Antidepressant response time across intermittent theta burst stimulation regimens and efficacy indicators in adolescents depression: a secondary analysis from a randomized controlled trial.

Background: Accelerated intermittent theta burst stimulation (aiTBS), which involves the administration of multiple daily sessions of iTBS, represents a novel regimen of repetitive transcranial magnetic stimulation. Studies have suggested that aiTBS may facilitate a fast response among patients with major depressive disorders. However, whether aiTBS can accelerate antidepressant response in adolescents suffering from depression is still unclear.

Prevalence of autism in first-episode psychosis in two Hong Kong teaching hospitals.

Autistic features are commonly observed in children and adolescents with first-episode psychosis, but they are sometimes overlooked by clinicians and caregivers. By comprehensively examining the clinical profiles of 103 children and adolescents (below 18 years old) with first-episode psychosis and conducting the Autism Diagnostic Interview-Revised (the 'gold standard' autism diagnostic tool) with their primary caregivers, we showed that around 28% of patients with first-episode psychosis had a comorbid autism diagnosis, and boys were 3.57 times more likely to have first-episode psychosis-autism spectrum disorder comorbidity than girls.

Vascular Ehlers-Danlos syndrome: A null COL3A1 variant found in a patient with loin pain without marked cutaneous features (case report).

Patients with null variants may have milder vascular Ehlers-Danlos syndrome, presenting with seemingly non-specific complaints and subtle cutaneous features that may be missed. A high index of suspicion and early genetic testing (aided by next-generation sequencing) were crucial for prevention of life-threatening complications in the patient and family members.

A randomized controlled trial on the effectiveness of the abridged illness management and recovery program for people with schizophrenia spectrum disorders.

Objective: This study aimed to investigate the effectiveness of an abridged version of the Illness Management and Recovery Programme (AIMR) that was modified and developed in Hong Kong through a mult-centre randomized controlled trial for patients with schizophrenia spectrum disorders.

Methods: This study was implemented in 10 occupational therapy departments, psychiatric day hospitals of 7 Hospital Authority clusters in Hong Kong. A total of 211 patients with schizophrenia or schizoaffective disorder was recruited and randomized into either the experimental or the control condition.

Proactive outcome monitoring and standardisation of physiotherapy stroke rehabilitation - A retrospective functional outcomes analysis of Accelerated Stroke Ambulation Programme (ASAP).

Background: A clinical quality improvement programme named Accelerated Stroke Ambulation Programme (ASAP) was piloted in Physiotherapy Department of Tai Po Hospital from 1st October 2019 to 30th September 2020 and executed as a standard practice afterwards. The goal of ASAP was to facilitate early maximal walking ability of stroke patients in early rehabilitation phase. ASAP featured (1) proactive outcome monitoring and standardised process compliance monitoring by a patient database - Stroke Registry; (2) standardised mobility prediction by Reference Modified Rivermead Mobility Index (MRMI) Gain and (3) standardised intervention database - Stroke Treatment Library.

Use of mobile app to enhance functional outcomes and adherence of home-based rehabilitation program for elderly with hip fracture: A randomized controlled trial.

Background: Mobile app has been used to improve exercise adherence and outcomes in populations with different health conditions. However, the effectiveness of mobile app in delivering home-based rehabilitation program to elderly patients with hip fracture is unclear.

Objective: The aim of this study was to test the effectiveness of mobile app in delivering home-based rehabilitation program for improving functional outcomes and reducing caregiver stress with enhancing adherence among the elderly patients with hip fracture.

Altered neutrophil-to-lymphocyte ratio in patients with non-affective first episode psychosis and its relationship with symptom severity and cognitive impairment.

Signatures of immune dysregulation as clinical biomarker for psychosis have remained unclear. We aimed to compare the Neutrophil-to-lymphocyte ratio (NLR) of patients with acute non-affective first-episode psychosis (FEP) with healthy controls after accounting for emotional states. We also explored the associations of NLR with symptom severity, onset profile and cognitive functions.

Safety of the JAK and TNF inhibitors in rheumatoid arthritis: real world data from the Hong Kong Biologics Registry.

Objectives: To compare the incidence of major adverse cardiovascular events (MACEs), cancer and infective complications in RA patients using Janus kinase (JAKis) and TNF (TNFis) inhibitors.

Method: A retrospective analysis of data from the Hong Kong Biologics Registry 2008-2021 was performed. RA patients who had ever used JAKis or TNFis were included.

Pinpointing the precise stimulation targets for brain rehabilitation in early-stage Parkinson's disease.

Background: Transcranial magnetic stimulation (TMS) is increasingly used as a promising non-pharmacological treatment for Parkinson's disease (PD). Scalp-to-cortex distance (SCD), as a key technical parameter of TMS, plays a critical role in determining the locations of treatment targets and corresponding dosage. Due to the discrepancies in TMS protocols, the optimal targets and head models have yet to be established in PD patients.

Five-year cardiovascular event risk in early rheumatoid arthritis patients who received treat-to-target management: a case-control study.

Objectives: This study explored whether the excess cardiovascular (CV) disease (CVD) risk in RA could be ameliorated by suppression of inflammation using a treat-to-target (T2T) approach. We compared the CV event (CVE) incidence among ERA patients managed by a T2T strategy with a CV risk factor-matched non-RA population and a historical RA cohort (HRA).

Methods: This was an observational study using the city-wide hospital data and the ERA registry.

Evaluation of an occupation-based sleep programme for people with Insomnia.

Background: Sleep problems are a health issue worldwide. Based on the Person-Environment-Occupation-Performance model, we developed an occupation-based sleep programme to promote awareness of sleep hygiene factors, promote an environment conductive to sleep, and restructure participation in daytime activities with a focus on occupational balance.

Method: This study uses a non-equivalent group design to evaluate the effectiveness of an occupation-based sleep intervention among community-dwelling adults with insomnia, when compared with a treatment-as-usual (TAU) group which focused on sleep hygiene, and relaxation.

High-definition transcranial direct current stimulation (HD-tDCS) as augmentation therapy in late-life depression (LLD) with suboptimal response to treatment-a study protocol for a double-blinded randomized sham-controlled trial.

Background: Late-life depression (LLD) has a poorer prognosis and higher relapse rate than younger adults, with up to one third of patients with LLD showing suboptimal response to antidepressant therapy. LLD has been associated with significant impairment in cognition and daily functioning. Few studies have evaluated the therapeutic effects of high-definition transcranial direct current stimulation (HD-tDCS) on depressive and cognitive symptoms of LLD.

Recommendations on the post-acute management of the osteoporotic fracture - Patients with "very-high" Re-fracture risk.

Unlabelled: Osteoporosis is a systemic skeletal disease where there is low bone mass and deterioration of bone microarchitecture, leading to an increased risk of a fragility fracture. The aim of this clinical guideline from Fragility Fracture Network Hong Kong SAR, is to provide evidence-based recommendations on the post-acute treatment of the osteoporotic fracture patient that presents for clinical care at the Fracture Liaison Service (FLS). It is now well established that the incidence of a second fracture is especially high after the first 2 years of the initial osteoporotic fracture.

Common mental disorders during the COVID-19 pandemic in Hong Kong: Age-related differences and implications for dementia risk.

Background: The COVID-19 pandemic has imposed a profound negative impact on the mental health and wellbeing of societies and individuals worldwide. Older adults may be more vulnerable to the mental health effects of the pandemic, either directly from the infection itself or indirectly through the preventive measures. However, the existing literature on mental health in the older age groups has not been consistent so far.

Nurses', patients', and informal caregivers' attitudes toward aggression in psychiatric hospitals: A comparative survey study.

Attitudes toward aggression is a controversial phenomenon in psychiatry. This study examined and compared attitudes toward patient aggression in psychiatric hospitals from the perspectives of nurses, patients and informal caregivers and identified factors associated to these attitudes. A total of 2,424 participants completed a self-reported instrument regarding attitudes toward aggression (12-items Perception of Aggression Scale; POAS-S).

Gait Synergy Analysis and Modeling on Amputees and Stroke Patients for Lower Limb Assistive Devices.

The concept of synergy has drawn attention and been applied to lower limb assistive devices such as exoskeletons and prostheses for improving human-machine interaction. A better understanding of the influence of gait kinematics on synergies and a better synergy-modeling method are important for device design and improvement. To this end, gait data from healthy, amputee, and stroke subjects were collected.

Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys.

Background: Most individuals with major depressive disorder (MDD) receive either no care or inadequate care. The aims of this study is to investigate potential determinants of effective treatment coverage.

Methods: In order to examine obstacles to providing or receiving care, the type of care received, and the quality and use of that care in a representative sample of individuals with MDD, we analyzed data from 17 WHO World Mental Health Surveys conducted in 15 countries (9 high-income and 6 low/middle-income).

Disentangling the relationship of gut microbiota, functional gastrointestinal disorders and autism: a case-control study on prepubertal Chinese boys.

Emerging evidence of an altered gut microbiome in autism spectrum disorder (ASD) suggests a pathomechanism through the gut-brain axis despite the inconsistent microbiome profile reported across studies. One of the knowledge gaps in the existing ASD microbiota studies is the lack of systematic exploration of the role of comorbid functional gastrointestinal disorder (FGID) in the association of ASD and altered gut microbiome. Consequently, 92 ASD and 112 age-matched typically developing (TD) boys were profiled on general psychopathology, FGID status by Rome IV classification, and gut microbiota using 16S ribosomal RNA amplicon sequencing at the V4 hypervariable region.

The effectiveness of telerehabilitation in patients after total knee replacement: A systematic review and meta-analysis of randomized controlled trials.

Background: Total knee replacement is a commonly adopted surgical intervention to reduce physical limitations and pain in advanced-stage knee osteoarthritis. However, these patients may experience physical dysfunction to limit their access during conventional rehabilitation after total knee replacement. The use of telemedicine may be the promising solution.

Perceived helpfulness of service sectors used for mental and substance use disorders: Findings from the WHO World Mental Health Surveys.

Background: Mental healthcare is delivered across service sectors that differ in level of specialization and intervention modalities typically offered. Little is known about the perceived helpfulness of the combinations of service sectors that patients use.

Methods: Respondents 18 + years with 12-month DSM-IV mental or substance use disorders who saw a provider for mental health problems in the year before interview were identified from WHO World Mental Health surveys in 17 countries.