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Simple Summary: Prostate mpMRI is currently the most widely used image diagnosis approach to detect prostate cancer, while the PI-RADS system was developed to standardize and improve the accuracy of suspicious lesion identification on MRI. However, there still remain several limitations including inter-individual inconsistencies and naked-eye insufficiency. This study aims to apply AI technology to image interpretation to enhance diagnostic efficiency and explore the use of T2-weighted image-based stimulated biopsy in predicting prostate cancer (PCa). Using 820 lesions from The Cancer Imaging Archive database and 83 lesions from Hong Kong Queen Mary Hospital, we constructed 18 machine-learning models based on three algorithms and conducted both internal and external validation. We found that the logistic regression-based model provides additional diagnostic value to the PI-RADS in predicting PCa. Background: Currently, prostate cancer (PCa) prebiopsy medical image diagnosis mainly relies on mpMRI and PI-RADS scores. However, PI-RADS has its limitations, such as inter- and intra-radiologist variability and the potential for imperceptible features. The primary objective of this study is to evaluate the effectiveness of a machine learning model based on radiomics analysis of MRI T2-weighted (T2w) images for predicting PCa in prebiopsy cases. Method: A retrospective analysis was conducted using 820 lesions (363 cases, 457 controls) from The Cancer Imaging Archive (TCIA) Database for model development and validation. An additional 83 lesions (30 cases, 53 controls) from Hong Kong Queen Mary Hospital were used for independent external validation. The MRI T2w images were preprocessed, and radiomic features were extracted. Feature selection was performed using Cross Validation Least Angle Regression (CV-LARS). Using three different machine learning algorithms, a total of 18 prediction models and 3 shape control models were developed. The performance of the models, including the area under the curve (AUC) and diagnostic values such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were compared to the PI-RADS scoring system for both internal and external validation. Results: All the models showed significant differences compared to the shape control model (all p < 0.001, except SVM model PI-RADS+2 Features p = 0.004, SVM model PI-RADS+3 Features p = 0.002). In internal validation, the best model, based on the LR algorithm, incorporated 3 radiomic features (AUC = 0.838, sensitivity = 76.85%, specificity = 77.36%). In external validation, the LR (3 features) model outperformed PI-RADS in predictive value with AUC 0.870 vs. 0.658, sensitivity 56.67% vs. 46.67%, specificity 92.45% vs. 84.91%, PPV 80.95% vs. 63.64%, and NPV 79.03% vs. 73.77%. Conclusions: The machine learning model based on radiomics analysis of MRI T2w images, along with simulated biopsy, provides additional diagnostic value to the PI-RADS scoring system in predicting PCa. [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]

In recent years, illegal felling of and damage to the incense tree Aquilaria sinensis (Lour.) Spreng. have been reported in Hong Kong. Their native populations are under increasingly severe threat. Therefore, the development of a standard and efficient method to classify and document wounds on vulnerable trees is urgently needed for conservation purposes. In this study, photogrammetry was used to document wounds in A. sinensis through 3D modeling. A total of 752 wound records from 484 individual A. sinensis trees from Hong Kong were included to establish a new wound classification system. Our major findings include a novel standardized procedure for photogrammetric documentation and a wound classification system. The results of this study will facilitate A. sinensis conservation, by enhancing wound documentation and information transfer to law enforcement and education. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of a comprehensive school-based sexuality education programme in enhancing sexual health knowledge and understanding among adolescents, parents and school personnel in six secondary schools in Hong Kong. Study outcomes were evaluated through pre- and post-tests. A total of 1588 students, 40 parents and 271 school personnel participated. Baseline student knowledge scores were highest among younger students, with significant improvements observed in both years for all grades except one. Baseline student attitude scores were ≥ 85% for younger students, with no significant improvement, while older students showed significant improvements. Parents scored below 40% correct at baseline for knowledge items, while self-efficacy items were generally higher. Baseline teacher knowledge scores were higher than parents, but self-efficacy scores were comparable or lower. Baseline guidance counsellors' surveys indicated low confidence levels and awareness of community resources to support students. This study identified a clear need for sexuality education in Hong Kong and a special focus on students in schools traditionally serving a high proportion of non-Chinese speaking students. The programme has significant potential for expansion in Hong Kong schools as well as for dissemination in Mainland China. [ABSTRACT FROM AUTHOR]

Background: Newborn screening programmes offer an opportunity to obtain dried blood spots (DBS) cards that contain a wealth of biological information that can be stored for long periods and have potential benefits for research and quality assurance. However, the storage and secondary uses of DBS cards pose numerous ethical, clinical, and social challenges. Empirical research exploring public attitudes is central to public policy planning as it can indicate whether or not there is broad public support, define public concerns, and ascertain the circumstances required to alleviate concerns and ensure support. This study aims to describe the clinical experience and attitudes towards newborn screening and investigate the perceptions and expectations of Hong Kong parents and healthcare providers regarding the retention of DBS cards and their usage for research. Methods: We conducted semi-structured in-person interviews with 20 parents and healthcare providers in Hong Kong. Thematic analysis was conducted. Results: Awareness of the significant research value of secondary uses of dried blood spot cards is low. Parents and healthcare providers support the storage and secondary uses of DBS cards with some concerns, including privacy and confidentiality breaches, the risk of discrimination or stigmatisation based on genetic information, and their inability to oversee the use of their child's biospecimen. Parents, however, prioritise their child's health over privacy concerns and support identifiable storage using pseudonymity to gain more information about their children's health. Conclusion: Child information takes precedence over potential concerns over privacy, underscoring the significance of engaging patients and the public in shaping public policy related to biobanking and healthcare research, in line with cultural and social values. [ABSTRACT FROM AUTHOR]

In this review, we critically examine existing literature on men and masculinities in Hong Kong, focusing on Hong Kong Chinese masculinity. We employ a five-stage scoping review methodological framework, and analyzed twenty-five relevant studies. We identified themes such as breadwinner masculinity, work, family, social respectability, and manifestations of soft masculinity. The findings highlight the importance of masculinity for men's well-being, and the need for further research. Specifically, age-specific studies, nuanced exploration of gender dynamics, and the interplay between family dynamics and masculinity. We also advocate for more focused examinations beyond the generic concept of "Chinese masculinity." Our findings inform future research, interventions, and initiatives addressing masculinities in Hong Kong and beyond. [ABSTRACT FROM AUTHOR]

The failure of the democratic movement during 2014–2020 prompted tens of thousands of Hongkongers (~40,000) to reluctantly leave their hometown and migrate to Taiwan to seek a freer future. Taiwan's cultural similarity to Hong Kong, together with Taiwan's democracy and geographic proximity, are commonly recognized as pull factors of migration. However, the intensifying cross-strait tensions since late 2021 have witnessed Taipei tighten its approval of Hongkongers' applications for permanent residency mainly in fear of the infiltration of Chinese agents. Based on mixed-methods in-depth interviews (N = 15) and an online survey (N = 147) with Hong Kong migrants, this paper reveals their complex experience in adapting to the Taiwan way of life, becoming frustrated by Taipei's attitudinal change, and contemplating onward migration. The findings reveal underlying cultural differences between Hong Kong and Taiwanese societies—manifesting as a cultural conflict—amid fears of an encroaching communist China. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is vital to improve the mental health (MH) of young people in Hong Kong, where the suicide rate has nearly doubled among those aged 15‐29 years since 2014. This multi‐method evaluation aimed to assess Coolminds, which promoted MH literacy by engaging students, parents, and educators in secondary schools in Hong Kong. METHODS: Students, parents, and teachers completed self‐report measures before and after attending workshops aimed at raising MH literacy. Pre‐ and post‐survey data were collected between November 2021 and August 2022. Qualitative data from participant feedback and a focus group interview with Coolminds staff were analyzed using descriptive content analysis. RESULTS: The final dataset included 2903 students, 395 parents, and 325 educators from 52 schools. Only 3 schools had engagement with all 3 key groups. Significant improvements in MH knowledge were observed after the Coolminds workshops for all 3 groups. Qualitative analysis identified a reactive approach to MH issues, and bureaucratic and logistical challenges as barriers to implementation. CONCLUSION: Findings support the effectiveness of the Coolminds curriculum in improving MH literacy for each group and the demand for MH promotions in school settings. The implementation challenges indicate the need for future initiatives to better align with local needs and practices. [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]

Introduction: Mind Space is an experiential mental health exhibition in Hong Kong, aiming to raise public awareness and provide education regarding mental health. This prepost study aimed to 1) examine the relationships between visitors' characteristics and their mental health stigma at baseline, and 2) provide a preliminary evaluation of the effectiveness of Mind Space in reducing stigma and promoting help-seeking attitudes toward mental health conditions. Methods: We analyzed data from all consenting visitors who attended Mind Space between September 2019 and December 2021. Visitors' attitudes toward mental health conditions and their willingness to seek professional psychological help were measured through online questionnaires before and after visits. Multiple linear regression was used to identify the demographic predictors of outcome variables at baseline. Changes in outcome variables after attending Mind Space were assessed using paired sample t-tests. Results: A total of 382 visitors completed the baseline questionnaires, among which 146 also completed the post-test. At baseline, higher socioeconomic levels and personal contact with people with mental health conditions predicted more positive attitudes and understanding toward mental disorders. Tentatively, the results also showed that after attending Mind Space, a significant reduction in negative attitudes about mental illness (t=4.36, p=<.001; d=.361) and improvements in the propensity to seek professional help (t=-5.20, p<.001; d=-.430) were observed, along with decreases in negative attitudes toward stereotypes (t=4.71, p=<.001; d=.421) and restrictions (t=2.29, p=.024; d=.205) among healthcare professionals. Discussion: Our findings highlight the need for mental health education for people with lower socioeconomic status and the importance of direct contact in public mental health education initiatives. The present study also suggests that Mind Space may be a useful model for public mental health education, but the exhibition requires further evaluation to ascertain if any reductions in stigma are maintained over time. [ABSTRACT FROM AUTHOR]

Background: Drawing on the extensive utilization of traditional Chinese medicine (TCM) to combat COVID-19 in Mainland China, experts designed a series of TCM anti-epidemic strategies. This study aims to understand Hong Kong CM practitioners' application of and opinions on the "Chinese Medicine Anti-epidemic Plans." Methods: Online focus group interviews were conducted, and purposive sampling was employed to invite 22 CM practitioners to voluntarily participate in three interview sessions. The interviews were audio recorded, then transcribed verbatim. The transcripts were analyzed using template analysis. Results: Three themes were derived: (1) facilitators of the "Chinese Medicine Anti-epidemic Plans," (2) barriers of the "Chinese Medicine Anti-epidemic Plans," and (3) expectations on improving the "Chinese Medicine Anti-epidemic Plans." The participants could obtain relevant information from various sources, which highlights the value of the plans for TCM medicinal cuisine and non-pharmacologic therapies and guiding junior CM practitioners, supplementing Western medicine interventions, and managing Chinese herb reserves in clinics. However, the barriers included the lack of a specialized platform for timely information release, defective plan content, limited reference value to experienced CM practitioners, and lack of applicability to Hong Kong. The expectations of the CM practitioners for improving the plans were identified based on the barriers. Conclusions: To enhance the implementation of the anti-epidemic plans, CM practitioners in Hong Kong expect to utilize a specific CM platform and refine the plans to ensure that they are realistic, focused, comprehensive, and tailored to the local context. [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]

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease with acute exacerbation (AECOPD) being a common sequalae which negatively impact health status, rates of hospitalization and readmission, and disease progression. N‐acetylcysteine (NAC) has been studied in COPD in both stable state and acute exacerbations, which has been shown to have small beneficial effects in stable COPD, as well as AECOPD. Yet, there has been lack of study with well‐designed protocol to assess the role of NAC in more objective outcomes in AECOPD. Methods: This is a double‐blind randomized controlled trial. Patients will be randomized in 1:1 ratio to receive oral NAC at 600 mg twice daily or placebo twice daily with standard of care. Partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and the ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO2/FiO2) will be measured on days 1 and 7. The following will be measure at baseline and on day 4 and 7: Forced expiratory volume in one second (FEV1), 24‐hour sputum volume, oxygen saturation (SaO2), end‐tidal CO2, Leicester Cough Questionnaire (LCQ) score, COPD Assessment Test (CAT) score, grading of wheeze and grade of dyspnoea; blood inflammatory markers (leucocyte count, neutrophil count, erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP) and high sensitivity CRP (hs‐CRP)). Patients will be randomized to oral NAC at 600 mg twice daily or placebo for 7 days. The main outcome measures include: The difference in PaO2 on day 7. Secondary outcome: Change in following parameters on day 4/7 from baseline: FEV1, sputum volume, CAT score, LCQ score, SaO2, grade of wheeze; mMRC Dyspnoea Scale, end‐tidal CO2, blood inflammatory marker, change in PaO2/FiO2 ratio from baseline to day 7, PaCO2 on day 7, 28 and 90 days' mortality, time to wean off supplemental oxygen, length of stay. Primary and secondary outcomes will be compared among the two treatment groups with two‐sample t‐test. Discussion: We hypothesize that NAC use in COPD exacerbation can provide benefits in clinical and laboratory parameters. Trial Registration: Name of the registry: ClinicalTrials.gov Trial registration number: NCT05706402. URL of the trial registry record for this trial: https://classic.clinicaltrials.gov/ct2/show/NCT05706402 Date of registration: Registered on 11th January 2023 Funding of the trial: The Health and Medical Research Fund (HMRF). Name and contact information for the trial sponsor: Wang Chung Kwok, Clinical Assistant Professor, Honorary Associate Consultant, Queen Mary Hospital, The University of Hong Kong, Hong Kong. Role of sponsor: The funder is not involved in the planning of the study, gathering, analysing, and interpreting the data, or in preparing the manuscript. [ABSTRACT FROM AUTHOR]

This paper conducts a comparative analysis of the governance and policing frameworks in Hong Kong and Taiwan, examining their responses to the COVID-19 pandemic’s public health crisis and the resulting shifts in policing contexts. Hong Kong experienced significant changes in police-citizen relations before the pandemic, notably during the 2019 protests that garnered global media attention and eroded public trust in the government. With the advent of COVID-19, Hong Kong introduced stringent anti-pandemic legislation aimed at achieving ‘zero-COVID’, further empowering the police for law enforcement. In contrast, Taiwan effectively managed the epidemic from 2020, keeping mass infections at bay until mid-2022, without significant social conflicts. This study delves into the academic implications of these divergent outcomes, seeking to explain what and why changes occurred (or did not) in these two places. Hong Kong’s response to the global health crisis, including the introduction of the National Security Law, fundamentally transformed its policing context, dismantling autonomous civil societies and reshaping public trust in the government and its police. In comparison, Taiwan’s policing exhibited limited post-crisis transformation, maintaining high public trust even amid stringent quarantine and lockdown regulations. This divergence reflects varying pathways of the legitimisation of police influenced by geopolitics, underscoring the importance of comparative studies in comprehending transformations of policing in different contexts following the global public health crisis. [ABSTRACT FROM AUTHOR]

Background: The available evidence presented inconsistencies and inconclusive findings regarding the associations between co-existing asthma and mortality among COVID-19 patients. The objective of the current study is to investigate the relationship between asthma and severe outcomes after SARS-CoV-2 Omicron infection in an infection-naïve population. Methods: A retrospective cohort study using propensity score matching was conducted. The COVID-19 patients requiring hospitalisation in Hong Kong from January 1, 2022, to November 13, 2022, an Omicron-predominated period, were identified. Severe clinical outcomes were defined as ICU admission and inpatient death after the first positive PCR results as well as a composite outcome of both. Results: Of the 74,396 hospitalised COVID-19 patients admitted, 1,290 asthma patients and 18,641 non-asthma patients were included in the matched cohort. The rates of death and the composite outcome were 15·3% and 17·2%, respectively, among the non-asthma patients,12·2% and 13·6%, respectively, among the asthma patients, with adjusted hazard ratios equal to 0·775 (95% CI: 0·660–0·909) and 0·770 (95% CI: 0·662–0·895), respectively. The negative association was more apparent in the elderly and female groups. Asthma remained a factor that lowered the risk of disease severity even though the patients were not fully vaccinated with at least two doses. Conclusions: We used real-world data to demonstrate that asthma was not a risk factor for COVID-19 severity of the infections of Omicron variant, even though the patients were not fully vaccinated. [ABSTRACT FROM AUTHOR]

This paper discusses the factors affecting the behaviours for coping with fake news among young people. The data were collected from a survey conducted in late 2019, which sampled 2112 secondary school students from 21 partnering schools. This study aims to understand the opinions and behaviours of teenagers towards disinformation when fake news was prevalent during the anti-extradition bill protests in Hong Kong. It finds that awareness of the problem alone had limited influence in facilitating coping strategies. Civic awareness and interaction with social media were useful predictors of internal and external coping behaviours, respectively. Confidence about one's ability to detect fake news was a crucial factor, yet a concern for the value of truth stood out as the strongest predictor of fake news coping behaviours. [ABSTRACT FROM AUTHOR]

Aims A randomized controlled trial was conducted to examine the effects of a home-based music-paced physical activity programme guided by Information-Motivation-Strategy (IMS) model and Self-determination theory on exercise-related outcomes for patients with coronary heart disease (CHD) after cardiac rehabilitation (CR). Methods and results A total of 130 patients with CHD from a regional CR centre in Hong Kong were recruited and randomly allocated into intervention (n = 65) or control groups (n = 65). The intervention group received theory-guided practical sessions on performing prescribed home-based physical activity with individualized synchronized music, and follow-up telephone calls. The primary outcome was exercise capacity. Secondary outcomes included exercise self-efficacy, physical activity level, and exercise self-determination. Data were collected at baseline, 3 months, and 6 months after study entry. The generalized estimating equations model was used to assess the intervention effects. Patients with CHD in the intervention group demonstrated significantly greater improvements in exercise capacity at 3 months [ β = 35.68, 95% confidence interval (CI) 2.69–68.68, P = 0.034] and significantly improved exercise self-efficacy at 6 months (β = 3.72, 95% CI 0.11–7.32, P = 0.043) when compared with the control group. However, no significant group differences were found in physical activity level and exercise self-determination. Conclusion The study findings provide evidence on an innovation on improving the exercise capacity and exercise self-efficacy of patients with CHD. The music-paced physical activity guided by the IMS model and Self-determination theory requires further investigation on its long-term effects in future studies. Clinical trial registration ChiCTR-IOR-17011015. [ABSTRACT FROM AUTHOR]

Digital multimodal composing (DMC) allows students to mobilize a wide range of multimodal resources to make meaning. While studies in DMC tended to focus on language-learning contexts, few of them examine its use in content-based courses whereby students are proficient L2 users expected to demonstrate understanding of abstract concepts using DMC. Drawing on semi-structured interviews with English-major students who attended a writing course in an English-medium instruction university in Hong Kong, the study investigated how the students' view of DMC was transformed after exposure to DMC pedagogy. The study findings suggest that students developed an increased awareness of the affordances and constraints of (new media) writing, and they strategically bring in and bridge 'in-class' and 'out-of-class' digital practices. Students also reported on the opportunities and challenges of DMC pedagogy through reflecting on their DMC experiences. The study proposes suggestions for implementing DMC in diverse teaching and learning contexts. [ABSTRACT FROM AUTHOR]

The independent predictive power of fatigue for community integration has not been investigated, although there is an increasing amount of literature that recognizes the importance of fatigue in people with stroke. To examine the correlation between community integration and fatigue, walking endurance, and fear of falling; and to quantify the relative contribution of fatigue to community integration in people with stroke. This was a cross-sectional study with 75 community-dwelling people with stroke. Data were collected using the Community Integration Measure (CIM), Fatigue Assessment Scale (FAS), 6-minute walk test (6MWT), and Survey of Activities and Fear of Falling in the Elderly (SAFE). Multiple linear regressions (forced entry method) were used to quantify the relative power of the FAS score to predict community integration in a model covering distance in the 6MWT and the SAFE score. After controlling for age, the CIM score significantly correlated with the scores for FAS (r=-0.48, p < 0.001), 6MWT distance (r = 0.24, p = 0.039), and SAFE (r=-0.39, p = 0.001). The entire model, including age, FAS score, 6MWT distance, and SAFE score, explained 26.1% of the variance in the CIM scores (F [4, 70] = 7.52, p < 0.001). The FAS scores independently explained 10.6% of the variance in the CIM scores. This study suggests that fatigue is an independent predictor of community integration among people with stroke, taking into account walking endurance and fear of falling. [ABSTRACT FROM AUTHOR]

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]

Purpose: Literature on antipsychotic medication adherence in early psychosis primarily assessed adherence behaviors and focused on young patients. There is a paucity of research investigating negative medication attitude and its determinants in the early illness course, particularly in older-aged sample. We aimed to examine prevalence and correlates of medication non-adherence behaviors and negative medication attitudes separately in adult patients with early psychosis. Methods: One hundred ninety-nine Chinese early psychosis patients aged 26–55 years who had received three-year treatment for first psychotic episode in Hong Kong were examined. Assessments encompassing socio-demographics, premorbid adjustment, clinical and treatment profiles, self-stigma and therapeutic alliance were conducted. Patients were evaluated with Medication Compliance Questionnaire, which is a modified Chinese-translated version of Medication Adherence Rating Scale and includes items measuring adherence behaviors and attitudes towards medications. Results: Rates of medication non-adherence and negative attitude towards medications were 38.7% and 50.8%, respectively. Multivariate regression analysis showed that more severe positive symptoms, greater self-stigma and negative medication attitude were independently associated with medication non-adherence. Negative attitude towards medications was significantly associated with younger age, higher educational attainment, diagnosis of other psychotic disorders, poorer insight, greater self-stigma and less satisfaction with communication with healthcare staff, which represented an index reflecting suboptimal therapeutic alliance. Conclusion: Antipsychotic non-adherence and negative medication attitudes are frequently observed in adult early psychosis patients. Our findings indicate that poor insight, elevated self-stigma and suboptimal therapeutic alliance may constitute potential treatment targets for promoting medication adherence and rectifying negative medication attitudes in the early illness stage. [ABSTRACT FROM AUTHOR]

Objectives: To identify factors associated with female sexual dysfunction (FSD) among Hong Kong Chinese women in a gynaecology outpatient clinic. Methods: Chinese women aged 18 to 65 years who had been sexually active in the past 4 weeks before recruitment and attended the gynaecology clinic of Kwong Wah Hospital between October 2020 and July 2021 were invited to participate in a sexual health survey. Participant demographics were collected through the clinical management system. Sexual function in the previous 4 weeks was assessed using the Female Sexual Function Index (FSFI). Results: 206 women (mean age, 43.6 years) were included in the analysis. The mean total FSFI score was 23.44; 42% of participants were at risk of FSD, with a total FSFI score of =23.45. The score was lowest in the sexual desire domain (2.88) and highest in the coital pain domain (4.51). Participants were divided into three age groups based on their reproductive age status: 18 to 35 years (n=44), 36 to 50 years (n=116), and 51 to 65 years (n=46). Although older age groups tended to have higher risks of FSD, the differences between groups were not significant. Specifically, only the satisfaction domain score was lower in the age group of 36 to 50 years than in the age group of 18 to 35 years (4.16 vs 4.61, p=0.01). The coital pain domain score was lower in menopausal women than in premenopausal women (3.76 vs 4.51, p=0.03). Parous women had a lower sexual desire domain score (2.78 vs 3.04, p=0.04) and higher vaginal lubrication domain score (4.42 vs 3.74, p=0.02) than nulliparous women. Women using contraception had a higher vaginal lubrication domain score than women not using contraception (4.47 vs 3.91, p=0.02). Women with distress related to sexual function had a lower total FSFI score (19.74 vs 23.78, p=0.01), lower satisfaction domain score (3.80 vs 4.42, p=0.02), and lower coital pain domain score (3.38 vs 4.51, p=0.01), compared with women without distress related to sexual function. Conclusion: Although older women tend to be at higher risk of FSD, the correlation between age and FSFI score was not significant. Menopausal women had a lower coital pain domain score; women not using contraception had a lower vaginal lubrication domain score. [ABSTRACT FROM AUTHOR]

Background: Necrotizing fasciitis (NF) is a rare but potentially life-threatening soft tissue infection. The objective of this study was to assess the association between timely surgery within 6 h and hospital mortality in patients with limb NF, and to describe the trends in patients with NF, time to surgery and standardized mortality ratio (SMR) over 11 years. Methods: This was a multicenter, retrospective cohort study of all intensive care unit patients who had emergency surgery within 24 h of hospitalization for limb NF between April 1, 2008 and March 31, 2019 in Hong Kong. Timely surgery was defined as the first surgical treatment within 6 h of initial hospitalization. Appropriate antibiotics were achieved if the patient was given antibiotic(s) for all documented pathogens prior to or on day of culture results. The primary outcome was hospital mortality. Results: There were 495 patients (median age 62 years, 349 (70.5%) males) with limb NF treated by surgery within 24 h of hospitalization over the 11 years. Appropriate antibiotic(s) were used in 392 (79.2%) patients. There were 181 (36.5%) deaths. Timely surgery was not associated with hospital mortality (Relative Risk 0.89, 95% CI: 0.73 to 1.07) but admission year, advanced age, higher severity of illness, comorbidities, renal replacement therapy, vasopressor use, and type of surgery were significant predictors in the multivariable model. There was an upward trend in NF diagnosis (1.9 cases/year, 95% CI: 0.7 to 3.1; P < 0.01; R2 = 0.60) but there was no downward trend in median time to surgery (-0.2 h/year, 95% CI: -0.4 to 0.1; P = 0.16) or SMR (-0.02/year, 95% CI: -0.06 to 0.01; P = 0.22; R2 = 0.16). Conclusions: Among patients operated within 24 h, very early surgery within 6–12 h was not associated with survival. Increasing limb NF cases were reported each year but mortality remained high despite a high rate of appropriate antibiotic use and timely surgical intervention. [ABSTRACT FROM AUTHOR]

AbstractA pilot randomized controlled trial was conducted to examine the effectiveness of a storybook package for enhancing the perceived knowledge and confidence of health and social care professionals in working with bereaved child siblings and their parents before and after the loss. Open-ended questions were asked to collect feedback, and thematic analyses were conducted to generate the themes. Quantitative findings provided preliminary but not strong evidence of its effectiveness, but qualitative findings showed that participants perceived their knowledge about supporting bereaved siblings and their parents was enhanced and considered the storybook package a useful tool for facilitating their practice. Participants also reflected on how real and specific the stories in the storybook should be. This study is the first step in developing an evidence-based practice tool for health and social care professionals. Future studies are required to further examine its effectiveness for practice. [ABSTRACT FROM AUTHOR]

Religious attributes affecting Christians’ environmentalism have received considerable attention since the publication of Lynn White's thesis in 1967, which accused Christianity as the root cause of the ecological crisis. This study aims to assess the relationship between Christianity and environmentalism in Hong Kong, an Asian city where Christianity has been introduced for just more than two centuries. In general, Hong Kong Christians had a stronger willingness to sacrifice for the environment as compared to non‐Christians. Both stewardship worldview and Christian justice and love were identified as the main drivers for environmentalism in Christians, which can be further improved via church environmental education. Our findings provide a particular example to broaden the diversity of the Christianity‐environmentalism nexus and highlight the functional role of stewardship worldview in the Hong Kong context. However, we also call for stronger environmental education in Hong Kong's church to bridge the willingness‐behavior gap among local Christians. [ABSTRACT FROM AUTHOR]

Street performance or busking is common in public spaces. The literature highlights two psychological issues: the effect of street performance on public space perception and the complexity of the appreciation of street performance, regarded as street audience experience (SAE). The present study aims at verifying the effect of street performance on public space perception, while examining SAE as a mediator of this effect. We conducted a between-subjects field experiment (a quasi-experiment; N = 292) in Hong Kong. Participants assessed a public space without (control) or with (experimental) musical busking on essentialism, anti-essentialism, sonic restorativeness, and overall liking. In the experimental condition, unengaged passersby and engaged audience further evaluated SAE factors of emotion, intellect, novelty, place, interaction, and technique, and outcomes of overall satisfaction and donation worth. The public space with busking was perceived as significantly more sonically restorative. Engaged audience perceived the space as significantly more essentialist, anti-essentialist, sonically restorative, and likeable. Engaged audience also experienced more positive SAE and outcome variables. SAE fully mediated the effects of street performance on public space perception and outcome variables, respectively. These findings support the positive impact of street performance, which may enhance city inhabitants' well-being. [ABSTRACT FROM AUTHOR]

The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

The study of Hong Kong identity has traditionally been positioned in a local–national dichotomy, where Hong Kong identity is viewed primarily as a local identity while the label of national identity is reserved for identification with the Chinese nation. Hong Kong nationalism, on the other hand, is generally considered a new phenomenon, the study of which has focused predominantly on the political activities in the post-handover period. Drawing on Partha Chatterjee's theory of anti-colonial nationalism, this paper seeks to broaden the understanding of Hong Kong nationalism by examining the nationalistic sentiments manifested during the Chinese language campaign (1964–1971). This paper draws on archival materials to shed light on the presence of anti-colonial nationalism in colonial Hong Kong, an aspect often overlooked or considered a mere extension of Chinese nationalism from mainland China. This paper also discusses the distinctions between anti-colonial nationalism in Hong Kong and Chinese nationalism, highlighting the intricate nature of the concept of Chineseness. [ABSTRACT FROM AUTHOR]

As part of a larger project that investigates the issue of identities in Hong Kong, this study anchored on the sociocognitive paradigm in second language acquisition (SLA) explores the potential relationship between one's identity and perceived language accentedness. Our study set in Hong Kong (HK) aims to extend Gatbonton and colleagues' works (e.g. [2005]. Learners' ethnic group loyalty and L2 pronunciation accuracy: A sociolinguistic investigation. TESOL Quarterly, 39(3), 489–511. ; [2008]. The ethnic group affiliation and L2 proficiency link: Empirical evidence. Language Awareness, 17(3), 229–248. ; [2011]. Ethnic group affiliation and patterns of development of a phonological variable. Modern Language Journal, 95(2), 188–204. ) that examine the relationship between ethnic group affiliation (EGA) and language proficiencies in diglossic contexts. HK is a multi-glossic context where Cantonese, English and Mandarin are the official languages, and they perform distinctive functions in various public and private domains. Through analysing participants' (n = 65; born between 1970s–1990s) self-identification and their reported accentedness in English and Mandarin, we address the question of whether EGA as a set of social factors has a bearing on a person's linguistic achievements. Findings indicate that participants' identification with the Chinese/ HK identity is related to their perceived accentedness in the targeted languages in intricate ways that do not align completely with our predictions. We conclude by calling for further socio-cognitively informed research that investigates multiglossic situations where languages/ language varieties complement or compete with each other. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) technologies are increasingly integral to our world, as they serve as the foundation for new value propositions and distinctive customer experiences. AI is crucial for offering better customer experiences, which strengthen the consumer–brand relationship and brand differentiation. Based on the stimulus–organism–response model, this study examined the influence of AI on brand preference for retail banks in Hong Kong. Structural equation modeling was used to analyze 300 responses collected from a questionnaire survey of Generation Z subjects. The findings indicate that AI marketing efforts affected brand experience, brand preference, and repurchase intention. Among AI marketing efforts, information, accessibility and customization exerted influences on brand experience, while interaction had no significant impact on it. Brand experience also mediated the relationship between AI marketing efforts and brand preference. The study will help retail banks to design AI marketing activities and formulate better marketing and branding strategies for customer acquisition and retention. [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]

Objective: This study aimed to characterize the changing landscape of circulating SARS-CoV-2 lineages in the local community of Hong Kong throughout 2022. We examined how adjustments to quarantine arrangements influenced the transmission pattern of Omicron variants in a city with relatively rigorous social distancing measures at that time. Methods: In 2022, a total of 4684 local SARS-CoV-2 genomes were sequenced using the Oxford Nanopore GridION sequencer. SARS-CoV-2 consensus genomes were generated by MAFFT, and the maximum likelihood phylogeny of these genomes was determined using IQ-TREE. The dynamic changes in lineages were depicted in a time tree created by Nextstrain. Statistical analysis was conducted to assess the correlation between changes in the number of lineages and adjustments to quarantine arrangements. Results: By the end of 2022, a total of 83 SARS-CoV-2 lineages were identified in the community. The increase in the number of new lineages was significantly associated with the relaxation of quarantine arrangements (One-way ANOVA, F(5, 47) = 18.233, p < 0.001)). Over time, Omicron BA.5 sub-lineages replaced BA.2.2 and became the predominant Omicron variants in Hong Kong. The influx of new lineages reshaped the dynamics of Omicron variants in the community without fluctuating the death rate and hospitalization rate (One-way ANOVA, F(5, 47) = 2.037, p = 0.091). Conclusion: This study revealed that even with an extended mandatory quarantine period for incoming travelers, it may not be feasible to completely prevent the introduction and subsequent community spread of highly contagious Omicron variants. Ongoing molecular surveillance of COVID-19 remains essential to monitor the emergence of new recombinant variants. [ABSTRACT FROM AUTHOR]

Objectives To compare the incidence of major adverse cardiovascular events (MACEs), cancer and infective complications in RA patients using Janus kinase (JAKis) and TNF (TNFis) inhibitors. Method A retrospective analysis of data from the Hong Kong Biologics Registry 2008–2021 was performed. RA patients who had ever used JAKis or TNFis were included. The incidence of MACEs, cancer and infections were compared between the two groups, with adjustment for confounding factors. Results A total of 2471 courses of JAKis (n  = 551) and TNFis (n  = 1920) were used in 1732 RA patients (83.7% women, age 53.8 [12.5] years; follow-up 6431 patient-years). JAKi users had significantly older age, more atherosclerotic risk factors and higher frequency of past malignancies. A total of 15 and 40 MACEs developed in the JAKi and TNFi users, respectively (incidence 1.34 vs 0.75 per 100 patient-years; P  = 0.22). There was no significant difference in the incidence of cancers between the two groups (0.81 [JAKi] vs 0.85 [TNFi] per 100 patient-years; P  = 0.25). The adjusted hazard ratios of MACE and cancer in the JAKi users were 1.36 (95% CI: 0.62, 2.96) (P  = 0.44) and 0.87 (95% CI: 0.39, 1.95) (P  = 0.74), respectively. Rates of infections were significantly higher in the JAKi than TNFi users (16.3 vs 9.9 per 100 patient-years; P  = 0.02), particularly herpes zoster (3.49 vs 0.94 per 100 patient-years; P  < 0.001). Conclusions In a real-life setting, there is no increase in MACEs or cancers in users of JAKis compared with TNFis. However, the incidence of non-serious infections, including herpes zoster, was increased in users of JAKis. [ABSTRACT FROM AUTHOR]

The crocodilians include true crocodiles, alligators, caimans, and gharial, and the trade of crocodilian products is regulated in accordance with the Convention of Wild Fauna and Flora (CITES). Hong Kong does not have her own wild crocodilians; thus, all crocodilians meat available is presumably imported with proper license. Here, we obtained a dataset of cytochrome oxidase I (COI) gene markers of 114 crocodilian meat samples (including frozen and dried crocodilian meat products) available in the contemporary market. We have also validated these barcodes in a phylogenetic approach with other data deposited on the GenBank, and detected 112 samples belonging to four crocodile species Crocodylus siamensis, C. porosus, C. niloticus and Alligator mississippiensis, and 2 samples belonging to snake Malayopython reticulatus. The dataset generated in this study will be useful for further studies including meat inspection, illegal trading, and enhancement of international and local legislations on illegal reptile importation. [ABSTRACT FROM AUTHOR]

There is limited research on real-world antidepressant utilization patterns in children and adolescents, particularly in non-western countries. We aimed to examine temporal trends of antidepressant prescribing practice among Chinese children and adolescents in Hong Kong over 14-year period. This population-based study identified 9566 patients aged 5–17 years who had redeemed at least one antidepressant prescription within 2005–2018, using data from health-record database of Hong Kong public healthcare services. We calculated annual prescription rates (per 1000 persons) for any antidepressant, antidepressant drug classes, and individual antidepressants. Joinpoint-regression analyses were performed to assess temporal antidepressant prescription trends, quantified by average annual-percent-change (AAPC), with 95 % confidence-intervals (CIs). Overall antidepressant prescription rate significantly increased over time (AAPC: 7.30 [95 % CI: 6.70–7.90]), from 3.883 in 2005 to 9.916 in 2018. The use of selective-serotonin-reuptake-inhibitors (SSRIs), serotonin-norepinephrine-reuptake-inhibitors (SNRIs), and other antidepressants significantly increased over 14 years, while tricyclic-antidepressants remained stable. SSRI represented the most commonly-prescribed drug class. Fluoxetine and sertraline constituted the two most frequently-prescribed individual antidepressants, while desvenlafaxine (AAPC: 55.68 [30.74–85.39]) and bupropion (AAPC: 35.28 [23.68–47.98]) exhibited the sharpest increase in prescription rates over the study period. Medication adherence could not be assessed and actual drug use may be overestimated. Our results affirm a significant rising trend of antidepressant prescriptions among Chinese children and adolescents over time. All antidepressant drug-classes, except TCA, demonstrated significantly increased use, with SSRI being the most frequently-prescribed drug class. Future investigation should clarify indications, hence off-label use, of antidepressant initiation in this vulnerable population. • 14-year real-world antidepressant prescribing trend in Chinese children/adolescents • A significant rising trend in overall antidepressant (AD) prescriptions over time • SSRIs, SNRIs and other ADs showed significant increase in use; TCAs remained stable. • SSRI, fluoxetine & sertraline are the most commonly-used AD class, and AD agents. • Desvenlafaxine & bupropion showed the sharpest rise in prescription rate over time. [ABSTRACT FROM AUTHOR]

Context Vitamin D inadequacy is globally prevalent among pregnant women; however, its impact on pregnancy remains inconclusive. Objective This study aims to explore the associations of maternal and umbilical cord serum 25-hydroxyvitamin D (25(OH)D) levels with pregnancy and neonatal outcomes. Method We used archived serum samples from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study participants in the Hong Kong center and assayed maternal 25(OH)D levels at midgestation and umbilical cord 25(OH)D at birth using liquid chromatography–tandem mass spectroscopy. Data regarding pregnancy and perinatal outcomes were extracted from the HAPO study dataset and the hospital computerized medical system. Results Only 247 (16.4%) mothers and 66 (5.0%) neonates met the criteria for vitamin D sufficiency (ie, 25(OH)D ≥ 75 nmol/L). The ratio of umbilical cord to maternal vitamin D levels was positively associated with maternal age and ambient solar radiation at the month of delivery, while negatively associated with maternal serum total 25(OH)D at midgestation (all P <.001). Umbilical cord serum 25(OH)D was independently associated with a lower primary cesarean section rate (OR 0.990, 95% CI 0.982-0.999; P =.032). There were no associations of maternal and umbilical cord 25(OH)D levels with other adverse pregnancy and neonatal outcomes. Conclusion Placental vitamin D transfer was found to be higher with a lower maternal vitamin D level, older maternal age, and higher ambient solar radiation at the time of the delivery. The protective effect of sufficient vitamin D in a cesarean section will require further studies. [ABSTRACT FROM AUTHOR]

Background: Elevations in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were reported as adverse events of nirmatrelvir/ritonavir users in the EPIC‐HR trial. Aim: To quantify the risk and severity of acute liver injury (ALI) associated with nirmatrelvir/ritonavir use. Methods: This self‐controlled case‐series study was conducted using electronic medical records of patients with confirmed diagnosis of SARS‐CoV‐2 infection between 26th February 2022 and 12th February 2023 in Hong Kong. Results: Among 2 409 848 patients with SARS‐CoV‐2 infection during the study period, 153 853 were prescribed with nirmatrelvir/ritonavir, of whom 834 (.5%) had incident ALI (moderate: 30.5%; moderate to severe: 18.9%; severe or fatal: 5.8%). Compared with the non‐exposure period, risk of ALI increased significantly during the pre‐exposure period (IRR = 38.13, 95% CI = 29.29–49.62) and remained elevated during the five‐day nirmatrelvir/ritonavir treatment (IRR = 20.75, 95% CI = 17.06–25.25) and during wash‐out period (IRR = 16.27, 95% CI = 13.23–20.01). Compared to the pre‐exposure period, risk of ALI was not increased during the five‐day nirmatrelvir/ritonavir treatment period (IRR =.54, 95% CI =.43–.70). Compared to 5469 non‐nirmatrelvir/ritonavir users with incident ALI, nirmatrelvir/ritonavir users had less severe ALI by the severity index (p <.001) and peak INR (1.7 vs. 2.3; p <.001). ALI cases with nirmatrelvir/ritonavir use had lower risk of all‐cause death (29.1% vs. 39.1%; OR =.64; p <.001) and no increase in risk of liver decompensation (1.0% vs. 1.3%; OR =.62; p =.230) compared to non‐users. Conclusion: The risk of ALI associated with nirmatrelvir/ritonavir treatment for COVID‐19 was elevated in the pre‐exposure period, but not following nirmatrelvir/ritonavir initiation. ALI following nirmatrelvir/ritonavir treatment were mostly mild and less severe than ALI events in non‐nirmatrelvir/ritonavir users. [ABSTRACT FROM AUTHOR]

Background/Purpose: This is a local retrospective review on the outcomes of tenolysis after phalangeal fracture. Methods: The clinical outcome of nine patients (mean age 51.9 years) with finger fractures and subsequent tenolysis performed were reviewed. Range of motion was evaluated. Results: Extensor tenolysis, capsulotomy with or without flexor tenolysis was performed at a mean of 8.2 months after hand fracture with fracture fixation done. The total active motion (TAM) improved from 121° preoperatively to 173° postoperatively (p = 0.02). Significant improvement of motion was observed at the proximal interphalangeal joint (p = 0.012). All patient's range of motion improved after surgery. Conclusion: The gain of motion of 52° is comparable to other series. Release of all pathological anatomy and aggressive mobilization may improve the result further. Tenolysis can provide an encouraging improvement of active motion for stiff finger after phalangeal fractures. Recent results using WALANT technique showed satisfactory outcome. Future study on WALANT technique may further consolidate its potential benefit. [ABSTRACT FROM AUTHOR]

Purpose: This research was undertaken to examine predictors of physical education (PE) teachers' attitudes toward teaching students with attention-deficit/hyperactivity disorder in general PE. Method: In-service PE teachers (n = 151) in Hong Kong completed a multi-section survey measuring demographic variables, attitudes, self-esteem, and intrapersonal and interpersonal mindfulness. Survey data were mainly analyzed through multiple regression analyses. Results: The results showed that special education-related coursework and self-esteem were positive predictors of attitudes. However, they were no longer a significant predictor after mindfulness was entered into the regression model while both types of mindfulness positively predicted attitudes. Discussion/Conclusion: Self-esteem as well as intrapersonal and interpersonal mindfulness play an important role in predicting PE teachers' attitudes toward teaching students with attention-deficit/hyperactivity disorder. Related training components may be included in the professional development programs for improving PE teachers' attitudes. [ABSTRACT FROM AUTHOR]

Academic libraries are experiencing significant changes and making efforts to deliver their service in the digital environment. Libraries are transforming from being places for reading to extensions of the classroom and learning spaces. Due to the globalized digital environment and intense competition, libraries are trying to improve their service quality through various evaluations. As reference service is crucial to users, this study explores user satisfaction towards the reference service through WhatsApp, a social media instant messenger, at a major university in Hong Kong and discusses the correlation between the satisfaction rating and three variables. Suggestions and recommendations are raised for future improvements. The study also sheds light on the usage of reference services through instant messaging in other academic libraries. [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: Psychiatric patients are susceptible to adverse mental health outcome during COVID-19 pandemic, but its associated factors are understudied. This observational cross-sectional study aimed to comprehensively examine prevalence and correlates of psychological distress, in terms of depression, anxiety and post-traumatic-stress-disorder (PTSD)-like symptoms, among Chinese adult psychiatric outpatients amidst the peak of fifth COVID-19 wave in Hong-Kong. Methods: A total of 415 patients (comprising 246 patients with common-mental-disorders [CMD] and 169 with severe-mental-disorders [SMD]) and 399 demographically-matched controls without mental disorders were assessed with self-rated questionnaires between 28-March and 8-April-2022, encompassing illness profile, mental health symptoms, psychosocial measures (loneliness, resilience, coping styles) and COVID-19 related factors. Univariate and multivariable logistic regression analyses were conducted to determine variables associated with moderate-to-severe depressive, anxiety and PTSD-like symptoms among psychiatric patients. Results: Our results showed that CMD patients had the greatest psychological distress relative to SMD patients and controls. Approximately 40–55% CMD patients and 25% SMD patients exhibited moderate-to-severe depression, anxiety and PTSD-like symptoms. Multivariable regression analyses revealed that female gender, lower educational attainment, single marital status, being housewife, more severe insomnia, psychotic-like symptoms and cognitive complaints, self-harm behavior, lower resilience, avoidance coping, never contracting COVID-19 infection, greater fear of contagion, and longer exposure to pandemic-related information were independently associated with depression, anxiety and/or PTSD-like symptoms in psychiatric patients. Conclusions: Our results affirm increased vulnerability of psychiatric patients toward psychological distress during pandemic. An array of identified correlates facilitates early detection of high-risk psychiatric patients for targeted strategies to minimize pandemic-related negative psychological impact. [ABSTRACT FROM AUTHOR]

Background Annual influenza vaccination is recommended for older adults but repeated vaccination with standard-dose influenza vaccine has been linked to reduced immunogenicity and effectiveness, especially against A(H3N2) viruses. Methods Community-dwelling Hong Kong adults aged 65–82 years were randomly allocated to receive 2017–2018 standard-dose quadrivalent, MF59-adjuvanted trivalent, high-dose trivalent, and recombinant-HA quadrivalent vaccination. Antibody response to unchanged A(H3N2) vaccine antigen was compared among participants with and without self-reported prior year (2016–2017) standard-dose vaccination. Results Mean fold rise (MFR) in antibody titers from day 0 to day 30 by hemagglutination inhibition and virus microneutralization assays were lower among 2017–2018 standard-dose and enhanced vaccine recipients with (range, 1.7–3.0) versus without (range, 4.3–14.3) prior 2016–2017 vaccination. MFR was significantly reduced by about one-half to four-fifths for previously vaccinated recipients of standard-dose and all 3 enhanced vaccines (β range,.21–.48). Among prior-year vaccinated older adults, enhanced vaccines induced higher 1.43 to 2.39-fold geometric mean titers and 1.28 to 1.74-fold MFR versus standard-dose vaccine by microneutralization assay. Conclusions In the context of unchanged A(H3N2) vaccine strain, prior-year vaccination was associated with reduced antibody response among both standard-dose and enhanced influenza vaccine recipients. Enhanced vaccines improved antibody response among older adults with prior-year standard-dose vaccination. [ABSTRACT FROM AUTHOR]

The present research reports the findings of three studies, with objectives to demonstrate the impacts of health-promoting behaviors on psychological well-being as well as the mediating roles of sense of control (SOC) and perceived severity of COVID-19 in these relationships. Study 1 was a cross-sectional survey conducted in 473 middle-aged and older Chinese adults before the COVID-19 pandemic to assess their health-promoting behaviors, personal mastery and perceived constraints, life satisfaction, and depressive symptoms. Study 2 was conducted during the second wave of the COVID-19 outbreak in Hong Kong (between March to April 2020), in which 292 participants from Study 1 were successfully contacted to report their emotional responses to the pandemic. Using a different sample, Study 3 was a longitudinal study that measured 495 participants' health-promoting behaviors, personal mastery and perceived constraints at baseline, and their perceived severity and mental health outcomes during the outbreak of omicron cases in Hong Kong (i.e., the fifth wave of the COVID-19 outbreak) in March 2022. All three studies demonstrate that the beneficial effects of health behaviors can be extended to psychological well-being and reveal possible underlying mechanisms through enhancing one's SOC and lowering perceived severity of the COVID-19 outbreak. These results provide important insights to future health promotion programs for improving psychological resources and psychological well-being of middle-aged and older adults in face of disease-related threats. [ABSTRACT FROM AUTHOR]

Aim: Rezūm is a novel treatment for patients with moderate to severe lower urinary tract symptoms as a result of benign prostatic hyperplasia (BPH). Recently, it has expanded to patients with urinary retention causing catheter dependence and the results are promising in Whites. However, it is unclear how effective Rezūm is in the Chinese population. Here, we report our experience in performing Rezūm on catheter‐dependent Chinese men with BPH and evaluate its safety and efficacy. Methods: A retrospective review of catheter‐dependent patients with BPH who underwent Rezūm from January to August 2022 was conducted. We evaluated the success rate of trial without catheter (TWOC) and compared pre‐ and post‐operative (at 6 months) uroflowmetry results, International Prostate Symptoms Score (IPSS), IPSS Quality of Life Score (IPSS QoL), and prostate volume. Results: Sixty‐three patients had Rezūm performed (44 and 19 patients had refractory urinary retention and obstructive uropathy, respectively) with a mean age of 74 years and a mean prostate size of 53.9 mL. The first attempt at TWOC was successful in 53 patients (85.5%; range 15–44 days post‐operation). By 98 days after the operation, all patients could void spontaneously. The 6‐month follow‐up showed that IPSS and IPSS QoL scores decreased by a mean of 9.0 and 1.8 points, respectively (both P <.01). The mean pre‐operative post‐voided residual urine was reduced by 559 mL (P <.01), with a mean prostate size reduction of 9.4 mL (P <.01). Seven patients had non‐serious complications (Grade 1–2 Clavien–Dindo classification) within 30 days of operation. Conclusion: Rezūm was shown to be effective and safe in catheter‐dependent Chinese men with BPH. [ABSTRACT FROM AUTHOR]

Introduction: This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. Methods: This qualitative study involved 90‐minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health‐related quality of life perceptions and gaps in patient empowerment in HIV care during February–May 2022. The COM‐B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents' experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. Results: A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20−49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long‐term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. Conclusions: There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing. [ABSTRACT FROM AUTHOR]

In Hong Kong, quality assessors from the Education Bureau (EDB) visit kindergartens to conduct Quality Review (QR) assessments. Their written reports, therefore, reflect the official local perspective of quality kindergarten education. We conducted a content analysis of 323 QR reports focusing on the positive and negative feedback and recommendations for improvement regarding music education. Two coding schemes were developed using an inductive approach. High inter-reliability was obtained. The most frequently mentioned positive feedback codes were related to sufficient exposure to music and enjoyable musical learning experiences. In contrast, there were negative feedback codes pointing out that children's musical exposure was insufficient at Kindergarten 3 (children aged 5–6 years), and some musical activities were poorly prepared and/or designed. Children's music learning outcomes were rarely mentioned in the reports. The analyses indicate that the local understanding of kindergarten music education strongly emphasizes exposing children to enjoyable musical activities, with a lower focus on the nature and quality of musical learning. We conclude that the QR reports reflect a teacher-centric view of music education. Findings may inform curriculum designers and teacher educators about EDB's expectations in the area of music education. Future research should explore the perspectives of other kindergarten stakeholders such as teachers, principals, and teacher educators. [ABSTRACT FROM AUTHOR]

This paper studies the Hong Kong economy from a trade intermediary's perspective. Using a structural vector autoregression (SVAR) framework, we discover that trade‐related external shocks mainly affect the economy through re‐exports channel over the offshore trade channel. We observe that re‐exports shock does not transmit to the real economy through the employment channel. A puzzling phenomenon is that trade‐related employment has been in decline since 2008. Moreover, we notice that although the Sino‐U.S. trade war exerted much downward pressure on economic growth between 2018 and 2019, the trade intermediary sector swiftly recovered in 2020, reflecting the versatility of the external trade sector in Hong Kong. [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]