, in our analysis, are demonstrating Hongkongers' agency in pursuing geographies of future beyond the state‐led agenda. [ABSTRACT FROM AUTHOR]

Aim: Therapeutic inertia, hypoglycaemia and poor treatment persistence can lead to glycaemic fluctuation and poor outcomes in type 2 diabetes (T2D). We compared glycated haemoglobin (HbA1c) variability, insulin initiation, severe hypoglycaemia and clinical events in patients with T2D initiated dipeptidyl peptidase‐4 inhibitors (DPP4is) at low versus high HbA1c thresholds. Methods: Using territory‐wide electronic medical records in Hong Kong, we curated a propensity score‐matched cohort of patients initiated DPP4i at HbA1c <7.5% versus ≥7.5% in 2007‐2019. We expressed the HbA1c variability score (HVS) as a proportion of HbA1c varied by ≥0.5% compared with preceding values. We used the Cox model to compare the risks of insulin initiation and clinical outcomes, adjusted for time‐varying variables between the two groups. Mediation analysis estimated the effects of HbA1c variability on outcomes. Results: Among 6874 insulin‐naïve patients who initiated DPP4i, 88.7% were treated with metformin and 79.6% with sulphonylureas at baseline (54.9% men; mean age 65.2 ± 11.4 years). After a median follow‐up of 4.6 years, compared with the high‐threshold plus high‐HVS group (≥50%), the low‐threshold plus low‐HVS (<50%) group had reduced hazard ratios (95% confidence interval) of insulin initiation (0.35, 0.31‐0.40), severe hypoglycaemia (0.38, 0.34‐0.44), major adverse cardiovascular endpoints (0.76, 0.66‐0.88), heart failure (0.42, 0.36‐0.49), end‐stage kidney disease (0.65, 0.36‐0.49) and mortality (0.45, 0.35‐0.57). Reduced HbA1c variability explained 31.1%‐81.2% of the effect size of DPP4i initiation at HbA1c <7.5% versus ≥7.5% on outcomes. Conclusions: In Chinese patients with T2D, avoiding therapeutic inertia with intensified glycaemic control at HbA1c <7.5% using drugs with low risk of hypoglycaemia and good tolerability, such as DPP4i, delayed insulin treatment, reduced HbA1c variability and improved clinical events. [ABSTRACT FROM AUTHOR]

Researchers' reflexivity usually focuses on the spatiality and sociality of their ethnographic fieldwork. As a result, the temporal context of their positionality, whereby their various identities interact with one another at different research phases, is often overlooked. This paper adopts an agentic intersectional approach and draws from our separate studies of Thai migrant women in Belgium and Hong Kong to unpack the temporality of the power dynamics between study participants and us (the researchers). Through this reflexive exercise, we identify three salient aspects: first, different identities of the researchers intersect at each phase of the study; second, researchers are dependent on gatekeepers and study participants, notably during the data-gathering phase; and third, the changing researcher–participant dynamics throughout the research process are embedded in broader relations of power that encompass social institutions and migrant/ethnic networks. Hence, researchers' self-discipline and constant awareness of positionality are of utmost importance for achieving well-situated knowledge (re)production. [ABSTRACT FROM AUTHOR]

While the youth's social network has affected violent behavior, the influences of different kinds of networks and their behaviors have been unclear. Accordingly, the antisocial and prosocial of the peer friend (less than 5 years older or younger) network, elder friend (aged > 40 years) network, and the linking or resourceful network are likely influential based on social learning, social bond, and social capital theories. For a contest of the network behaviors, this study surveyed 2,363 youths (aged 16–24 years) in the Chinese society of Hong Kong. Results reveal that the prosocial behavior of peer and elder networks significantly inversely predicted the youth's violent behavior, whereas the antisocial behavior of the linking network was significantly positively predictive. These network effects were not significantly different between the migrant and native and between the younger (aged below 20 years) and older (aged 20+ years) youths. The results imply the value of preventing the youth's violent behavior by raising the youth's bonding with prosocial friends and preventing the youth's antisocial linking network with the guidance of the theories. [ABSTRACT FROM AUTHOR]

Background Molnupiravir and nirmatrelvir-ritonavir are orally administered pharmacotherapies for mild to moderate COVID-19. However, the effectiveness of these drugs among very old (≥80 years), hospitalised patients remains unclear, limiting the risk–benefit assessment of these antivirals in this specific group. This study investigates the effectiveness of these antivirals in reducing mortality among this group of hospitalised patients with COVID-19. Methods Using a territory-wide public healthcare database in Hong Kong, a target trial emulation study was conducted with data from 13 642 eligible participants for the molnupiravir trial and 9553 for the nirmatrelvir-ritonavir trial. The primary outcome was all-cause mortality. Immortal time and confounding bias was minimised using cloning-censoring-weighting approach. Mortality odds ratios were estimated by pooled logistic regression after adjusting confounding biases by stabilised inverse probability weights. Results Both molnupiravir (HR: 0.895, 95% CI: 0.826–0.970) and nirmatrelvir-ritonavir (HR: 0.804, 95% CI: 0.678–0.955) demonstrated moderate mortality risk reduction among oldest-old hospitalised patients. No significant interaction was observed between oral antiviral treatment and vaccination status. The 28-day risk of mortality was lower in initiators than non-initiators for both molnupiravir (risk difference: −1.09%, 95% CI: −2.29, 0.11) and nirmatrelvir-ritonavir (risk difference: −1.71%, 95% CI: −3.30, −0.16) trials. The effectiveness of these medications was observed regardless of the patients' prior vaccination status. Conclusions Molnupiravir and nirmatrelvir-ritonavir are moderately effective in reducing mortality risk among hospitalised oldest-old patients with COVID-19, regardless of their vaccination status. [ABSTRACT FROM AUTHOR]

This study explores the mediating role of self-regulation in the relationship between bullying victimization and depressive symptoms among adolescents, considering the moderating effects of gender and region. A cross-sectional analysis was conducted with 3984 adolescents aged 12–18 from the United Kingdom, Hong Kong, Taiwan, and the Netherlands. Data were collected via an online survey administered through Qualtrics. The survey included validated measures such as the Illinois Bullying Scale (IBS) to measure bullying victimization, the Adolescent Self-Regulatory Inventory (ASRI) to measure self-regulation, and the Patient Health Questionnaire (PHQ) to measure depression. The SPSS macro PROCESS was employed for data analysis, with model 4 used for testing the mediating effects of self-regulation and model 1 for assessing the moderating effects of gender and region. The results demonstrated significant associations between bullying victimization, self-regulation, and depressive symptoms. Self-regulation mediated the positive association between bullying victimization and depression, with notable variations across genders and regions. Specifically, male students in Hong Kong exhibited an increased susceptibility to depression when subjected to bullying. These findings underscore the protective role of self-regulation in mitigating the adverse effects of bullying victimization on adolescent mental health. Implications for interventions and prevention strategies targeting adolescent depression are discussed. [ABSTRACT FROM AUTHOR]

During Hong Kong's 2019 political turmoil and the subsequent impact of the coronavirus disease 2019 pandemic, a rapid rise in turnover rates in certain occupations, such as teachers, medical workers and civil servants, was observed. Some attributed this trend to the increasing rate of emigration. Previous studies have suggested that younger and better‐educated individuals are more likely to emigrate, and that the emigration of a specific group of the population has various impacts on the society of origin. Therefore, we explored the demographic characteristics of potential emigrants in Hong Kong and contrasted such findings with a previous wave of migration to examine the potential impact of the current wave. Based on a territory‐wide telephone survey, we found that (1) the associations of age and level of education with the intention to emigrate internationally (i.e., to destinations other than mainland China) corresponded to the typical young, well‐educated emigrant described in the literature; (2) a higher level of income was associated with a lower intention of international migration; (3) people in occupations such as professionals and managers, clerical and service workers and students reported a greater intention to emigrate than other groups; and (4) individuals born in Hong Kong were more likely to emigrate and less likely to move to mainland China than those born in mainland China. The implications of these intended migration patterns for ageing and fertility, short‐ and long‐term workforce shortages in tertiary sectors and the city's overall competitiveness are discussed. [ABSTRACT FROM AUTHOR]

Since 2019, Hong Kong has been experiencing a social and mental health crisis caused by social unrest and the COVID-19 Pandemic. As a result, there have been reports of increasing family conflicts among secondary students. With the understanding that family support and positive relationships are crucial for maintaining the mental well-being of young people, narrative therapy is a practical approach for helping families shift from problem-focused perspectives to empowering strategies for rebuilding positive relationships. The study aims to report on the effectiveness of a pilot group parent narrative therapy workshop for family relationship harmonisation and enhancing parenting competency using quantitative and qualitative methods. The study participants included 34 parents from five local schools. The results indicated a significantly increased sense of parental competency, general self-efficacy, adult hope, and decreased parental stress. Qualitative reports and participants’ narratives also demonstrated the positive effect of the narrative therapy workshop on their parent–adolescent relationships. [ABSTRACT FROM AUTHOR]

Background: The second-generation metaphyseal cone was useful in managing bone defects in revision knee arthroplasty. However, due to the anatomical constraints in Asian osteometry, the authors utilized a novel free-hand burring technique instead of cannulated reaming for bone preparation. We reported the short-term outcomes of our surgical techniques specific to Asian osteometry. Methods: We conducted a case series by consecutively recruiting 13 female and 12 male patients (involving 25 knees), with a mean age of 71 years (range, 54–88 years). The patients underwent revision total knee arthroplasty during the period from April 2017 to June 2022. Twenty-three tibial cones and 4 femoral cones using free-hand burring technique were implanted. The mean follow-up duration was 51 months (range 18–80 months). Due to the relatively small bone size and meta-diaphyseal center mismatch in the Asian knees, the free-hand burring technique instead of the cannulated reaming technique was adopted in preparing for cone implantation. The clinical outcomes were knee ranges of motion, the Knee Society Knee scores (KSS), end-of-stem pain, infection, and the need for revision surgery. The radiological outcomes included osteointegration, fracture, and loosening. Results: Mean knee range of motion improved from 83 degrees (range 0°–120°) preoperatively to 106 degrees (range 60°–125°) postoperatively (P < 0.001). Mean KSS improved significantly from 29 (range 0–70) to 69 (range 5–100) (P < 0.001). All cones were osteointegrated. One case had transient end-of-stem pain, two developed intraoperative minor femoral fractures and one suffered from recurrent infection that did not require cone revision. Cone revision-free survivorship was 100%. There was no aseptic loosening. Conclusions: The second-generation cone implanted with free-hand burring bone preparation yielded promising short-term outcomes in Asian knees. [ABSTRACT FROM AUTHOR]

Previous studies showed that nightmares are prevalent and are associated with negative health outcomes. However, no empirical data is available demonstrating the extent to which nightmare disorder persists over time. Current literature provides a limited understanding of the trajectory and wider mental health outcomes of nightmare disorder. This longitudinal study examined the persistence and mental health outcomes of nightmare disorder. A total of 230 Hong Kong Chinese adults completed standardized assessments twice with an interval of about 6 months. Over half (66.7%) of the participants with probable nightmare disorder at baseline remained to meet the DSM-5 criteria for the disorder at follow-up. Participants with probable nightmare disorder at baseline were significantly more likely to screen positive for PTSD (82.1% vs 18.3%) (p <.001) (p <.001), and they reported higher rates of mental health service usage at both timepoints (p =.001 to.003). Baseline nightmare disorder severity was negatively associated with subsequent self-rated mental health (β = -.151, p =.010) and self-esteem (β = -.141, p =.009) and it also predicted subsequent PTSD symptoms (β =.122, p =.012). This study provides first empirical data showing that nightmare disorder could be persistent over time. Nightmare disorder symptoms are associated not only with PTSD symptoms but also with a broader range of mental health issues. This study points to the public health importance of identifying and managing nightmare disorder symptoms in the community. Additionally, the presence of nightmare disorder symptoms may be a helpful indicator for identifying post-traumatic stress. [ABSTRACT FROM AUTHOR]

The meanings and value of the arts and their impact on students' learning have long been main areas of focus in arts education research. In Hong Kong, there are only a few studies discussing the impact of performing arts education on students' learning, which leaves a gap in the overall understanding of performing arts education. This article reports on a study of performing arts education in Hong Kong. The participants of the study are students, teachers, principals and arts groups. A total of 28 focus group interviews were conducted with participants recruited from 25 primary schools, 26 secondary schools, one international school, nine tertiary institutions, five special schools and 20 arts groups. Although this study confirms the claims made by arts educators that performing arts education can promote students' awareness of creative and critical thinking skills, change their behavior and attitudes, increase their socio-cultural awareness and benefit their all-round development, the stakeholders had different interpretations of the meaning and value of performing arts education. There appears to be a gap between arts groups and schools in the understanding of the fundamental purposes of performing arts education and the role that it should play in the school context. [ABSTRACT FROM AUTHOR]

Background and Aim: Obesity has been a global public health issue due to the increasing mortality rate and prevalence among children. However, there are scarce studies on obesity prevalence in Hong Kong children. The study aims to identify the risk factors of obesity among primary and secondary school students by assessing the relationship between sociodemographic factors, health‐related behaviors, and social relationships. Methods: Self‐administrated surveys were collected from 30 primary schools and 25 secondary schools participating in the "Quality Education Fund Thematic Network on Health Schools" project. Descriptive analysis was conducted to examine the proportions of different characteristics and to compare the disparity between primary and secondary school students with obesity. Results: A total of 4884 responses were collected. A larger proportion of primary school students with obesity were male (adjusted odds ratio [aOR]: 2.55, 95% confidence interval [CI]: 1.77–3.67, p < 0.001) and actively gamed (aOR: 1.64, 95% CI: 1.07–2.51, p = 0.024). Secondary school students with obesity were male (aOR: 1.61, 95% CI: 1.21–2.13, p = 0.001), had poor self‐perceived academic performance (aOR:1.51, 95% CI: 1.10–2.08, p = 0.011) and expressed higher life satisfaction (family) (aOR: 1.13, 95% CI: 1.01–1.26, p = 0.032). There were negative associations found between obesity and physical activity, high consumption of sugary drinks, chocolate or candies, and insufficient consumption of vegetables. Conclusion: Male sex, physical inactivity, low self‐perecived academic performance, and poor dietary behaviors were the risk factors for obesity among primary and secondary school students. The findings highlighted the importance of identifying younger individuals who were at risk of becoming clinically obese. Further studies should explore the effectiveness of various interventions through longitudinal study. [ABSTRACT FROM AUTHOR]

The endowment effect is a behavioral bias; postulating people demand more to part with an object they own than they would offer to acquire the same object owned by others. Recent experimental research, however, suggests that this effect applies to consumption goods rather than exchange goods. Given that housing is a mix of consumption and exchange goods, it presents a unique opportunity to examine whether the effect exists in the real world through a quasi-experiment. Based on a policy change that relaxed the resale constraints of shared ownership housing in Hong Kong, we found that more constrained homeowners were more likely to sell their homes compared to those with fewer constraints when granted the right to exchange, all other factors affecting liquidity being held constant. This marks the first field study revealing that the endowment effect diminishes when a good enhances its exchange nature, such as being given an exchange right. [ABSTRACT FROM AUTHOR]

As different classes of residential dwellings, government-subsidised Home Ownership Scheme (HOS) housing and unsubsidised private housing are aimed at adjacent groups of households on the housing ladder in Hong Kong. Subsidised housing is in high demand, and one important way of meeting it is to have better-endowed HOS families move up by buying into the private market. The paper explores the differences in price trends between these two classes of properties and attempts to find some of their determinants. Empirical analysis of historical prices of HOS and private housing reveals higher volatility in HOS prices and a differing trend with private market prices, as well as many more HOS transactions after the implementation of the White Form Secondary Market (WSM) Scheme. [ABSTRACT FROM AUTHOR]

Big data is characterized by three attributes: volume, variety,, and velocity. In healthcare setting, big data refers to vast dataset that is electronically stored and managed in an automated manner and has the potential to enhance human health and healthcare system. In this review, gastric cancer (GC) and postcolonoscopy colorectal cancer (PCCRC) will be used to illustrate application of big data approach in the field of gastrointestinal cancer research. Helicobacter pylori (HP) eradication only reduces GC risk by 46% due to preexisting precancerous lesions. Apart from endoscopy surveillance, identifying medications that modify GC risk is another strategy. Population‐based cohort studies showed that long‐term use of proton pump inhibitors (PPIs) associated with higher GC risk after HP eradication, while aspirin and statins associated with lower risk. While diabetes mellitus conferred 73% higher GC risk, metformin use associated with 51% lower risk, effect of which was independent of glycemic control. Nonetheless, nonsteroidal anti‐inflammatory drugs (NA‐NSAIDs) are not associated with lower GC risk. CRC can still occur after initial colonoscopy in which no cancer was detected (i.e. PCCRC). Between 2005 and 2013, the rate of interval‐type PCCRC‐3y (defined as CRC diagnosed between 6 and 36 months of index colonoscopy which was negative for CRC) was 7.9% in Hong Kong, with >80% being distal cancers and higher cancer‐specific mortality compared with detected CRC. Certain clinical and endoscopy‐related factors were associated with PCCRC‐3 risk. Medications shown to have chemopreventive effects on PCCRC include statins, NA‐NSAIDs, and angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers. [ABSTRACT FROM AUTHOR]

School counselling is a well-established means of supporting the mental health of children. Counsellors are most effective when they collaborate with parents, so it is important that parents have a good understanding of and access to school counselling services. Despite this, little is known about parents' perceptions of counselling in Hong Kong schools. We interviewed 27 parents in Hong Kong to investigate how they perceived the counselling services provided by their children's local and international schools, and analysed the data thematically. International school parents recognised the potential of school counselling as a means of support for their children and wanted to work more closely with counsellors to a greater extent than local school parents. Parents were confused about the roles of counsellors and experienced stigma and concerns about confidentiality which inhibited them from engaging with counselling services. Our findings suggest that school principals should work with counsellors to establish and communicate roles more clearly. Greater recognition of counsellors' professionalism, and clearer role differentiation between counsellors and other mental health and educational professionals may improve parental engagement with and support for school counselling. [ABSTRACT FROM AUTHOR]

Kikuchi‐Fujimoto Disease (KFD), also known as Kikuchi disease or Kikuchi histiocytic necrotizing lymphadenitis, is a rare and self‐limiting condition characterized by cervical lymphadenopathy and fever, primarily affecting young Asian adults. The aetiology of KFD remains unknown, although various infectious agents have been suggested as potential triggers. With the emergence of the COVID‐19 pandemic, cases of post‐COVID‐19 KFD and post‐COVID‐19 vaccine KFD have been reported. In this article, we present the first case of post‐COVID‐19 KFD in Hong Kong. A 24‐year‐old man developed fever and painful neck swelling 1 month after recovering from COVID‐19. Diagnostic evaluation, including ultrasound‐guided fine needle aspiration cytology (FNAC), confirmed the diagnosis of KFD. The patient's symptoms resolved spontaneously with supportive care. This case underscores the importance of considering KFD as a potential differential diagnosis in patients presenting with cervical lymphadenopathy and fever following COVID‐19 recovery or vaccination. [ABSTRACT FROM AUTHOR]

Background: Intraoperative indocyanine green (ICG) fluorescence imaging has been shown to be a new and innovative way to illustrate the optimal resection margin in hepatectomy for hepatocellular carcinoma. This study investigated its accuracy in resection margin determination by looking into the correlation of ICG intensity gradients with pathological examination results of resected specimens. Methods: This was a prospective, single-center, non-randomized controlled study. Patients who had liver tumors indicating liver resection were recruited. The hypothesis was that the use of intraoperative near-infrared/ICG fluorescence imaging would be a promising guiding tool for removing hepatocellular carcinoma with a better resection margin. Patients were given ICG (0.25 mg/kg) 1 day before operation. Resected specimens were inspected under a fluorescent imaging system. Biopsies were taken from tumors and normal tissue. Color signals obtained from ICG fluorescence imaging were compared with biopsies for analysis. Results: Twenty-two patients were recruited for study. The median size of their tumors was 2.25 cm. One patient had resection margin involvement. Under ICG fluorescence, the tumors typically lighted up as yellow color, wrapped by a zone of green color. Tumors of 17 patients (77.3%) displayed yellow color and were confirmed malignancy, while tumors of 12 patients (54.5%) displayed green color and were confirmed malignancy. Receiver operating characteristic curve was used to measure the sensitivity and specificity of the green color to look for a clear resection margin. The area under the curve was 85.3% (p = 0.019, 95% confidence interval 0.696–1.000), with a sensitivity of 0.706 and specificity of 1.000. Conclusion: The use of ICG fluorescence can be helpful in determining resection margins. Resection of tumor should include complete resection of the green zone shown in the fluorescence image. [ABSTRACT FROM AUTHOR]

Antibiotics are routinely added to ornamental fish tanks for treating bacterial infection or as a prophylactic measure. However, the overuse or subtherapeutical application of antibiotics could potentially facilitate the selection of antibiotic resistance in bacteria, yet no studies have investigated antibiotic use in the retail ornamental fish sector and its impact on microbial communities. The present study analyzed the concentrations of twenty antibiotics in the carriage water (which also originates from fish tanks in retail shops) collected monthly from ten local ornamental fish shops over a duration of three months. The antibiotic concentrations were correlated with the sequenced microbial community composition, and the risk of resistance selection in bacteria was assessed. Results revealed that the detected concentrations of tetracyclines were the highest among samples, followed by fluoroquinolones and macrolides. The concentrations of oxytetracycline (44.3 to 2,262,064.2 ng L−1) detected across three months demonstrated a high risk for resistance selection at most of the sampled shops. Zoonotic pathogens (species of Rhodococcus, Legionella, and Citrobacter) were positively correlated with the concentrations of oxytetracycline, tetracycline, chlortetracycline, and enrofloxacin. This suggests that antibiotic use in retail shops may increase the likelihood of selecting for zoonotic pathogens. These findings shed light on the potential for ornamental fish retail shops to create a favorable environment for the selection of pathogens with antibiotics, thereby highlighting the urgent need for enhanced antibiotic stewardship within the industry. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy and safety of CHM in the prevention of COVID-19 infection and treatment for COVID-19 related symptoms. Design: Prospective open-label randomized controlled trial. Setting: Participants' home in Hong Kong. Participants: Participants who had household close contact with COVID-19-infected family members. Interventions: Close contacts were stratified into 4 groups (cohort A, B, C, D) based on symptoms and infection status and were randomized in 4:1 ratio to receive CHM granules (9g/sachet, two times daily) or blank control for 7 days with 2 weeks of follow-up. Main outcome measures: The primary outcome measure was the rate of positive nucleic acid tests. Secondary outcomes were the proportion of developed COVID-19 related symptoms and adverse events during the whole 3-week study period. Subgroup analysis was used to evaluate demographic factors associated with positive infection rates. Results: A total of 2163 contacts were enrolled and randomly assigned to the CHM group (1720 contacts) and blank control (443 contacts) group. During the 21 days, the rate of PCR-positive cases in cohort A was markedly lower in the CHM group (3.6%) compared to the control group (7.0%) (P=0.036). Overall, the rate of infection in the CHM group was significantly lower than that in the control group (10.69% vs. 6.03%; RR 0.56, 95% CI 0.39-0.82) after 7-day treatment. No serious adverse events were reported during the medication period. Conclusion: The preliminary findings indicate that CHM may be effective and safe in preventing COVID-19. Future double-blind, randomized controlled trials and long-term follow-up are needed to fully evaluate the efficacy of CHM in a larger contact population. [ABSTRACT FROM AUTHOR]

Cardiovascular events are the leading cause of death among hip fracture patients. This study aims to identify subphenotypes of hip fracture patients and investigate their association with incident cardiovascular events, all-cause mortality, and health service utilisation in Hong Kong and the United Kingdom populations. By the latent class analysis, we show three distinct clusters in the Hong Kong cohort (n = 78,417): Cluster 1 has cerebrovascular and hypertensive diseases, hyperlipidemia, and diabetes; Cluster 2 has congestive heart failure; Cluster 3 consists of relatively healthy patients. Compared to Cluster 3, higher risks of major adverse cardiovascular events are observed in Cluster 1 (hazard ratio 1.97, 95% CI 1.83 to 2.12) and Cluster 2 (hazard ratio 4.06, 95% CI 3.78 to 4.35). Clusters 1 and 2 are also associated with a higher risk of mortality, more unplanned accident and emergency visits and longer hospital stays. Self-controlled case series analysis shows a significantly elevated risk of major adverse cardiovascular events within 60 days post-hip fracture. Similar associations are observed in the United Kingdom cohort (n = 27,948). Pre-existing heart failure is identified as a unique subphenotype associated with poor prognosis after hip fractures. Cardiovascular events (CVEs) are the leading cause of death among hip fracture patients. Here, the authors show the findings on subphenotyping the heterogeneous spectrum of hip fracture patients in both Hong Kong and the United Kingdom older adult populations and temporal associations with CVEs across all subphenotypes. [ABSTRACT FROM AUTHOR]

Background: This is the first study to evaluate the efficacy and safety of transcranial pulse stimulation (TPS) for the treatment of attention-deficit/hyperactivity disorder (ADHD) among young adolescents in Hong Kong. Methods: This double-blind, randomized, sham-controlled trial included a TPS group and a sham TPS group, encompassing a total of 30 subjects aged 12-17 years who were diagnosed with ADHD. Baseline measurements SNAPIV, ADHD RS-IV, CGI and executive functions (Stroop tests, Digit Span) and post-TPS evaluation were collected. Both groups were assessed at baseline, immediately after intervention, and at 1-month and 3-month follow-ups. Repeated-measures ANOVAs were used to analyze data. Results: The TPS group exhibited a 30% reduction in the mean SNAP-IV score at postintervention that was maintained at 1- and 3-month follow-ups. Conclusion: TPS is an effective and safe adjunct treatment for the clinical management of ADHD. [ABSTRACT FROM AUTHOR]

Background: The 2022 World Health Organization (WHO) classification of pituitary neuroendocrine tumour (PitNET) supersedes the previous one in 2017 and further consolidates the role of transcription factors (TF) in the diagnosis of PitNET. Here, we investigated the clinical utility of the 2022 WHO classification, as compared to that of 2017, in a cohort of patients with non-functioning PitNET (NF-PitNET). Methods: A total of 113 NF-PitNET patients who underwent resection between 2010 and 2021, and had follow-up at Queen Mary Hospital, Hong Kong, were recruited. Surgical specimens were re-stained for the three TF: steroidogenic factor (SF-1), T-box family member TBX19 (TPIT) and POU class 1 homeobox 1 (Pit-1). The associations of different NF-PitNET subtypes with tumour-related outcomes were evaluated by logistic and Cox regression analyses. Results: Based on the 2022 WHO classification, the majority of NF-PitNET was SF-1-lineage tumours (58.4%), followed by TPIT-lineage tumours (18.6%), tumours with no distinct lineage (16.8%) and Pit-1-lineage tumours (6.2%). Despite fewer entities than the 2017 classification, significant differences in disease-free survival were present amongst these four subtypes (Log-rank test p=0.003), specifically between SF-1-lineage PitNET and PitNET without distinct lineage (Log-rank test p<0.001). In multivariable Cox regression analysis, the subtype of PitNET without distinct lineage (HR 3.02, 95% CI 1.28-7.16, p=0.012), together with tumour volume (HR 1.04, 95% CI 1.01-1.07, p=0.017), were independent predictors of a composite of residual or recurrent disease. Conclusion: The 2022 WHO classification of PitNET is a clinically useful TF and lineage-based system for subtyping NF-PitNET with different tumour behaviour and prognosis. [ABSTRACT FROM AUTHOR]

Background: Alcohol screening and brief intervention (SBI) is an evidence-based intervention recommended by the World Health Organization. This study applied the Consolidated Framework for Implementation Research (CFIR) to understand facilitators and barriers of SBI implementation in primary care settings in Hong Kong, China. Methods: This was a sequential mixed-method study. In-depth interviews of 21 physicians and 20 nurses working in the primary care settings from the public and private sectors were first conducted to identify CFIR constructs that were relevant to SBI implementation in the Chinese context and potential factors not covered by the CFIR. A questionnaire was then developed based on the qualitative findings to investigate factors associated with SBI implementation among 282 physicians and 295 nurses. Results: The in-depth interviews identified 22 CFIR constructs that were facilitators or barriers of SBI implementation in Hong Kong. In addition, the stigmatization of alcohol dependence was a barrier and the belief that it was important for people to control the amount of alcohol intake in any situation was mentioned as a facilitator to implement SBI. In the survey, 22% of the participants implemented SBI in the past year. Factors associated with the SBI implementation echoed most of the qualitative findings. Among physicians and nurses in both sectors, they were more likely to implement SBI when perceiving stronger evidence supporting SBI, better knowledge and self-efficacy to implement SBI, more available resources, and clearer planning for SBI implementation in the clinics but less likely to do so when perceiving SBI implementation to be complicated and of higher cost, and drinking approved by the Chinese culture. Participants were more likely to implement SBI when perceiving SBI fit better with the existing practice and better leadership engagement in the public sector, but not in the private sector. Perceiving a stronger need and greater importance to implement SBI were associated with higher likelihood of SBI implementation among physicians, but not among nurses. Perceiving better organizational culture supporting SBI was positively associated with SBI implementation among nurses, but not among physicians. Conclusions: There was a significant gap between SBI evidence and its implementation. Some strategies to improve SBI implementation may be different between physicians and nurses and between those in the public and private sectors. The CFIR is a useful framework for understanding facilitators and barriers of SBI implementation in primary care settings. [ABSTRACT FROM AUTHOR]

The present study aims to validate the 40-item and the brief 17-item Washoe County School District Social–Emotional Competency Assessment (WCSD-SECA), a self-report measure of social–emotional competencies, among Chinese school-aged children residing in Hong Kong. A total of 349 children (M = 9.86 years, SD = 1.22; 45.82% girls) and their parents (77.84% mothers) completed a set of questionnaires independently. The factor structure of both versions of the WCSD-SECA was assessed via confirmatory factor analyses. Structural equation models were then conducted to examine the predictive validity of the WCSD-SECA. The findings indicated that both the 40-item and the 17-item versions of the WCSD-SECA fit the data adequately. Both versions were also associated with self-reported positive and negative affect and parent-reported internalizing problems and externalizing problems. Additionally, social–emotional competencies as measured by the 40-item version were significantly associated with parent-reported prosocial behavior, whereas those as measured by the 17-item version were associated with prosocial behavior with a marginal significance. The findings demonstrated an adequate factor structure and predictive validity of the full version and the brief version of the WCSD-SECA in assessing social–emotional competencies. Hence, they serve as a useful tool for researchers, educators, and mental health practitioners to evaluate school-aged children's social–emotional competencies in the Chinese context. [ABSTRACT FROM AUTHOR]

Objective: To examine the role of insomnia as a mediator between worrying and mental health and whether the association between worrying and insomnia is moderated by the levels of exercise frequency. Methods: A cross-sectional online survey was conducted during the fourth wave of the COVID-19 outbreak in Hong Kong (n = 988). Participants' insomnia, psychological distress, and exercise frequency were evaluated. A mediation analysis was performed to examine the direct effect of COVID-19 worries and their indirect effect through insomnia on psychological distress. Results: A significant indirect effect of COVID-19 worries through insomnia was found on psychological distress (beta = 0.18, SE = 0.02, 95% CI = 0.14-0.22, p < .001). The significant index of moderated mediation supported the moderating effect of exercise frequency on the indirect effect of COVID-19 worries on psychological distress (IMM = 0.06, SE = 0.02, 95% CI = 0.02-0.10, p = .006). The conditional indirect effects of insomnia on psychological distress were significant in individuals with mean and higher exercise frequency but not in those with lower exercise frequency. Conclusion: COVID-19 worries increased psychological distress through the worsening of sleep, and such an array of COVID-19 worries on insomnia was moderated by exercise frequency. Engaging more frequent exercise could reduce insomnia in people with less COVID-19 worries. [ABSTRACT FROM AUTHOR]

Aim: Stroke represents a significant cause of long‐term disability in adults. Repetitive transcranial magnetic stimulation (rTMS) is a non‐invasive brain stimulation method known for its potential to enhance motor recovery. Intermittent theta burst stimulation (iTBS), a standardised rTMS protocol initially utilised in patients with depression, has garnered attention in the realm of stroke rehabilitation. This study seeks to establish the efficacy profile of iTBS in motor rehabilitation for patients with subacute or chronic stroke. Patients and methods: This study is a prospective cohort trial in which eligible patients with stroke were recruited into the iTBS group. Ten sessions of iTBS were conducted, followed by physiotherapy. An equal number of matched controls were recruited into the conventional physiotherapy group. The differences in various scoring systems related to motor performance at 6 months were analysed using independent two‐sample t test. Results: Forty patients were enrolled in the study. At 6 months, iTBS demonstrated a statistically significant improvement compared with conventional physiotherapy across various scoring systems, including motor power grading (47.4% vs 0%, P <.0001), Upper Extremity Fugl–Meyer Assessment (19.8% vs 0.7%, P <.0001), Box and Block Test (25.6% vs 1.7%, P =.007) and Barthel Index (17.8% vs 0.1%, P =.0002). No major adverse events were reported in the iTBS group at 6 months. Conclusion: iTBS resulted in significant improvement in motor performance across various domains at 6 months compared with conventional physiotherapy alone. This method proves to be a safe approach for motor rehabilitation. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoke or aerosols from cigarettes, e-cigarettes (ECs), or heated tobacco products (HTPs) are harmful. Yet, there is little knowledge about the specific patterns of secondhand tobacco exposure by source within household settings and the socioeconomic status (SES) differences in adolescents. METHODS We used territory-representative student data from a cross-sectional school-based survey in 2020-2021 to calculate the weighted prevalence of secondhand exposure to cigarettes, e-cigarettes, and HTPs in the past seven days. Parental education and perceived family affluence were used as indicators of socioeconomic status. Generalized linear mixed models were used to analyze associations. RESULTS Among 22039 participants, 29.8% reported any secondhand tobacco exposure (SH-Any) at home, primarily from cigarettes (27.4%), followed by e-cigarettes (4.0%) and HTPs (0.9%). Tertiary parental education level was associated with lower SH-Any exposure (Adjusted odds ratio, AOR=0.49; 95% CI: 0.45-0.53, p<0.001), fewer exposure days (β= -0.685, p<0.001), lower exposure to cigarettes (SH-CC) (AOR=0.49; 95% CI: 0.45-0.54, p<0.001) and to e-cigarettes or HTPs (SH-EC/HTP) (AOR=0.57; 95% CI: 0.45-0.71, p<0.001). 'Poor' family affluence was associated with higher exposures [AOR(SH-Any) =1.14; 95% CI: 1.06-1.22, p=0.001; β(days)=0.160, p<0.001; AOR(SH-CC) =1.15; 95% CI: 1.07-1.24, p<0.001], except for SH-EC/HTP exposure, which was higher in students in an affluent family (AOR =1.66; 95% CI: 1.25-2.21, p<0.001). Significant SES differences in SH-EC/HTP exposure were found only in groups with low parental education level. Dose-response relationships were found between lower SH-Any and SH-CC and higher SES categories (p for trend<0.001). CONCLUSIONS Adolescents experienced a high prevalence of tobacco smoke exposure at home, primarily from cigarettes. Higher SES was associated with lower tobacco exposure, except for SH-EC/HTP, which was higher among adolescents from affluent families. Additionally, high parental education level was protective against exposure to SH-EC/HTP. Comprehensive control measures to reduce the use of these tobacco products are needed to protect adolescents of diverse socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

Objectives: To compare the prevalence of anxiety/depression, resilience, and social support among nurses, foreign domestic helpers (FDHs), and residents living in subdivided units (SDUs), and to examine their associations in these high-risk groups in Hong Kong during Omicron waves. Methods: We recruited 1,014 nurses, 621 FDHs, and 651 SDU residents from December 2021 to May 2022 in this cross-sectional survey. The depression, anxiety, social support, and resilience levels were measured by the validated scales. The multivariate binary logistic regression and causal mediation analysis were applied to examine the associations. Results: We observed a prevalence of 17.7% in anxiety and 21.6% in depression which were the highest in SDU residents, followed by FDHs, and lowest in nurses. Social support was associated with increased resilience levels and decreased risks of anxiety/depression. The association of social support with mental disorders was partly mediated by resilience, accounting for 30.9% and 20.9% of the total effect of social support on anxiety and depression, respectively. Conclusion: Public health strategies should target improving social support and providing resilience-promoting interventions to help reduce mental disorders in vulnerable groups. [ABSTRACT FROM AUTHOR]

The Transporters intervention contains 15 animated episodes that autistic children watch daily for a month and learn emotion recognition through stories depicting social interactions between vehicle characters with grafted human faces, expressing emotions. Its automated, home-based format is cost-effective. This study included four groups of young Chinese children in Hong Kong: two intervention groups (an autism intervention group and an autism + attention-deficit/hyperactivity disorder (ADHD) intervention group), an autism control group and a non-autistic group. The autism + ADHD intervention group was one that had not been separately examined before. In this study, The Transporters episodes were delivered via an App instead of the dated DVD technology. Following The Transporters intervention, both autism and autism + ADHD intervention groups improved significantly and similarly on emotion recognition and were more like the non-autistic group, while the autism control group did not. Learning was generalizable to novel situations/characters. There was no dosage effect, with the standard recommended number of episodes viewed as sufficient for significant improvement. Besides confirming the effectiveness of The Transporters for young Chinese autistic children, this study contributes to the literature/practice by expanding the range of applicability of The Transporters to autistic children with ADHD, which is important given the high co-occurrence rate between autism and ADHD. Trial Registration: This study was registered with the German Clinical Trials Register – Deutschen Register Klinischer Studien (DRKS) on 23 December 2018. The Trial Registration Number (TRN) is DRKS00016506. The Transporters App is an intervention programme with 15 animated episodes that teach emotion recognition skills to autistic children between 4 and 6 years of age. Each episode contains a story depicting social interactions between characters in the form of a vehicle, with human faces grafted on to each of them. Each episode teaches a specific emotion in a story context. Autistic children watched at least three episodes at home for about 15 min daily for a month, with parental guidance. Its automated, home-based format is cost-saving and readily accessible. This study translated The Transporters to a Cantonese-Chinese version. Results showed a significant improvement in emotion recognition following viewing The Transporters in a group of Hong Kong Chinese autistic children, between 4 and 6 years of age, with and without attention-deficit/hyperactivity disorder (n = 48) relative to a control group (n = 24). A non-autistic group (n = 23) showed that the autistic children scored lower in emotion recognition pre-intervention. Post-intervention, the autistic children had improved in emotion recognition to the level of the non-autistic children. The autistic children in the intervention groups also generalized their learning to novel situations/characters not taught within The Transporters. There was no dosage effect, with the standard recommended number of episodes viewed being sufficient to achieve significant improvement. This study confirms the effectiveness of The Transporters for Chinese autistic children and contributes to the literature/practice by expanding the range of applicability of The Transporters to autistic children with attention-deficit/hyperactivity disorder, which is important given the high rate of co-occurrence between autism and attention-deficit/hyperactivity disorder. [ABSTRACT FROM AUTHOR]

• Mpox vaccine uptake among GBMSM in Hong Kong was 21.7%. • Younger and lower-income GBMSM were less likely to vaccinate against mpox. • Diverse communication channels should be considered in promoting mpox vaccination. • Messaging should balance between conveying health risks and benefits of vaccination. Following the global mpox outbreak in 2022, multiple regions in Asia have been reporting ongoing mpox cases within high-risk groups, including gay, bisexual, and other men who have sex with men (GBMSM). An optimal level of vaccination rate is essential to prevent further mpox outbreaks. However, no existing studies have examined mpox vaccine uptake among GBMSM in East Asia. A cross-sectional survey was conducted among a sample of 531 GBMSM in Hong Kong, China, between March and October 2023. The study used multivariable logistic regression models to investigate the associations between mpox-related disease perceptions, exposures to sources and contents of mpox-related information, and mpox vaccine uptake. The prevalence of mpox vaccine uptake among GBMSM in Hong Kong was 21.7%, with 7.7% completing one dose and 13.9% completing two doses. GBMSM who were younger or earning less monthly income were less likely to have been vaccinated. After adjusting for confounding variables, participants who perceived more negative impacts on their lives if they were to contract mpox, more severe symptoms, and a more coherent understanding of mpox were positively associated with mpox vaccine uptake. In addition, more frequent exposure to information through the following sources: TV, newspaper, radio and posters, government websites, news websites or apps, other people's social media, and communication over the phone or face-to-face was positively associated with mpox vaccine uptake. Finally, more frequent exposure to the following information contents: mpox statistics from other countries, the Hong Kong government's responses to mpox cases, negative information about patients with mpox, and information on prevention and treatment of mpox were positively associated with mpox vaccine uptake. This study provides timely and evidence-based implications to address health communication and messaging needs in promoting mpox vaccination among GBMSM in Hong Kong, relevant to regions with similar sociocultural contexts. [ABSTRACT FROM AUTHOR]

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Background: Neutralizing antibody level wanes with time after COVID-19 vaccination. We aimed to study the relationship between baseline gut microbiota and immunogenicity after three doses of CoronaVac. Methods: This was a prospective cohort study recruiting three-dose CoronaVac recipients from two centers in Hong Kong. Blood samples were collected at baseline and one year post-first dose for virus microneutralization (vMN) assays to determine neutralization titers. The primary outcome was high immune response (defined as with vMN titer ≥ 40). Shotgun DNA metagenomic sequencing of baseline fecal samples identified potential bacterial species and metabolic pathways using Linear Discriminant Analysis Effect Size (LEfSe) analysis. Univariate and multivariable logistic regression models were used to identify high response predictors. Results: In total, 36 subjects were recruited (median age: 52.7 years [IQR: 47.9–56.4]; male: 14 [38.9%]), and 18 had low immune response at one year post-first dose vaccination. Eubacterium rectale (log10LDA score = 4.15, p = 0.001; relative abundance of 1.4% vs. 0, p = 0.002), Collinsella aerofaciens (log10LDA score = 3.31, p = 0.037; 0.39% vs. 0.18%, p = 0.038), and Streptococcus salivarius (log10LDA score = 2.79, p = 0.021; 0.05% vs. 0.02%, p = 0.022) were enriched in low responders. The aOR of high immune response with E. rectale, C. aerofaciens, and S. salivarius was 0.03 (95% CI: 9.56 × 10−4–0.32), 0.03 (95% CI: 4.47 × 10−4–0.59), and 10.19 (95% CI: 0.81–323.88), respectively. S. salivarius had a positive correlation with pathways enriched in high responders like incomplete reductive TCA cycle (log10LDA score = 2.23). C. aerofaciens similarly correlated with amino acid biosynthesis-related pathways. These pathways all showed anti-inflammation functions. Conclusion: E. rectale,C. aerofaciens, and S. salivarius correlated with poorer long-term immunogenicity following three doses of CoronaVac. [ABSTRACT FROM AUTHOR]

Objective: This study examines the relationship between domestic outsourcing, housework evaluations, and marital conflict, while also comparing the effects of parents' informal help and paid domestic workers' formal help on marital relations. Background: Whereas the role‐strain perspective asserts that shifting the housework burden to a third party can reduce marital conflict arising from housework division, the conflict perspective contends otherwise, especially when an additional family member is involved. Methods: We analyzed household survey data with a representative sample of full‐time dual‐earning married couples in Hong Kong (N = 1,197). We used bivariate analysis and linear regression models to evaluate the relationship between domestic outsourcing, housework evaluations, and marital conflict. Results: Results showed that getting help had significant indirect effects on marital conflict through housework evaluations. However, the two types of help were also positively associated with marital conflicts. The two types of help had simultaneously positive direct effects and negative indirect effects on marital conflicts, canceling out the effect of each other. Implications: Our study illuminates the positive effect of outsourcing through housework evaluation. However, the benefit of domestic outsourcing cannot be realized if the conflicts induced by domestic outsourcing are not resolved. [ABSTRACT FROM AUTHOR]

Leptogenys is the most diverse genus of the ant subfamily Ponerinae and is widely distributed across the world's tropical and subtropical regions. More than 40 species are known from the Oriental realm displaying a wide range of ecologies, although their life history traits remain poorly understood, and new species are frequently discovered. Here, a faunal review of the genus from Hong Kong SAR, southern China is provided. A total of nine species are recorded, with one new species, Leptogenys grohli Hamer, Lee & Guénard, sp. nov. described. Ecological and biogeographic information, including new information on reproductive modes for two species are provided with the ergatoids of L. binghamii Forel, 1900 and L. rufidaZhou et al., 2012 described. Additional records for five of these species within the neighbouring province of Guangdong are also provided. Finally, an illustrated key to species known from Hong Kong is presented, as well as notes on each species' distribution, ecology, and behaviour. An updated provincial distributional checklist of the Leptogenys species of Mainland China and Taiwan is also supplied. [ABSTRACT FROM AUTHOR]

Background: It has been a long-standing tradition of using herbal tea for preventive and therapeutic healthcare in Hong Kong and South China and Five Flowers Tea is one of the most popular herbal teas. Based on the principle of traditional Chinese medicine, the pharmacological functions are to clear heat and dispel dampness in the body. Heat and dampness are thought to contribute to a range of health problems, especially during the hot and humid season in South China and Hong Kong. The most prevalent herbs in the formula contain bioactive compounds including flavonoids, alkaloids and terpenoids, which have a wide range of pharmacological properties including anti-inflammation, antivirus, antidiarrhoea, antibacteria, and antioxidation. However, with the composition varies widely, the ethnopharmacological benefits described may not be delivered uniformly. This study is to provide a comprehensive analysis on the composition of the Five Flowers Tea sold in Hong Kong and investigate the rationale behind the selection of herbs used in the formula. This study also provides information on the variation and quality of the Five Flowers Tea in the market. Methods: Thirty-three Five Flowers Tea samples were collected from various locations in Hong Kong. The size, texture, colour and organoleptic properties were documented. Macroscopic and molecular authentication methods were employed to identify the individual components. Results: Macroscopic identification revealed there were 23 herbs belonging to 18 plant families. The most prevalent herb was Bombax ceiba L., followed by Chrysanthemum morifolium. Ten adulterants and the existence of insect Lasioderma serricorne were confirmed by DNA barcoding techniques. Conclusion: This study employed a comprehensive approach to authenticate the herbs in Five Flowers Tea samples collected from various locations in Hong Kong. Macroscopic and molecular methods were used to identify the herbs and adulterants. The findings revealed the varied composition in Five Flowers Tea and the occurrence of adulterants in some samples. This shows that quality assurance of Five Flowers Tea is essential for the effective use of this popular folk medicine. [ABSTRACT FROM AUTHOR]

Although it has been widely acknowledged that hope, career competency, and outcomes of social well-being (i.e., social integration, social contribution, and civic engagement) are key components of youth's career and life development (CLD), those interrelationships, their predictive relationships, and the relative importance of the variables in the relationships remain poorly understood. To fill that gap, we conducted two network analyses on three waves of data collected in the CLAP@JC Community Intervention Project. A total of 4,220 non-engaged youth (NEY) from Hong Kong participated in the project, all of whom were 13–29 years old (M = 18.66, SD = 3.20) and 53.3% of whom were boys and young men. The first network analysis, conducted on the data at baseline, revealed a moderate correlation between career competency and hope and a strong correlation between civic engagement and social contribution. The second network analysis, conducted on the aggregated three-wave data, showed that career competency could predict all other variables and that only hope could positively impact career competency over time. We also observed that social contribution can positively influence hope. Overall, our findings highlight the central role of career competency in networks while also revealing the different roles of the examined variables within the networks. Our new findings on the functions of and the relationships among those variables provide insights for further theorizing CLD, while the information obtained can also help practitioners to develop effective intervention strategies for promoting CLD among NEY. [ABSTRACT FROM AUTHOR]

In the countryside, where intensive rural development and rising property values have been observed since the late 1970s, the preservation and meaning of traditional dwellings have emerged as crucial considerations in shaping Hong Kong's countryside conservation policy. The focus of this paper is on the conservation of temples, as we are drawn to these structures not only for their architectural merit but also for their role as public buildings within the countryside. Consequently, their cultural significance is heavily influenced by the stakeholders they are associated with, distinguishing them from other types of dwellings. This paper examines the coastal landscape of South Lantau, which includes several villages with distinct traditions that have undergone significant transformations since the 1960s. Located at the southwest edge of Hong Kong, Lantau Island had a rural lifestyle that was relatively undisturbed before WWII because of the difficulty in accessing the island. However, in response to the large people influx from China's mainland after 1949, the Hong Kong government introduced the Lantau Development Plan in 1953, mainly to open up new sources of freshwater resources for Hong Kong Island. The construction of South Lantau Road in 1955 and Shek Pik Reservoir in 1957 gradually led to the decline of agricultural activities in South Lantau and the population exodus of local villagers, resulting in a rupture to regional traditions. In multilineage communities such as the villages on South Lantau, worship of a common deity provides a vital source of social bonding, particularly for an area long beset by typhoons, piracy and banditry. Local people pray for safety and prosperity through collective rituals and celebratory activities. Therefore, temples are not only religious establishments but also embody the sense of social solidarity among villagers on South Lantau. Through the case study of three rural villages on South Lantau, this paper examines how temples play an important role in the continuity of the communal network amid repercussions from the postwar disruption of traditional rural life. Significantly, this pilot study also draws attention to the functions of temples in their historical context. It emphasises the importance of recognising and re-evaluating these buildings for cultural enhancement as part of community engagement. This study provides valuable insights for future conservation efforts for religious buildings in the countryside. [ABSTRACT FROM AUTHOR]

The impacts of adverse childhood experiences (ACEs) have been well documented. One possible consequence of ACEs is dissociation, which is a major feature of post-traumatic psychopathology and is also associated with considerable impairment and health care costs. Although ACEs are known to be associated with both psychoform and somatoform dissociation, much less is known about the mechanisms behind this relationship. Little is known about whether social and interpersonal factors such as family environments would moderate the relationship between ACEs and somatoform dissociation. This paper discusses the importance of having a positive and healthy family environment in trauma recovery. We then report the findings of a preliminary study in which we examined whether the association between ACEs and somatoform dissociation would be moderated by family well-being in a convenience sample of Hong Kong adults (N = 359). The number of ACEs was positively associated with somatoform dissociative symptoms, but this association was moderated by the level of family well-being. The number of ACEs was associated with somatoform dissociation only when the family well-being scores were low. These moderating effects were medium. The findings point to the potential importance of using family education and intervention programs to prevent and treat trauma-related dissociative symptoms, but further investigation is needed. [ABSTRACT FROM AUTHOR]

CoronaVac immunogenicity decreases with time, and we aimed to investigate whether gut microbiota associate with longer-term immunogenicity of CoronaVac. This was a prospective cohort study recruiting two-dose CoronaVac recipients from three centres in Hong Kong. We collected blood samples at baseline and day 180 after the first dose and used chemiluminescence immunoassay to test for neutralizing antibodies (NAbs) against the receptor-binding domain (RBD) of wild-type SARS-CoV-2 virus. We performed shotgun metagenomic sequencing performed on baseline stool samples. The primary outcome was the NAb seroconversion rate (seropositivity defined as NAb ≥ 15AU/mL) at day 180. Linear discriminant analysis [LDA] effect size analysis was used to identify putative bacterial species and metabolic pathways. A univariate logistic regression model was used to derive the odds ratio (OR) of seropositivity with bacterial species. Of 119 CoronaVac recipients (median age: 53.4 years [IQR: 47.8–61.3]; male: 39 [32.8%]), only 8 (6.7%) remained seropositive at 6 months after vaccination. Bacteroides uniformis (log10LDA score = 4.39) and Bacteroides eggerthii (log10LDA score = 3.89) were significantly enriched in seropositive than seronegative participants. Seropositivity was associated with B. eggerthii (OR: 5.73; 95% CI: 1.32–29.55; p = 0.022) and B. uniformis with borderline significance (OR: 3.27; 95% CI: 0.73–14.72; p = 0.110). Additionally, B. uniformis was positively correlated with most enriched metabolic pathways in seropositive vaccinees, including the superpathway of adenosine nucleotide de novo biosynthesis I (log10LDA score = 2.88) and II (log10LDA score = 2.91), as well as pathways related to vitamin B biosynthesis, all of which are known to promote immune functions. In conclusion, certain gut bacterial species (B. eggerthii and B. uniformis) and metabolic pathways were associated with longer-term CoronaVac immunogenicity. [ABSTRACT FROM AUTHOR]

Objective: The study tests the reliability and validity of the Cantonese Chinese version of Short Form McGill Pain Questionnaire 2 (SF‐MPQ‐2‐CC). Methods: The original Short Form McGill Pain Questionnaire (SF‐MPQ‐2) was translated into Cantonese Chinese version. Cantonese‐speaking chronic pain patients from three pain centers in Hong Kong were recruited and asked to complete SF‐MPQ‐2‐CC, validated Chinese versions of Identification Pain questionnaire (ID Pain), Pain Catastrophizing Scale (PCS), and Short Form Health Survey (SF‐36) for evaluation of convergent and divergent validity, 2 weeks apart for evaluation of internal consistency. Results: A total of 333 and 197 participants completed the first and second set of questionnaires, respectively. SF‐MPQ‐2‐CC was shown to have excellent internal consistency, with an overall Cronbach's alpha value of 0.933. The overall correlation coefficient was 0.875 that shows good test–retest reliability. Construct validity was evaluated using confirmatory factor analysis, where a seconder‐order factor model demonstrated a good fit with our data (χ2 = 826.51, p < 0.001, CFI = 0.92, TLI = 0.908, RMSEA = 0.097; SRMR = 0.063; error terms adjusted). SF‐MPQ‐2‐CC also showed good convergent validity with Chinese versions of ID Pain (neuropathic pain) and PCS (continuous pain), and divergent validity was shown by a negative correlation with Chinese version of SF‐36. Conclusions: Our study demonstrated that SF‐MPQ‐2‐CC is a valid and reliable pain assessment tool for Cantonese‐speaking patients in Hong Kong with a wide range of chronic pain conditions. It also helps to identify the presence of neuropathic pain and negative pain cognition among respondents. [ABSTRACT FROM AUTHOR]

Severe Typhoon Koinu passed south of Hong Kong on 8 and 9 October 2023, triggering the issuance of the Increasing Gale or Storm Signal No. 9, the second highest tropical cyclone (TC) warning signal in Hong Kong. Koinu was a difficult case for TC warning service due to its compact size and rather erratic movement over the coastal waters of Guangdong. To monitor Koinu's movement and wind structure, the Hong Kong Observatory utilized various observational platforms, including meteorological aircraft, ocean radar, and synthetic aperture radar on polar orbiting satellites. The paper presents major observations derived from these measurements. The aircraft probe and dropsonde data suggested boundary layer inflow, warm core structure, eyewall updraft, and high turbulence in the eyewall of the typhoon. The weather radar observations indicated the occurrence of a waterspout in the vicinity of the typhoon. Additionally, the study highlights the forecasting performance of the AI‐based Pangu‐Weather model, which could outperform the conventional global numerical weather prediction models in forecasting TC track in the region. The documentation of these observations aims to provide valuable references for weather forecasters and stimulate further research on forecasting this type of tropical cyclone. Key Points: Observations from meteorological aircraft, ocean radar, and synthetic aperture radar show the structure of Severe Typhoon KoinuWeather radar observations suggest the occurrence of a waterspout in the vicinity of KoinuAI‐based Pangu‐Weather model could outperform the conventional global numerical weather prediction models in forecasting Koinu's track [ABSTRACT FROM AUTHOR]