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Background The goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy versus health qigong-based cognitive therapy versus waitlist control among individuals with mood disorders. Methods A total of 187 individuals with mood disorders were randomized and allocated into mindfulness-based cognitive therapy, health qigong-based cognitive therapy, or waitlist control groups. All participants were assessed at three time points with regard to depressive and anxiety symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data. Results Mindfulness-based cognitive therapy and health qigong-based cognitive therapy both produced greater improvements on all outcome measures as compared with waitlist control. Relatively, more reductions of mood symptoms were observed in the health qigong-based cognitive therapy group as compared with the mindfulness-based cognitive therapy group. Health qigong-based cognitive therapy is more conducive to physical health status whereas mindfulness-based cognitive therapy has more favorable mental health outcomes. Individual growth curve models indicated that alterations in perceived stress was the common predictor of mood changes in both intervention groups. Conclusions The predominant emphasis on physical health in health qigong-based cognitive therapy makes it more acceptable and effective than mindfulness-based cognitive therapy as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed. Trial registration HKU Clinical Trials Registry. Identifier: HKUCTR-2558 . Registered 21st Nov 2018.

Developed as an antidiabetic drug, recent evidence suggests that several sodium-glucose co-transporter 2 inhibitors (SGLT2i), especially canagliflozin and dapagliflozin, may exhibit in vitro and in vivo anticancer activities in selected cancer types, including an inhibition of tumor growth and induction of cell death. When used in combination with chemotherapy or radiotherapy, SGLT2i may offer possible synergistic effects in enhancing their treatment efficacy while alleviating associated side effects. Potential mechanisms include a reduction of glucose uptake into cancer cells, systemic glucose restriction, modulation of multiple signaling pathways, and regulation of different gene and protein expression. Furthermore, preliminary clinical findings have reported potential anticancer properties of canagliflozin and dapagliflozin in patients with liver and colon cancers respectively, with reference to decreases in their tumor marker levels. Given its general tolerability and routine use in diabetes management, SGLT2i may be a good candidate for drug repurposing in cancer treatment and as adjunct to conventional therapies. While current evidence reveals that only certain SGLT2i appear to be effective against selected cancer types, further studies are needed to explore the antitumor abilities of each SGLT2i in various cancers. Moreover, clinical trials are called for to evaluate the safety and feasibility of introducing SGLT2i in the treatment regimen of patients with specific cancers, and to identify the preferred route of drug administration for targeted delivery to selected tumor sites.

The efficacy of anti-angiogenic agents (AAAs) in epithelial ovarian cancer (EOC) remains unclear. Therefore, we conducted a systematic review and network meta-analysis (NMA) to synthesize evidence of their comparative effectiveness for improving overall survival (OS) among EOC patients. We searched six databases for randomized controlled trials (RCTs) from their inception to February 2021. We performed an NMA with hazard ratios (HRs) and 95%-confidence intervals (CIs) to evaluate comparative effectiveness among different AAAs in chemotherapy-naïve and recurrent EOC. P-score was used to provide an effectiveness hierarchy ranking. Sensitivity NMA was carried out by focusing on studies that reported high-risk chemotherapy-naïve, platinum-resistant, and platinum-sensitive EOC. The primary outcome was OS. We identified 23 RCTs that assessed the effectiveness of AAAs. In recurrent EOC, concurrent use of trebananib (10 mg/kg) with chemotherapy was likely to be the best option (P-score: 0.88, HR 1.67, 95% CI 0.94; 2.94). The NMA indicated that bevacizumab plus chemotherapy followed by maintenance bevacizumab (P-score: 0.99) and pazopanib combined with chemotherapy (P-score: 0.79) both had the highest probability of being the best intervention for improving OS in high-risk chemotherapy-naïve and platinum-resistant EOC, respectively. AAAs may not play a significant clinical role in non-high-risk chemotherapy-naïve and platinum-sensitive EOC.

Objectives Attention‐deficit/hyperactivity disorder (ADHD) prevalence is similar across world regions. However, because informants' decision thresholds may vary between regions, these similarities may mask regional variations in actual ADHD behaviours. We tested this by comparing the relationship between informant's ratings and children's measured activity in United Kingdom (UK) and Hong Kong (HK) and then explored whether any national differences in endorsement thresholds discovered are linked to cultural variations in parenting factors. Methods Parents rated the 18 ADHD symptoms in 112 three‐to‐five‐year‐old children stratified for ADHD symptom levels (49 girls and 63 boys; 55 from the UK and 57 from HK) and completed some parenting questionnaires. Children's task‐related activity was measured using actometers. Results In both groups, measured activity was positively correlated with hyperactivity/impulsivity (r = 0.44HK; r = 0.41UK). While HK children were less active than UK children (p < 0.01), HK parents rated their children as more hyperactive/impulsive and inattentive (ps < 0.05). The lower rating threshold indicated by this pattern in HK parents were explained by their higher child‐related stress levels. Conclusions UK and HK parents operated different ADHD symptom endorsement thresholds. The link between these and child‐related stress may mark a more general role of cultural pressure for child conformity and school achievement in HK.

The concept of attention-deficit/hyperactivity disorder (ADHD) is considered to have cross-cultural validity, but direct comparisons of its psychological characteristics across cultures are limited. This study investigates whether preschool children’s ADHD symptoms expressed in two cultures with different views about child behaviour and parenting, Hong Kong and the UK, show the same pattern of associations with their waiting-related abilities and reactions, an important marker of early self-regulation. A community sample of 112 preschoolers (mean age = 46.22 months; 55 from UK, 57 from HK) completed three tasks measuring different waiting elements – waiting for rewards , choosing the amount of time to wait , and having to wait unexpectedly when a task is interrupted . Participants’ waiting-related behavioural and emotional reactions were coded. Parents rated their children’s ADHD symptoms and delay aversion. Our findings revealed that the associations between ADHD symptoms and waiting-related responses were comparable in both UK and HK samples. This suggests that the core psychological characteristics of ADHD, particularly in relation to waiting behaviours, may exhibit similarity across cultural contexts. Future research can extend this cross-cultural analysis to other ADHD-related psychological domains and explore additional cultural settings.

Background The EQ-5D-5 L is a commonly used generic measure of health. This study aimed to evaluate the psychometric properties of the EQ-5D-5 L in patients with Graves’ disease (GD). Methods A prospective cohort of patients with GD recruited at three public hospitals in Hong Kong completed the EQ-5D-5 L and ThyPRO-39 questionnaires at baseline, 1-month, and 6-month follow-ups. Convergent validity was tested by examining the Spearman correlation between EQ-5D-5 L and ThyPRO-39 scores at baseline. 1-month test-retest reliability was assessed by Intraclass Correlation Coefficient (ICC), Gwet’s Agreement Coefficient 2 (AC2), and percentage agreement. Responsiveness of EQ-5D-5 L index and EQ-VAS scores was assessed using effect size statistics (standardized effect size [SES] and standardized response mean [SRM]). Results Of 125 recruited patients, 101 (80.8%) and 100 (80.0%) patients were followed up at 1- and 6-month, respectively. For convergent validity, there was a moderate negative correlation between EQ-5D-5 L index or EQ-VAS score and ThyPRO-39 overall QoL-impact score (-0.350, -0.451), between EQ-VAS score and composite score (-0.483), and strong negative correlation between EQ-5D-5 L index score and composite score (-0.567). The Gwet’s AC2 and percentage agreement were the highest in self-care (0.964 and 0.967), followed by mobility (0.952 and 0.962), usual activities (0.934 and 0.948), pain/discomfort (0.801 and 0.887), and anxiety/depression (0.788 and 0.882). The ICC for the EQ-5D-5 L index and the EQ-VAS was 0.707 and 0.700. For patients who reported having ‘worsened’ health at 6-month follow-up, the SES and SRM were − 0.66 and − 0.42 for EQ-5D-5 L index and − 1.15 and − 1.00 for EQ-VAS, respectively. Conclusions The EQ-5D-5 L demonstrated convergent validity, test-retest reliability, and responsiveness to worsened health status among patients with GD.

Leung Ping Kwan brought as much talent and inspiration to the writing of his short stories as he did to his poems. ‘I have drawn on magical realism to explore the absurdity of Hong Kong,’ he wrote of the story ‘See Mun and the Dragon’ (1975) in which we find him using a simple, clipped style. The later story ‘Drowned Souls’ (2007) was written in a more symbolic, lyrical and more complex manner. Although the two stories are separated by over thirty years, and are in many ways so very different, dragons play a prominent part in both. The dragon has always been a fascinating creature, a complex embodiment of the timeless soul of China, symbol of the universal power of the imagination, of the creative energy and transformative possibilities of the Tao. Both of these enchanting stories are anchored in the author’s idea of freedom and liberation.

Over the past decades, the significant high environmental impacts of meat consumption have drawn increasing attention around the globe. This study took 2018 meat consumption levels as baselines. It explored the emission implications of the more sustainable counterfactual healthy red meat diet (HRMD), healthy poultry meat diet (HPMD), and world balanced meat diet (WBMD). Meat commodity supply for human consumption data was extracted from the FAOSTAT database. The data were then adjusted for cooking and edible meat yields to obtain the cooked-and-edible meat. Emission factors obtained from published meta-analyses were used to estimate the emission implications of cooked-and-edible meat consumption. Counterfactual HRMD showed that adjusting 18 regions’ (10% of the world population) red meat consumption to a serving per day and poultry meat consumption to three servings per week equivalent could reduce the meat-related emission by 4%. The HPMD showed that further reducing red meat consumption in the HRMD to the world average in 21 regions (13% of the world population) and substituting the reductions with poultry meat could reduce the meat-related emission by 12%. WBMD showed aligning all regions’ meat consumption to a serving of each bovine, pig, and poultry meat per week, and the ovine meat consumption to the world average could reduce the meat-related emission by 21%. HRMD and HPMD could be the step-by-step transition strategies towards a WBMD to reduce greenhouse gas emissions and simultaneously address malnourishment issues.

Background Recent developments in esophageal cancer treatment, including studies exploring active surveillance following chemoradiotherapy, have led to a need for clear terminology and definitions regarding different multimodal treatment options. Objective The aim of this study was to reach worldwide consensus on the definitions and semantics of multimodal esophageal cancer treatment. Methods In total, 72 experts working in the field of multimodal esophageal cancer treatment were invited to participate in this Delphi study. The study comprised three Delphi surveys sent out by email and one online meeting. Input for the Delphi survey consisted of terminology obtained from a systematic literature search. Participants were asked to respond to open questions and to indicate whether they agreed or disagreed with different statements. Consensus was reached when there was ≥75% agreement among respondents. Results Forty-nine of 72 invited experts (68.1%) participated in the first online Delphi survey, 45 (62.5%) in the second survey, 21 (46.7%) of 45 in the online meeting, and 39 (86.7%) of 45 in the final survey. Consensus on neoadjuvant and definitive chemoradiotherapy with or without surgery was reached for 27 of 31 items (87%). No consensus was reached on follow-up after treatment with definitive chemoradiotherapy. Conclusion(s) Consensus was reached on most statements regarding terminology and definitions of multimodal esophageal cancer treatment. Implementing uniform criteria facilitates comparison of studies and promotes international research collaborations.