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Competing Interests: RNS Lui has served as an advisory board member for Gilead Sciences and speaker for GenieBiome; he also holds equity in Pfizer. As an editor of the journal, RNS Lui was not involved in the peer review process. LLY Mak has served as a speaker for Roche. HLY Chan is an advisor for Aligos, GlaxoSmithKline, Roche, Vaccitech, and Virion Therapeutics; a speaker for Echosens, Gilead Sciences, Roche, and Viatris; and a data management board member for Aligos, Arbutus, Roche, Vaccitech, and Zhimeng Therapeutics. MF Yuen has served as an advisor/consultant for and/or received grant/research support from AbbVie, Aligos, AiCuris, Antios Therapeutics, Arbutus Biopharma, Arrowhead Pharmaceuticals, Assembly Biosciences, Bristol Myers Squibb, ClearB Therapeutics, Dicerna Pharmaceuticals, Finch Therapeutics, Fujirebio, GlaxoSmithKline, Gilead Sciences, Immunocore, Janssen, Roche, Silverback Therapeutics, Sysmex Corporation, Tune Therapeutics, Vir Biotechnology, and Visirna Therapeutics. GLH Wong has served as an advisory board member for AstraZeneca, Gilead Sciences, and Janssen, as well as a speaker for Abbott, AbbVie, Ascletis, Bristol Myers Squibb, Echosens, Gilead Sciences, Janssen, and Roche; she has also received a research grant from Gilead Sciences. Other authors have disclosed no conflicts of interest.

Objective: To examine the predictive attributes for accidental falls in community-dwelling older people in Hong Kong using decision tree analysis., Methods: We recruited 1151 participants with an average age of 74.8 years by convenience sampling from a primary healthcare setting to carry out the cross-sectional study over 6 months. The whole dataset was divided into two sets, namely training set and test set, which respectively occupied 70% and 30% of the whole dataset. The training dataset was used first; decision tree analysis was used to identify possible stratifying variables that could help to generate separate decision models., Results: The number of fallers was 230 with 20% 1-year prevalence. There were significant differences in gender, use of walking aids, presence of chronic diseases, and co-morbidities including osteoporosis, depression, and previous upper limb fractures, and performance in the Timed Up and Go test and the Functional Reach test among the baselines between the faller and non-faller groups. Three decision tree models for the dependent dichotomous variables (fallers, indoor fallers, and outdoor fallers) were generated, with overall accuracy rates of the models of 77.40%, 89.44% and 85.76%, respectively. Timed Up and Go, Functional Reach, body mass index, high blood pressure, osteoporosis, and number of drugs taken were identified as stratifying variables in the decision tree models for fall screening., Conclusion: The use of decision tree analysis for clinical algorithms for accidental falls in community-dwelling older people creates patterns for decision-making in fall screening, which also paves the way for utility-based decision-making using supervised machine learning in fall risk detection., Competing 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) 2023.)

Because of an often complicated and difficult-to-access care system, help-seeking for people with suspected dementia can be stressful. Difficulty in help-seeking may contribute to carer burden, in addition to other known stressors in dementia care. This study examined the relationship between perceived help-seeking difficulty and carer burden, and the barriers contributing to perceived difficulty. We interviewed 110 carers accessing a community-based dementia assessment service for suspected dementia of a family member for their perceived difficulty, delays, and barriers in help-seeking, and carers burden in terms of role strain, self-criticism, and negative emotions. Linear regression models showed that perceived help-seeking difficulty is associated with carer self-criticism, while carer role strain and negative emotions are associated with symptom severity of the person with dementia but not help-seeking difficulty. Inadequate knowledge about symptoms, service accessibility, and affordability together explained more than half of the variance in perceived help-seeking difficulty (Nagelkerke R 2 = 0.56). Public awareness about symptoms, support in navigating service, and financial support may reduce perceived difficulty in help-seeking, which in turn may reduce carer self-criticism during the early course of illness.

Haemoglobin H (HbH) disease is a type of non-transfusion-dependent thalassaemia. This cross-sectional study aimed at determining the prevalence and severity of liver iron overload and liver fibrosis in patients with HbH disease. Risk factors for advanced liver fibrosis were also identified. A total of 80 patients were evaluated [median (range) age 53 (24-79) years, male 34%, non-deletional HbH disease 24%]. Patients underwent 'observed' T2-weighted magnetic resonance imaging examination for liver iron concentration (LIC) quantification, and transient elastography for liver stiffness measurement (LSM) and fibrosis staging. In all, 25 patients (31%) had moderate-to-severe liver iron overload (LIC ≥7 mg/g dry weight). The median LIC was higher in non-deletional than in deletional HbH disease (7·8 vs. 2.9 mg/g dry weight, P = 0·002). In all, 16 patients (20%) had advanced liver fibrosis (LSM >7.9 kPa) and seven (9%) out of them had probable cirrhosis (LSM >11.9 kPa). LSM positively correlated with age (R = 0·24, P = 0·03), serum ferritin (R = 0·36, P = 0·001) and LIC (R = 0·28, P = 0·01). In multivariable regression, age ≥65 years [odds ratio (OR) 4·97, 95% confidence interval (CI) 1·52-17·50; P = 0·047] and moderate-to-severe liver iron overload (OR 3·47, 95% CI 1·01-12·14; P = 0·01) were independently associated with advanced liver fibrosis. The findings suggest that regular screening for liver complications should be considered in the management of HbH disease., (© 2020 British Society for Haematology and John Wiley & Sons Ltd.)

Children with autism spectrum disorder (ASD) are reported to participate less in everyday activities, and their parents face stigma on account of having a child with ASD, which they often internalize as affiliate stigma. Studies have examined the impact of affiliate stigma on parents' psychological well-being and social behaviors, but little is known about how affiliate stigma impacts their children's activity participation. This study aimed to investigate the relationship between parents' affiliate stigma and activity participation of their children with ASD. Sixty-three parents of children with ASD (aged 2-6 years) were recruited. They completed questionnaires, which captured affiliate stigma, their child's participation (frequency and involvement) in home, preschool, and community activities, and demographic characteristics. Results indicated that these parents had a moderate level of affiliate stigma, which did not correlate with the frequency of their children's participation in activities. However, the parents' affiliate stigma was found to have negative impacts on their children's involvement in overall community participation and participation in one particular activity at home. The findings highlight the importance of destigmatization of parents of children with ASD in order to promote their children's participation in community activities.

Background: Body weight supported treadmill training (BWSTT) is a frequently used approach for restoring the ability to walk after spinal cord injury (SCI). However, the duration of BWSTT is usually limited by fatigue of the therapists and patients. Robotic-assisted body weight supported treadmill training (RABWSTT) was developed to tackle the aforesaid limitation. Currently, limited randomized controlled trials are available to investigate its effectiveness, especially on cardiopulmonary function. The aim of this two-arm, parallel-group randomized controlled trial is to examine the feasibility of adapting an EMG-biofeedback system for assist-as-needed RABWSTT and its effects on walking and cardiopulmonary function in people with SCI., Methods: Sixteen incomplete SCI subjects were recruited and randomly allocated into an intervention group or control group. The intervention group received 30 min of RABWSTT with EMG biofeedback system over the vastus lateralis muscle to enhance active participation. Dose equivalent passive lower limbs mobilization exercise was provided to subjects in the control group., Results: Significant time-group interaction was found in the Walking Index for Spinal Cord Injury version II (WISCI II) (p = 0.020), Spinal Cord Independence Measure version III (SCIM III) mobility sub-score (p < 0.001), bilateral symmetry (p = 0.048), maximal oxygen consumption (p = 0.014) and peak expiratory flow rate (p = 0.048). Wilcoxon signed-rank test showed that the intervention group had significant improvement in the above-mentioned outcomes after the intervention except WISCI II, which also yielded marginal significance level., Conclusion: The present study demonstrated that the use of EMG-biofeedback RABWSTT enhanced the walking performance for SCI subjects and improve cardiopulmonary function. Positive outcomes reflect that RABSTT training may be able to enhance their physical fitness., Trial Registration: The study protocol was approved by the Research Ethics Committee (Kowloon Central/ Kowloon East), Hospital Authority on 6 December 2013, and the Human Subjects Ethics Sub-committee of The Hong Kong Polytechnic University on 15 May 2013, with reference numbers KC/KC-13-0181/ER-2 and HSEARS20130510002 respectively. The study was registered in ClinicalTrials.gov on 20 November 2013, with reference number NCT01989806 .).