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Introduction Bystander cardiopulmonary resuscitation (CPR) and defibrillation by an automated external defibrillator (AED) in out-of-hospital cardiac arrest (OHCA) events were low in Hong Kong (HK). This study evaluated the willingness and associated factors of performing CPR with AED in HK using the theory of planned behaviour (TPB).Methods A total of 1449 responses from HK Chinese aged 15–64 years were collected in a cross-sectional online survey using convenience sampling on social media including Facebook, Instagram and WhatsApp. Three TPB determinants, namely attitude, subjective norm and perceived behavioural control; and perceived barriers were asked using 5-point Likert scales. Associations between each predictor and willingness to perform CPR with AED were evaluated using univariate ordinal regressions. Predictive models were constructed using hierarchical multiple ordinal regressions (MOR) to explore associated predictors and the adjusted OR (ORadj).Results There were 44.8% and 47.8% of respondents who were willing to perform CPR and use AED, respectively. Young adults aged 18–25 years demonstrated the lowest willingness to perform CPR (ORadj=0.63, 95% CI 0.42 to 0.94, p=0.023). Knowledge level was not associated with either CPR or AED willingness, thus was eliminated in backward selection in the MOR. Attitude, subjective norm and perceived behavioural control were all positively associated with both willingness (all ORadj>1.5, p

Background: Understanding trauma epidemiology is essential in formulating region-specific strategies for injury prevention. Our study aimed to evaluate the characteristics and clinical outcomes of critical pediatric trauma requiring intensive care in Hong Kong. Methods: A retrospective analysis was performed on pediatric patients who were injured and admitted to the pediatric intensive care unit (PICU), Queen Elizabeth Hospital, Hong Kong between 2014 and 2018. Clinical features of patients who sustained injuries before and after 2 years old were compared. Results: 141 patients were admitted to the PICU due to trauma during the study period. Most patients sustained injuries due to fall (48.2%) or road traffic injuries (34.0%), with the latter more common in older patients. Two (1.4%) patients died due to the trauma. The majority (95.0%) of the survivors had good recovery assessed by Glasgow Outcome Scale. Patients younger than 2 years old were mostly injured at home due to fall while left unattended. Children in this age group were more likely to receive interventions, including mechanical ventilation (OR 2.61; 95% CI 1.15–5.95), anti-epileptic medications (OR 2.61; 95% CI 1.17–5.83), blood transfusion (OR 5.37; 95% CI 2.29–12.60) and inotropic support (OR 4.08; 95% CI 1.31–12.70), and require longer hospitalization (PICU stay 2.5 vs. 1.5 days, p = 0.011; hospital stay 10.9 vs. 6.9 days, p = 0.012). Conclusion: Fall injuries and road traffic injuries were common etiologies of critical pediatric trauma in Hong Kong. Patients younger than 2 years old had worse clinical outcomes. Parental education on home safety and importance of close supervision should be emphasized in this age group.

Abstract Background Osteoarthritis of the knee is a common degenerative joint disorder in our ageing population. A combination of thermal therapy with a self-management exercise have shown a positive effect in the management of osteoarthritis of the knee. This study aimed to compare the effectiveness of topical heat pack versus focal application of heat therapy at the acupressure points in the treatment of osteoarthritis of the knee. Methods A randomized controlled trial was conducted in 76 patients with osteoarthritis of the knee, diagnosed by an experienced orthopedic surgeon. Following inclusion and exclusion selection, patients were randomly allocated to group 1 (Heat pack) or group 2 (Thermal gun). All patients received 30 min of treatment in each session, twice a week for 4 weeks. They also received an education program and taught home knee exercises. Outcome measurements were the visual analog scale (VAS) for pain intensity, muscle power, knee ROM, WOMAC and SF-12v2. Results In the Thermal gun group, function and total scores (WOMAC) and Physical Composite Scale (SF-12v2) were significantly improved after 8 sessions. Quadriceps strength was significantly improved after 8 weeks (from 4.42 to 4.63; p = 0.02). In the Heat pack group, flexion was significantly improved after 8 sessions (p = 0.02). Mean VAS scores after Heat pack treatment was consistently better (lower) than mean VAS scores after Thermal gun treatment. Conclusion The combination of focal thermal therapy at acupressure points is a viable conservative treatment in osteoarthritis of the knee. The pressure at the acupressure points has a synergistic benefit than topical thermal therapy alone. Trial registration ClinicalTrials.gov , NCT04735029 Date of registration: February 2, 2021 (Retrospectively registered)

The recent progress in the association of cumulus cells with immune functions is a largely ignored area. With over 350 million new sexually transmitted infections occurring annually in adults of reproductive age, we feel the need to explore more about how the cumulus cells defend themselves and protect the oocytes during the development through the ovulation period. Application of assisted reproductive technologies allows scientists to study and better understand cumulus cells. There are still many immune factors to be taken into consideration to optimize the oocyte quality besides ovarian stimulations. The objective of this review is to summarize the key elements of cumulus cells and their association with the immune function.