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Nonalcoholic steatohepatitis (NASH) is hepatic inflammation caused by a buildup of fat in the liver. This study was designed to examine whether the NASH-associated increase in hepatic TNF-alpha mRNA expression and serum TNF-alpha, and decrease in hepatic PPARalpha mRNA expression in rats secondary to 12-week consumption of a high-fat diet would be attenuated with concurrent exercise. A total of 28 male Sprague-Dawley strain rats were randomly assigned into four groups: standard diet without (C, n = 6) and with (E, n = 7) concurrent exercise; and high-fat diet without (H, n = 8) and with (HE, n = 7) concurrent exercise. The mean daily energy intake during the intervention period resulting from the standard and high-fat diets was approximately 82 kcal and 95 kcal, respectively. Swimming exercise was carried out in the E and HE groups for 12 weeks. The initial swimming duration of 30 minutes was progressively increased by 10 min x d[-1] to 90 minutes by the end of the fourth week, which then remained unchanged. NASH revealed by histological activity index, which occurred in the H but not the C group, was alleviated in the HE group. Moreover, the upregulation of hepatic TNF-alpha mRNA expression and serum TNF-alpha, and downregulation of hepatic PPARalpha mRNA expression, which were shown in the H group, were attenuated in the HE group. Such findings suggest that long-term exercise carried out concurrently with consumption of a high-fat diet could alleviate high-fat diet-induced NASH. These may be partly attributable to the attenuation of hepatic TNF-alpha overexpression and the upregulation of hepatic PPARalpha mRNA expression. [ABSTRACT FROM AUTHOR]

It was wondered if the counting of fat mass (FM) in the workload of Wingate test (WAnT) of 75 g.kg[-1] total body mass (TBM) would invalidate the test on evaluating leg anaerobic power in minor overfat young adults. This study examined the hypothesis that the neglect of FM in the WAnT workload assignment would improve the peak power (PP), mean power (MP) and fatigue index (FI) in minor overfat subjects. In this study, we found in 16 male and female young adults with normal percent body fat (%BF) that the WAnT workloads of 86 g.kg[-1] and 95 g.kg[-1] fat free mass, respectively, could develop the PP, MP and FI equivalent to those obtained from the original workload of 75 g.kg[-1] TBM. When these new workloads were applied to 18 male and 15 female subjects with a little above-normal %BF, the PP and MP, but not the FI, were declined from the original values (p < 0.05). The declines were positively correlated to their %BF (p < 0.05). Such findings do not support our hypothesis. The findings show that the neglect of FM in the WAnT workload assignment lessens the maximum anaerobic power output of the minor overfat subjects. It further suggests that the counting of FM in the traditional WAnT workload of 75 g.kg[-1] TBM may not impair their maximum performance. However, the interpretation of lack of negative influence of FM on the WAnT performance in minor overfat young adults should be made with caution. [ABSTRACT FROM AUTHOR]

Introduction: To minimise adverse health events among older adults, physical activity (PA) is considered one of the most fundamental and effective forms of lifestyle. Therefore, an urgent effort to promote a physically active lifestyle among our older adults is needed, in which walking could be a better choice, especially for mass promotion. Besides, the types of PA interventions were also shown to affect their effectiveness on older adults' psychosocial outcomes. Hence, the overall aim of the project is to examine the effectiveness of supervised group-based walking intervention by comparing it with unsupervised group-based walking and unsupervised individual-based walking interventions on improving physical, psychological and social outcomes among older adults in Hong Kong., Methods and Analysis: The research will conduct a four-group (supervised group-based, unsupervised group-based walking, unsupervised individual-based, control group), double-blind, randomised control trial, targeting 184 older adults in Hong Kong. The primary outcomes will be measured by participants' changes in resting heart rates, body compositions, resting blood pressures, walking performance, loneliness, perceived social support and PA enjoyment. The results will be analysed using repeated analysis of variance and one-way analysis of covariance, as well as by conducting in-depth interviews with selected participants. Also, the outcomes of the research will be used as references for designing an effective walking operation manual for promoting healthy ageing among older adults in the community., Ethics and Dissemination: The current study involves human participants, and the research protocol has been approved by the research ethics committee at Hong Kong Baptist University (Ref: R2022-2023-0013). All participants will be provided with written informed consent to participate. The outcomes of the intervention protocol will be disseminated through manuscript publications., Trial Registration Number: The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT05907252; date of first posted: 16 June 2023)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background/objectives: The study aimed to examine the physical fitness and activity levels of kindergarteners in Hong Kong during the coronavirus disease 2019 pandemic., Methods: A total of 2052 kindergarteners (48% girls; 32.9% Grade 1, 34% Grade 2, and 33.1% Grade 3) were recruited from July 2020 to November 2021. Participants completed the physical fitness tests, including body composition, flexibility, lower-limb muscle strength, upper-limb muscle strength, lower-limb muscle endurance, and agility. Children's physical activity and overall well-being were examined using parental proxy reports. Parents also reported their physical activity and parental support to children's physical activity engagement, as well as their perception of children's kindergarten physical activity environment. Fitness differences by age and gender were analyzed using one-way ANOVA and ANCOVA measuring effect size with partial eta-squared. Additionally, correlations assessed the relationship between children's fitness and parents' proxy reports., Results: The results of the physical fitness tests were higher than those in previous studies conducted by the Physical Fitness Association of Hong Kong in 2015-2018. Gender-based differences were observed in most tests for children aged 4 years and older, with boys showing higher scores in the standing long jump, shot put, and balance tests, while girls had higher scores in the sit-and-reach test. Parents' proxy questionnaire answers indicated that children's continuous jump test performances were significantly related to their frequency of physical activity per week (r = 0.19, p < 0.001), and that children's health was significantly and positively correlated with their fitness level (r = 0.179, p < 0.009). Inadequate school physical activity was associated with poor upper-limb strength (r = 0.078, p < 0.005). Moreover, a high level of parental support for their children's participation in physical activity was correlated with a high level of parental participation in vigorous-intensity physical activities (r = 0.167, p < 0.005)., Conclusion: The physical fitness of children in Hong Kong was less affected by the epidemic. Parents' healthy behaviors and support were related to children's participation in PA. Efforts to improve children's physical fitness and motor development should include parent education and physical activity involvement., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd.)

Objective: To assess the efficacy of valganciclovir in infants with hearing loss and clinically inapparent congenital cytomegalovirus infection (cCMV), as there is no consensus on treatment of this group., Study Design: A nationwide, nonrandomized controlled trial, comparing 6 weeks of oral valganciclovir to no treatment in infants with cCMV, recruited after newborn hearing screening resulted in referral to an audiologist. The choice whether to treat was left to parents of subjects. Eligible subjects were full term infants aged <13 weeks with sensorineural hearing loss and diagnosed with cCMV through dried blood spot testing. The primary outcome, measured by linear and ordinal logistic regression, was change in best-ear hearing from baseline to follow-up at 18-22 months of age., Results: Thirty-seven participants were included in the final analysis, of whom 25 were in the treatment group and 12 in the control group. The majority of subjects in both groups had neuroimaging abnormalities, which were mostly mild. Hearing deterioration was more likely in the control group compared with the treatment group (common OR 0.10, 95% CI 0.02-0.45, P = .003). Mean best-ear hearing deteriorated by 13.7 dB in the control group, compared with improvement of 3.3 dB in the treatment group (difference 17 dB, 95% CI 2.6 - 31.4, P = .02)., Conclusions: We investigated treatment in children with hearing loss and clinically inapparent cCMV. Although our study was nonrandomized, it is the first prospective and controlled trial in this population. Valganciclovir-treated children with hearing loss and inapparent cCMV had less hearing deterioration at 18 through 22 months of age than control subjects., Eudract Registry Number: 2013-003068-30., Competing Interests: Declaration of Competing Interest A.C.T.M.V. reports financial support was provided by NutsOhra Fund (grant number 0901-054). A.M.O.-M. reports a relationship with National advisory board on newborn hearing screening that includes board membership. The other authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Radiotherapy causes significant nasal comorbidity in nasopharynx cancer (NPC) patients. However, the literature addressing the sino-nasal quality of life (QoL) of those patients, especially on structural and functional changes after radiotherapy, is limited. Method: It is a case-control study with 14 NPC groups and 14 healthy control group. The sino-nasal QoL, including the olfactory threshold using Butanol Threshold Test (BTT), the olfactory identification level using the University of Pennsylvania Smell Identification Test (UPSIT), nasal symptoms using the sino-nasal outcome test (SNOT-22) questionnaire, nasal cross-sectional area, nasal flow, and nasal resistance using the acoustic rhinometry and rhinomanometry, were measured and compared. Result: The mean BTT score of the control group was higher than that of the NPC group (5.17 vs 2.71). The UPSIT score of the control group was higher than that of the NPC group (31.93 vs 25.14). The mean SNOT-22 score of control group was lower than that of the NPC group of (16.71 vs 37.71). All 3 results are statistically significant ( P < .05). However, there is no statistical difference in nasal cross-sectional area, nasal flow, and nasal resistance between these 2 groups. Conclusion: In this study, we concluded that NPC patients who received radiotherapy suffered a worsening of sino-nasal functional changes, including the olfaction threshold, olfaction identification, and nasal symptoms. However, the sino-nasal structural changes on nasal cross-sectional area, nasal flow, and nasal resistance after radiation remain questionable., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Older adults are at greater risk of complications from seasonal influenza, and promoting uptake and adherence to preventive behaviors is key to attenuating this risk. The current study examined the efficacy of a theory-based telephone-delivered intervention to promote uptake and maintenance of influenza preventive behaviors in a sample of Hong Kong residents 65 years and older. The intervention adopted a three-group randomized controlled design (n = 312) with two intervention conditions, motivational and motivational + volitional, and a measurement-only control condition. The primary outcome variable was self-reported compliance with influenza preventive behaviors, including washing hands, avoiding touching eyes, nose, or mouth, and wearing face masks. Secondary outcomes were theory-based psychological variables. Influenza preventive behaviors in participants in the motivational + volitional intervention group were significantly improved 3 months post-intervention relative to those in the control condition. However, participants in the intervention group demonstrated no difference in behavior at 6 and 12 months post-intervention relative to the participants in the control group. Intervention effects were observed on the theory-based social support, action planning, and coping planning variables. Although short-term benefits of the intervention were observed, effects appeared to be short-lived and future research should investigate more intensive interventions that lead to greater behavioral maintenance., (© 2023 The International Association of Applied Psychology.)

Background: Kingdom of Saudi Arabia (KSA) demographics are also changing with the increase in life expectancy in the country and the rise in the number of older Saudi Arabians. Saudi Arabia has a higher rate of physically inactive people, and most of them are between the ages of 55-64. Walking is one of the most prevalent forms of physical activity in Saudi Arabia and the study showed that most people prefer walking for recreational and health benefits. Therefore, the purpose of the proposed study is to compare the effects of supervised group-based walking and non-supervised individual-based walking interventions on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia., Method: This study will apply a three-group (2 intervention groups and 1 control group), double-blinded, randomized controlled trial (RCT) to examine the effect of different forms of walking interventions on Saudi Arabia older adults' frailty, cognitive function and quality of life immediately after a 16-week intervention, as well as the residual effects 12 weeks after completion of the interventions., Discussion: This study aims to determine whether supervised group walking and non-supervised individual walking lead to different effects. Given the limited evidence in the literature regarding Saudi Arabia older adults' physical fitness and health, it is worthwhile to explore the effect of walking, as well as the forms of walking on improving the overall physical fitness and psychological status of older adults in Saudi Arabia. The findings of the current study could also create awareness of the government and the general public in Saudi Arabia of the ageing problems and the effective ways of achieving better intervention results., Trial Registration: The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT05151575; Date of first posted: 12/07/2021)., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: To evaluate clinical, audiological and neuroimaging findings in a cohort of infants diagnosed with congenital cytomegalovirus (cCMV) infection after failure at newborn hearing screening., Methods: A prospective observational study in the Netherlands, using the existing newborn hearing screening infrastructure for well babies. Between July 2012 and November 2016, cytomegalovirus (CMV) PCR testing of neonatally obtained dried blood spots (DBS) was offered to all infants who failed newborn hearing screening. Clinical, neuroimaging and audiological data were collected., Results: DBS of 1374 infants were successfully tested and 59 were positive for CMV (4.3%). Data of 54 infants were retrieved. Three were small for gestational age and six had microcephaly. Forty-eight (89%) had sensorineural hearing loss (SNHL), of whom half had unilateral SNHL. In both unilaterally and bilaterally affected children, the majority of the impaired ears had severe or profound hearing loss. Neuroimaging abnormalities were found in 40 of 48 (83%) children who had evaluable cranial ultrasound and/or cerebral MRI. The abnormalities were mild in 34, moderate in 3 and severe in 3 infants. The degree of SNHL and the severity of neuroimaging abnormalities were found to be correlated (p=0.002)., Conclusions: The yield of targeted cCMV screening following newborn hearing screening failure was eight times higher than the estimated national birth prevalence of cCMV. The majority of this cohort of infants with clinically unsuspected cCMV disease had confirmed SNHL, neuroimaging abnormalities and lower than average birth weights and head circumferences. Newborns who fail newborn hearing screening should be tested for CMV to ensure appropriate clinical, neurodevelopmental and audiological follow-up., Competing Interests: Competing interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following non-financial interests/personal relationships which may be considered as potential competing interests: AMO-M is a member of the national advisory board on newborn hearing screening, which is an unpaid function., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Importance: Depression is the second most prevalent mental disorder among children and adolescents, yet only a small proportion seek or receive disorder-specific treatment. Physical activity interventions hold promise as an alternative or adjunctive approach to clinical treatment for depression., Objective: To determine the association of physical activity interventions with depressive symptoms in children and adolescents., Data Sources: PubMed, CINAHL, PsycINFO, EMBASE, and SPORTDiscus were searched from inception to February 2022 for relevant studies written in English, Chinese, or Italian., Study Selection: Two independent researchers selected studies that assessed the effects of physical activity interventions on depressive symptoms in children and adolescents compared with a control condition., Data Extraction and Synthesis: A random-effects meta-analysis using Hedges g was performed. Heterogeneity, risk of bias, and publication bias were assessed independently by multiple reviewers. Meta-regressions and sensitivity analyses were conducted to substantiate the overall results. The study followed the PRISMA reporting guideline., Main Outcomes and Measures: The main outcome was depressive symptoms as measured by validated depression scales at postintervention and follow-up., Results: Twenty-one studies involving 2441 participants (1148 [47.0%] boys; 1293 [53.0%] girls; mean [SD] age, 14 [3] years) were included. Meta-analysis of the postintervention differences revealed that physical activity interventions were associated with a reduction in depressive symptoms compared with the control condition (g = -0.29; 95% CI, -0.47 to -0.10; P = .004). Analysis of the follow-up outcomes in 4 studies revealed no differences between the physical activity and control groups (g = -0.39; 95% CI, -1.01 to 0.24; P = .14). Moderate study heterogeneity was detected (Q = 53.92; df = 20; P < .001; I2 = 62.9% [95% CI, 40.7%-76.8%]). The primary moderator analysis accounting for total physical activity volume, study design, participant health status, and allocation and/or assessment concealment did not moderate the main treatment effect. Secondary analyses demonstrated that intervention (ie, <12 weeks in duration, 3 times per week, unsupervised) and participant characteristics (ie, aged ≥13 years, with a mental illness and/or depression diagnosis) may influence the overall treatment effect., Conclusions and Relevance: Physical activity interventions may be used to reduce depressive symptoms in children and adolescents. Greater reductions in depressive symptoms were derived from participants older than 13 years and with a mental illness and/or depression diagnosis. The association with physical activity parameters such as frequency, duration, and supervision of the sessions remains unclear and needs further investigation.

The aging Chinese population is growing fast, and the proportion of the population aged 60 years old is projected to reach 28% by 2040, estimated 402 million. With increased life expectancy, the aging population tends to suffer from health risks and diseases, which create a burden on public health policy. Hence, it is essential to promote healthy and active aging, which includes improving older adults' physical and mental capacities and advocating for the achievement of a healthy life expectancy. Despite the rapidly growing aging population in China, there have been no reviews investigating the effect of physical activity on physical and mental health among older Chinese adults. Therefore, the current study aimed to review studies from the past 15 years that illustrate the effect of physical activity on physical and mental health among Chinese older adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR), this review addresses the associations between physical activity, physical health and mental health among older Chinese adults. A total of 371 studies were included in the scoping review, which covered the relationships between physical activity, physical health and mental health variables. The scoping review also revealed the impact of various kinds of physical activity affecting older adults' physical health, such as functional fitness, body composition, fall risk and balance, and mental health issues, such as depression, anxiety, cognitive function and quality of life. Moreover, studies have identified innovative forms of physical activity as emerging trends in physical activity interventions for older adults. To conclude, this scoping review captured the common effects between physical activity and overall wellbeing, including physical, mental, and cognitive health. Additionally, diverse forms of physical activity intervention, such as group-based and supervised individual interventions, should be supported, and cross-cultural exercise comparisons should be made in future explorations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wong, Ou, Chung, Chui and Zhang.)

Objectives: Athlete burnout is a maladaptive outcome that is potentially detrimental for performance and wellbeing. Cross-sectional evidence suggests that mindfulness might be associated with athlete burnout via experiential avoidance and cognitive fusion. In the current study, we extend knowledge of these hypothesized mediational pathways using a longitudinal design., Methods: Data was collected at three occasions with a three-month interval. A final sample of 280 elite Chinese athletes aged 15-32 years (M age  = 19.13; SD = 2.92; Female = 130) reported their mindfulness at Time 1, experiential avoidance and cognitive fusion at Time 2, and athlete burnout at Time 3. Structural equation modelling was adopted to examine the mediating roles of experiential avoidance and cognitive fusion on the effects from mindfulness to athlete burnout., Results: We found statistically meaningful directs effects from mindfulness (Time 1) to experiential avoidance and cognitive fusion (Time 2), which in turn influenced athlete burnout (Time 3). However, the direct effect from mindfulness at Time 1 to athlete burnout at Time 3 was non-significant. The indirect effects of experiential avoidance and cognitive fusion on the effects from mindfulness to athlete burnout were significant, providing longitudinal evidence that these two variables contribute meaningfully to the mindfulness-burnout pathway., Conclusion: With initial evidence for the mediating effects of experiential avoidance and cognitive fusion, future studies could consider using experimental designs to examine the potential changing mechanisms of mindfulness on reducing athlete burnout., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Individuals affected by childhood cancer can have cognitive dysfunction that persists into adulthood and negatively affects quality of life. In this study, we aimed to evaluate the effects of physical activity and exercise on cognitive function among individuals affected by childhood cancer., Methods: In this systematic review and meta-analysis, we searched seven databases (CINAHL Plus, Cochrane Library, Embase, MEDLINE, PsycINFO, SPORTDiscus, and Web of Science) and two clinical trial registries (ClinicalTrials.gov and the International Clinical Trials Registry Platform) for randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) published (or registered) from database inception to Jan 30, 2022, with no language restrictions. We included studies that compared the effects of physical activity or exercise interventions with controls (no intervention or usual care) on cognitive function among individuals diagnosed with any type of cancer at age 0-19 years. Two reviewers (JDKB and FR) independently screened records for eligibility and searched references of the selected studies; extracted study-level data from published reports; and assessed study risk of bias of RCTs and NRSIs using the Cochrane risk of bias tool for randomised trials (RoB 2) and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tools, certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach, and any adverse events. We used intention-to-treat data and unpublished data if available. Cognitive function was assessed by standardised cognitive performance measures (primary outcome) and by validated patient-reported measures (secondary outcome). A random-effects meta-analysis model using the inverse-variance and Hartung-Knapp methods was used to calculate pooled estimates (Hedges' g) and 95% CI values. We estimated the heterogeneity variance by the restricted maximum likelihood method and calculated I 2 values to measure heterogeneity. We examined funnel plots and used Egger's regression test to assess for publication bias. This study is registered with PROSPERO, CRD42021261061., Findings: We screened 12 425 titles and abstracts, which resulted in full-text assessment of 131 potentially relevant reports. We evaluated 22 unique studies (16 RCTs and six NRSIs) with data on 1277 individuals affected by childhood cancer and low-to-moderate risk of bias. Of the 1277 individuals, 674 [52·8%] were male and 603 [47·2%] were female; median age at study start was 12 (IQR 11-14) years, median time since the end of cancer treatment was 2·5 (IQR -1·1 to 3·0) years, and median intervention period was 12 [IQR 10-24] weeks. There was moderate-quality evidence that, compared with control, physical activity and exercise improved cognitive performance measures (five RCTs; Hedges' g 0·40 [95% CI 0·07-0·73], p=0·027; I 2 =18%) and patient-reported measures of cognitive function (13 RCTs; Hedges' g 0·26 [0·09-0·43], p=0·0070; I 2 =40%). No evidence of publication bias was found. Nine mild adverse events were reported., Interpretation: There is moderate-certainty evidence that physical activity and exercise improves cognitive function among individuals affected by childhood cancer, which supports the use of physical activity for managing cancer-related cognitive impairment., Funding: Research Impact Fund of Research Grants Council of the Hong Kong University Grants Committee (R7024-20) and Seed Fund for Basic Research of the University of Hong Kong., Copyright: © 2022 Published by Elsevier Ltd. All rights reserved., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Despite the well-known health benefits of adopting a healthy lifestyle, older adults' self-determination, goals, and motivation, as well as other personality factors, are known to influence their healthy lifestyle behaviors, yet these interactions have rarely been discussed., Method: The literature that investigated and discussed the interaction of personality, goals, and healthy lifestyle behaviors among older adults was reviewed. In addition, interview responses from older adults regarding their experiences in participating in a real-life physical activity intervention and its relationship with their personality traits and goal setting were synthesized using content analysis., Results: The current review highlights the relationship between healthy living practices, goal setting, and personalities, and it is backed up and expanded upon by interviews with participants. People with different personality types are likely to have diverse views on HLBs. Individuals who are more conscientiousness or extraverted are more likely to adopt HLBs than those who are not., Discussion: It is suggested that a meta-analysis should be conducted on the relationship between personality, goal setting, and physical exercise or other specific HLBs. In addition, future research should focus on various types of HLB therapies that take into account personality and goal setting.

(1) Background: Square dancing is an emerging form of aerobic exercise in China, especially among middle-aged and older people. The benefits of square dancing have been investigated and promoted in recent years through research and interventions. Interventions have been conducted to promote the participants' reactionary participation in physical activity, social and family cohesion, and other psychological benefits. Therefore, square dancing has been promoted as a major factor in China's increase in physical activity prevalence. (2) Methods: A systematic review was used to identify studies that have indicated the effect of square dancing on the physical and mental health among Chinese older adults. (3) Results: Twenty-four studies examining the effects of square dancing on older Chinese adults were extracted. These studies were not found in English databases. The quality of the retrieved studies had a moderate-to-high risk of bias. Square dancing interventions were shown to result in effective mental, physical, and cognitive improvements in the systematic synthesis. (4) Conclusions: This study examined the effects of square dancing in China over the past 10 years on the physical and mental health of older adults. Based on the results of this study, recommendations can be made for future square dance interventions for older adults such as male-oriented, mixed-gender, or intergenerational programs.

Background: Meticillin-resistant Staphylococcus aureus (MRSA) infections are rampant in hospitals and residential care homes for the elderly (RCHEs)., Aim: To analyse the prevalence of MRSA colonization among residents and staff, and degree of environmental contamination and air dispersal of MRSA in RCHEs., Methods: Epidemiological and genetic analysis by whole-genome sequencing (WGS) in 12 RCHEs in Hong Kong., Findings: During the COVID-19 pandemic (from September to October 2021), 48.7% (380/781) of RCHE residents were found to harbour MRSA at any body site, and 8.5% (8/213) of staff were nasal MRSA carriers. Among 239 environmental samples, MRSA was found in 39.0% (16/41) of randomly selected resident rooms and 31.3% (62/198) of common areas. The common areas accessible by residents had significantly higher MRSA contamination rates than those that were not accessible by residents (37.2%, 46/121 vs. 22.1%, 17/177, P=0.028). Of 124 air samples, nine (7.3%) were MRSA-positive from four RCHEs. Air dispersal of MRSA was significantly associated with operating indoor fans in RCHEs (100%, 4/4 vs. 0%, 0/8, P=0.002). WGS of MRSA isolates collected from residents, staff and environmental and air samples showed that ST 1047 (CC1) lineage 1 constituted 43.1% (66/153) of all MRSA isolates. A distinctive predominant genetic lineage of MRSA in each RCHE was observed, suggestive of intra-RCHE transmission rather than clonal acquisition from the catchment hospital., Conclusion: MRSA control in RCHEs is no less important than in hospitals. Air dispersal of MRSA may be an important mechanism of dissemination in RCHEs with operating indoor fans., (Copyright © 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)

Background: Adolescence is at a transition stage of developmental psychology, and they must go through their psychosocial and identity crisis, which affect their self-concept. According to the structure of self-concept, physical is considered as one of the elements affecting a person's evolvement of self, which can be called as physical self-esteem. In regards to the equilibrium mental benefits of self-compassion, the concept of body compassion was focused. Together with the lack of body-part related research being further investigated among non-western countries, this research aimed at translating the Body Compassion Scale (BCS) to Chinese and examining the reliability and validity of the Chinese translated BCS among Hong Kong adolescents., Methods: The reliability of the translated BCS was examined by the test-retest reliability test as well as the Cronbach's alpha value for the internal consistency. The confirmatory factor analysis (CFA) was adopted to investigate the construct validity, and Pearson's correlation was used to examine the convergent validity with other related scales., Results: The Chinese translated BCS (Pilot Study: n  = 220; Main Study: n  = 1047) showed adequate psychometric properties results. It had a satisfying internal consistency and test-retest reliability. It showed an adequate goodness of fit results in CFA, with X 2 (465.64)/227 = 2.05, p  < 0.001, CFI = 0.916, TLI = 0.906,SRMR = 0.071,RMSEA = 0.069 [90% CI = 0.06 to 0.078]. Additionally, the measurement invariance model suggested that the factor loadings and mean differences of the translated BCS were invariant across early and older adolescents., Conclusion: The Chinese translated BCS is considered as valid and reliable in examining Hong Kong adolescents' body compassion., (© 2021 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd.)

Background: Esports is seen as an emerging industry that has enjoyed a surge in popularity worldwide. As a result, researchers have undertaken studies to try to understand the motivations and factors that impact Esports gameplay. Given the extensive utilization of TPB in many research projects to conceptualize and predict various behaviors, the current study aimed to further extend this theory to the Esports context by developing and validating an instrument that can illustrate the factors that impact the intention to participate in Esports, thus predicting Esports game playing behaviors., Methods: A total of 25 participants were involved in the development of the questionnaire using the qualitative approach, while 915 university students and 1164 secondary school students were involved in the survey for the questionnaire validation using the exploratory factor analysis and the confirmatory factor analysis., Results: All measurement models of the TPB subscales are considered as good fit., Conclusion: Hence, showing the newly designed TPB Esports Intention Questionnaire was found to be reliable and valid in revealing the level of intentions as well as the factors affecting Hong Kong students playing Esports.

This study aimed to (1) establish age- and sex-specific functional fitness (FF) norms in Chinese older adults living in urban communities and (2) explore ageing-related degradations and sex differences in each FF dimension. A pool of 2398 individuals (1128 men; 1270 women) aged 60-98 years were recruited from urban communities of Nanjing, China. FF was measured using the Senior Fitness Test battery. FF norms were established for men and women in 5-year age intervals using five percentiles (10th, 25th, 50th, 75th, 90th). Significant degradations in FF were correlated with increases in age. Around half of test items in 75-79 years group (3 for men; 4 for women) and over half in 80-84 years group (5 for men; 4 for women) exhibited significant decreases in FF compared with the adjacent younger group, indicating that ages of 75 and 80 years are two potential turning points in FF declines. Significant differences existed between the overall FF of men and women; women outperformed men in flexibility and men outperformed women in upper body strength, agility/dynamic balance, and aerobic endurance. Significant age and sex effects occurred in each fitness dimension, which helps individualised program design and promotes an active lifestyle in older adults., (© 2021. The Author(s).)

Background: People with physical disabilities (PWPD) have limited opportunities to participate in sport activities. Sitting light volleyball (SLVB) is an adapted sport that combines light volleyball and paralympic sitting volleyball. This study examined the effectiveness of an SLVB intervention program to improve the physical and psychological health outcomes of PWPD in Hong Kong, China., Methods: Thirty-two PWPD [13 women; SLVB group, n = 18; control group (CG), n = 14] with an average age of 48.89 years (SD = 14.42 years) participated in a 16-week intervention consisting of basic SLVB skills, and they also received instructions on the required posture, team tactics, and SLVB rules. Physical (i.e., muscular strength, muscular endurance, body composition, flexibility, and aerobic endurance) and psychological (i.e., physical activity enjoyment and quality of life) health outcomes were measured before and after the intervention., Results: Individuals in the SLVB group exhibited statistically significant improvements in cardiovascular endurance [F(1,29) = 4.23, p = .049], body composition [F(1,23) = 6.67, p = .017], and physical activity enjoyment [F(1,29) = 16.94, p = .001] compared with adults in the CG., Conclusions: Participating in SLVB has physical and psychological benefits for adults with physical disabilities in this study. Registration number of trial registry: The trial is registered at chictr.org.cn, number ChiCTR2000032971 on 17/05/2020., (© 2021. The Author(s).)

Objectives: In this study, we aimed to investigate older adults' perceptions of their walking experiences, using the social-ecological model as a guiding framework and to propose future walking intervention content., Methods: Thirty-eight participants (19 women; 47% from private elderly centers; mean age = 72.8 (SD = 7.4 years) took part in semi-structured interviews. Qualitative data analysis software QSR-NVivo was used for thematic coding., Results: Thematic deductive analysis revealed pertinent themes at the individual level (health benefits and barriers, fall risk, perseverance, and walking as a suitable activity for older adults), social environment level (social support and social interaction), physical environment level (density, land-use mix, and connectivity; perceived safety, pedestrian facilities (benches, quality of walking paths and sidewalks, and aesthetics), other pedestrian behaviors, and weather, and policy level (lack of walking programs in the community, and supportive culture for an active lifestyle)., Discussion: Our findings provide insights for the planning of future multilevel walking intervention programs for older adults in Hong Kong. It is suggested that future walking intervention should include professionals (e.g., physiotherapist or coach) in a group setting, practical walking recommendations such as proper walking posture, and additional fun activities for older adults.

Esports is a rapidly growing industry worldwide, and it is making significant inroads in Hong Kong as well. However, owing to debates regarding the distinction between Esports and video gaming and the potential negative effects of engaging in Esports, its development in Hong Kong is still in its infancy. Therefore, this qualitative study investigated the perceptions and attitudes of teenagers and young adults toward Esports development and engagement, using the theory of planned behavior. Twenty-five teenagers and young adults (male = 24, female =1) participated in this study, with their ages ranging from 15 to 29 years. Our results revealed the views of Hong Kong teenagers and young adults on the beneficial and deleterious outcomes (goal setting and achievement, physical health, socialization and teamwork, psychological benefits, academics and time distribution, physical strain, negative social image, and perception toward sport participation), subjective norms (parents, peers, teachers, and modeling effect), and barriers and facilitators (balance between academics and Esports, capability, career prospects and future reality, psychological benefits, and peer encouragement and support) of participating in Esports. Additionally, the results of this qualitative study may contribute toward a deeper understanding of Hong Kong Esports players to develop a theory of planned behavior construct for capturing the beliefs and perceptions of Hong Kong teenagers toward Esports., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wong, Chung, Ou and Leung.)

Background: There is on one hand sufficient evidence showing strong association between resilience and self-rated successful aging. On the other hand, strength training could contribute the cultivation of resilience among older adults. Therefore, the current study aims to examine the effectiveness of resistance training on resilience among Chinese older adults in Hong Kong., Methods: This study will apply a three-group, double blinded (outcome assessors and data analysts), randomized controlled trial (RCT) to examine the effectiveness of the interventions on resilience, functional fitness, and health related quality of life immediately after a 16-week intervention, as well as the residual effects 12 weeks after completion of the interventions., Discussion: It is expected that resistance training is promising or even superior to aerobic training in the improvement of resilience. Given the limited evidence on the literature, it is urgently needed to explore the effects of resistance training on the improvement of resilience in older adults. Findings of the current study can contribute to the development of effective resistant training programs for the promotion of resilience among older adults., Trial Registration: The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT04690465 ; Date of First Posted: 30/12/2020).

The association between physical activity in achieving mental health benefits and subjective well-being is consistently identified by empirical research. The causation of a positive self-concept created by physical exercise is empirically supported by Sonstroem and Morgan's (1988) exercise and self-esteem model (EXSEM). However, various drawbacks of maintaining high self-esteem have been identified; thus, the concept of self-compassion was conjectured to be a form of "true self-esteem." Hence, the current study aimed to investigate the relationship between physical activity and self-compassion by examining the exercise and self-esteem model revised with self-compassion (EXSEM-SC). This study recruited secondary school students from Hong Kong using convenience sampling. The structural equation modeling (SEM) approach, including path analysis and multiple indicators, multiple causes (MIMIC) modeling, were used to reveal the results of the study. The results ( n = 1097) indicated that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs. The SEM also demonstrated the direct paths from physical activity to self-compassion and mental well-being, indicating the significant effect of physical activity on self-compassion.

Background: Cartilage repair procedures using mesenchymal stem cells (MSCs) can provide superior cartilage regeneration in the medial compartment of the knee joint when high tibial osteotomy (HTO) is performed for varus knee osteoarthritis (OA). However, few studies have reported the factors influencing the outcomes of MSC implantation with concomitant HTO., Purpose: To investigate the outcomes of MSC implantation with concomitant HTO and to identify the prognostic factors that are associated with the outcomes., Study Design: Case series; Level of evidence, 4., Methods: A total of 71 patients (75 knees) were retrospectively evaluated after MSC implantation with concomitant HTO. Clinical and radiological outcomes were evaluated, and magnetic resonance imaging (MRI) was used to assess cartilage regeneration. Statistical analyses were performed to determine the effect of different factors on clinical, radiographic, and MRI outcomes., Results: Clinical and radiographic outcomes improved significantly from preoperatively to final follow-up ( P < .001 for all), and overall cartilage regeneration was encouraging. Significant correlations were found between clinical and MRI outcomes. However, radiographic outcomes were not significantly correlated with clinical or MRI outcomes. Patient age and number of MSCs showed significant correlations with clinical and MRI outcomes. On multivariate analyses, patient age and number of MSCs showed high prognostic significance with poor clinical outcomes., Conclusion: MSC implantation with concomitant HTO provided feasible cartilage regeneration and satisfactory clinical outcomes for patients with varus knee OA. Patient age and number of MSCs were important factors that influenced the clinical and MRI outcomes of MSC implantation with concomitant HTO for varus knee OA., Competing Interests: The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2021.)

Background/objective: The Community Health Activities Model Program for Seniors questionnaires (CHAMPS-Q) is one of the most extensively used instruments in assessing physical activity among older adults. However, no study had translated the CHAMPS-Q into Chinese, and no evaluations were made on the psychometric properties of the CHAMPS-Q among the Chinese population. Considering cultural differences in perceptions of language, cultural context and living habits, this study was of necessary to 1) translate and cross-culturally adapt the original CHAMPS-Q, and 2) examine the test-retest reliability and construct/predictive validity of the Chinese version of the CHAMPS-Q., Methods: The English CHAMPS-Q was first translated into Chinese, synthesized, back-translated, and revised by an expert committee according to the pre-test results. The Chinese CHAMPS-Q was then assessed in a cross-sectional study consisting of 101 apparently healthy older adults. Test-retest reliability test was conducted with 7 days apart. The construct validity of the Chinese CHAMPS-Q was tested against accelerometer data, and the predictive validity was assessed against physical fitness as measured by the Senior Fitness Test., Results: The Chinese CHAMPS-Q has moderate to excellent test-retest reliability ( ICC  = 0.72-.96, p  < .05). Energy expenditure and duration in PA significantly correlated with all accelerometry outcomes ( ρ  = 0.22-.31, p  < .05). All the outcomes from the CHAMPS-Q showed significant correlations with upper body muscle strength ( ρ  = 0.22-.34, p  < .05)., Conclusion: The Chinese CHAMPS-Q has excellent test-retest reliability and acceptable construct and predictive validity in assessing the physical activity of Chinese older adults., Competing Interests: None., (© 2020 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd.)

Background: A cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in knees with osteoarthritis (OA)., Purpose: To evaluate the midterm outcomes, analyze the survival rates, and identify the factors affecting the survival rate of MSC implantation to treat knee OA., Study Design: Case series; Level of evidence, 4., Methods: We retrospectively evaluated 467 patients (483 knees) who underwent MSC implantation on a fibrin glue scaffold for knee OA with a minimum 5-year follow-up. Clinical outcomes were determined based on the International Knee Documentation Committee (IKDC) and Tegner activity scale results measured preoperatively and during follow-up. Standard radiographs were evaluated using Kellgren-Lawrence grading. Statistical analyses were performed to determine the survival rate and the effect of different factors on the clinical outcomes., Results: The mean IKDC scores (baseline, 39.2 ± 7.2; 1 year, 66.6 ± 9.6; 3 years, 67.2 ± 9.9; 5 years, 66.1 ± 9.7; 9 years, 62.8 ± 8.5) and Tegner scores (baseline, 2.3 ± 1.0; 1 year, 3.4 ± 0.9; 3 years, 3.5 ± 0.9; 5 years, 3.4 ± 0.9; 9 years, 3.2 ± 0.9) were significantly improved until 3 years postoperatively and gradually decreased from 3- to 9-year follow-up ( P < .05 for all, except for Tegner score at 5 years vs 1 year [ P = .237]). Gradual deterioration of radiological outcomes according to the Kellgren-Lawrence grade was found during follow-up. Survival rates based on either a decrease in IKDC or an advancement of radiographic OA with Kellgren-Lawrence scores were 99.8%, 94.5%, and 74.5% at 5, 7, and 9 years, respectively. Based on multivariate analyses, older age and the presence of bipolar kissing lesion were associated with significantly worse outcomes ( P = .002 and .013, respectively), and a larger number of MSCs was associated with significantly better outcomes ( P < .001) after MSC implantation., Conclusion: MSC implantation provided encouraging outcomes with acceptable duration of symptom relief at midterm follow-up in patients with early knee OA. Patient age, presence of bipolar kissing lesion, and number of MSCs were independent factors associated with failure of MSC implantation., Competing Interests: The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2020.)

Similar to their Western counterparts, children in Hong Kong generally fail to reach the recommended levels of physical activity (PA). As an ultra-dense metropolis, Hong Kong is different from most Western cities. It is therefore important to update and appraise previous PA research in order to inform future PA promotion for Hong Kong children. Using a scoping review, the current study aimed to evaluate PA research among preschool and school-aged children in Hong Kong aged 3-12 years old who are at a critical development stage. Literature was searched from four English databases: Medline via EBSCOhost, SPORTDiscus, ERIC and PsycINFO via ProQuest; and three Chinese databases: CNKI, CQVIP and WAN-FANG. PA research among Hong Kong children published from 1 January 1997 to the searching date, 31 March 2020 was included. A total of 63 studies were identified, with the majority of studies focused on school-aged children as compared to preschoolers, adopted a cross-sectional design, using self-reported PA measures, and with small to medium sample sizes. We classified eligible studies into five main categories: (a) Health benefits of PA ( k = 12). Consistent evidence on the health benefits of skeletal and cardiovascular capacity, quality of life, cognitive function, and sleep quality was revealed. However, inconsistent evidence was found on the benefits of weight-related indicators and academic performance. (b) Patterns of PA ( k = 12). There is a general pattern of low levels of PA among Hong Kong children, in particular girls and children with special educational needs. (c) Measures of PA and related constructs ( k = 11). The Chinese versions of self-reported measures of PA, PA-related social environment, and PA-related psychological constructs showed acceptable reliabilities and validities. (d) Correlates of PA ( k = 18). The correlates of PA include physical environment, social environment, physical factors, psychological factors, and multiple correlates, which is in line with the social-ecological model. (e) Interventions for promoting PA ( k = 10). PA interventions among Hong Kong children were conducted for healthy children, children with special educational needs, and children with cancer. Overall, there is a growing volume of PA research among children in Hong Kong in the recent decade. Yet, there is a lack of high-quality research for measuring, understanding, and promoting PA among Hong Kong children. It is highly recommended that future PA research among children should pay more attention on the preschoolers, adopting robust research design (e.g., randomized controlled trials), recruiting large and representative sample, and collecting device-assessed data.

Purpose: Intra-articular injection of hyaluronic acid (HA) has shown promises in reducing pain and improving physical function in knee osteoarthritis (OA). Recently, cell-based therapies using mesenchymal stem cells (MSCs) have emerged as potential treatments. However, few studies have compared the treatment outcomes between MSCs and HA. This study aimed to compare the clinical and radiological outcomes of intra-articular injections of MSCs versus HA in patients with knee OA., Methods: A cohort of 209 patients with knee OA were retrospectively screened for those who underwent intra-articular injections using MSCs or HA. Thirty MSC-treated patients (MSC group) were pair-matched with thirty HA-treated patients (HA group) based on gender and age. Clinical outcomes were evaluated using the visual analog scale (VAS), International Knee Documentation Committee (IKDC) rating system, and Lysholm scoring system. Radiological evaluation was assessed using the Kellgren-Lawrence (K-L) grading system., Results: MSC treatment yielded consistent significant improvements in VAS, IKDC and Lysholm scores. In the HA group, VAS scores significantly decreased at 1 month, slightly increased at 3 months, and increased significantly from 3 months to 1 year after injection. The IKDC and Lysholm scores improved significantly until 3 months, but gradually worsened thereafter. Significantly greater improvements in VAS (P = 0.041), IKDC (P = 0.014), and Lysholm (P = 0.020) scores were observed in the MSC group compared to those in the HA group at 1-year post-treatment. The K-L grade worsened in a few patients, especially those in the HA group, albeit no significant difference., Conclusions: MSC group showed better VAS, IKDC, and Lysholm scores at 1-year post-treatment, compared to the HA group, although earlier clinical improvements were superior in the HA group for the initial 3 months., Level of Evidence: Therapeutic study, Level III.

Purpose: Resilience is an important trait for older adults facing adversity. This qualitative study aimed to identify the characteristics that contribute to resilience in a group of community-dwelling older adults in Hong Kong. Methods: Twenty-five Chinese older adults were invited. Interviews were conducted to collect information about the adverse events in their lives, their attitudes towards adversity and the beliefs underlying their approaches to overcoming adversity. The transcripts were analyzed using qualitative content analysis. Results: Seven themes emerged from the interviews: equanimity, positive attitudes towards life; meaningfulness, self-reliance, social support, environmental support, and spirituality and faith. Conclusion: Our qualitative analysis found that resilience among older adults in Hong Kong is characterized by internal, external and existential factors. The results may be useful for the development of proactive interventions aimed at assisting older adults to enhance the positive experiences in their lives., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Mental health literacy (MHL) is recognised as a major factor in whether athletes seek help when they experience mental health difficulties. Therefore, the current study aimed to provide a systematic review of the effectiveness of MHL training programmes in improving mental health knowledge and help-seeking and reducing stigma among athletes. To identify intervention studies of MHL programmes, five electronic databases were systematically searched for articles published before May 2020. The selection procedure was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All kinds of study designs were included. Effect sizes were calculated for mental health knowledge, stigma reduction and help-seeking attitudes, intentions and behaviours. Risk of bias was assessed for each study using the Cochrane tool and the Newcastle-Ottawa quality assessment scale. Five studies (1239 participants in total) were selected for review. Overall, either small or medium effects were found for mental health knowledge, stigma reduction, help-seeking attitudes, and intentions for post- and follow-up interventions, whereas a null effect was found in help-seeking behaviours for both post- and follow-up interventions. Furthermore, three studies had a low risk of bias, and two had a high risk of bias. MHL interventions can enhance help-seeking attitudes and intentions and mental health knowledge and reduce stigma but do not increase help-seeking behaviours for now. Further studies should evaluate interventions to enhance help-seeking behaviours. Furthermore, the methodological quality of studies, including randomized controlled trials and other designs, should be improved in future research., Competing Interests: The authors declare no conflict of interest

Background: This study translated the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF) into Chinese and examined its factor structure and measurement invariance in Chinese adolescents in Hong Kong., Methods: A sample of 4136 Chinese adolescents in Hong Kong was invited to complete a set of questionnaires. The factor structure of the I-PANA-SF was examined using confirmatory factor analysis (CFA) and exploratory structural equational modeling (ESEM). Internal consistency reliability was evaluated using Cronbach's alpha coefficients, and nomological validity was assessed using bivariate correlations between positive affect (PA) and negative affect (NA) subscales with effort, worry and lack of concentration. Finally, measurement invariance across genders and grades was examined to evaluate the invariance of the I-PANAS-SF., Results: Factor structure analysis suggested that the ESEM model outperformed the CFA model. The results of ESEM analysis indicated that one item ("alert") was problematic and a 9-item two-factor measurement model with that item removed was a better fit for the data. The Cronbach's alpha values were above 0.70 (0.81 and 0.83), revealing excellent internal consistency reliability. The PA subscale was positively associated with effort and negatively associated with worry and lack of concentration. The NA subscale was negatively associated effort and positively associated with lack of concentration and worry, indicating nomological validity. Finally, measurement invariance analysis revealed strict invariance across genders and grades., Conclusions: The results of the study provide preliminary support for validity and reliability of the 9-item Chinese version of the I-PANAS-SF and suggest that it is suitable for use among Chinese adolescents in Hong Kong.

Background: This study was a part of 16-week sitting light volleyball (SLVB) intervention program which examined the effects of the intervention on the physical and psychological attributes of adults with physical impairments (PWPI) in Hong Kong. Gaining a deeper understanding of the perceptions and experiences of PWPI in the SLVB intervention is critical to the development of SLVB as a physical activity and a sport. The aims of this study were (a) to assess participants' experiences of the intervention and (b) to examine the suitability and feasibility of SLVB intervention for PWPI., Methods: Twenty participants (mean age = 53.52 years, standard deviation 9.02 years; 60% female; 25% with at least a college degree) participated in semi-structured interviews., Results: Content analysis revealed features of their experiences at the individual or intrapersonal level (physical and psychological health, enjoyment, novelty, competence, autonomy), interpersonal level (socialization and teamwork, social support), organizational and community levels (perceived sport venue environment, venue accessibility, safety, dissemination of information), and policy level (resources allocation by the government). The participants also commented on the suitability and feasibility of the SLVB intervention for PWPI, its content and coaching, the modified rules, the duration of sessions, scheduling, and the number of participants and coaches., Conclusions: This study identified several themes relevant to the promotion of PWPI engagement with SLVB and demonstrated that adopting a multilevel approach to the intervention resulted in positive outcomes for participants. Playing SLVB is suitable and feasible for PWPI. The findings contribute to the understanding of the experiences PWPI had of the SLVB intervention, which is critical to the further development of SLVB as a physical activity and a sport., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

Background: The frustration of basic psychological needs can be detrimental to people's health. To date, a scale developed specifically for measuring such perceived negative experiences, derived from a need thwarting environment in the physical activity context, is lacking. The present research attempted to develop and validate the Psychological Need Frustration Scale for Physical Activity (PNFS-PA) grounded in self-determination theory via multiple studies., Method: In Study 1, an item pool was created, and its face and content validity were established. In Study 2, the factor structure of the scale was demonstrated using exploratory structural equation modelling (ESEM). In Study 3, its factor structure was cross-validated. Also, the nomological validity, reliability and measurement invariance of the scale were established., Result: Taken together, the research suggests the newly developed PNFS-PA is valid and reliable and can be applied to assess psychological needs frustration experiences in the physical activity context., Competing Interests: The authors declare there are no competing interests., (©2020 Chung et al.)

Background: Feedback is considered as an effective means of motivating, guiding, and reinforcing desired behaviours. However, the ways to interpret external feedback may be different among individuals with different personality traits; therefore, this would influence the effects of feedback on performance. Accordingly, the influencing effects of personality towards different styles of feedback on cognitive task performance were examined., Methods: Participants (N = 71) were given three Stroop tasks as a dependent variable, whereas the Trail Making Task was an independent variable; additionally, a personality test was used to record the personality traits of each participant. The relationship between personality and feedback-induced changes in Stroop performance was computed by means of Pearson correlation, followed by a mixed-effect model to demonstrate the effect of personality on the overall performance with feedback., Results: The statistical analysis indicated that performance from those with higher levels of extraversion generally profitted from feedback, irrespective of whether it was negative feedback (r = 0.201) or positive feedback (r = 0.205). Additionally, the moderating effect of personality on feedback and performance was demonstrated., Conclusions: The limitations of the sample size and other external influences may have reduced the representativeness of the research. Nonetheless, more potential influencing factors need to be included and explored in future research.

Rotavirus has been associated with neonatal seizures and specific white matter magnetic resonance imaging (MRI) abnormalities. We describe monochorionic twins who not only tested positive for rotavirus with these white matter MRI abnormalities but who also showed an electroencephalogram (EEG) pattern characteristic of early infantile epileptic encephalopathy (EIEE), which has so far solely been described in epileptic encephalopathies with a poor prognosis. This report suggests that rotavirus infection must be added to the list of causes of EIEE EEG, and that the outcome then is likely more favorable. As MRI and EEG signs of rotavirus encephalopathy were present in one twin with only subtle neurologic symptoms, rotavirus may well cause insidious central nervous system complications more often. We suggest considering rotavirus infection in neonates presenting with seizures, and to add rotavirus infection to the differential diagnosis of EIEE., Competing Interests: None declared., (Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: This study aimed to compare the clinical, radiological, and second-look arthroscopic outcomes of implanting mesenchymal stem cells (MSCs) alone and together with allogenic cartilage in patients treated with concomitant high tibial oteotomy (HTO) for varus knee osteoarthritis., Methods: Eighty patients treated with cartilage repair procedures and concomitant HTO were prospectively randomized into two groups: MSC implantation (MSC group), and MSC implantation with allogenic cartilage (MSC-AC group). Clinical outcomes were evaluated using the Lysholm Score and the Knee Injury and Osteoarthritis Outcome Score (KOOS) at preoperative and every follow-up visit. Radiological outcomes were evaluated by measuring the femorotibial angle and posterior tibial slope. During second-look arthroscopy, cartilage regeneration was evaluated according to the Kanamiya grade., Results: Clinical outcomes at the second-look arthroscopy (mean 12.5 months [MSC group] and 12.4 months [MSC-AC group]) improved significantly in both groups (P < 0.001 for all). Clinical outcomes from the second-look arthroscopy to the final follow-up (mean 27.3 months [MSC group] and 27.8 months [MSC-AC group]) improved further only in the MSC-AC group (P < 0.05 for all). Overall, the Kanamiya grades, which were significantly correlated with clinical outcomes, were significantly higher in the MSC-AC group than in the MSC group. Radiological outcomes at final follow-up revealed improved knee joint alignments relative to preoperative conditions but without significant correlation between clinical outcomes and Kanamiya grade in either group (n.s. for all)., Conclusion: Implantation of MSCs with allogenic cartilage is superior to implantation of MSCs alone in cartilage regeneration accompanied with better clinical outcomes., Level of Evidence: Therapeutic study, level II.

Background: Our pilot study has demonstrated improvements in health outcomes through participation in a new sport, light volleyball (LVB), among older adults. In response to the promising results of the LVB pilot study and the priority of allocating resources to the prevention of age-related fitness degradation by the Hong Kong (HKG) government, the present study aims to investigate the effectiveness of a LVB intervention on physical and psychological health attributes among older adults at a larger scale in HKG., Methods/design: This study will apply both quantitative and qualitative methods with a large sample (approximately 315 participants). We will adopt a randomized controlled trial (RCT) design to further evaluate the effectiveness of a LVB intervention on health outcomes against a comparison group, Tai Chi (TC), and a control group (C). Older adults will be eligible to join the intervention if they are (a) aged 65 years and above; (b) living in the community independently; (c) absent of diagnosed cognitive impairment; (d) not regular participants in a structured PA program for two years preceding the study; and (e) able to achieve a passing score on the Timed-up-and-go test (TUG) and Abbreviated Mental Test (AMT).About 315 participants will be randomly assigned into 3 groups in 1:1:1 ratio. LVB group participants will receive 16-week LVB program; TC group will utilize a simplified 24-form Yang Style TC, and C group participants will be instructed to maintain their normal daily activity and join regular non-exercise social gatherings. Measurements will be collected before and after the intervention, and 6 months and 12 months after completion of the intervention., Discussion: This intervention, if effective, will enhance older adult's physical and psychological health, and provide the data and evidence to support policymaking in relation to future PA promotion for older adults., Trial Registration Number: ChiCTR1900026657., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2020.)

This study examined the associations between physical environment, social environment, and walking for transportation and recreation among older adults in Hong Kong. Cross-sectional data from 450 older adults (79 years or younger [71.9%], female [79.7%]) from 18 districts in Hong Kong were used. The participants' perceptions of their physical and social environments were collected and their walking behaviors were self-reported. The results revealed that positive physical environment-facilitators and social environments were associated with increased total walking. Only positive physical environment-facilitators were associated with increased walking for transportation, and physical and social environments had no notable effect on walking for recreation. These findings suggest that policymakers and walking intervention designers should develop strategies to enhance physical and social environments to promote total walking and walking for transportation.

The purpose of this study was to verify if customized prosthesis better preserves the native knee joint kinematics and provides lower contact stress on the polyethylene (PE) insert owing to the wider bone preservation than that of standard off-the-shelf prosthesis in posterior cruciate-retaining type total knee arthroplasty (TKA). Validated finite element (FE) models for were developed to evaluate the knee joint kinematics and contact stress on the PE insert after TKA with customized and standard off-the-shelf (OTS) prostheses as well as in normal healthy knee through FE analysis under dynamic loading conditions. The contact stresses on the customized prosthesis decreased by 18% and 8% under gait cycle loading conditions, and 24% and 9% under deep-knee-bend loading conditions, in the medial and lateral sides of the PE insert, respectively, compared with the standard OTS prosthesis. The anterior-posterior translation and internal-external (IE) rotation in customized TKA were more similar to native knee joint behaviors compared with standard OTS TKA under gait loading conditions. The difference from normal knee kinematics was lower for femoral rollback and IE rotation in customized TKA than in standard OTS TKA in the deep-knee-bend condition. In general, customized prostheses achieve kinematics that are close to those of the native healthy knee joint and have better contact stresses than standard OTS prostheses in gait and deep-knee-bend loading conditions., (© 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Objectives: This study examined the factor structure of the Senior Fitness Test and examined its measurement and structural invariance across participants with normal body weight and participants who were overweight., Methods: Eight hundred and forty-five community-dwelling older adults in Hong Kong participated in this study. Their functional fitness was assessed using the Senior Fitness Test. Confirmatory factor analysis was conducted to examine and compare two competing models: a one-factor model and a second-order model. Multiple-group confirmatory factor analysis was conducted to evaluate the measurement and structural invariance of the SFT measurement model. Multiple fit indices were used to evaluate the adequacy of the model fit to the data., Results: The second-order model outperformed the one-factor model. For men participants, the second-order 4-factor model was indicated, while for women participants, the second-order 5-factor model was evidenced. The measurement and structural invariance of the SFT measurement model across normal weight and overweight participants were also supported., Conclusion: This study provided initial evidence for the construct validity of the SFT. However, there were some differences in the factor structure of the SFT for men and women participants. Body composition did not necessarily reflect the functional fitness of men participants. All of the older adults responded to the testing items in a similar way regardless of body weight status in both men and women samples. The significance of each component for functional fitness was also similar for participants with different body weight statuses., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Although vaccination is the first-line strategy controlling and preventing influenza A/H1N1 for older adults, personal protective measures, such as wearing facemasks, are also important preventive behaviors to reduce the risk of becoming infected with influenza A/H1N1 during a pandemic. In the current study, we aimed to explore the belief-related psychological factors of wearing facemasks for influenza A/H1N1 prevention in a sample of Hong Kong older adults. Community-dwelling Chinese adults (N = 137) aged between 65 and 80 years (M age = 75.10; SD age = 6.49) participated in semistructured interviews. Data were analyzed using theoretical thematic analysis and identified themes were matched deductively within the belief-based processes of the health belief model. Results revealed beliefs that underpinned 4 general dimensions of facemask wearing: (1) perceived susceptibility and seriousness of influenza A/H1N1 pandemic (e.g., influenza A/H1N1 as contagious and lethal), (2) modifying factors (e.g., social responsibility to prevent influenza), (3) cues to action (e.g., seeing others doing it), and (4) perceived benefits and barriers (e.g., protects oneself and others, difficult to breathe). Future interventions can target these beliefs to improve facemask wearing of older adults and, thus, curb preventable infection rates during an influenza A/H1N1 pandemic.

Purpose: This study translates the Subjective Vitality Scale (SVS) into Chinese and examines its factor structure and measurement invariance in a sample of Chinese adolescents in Hong Kong., Methods: Chinese adolescents in Hong Kong were invited to participate in the study. Four models of the SVS (a 7-item model, two 6-item models and a 5-item model) were compared using confirmatory factor analysis (CFA). The internal consistency reliability was evaluated using Cronbach's alpha coefficients, and the criterion validity was assessed using bivariate correlations between subjective vitality and positive and negative affect. Finally, measurement invariance across genders and time points was examined to evaluate the invariance of the SVS model., Results: The results of the CFA analysis indicated that the 5-item measurement model fit the data better than the other three models. The Cronbach's alpha was above 0.70 (0.92), revealing excellent internal consistency reliability, and the SVS was significantly associated with positive affect and negatively associated with negative affect, indicating criterion validity. Finally, the measurement invariance analysis of the 5-item model displayed strict invariance across genders and time points., Conclusions: The results support the 5-item measurement model of the Chinese version of the SVS. This model has excellent internal consistency reliability, supports the criterion validity of the instrument and demonstrates strict invariance across genders and time points. In summary, the findings suggest that the 5-item Chinese version of the SVS is a reliable and valid instrument for assessing the subjective vitality of Chinese adolescents in Hong Kong.

Background: People 65 years or older are at greater risk of serious complications from the seasonal influenza compared with young. To promote elderly people's behavioral compliance toward influenza prevention, the aim of the current project is to develop, implement, and evaluate a theory-based low-administration-cost intervention building on a leading psychological theory, the Health Action Process Approach (HAPA)., Methods: The target group is Hong Kong Chinese elderly people aged 65 or older who rarely or never adopt any preventive actions. This project will be conducted in three phases over 24 months. In phase 1, intervention program will be developed building on the HAPA theoretical framework which comprises both the initiation and maintenance of influenza prevention behaviors. In phase 2, intervention will be implemented and evaluated using a randomized controlled trial, including: (a) behavior initiation only, (b) behavior initiation + behavior maintenance, and (c) control group. Both the initiation and maintenance components will comprise weekly-delivered telephone-based individual intervention sessions in 3 months. In phase 3, outcome evaluation of behavioral and psychological variables and process evaluation will be conducted. The effectiveness of the intervention will be analyzed using a series of linear mixed models on each behavioral and psychological outcome variable. Structural equation modelling will be used to test the hypothesized theoretical sequence in the HAPA model., Discussion: The proposed project is expected to design theory-based intervention materials to promote the influenza prevention behaviors in Hong Kong elderly people and provide information on its effectiveness and the potential changing mechanism of behavior initiation and maintenance., Trial Registration: This randomized controlled trial was funded by the Health and Medical Research Fund (HMRF), Food and Health Bureau of the Government of the Hong Kong Special Administrative Region (Ref: 16151222) and was registered on 13/10/2017 at CCRB Clinical Trials Registry of the Chinese University of Hong Kong, a Partner Registry of a WHO Primary Registry (Ref: CUHK&#95;CCRB00567 ).

Background: Human astroviruses (HAstV) comprise three phylogenetically compact and non-adjacent groups of species including classical HAstV (HAstV-C) and the novel ones (HAstV-VA/HMO and HAstV-MLB). Of these, HAstV-C is known to be responsible for gastroenteritis while the novel HAstV are associated with cases of neurological disorders. Accurate detection of all known variants by (real-time) PCR is challenging because of the high intra- and intergroup genetic divergence of HAstV., Objectives: To evaluate published HAstV PCR assays in silico, design de novo real-time PCR assays that can detect and discriminate three groups of HAstV, and apply those to patient samples to analyse the prevalence of HAstV in stool and cerebrospinal fluid (CSF) specimens., Study Design: In silico evaluation of published PCR assays and design of real-time PCR assays for detection of different subsets of HAstV was conducted within a common computational framework that used all astrovirus full genome sequences from GenBank. The newly designed real-time PCR assays were evaluated in vitro and applied to faecal samples (collected in January-May 2016) and cerebrospinal fluid specimens (2010-2016) from patients in the Netherlands., Results: Quantitative in silico evaluation of published PCRs is provided. The newly designed real-time PCR assays can reliably assign all available HAstV genome sequences to one of the three phylogenetic groups in silico, and differentiate among HAstV-specific controls in vitro. A total of 556 samples were tested using these PCR assays. Fourteen fecal samples (2.5%) tested positive for HAstV, 3 of which could be identified as the novel HAstV-MLB variants. No novel HAstV were found in CSF specimens., Conclusion: Newly designed real-time PCR assays with improved detection of all known HAstV allowed the first-time identification of novel astroviruses from stool samples in the Netherlands., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

This study examined the psychometric properties of the eight-item Physical Activity Enjoyment Scale (PACES) in Hong Kong older adults. Study 1 assessed the scale's factor validity and test-retest reliability, whereas Study 2 examined its convergent validity in Hong Kong older adults. A total of 168 (Study 1) older adults completed the PACES twice over a 2-week interval, and 57 (Study 2) older adults completed both the eight-item PACES and a measure of quality of life. The results of both studies showed that the eight-item PACES had a high degree of internal consistency. Both the composite reliability and average variance extracted from Study 1 were high, suggesting that as a set, the eight items of the PACES reliably measured the construct. The observed test-retest reliability was satisfactory over a 2-week interval. This eight-item PACES is an expedited and reliable instrument for assessing physical activity enjoyment in Chinese older adults.